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Last updated on September 20, 2017 By MPGteam

Dialectical Behavior Therapy (DBT) Distress Tolerance Skills: TIPP Skills

Dialectical Behavior Therapy (DBT) focuses on teaching patients and families several strategies to help tolerate painful emotions and to manage difficult situations in the best way possible. We all face situations that are out of our control, that are difficult to tolerate, and that cause us to feel emotionally out of control. TIPP skills are made for just these types of situations and aim to help you regulate your emotions so that you are better able to think clearly and problem solve.

T stands for Tip The Temperature: In order to calm down quickly, try holding your breath and putting your face in a bowl of cold water or holding a cold pack on your eyes and cheeks for at least 30 seconds. This will cue your mammalian diving reflex which is a natural reflex that occurs in all mammals and is triggered in humans when our faces are submerged in cold water. The reflex causes our body chemistry to change—heart rate drops down immediately and the parasympathetic nervous system is activated to prompt a relaxation response. Make sure to keep water above 50 degrees Fahrenheit

I stands for Intense Exercise: Try to engage in intensive exercise, even if it’s only for a short amount of time. Exercising intensely will help your body get rid of negative energy that can sometimes be stored from strong emotions. Get rid of this energy by running, walking at a fast pace, doing jumping jacks, etc. Exercise naturally releases endorphins which will help combat any negative emotions like anger, anxiety, or sadness.

P stands for Paced Breathing: Another way to cue your parasympathetic nervous system is to breathe deeply into your stomach. Try to slow down the pace of your inhales and exhales (on average, five to six breaths per minute). It helps if you try to breathe out more slowly than you breathe in.

The last P in TIPP stands for Paired Muscle Relaxation: It can help if you add muscle relaxation to paced breathing. While breathing deeply and slowly, deeply tense each of your body muscles one by one. Notice this tension and then breathe out and let go of the tension by completely relaxing your muscles. Pay attention to the difference in your body as you tense and let go of each muscle group.

The TIPP skills may not work immediately, but with practice they can help to build up your ability to regulate strong emotions, manage difficult situations, and generally feel better. It can take some practice and in many cases it helps to work with a DBT therapist to ensure that you are engaging in the skills correctly. Part of DBT can include sessions to focus on breathing exercises and progressive muscle relaxation to help gain mastery of the skills.

Filed Under: Adult & Couples Therapy, Child & Adolescent Therapy, Parenting & Family Therapy

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