How to Calm Down Fast.

When I was little I would sometimes get myself into a big state about something, crying and crying and unable to calm down.  After this had gone on for quite some while, my dad would generally try to resolve it by bringing me a hot flannel to put on my face and neck, at least partly to calm me down (though probably also to reduce the attractive post-cry puffiness).  I suppose in doing so he was using some variant of the TIP skill.

The TIP skill is a good choice for people who become intolerably overwhelmed, have found themselves in a state whereby they cannot think clearly or even conceive of calming down, or have the urge to harm themselves in some way.  It is another Distress Tolerance Skill from DBT (Dialectical Behavior Therapy) and is designed to quicky reduce emotional arousal by changing our physiological state.

This skill has four parts:

Temperature
Intense Exercise
Paced Breathing and Paired Muscle Relaxation

The two Ps count as one in the acronym but are two distinct skills.  Don't ask why; I'm not sure beyond it ruining the acronym otherwise!

T is for Temperature.
This skill is not recommended for people with a history of heart difficulties or an allergy to the cold (e.g. cold urticaria).  Otherwise, it can be a really very effective way of calming down quickly!

To use this skill, hold your breath, and place your face in cold water.  Your eyes, nose, and mouth should all be submerged.  Keep your face in the water for between 30 and 60 seconds, depending on your lung capacity and how uncomfortable this is for you.

Doing this tricks your brain into thinking you have dived into cold water.  For this reason, this skill is often called the "Dive Skill" or "Dive Reflex Skill".  The dive reflex is a mammalian reflex in which the body responds to being immersed in cold water without oxygen by slowing the heart right down to below the normal resting rate.  The parasympathetic nervous system kicks in to decrease arousal, which is handy as it was under-active whilst you were distressed!

The easiest way to use this skill is to fill the sink or a bowl and to dunk your face, but you can also use a cold compress or an ice-pack (wrapped in a towel to avoid freezer burn!).  The water in a bowl or sink shouldn't really be below 10C (50F) as this is likely to cause pain, and that really isn't the point here, so don't add ice to this.  If submerging your face is not an option, splashing it with cold water whilst holding your breath is an alternative, though this is unlikely to be as effective.

The Dive Skill is probably most useful when you are feeling completely overwhelmed and finding it hard to calm down; however, it can also be helpful to ground you if you are dissociating.

This skill is generally very effective in decreasing arousal; however, if you return to the stressful situation immediately afterwards, the agitation may quickly return, so it is important to consider combining this with another skill.


I is for Intense Exercise.
This skill involves doing at least 20 minutes of aerobic/cardio exercise.  This might include spinning, running, walking, swimming, dancing, kickboxing, or hiking.  The aim is to decrease negative mood and increase positive affect.  Research has shown significant increases in positive emotions for those who manage to get their heart rate up to 70% of the maximum heart rate for their age. 

Part of the rationale for using intense exercise comes from what we know about the body's reaction to intense emotions.  As animals, our emotions tend to evoke actions in a bid to help us survive.  Anger prepares us to fight whilst fear prepares us to run.  Completing a burst of action might therefore re-regulate our emotions by releasing the physical energy and tension.

Exercise is a good choice when you are feeling angry or so anxious that you feel sick or have an upset stomach.  It should probably be avoided if your relationship with exercise is potentially harmful, for example,  if it is involved in an eating disorder.


P is for Paced Breathing.
Paced breathing involves slowing your breathing right down to five or six breaths per minute, and ensuring those breaths are coming from your belly (low abdomen).  If you are breathing in for four seconds, you should generally be aiming to breathe out for about eight.

The heart is generally slower during out-breaths than in-breaths, so breathing in this way can help reduce your heart rate when you are agitated.  This can have a similar effect to the Dive Reflex.


P is also for Paired Muscle Relaxation
Paired Muscle Relaxation combines paced breathing with progressive muscle relaxation.  The general idea is that when you are feeling stressed, overwhelmed, angry, or anxious, you are probably very tense, and there is a good chance you are not even aware of where you are holding the tension.  By deliberately tensing and relaxing your muscles, a zone at a time, you will release any tension you were inadvertently holding before.  This will increase awareness of the tension you had as well as heightening the sense of relaxation.  Noticing this can be quite mindful, and as mindfulness is also a very useful skill for people struggling with emotional intensity, this is a bonus.  If you fancy it, you can also say "relax" to yourself in your mind as you exhale and release the tension.

To try progressive muscle relaxation do the following:

Find a quiet place with minimal distractions.  Sit or lie down.  As you tighten each set of muscles, breathe in.  As you release, breathe out, and try thinking "relax".  Hold the tension for 5-10 seconds each time.  Being tense should be very still and tight, whilst the relaxed state should feel more like being a ragdoll.  It may take practice to achieve this.

Try each group, one at a time.

1) Make fists with both hands and pull fists up on your wrists, towards your body.
2) Make fists and bend your arms so your fists touch your shoulders.
3) Pull your shoulders up to touch your ears in a shrug.
4) Try to pull your eyebrows together, wrinkling your forehead.
5) Shut your eyes tightly.
6) Scrunch up your nose and bring your lips and cheeks up towards your eyes.
7) Press your lips together and stretch the edges of your lips back towards your ears in a closed smile.
8) Press your teeth together and push your tongue against the roof of your mouth.
9) Push your head back against your back, or forward so your chin is on your chest.
10) Take a deep breath and hold it.
11) Hold your stomach in tightly.
12) Squeeze your buttocks together.
13) Put your legs out and tense your thighs.
14) Put your legs out and point your toes down.
15) Put your legs out, point your toes together with your heels out, and curl your toes under.


Next time you are feeling overwhelmed and need to calm down fast, give these a try and let me know how you get on.  I hope to see you again soon.

The Bear xXx