Life Kit: Health What to do when you're too upset to think straight
Jul 23, 2026
Shireen Rizvi, a psychiatry professor and DBT specialist, walks through quick distress-tolerance tactics and longer IMPROVE strategies. She explains TIP skills like cold-water grounding and mental imagery techniques. She also contrasts willingness with willfulness and shows simple physical cues to help you shift out of overwhelm.
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Distress Is Inevitable And Drives Avoidant Behavior
- Distress and pain are inevitable, and many maladaptive behaviors (drinking, lashing out) are attempts to avoid them.
- Shireen Rizvi frames distress tolerance as learning to accept unbearable feelings when you can’t immediately fix the situation.
Use Cold Water To Trigger The Mammalian Dive Reflex
- Try the T in TIP: dunk your face in very cold water with ice to trigger the mammalian dive reflex and quickly lower heart and respiratory rates.
- Avoid this if you have a heart condition or take beta blockers.
Rev Yourself Then Stop With Intense Exercise
- Use intense exercise briefly (jumping jacks, run stairs) to rapidly raise heart rate, then stop to get a calming drop in arousal.
- Shireen Rizvi taught this live with group jumping jacks as an example.
