How To Deal With Overwhelm: A Psychologist's 4-Step Method

Looking for strategies to help deal with the overwhelm of, well, everything? Same. Dr Emily, our resident psychologist, is back in the studio to talk through overwhelm; how to greet it, how to get through it, and how to build your resilience towards it. 💌Join 6,500+ people getting our takeaways and favourite moments from this episode in our weekly newsletter - http://bit.ly/45NyQDy In this episode, Dr Emily introduces how to understand your ‘window of tolerance,’ the cost of being overwhelmed for too long, and what happens when we slip into avoidance. OF COURSE, this episode is delightfully sprinkled with practical strategies that you can do right now, in this moment, to ease the burden of the overwhelm. Dr Em, this episode was an emotional regulation for the ages. 🫖 Other Imperfects episodes mentioned in this episode Dr Emily - How to Stress Less - https://bit.ly/4tiZa2y Mick Fanning - Riding The Waves Of Loss - https://bit.ly/4s29wCI 📖 Things to read Burnout, by Emily and Amelia Nagoski - https://bit.ly/4c18Yah 💪 Things to do The Hulk Progressive Relaxation Technique - https://bit.ly/3PFv4Yq 🩷To host your own Vulnerabilitea House, purchase here - http://bit.ly/4lyuuWz 🩵To purchase our journal (or your novel) My Imperfect Life, click here - http://bit.ly/4lyuuW 🩵To join our subscriber community, A Little More Imperfects, follow this link - http://bit.ly/4mqunxu 🩷 AND you can subscribe to A Little More Imperfects through Apple Podcasts too, here - http://apple.co/theimperfects The Imperfects is not a licensed mental health service and is not a substitute for professional mental health advice, treatment or assessment. The advice given in this episode is general in nature, but if you’re struggling, please see a healthcare professional, or call lifeline on 13 11 14. See omnystudio.com/listener for privacy information.

• 0:00Speaker 00

  What I'd really like to explore today is how we survive when you're really overwhelmed and when distress is very high. What do you guys think overwhelm is?

• 0:09Speaker 01

  It's too much for me to manage.

• 0:11Speaker 02

  Yeah, I feel like my intellect kind of shuts down. Too many people wanting too much of me at a certain time and then a feeling of wanting to call mum and dad.

• 0:19Speaker 00

  In essence, it's like when the system is overloaded. You know, if you imagine basically like a window, inside this window is everything that you can tolerate. But when the demands of a situation pushes out to the window sill, we now move into overwhelm. The larger the window, the more resilience I can experience.

• 0:41Speaker 01

  So you grow the window.

• 0:42Speaker 00

  Grow the window, yeah. Okay, so what do we do when we're outside of our window? Shall I dive in?

• 0:48Speaker 01

  Yeah.

• 0:49Speaker 00

  Okay.

• 0:49Speaker 01

  Give us the tools.

• 0:50Speaker 00

  Yeah, all right.

• 0:51Speaker 01

  Quick, is anyone here a doctor? Yes, her name is Dr Emily and she's a psychologist. Please welcome to The Imperfect, our very own psychologist. And we are fresh off a lovely lunch together. We all went out for lunch. Em, you were very impressed with your meal.

• 1:10Speaker 00

  It was good.

• 1:11Speaker 01

  Yeah, just good.

• 1:13Speaker 00

  Quite good, very, very good. It was very good. It was very large.

• 1:17Speaker 01

  What did you have again?

• 1:18Speaker 00

  A pumpkin salad.

• 1:19Speaker 01

  Hmm, great.

• 1:21Speaker 00

  Yeah.

• 1:22Speaker 02

  If, if Em were a genre of music, what would she be?

• 1:25Speaker 01

  Oh, great question. Um, industrial metal? Or, or, um, like the, uh, I don't know what the genre is, but I know the artist. Like there's this guy, Olafur Arnold, it's like Scandinavian kind of peaceful.

• 1:47Speaker 02

  Like ambient classical.

• 1:48Speaker 01

  Ambient, beautiful music that makes you feel nice.

• 1:51Speaker 00

  That's very kind, thank you.

• 1:53Speaker 02

  Okay.

• 1:54Speaker 01

  Right.

• 1:55Speaker 02

  Okay.

• 1:56Speaker 01

  Right, um, all right, small talk, check.

• 2:00Speaker 01

  Uh, Dr. M.

• 2:02Speaker 00

  Yes.

• 2:03Speaker 01

  As some people know, as most people know, every month you drop on by.

• 2:07Speaker 00

  Yep.

• 2:08Speaker 01

  Pick out an episode from the past and expand on it in a clinical way.

• 2:12Speaker 00

  Mm hmm.

• 2:12Speaker 01

  Cause you're a bloody psychologist. Today, what episode are you flashing back to?

• 2:18Speaker 00

  Um, I would like to flashback to Mick Fanning's.

• 2:21Speaker 01

  Oh, Mick Fanning.

• 2:23Speaker 00

  Pretty incredible.

• 2:24Speaker 01

  Yeah.

• 2:24Speaker 00

  Story. Yeah.

• 2:25Speaker 02

  I often flashback to Mick Fanning's episode in my mind.

• 2:28Speaker 01

  Yeah.

• 2:28Speaker 02

  Yeah, just, I just think about the episode. No, just him.

• 2:32Speaker 01

  Oh, yeah.

• 2:33Speaker 02

  Just him.

• 2:33Speaker 01

  Yeah.

• 2:33Speaker 02

  Yeah. Just him.

• 2:34Speaker 01

  Yeah. Yeah. Um, so M.

• 2:41Speaker 01

  Um, so what particularly about Mick Fanning, other than how great of a guy he is?

• 2:47Speaker 00

  Yeah.

• 2:47Speaker 01

  What did you want to talk about in particular?

• 2:49Speaker 00

  Well, so obviously there were so many different themes in, in what he was sharing, but, um, one of them to me related to how we survive crisis.

• 2:59Speaker 01

  Mm hmm.

• 2:59Speaker 00

  Um, and that in clinical terms is often referred to as distress tolerance. And so I will play a little grab, but what I'd really like to explore today is how we survive when distress is really high.

• 3:13Speaker 01

  Cause this, before we play the clip, I mean, for those who haven't heard the Mick Fanning episode, it was really surprising to hear his story because I think most people would know Mick Fanning as one of the world's greatest ever surfers, um, and famously had an incident with a shark during a, um, during competition. Uh, but his personal life and his upbringing and stuff are things that I was really, really surprised to hear about and quite traumatic for him.

• 3:37Speaker 00

  Yeah.

• 3:37Speaker 01

  Yeah. So let's play. Well, any context for the clip?

• 3:40Speaker 00

  It's in reference to the losses that he'd experienced.

• 3:43Speaker 01

  Mm hmm.

• 3:44Speaker 00

  And this kind of choice that he made around how to, how to deal with them.

• 3:47Speaker 01

  Yeah, great.

• 3:49Speaker 03

  You know, if I take the, if I take the bad path or the dark path.

• 3:56Speaker 01

  Hmm.

• 3:57Speaker 03

  Where's that gonna lead me to? Is that gonna lead me to alienating myself? Is that leading me to, um, alcohol or drug depression? Is that gonna lead me to, um, yeah, doing something worse?

• 4:12Speaker 01

  Hmm.

• 4:13Speaker 03

  Or look at the good path and say.

• 4:18Speaker 03

  Find strength, better yourself, try and learn from mistakes and, and just keep, as we always said at the start, just do your best.

• 4:30Speaker 04

  Hmm.

• 4:30Speaker 03

  And, yeah, looking at those two pictures, this one didn't look great to me.

• 4:35Speaker 04

  Hmm.

• 4:35Speaker 03

  And so I was like, I'm just gonna keep my best and, and um, it's not gonna be like, you know, you walk through a door and it's green fields and, and stuff like that. It's more, it's gonna take work and, and with anything, you've got to work hard at getting through these situations and, you know, and there's definitely been times where I couldn't get out of bed. There's definitely been times where I was so deep and dark in depression where, you know, I'd close up the room, didn't wanna see anyone or, um, and, but over the years, I've sort of been able to

• 5:18Speaker 03

  almost put a, a label on it. Um, like at the end of two thousand fifteen, like I had the shark attack, had, um, I had a marriage breakdown and then my brother, Peter, passed away at the end of the year and, and a picture that came to me was like, imagine like a, a giant barrel, like a keg, wooden keg sort of thing. And, you know, if it's filled with water, you're having a lot of fun. I looked in mine at the end of that year and it was just bone dry, like the, there was no light in it, there was no life. It was just empty and I made a decision that

• 5:59Speaker 03

  I'm gonna do things for me, do things that make me happy and do things that I wanna do to fill that barrel back up.

