TIPP
When your body is hijacked by a big emotion. It’s one of the DBT distress tolerance skills, and the skills picker can route a client here in the moment.
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Open the skills pickerWhat is TIPP?
TIPP is a DBT distress tolerance crisis-survival skill for bringing extreme emotional arousal down fast by changing your body chemistry. The letters stand for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation.
It works on the body, not the thoughts, which is the point: when arousal is so high you can’t think clearly, TIPP lowers the physiological storm enough that other skills become possible again. The Temperature step uses the mammalian dive reflex — cold on the face slows the heart rate.
When to reach for TIPP
When your body is hijacked by a big emotion.
A common misconception
TIPP is not a long-term coping strategy or a substitute for emotion regulation. It’s a fast circuit-breaker for moments of overwhelming arousal — minutes, not hours. Leaning on it instead of building emotion regulation skills misses its purpose. Safety note: the cold-water Temperature step can affect heart rate and isn’t appropriate for everyone, including some people with cardiac conditions or eating disorders — check with a clinician.
How to practice TIPP
- **Temperature** — cold water on your face for 30s, or hold an ice cube.The dive reflex slows your heart rate fast.
- **Intense exercise** — 20 jumping jacks, or run in place 2 min.Burns off adrenaline.
- **Paced breathing** — slow exhales, longer than inhales. 4 in, 8 out, for 2 min.
- **Paired muscle relaxation** — tense then release muscle groups from feet up.
TIPP in practice
A client is in a panic spiral — heart racing, can’t form a thought. They hold an ice pack to the face or splash cold water (Temperature), which drops the heart rate within seconds. That small physiological shift is often just enough to access STOP or a grounding skill that wasn’t reachable a moment earlier.
Related skills
Tracking TIPP on a diary card
Whether a client used TIPP — and whether it helped — is exactly what a DBT diary card captures. Recording skill use day by day is how you see, in session, whether distress tolerance skills are generalizing.
Track skill use for free
Build a custom diary card that tracks the skills you’re working on, or track it digitally in Theracharts.
Build a diary cardAll DBT skillsFAQ
What is TIPP in DBT?
TIPP is a DBT distress tolerance skill. When your body is hijacked by a big emotion.
When should I use TIPP?
Reach for TIPP when your body is hijacked by a big emotion.
How does cold water help with TIPP?
Cold on the face above the cheekbones triggers the mammalian dive reflex, which slows your heart rate and lowers physiological arousal quickly — buying you enough calm to think and use other skills.
When should I use TIPP?
Use TIPP when emotional arousal is so high that you can’t think or use any other skill. It’s a short-term tool to get you out of the red zone, not an everyday coping plan.
In crisis? Call or text 988 (Suicide & Crisis Lifeline, US) — free, confidential, 24/7. This page is educational and is not therapy, diagnosis, or a substitute for professional care.