How to Use Dbt Skills for Anxiety: a Step-By-Step Guide
Anxiety can be a debilitating feeling that can take over your life. However, there are tools that can help you manage anxiety, one of which is Dialectical Behavioural Therapy (DBT). DBT is an evidence-based therapy that focuses on helping people regulate their emotions and improve their interpersonal relationships. In this step-by-step guide, we’ll explore how to use some of the key DBT skills to help manage anxiety.
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STOP SKILL
The STOP skill is an acronym that stands for Stop, Take a step back, Observe, and Proceed mindfully. This skill can be helpful when you’re feeling overwhelmed by your emotions, particularly when anxiety is running high. To use the STOP skill, follow these steps:
- Stop what you’re doing and take a deep breath.
- Take a step back from the situation that’s causing you anxiety.
- Observe what’s happening around you and within you. Try to notice your thoughts, emotions, and physical sensations without judgment.
- Proceed mindfully. Once you’ve taken a step back and observed what’s happening, you can make a more informed decision about how to proceed.
For example, if you’re feeling anxious about an upcoming job interview, you can use the STOP skill to take a step back from your anxious thoughts and observe them without judgment. Once you’ve done this, you can make a more informed decision about how to proceed, such as practicing your interview skills or seeking support from a friend or therapist. The STOP skill is a great one to put to use as soon as you notice yourself getting anxious. It can be an effective way to break the cycle of anxious thoughts.
TIPP SKILL
The TIPP skill stands for Temperature, Intense Exercise, Paced Breathing, and Paired Muscle Relaxation.
Temperature:
- Fill a large bowl or sink with very cold water and some ice.
- Place your face into the water up to your eyes for 30 seconds.
- Hold your breath for 30 seconds while your face is submerged.
- Slowly lift your face out of the water and breathe normally.
- Focus on the feeling of coldness on your face and how it helps to calm your nervous system
- The temperature component of TIP is based on the mammalian dive response, which is a physiological response that occurs when the face is submerged in cold water. This response is characterised by a slowing of the heart rate and a decrease in blood pressure, allowing the body to conserve oxygen. The same response can be triggered by immersing your face in cold water or holding a cold pack to your eyes. This response helps to regulate the nervous system, which can be helpful for people with anxiety as they often experience heightened physiological responses such as increased heart rate and rapid breathing.
Intense Exercise:
- Choose an exercise that gets your heart rate up such as running, jumping jacks, or burpees.
- Perform the exercise for 60 seconds.
- Stop and focus on how your heart rate has increased and how your body feels.
- Take a few deep breaths and focus on the sensations in your body.
Paced Breathing:
- Sit in a comfortable position and close your eyes.
- Inhale deeply through your nose for 4 seconds.
- Hold your breath for 4 seconds.
- Exhale slowly through your mouth for 6 seconds.
- Repeat this process for 2–3 minutes, focusing on the rhythm of your breath.
Progressive Muscle Relaxation:
- Start by tensing the muscles in your feet and holding for 5 seconds.
- Release the tension and focus on how your muscles feel.
- Move up to your calves, thighs, and so on, tensing each muscle group for 5 seconds and then releasing the tension.
- Focus on the feeling of relaxation in your muscles as you release the tension.
CHECK THE FACTS:
One of the ways that anxiety can be triggered is through catastrophising or blowing things out of proportion. This is where checking the facts comes in as a helpful skill. Checking the facts involves taking a step back and assessing the situation objectively. Ask yourself if there is any evidence to support the anxiety-inducing thoughts you are having. Are you jumping to conclusions? Once you identify what the facts are, you can begin to make a more balanced assessment of the situation.
For example, imagine that you have a big presentation coming up at work. You start to feel anxious and think to yourself, “I’m going to mess this up, and I’ll lose my job.” Instead of letting these thoughts spiral out of control, you can take a step back and check the facts. Is there any evidence to suggest that you will mess up the presentation? Have you received any negative feedback about your work in the past? By taking the time to check the facts, you can approach the situation with a more balanced and rational mindset.
PROBLEM-SOLVING:
Another DBT skill that can be helpful for managing anxiety is problem-solving. This skill involves breaking down a problem into smaller, more manageable parts and developing a plan of action to address each part. By taking this approach, you can feel more in control of the situation and reduce your overall level of anxiety.
For example, let’s say that you are feeling anxious about an upcoming move. There are so many details to manage, and it feels overwhelming. By using problem-solving skills, you can break down the move into smaller tasks, such as finding a moving company, packing, and notifying utility companies of your change of address. You can then develop a plan of action for each task and tackle them one at a time. By breaking down the move into smaller, more manageable parts, you can feel more in control and less anxious about the overall process.
OPPOSITE ACTION:
Finally, another DBT skill that can be helpful for managing anxiety is opposite action. This skill involves doing the opposite of what your emotions are telling you to do. If your emotions are telling you to avoid a situation, opposite action would be to approach the situation instead.
For example, imagine that you have social anxiety and are invited to a party. Your emotions are telling you to decline the invitation and stay home, but using opposite action, you could attend the party instead. By doing the opposite of what your emotions are telling you to do, you can start to challenge the anxiety-inducing thoughts and feelings that are holding you back.
DBT skills can be incredibly helpful for managing anxiety. By using skills like STOP, TIP, Distraction & Self-Soothing, Check the Facts, Problem-Solving, and Opposite Action, you can learn to identify and regulate your emotions, develop a more balanced mindset, and feel more in control of your life. Remember, DBT is a practice, and it takes time and effort to develop these skills fully. However, with patience and dedication, you can learn to manage your anxiety and lead a more fulfilling life.
If you are struggling with anxiety and want to learn more about how DBT skills can help you, consider booking a consultation with a DBT therapist. We can provide you with personalized guidance and support in developing these skills and applying them to your specific situation. Remember, DBT is a proven and effective therapy for managing anxiety, and you don’t have to go through it alone.
Take the first step towards feeling better today by reaching out for help.