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Medically Reviewed by
Cimone Safilian-Hanif, PhD in International Psychology, on February 11, 2024


The last exercise for distress tolerance is the TIPP technique. This technique is another method that you can use to cope with overwhelming emotions and reduce distress in the moment. TIPP is a skill that can help prevent impulsive or harmful behaviors and is used as a first-line intervention during times of crisis or extreme distress.

If you feel a strong wave coming all over you and you don't know how to deal with it, this technique will help you. Usually, when people find themselves in situations like this, their ability to think clearly is diminished - you are not centered in your wise mind, but in your emotional mind. TIPP is an acronym that stands for the following four steps: temperature, intense exercise, paced breathing, progressive muscle relaxation.

It's important to note that TIPP is not a long-term solution, but rather a temporary tool to help you navigate acute or overwhelming distress. Each component of TIPP serves a specific purpose in helping individuals shift their emotional state and reduce distress.

DBT Distress Tolerance: TIPP
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Practice each of these techniques, so you know what they feel like. Then use them, when you feel overwhelming emotion and you feel like you need them.

T: Temperature

Similar to one of the previous techniques that we worked on, the first steps works by changing the temperature.

Cooler temperatures decrease your heart rate (which is usually faster when we are emotionally overwhelmed). You can either splash your face with cold water, take a cold (but not too cold) shower, or if the weather outside is chilly you can go outside for a walk. Another idea is to take an ice cube and hold it in your hand or rub your face with it.

Higher temperatures increase your heart rate (which is usually lower when you feel depressed, sad, or anxious). You can take a hot bath, nestle up in a blanket, go outside on a hot day, or drinking a warm tea.

Note, be smart about it. You don’t need to go full Wim Hof. Cold exposure can make your blood pressure drop, and heat exposure can raise your blood pressure. If you have a medical condition where this could be a problem, skip this step or consult your physician.

I Intense Exercise

When you have a built-up energy as a result of experiencing overwhelming emotions, it can be a really good idea to spend this energy by doing a cardio work-out. It doesn't have to be anything fancy - you don't need special equipment or expensive membership in a gym. Simply get on your feet and do one of the following: go for a run around the block, do jumping jacks in your room, go outside and walk fast. You can also try jumping rope, dancing or lifting weights (if you already have them). Do this for 10-15 minutes but don't overdo it. When you spend that conserved energy you will feel more tired and your overwhelming emotions will become more balanced.

P: Paced Breathing

In order to reduce the physical manifestation of the overwhelming emotions you feel (for e.g. increased heart rate, flushed face, dry mouth, sweating etc.) it helps to try to control your breathing so that its rate will eventually decrease. Try the following technique: breathe in deeply through your nose (abdominal breathing) for four seconds and then breathe out through your mouth (for six seconds). Do this for 1-2 minutes.

P Progressive Muscle Relaxation

In order to relax the tense muscles in our body while we are experiencing extreme emotions, you can try progressive muscle relaxation. You can do this from a seated position. Start with the top of your body - become aware of your muscles and the upper back and deliberately tighten them for five seconds. Then let go - you should feel the region loosening up. Keep doing this with your arms, your abdominal and back muscles, your bottom muscles, thighs and upper legs and calves. This is a great way for your body to let go of the excessive energy that has built up with the overwhelming emotions.


Situation: "Today when I woke up, I felt very empty and down. It didn't help that the weather has been dull for days now. All of this reminded me how 2 years ago, this time of the year, I was feeling very depressed and was coping with the dysfunctional relationship I have with my father. This memory made me spiral down, and in no time I didn't want to go on with my day, finish the work responsibilities that I have, or do anything. As the morning went on I felt even more depressed and empty."

T - Temperature: I chose to have a hot bath, something that will make me feel warmer, both physically and potentially emotionally as well. It felt like an act of self-kindness, and it really did help me not to fall even more into this sad memory lane.

I - Intense exercise: I put on some music since I could use having a little fun time, and I put the effort to get my muscles going and dance. I did this for 10 minutes, and I felt more energized after.

P - Paced breathing: I did two minutes of the paced breathing technique.

P - Progressive muscle relaxation: By step four, I already felt better doing the previous three. Nevertheless, I sat comfortably and did the progressive muscle relaxation instructions. I feel like the TIPP technique really helped me not to feel more empty and depressed, and I went on with my day.

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Do I need to do all the steps from the TIPP technique?

In some cases, you may feel better even after doing the first ones. This is a great sign because it means that the technique is working for you. However, if you have the time, you should do all the steps so that you will maximize the effect. Also, you will probably need around 30 minutes to do all the steps - which is not that long.

When I'm overwhelmed with emotions, I don't feel like doing this is something useful. How do I motivate myself to try this technique?

The key is to first consider and practice this technique when you're not overwhelmed with emotions. First, prepare and make a plan that you will try this exercise next time when you are emotionally overwhelmed since it might save you a lot of unnecessary spent energy. At first, it might seem like perhaps it's a lot of effort, but when you compare how much energy you would spend suffering from the negative overwhelming emotions, it usually seems like a good investment to try and do this technique next time you are experiencing an emotional crisis.

I get very hyped when I do cardio work-out, and I'm not sure that this will balance my overwhelming emotions.

Make sure that you don't overdo the activities from any of the steps. When we work out, we get a natural release of the hormone dopamine, which is responsible for elevating your mood. This technique is meant to help you take care of yourself when you are in an emotional crisis, so keep that in mind and try to do this exercise in a way that best suits you.

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If you have any behavioral health questions or concerns, please talk to your healthcare or mental health care provider. This article is supported by peer-reviewed research and information drawn from behavioral health societies and governmental agencies. However, it is not a substitute for professional behavioral health advice, diagnosis, or treatment.

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Comments About TIPP

  1. The DBT information on this website has been so helpful. Resources like this are needed by many people who can’t afford to see a therapist and aren’t easy to come by. God bless you for making this!

  2. Hi, I really like your website. I have been printing out the worksheets and doing all the exercises. Your help is much appreciated.

  3. As a person with anxiety, I can’t tell you how many times people hand me the solution of deep breathing. As ridiculous as it seems to me after dozens people telling me, it always helps.

  4. This hasn’t helped me @ all in fact it made me worse, I had to go to the Dr to get me some quick acting anti anxiety drug to help.
    When you are in Church you can’t put your face in cold water how silly.

  5. Hey, I am an assistant psychologist with a background in sports science. Sometimes all of the TIPP methods won’t be available or work for you. My advice would be to focus on the ones you can. If you are in Church and you haven’t got cold water available you can still do the breathing PT1.

  6. PT2. Further you can do muscle relaxation exercises and you could actually use the Church toilet facilities to splash your face with cold water or run your hands under the tap. Exercise may not work for everyone as your heart rate increasing may cause your body to think it is more anxious.

  7. So many thanks to you for making this website available to all.
    I am very grateful for the information on this website.

  8. These are skills, not end all and be all. Panic is horrible. Experiment and find what works for you and find ways to disengage from Panic being your threat.

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