How DBT Uses the Nervous System to Help Regulate Anxiety
Dialectical Behavior Therapy (DBT) is a powerful and research-backed therapy modality that helps individuals manage anxiety by working with both the mind and the body. Rooted in mindfulness and neuroscience, DBT offers practical tools to regulate intense emotions, navigate crisis moments, and ground us in the present moment.
But what makes DBT especially effective for anxiety? It taps into the nervous system—specifically, the parts responsible for stress, panic, and calm. Understanding this connection can empower you to take control of anxiety in a body-based, somatic way.
Understanding the Nervous System and Anxiety
To get into the science of things, your nervous system is composed of two main parts: the central nervous system (CNS) and the peripheral nervous system (PNS). Within the peripheral system lies the somatic nervous system and the autonomic nervous system. The autonomic nervous system, and our focus for this article, regulates vital involuntary body functions like heart rate, breathing, and digestion—without us even thinking about it.
The autonomic nervous system is further split into:
The Sympathetic Nervous System (SNS): Activates the body's "fight-or-flight" response.
The Parasympathetic Nervous System (PNS): Calms the body back down into a state of “rest and digest.”
Note: To help remember which is which, you can associate parasympathetic with parachute, gently bringing you back down.
When our SNS is activated, we experience things like an increased heart rate, sweating, dilated pupils, muscle tension, and an increase in adrenaline. These are all normal and healthy responses. However when the SNS becomes overactive, it can lead to chronic anxiety and panic attacks. That’s where DBT steps in—with skills designed to manually activate the PNS and help restore balance to the body.
Regulating Anxiety with the DBT TIPP Skill
In our previous blog about DBT, we introduced one of the most effective distress tolerance tools for calming the nervous system: the TIPP skill. TIPP is a short-term distress tolerance technique designed to help your body and brain come back to baseline when emotions become overwhelming. This means it is a good skill to use when you feel past the point of using your typical coping skills. After you use the TIPP skill to deescalate yourself emotionally, try using another coping skill once you feel ready.
TIPP stands for:
Temperature
Intense Exercise
Paced Breathing
Paired Muscle Relaxation
Let’s break each one down and explore how they help regulate the nervous system:
1. Temperature: Activate the Diving Reflex
When you cool your face or body rapidly, you can trigger something called the diving reflex—a built-in survival mechanism that activates the vagus nerve, slowing down your heart rate and and restricting blood flow to conserve oxygen. All air-breathing vertebrates have this reflex to help conserve energy when submerged in water!
How to do it:
Submerge your face in cold water for 15–30 seconds
Place a cold towel or ice pack on your face (focus on cheeks and eyes)
Hold your breath during the exercise for deeper PNS activation
2. Intense Exercise: Burn Off Excess Adrenaline
High-intensity movement helps release adrenaline and naturally transitions the body into a state of calm. It’s a healthy way to use up the energy from an activated SNS and invite the PNS to take over.
Suggestions:
Jumping jacks or a run
Dancing, biking, or brisk walking
Any movement that you enjoy that gets your heart pumping for 10–15 minutes
3. Paced Breathing: Soothe Your System Through the Breath
Slowing and structuring your breath directly impacts the nervous system. Deep breathing helps lower cortisol levels, slow your heart rate, and bring your body into a state of rest.
Try:
Box Breathing: Inhale for 4 seconds, hold for 4, exhale for 4, hold for 4
Extended Exhales: Inhale for 4 seconds, exhale for 7 seconds
Breathe in through your nose and out through your mouth for best results
4. Paired Muscle Relaxation: Release Stored Tension
When we're anxious (and our SNS is active), our muscles tighten—often without us noticing, and it can sometimes be difficult to get them to relax. By pairing paced breathing with muscle tension and release, we teach our body to relax consciously.
How to do it:
Inhale and tense a muscle group (like your shoulders or fists)
Exhale and release the tension completely
Work your way through different muscle groups
You can find free guided videos for this technique online
DBT and the Mind-Body Connection
By understanding how DBT works with the nervous system, we can shift anxiety from feeling like a mental storm to a physical process we can interrupt. Activating the parasympathetic nervous system is a key way to reset, reduce panic symptoms, and reclaim a sense of safety and calm.
Whether you're in therapy or practicing DBT skills on your own, knowing how your body responds to anxiety gives you greater power to navigate it. The TIPP skill is just one of many DBT tools that offer real-time, body-based relief—and can be the first step in breaking the cycle of chronic stress and emotional overwhelm.
Looking for Holistic Anxiety Support?
At Reset Brain and Body, we offer DBT-informed therapy with a holistic and somatic approach. Our therapists help you explore mind-body tools that align with your unique nervous system and emotional patterns. If you're ready to manage anxiety with more intention, compassion, and clarity—we’re here to support you.
Contact us today to learn more or get started with one of our Reset therapists today.