• 6:09Speaker 04

  Hmm.

• 6:10Speaker 03

  And it took me, like, took me a, a good couple of years.

• 6:14Speaker 04

  Yeah.

• 6:15Speaker 03

  But, um, yeah, the barrel's pretty bloody full.

• 6:19Speaker 04

  Hmm. Beautifully said.

• 6:22Speaker 01

  Wow, pretty, pretty powerful stuff.

• 6:26Speaker 00

  Mm hmm.

• 6:26Speaker 01

  Hmm.

• 6:28Speaker 00

  Yeah, I mean, most obviously, that was a very powerful episode and so highlighting around, around the fact that, you know, for all of us, we will experience, you know, great suffering and points in life that are so challenging to our sense of self, our sense of wellbeing and our sense of safety. And so I thought that it might be really helpful to have a look from a clinical point of view, you know, how we go about surviving at those crisis points.

• 6:57Speaker 01

  Whoa.

• 6:57Speaker 00

  You know, when you're really overwhelmed and when distress is very high.

• 7:02Speaker 01

  Jeez, that is very, very helpful.

• 7:05Speaker 00

  Mm hmm.

• 7:05Speaker 01

  That's scary.

• 7:07Speaker 00

  Yeah, yeah, it is. And it would, you'd be hard pressed not to feel a great deal of fear or sadness or struggle when you listen to that episode, for example, too.

• 7:19Speaker 01

  Yeah.

• 7:19Speaker 00

  That, you know, here is, here we are, these humans with this capacity to experience such significant loss and such significant suffering. But at the same time, we also have a life that's worth living here as well.

• 7:30Speaker 01

  Yeah.

• 7:31Speaker 02

  It's a thing that will happen to all of us at some point, if it hasn't already, a moment where your world gets turned upside down.

• 7:37Speaker 00

  Mm hmm.

• 7:38Speaker 02

  And then the thought of continuing on is like, it's like an improbable, impossible task, but you have to.

• 7:46Speaker 00

  Yes, and I think it's interesting because a lot of people will, will say to people that are going through something really difficult, I don't know how you've done it. And so often the people that are going through it are saying, what choice did I have?

• 8:00Speaker 01

  Mm hmm.

• 8:01Speaker 00

  But I will say that in, like in the clinical work, that there are ways that we cope that can make things better, and there are also ways that we cope that can make things worse. And so obviously I wanted to talk today about some of the skills that we can practise and learn that helps us get through a crisis or helps us get through a really difficult time without making things worse.

• 8:29Speaker 01

  Mm hmm.

• 8:29Speaker 04

  Right. So like alcohol, all those things.

• 8:32Speaker 00

  Yeah, yeah. So when I say like making things worse, it would be like basically being extremely reactive to what's happening. And that in that space of reactivity, that you might drink, you might abuse drugs, you might self harm, you may attempt suicide, you could lash out and be very aggressive and angry or violent, or you could completely withdraw and shut down. Now, all of those responses, I want to emphasise again, are always very understandable. So when distress is very high, our automatic reaction is in some ways to get rid of this pain. So very understandable that we will have this kind of response. But

• 9:13Speaker 00

  there are absolutely ways in which we can learn to ride through that, I use this metaphor, to ride through the wave of, of like immense pain and discomfort, to get to a place where I've now grown my resilience in some ways.

• 9:31Speaker 01

  And this, this, doing that, I guess, doing that must take practise. I mean, some people are better at it than others. Because I know that whenever I've, and I've never faced this, that level of sort of trauma and heartache that Mick has. But, you know, in times where I've really been going through it and I am like, I've got that kind of pain in my body and I just, that like has, as you describe, I just want it out. I just want like, get me out of this situation. I'm, I really struggle, even though I know the tools and Jam might remind me, let, you know, try this. I, I just don't, I don't want to do anything. It's, it's almost like I don't want to, I don't, like, I do want to feel better, but I don't want to do anything to get better. It's like I'm angry at the tools or something like that.

• 10:15Speaker 00

  Yeah, yeah. I think there can be a very big obstacle. There's this feel, basically like this feeling tone that's here, brings with it an urge. This is actually where we can talk about what's called doing the opposite action or action urges. So if you think about our primary emotions, all emotions bring with them an urge to act and behave in a certain way. So if you think about like the emotion of happiness, when you feel happy, what urge does it bring with it? What does it make you wanna do?

• 10:46Speaker 01

  Connecting, connecting mainly.

• 10:48Speaker 02

  Yeah.

• 10:48Speaker 00

  Yeah, yeah. Yeah, and so it promotes pro-social action usually. If you think about anxiety, anxiety brings with it an action urge, which would typically be what, do you think?

• 11:02Speaker 01

  Like, go to bed.

• 11:04Speaker 00

  Yeah.

• 11:04Speaker 01

  Yeah.

• 11:05Speaker 00

  Yeah, so usually like a flight response often. So with like withdrawing, avoiding, something like that. That's the action urge. When we think about sadness, the action urge often is a shutdown response. So staying in bed, listening to sad music, engaging in something that feels really consistent with the emotion.

• 11:26Speaker 01

  Hmm.

• 11:27Speaker 00

  Again, that's an action urge. When we can go through all of the different emotions and they will all bring with them some kind of urge to behave in a certain way.

• 11:34Speaker 01

  What about, I know we won't go through all of them, but what about anger?

• 11:36Speaker 00

  Mm hmm.

• 11:36Speaker 01

  Like when you're really angry?

• 11:37Speaker 00

  Yeah, so anger primarily promotes a fight response. Like if we really tune into it, so often, but it depends upon your learning history.

• 11:46Speaker 01

  Ah.

• 11:47Speaker 00

  So I know that whole thing. Um, so just in a really basic way, you know, you feel angry, it prepares the body. So the body's mobilized with all of this adrenaline, cortisol and other hormones that are kind of surging through the body. And in essence, it's promoting some kind of fight response. But if you have been socialized as a child, for example, to not be angry, to not express anger, then we can actually have an internalized response. That might be something like a ruminative cycle internally.

• 12:24Speaker 01

  Yeah.

• 12:24Speaker 00

  Or it can actually be that it's even really hard to hold anger, it actually moves into sadness. Um, so some people that may have had experiences in childhood where anger was not allowed, it was not expressed, and it was like a bad feeling to have, they may have a lot of difficulty actually feeling angry.

• 12:47Speaker 00

  And that it may be an emotion that that they don't really kind of even relate to.

• 12:51Speaker 01

  So how does it, if they can't feel, if they're angry about something, but they can't feel anger, how does that?

• 12:57Speaker 00

  They may not notice that they feel angry about something, they may notice they feel sad.

• 13:00Speaker 01

  Ah, okay.

• 13:01Speaker 00

  But in some of, this is kind of slightly off track, but in some of the work for people that have that experience, it's actually like, how do you bring them up to feel the anger? Because the anger has a really important function. And that function would be that it points to when something's been violated for you. And that the action there would be to stand up for yourself. But if I only feel sadness, then I might withdraw and I might not actually take action when really it might be needed.

• 13:30Speaker 01

  Right.

• 13:30Speaker 00

  Yeah. So all emotions bring with it information. It's how we tune into them and what we do with them that's really important.

• 13:37Speaker 01

  Yep.

• 13:38Speaker 00

  Yep.

• 13:38Speaker 01

  Brilliant.

• 13:39Speaker 02

  I've been thinking about that a lot recently, just with our kids and trying to talk about emotions. And that that thing that all emotions are information, I just have this picture in my head of like a cartoon character coming out with a file. Like it's got the emotion on the front and like giving it to, and you've got to sift through it all. Like there's a lot of information in this. Need to go through it. And that's kind of like the analogy I'm trying to present to my kids, but it makes no sense to them, but it does to me.

• 14:02Speaker 00

  And that's probably all that is important at the moment too.

• 14:04Speaker 01

  Probably the problem is you're talking to them about a filing cabinet and no one uses those.

• 14:09Speaker 01

  What's paper, dad?

• 14:12Speaker 00

  So like when we think about when life feels distressing, I want to mention that there's obviously a really big range of what is going to elicit a feeling basically of overwhelm. So that's kind of what we're looking at here is any time that you're feeling really overwhelmed. It's going to vary between individuals. It's also going to vary across your lifetime. Right? So if we just start by even looking at what is overwhelmed, sometimes I will, you know, we'll even hear people say like, um, how are you feeling overwhelmed? What do, what do you guys think is the, what overwhelm is? How would you describe it?

