5 min

TIPP Skills for Distress Tolerance

Rapid physiological techniques to lower extreme emotional arousal and prevent crisis behavior.

Crisis & Safety
Beginner
5 min

TIPP skills are high-speed 'reset buttons' for your nervous system. In Dialectical Behavior Therapy (DBT), these skills are used when emotional pain is so intense (8/10 or higher) that cognitive tools like 'challenging thoughts' simply won't work because the logical part of the brain has gone offline.

The acronym stands for Temperature, Intense Exercise, Paced Breathing, and Paired Muscle Relaxation. Each of these techniques leverages your body's biology to force a change in your emotional state.

For example, using cold water (Temperature) triggers the Mammalian Dive Reflex, which naturally slows your heart rate and redirects blood flow to the brain and heart. These skills don't solve the original problem, but they 'bring you back down' so that you are regulated enough to use other coping tools.

TIPP Skills for Distress Tolerance

TIPP Skills for Distress Tolerance

Rapid physiological techniques to lower extreme emotional arousal and prevent crisis behavior.

When to Use

  • During an acute crisis or overwhelming emotional surge
  • When you feel an impulsive urge to engage in harmful behavior
  • When your distress is so high that you cannot think straight
  • To physically reset your system after a traumatic trigger

How to Use

  1. 1
    T (Temperature): Use cold water or an ice pack on your face for 30 seconds.
  2. 2
    I (Intense Exercise): Engage in 20 minutes of high-intensity movement like jumping jacks.
  3. 3
    P (Paced Breathing): Slow your breath to 5-7 breaths per minute (exhale longer than inhale).
  4. 4
    P (Paired Muscle Relaxation): Tense and then release muscle groups in sync with your breath.
  5. 5
    Observe the shift: Notice how your heart rate and internal 'speed' decrease.
  6. 6
    Follow up: Once you are calmer, use a cognitive or problem-solving skill.

Research & References

  • Linehan, M. M. (2014). DBT Skills Training Manual. Guilford Press.