Episode 33 – Distress Tolerance (Pt. 3)

This is a bit later than I wanted it to be. I’ve been a bit busy and then I was depressed. But now we’ll cover the second P in TIP Skills, and then in the next post I will cover the last few things we went over after that.

The second P in TIP stands for Paired muscle relaxation. This involves relaxing muscles, obviously, with controlled breath. It’s a bit difficult for me because I can’t focus on the two things at once it would seem, which is supposed to improve over time with practice, but it can be very effective in distressing situations.

It involves using your entire body, so it’s best to be comfortably lying or sitting down with no body parts crossed or supporting any other parts. There are several muscle groups to start with, and the goal is to gather tension by tightening muscles and hold it for 5-6 seconds while you inhale. Focus on the feeling of the tension, and then after 5-6 seconds, release it as you exhale. As you breathe out, think the word “relax”. Then you observe changes in sensations while you relax for several seconds, and then you move on to the next muscle or muscle group.

There are 16 muscle groups initially listed. Once you can do the small groups, you move on to the medium groups, then you move on to large groups. Eventually you practice tensing your entire body.

The 16 small groups are: 1.) hands and wrists; 2.) lower and upper arms; 3.) shoulders; 4.) forehead; 5.) eyes; 6.) nose and upper cheeks; 7.) lips and lower face; 8.) tongue and mouth; 9.) neck; 10.) chest; 11.) back; 12.) stomach; 13.) buttocks; 14.) upper legs and thighs; 15.) calves; and 16.) ankles.

The 8 medium groups include:

  • 1-2
  • 3
  • 4-6
  • 7-8
  • 9
  • 10-11
  • 12-13
  • 14-16

The 4 large groups include:

  • 1-3
  • 4-8
  • 9-11
  • 12-16

After that, you tense your entire body at once.

You can use paired relaxation with effective rethinking for a longer-lasting effect. To do this, you write down a common prompting event that sets off a distress response. Ask what interpretations and thoughts of yours that cause such an emotional reaction. Rethink the situation and its meaning in a way that counteracts the thoughts and interpretations causing stress. Write down effective thoughts to replace the stressful ones. When not in the distressing event, practice imagining the event. As you breathe in, say the effective self-statement, and say “relax” as you breathe out and relax all your muscles. Then when a stressful situation occurs, practice this method.

The next post will include some acronyms for a few other distress tolerance skills. The next module is emotional regulation, which I think will be particularly related to the point of this blog, but I am enjoying documenting my experiences with DBT, for myself and for anyone who happens to benefit from these methods. They are proven to be effective, as are all things in DBT, since it was specifically developed to do these things.

Published by Rawry

I'm just a writer and gamer living in the middle of nowhere..

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