So distressed you can't think straight? Lower the intensity with these 4 skills

Think about the last time you were distressed.How did you cope?Did you lash out at someone? Drink alcohol? Pretend like it never happened?There are healthier ways to deal with the pain.

"Those behaviors are the result of not knowing how to tolerate what feels intolerable," says Shireen Rizvi, a professor of psychiatry and behavioral sciences at Montefiore Medical Center."In those moments, we have to learn how to accept the distress and respond in a more effective way."She explains how to do just that in her book Real Skills for Real Life: A DBT Guide to Navigating Stress, Emotions, and Relationships, published earlier this year.

She and co-author Jesse Finkelstein, a clinical psychologist, use engaging diagrams and illustrations to teach skills rooted in dialectical behavior therapy (DBT), a form of therapy that helps people manage difficult emotions.There's a decision tree on how to use DBT skills to resolve conflict, for example, and an infographic on how to practice mindfulness.DBT was first developed by psychologist Marsha Linehan in the 1980s to treat borderline personality disorder.

Since then, many studies have shown that "DBT skills are helpful for lots of different people with many different types of problems," write Rizvi and Finkelstein in their book — not just for those with complex mental health issues.Rizvi, a board-certified DBT therapist, shares a set of techniques from her book called TIP.The acronym stands for temperature, intense exercise, paced breathing and paired muscle relaxation.You can use these four distinct skills in moments when you're so distressed that you can't think straight, she says.

For example, if you get in a big fight with your partner, or if you're dealing with a big life event like illness or death.TIP can quickly bring down the level of emotional intensity from extreme to moderate.They can "help you go from, say, a 100 to an 80 on a scale from zero to 100," Rizvi says.

Then when you're at an 80, you'll have more clarit...