DBT Distress
Tolerance: TIPP

THERAPEUTIC SUPPORT TOOLS

Four body-based skills for reducing emotional intensity
in moments of crisis

How This Tool Works

Most coping strategies work through thought - reframing, perspective-taking, problem-solving. TIPP is different. It works through physiology. When emotional intensity reaches a level where cognitive strategies stop working, the body itself becomes the lever.

The four TIPP skills - Temperature, Intense Exercise, Paced Breathing, and Progressive Muscle Relaxation - each act on the nervous system directly. Temperature activates the mammalian dive reflex. Intense exercise burns off stress hormones. Paced breathing shifts the body from sympathetic to parasympathetic activation. Muscle relaxation releases tension that emotion stores in the body. None of these require clear thinking to work. That is the point.

Leaders who encounter this tool often dismiss it initially. The exercises look too simple, too physical, too far from the boardroom. What changes after using one in a real crisis is the understanding that the body was already managing the situation - just not skillfully. The tracker on the following page builds the habit of deliberate skill use. Consistent practice shortens the time it takes for each skill to produce an effect.

How to Use This Reference Card

  1. Read through all four skills before you need them. Familiarity matters when you are in crisis.
  2. Identify which skill fits your situation: cold water for acute overwhelm, exercise for agitation, breathing for panic, muscle relaxation for body tension.
  3. Use one skill at a time. Complete it fully before assessing whether you need another.
  4. Log each practice on the tracker. Note which skill, what situation prompted it, and how effective it was on a 1-10 scale.
  5. Bring the tracker to your next session. Patterns in what works - and when - are worth exploring.
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TIPP Reference Card

T Temperature

Submerge your face in cold water (at least 50°F) for 30 seconds, or apply cold packs to your face and eyes. You can also hold ice in your hands. Hold your breath while your face is in the water.

Effect: Activates the dive reflex. Can reduce emotional intensity up to 40% within 30 seconds.
I Intense Exercise

20 minutes or less of vigorous physical activity: running, jumping jacks, push-ups, vigorous dancing. Match the intensity to your level of distress.

Effect: Metabolizes adrenaline and cortisol. Releases physical tension. Activates endorphins.
P Paced Breathing

Breathe in through your nose for 4 counts. Hold for 7 counts. Breathe out through your mouth for 8 counts. Repeat 4-6 times. The exhale must be longer than the inhale.

Effect: Activates the parasympathetic nervous system. Slows heart rate. Signals safety to the body.
P Progressive Muscle Relaxation

Tense each muscle group for 5-7 seconds, then release completely. Work upward: feet, calves, thighs, abdomen, hands, forearms, shoulders, face. For Paired Muscle Relaxation, breathe in while tensing and breathe out while releasing.

Effect: Releases tension stored in the body during emotional crisis.

Before Your Next Session

Which of the four skills feels most accessible when you are in crisis? Which feels most difficult - and what does that resistance tell you?

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7-Day Practice Tracker

Day Skill Used Situation Effectiveness
(1-10)		 Notes
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
At the end of the week: Which skill worked best? In what situations? What would you try differently?
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