• 14:50Speaker 01

  I mean, like for me, it's, it's, it's too much for me to manage. It's like the emotions are too, too, I, I, I don't know what to do right now. And it's the stress of not having a solve for this problem.

• 15:06Speaker 00

  Yeah.

• 15:06Speaker 01

  Yeah.

• 15:07Speaker 04

  I feel like, yeah, I feel like my intellect kind of shuts down. Like I, I feel raw emotion and catastrophe and my ability to cope. My, my perception of my ability to cope disappears.

• 15:22Speaker 00

  That's great.

• 15:22Speaker 04

  Yeah.

• 15:24Speaker 02

  My version is too many people wanting too much of me at a certain time. And then the feeling of wanting to call mum and dad to vent.

• 15:32Speaker 00

  Yeah. So it's a good, it's, it's good to, I think, even to name and to notice when is it that overwhelm is here. Overwhelm is not one single emotion. It's a, it's usually a combination of many, but in essence, it's like when the system is overloaded.

• 15:46Speaker 04

  Yeah.

• 15:47Speaker 00

  And that, um, that like in clinical practice, we often might use the term window of tolerance. And you may be familiar with what, what that looks and, and feels like. But in essence is that the demands of the situation or my internal situation have exceeded my window of tolerance. So they've exceeded my ability or my perceived ability to cope. So the notion of a window of tolerance, it's used a lot in trauma work. It was really kind of popularized by Dan Siegel, who was a psychiatrist. And, you know, if you imagine basically like a window and you've got, um, the top end of the window and the bottom end of the window.

• 16:28Speaker 00

  So inside this window is everything that you can tolerate, that you can be balanced, calm. You can handle some stress and you can still function relatively effectively.

• 16:42Speaker 00

  But when the demands of a situation or our experience pushes out to the windowsill.

• 16:50Speaker 00

  We now move into overwhelm. It's like, I cannot tolerate this in this way anymore. And so we get two responses. If you imagine at the top end of the window, when the system is overloaded, when we're overwhelmed, we move into what's called hyperarousal. So that's when we get like a really big anxious response. Panic, um, big physiological symptoms.

• 17:19Speaker 02

  Heart racing.

• 17:20Speaker 00

  Yeah, yeah. So really, in essence, what we've got here is the activation of the fight or flight response, which is a major physiological change in the body. So there's that response, okay? At the bottom of the window, though, is what's called hypoarousal. And that's when we get an activation of a different part of the nervous system that actually moves us down into numbness and shutdown. This is where we might have people collapsing. They might be dissociating. They might be withdrawing and sleeping. It kind of looks like depression sometimes. So it's these two extremes of the window.

• 18:00Speaker 00

  These two ends of the spectrum represent a significant sense of being overwhelmed.

• 18:07Speaker 02

  Mm hmm.

• 18:08Speaker 00

  And the work that we want to do is see if we can expand our window of tolerance. So there's more space in there for us to be able to deal with the life's challenges, for example.

• 18:18Speaker 02

  So you grow the window.

• 18:19Speaker 00

  Grow the window, yeah. And so really what we're looking at there is resiliency.

• 18:24Speaker 02

  Hmm.

• 18:24Speaker 00

  Is that the larger the window, the more resilience I can experience.

• 18:29Speaker 02

  Yeah, a little renovation.

• 18:30Speaker 00

  Yep. Having said this, I do really want to emphasise that it's very much valid and okay that we will move into hypo and hyperarousal.

• 18:40Speaker 02

  Mm hmm.

• 18:40Speaker 00

  Very normal part of our evolutionary history. But we wanted, we don't want to stay there too long.

• 18:46Speaker 02

  Yeah.

• 18:46Speaker 00

  Right, so we want to come back into the window.

• 18:48Speaker 02

  I reckon I was hypo last year.

• 18:50Speaker 00

  Mm hmm.

• 18:51Speaker 02

  Full hypo.

• 18:52Speaker 00

  Yeah. Yeah, yeah. And what's that been like?

• 18:54Speaker 02

  In August, I was full hypo.

• 18:55Speaker 00

  Yeah.

• 18:58Speaker 02

  Yeah, awful.

• 18:58Speaker 00

  Um.

• 18:59Speaker 02

  Awful.

• 18:59Speaker 00

  Mm hmm.

• 19:00Speaker 02

  Yeah.

• 19:00Speaker 00

  Yeah.

• 19:01Speaker 02

  To be someone who does a lot of stuff to find it hard to get out of bed is such a like, that

• 19:06Speaker 00

  Um.

• 19:07Speaker 02

  That felt very confronting. My kids were so confused. Why are you still in bed?

• 19:13Speaker 01

  It is, that is, it's, it's so strange to hear, to imagine that you not being able to get out of bed.

• 19:18Speaker 02

  Yeah, yeah, it's a strange.

• 19:19Speaker 00

  Um.

• 19:20Speaker 02

  It's, yeah, I've had it once before. Um, but yeah, to have it again and to, I had to say to my kids, it's called hyper arousal.

• 19:29Speaker 00

  I'm outside my window.

• 19:30Speaker 02

  Yeah, yeah, exactly.

• 19:33Speaker 00

  Yeah, so it is, um, there are times when we will find ourselves in, you know, at either ends of the spectrum. And there's nothing wrong with that. Um, again, to me, it's always, you know, bringing this compassionate understanding as to, okay, so here I am, how have I got here? And how do I get myself back?

• 19:50Speaker 01

  Hmm.

• 19:50Speaker 00

  Um, and, you know, in, sometimes we, like in polyvagal theory, um, we would talk about this idea of like coming back to home base. So coming back to safety. And it's from this place of feeling safe enough that we're then able to perform and live life well.

• 20:07Speaker 01

  When you say, just to quickly recap, what to come back to home base?

• 20:11Speaker 00

  Yeah.

• 20:11Speaker 01

  What do you mean by that?

• 20:12Speaker 00

  So home base is the place that you feel calm, safe, engaged, connected, present.

• 20:18Speaker 01

  And that's like mentally, you mean?

• 20:19Speaker 00

  Yeah, yeah. So how do we come home to safety?

• 20:22Speaker 01

  Yeah.

• 20:22Speaker 00

  Um, rather than how do we run away to safety? Or how do we shut down so I don't feel anything anymore?

• 20:28Speaker 01

  Yeah.

• 20:28Speaker 00

  Yeah. Okay. So if we have this frame of this window of tolerance, um, obviously we want to be able to bring awareness to when we're tipping into uh, either end. But really what I want to have a look at today is, okay, so what do we do when we're there? What do we do when we're outside of our window?

• 20:46Speaker 01

  Mm hmm.

• 20:47Speaker 00

  Um, and one of, like, probably one of the most evidence-based approaches, um, for crisis survival skills is based on dialectical behaviour therapy or DBT. And let me be, um, clear that there are very many other approaches as well, which may be equally as helpful. This is the one that I will often use and I think can be very, very helpful. It's based on, I've mentioned this in the past, but it's based upon initially the treatment of borderline personality disorder. And that disorder is characterised by what, probably what we'd say is like a lot of emotional instability. Um. So emotions can be very high and very distressing. Um. And can often prompt really unhelpful behaviours like self harming, for example,

• 21:32Speaker 00

  or more reactivity in your relationships. So it was originally designed for the treatment of that, but it has enormous applicability to all of us. And it can be a really useful um kind of set of tools and techniques to help us manage when things get really overwhelming.

• 21:46Speaker 02

  Yep.

• 21:47Speaker 00

  So, shall I dive in? Yes. Okay.

• 21:50Speaker 01

  Give us the tools.

• 21:51Speaker 00

  Yeah, all right.

• 21:51Speaker 02

  I love how I'm is like so good at just pausing to like, give us a chance to hear us to say something, but then we're like, no, no, just tools, please.

• 21:58Speaker 01

  Yeah, yeah, it's like, it's like, at this point, I'm at the drive through window and the person's like talking to me, holding the bag of like my food.

• 22:07Speaker 01

  So yeah, no, this is, this is great, but I want the burger. Like, I'm really, really hungry for the good bit. Yeah.

• 22:12Speaker 00

  Okay.

• 22:13Speaker 01

  Yeah.

• 22:13Speaker 00

  So the first thing is.

• 22:15Speaker 01

  Not to say that everything's been boring.

• 22:17Speaker 00

  I'm just doing like the setup, yeah. Um. The first thing is that we need to be able to, in some ways, be able to recognise how distressed I am. And so often using this technique, we'd actually invite you to rate how distressed you feel. Um. And we might get you to rate it out of five. So five out of five, I'm at my maximum. I'm absolutely overwhelmed, in a state of panic, um feeling deeply distressed. And then obviously, you know, one would be, I'm feeling safe and calm. Now, the more distressed we feel, the less able we are to use our cognitive capacities.

