TIPP Skills

Definition

TIPP skills are crisis survival techniques from Dialectical Behaviour Therapy (DBT) designed to quickly change your body chemistry when you're experiencing intense emotional distress.

These skills help you rapidly reduce overwhelming emotions by targeting your body's physiological response, giving you space to think more clearly and make better decisions during crisis moments.

What TIPP Stands For

The TIPP Acronym

T: Temperature - Change your body temperature to shift your emotional state

I: Intense Exercise - Use vigorous physical activity to burn off stress chemicals

P: Paced Breathing - Slow your breathing to activate your body's relaxation response

P: Progressive Muscle Relaxation - Systematically tense and release muscle groups

When You Need TIPP Skills

Crisis Situations

You can use TIPP skills when your emotions feel overwhelming and out of control, you're having thoughts of self-harm or suicide, you feel like you might act impulsively in ways you'll regret, your anxiety or panic feels unbearable, or you're so angry you might say or do something destructive.

The Goal of TIPP

These skills aren't meant to solve your problems or eliminate all distress. Instead, they help you survive crisis moments safely so you can address underlying issues when you're in a better state to think clearly.

Temperature (T)

How Temperature Changes Help

When you change your body temperature, you activate your body's "dive response," which quickly slows your heart rate and helps you feel calmer.

This is one of the fastest ways to reduce intense emotions.

Ways to Use Temperature

You can hold ice cubes in your hands or against your temples, splash cold water on your face, take a cold shower, hold a bag of frozen vegetables, drink ice water, or step outside in cold weather.

Safety Considerations

Make sure the temperature change is intense enough to be effective but not so extreme that you harm yourself.

The goal is to create a strong sensation that shifts your body's response.

Intense Exercise (I)

How Exercise Helps in Crisis

When you're in emotional crisis, your body is flooded with stress chemicals. Intense exercise helps burn off these chemicals and releases endorphins that improve your mood and help you feel more stable.

Effective Exercise Options

You can try running or jogging, doing jumping jacks or burpees, dancing vigorously, doing push-ups or sit-ups, climbing stairs repeatedly, or any other activity that gets your heart rate up significantly.

Duration and Intensity

Aim for 10-20 minutes of intense activity, or until you feel your emotional intensity decrease.

The exercise should be vigorous enough that you're breathing hard and your heart rate increases noticeably.

Paced Breathing (P)

How Breathing Affects Emotions

Your breathing pattern directly affects your nervous system. When you slow your breathing and make your exhale longer than your inhale, you activate your body's relaxation response and help calm intense emotions.

Effective Breathing Techniques

You can try breathing in for 4 counts and out for 6 counts, breathing in for 3 counts and out for 5 counts, or any pattern where your exhale is longer than your inhale.

Focus on breathing from your diaphragm rather than your chest.

Making It Work for You

Find a breathing pattern that feels comfortable and sustainable.

Some people prefer counting, while others prefer visualising their breath or using guided breathing apps.

Progressive Muscle Relaxation (P)

How Muscle Relaxation Helps

When you're emotionally distressed, your muscles often tense up, which can increase your emotional intensity. Progressive muscle relaxation helps you release physical tension, which can help reduce emotional tension as well.

Basic Technique

You can start with your toes and work up to your head, tensing each muscle group for 5-10 seconds, then releasing and noticing the contrast between tension and relaxation.

Focus on major muscle groups like your feet, legs, abdomen, arms, and face.

Quick Version for Crisis

When you're in crisis, you might not have time for a full progressive muscle relaxation.

You can focus on the areas where you hold the most tension, such as your shoulders, jaw, or hands.

Research and Evidence

What Studies Show

Research demonstrates that TIPP skills effectively reduce acute emotional distress, help prevent impulsive behaviours during crisis, provide rapid relief that allows for better decision-making, and support overall emotional regulation when used consistently.

Using TIPP Skills Effectively

Choosing the Right Skill

Different TIPP skills work better for different people and situations.

You might find that temperature works best for panic, exercise works best for anger, breathing works best for anxiety, or muscle relaxation works best for general overwhelm.

Combining Skills

You can use multiple TIPP skills together for greater effectiveness.

For example, you might start with cold water on your face, then do some intense exercise, followed by paced breathing.

Practice When Calm

Like all crisis skills, TIPP techniques work better when you've practised them during calm moments.

This helps you remember them and use them more effectively when you're actually in crisis.

Common Challenges and Solutions

When Skills Don't Work Immediately

Remember that TIPP skills are designed to reduce emotional intensity, not eliminate all distress. If one skill doesn't help, try another, or combine multiple skills for greater effect.

Physical Limitations

If you have physical limitations that prevent you from using certain TIPP skills, you can adapt them to your abilities or focus on the skills that work best for your situation.

Scepticism About Effectiveness

It's normal to feel sceptical about these skills, especially if you're used to more complex coping strategies.

Give them a genuine try during less intense moments first, so you can experience their effectiveness.

Building Your TIPP Skills Toolkit

Identifying Your Preferences

Notice which TIPP skills feel most natural and effective for you, consider your living situation and what's practical to use, think about which skills you can use in different settings (home, work, public), and prepare materials you might need (ice, exercise equipment, etc.).

Creating Crisis Plans

Write down your preferred TIPP skills when you're calm, keep the list somewhere easily accessible, share your plan with trusted people who might help during a crisis, and practice using your chosen skills regularly.

Cultural and Personal Considerations

Individual Differences

Your most effective TIPP skills might vary based on your physical health, cultural background, living situation, personal preferences, and past experiences with these types of interventions.

Accessibility and Adaptation

You can modify TIPP skills to work within your circumstances, whether that means finding alternatives to cold water, adapting exercises for physical limitations, or using breathing techniques that work with your lung capacity.

Professional Applications

If You're Receiving Treatment

Your therapist should teach you TIPP skills systematically, help you practice them in session, assist you in identifying which skills work best for you, and support you in creating personalised crisis plans.

For Mental Health Professionals

When teaching TIPP skills, you should demonstrate techniques in session, help clients practice during calm moments, address any concerns or resistance, and help clients adapt skills to their unique circumstances.

Relationship to Other DBT Skills

Integration with Other Modules

Distress tolerance: TIPP skills are part of the broader distress tolerance toolkit

Emotion regulation: These skills provide quick relief that supports longer-term emotion regulation

Mindfulness: Present-moment awareness helps you recognise when you need TIPP skills

Interpersonal effectiveness: Using TIPP skills can help you communicate more effectively during conflict

Your TIPP Skills Plan

Assessment and Preparation

Identify which types of emotional crisis you experience most often, determine which TIPP skills are most practical for your lifestyle, gather any materials you might need, and practice skills during calm moments.

Emergency Implementation

Create a plan for accessing TIPP skills during a crisis, including where you'll keep your crisis plan, how you'll remember to use these skills when distressed, and who might help remind you or support you in using them.

Moving Forward

Building Confidence

As you practice TIPP skills and experience their effectiveness, you'll likely feel more confident in your ability to handle emotional crises.

This increased confidence can actually help prevent some crises from becoming as intense.

Long-term Benefits

Regular use of TIPP skills often leads to faster recovery from emotional distress, increased confidence in crisis management, reduced fear of intense emotions, and better overall emotional regulation.

Conclusion

TIPP skills provide you with rapid, effective tools for managing emotional crises by working directly with your body's physiological responses.

These skills help you survive difficult moments safely so you can address underlying issues when you're better able to think clearly and make good decisions.

References

McLean Hospital. (n.d.). Practical DBT strategies & techniques. https://www.mcleanhospital.org/dbt-strategies