The call ended twenty minutes ago and your hands still aren’t steady. You’ve read the same line of the same email four times and none of it has gone in.
Whatever you are supposed to do next, you can’t get to it, because the part of you that works things out has stopped answering.
The TIPP skills come from dialectical behaviour therapy (DBT), and they are built for exactly this: bringing extreme emotional arousal down quickly, when it is running too high for anything else to reach you.
Rather than asking you to reason your way anywhere, these distress tolerance skills suggest changing something physical — your body temperature, your movement, your breath, the tension in your muscles — and let your mind follow. There are four of them, they work in minutes rather than hours.
What TIPP Skills Can and Cannot Do
TIPP skills work on your body, not on your situation.
That lands two ways. It can sound like a trick, a way of feeling better about something that hasn’t changed. It can also sound too easy, as though a bowl of cold water could hold its own against whatever has actually happened. Both critiques are fair.
The answer to both is the same. When arousal gets extreme enough, you end up in what DBT calls “emotion mind” — a state where feeling rather than judgement is making the decisions. No amount of reasoning brings sound judgement back while you are there, because reasoning is the thing that has gone. Changing your physical state is what helps return it.
These are commonly called the TIPP skills (spelled TIP in the actual literature). It is an abbreviation for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation. Reach for them when a distressing emotion is very strong, or when the urge to do something damaging is.
This skill pairs really well with the STOP skill.
Temperature: Why Cold Water on the Face Works
Fill a bowl with cold water, cold but no colder than about 10°C. Hold your breath and put your face in it for around 30 seconds.
If your tap doesn’t run cold enough, or a bowl isn’t practical, a cold pack or a sealed bag of cold water held against your eyes and upper cheeks does the same job.
What this sets off is called the dive response. Cold on the face plus a held breath is the combination your body reads as being underwater, and it responds accordingly: your heart slows, and blood flow to the organs that can manage without it for a moment is reduced, so that more of it reaches your brain and heart.
It can take 15-30 seconds to begin, and it works best when you are sitting quietly, as moving about or keeping busy makes it less effective.
Intense Exercise: Even for a Minute
Run, walk fast, jump, lift something heavy. It doesn’t have to go on for long.
A strong emotion revs the body up. It readies you to do something — to run, to fight, to get out of there — and that readiness is stored physical energy waiting to be spent.
When the thing your body is prepared for never arrives, the energy stays where it is, which is part of why a difficult hour can leave you restless and unable to settle long after the moment that caused it.
Intense exercise channels that energy constructively and gives it somewhere to go.
Doing jumping jacks in your kitchen at eleven at night can look comically undignified. It is also, at eleven at night, one of the few things still available to you.
Paced Breathing & Paired Muscle Relaxation: Two TIPP Skills You Can Use Anywhere
These last two TIPP skills need nothing else apart from yourself. They can be done at a desk, on a bus, or beside someone who has no idea you are doing them.
Paced breathing is breathing deep into your belly and slowing the whole thing right down, so that you are breathing out for longer than you are breathing in. 5 seconds in and 7 seconds out is a workable rhythm, so is 4 seconds in and 6 seconds out or 6 seconds in and 8 seconds out.
Paired muscle relaxation is pairing that same breathing with your muscles joining in. As you breathe in, tense your body (for example, clench your fists) — firmly, though not so much as to cramp. Notice how the tension feels. As you breathe out, say the word relax to yourself, and let all of it go (following the same example, relax your tensed fists). Then notice the difference.
What these two TIPP skills are doing is slower, fundamental, and powerful: your breath is one of the few parts of your body’s alarm system that you can work by hand.
What Happens After the Arousal Drops
Once one of these skills works, your heart rate comes down, the pressure behind your eyes eases, and you can think again. The situation is exactly where you left it.
That is the design. TIPP doesn’t decide anything for you. It hands you back the capacity to decide. What you do with it is a separate question, though one you are now in a position to answer rather than react to.
The effect of a TIPP skill may not hold up long. Fast relief tends to be temporary, and a hard evening can send you back up twenty minutes later. Doing it again is not a sign that you have done it wrong; it is how the skill is meant to be used. You can also mix and match different skills to find what works best for you, which may also change as per the situation.
If you find yourself reaching for a TIPP skill most days, that is worth attending to.
It says something about what is sitting underneath, rather than proving the skills are doing their job. They also won’t suit everyone equally, and if one of them does nothing for you, that doesn’t mean you’ve failed at using it.
Your body is with you when your reasoning isn’t. Using TIPP skills is not an admission that you couldn’t think your way out of something; it is taking a better and surer route.
When you want to look at what sits underneath moments like these and emotional coping tools beyond distress tolerance, we’re always just a call away!