TIPP skills

Advanced Clinical Fellow Julia Papale

I’ve written a bit here about emotional regulation by attending to our nervous system on a consistent basis, particularly through breathwork. Our breath is always an anchor to bring us back into presence, the only place where life is ever happening. For those moments of high distress and activation, when emotional overwhelm feels like it’s too much to handle, you might try implementing any of the below DBT practices known as the TIPP skills.

Temperature – Change the temperature. If you’re looking to bring your heart rate down and activate the parasympathetic nervous system from a place of overwhelm, bring on the cold! Whether it be a cold, full-body shower, splashing your face with water, or filling a bowl with ice-cold water and plunging your face in, bringing cold to your system will help with down-regulation. Heat, on the other hand, will raise your blood pleasure if you’re looking to upregulate from a depressed, sad, or anxious state. A hot bath, some warm tea, or curling up in a blanket can do the trick.

Intense exercise – An overwhelmed nervous system can also be well served with bursts of intense exercise to release energy through the system. 10-15 minutes is ideal, and this might look like jumping jacks, going for a run, jumping rope, or putting on some music and dancing.

Paced breathing – As mentioned, our breath is always a resource. Breathe into your diaphragm (stomach) for four counts and then out through your mouth with pursed lips for six counts. If you’d like, pause at the top of the inhale, take one more breath in, and then exhale. To ensure you’re activating the parasympathetic nervous system, make sure you breathe out for longer than you breathe in.

Progressive muscle relaxation – You can also calm fight or flight and activate rest and digest through a skill also known as paired muscle relaxation. This practice is like an active body scan where you tense your muscles for five seconds before you release and relax. Do this in a seated position and begin at the top of your back between your shoulders and then continue down your body – arms, abdomen, thighs, calves, etc. – all the way down to your toes.

The more you practice calling in these tools, the more robust a toolbox you will have down the line for challenging, triggering situations. But like anything, progress, not perfection.

T10: TIPP. Dialectical Behavioral Therapy. Retrieved July 19, from https://dialecticalbehaviortherapy.com/distress-tolerance/tipp/