Panic Attack Reset: Using Cold To Calm Your Body

This guided DBT Dive Skill uses cold water to help quickly reduce intense physiological arousal during a panic attack, anxiety, emotional overwhelm or acute distress.
Based on the DBT TIP skills, this body-based distress tolerance technique activates the dive reflex, helping slow the body’s stress response and support nervous system regulation when emotions feel overwhelming.

Transcript

Hi there. If you're experiencing panic or very intense emotions right now, I'm going to guide you to use cold water to help bring down the intensity in your body. My name's Alex, I'm a mental health social worker and a DBT therapist, And I'm going to guide you through this. So this skill that I'm going to teach you and guide you through is called the dive skill. And this is a key strategy that we use in dialectical behavioral therapy when distress is very high. And it's a very powerful skill that works very quickly to change your body chemistry and settle down an over activated nervous system. Now before we begin, You'll need a sink or a basin filled with cold tap water. Alternatively, You could get a bucket or a bowl and fill that up with cold tap water. If you haven't done that yet, Pause this recording now. Fill up your bathroom sink with cold water, And come back and press play when you're ready. Now, Before we start, A quick safety note. This practice involves putting your face into cold water while briefly holding your breath. And this changes our heart rate. It reduces our heart rate quickly. If you have a heart condition where dropping your heart rate suddenly may be problematic, Please check with your doctor before using this skill. You might like to choose my paced breathing or muscle tensing practice instead for now. Okay. Come to your sink and make sure you're in a comfortable position standing up. We're going to do something very simple. You're going to take a normal breath in, Hold your breath, And then place your face into the cold water, Immersing your face just up to your temples. You're going to hold your breath like this with your face in the water as long as you feel comfortable. When your body tells you you need to breathe, Simply lift your face out of the water and breathe normally. Okay, Ready to give it a go? Take a comfortable breath in, Hold your breath, And lower your face into the cold water now. And whenever you need to, Simply come back up. When you come back out of the water, Just breathe. No need to rush. Let your breathing return to normal. You might like to pat your face dry with a towel. And just take a moment to notice your body. You may notice quite a sudden change. You may feel your heart rate is different. Perhaps your attention has shifted. Perhaps the intensity has dropped slightly. Just notice. Now we're going to do this again. And remember, You get to decide how long you hold your breath for. Come up whenever you need to breathe. Ready? Take a comfortable breath in, Hold, And put your face into the cold water. And when you're ready, Come back up. And breathe normally. Give yourself a moment. Pat your face dry with your towel if you like. You can continue to do another round if you would like. Just following the same steps as before. This skill won't get rid of anxiety or distress altogether, But it is very powerful at reducing the intensity of it. You can also follow this skill with my paced breathing or my paired muscle exercise if you like. But if you feel that this skill has helped to take your intensity down, Noticing, Giving yourself credit for doing this very skillful thing. And perhaps practicing some self-soothing or some skillful distraction as a follow-up to this skill. Well done. You can come back to this video anytime you want to do this practice again. Thank you for practicing with me.