The following blog has been written by one of our therapists Leah McMaster. Leah has been working with people who have been presenting with generalized anxiety and here she shares some of the tools she offers to help people cope with the challenges anxiety can bring. Leah is sharing some of her wisdom with you all in the following article.

Thank you for your wisdom Leah……….

Anxiety is a universal human experience. A friend of mine once explained that his anxiety feels like walking down a dark alley, and having no idea what he’s going to run into. I could relate to this feeling; unpredictability, fear of the unknown, lack of control, stress. I imagine that these feelings are all too familiar for many. What some might not know, is that anxiety isn’t the bad guy in this scenario. Believe it or not, the anxiety is attempting to support you through difficult feelings such as the ones listed above, it just doesn’t know how. When I realized this about myself, I began to shift the way I decided to maneuver feelings of anxiety, with the use of skills and coping strategies. I have decided to share some of the ones I use most with my own clients, that I find to be effective and sustainable.

1.     TIPP (Dialectical behavioural therapy skill)

TIPP is an acronym used in Dialectical behavioural therapy to teach emotional regulation through the use of your body. When we experience our feelings, a physiological occurrence happens in our body which we label with an emotion. In the case of anxiety, these include rapid breathing, increased heart rate, nausea etc. TIPP includes 4 physical exercises we can engage in to activate our parasympathetic nervous system, which prompts feelings of relaxation.

T- temperature

The physiological occurrence referred to above, includes an increase in temperature. In other words, when we’re emotional, we get hot. Changing your body temperature, can be very helpful in decreasing the intensity of that emotion. Some effective ways to do so include; dunking your head in a bucket of cold or ice water, taking a cold shower, splashing your face with cold water, or going outside if it is winter time.\

TIPP Skills

I- Intense exercise

Engaging in some form of exercise helps to release the intense energy that can often be stored in the body from experiencing anxiety. Exercise also increases your level of endorphins in the brain, which help to relieve pain and reduce stress. In true DBT fashion, I encourage you to actually run or do jumping jacks on the spot. However, any form of high intensity exercise will do the trick.

P- Paced breathing

Paced breathing means that your breath out is longer than your breath in. When doing so, make sure that you are breathing into your stomach, as we want deepen the breath. 5 to 6 breaths per minute is a good place to start.

P- Paired muscle relaxation

Paired muscle relaxation is something you can do in conjunction with paced breathing, to make the exercise that much more effective. Use this skill by tensing your muscles when you breath in, and releasing when you breath out.

2. Challenge the ‘What If”

Thoughts that are associated with sensations of anxiety often begin with “what if.” What if I fail my test? What if my partner cheats on me? What if my boss is mad at me? What if I said something that offended my friend? The part of you that asks “what if”, is concerned with the future, and wants to create predictability in the system. It’s protective. The thing is, we can’t predict the future, and giving energy to these negative “what if” scenarios create anxiety. Here are some ways that we can challenge the “what if”:

Replace the thought- Use what is referred to as ‘Opposite Action”, and think about what was positive about a scenario instead of what could’ve been negative. This will oppose the what if. You can also engage in any form of healthy distraction.

Emotionally Regulate- Pick a strategy that has worked for you in the past, and attempt to regulate the anxiety and fear that is showing up in your system.

Let the thought go- release the thought through exercise, screaming, journaling, visualize it leaving your system, meditation, drawing/painting etc.

3. Check the Facts and Problem Solve (Dialectical Behavioural Therapy Skill)

The part of us that experiences anxiety throws logical reasoning out the window. As a result, we begin to create catastrophe. I use the language “create”, because anxiety causes us to identify threats in our environment that aren’t even there, or aren’t even true. In these moments, it is important to remind ourselves what we actually know to be true, and what we have control over.

Questions you can ask yourself when checking the facts:

•    What is the prompting event?

•    What did I actually observe?

•    How am I interpreting this event? And am I making any assumptions?

•    Am I assuming a threat?

•    What is the catastrophe?

•    Does my emotional reaction fit these facts?

If you are able to identify something within the facts that is problematic to you, create a solution around it, while being mindful about what you can control. Maybe your friend was offended by what you said, because they told you they were. Ask yourself, what can I actually control in how I go about resolving this?

4. Set the tone for the day

If you struggle with anxiety, you may notice that it feels really intense first thing in the morning. Your nervous system is defensive in nature, so it often goes right into fight, flight or freeze mode at the thought of another anxiety filled day. Your body will continue to repeat this process if it believes that you are going to encounter discomfort and fear throughout your day. Setting a tone for the day helps to reduce the anticipation of negativity. Here’s how you can do it:

Create predicability by sticking to a morning routine which includes at least one healthy habit for your mind and body (mediation, skin care, stretching, sitting down for breakfast, cold shower, reduce social media use in morning etc.)

Use a gratitude journal. Write down 3-5 things you are grateful for every morning

Positively affirm yourself. Write down or tell yourself 3 things you are looking forward to that day.

5. Be in relationship with your anxiety

This one may sound strange. Why would I want to be in relationship with this overwhelmed, stressed out, irrational part of myself? Well, it is because this part of us has inner wisdom. It knows what you need but just doesn’t know how to tell you. To begin this process, begin to see physical symptoms of anxiety as your messengers. That awful feeling you get in your stomach when your nervous? That’s just your body asking for support in an environment that feels uncomfortable. Try sitting with that feeling if you can. Can you ask it what is so scary? What is so uncomfortable? What does it need? It might tell you, it might not. Regardless, this part deserves compassion from you. It is okay to feel anxious. You’re not a failure if you get stage fight. You’re not a coward because you’re afraid to confront your partner. You’re not weak because the gym makes you socially nervous. A part of you is just anxious, and you deserve support. A universal, and acceptable human experience.

Links and Resources:


Temperature control- TIPP2

Paced breathing techniques- Breathwork

Paired muscle relaxation- PMR Video

Gratitude prompts- Gratitude

DBT skills workbook- DBT Workbook

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