Music icon Lady Gaga is no stranger to opening up about her health struggles. In a new interview with Oprah Winfrey for Elle Magazine, Gaga not only shared for the first time that she struggled with self-harm — she also offered a surprising tip that helps her get through moments when she feels like hurting herself.

“I’ve actually not opened up very much about this, but I think it’s an important thing for people to know and hear: I was a cutter for a long time,” Gaga said, adding:

Though dunking your hands in ice water might sound a bit whacky, it’s actually a therapeutic technique from dialectical behavior therapy (DBT). Developed by Marsha Linehan, Ph.D., DBT is a type of therapy designed to help people who struggle with emotional regulation, self-harm or borderline personality disorder (BPD).

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DBT skills are broken up into four categories — mindfulness, distress tolerance, interpersonal effectiveness and emotion regulation. Gaga’s tip for thrusting your hands into a bowl of ice water is part of a distress tolerance skill known by the acronym, TIPP. Below, you can see what TIPP stands for:

T – Temperature

I – Intense Exercise

P – Paced Breathing

P – Paired Muscle Relaxation

According to Sunrise Residential Treatment Center, when we’re upset, our bodies typically feel hot. By holding ice cubes or dunking your face in cold water, you can change your body temperature — helping you cool down physically and emotionally.

The other points of TIPP — engaging in intense exercise, focusing on the breath and muscle relaxation — can also help us de-escalate our emotional experiences in intense moments.

Gaga isn’t the only celebrity to have tried DBT distress tolerance skills. On an episode of Marc Maron’s “WTF” podcast in 2017, comedian Pete Davison (who lives with borderline personality disorder) shared DBT skills, like holding ice, help him through emotionally intense moments — even though it’s sometimes difficult for him to put the skills into practice. He said:

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In addition to discussing DBT, Gaga got candid with Oprah about the relationship between her past trauma history and fibromyalgia, a pain processing disorder in the central nervous system. Though more research needs to be done on the condition, some studies suggest early life trauma is a risk factor for developing fibromyalgia later in life.

“For me, my fibromyalgia and my trauma response kind of go hand in hand. The fibro for me is a lighter pain; the trauma response is much heavier,” Gaga explained. “It’s a recurring feeling. So I had a psychotic break at one point, and it was one of the worst things that’s ever happened to me.”

Related:​ To My Friend Who Attempted Suicide

When facing her recurring health challenges, Gaga turns to kindness as a way to cope. She told Oprah she believes this is what life is asking of all of us:

To learn more about DBT or fibromyalgia, check out the following stories from our Mighty community. To find a DBT therapist in your area, check out this DBT-certified therapist directory.

• These Might Be the 5 Weirdest Therapy Skills, but Here’s Why They Work

• How Dialectical Behavior Therapy Saved Me

• What Is Fibromyalgia?

• If You Feel ‘Too Emotional’ (or Not Emotional Enough), Here’s a Skill You Need

Have you tried this skill?

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