How to Use The Physiological Sigh for Distress Tolerance in DBT

Stress is an inevitable guest in all of our lives, and sometimes it overstays its welcome. Amidst the myriad of strategies to counter this uninvited visitor, there's one that stands out for its simplicity and immediate effect: the physiological sigh. This technique, popularized by neuroscientist Andrew Huberman, intersects beautifully with the principles of Dialectical Behavior Therapy (DBT), offering a bridge between physiological response and emotional regulation.

The Physiological Sigh and DBT

DBT, a therapy designed to help people navigate emotional dysregulation, emphasizes the importance of mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. At the heart of DBT is the idea that understanding and acceptance can coexist with change. The physiological sigh, a simple breathing exercise, aligns with this philosophy by offering an immediate method to regulate emotions and reduce stress without needing to step away from the triggering situation.

Andrew Huberman explains, "Billions of people suffer from stress...The best way that I am aware to do that is called the physiological sigh" (Huberman). This breathing pattern, consisting of two inhales followed by an extended exhale, was discovered in the 1930s as a natural response to high carbon dioxide levels in the bloodstream, indicative of stress or discomfort.

The Physiological Sigh in Three Simple Steps

Implementing the physiological sigh is straightforward and can be seamlessly incorporated into DBT practices, particularly during moments of heightened stress or anxiety. Here's how you can do it:

1. Begin with a Double Inhale: Take a deep inhale through your nose, filling your lungs. Before exhaling, take a second, shorter inhale on top of the first. This process is crucial as it reinflates any collapsed alveoli (tiny air sacs in the lungs), enhancing oxygen intake and carbon dioxide expulsion.
2. Follow with a Long, Extended Exhale: After your double inhale, exhale slowly and fully through your mouth. This extended exhale facilitates the reduction of carbon dioxide levels, signaling to your brain that it's time to relax.
3. Repeat if Necessary: While one physiological sigh can significantly impact, you may repeat the cycle one to three times as needed to feel more calm and centered.

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The Contextual Application of the Physiological Sigh in DBT

In DBT, the physiological sigh can be an invaluable tool for the distress tolerance module, which focuses on managing intense emotional situations without resorting to self-destructive behaviors. Huberman notes, "anytime you're feeling too stressed and you want to feel more calm...just one or two, maybe three physiological sighs are sufficient to bring your level of stress and alertness down very fast" (Huberman). This rapid reduction in stress levels allows individuals to stay present in challenging situations, providing the space to apply further DBT skills such as mindfulness.

The beauty of the physiological sigh lies in its simplicity and efficacy, making it a perfect complement to DBT practices. By bridging physiological responses with emotional regulation strategies, you gain a quick and effective method to manage stress in real-time. Remember, in the journey toward emotional wellbeing, sometimes a deep breath is all it takes to take the first step forward.