Happy Monday, welcome to your mental health mini. You have a solo today and we are talking about how to cope with a panic attack, exactly what skills to use, how to navigate the physical distress and then work through the mental avoidance amplifies our emotions. Whenever you feel an emotion rise, do your best to ride it out, to feel it, to just sit with it and that will long term
do so much good. But when you cannot sit with the emotion because you're in crisis mode, for example, you are having a panic attack, this is what you are going to do. It's the first skill, the Stop skill. It stands for Stop. Take a step back, observe, and proceed mindfully. We first are physically stopping and mentally stopping. So say you are in class, you're
about to give a speech. You all of a sudden feel a panic attack coming on. You can't breathe, freeze, physically freeze, and mentally freeze. You're going to remember we're pausing because our emotions are urging us to act and because the emotional intensity is so strong. The urge to act on the emotion is really strong. The urge is to avoid. The urge is to hide, to run away. Ideally you leave the situation both physically and mentally.
If you're about to give your speech, you're going to see if you can really quickly run to the bathroom and take a break. You're going to take a couple deep breaths. If you can really focus, inhaling through the nose, exhaling through the mouth, and pausing after you inhale. You also want to try to make your exhales longer than inhales. We're going to do everything we can here to avoid acting impulsively with regard to what our emotions are urging us to do.
And how we're going to do this is we're going to observe this is the next part of the top scales. We've done stop. We've taken a step back. So now we're going to figure out what's going on both internally and externally. Most of the time when you're feeling really overwhelmed with anxiety, it's easier to start with externally. Where were you? What was happening? How are you feeling right now? Is it feeling hot? Are you feeling cool? What is going on? Now you're going to go
internally. Is your heart racing? Are your muscles clenched? Are you breathing really rapidly? Are your thoughts spiraling and having certain urges to avoid, to run away, to engage in unhealthy behavior? Whatever it is, take a minute, observe those. Make sure to really hone in on the thoughts, the feelings and things that others are saying or doing. We want to get really clear. And when we're observing, we're using a little bit of mindfulness here. So we're being objective.
We're saying only things that can be observed without judgment. We're not like that was so annoying or that was so frustrating, or that's not fair. Those are all kind of judgments and not objective facts. So really focus on the facts for this observing part. And what's great about this is as you start to lay out the facts and let go of those assumptions and judgments, some of the anxiety does sometimes go away. And the last part of the stop scale, you're going to proceed
mindfully. You're going to act with awareness. You're going to consider your thoughts, your feelings, situations, and other people's thoughts and feelings. You're going to be as effective as possible and balance that rational side of things and the emotional side of things. You're going to think about what your goal in the situation is. What is your objective? So if you were supposed to give a talk in class, it's your objective to get through the talk.
So your objective to ask your teacher if you could postpone, but you're going to actually follow up and do the speech. Are you going to try and just go after the next person who's presenting whatever it is? Figure out what your goal is and make sure that you are truly listening to both the rational side of things and the emotional side of things, not just what your emotion is urging you to do, which is likely to avoid.
Also important to ask yourself and you ask your wise mind, which in DBT is that balance of the rational and emotional? And we're going to decide, will this action that you'd like to take to move forward, is it going to make things better or worse? If you avoid the situation long term, that's going to make it worse. You are going to work through this, use a coping skill effectively that will make the situation better.
We also have to address the physical, and that's where the TIP skill comes in. TIP is an acronym in DBT that stands for temperature, intense exercise, pace breathing, and paired muscle relaxation. The temperature part of the TIP scale. Ideally you have a bowl of ice. You're going to take a deep breath in, you're going to hold your breath, you're going to place your face in that bowl of ice water. You are going to hold it for 30 seconds or however long you can kind of hold your breath.
You're going to take your head above the water, breathe in, breathe out, go back under. So you are going to repeat this until your heart rate and your breathing rate decreases. When your body comes into contact with this cold water, what is stimulated is your heart rate decreases and in turn your breathing rate decreases. We know that our heart rate, breathing rate are increased with anxiety, so it will lower it past that threshold and it will get it back to your normal
level. The intense exercise again targets a part of our anxieties fight or flight response, which is that when you are overwhelmed, your heart rate, your breathing rate increases. And when you are engaging an intense exercise, your body does its normal process of lowering its heart rate and lowering its breathing rate, and in turn, it goes past that threshold that it was at for anxiety. He's breathing very simple. You are breathing deeply into
your belly. You are slowing the pace of inhaling and exhaling way down past what it's at with anxiety. So DBT says 5 seconds in, seven seconds out. But the key is that your exhale is longer than your inhale. You're going to do that for a few minutes. And then the last part of the tip scale is paired muscle
relaxation. So what we're going to do as we're doing our breathing, and as you inhale, you clench the muscle and as you exhale, you let go and you're letting go of not only the tension that you've just caused by squeezing your muscles, but also the tension that was there from that anxiety and from that emotional intensity. After you were less consumed by these physical symptoms of anxiety, we're then able to establish a plan of how can I cope? How can I proceed?
How can I effectively get myself out of this situation? Having the trust in yourself that you know skills that will work and that you can get yourself out of that stressful situation is a game changer and it gives you a lot of help.