• 22:53Speaker 01

  That, yeah, much better way of saying what I was trying to talk about before. Yes.

• 22:58Speaker 00

  Yeah, yeah. So this is really key, um that we need to be able to know and practise these things when, when we're feeling calm for a start. So we want to have this like in our toolbox to be able to pull out when, when distress is really high. And it's really important that we know that we cannot rely on our rational, higher order executive functioning brain to be able to help us when distress is very, very high. It's not online. We're really functioning from the threat centre of the brain, so the amygdala and the limbic system. Okay, that system, its goal is to keep you alive. It does not care for strategies at that time.

• 23:38Speaker 01

  Mm hmm.

• 23:39Speaker 00

  Okay, so when you know, if like, let's say you're at a three to a five. Okay, so a three to a five level of distress, we need to implement some strategies quickly. And we need to focus them a lot on the body. So if we think that the window of tolerance really is all based upon a physiological response. It makes sense that we then want to look at the body first to change the state of the body. In order to then go and implement the more advanced techniques.

• 24:13Speaker 01

  Yeah.

• 24:13Speaker 00

  Okay. Is that making sense?

• 24:15Speaker 01

  Absolutely.

• 24:16Speaker 00

  Okay. So the more distressed you are, this is also important. The more distressed you are, the more things you're going to have to do to bring you back into some kind of regulation.

• 24:27Speaker 01

  The more tools you're gonna have to.

• 24:28Speaker 00

  Yes.

• 24:29Speaker 01

  Reach for.

• 24:29Speaker 00

  Yep, so it like, for example, it might not be uncommon that I might make a suggestion of one technique. And they, you know, someone might come back and say, Emily, I tried this and like it just really didn't do anything. And then the question might be, well, you know, how distressed were you at that moment? And they were like, I'm maxing out. And I was like, okay, so one is not enough. One skill there is not enough to really kind of what we're trying to do is bring you to a point where you can implement other. Other strategies that are going to be helpful.

• 24:58Speaker 01

  Yeah.

• 24:59Speaker 00

  Kind of like really bringing you back more into like sitting on the window sill rather than being way out of the window.

• 25:05Speaker 01

  Yeah, to put it in a, in a way that like, yeah, a bloke like me can understand. Um, it's, it's almost like there's a big Renault job to do. And God, this, it's a real mess in there. There's like the walls falling down, the doors come off the bloody hinge. And this is, I'm gonna need more than a screwdriver, I tell you right now. I'm gonna need the screwdriver, I need the drill, I'm gonna need the level. I'm gonna bring, bring all the tools out of the corner. Yeah, I need the plug level. Yeah. I don't have one without it. Yeah. So yeah, I, I hear you, Dr. Em.

• 25:33Speaker 00

  Yeah, you need more tools. You need more tools. The more of a mess it is. Exactly. Yeah, correct.

• 25:37Speaker 04

  To continue that analogy.

• 25:39Speaker 00

  Go on, mate.

• 25:41Speaker 04

  Do you need to, are you saying that the tools can work when the house is falling down? Or you need to be getting in there before the house is falling down?

• 25:49Speaker 00

  That is a good question. Well, you know, in an ideal world, we would be able to, we can kind of differentiate this basically between what are called cold skills and hot skills. Hot skills are for very heightened distress and the cold skills are the kinds of things that help us probably not get to the point of needing the hot skills.

• 26:09Speaker 04

  Yeah.

• 26:09Speaker 00

  But life is uncertain. Life is going to throw stuff at you that you can't prepare for.

• 26:14Speaker 04

  Yeah.

• 26:14Speaker 00

  So we want to be able to practise the skills. And we also want to use more of them when distress is really high.

• 26:22Speaker 04

  Yeah.

• 26:23Speaker 00

  Because there's kind of two parts there.

• 26:24Speaker 04

  Yeah.

• 26:24Speaker 00

  Yeah. So I wanted to start with, you will know from a previous episode that I've done that DBT is a fan of acronyms.

• 26:32Speaker 04

  Oh, yeah.

• 26:33Speaker 00

  So I have another good one for you. And the acronym is TIP, T I P P. And before I go into it, I'm just going to put a big disclaimer in here. Any of these strategies that I mention are general, I feel like I'm going to go on the radio show, it's general advice. I do really encourage you because it's using the body to seek medical advice around this, particularly because one of the strategies involves cold water. And obviously, if you have any conditions that are going to be exacerbated by the use of cold water, then please seek your own attention around them.

• 27:07Speaker 04

  If pain persists.

• 27:09Speaker 00

  Yeah. Yeah, yeah, yeah, but what's tip? Okay, so tip is four separate skills, four separate strategies to use. And they are used, once again, for crisis moments. They're not going to make your life happier, they're going to help you get through a period of time without the situation becoming worse.

• 27:30Speaker 04

  Yeah, really good.

• 27:32Speaker 00

  Okay.

• 27:32Speaker 04

  Yeah, clarification.

• 27:33Speaker 00

  Yeah, so the T is temperature. Now, if you were to Google this strategy, there are many different ways in which you can use this, but one of the most effective involves using a basin of water.

• 27:47Speaker 00

  Uh. So let's just say things are really distressed, like you're feeling really distressed. So the T is you go into the bathroom, you fill the basin with cold water. If you wanted to, you could put some ice cubes in there. You take a breath, you hold your breath and you submerge your head into the sink.

• 28:05Speaker 01

  Your whole head.

• 28:05Speaker 00

  Your whole head.

• 28:06Speaker 01

  Hmm.

• 28:07Speaker 00

  And you hold it there until you safely can um come up again. And you do that three, maybe three to four times.

• 28:14Speaker 01

  Oh.

• 28:15Speaker 00

  So once again, please, um please attend to medical advice here. But this practice here is so swiftly changes the state of the body.

• 28:28Speaker 01

  And this is the head, head goes in.

• 28:30Speaker 00

  Head, your face goes in, you don't have to get your whole head. But your face goes in to the basin of cold water. And it's the holding of the breath too, that's really integral.

• 28:41Speaker 01

  Yeah. Yeah.

• 28:41Speaker 00

  So there's a whole physiological change that is occurring with the breath and with the temperature.

• 28:47Speaker 01

  Mm hmm.

• 28:47Speaker 00

  This is for those very overwhelming moments where you're in danger of doing something that could make it worse. Or that you just cannot be with this feeling anymore. Yeah, okay. So the holding of the breath and the submerging the face in the water, three to four times.

• 29:04Speaker 01

  Okay.

• 29:04Speaker 00

  Yeah.

• 29:05Speaker 01

  And thread like as in like go, how long do you go, like only a couple of seconds, I'm assuming?

• 29:09Speaker 00

  Well, whatever feels safe enough for you, right? So you take a breath, maybe it's, you know, maybe it's four counts, you hold it and then you come up again. You take another breath, you hold it and then you go down again.

• 29:20Speaker 01

  Okay, yeah.

• 29:21Speaker 00

  Okay.

• 29:21Speaker 01

  Great.

• 29:22Speaker 00

  Um. So what we're getting there is a very swift physiological change. So often it might be, for example, that you're sitting in uh the sympathetic nervous system activation, which is fight or flight, and that this would kind of bring us back down into parasympathetic.

• 29:40Speaker 01

  Mm hmm.

• 29:41Speaker 00

  Now, this change may be enough if you're not super, super distressed. But it may not be enough if you are really. But what it will do is offer a very quick circuit breaker.

• 29:53Speaker 01

  Yeah.

• 29:54Speaker 00

  Okay. So it's not going to change, for example, it's not going to change the heartbreak that you're experiencing if someone has ended a relationship.

• 30:00Speaker 01

  Yeah.

• 30:01Speaker 00

  But it will help you get through to the next moment.

• 30:04Speaker 01

  Yeah.

• 30:04Speaker 00

  So that's the T, temperature.

• 30:05Speaker 01

  Yeah.

• 30:07Speaker 00

  The I is intense exercise.

• 30:09Speaker 01

  Hmm.

• 30:10Speaker 00

  Um, and that.

• 30:13Speaker 00

  Really, like the recommendation generally is around 20 minutes of exercise that that elevates your heart.

• 30:20Speaker 01

  Yeah.

• 30:20Speaker 00

  Okay.

• 30:21Speaker 01

  And sorry to jump in, but I I'm assuming that to do the T first is somewhat important before the I, because to go straight to it, I I don't think I could possibly go to intense exercise first.

• 30:36Speaker 00

  Yeah.

• 30:36Speaker 01

  Because if I'm so overwhelmed, it's like, there's no like, there's no way you're getting me doing that.

