TIPP: A DBT Skill for Distress Tolerance

In our blog post on Intro to Dialectical Behavior Therapy (DBT), we mentioned the distress tolerance module. Distress tolerance is your ability to tolerate, or withstand, distress. Think of being able to handle stressful situations with a calm mind. Distress tolerance skills might be helpful if you experience anxiety, panic, or discomfort to the point where you're unable to navigate your circumstances with intention.

One distress tolerance skill is the TIPP skill, which gives options for regulation.

TIPP stands for:

• Temperature

  • Cool down with some cold water on your skin or face

  • Hold something cold, like an ice pack

  • Why does this work? Your body temperature can rise when feeling distress. Cooling down can teach your body that it's safe to lower your heart rate and relax.

• Intense exercise

  • Do whatever exercise is accessible for you (e.g. jumping jacks, leg raises, etc.)

  • Why does it work? Experiencing distress can build up energy in your body as it gets ready to engage with "danger." Exercise can release this energy and adrenaline, allowing you to feel more regulated afterwards.

• Paced breathing

  • Do a breathing exercise, like square breathing, or simply recognize the pace of your breath and slow it down.

  • Why does this work? Similar to your temperature, you might hold your breath or experience quick inhales and exhales when experiencing distress. Slowing down your breath is often paired with your heart rate slowing down, and your body relaxing.

• Paired muscle relaxation

  • There are many guided progressive muscle relaxation meditations available, or you can practice yourself! Inhale while tensing a part of your body, hold it for a few seconds, then exhale while releasing. Do this across various parts of your body.

  • Why does this work? You're manually releasing tension throughout your body!

Using TIPP allows you to regulate and engage with the distressing event with a clear mind. These skills are important to help you tolerate distress, not to solve your distress.