Top Skills Thursday: T.I.P.P.

T.I.P. is an acronym used in DBT therapy and stands for

  • Temperature
  • Intense Exercise
  • Paced Breathing
  • Paired Muscle Relaxation

Specifically, TIP is used in distress tolerance. It’s for those times when everything is overwhelming and emotion is taking off with you. I’ve had to use it myself a few times since COVID-19 hit the US. Here’s how it works.


A shift in body temperature will also shift the response you’re experiencing. Gauge whether you feel hot or cold. If you feel hot, get an ice pack (a bag of frozen veggies or even a slice of frozen meat will work if you’re out of ice – and the meat will defrost so you’ll have dinner out, so bonus!) If you feel cold, wrap in a warm blanket, get a heating pad (careful, don’t burn yourself), a cup of hot tea/water, or a hot water bottle.

Place it across the back of your neck, between your wrists, or over your stomach. Once it’s in place, just breathe deeply a few times. The impact should be quickly noticeable.

Intense Exercise

While we may not be able to take off to a gym right now, there are ways to put in a few minutes of intense exercise in your home. Of course, please consider your own health and physical capabilities when deciding what to do.

Around the house, if you are like me and don’t have a home gym, there are things that have weight, so yes, you can lift. One gallon of water is 8.34 lbs. (US). Wash out an empty milk jug, drop in a cap of bleach to prevent mold from growing, fill the jug and seal it. Instant weight! One cup of uncooked rice is usually about 7 ounces, so two cups is almost a pound (16 oz). If you can’t do a gallon jug, try a sealed bag with dry rice. Lift these a few times.

If you have a stairwell and are able, you can exercise there. Step up two stairs and down one, and then repeat until you reach the top. I promise that’ll be a workout.

Even a walk, as opposed to sitting, counts. Just keep your distance from others if you use this option right now.

Paced Breathing

I did a post on breathing exercises not long ago. Review it and use those counted breaths to slow your heart rate, your breathing, and increase your oxygen levels.

Paired Muscle Relaxation

This one is designed to make your muscles relax and increase blood flow through your body. It’s very simple to do, anywhere you go.

For this piece, simply tighten and hold a group of muscles on both sides of your body. Count to five and keeeeeeeeep tightening. Then let go. Wait 5 seconds and do it again if you need. Then if you’re still needing it, use a different group.

The way I do it is hands, back, thighs. If I am somewhere no one can see me, I make the best fists I can make. If others are around, I press my shoulders back as if I’m stretching. If I’m in a crowded place and sitting, I tighten the top of my thighs. It’s all very covert, and I can’t think of a single time anyone has noticed what I was doing.

At any time, when feeling overwhelmed or distressed by any situation, these four practices can help you defuse things enough to get yourself some mental space. Practice them when you’re not feeling distressed so they become easier when you do. Also, especially with most of the world under some level of isolation, remember that feeling overwhelmed is absolutely normal. It’s going to happen. Accept that you’re only human and don’t put yourself down by saying you “shouldn’t” feel a certain way. You feel however you feel. Just try to mitigate it so you don’t end up in a headspace you don’t want.

Be safe and healthy out there!




All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.

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