• 30:41Speaker 00

  Yeah, yeah.

• 30:41Speaker 01

  But if you the circuit break it first with the T.

• 30:43Speaker 02

  So are you saying you do all these four things in a row? Or is this just like, you could do this one, or you could do that, or?

• 30:49Speaker 00

  Well, there is, there isn't a strict kind of

• 30:52Speaker 02

  Okay.

• 30:52Speaker 00

  criteria around it, but I think it requires us also being able to tune into what, what is going to work for us. The temperature can be very good, I will be honest.

• 31:01Speaker 01

  Yeah.

• 31:01Speaker 00

  Particularly when there's like self harming urges showing up, I think that can be a really good one.

• 31:06Speaker 01

  Hmm.

• 31:06Speaker 00

  Um, but if you know, for example, Ryan, if you know that like, there's no way I'm going to go and intensely exercise when I feel this, that you might need that.

• 31:13Speaker 01

  Yep.

• 31:14Speaker 00

  Yep. There is a suggestion that you can do them in order. Um, and that you can stop when you're feeling okay enough. You may not need to use all four techniques, for example.

• 31:24Speaker 01

  Yeah, you might tip might be fine as opposed to tip up.

• 31:27Speaker 00

  Yes, exactly.

• 31:28Speaker 01

  Yeah.

• 31:29Speaker 00

  Or you may notice that, let's just say, the intense exercise is your thing. And you get to the end of that 20 minutes and you're like, I'm okay enough. I don't need to go and do the others. Okay.

• 31:39Speaker 01

  Yeah.

• 31:39Speaker 00

  So again, it requires some attunement to like, what do I need? The intense exercise, yes, 20 minutes is the recommended one, that kind of idea. Um, and that we're really exercising at a point where we can't hold a conversation. Um, so definitely that we're kind of out of breath, we're elevating our heart rate. Now, that intense exercise can look different. So you could, for example, do like maybe 10 minutes of high intensity interval training. And that may be enough. Um, you could do burpees, you could do skipping, you could do boxing. What is not

• 32:16Speaker 01

  Peloton.

• 32:16Speaker 00

  Yes, exactly. Anything that is really going to get you out of breath. What is not kind of recommended at this point is something like walking.

• 32:24Speaker 01

  Hmm, it's not enough.

• 32:26Speaker 00

  It's not enough. And sometimes it will keep you trapped in this kind of cycle of rumination and engagement in like getting very hooked into the thinking.

• 32:34Speaker 01

  Yeah, I walk pretty fast, but yeah, I get your point.

• 32:38Speaker 00

  So we really, really kind of what we're doing there is utilizing the mobilized response in the body. So the body is ready to fight or flee. So we use that response.

• 32:49Speaker 01

  Uh, to work off the adrenaline.

• 32:52Speaker 00

  Yes, exactly. And I mentioned a long time ago, I think in this, in an episode on stress and burnout, that there are some authors that have written a book called Burnout, Emily and Amelia Nagoski. And they talk about this idea that the exercise actually completes the stress response. So we're really using this mobilized energy to tell the body that I am now safe once I finish.

• 33:17Speaker 01

  And that episode is Hall of Fame episode. We'll link to it in the show notes.

• 33:23Speaker 00

  So that's, I mean, this exercise, again, this is another body, we're using the body here to change the state of the mind.

• 33:30Speaker 01

  Yep.

• 33:30Speaker 00

  Yep. So that's the I, but make it work for you. So it doesn't have to be that you go sprinting. It can be genuinely that you're going to be doing like skipping at home, for example, or you've got a punching bag, or actually, having said this, when you're doing the intense exercise, be careful if there's a big anger response that's showing up and to not choose something that is going to exacerbate the feeling of anger. So boxing, as an example, you could continue to get really fused and hooked into this like angry feeling. And now we're just exacerbating it by punching something, for example.

• 34:07Speaker 01

  Interesting.

• 34:08Speaker 00

  So we might want to be mindful in that choice around what we want to do. Yep.

• 34:13Speaker 01

  Yep.

• 34:14Speaker 00

  So that's the I.

• 34:15Speaker 01

  Yep.

• 34:15Speaker 00

  The.

• 34:16Speaker 02

  I would, I recommend running a lap of an ashtray as fast as you can. It'll take, well, probably a bit more than a minute.

• 34:23Speaker 00

  Yeah.

• 34:24Speaker 01

  And it'll save you time.

• 34:27Speaker 01

  It'll take you, you know, 40 seconds.

• 34:31Speaker 02

  It is the like, nothing destroys you more than that. And it takes a certain amount of time to be in the fast.

• 34:41Speaker 00

  Yeah.

• 34:42Speaker 02

  So like, if you've got an oval nearby, go to the oval and run as fast as you can and stretch and then run as fast as you can around the oval.

• 34:48Speaker 01

  Yeah. And how long would it take? How long would it take you?

• 34:53Speaker 01

  Doesn't it?

• 34:56Speaker 02

  No, no, it's just, yeah.

• 34:57Speaker 00

  So I think it's important with the first two, I think it's important that we have some variations to them so that we can use them if, for example, we're not at home.

• 35:08Speaker 01

  Yep.

• 35:09Speaker 00

  So I will mention just briefly that with the temperature, say you don't, you're not at home, you don't have a sink. What you can do is maybe you have access to a water bottle that's cold. You place the water bottle on your forehead and you put the, your forehead between your knees and you hold your breath. So we're getting a similar kind of response. If you've got an ice pack, you can put it on your forehead or over your eyes, hold your breath, put your head between your knees. Same thing, mimicking the same response as the basin.

• 35:41Speaker 01

  Gotcha. So it's important that you're leaning over.

• 35:43Speaker 00

  Yeah. And there is a whole neurophysiology part to this that is reflective of what's called the dive response. And I'm not, I'm not well versed enough in this to explain the actual mechanics, but.

• 35:56Speaker 01

  Is this an acronym within the acronym?

• 35:58Speaker 00

  No.

• 36:00Speaker 00

  So you know, when you go to the beach and you dive underwater.

• 36:05Speaker 01

  Good feeling.

• 36:05Speaker 00

  And your head goes first. Your head is above your heart and your lungs. What's that?

• 36:10Speaker 02

  Ryan doesn't do that.

• 36:10Speaker 00

  You don't go under?

• 36:12Speaker 01

  Huh?

• 36:12Speaker 02

  Remember you don't like doing that, diving headfirst into the waves?

• 36:15Speaker 01

  Oh yeah, just, just don't want to hit the ground.

• 36:18Speaker 02

  Yeah.

• 36:19Speaker 01

  There's no, there's no real like particular fear. It's just like, yeah, I don't, yeah, I don't know if we'll cut this out.

• 36:26Speaker 01

  But yeah, it's true. I don't like doing that.

• 36:28Speaker 02

  No.

• 36:28Speaker 00

  Yeah. Okay. Well, you're missing out because

• 36:30Speaker 01

  Yep.

• 36:31Speaker 00

  You're missing out because when you dive down, we get a, we get this kind of same response.

• 36:38Speaker 02

  I told you.

• 36:39Speaker 00

  Yeah.

• 36:39Speaker 01

  Yeah.

• 36:40Speaker 00

  Yeah. And so when you emerge, do you not feel refreshed?

• 36:42Speaker 02

  I do.

• 36:43Speaker 01

  I do, yeah.

• 36:44Speaker 00

  And it's not the same.

• 36:45Speaker 01

  Are we talking about not putting your hands first? You put your head first without your hands first?

• 36:48Speaker 00

  Oh, you put your hands first.

• 36:50Speaker 01

  That's what he's talking about.

• 36:51Speaker 02

  No, you just, when we go to the beach, you're like, no, I don't dive headfirst into the water because you saw a guy at your beach come actually hit the sand.

• 36:59Speaker 01

  Oh, yes.

• 36:59Speaker 02

  In a lot of distress.

• 37:00Speaker 01

  Yes, but you know, well, I mean, this is definitely a divergence, but he, he dove like a, did like a dolphin dive.

• 37:06Speaker 02

  Why did he do that?

• 37:07Speaker 00

  Oh, that's no good.

• 37:08Speaker 01

  You know, he just wasn't thinking. And yeah.

• 37:10Speaker 02

  Oh, okay.

• 37:11Speaker 01

  Yeah, yeah.

• 37:12Speaker 02

  Oh, so if your hands are first, you will dive?

• 37:14Speaker 01

  Yep, for the record.

• 37:15Speaker 00

  Okay.

• 37:20Speaker 01

  If everyone's, anything else you wanna know about my swimming do's and don'ts? Wills and won'ts?

