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TIPP Skills for Distress Tolerance

TIPP Skills for Distress Tolerance

TIPP is an acronym for Temperature, Intense Exercise, Paced Breathing, and Paired Muscle Relaxation.

Resetting the system

When the limbic (fight or flight) system is in a state of extreme arousal, it may be difficult for us to regulate our emotions. Similarly, when a computer is working so hard that it is overheating, it will eventually become overloaded and freeze. The only way to recover from this is to restart the system, thereby returning it to a working state.

In an extreme emotional crisis, TIPP skills are the fastest way that you can restart your body chemistry to return to a calmer state of mind. Again, this is similar to restarting a computer when nothing else works.

TIPP skills have rapid effects, typically taking only a few seconds to a few minutes, in soothing the limbic system and reducing emotional distress levels. They are simple to perform and can be practiced anywhere, including public settings. With regular practice, TIPP skills can evolve into a versatile coping technique that is accessible to anyone, regardless of where you are.

TIPP skills include:

1. Temperature with cold water

Cold water provides a shock to the system. If you are having difficulty regulating your emotions, splash cold water on your face, take a cold shower, or hold ice cubes in your hands.

These are tasks that will not hurt you, but the cold temperature will prevent you from remaining in an elevated emotional state.

2. Intense Exercise

Similar to cold temperatures, intense exercise changes the biochemistry of the system adaptively. During intense exercise, the heart rate is up and adrenaline is pumping. When adrenaline floods the system, it provides a euphoric feeling. Intense exercise is useful as it is difficult for us to feel distressed and elated simultaneously.

3. Paced Breathing

With paced breathing, inhale through your nose slowly for a count of two, hold the breath for three seconds, and then exhale slowly through your mouth for a count of five.

Paced breathing helps us regain a sense of control by controlling our most basic biological function: our breath. When you learn to breathe slowly and calmly, your blood pressure will lower, and you will feel more relaxed and less stressed. This can help address the effects of anxiety, insomnia, and fatigue, among other problems.

4. Paired Muscle Relaxation

In Paired Muscle Relaxation (PMR), a pair of muscles, such as the toes on both feet, are tensed while breathing in and then relaxed while breathing out. Work on the muscles in a particular order, from the top of the head to the feet or vice versa.

When the body is physically relaxed, it is difficult to be emotionally agitated.


The mind–body connection is very strong, so to calm the mind means to calm the body. PMR also teaches mindfulness of the body and self-awareness. 


TIPP skills are designed to work quickly and effectively in bringing down the intensity of emotions and helping you regain a sense of control.

They can be used in various situations, such as during moments of crisis, high emotional states, insomnia, anxiety, rumination, or to increase and energise mood during times of depression.

These skills are easily tailored and slightly alterable depending on your individual needs and can be practiced at home or in therapy sessions.

TIPP skills are part of distress tolerance techniques, which focus on calming the body and coping with distress. They can also be beneficial if you are coping with self-harm urges.

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