DBT Distress-Tolerance Skill
TIPP
What Is TIPP?
TIPP is a DBT crisis-survival skill used when emotional intensity is very high and you need to bring your body's level of arousal down before deciding what to do next.
TIPP stands for:
- T — Temperature
- I — Intense Exercise
- P — Paced Breathing
- P — Paired Muscle Relaxation
TIPP is primarily intended to change immediate physical arousal. It does not solve the situation that caused the emotion. Once intensity decreases, another skill may be needed to decide what to do next.
Try This Now
Start With Paced Breathing
- Pause and notice your current breathing.
- Inhale gently for about 4 seconds.
- Exhale slowly for about 6 seconds.
- Continue for approximately one minute.
- Notice whether the physical intensity has changed, even slightly.
If this is not enough, consider another appropriate TIPP strategy below.
The TIPP Skills
T — Temperature
A rapid change in temperature can provide strong physical input when emotional arousal is extremely high.
Safer everyday options include:
- Holding a cool pack against your face
- Splashing cool water on your face
- Running cool water over your hands
- Holding a cool object
The goal is a brief physical reset, not to cause pain or expose yourself to unsafe temperatures.
Safety: Extreme cold techniques may not be appropriate for everyone. Use extra caution or consult a healthcare professional if you have cardiovascular problems, circulation problems, cold sensitivity, fainting problems, or another medical condition that could make sudden temperature changes unsafe.
I — Intense Exercise
Brief physical activity can give the body a way to use some of the energy associated with intense emotional arousal.
Depending on your ability and health, examples may include:
- Fast walking
- Jogging
- Going up and down stairs
- Dancing
- Body-weight exercise
- Another safe activity that noticeably raises your activity level
Choose movement that is appropriate for your physical condition and environment.
If intense exercise is medically unsafe for you, use another TIPP strategy.
P — Paced Breathing
Intentionally slow your breathing and allow the exhale to be somewhat longer than the inhale.
One simple example is:
- Inhale for about 4 seconds
- Exhale for about 6 seconds
The exact count is less important than finding a comfortable, slow rhythm.
If you become dizzy or uncomfortable, return to normal breathing.
P — Paired Muscle Relaxation
Pair breathing with intentionally tensing and releasing muscle groups.
- Choose a muscle group.
- As you breathe in, gently tense those muscles.
- Notice the feeling of tension.
- As you breathe out, release the muscles completely.
- Notice the difference between tension and relaxation.
- Repeat with another muscle group if helpful.
Do not tense injured or painful areas.
When TIPP Can Be Useful
TIPP may be particularly useful when you notice:
- Very high emotional intensity
- A strong urge to react impulsively
- Panic or intense physical anxiety
- Difficulty thinking clearly because you are overwhelmed
- A need to lower physical arousal before using another skill
What Comes After TIPP?
TIPP is a crisis-survival strategy rather than a complete solution to the underlying problem.
Once your emotional intensity decreases, consider whether another strategy would be useful, such as:
- Wise Mind
- Check the Facts
- Problem Solving
- Opposite Action
- Pros and Cons
- Grounding
- Talking with a trusted person