• 37:28Speaker 00

  Next time that you do diving. You, when you dive in headfirst with your hands out, uh, you will have this similar kind of response. Because when you come back, when you emerge from the water, you always feel refreshed.

• 37:43Speaker 01

  Yeah.

• 37:43Speaker 00

  It feels very cleansing in some ways. It's the same experience that we're, that we're mimicking when we're doing the basin. So the head is below the heart and the lungs in essence.

• 37:53Speaker 01

  Yeah.

• 37:54Speaker 00

  And again, there is some physiology to this that I am not smart enough to explain.

• 37:58Speaker 01

  Yeah.

• 37:58Speaker 00

  But it is really based on our nervous system. Um, and it, it's absolutely grounded in, in some good research.

• 38:05Speaker 01

  Yeah.

• 38:05Speaker 02

  Are you guys able to get your head between your knees?

• 38:07Speaker 01

  Were you just trying?

• 38:07Speaker 02

  Yeah.

• 38:08Speaker 01

  I thought I saw your head going up. Yeah. I'm not sure I'll be able to. I've never tried. Yeah, I don't think, not, not directly between, but, um, I'm not gonna try.

• 38:17Speaker 00

  Just, just downwards, down.

• 38:18Speaker 01

  Yeah. Yeah, I've never, I've never. Why would I put my head down there? Well, why would I possibly put my head down there? What am I even trying to check? Don't know, it doesn't matter. Anyway.

• 38:29Speaker 00

  Oh, no. Um, so that's a variation that you need.

• 38:33Speaker 01

  Got all my ribs. Okay.

• 38:39Speaker 01

  Step too far.

• 38:41Speaker 00

  Okay.

• 38:43Speaker 01

  Okay.

• 38:43Speaker 00

  There are obviously a number of variations that you can use that are using temperature. At a very, very easy way, if you're feeling overwhelmed and you're out, go into a bathroom and splash cold water on your face.

• 38:54Speaker 01

  Yeah, yeah.

• 38:54Speaker 00

  Yep, similar thing, really swift, very easy to do.

• 38:57Speaker 01

  Yeah.

• 38:58Speaker 00

  With the intense exercise, let's just say you are at work, go outside, do some star jumps.

• 39:04Speaker 01

  Yeah.

• 39:05Speaker 00

  Um, so something that is going to really quickly get your heart rate elevated.

• 39:08Speaker 01

  Yeah.

• 39:09Speaker 00

  Um, running on the spot, it doesn't need to be that you have access to gym clothes and a gym and an oval or whatever.

• 39:14Speaker 01

  Yeah, yeah.

• 39:15Speaker 00

  So you make this work for you.

• 39:16Speaker 01

  Yeah, that's, that's, that's really good because it's like, I think sometimes I will do nothing because I can't do everything.

• 39:23Speaker 00

  Yes, exactly. Is that really something is better than nothing?

• 39:27Speaker 01

  Yeah.

• 39:27Speaker 00

  And it's going to shift the dial just a little bit. And then when you do get home or when you do get access to whatever you need, then you can do that properly.

• 39:35Speaker 01

  Yep.

• 39:36Speaker 00

  But we're just talking about really shifting the needle back as much as we can to get us to a place of being okay.

• 39:43Speaker 01

  Yeah.

• 39:43Speaker 00

  Yeah, okay. So that's the T and that's the I, temperature, intense exercise. The first P is called progressive muscle relaxation.

• 39:51Speaker 01

  Knew it.

• 39:52Speaker 00

  Yeah.

• 39:55Speaker 00

  And so this practice is readily available everywhere on the internet and that will probably be on all of the apps that you might use for meditation practice. It's not a meditation, it's a very active um way of changing the state of the body. Okay, um, I could do a mini version now if you want me to.

• 40:15Speaker 01

  Yeah, please.

• 40:16Speaker 00

  Yeah, okay. So if you're driving, please don't close your eyes and maybe practice this another time. Okay, so when you do this at home or when you get access to this um ordinarily, that we could do this for up to, you know, 20, 30 minutes if we want to. This is a micro version, so it'll be five minutes at, at, at most.

• 40:36Speaker 01

  Yeah.

• 40:37Speaker 00

  Okay. All right. So whenever you're ready, if you wanted to close your eyes.

• 40:44Speaker 00

  Just taking a few slow grounding breaths here.

• 40:50Speaker 00

  And seeing if you can direct the focus of the attention all the way down to the feet. And as you do that, I want you to clench all the muscles in the feet and the toes. And so, hold the tension here, holding it.

• 41:09Speaker 00

  And then next out breath, letting go. So letting the feet and the toes fully relax.

• 41:16Speaker 00

  Now shifting the attention to the calves and tightening the calf muscles, if that feels safe to do. Holding the tension, holding it here and letting go.

• 41:29Speaker 00

  Fully relaxing, shifting up to the thighs and clenching the quad muscles here.

• 41:40Speaker 00

  And letting go.

• 41:43Speaker 00

  Coming into the pelvic region and the buttocks and clenching this part of the body.

• 41:51Speaker 00

  And gently letting go.

• 41:54Speaker 00

  Coming now into the abdominal region and clenching the tummy muscles here.

• 42:01Speaker 00

  Holding.

• 42:04Speaker 00

  And letting go.

• 42:08Speaker 00

  Coming up now into the chest area.

• 42:12Speaker 00

  And clenching the muscles.

• 42:15Speaker 00

  And letting go.

• 42:19Speaker 00

  Moving down now into the forearms and all the way out to the hands and the fingers and tightening the hands.

• 42:30Speaker 00

  Letting go.

• 42:32Speaker 00

  Up into the biceps and the triceps, tightening the muscles here.

• 42:41Speaker 00

  Letting go.

• 42:43Speaker 00

  Coming up into the shoulders, so you might like to put the shoulders up towards the ears.

• 42:50Speaker 00

  And letting go.

• 42:53Speaker 00

  Coming now into the face. And so you can just do the face all at once and just holding a lot of tightness and tension in the face. This is screwing up the nose and the eyes.

• 43:04Speaker 00

  And letting go.

• 43:08Speaker 00

  And now taking one slow in breath.

• 43:12Speaker 00

  And one long, slow out breath. And feeling this full sense of the body letting go.

• 43:23Speaker 00

  And whenever you're ready, coming back to them.

• 43:27Speaker 00

  Okay.

• 43:31Speaker 00

  How was that?

• 43:31Speaker 01

  Who's, who's scrunched up face was funniest? I could tell you, so I couldn't help but look. Oh, you looked? Did you? I think it was quite funny for you to look back on it. You should have gone and gone.

• 43:40Speaker 00

  Um, so that's the progressive muscle relaxation. I'm curious, what did you notice?

• 43:46Speaker 01

  Uh, well, I guess it, it felt like meditative. In, in like a sort of grounding, sort of. It, it, it makes you present, I guess. Cause you're focusing on different things. A little bit conscious that my pec muscles wouldn't flex that much. That's a bit disappointing. I was thinking, I was thinking about Hugh, I was like, Hugh's gonna look really good in this one.

• 44:07Speaker 01

  So I was a bit distracted then. But otherwise, yeah, I really, it was really, really nice, yeah.

• 44:12Speaker 00

  Yeah, so this is a really brief, really, really brief version. But what we're kind of exposing ourselves to is what it feels like to hold tension. And that this is often an experience that's happening when we're feeling very overwhelmed is that we are unconsciously and automatically contracting the muscles. And we don't notice that we're actually holding. And so for example, you might notice a lot of tightness in your jaw. You don't, you're not doing this on purpose. Some people might clench their tummy or their thigh muscles. And they were doing this so habitually that we actually forget. But the body is sitting in this stress response that is occurring, so.

• 44:46Speaker 01

  I've, I've, I've actually noticed in the last like couple of months that I've had really, I've been really sore. And I've. And then I'm, so I'm trying to, I've sort of, I've thought recently, oh, maybe it's because I'm like tense. And I, I keep noticing that my shoulders are tense.

• 45:01Speaker 00

  Yes.

• 45:02Speaker 01

  And I keep dropping them and it's, it's, it's amazing. And then also whenever I, like often when I do like the Peloton bike exercises, often the instructors say like, okay, just unclench your jaw. And they always know that I'm doing it. It's like, how did you know I was doing that?

• 45:17Speaker 00

  Yeah, yeah. So it's kind of teaching us what it feels like to hold tension. And then really importantly, it's teaching us and exposing us to what it feels like to let go. So the letting go is actually a practice of emotion regulation.

• 45:30Speaker 01

  Yeah.

• 45:31Speaker 00

  So we're letting go of this holding and this bracing that's here. And that is again, shifting the state of the body.

