The Fizz


The Fizz is a tool used in Dialectical Behavioural Therapy (DBT), it is a structured, evidence-based form of therapy designed to help people who experience intense emotions, self-destructive behaviours, or interpersonal difficulties. It was developed by psychologist Dr. Marsha Linehan in the late 1980s, originally to treat individuals with Borderline Personality Disorder (BPD), but it's now used for a wide range of mental health challenges.  The Fizz is often used in combination with STOPP (found here ), a tool which can be used when we notice The Fizz. 

What is the "FIZZ"?

The "FIZZ" refers to the physical signs of emotion in your body that sometimes, can be overwhelming. Think of it like being a bottle of pop that's being shaken. It starts small, afew bubbles, but if we keep going and don't release the pressure safely, it might explode.  Its the same with our emotions, without coping skills, our emotions can build-up and explode, just like that bottle of pop. This can result in an unhelpful behaviour. When we talk about physical signs of emotion we mean:

  • Tense muscles
  • Body sweats
  • Dry mouth 
  • Racing thoughts
  • Eyes widen
  • Fast and shallow breath
  • Stomach pain
  • Rapid heart beat

These physical signs happen automatically in the body, they are not within our control however, if we can spot them early on, they are our indicators that something is happening, we are moving away from our calm, relaxed state to something else.  If we can build the skill of noticing when these are happening we have more choice about what we do next.

Using the FIZZ in Practice

  • Track it: Rate your FIZZ from 1–10 to build awareness.

  • Name it: "I feel my FIZZ rising—time to press pause."

  • Respond to it: Choose a skill that helps you cool down before reacting.

Spotting the FIZZ

Use this checklist to help recognize when the FIZZ is rising:

Physical Sign                                                         What It Might Feel Like
Tense muscles                                                       Shoulders tight, jaw clenched
Sweaty palms                                                         Damp hands, clammy skin
Dry mouth                                                              Hard to speak, throat feels tight
Racing thoughts                                                    "I can't stop thinking!"
Wide eyes                                                              Hyper-alert, scanning the room
Fast breathing                                                       Shallow, rapid breaths
Stomach discomfort                                              Nausea, butterflies, cramps
Pounding heart                                                      Heart racing, chest thumping 

To help you notice and name the signs and symptoms, print off the 'The Fizz' below and fill it in.  This helps you really tune in to what is going on in your body when a strong emotion is surfacing and possibly about to hijack you.  There are then a range of skills available to you to try and manage these emotions rather than being swept away by them, for example breathing, mindfulness.  Go to STOPP also which is often used alongside the Fizz

DOWNLOAD The Fizz.pdf