Managing Distress with DBT Skills from Shireen Rizvi’s Guide

Professor Shireen Rizvi specializes in psychiatry and behavioral sciences. She co-authored Real Skills for Real Life: A DBT Guide to Navigating Stress, Emotions, and Relationships. This publication offers ways to manage distress through dialectical behavior therapy (DBT).

Consider the last time you felt distressed. Did you confront someone or use substances to escape? There are more effective coping methods. Rizvi observes that such reactions stem from an inability to handle what seems unbearable. The solution lies in accepting distress and responding effectively.

Rizvi and co-author Jesse Finkelstein, both experts in their field, present skills using diagrams and illustrations. DBT was initially created by Marsha Linehan to treat borderline personality disorder. Recent studies confirm its utility for various emotional struggles.

Using DBT Skills

A decision tree in the book guides users on resolving conflicts using DBT skills. Mindfulness and other practices are also highlighted to maintain emotional stability.

TIP Technique for Immediate Distress Handling

Rizvi introduces the TIP technique from her book, which includes four skills: temperature, intense exercise, paced breathing, and paired muscle relaxation. These are particularly useful during overwhelming events, such as major arguments or personal crises.

• T: Lower Your Temperature
  
  Fill a bowl with cold water and ice, take a deep breath, and submerge your face. This activates the mammalian dive reflex, slowing your heart and respiratory rates, essential during distress. Avoid if you have a heart condition or are on beta blockers.
• I: Intense Exercise
  
  Any quick heart-pumping activity, like climbing stairs or jumping jacks, can help. It boosts agitation temporarily, dropping your heart rate afterward and calming you.
• P: Paced Breathing
  
  Breathe in for four counts, out for six. This method achieves relaxation by counteracting hyperventilation.
• P: Paired Muscle Relaxation
  
  Tense muscle groups, then release while exhaling and thinking of a relaxation word like “calm.” This enhances relaxation more than simply trying to relax.

Misperceptions about Distress

Many believe distress will persist unless immediately alleviated. Rizvi emphasizes that intense feelings are temporary and will inevitably subside. Awareness of this fact provides relief.

This article draws insights from Rizvi’s book and offers practical DBT skills for everyday challenges. Readers can further explore these strategies through resources like podcasts and newsletters.