• 45:39Speaker 01

  It's, it's probably related a bit different, but I've really gotten into breath work this year and love it. And I know you do as well, Q. But I, my favorite part is when you get to do like a real clench at the, like you've been doing breath work and you tighten up as, like, as many muscles as you can and then release on an exhale.

• 45:59Speaker 00

  Yeah.

• 45:59Speaker 01

  It feels like I'm a whole new person after that.

• 46:02Speaker 00

  Yeah.

• 46:02Speaker 01

  Yeah.

• 46:03Speaker 00

  So it's actually, there's a version of the progressive muscle relaxation that you can do that's actually called the Hulk. And I won't do it.

• 46:13Speaker 01

  Is that where you tear through a city and like knock over buildings?

• 46:18Speaker 00

  But it's this idea, like if you don't have time or maybe you're at work or you don't have time to do the whole progressive muscle relaxation is that you literally stand like the Hulk and you, you clench all of your muscles all at once and you hold it all and then you relax.

• 46:32Speaker 01

  Yeah. God, that'd be an embarrassing one for someone to walk in on.

• 46:36Speaker 00

  And you might do that three times, for example.

• 46:38Speaker 01

  Yeah.

• 46:39Speaker 00

  But it's again about using this body here to change the state of our emotional experience.

• 46:45Speaker 01

  Yeah.

• 46:46Speaker 00

  And that, that's a very quick way of doing that.

• 46:48Speaker 01

  Correct. Awesome.

• 46:50Speaker 00

  That's the first P. The second P is paced breathing. So the reason why it's at the end is that you may not be okay enough to do paced breathing.

• 47:03Speaker 00

  As your first port of call, if distress is really high. But maybe you are, but I think it's helpful to have it at the end of the acronym. Um, because you might need to do those other three um skills before you move into paced breathing. Sometimes when we tune into the breath, it can actually be too overwhelming.

• 47:22Speaker 01

  Yeah.

• 47:23Speaker 00

  But paced breathing basically is referring to diaphragmatic breathing or breathing that is allowing us to have a calm, regulated response. There are, I mean, when we talk about breath work, there are so many different incarnations of how you could do paced breathing. Some of the very common ones would be box breathing. So you guys familiar with box breathing? Yeah. So.

• 47:46Speaker 01

  I don't know.

• 47:47Speaker 00

  So imagine the shape of a box. You breathe in for four, you hold for four.

• 47:52Speaker 01

  Oh, yes, I do.

• 47:53Speaker 00

  You breathe out for four, you hold for four. And we just do this. So it becomes very regulating, having this um very timed breath.

• 48:03Speaker 01

  Hmm.

• 48:03Speaker 00

  Yep. So that's one way. We can also do um a a different paced breathing that involves having a longer out breath. So as we know from um in the nervous system, that it's actually the out breath that is activating our parasympathetic nervous system. So it's really helpful to have longer out breaths because that's what activates the slowing down part.

• 48:28Speaker 01

  Is it, whenever you're doing these breathing things, should I always be in through the nose, out through the mouth? Or does it not matter?

• 48:35Speaker 00

  There's so many different instructions around that, to be honest.

• 48:38Speaker 01

  Okay.

• 48:38Speaker 00

  Um, yes, I think you can do in through the nose and out through the mouth. But there are other suggestions that say do it all through the nose. There are other people that say do it all through the mouth. So I think do what feels okay enough for you.

• 48:51Speaker 01

  Mm hmm.

• 48:51Speaker 00

  Um, but certainly when we have a longer in breath than the out breath, that will more likely trip us into hyperventilation or feeling more anxious.

• 49:02Speaker 01

  Mm hmm.

• 49:03Speaker 00

  Physiologically, I'll tell you why that happens. So. When we're in a resting state, um, we have input from the sympathetic nervous system, which is uh fight or flight and the parasympathetic, which is rest and digest. So in a normal moment, like right now, I'm getting system input from both. So sympathetic nervous system is like the accelerator of a car. When I breathe in, the accelerator goes on. When I breathe out, the brake comes on.

• 49:34Speaker 04

  Mm hmm.

• 49:35Speaker 00

  So we can see this through our heart rate. So for example, actually, we might just do this now. Um, if you want to, just um finding your heart rate, if you can.

• 49:49Speaker 00

  And I just want you just to take one long, slow in breath and then one long, slow out breath. And just observe what's happening with the heart rate.

• 50:06Speaker 00

  Okay, what do you notice?

• 50:07Speaker 04

  Actually quite dramatic. It slowed down a bit. Yeah. Did it?

• 50:10Speaker 00

  Yeah.

• 50:11Speaker 04

  On the out?

• 50:11Speaker 00

  Yes.

• 50:12Speaker 04

  Yeah.

• 50:12Speaker 02

  I'm watching it on my watch, the actual, it's unbelievable.

• 50:15Speaker 04

  But it really accelerated as I was breathing in.

• 50:16Speaker 00

  Yeah, and so like I actually find this so uh informative and so such a powerful, really biofeedback. Is that we see on the in breath, your heart will elevate. Here we have sympathetic arousal, right? And then the brake comes on of the um parasympathetic, it slows our heart rate down. So we're getting kind of this constant input, sympathetic, parasympathetic, sympathetic, parasympathetic. When we're getting overwhelmed and it's taking us into hyper arousal, we're getting too much accelerator. And not enough brake input.

• 50:51Speaker 04

  Mm hmm.

• 50:52Speaker 00

  So when we're doing paced breathing, we're bringing the brake on more.

• 50:55Speaker 04

  Hmm.

• 50:56Speaker 00

  And taking our foot off the accelerator. Yeah.

• 50:59Speaker 04

  I've been experimenting with trying something and I don't know if I should be with a child. But when my toddler is really distressed and losing it and definitely overwhelmed. I've been trying something recently that's worked pretty well of I'll get him away from the situation. And then so let's have a competition to see who can hold like, take the biggest breath we can. And then hold our breath for as long as we can. And I've been really surprised at how dramatically and quickly it gets him to a point where he's, I can communicate with him again.

• 51:32Speaker 00

  That's so cool.

• 51:33Speaker 04

  Yeah, it works because he's a little bit competitive. It works really well to play into that.

• 51:37Speaker 00

  Yeah.

• 51:38Speaker 04

  Um, but I haven't really been thinking about the out breath. Maybe I need to incorporate something now for like, and now like, who can blow it out like the longest, like who can extend that the longest possible.

• 51:50Speaker 00

  We can use that like as the dragon breath. So like the breathing out of dragon fire. That's quite a good one too.

• 51:56Speaker 04

  Okay.

• 51:56Speaker 00

  Yeah.

• 51:56Speaker 04

  Right. Yeah. And it shocked me. I was like, I'll try it once. And it really blew my mind that it changed his state completely.

• 52:03Speaker 00

  Yeah.

• 52:04Speaker 04

  Yeah.

• 52:04Speaker 00

  So we're just looking really for these little changes here to bring us back online. So that's the, the tip method and there are four skills in there.

• 52:15Speaker 04

  Temperature, intense training, intense exercise, P M R.

• 52:20Speaker 00

  Aggressive muscle relaxation.

• 52:21Speaker 04

  Progressive muscle relaxation and.

• 52:25Speaker 00

  Pace breathing.

• 52:26Speaker 04

  Breathing. Yeah, exactly. Pace breathing.

• 52:28Speaker 00

  Yeah. Yeah. So you can go and Google this. There are worksheets and handouts on this everywhere across the internet. And they'll give you other options there that you can use as well.

• 52:39Speaker 00

  So that's a really well evidence-based approach to like crisis in the moment. What can I do to bring myself slightly back into the window? Yep.

• 52:48Speaker 04

  It's so liberating, I think, to hear that.

• 52:52Speaker 04

  There's something, because the, the, the experience of being overwhelmed feels like there's nothing you can do.

• 52:58Speaker 00

  Hmm.

• 52:58Speaker 04

  It's so liberating to know that there's just like, there's things you can do to your body that are physical and concrete in that moment. It's like, it feels counterintuitive or something.

• 53:09Speaker 00

  Hmm.

• 53:09Speaker 04

  But it's, it's awesome.

• 53:10Speaker 00

  Yeah.

• 53:11Speaker 04

  Yeah.

• 53:11Speaker 00

  It's, um, I think it's a really helpful thing to be just holding awareness of. And even if there's one thing that you use, and maybe it tips you slightly into feeling slightly more okay, it's from that place that we can then make the better choices for ourselves as well.

• 53:27Speaker 04

  Hmm.

