What does TIPP stand for?

TIPP is a DBT distress-tolerance skill: Temperature (cold water on the face triggering the mammalian dive reflex), Intense exercise (60 seconds of all-out effort to burn off stress hormones), Paced breathing (slow exhales longer than inhales to activate the parasympathetic system), and Paired muscle relaxation (tense-and-release to discharge held tension).

When should TIPP be used?

TIPP is designed for crisis-level distress (7–10/10 on the SUDS scale) when the emotion is too high to think clearly or use other skills. It changes body chemistry fast — typically bringing arousal down within 60–90 seconds — which then makes other DBT skills accessible.

Is TIPP safe for everyone?

TIPP has real contraindications. Cold-water Temperature can be dangerous for people with cardiac conditions, eating disorders (bradycardia risk), or a history of cold-water fainting. Intense exercise is contraindicated in pregnancy complications, cardiac disease, or certain injuries. Always screen medically before teaching the Temperature and Intense-exercise steps; Paced breathing and Paired muscle are safe for nearly everyone.

Marsha Linehan developed TIPP as part of Dialectical Behavior Therapy (DBT) in the 1990s. It sits inside the Distress Tolerance module — specifically the crisis-survival skills — alongside STOP, ACCEPTS, and Self-soothe.

How is TIPP different from grounding?

Grounding (like 5-4-3-2-1) works through attention and orientation. TIPP works through direct physiology — it changes heart rate, blood chemistry, and muscle tension. Use TIPP when arousal is too high for cognitive skills; move to grounding once the body has come down enough to focus.

TIPP Skill (DBT) — Free Guided Crisis Timer

Temperature · Intense exercise · Paced breathing · Paired muscle

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TIPP skills: how to calm down fast when emotions are too big

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