Distress Tolerance: TIPP Skills

Have you ever been so overwhelmed that you felt like no matter what coping mechanism you tried, nothing was effective? Sometimes we are beyond the point of being able to utilize emotion regulation skills. There are times when we are so escalated that we need something quick and accessible to bring us down from distress to dysregulation so we can effectively use soothing mechanisms.


This is where TIPP comes in. But what is TIPP? TIPP is a dialectical Behavioral Therapy distress tolerance skill. It is an acronym that stands for temperature, intense aerobic exercise, paced breathing, and progressive muscle relaxation. So, now that we know what TIPP is, how does it work?

T- Temperature

When we are overwhelmed and distressed, we need a shock to our system. Oftentimes, we feel overheated when experiencing distressing situations.Therefore, try using a cold compress on your forehead or holding ice in your hand to cool your body temperature down rapidly.

I – Intense Aerobic Exercise

When we feel anxious or stressed, our heart tends to beat faster. If we engage in intense aerobic exercise, that gives us somewhere to expel our tension and energy. It also tricks our brains into attributing our increased heart rate with exercise instead of distress, which is protective against additional stress. Be mindful of what your limits are and listen to your body while engaging in any sort of physical activity or movement.

P – Paced Breathing

The first “P” is paced breathing. This skill may work best in tandem with another part of TIP – though you can use all of them separately or in whichever order works best for you. Paced breathing can look a variety of ways. One common method is to inhale for a count of four, hold for four, and exhale for four. Allow your breathing to center you and serve as a focus point when your attention starts to wander and you feel anxiety creeping back up.

P- Progressive Muscle Relaxation

Start from the top of your head and slowly work your way down to your toes, squeezing each muscle group without straining. Hold the tension for as long as is comfortable (one count of five is recommended), then release. Slowly move down your body, focusing on one muscle group at a time. Tense and release the muscle in your forehead, then jaw, neck, shoulders, and so on. Release each one before moving onto the next.

TIPP skills are designed to be brief and fast-acting. They serve as a shock to your nervous system to allow you to move out of a distressed place and into a place from which other more long-lasting coping skills are accessible to utilize.

You may find one skill in particular becomes your go-to or perhaps you will find it useful to cycle through all four. Whatever system works for you, we hope TIPP serves as a helpful “tip” for you in times of distress and overwhelm.

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