• 53:27Speaker 00

  Um, now this is like, the tip method is just one set of crisis skills and there are a multitude of others. I find that's the most helpful for those really, really heightened points in time. The things like the cold skills that I'm kind of vaguely mentioned earlier, they would be things like being able to practise mindfulness meditation, being able to journal, uh, being able to go for a walk, being in nature. So those things we use to really help us stay in the window. Um, but we may, they may not be as effective when a crisis is here.

• 54:02Speaker 04

  Yeah.

• 54:03Speaker 00

  Yeah. We may get to them once we've used our crisis skills and now we can really use them and help us, to help us feel better.

• 54:11Speaker 04

  Hmm.

• 54:11Speaker 00

  Um, so they're hat, they have a definite place, but they may not be as useful as doing some of these other skills at the time.

• 54:18Speaker 04

  Yep.

• 54:18Speaker 00

  Yeah.

• 54:19Speaker 04

  Hmm.

• 54:19Speaker 00

  I think it's also really important to mention that, um, when it comes to tolerating really overwhelming times, that it kind of, uh, brings into question or makes us reflect upon how we cope with more mild discomfort.

• 54:33Speaker 04

  Hmm.

• 54:34Speaker 00

  And that if when we're faced with mild discomfort, our strategies are ones of avoidance, then how on earth will we be? When we're faced with the big discomforts.

• 54:49Speaker 04

  And so you're talking about like the thing that we all go through every day, which is like the small discomfort of a quick silence in a conversation. And then we quickly pull out our phone and pretend we're checking our mountains of emails that we're not getting.

• 55:03Speaker 00

  Yeah, yeah, or even things like you've had a really stressful day at work.

• 55:09Speaker 00

  It's manageable, it might be relatively within your window, but it feels uncomfortable or aversive. And so you go through the normal rigmarole of getting home. And then what you do to get rid of this unpleasant feeling is to go and scroll on your phone. And we've, we've spoken about this before, extremely common, makes a lot of sense. But is this actually really taking away or compromising our ability to grow our skills to tolerate discomfort and to be okay in accepting of it?

• 55:40Speaker 04

  Yeah.

• 55:40Speaker 00

  So if we can practise in those more mild moments, those cold skills that I mentioned. So things like movement, mindfulness, journaling, gratitude, any of those practices. If we can start to use those when the discomfort is mild, it gives us a much greater platform to then be able to be okay with the bigger ones.

• 56:01Speaker 04

  Hmm, here, here.

• 56:04Speaker 00

  Great.

• 56:05Speaker 04

  I don't know if this analogy will work, but do you know like channeling, water channeling? How like water will, if you like allow, like if you trick, say you got like sand and you trickle some water and the, the sand will kind of, the water will find its sort of natural path along the sand. It kind of feels like if when little bits of water is coming along and you only let it go down that one path. When a lot of water comes, there's only that one way that the water can go.

• 56:31Speaker 00

  Yep.

• 56:32Speaker 04

  Whereas if you're directing the water down different paths each time. And when a lot of water comes, you've got many more ways for the water to disperse.

• 56:40Speaker 00

  Yes. In fact, it's funny that you say that because I actually often use in therapy, I often use the analogy of imagining a mountain. And when it's raining, that the rain will find the pathway of least resistance. And then the rain always goes down that one path.

• 56:53Speaker 04

  Oh, yeah.

• 56:54Speaker 00

  Yeah.

• 56:54Speaker 04

  Yeah.

• 56:55Speaker 00

  So same thing. And what we're doing from a neuronal point of view is actually creating new pathways, neural pathways by practising these new skills. So the more that you're practicing the cold skills, for example, you know, being able to tolerate discomfort, being able to lean into it, to be accepting of it, it's actually changing the the structure of the brain.

• 57:17Speaker 04

  Yeah, awesome.

• 57:18Speaker 01

  That's really, it's amazing, like that sort of stuff when you hear like, cause we all know be on our phones less, but to have a practical like reason, I like the benefit to not being on your phone as well, at least resorting to your phone to be comfortable. That's really good to know.

• 57:35Speaker 04

  Has anyone ever looked at the tip method, could you call it that? Method for addiction?

• 57:44Speaker 00

  Yeah, it has a huge applicability for that.

• 57:46Speaker 04

  Yeah.

• 57:46Speaker 00

  When we think about, for example, engaging in urges.

• 57:50Speaker 04

  Yeah.

• 57:50Speaker 00

  So really this is looking at this notion of like the action urge. And delaying the urge. So whether it's addiction or self harm or like suicidality, for example, you know, this really what we're looking at here is being able to stay, stay longer in a state of not engaging in unhelpful behaviours, really, that that I may be able to stay here enough to delay the the urge response.

• 58:22Speaker 04

  Yeah.

• 58:22Speaker 00

  Yep. So kind of I've mentioned this before, this idea of urge surfing, right?

• 58:26Speaker 04

  Yeah.

• 58:27Speaker 00

  So that we're able to sit through the peak of the distress to notice, to notice that it's coming down and there's something inherently masterful about being able to sit through something that's very overwhelming. So when we engage in the unhelpful behaviours, it's like we actually miss the opportunity to have a real sense of mastery. So if I, the more I can practice this and the more I can see that I have an some agency that that imbues more confidence, it also increases my sense that I can be okay, even when there are really hard things here. Like that's such a vital kind of foundation really of psychological wellbeing.

• 59:13Speaker 04

  Yeah, I was gonna ask about this earlier and I'm glad I didn't so we could talk about it now in that I found, and obviously this is not a crisis of some of the sorts that we're talking about, but a mild thing that I found overwhelming and distressing in work that I probably can't go into the details, but a few years, a couple of years ago, where we had like had some difficult conversations.

• 59:38Speaker 04

  And Bridget and I were working on some stuff together and the two of us had to go into meetings and have difficult conversations. I was really nervous about it. I'm like, I can't do this. I'm so bad at conflicts. I'm finding it all very overwhelming to go through it and get through it and come out the other side and think, oh my God, I just did that.

• 59:54Speaker 00

  Yeah.

• 59:55Speaker 04

  I felt, I felt so good afterwards and for like days and weeks afterwards, I felt like on a bit of a high from it, that I've actually done something I thought I couldn't do.

• 1:00:05Speaker 00

  Yeah.

• 1:00:05Speaker 01

  And you guys rehired me pretty quickly after that, but it was a pretty tense week. Yeah, I couldn't believe it. I was like, didn't see this coming. Yeah.

• 1:00:14Speaker 04

  At least I got some growth from it.

• 1:00:16Speaker 01

  Yeah, you did really well. You were very convincing.

• 1:00:18Speaker 00

  I mean, that's such an example here of how we're growing our window of tolerance and growing our comfort zones. So there's something that is so powerful about showing yourself that you can get through hard things and not make that worse.

• 1:00:37Speaker 04

  Yeah.

• 1:00:37Speaker 00

  That in fact, I didn't go and use my habitual patterns. I didn't go and use my kind of automatic reactions. And in fact, I've now given myself space to make better choices. It's really powerful, I think.

• 1:00:51Speaker 04

  Yeah, yeah, it was all, it feels awesome.

• 1:00:54Speaker 00

  I swear. Now, there are a whole lot of other things that I could go into, but I just wonder is that...

• 1:00:59Speaker 01

  Well, I think that's very helpful. And I think like if, so I guess if people, you know, people, tip is obviously so helpful and you've given so many helpful things. And like you say, there's probably so many more things that people can look into. And if the demand is there, we can maybe do another episode down the track and go into more stuff. But that feels like a pretty helpful amount of stuff, I would say. Yeah.

• 1:01:22Speaker 02

  I think especially like just the water thing is so provided you're at home. It's such an easy thing to do. It's a quick thing to do.

• 1:01:29Speaker 00

  Yeah.

• 1:01:30Speaker 02

  Um, yeah, that's great.

• 1:01:32Speaker 00

  Thank you very much.

• 1:01:33Speaker 01

  Thank you, Em. Great to see you.

• 1:01:35Speaker 04

  Yeah.

• 1:01:35Speaker 00

  Great to be here.

• 1:01:39Speaker 04

  If you enjoyed this episode and want a little more, you might enjoy our subscriber-only apps, available on Patreon and Apple Podcasts. If you want a little more but don't want to pay any more, then you can join our newsletter at theimperfects.com.au. And while you're there, you'll be able to see the names and faces of all the incredible people who help make this show. A show made on the lands of the Wurundjeri Wurundjeri people, and we pay our respects to elders past and present. The Imperfects is not a licensed mental health service and is not a substitute for professional mental health advice, treatment or assessment. The advice given in this episode is general in nature, but if you're struggling, please see a healthcare professional or call Lifeline on 131114.