╰┈➤  TIPP skills are effective ways to cope that are part of DBT therapy. These skills help teenagers deal with emotions when they feel too much, get scared, get too angry, or can’t control themselves. The letters in TIPP stand for temperature, exercise, paced breathing, and progressive muscle relaxation. TIPP techniques help control the body’s reactions. So, these techniques give people time to think before they do something impulsively. However, TIPP skills are coping methods but are not therapy or treatment in case you have a psychological disorder.

The aim of this article is to provide information about TIPP skills, explain their meaning and working process, ways to apply them for teenagers under emotional distress, examples, precautions, and the difference between TIPP and other DBT coping skills.

What Are TIPP Skills?

TIPP is one of the DBT skills for distress tolerance, and it is meant to help in situations where one’s emotions get so high that the process of problem-solving becomes impossible.

The four steps include the following:

T – Temperature: Changing the temperature around your face to help yourself calm down due to strong physical arousal.

I – Intense Exercise: Doing quick exercises to discharge accumulated physical energy.

P – Paced Breathing: Slowing down your breath, especially making the exhalation longer.

P – Progressive Muscle Relaxation: Contracting and relaxing particular muscle groups to release physical tension.

Well, the idea is not to make the disturbing situation go away.

What needs to be done is just lowering the intensity of your emotional response first, and only after that will you be able to think, communicate, or apply any other coping method.

Is It TIPP or TIP?

Well, you will find both TIP skills and TIPP skills on the internet.

Original TIP skills generally involve:

• Temperature
• Intense Exercise
• Paced Breathing

However, many DBT materials and therapists consider TIPP as four steps that incorporate Progressive Muscle Relaxation into TIPP skills.

This means that when you type “TIP skills,” “TIPP skills,” or “DBT TIPP” into your search engine, you will likely find almost identical information.

Why Do Teens Use TIPP Skills?

Undoubtedly, adolescence comes with intense emotions, peer pressure, school-related pressures, family conflicts, relationship issues, and fast-changing situations.

Occasionally, the emotional response becomes greater than the situation.

For instance, consider the case of a teenager receiving an SMS from his good friend:

 “We need to talk.”

In seconds, the person may begin asking himself:

• Did I do something bad?
• Are they upset with me?
• Are they going to ignore me?
• Everyone will know.

His heartbeat will speed up. The person’s muscles become tight. He feels the need to fire back a message full of rage or repeatedly call his buddy.

Then, trying to sort everything out with a calm mind may not be easy.

Therefore, TIPP provides the teenager with something practical to do before anything else.

After the body calms down, the teenager can choose what to do next.

And here lies the essence of distress tolerance – surviving the wave of emotions without worsening the situation.

How Do TIPP Skills Work?

TIPP is about the relationship between your body and emotions.

Emotions are not only thoughts; they may lead to physical responses such as:

• A quickening heart rate
• Tensing of muscles
• Sweating
• Increased respiration
• Irritability
• Shaking
• Sensation of heat or cold
• Powerful urge to take action right away

So, TIPP intervenes in these physical responses. Rather than fighting the emotion, you work on calming your mind and the body for a moment.

This is important because the overload of the nervous system makes it difficult to stop and reflect before choosing an action.

What Does the “T” in TIPP Stand For?

T = Temperature

The first T refers to “Temperature”.

According to the conventional DBT TIP strategy, the application of cold stimuli to the face is used as a quick distress tolerance strategy. Cold water or ice is applied to the face for some time.

It does not mean that you have to “freeze” your emotions.

Cold stimuli may produce a strong bodily response, which helps distract you from the emotional process and decrease your physiological arousal.

How Can a Teenager Apply Temperature Safely?

Here is a simplified way:

1. Get a cold pack.
2. Cover it with some kind of cloth.
3. Apply the pack gently; place it on the face for some time.
4. Take it off and pay attention to the changes in the physiological state of your body.
5. Take several deep breaths.

DBT manuals mention the following ways of using cold stimuli – facial immersion in ice water or holding your breath using cold water. However, there are some contraindications to applying such techniques.

If you suffer from any heart disease, respiratory disorders, tend to faint, or have some other health issues, you had better consult with your doctor before using intense cold stimuli.

Do not expose yourself to extremes of cold, direct application of ice to the body, or any form of torture.

The purpose of these practices is to control the body, not torture it.

What Does the “I” in TIPP Stand For?

I = Intense Exercise

So, “ I” stands for “Intense Exercise”.

If you are very angry, anxious, restless, or emotionally activated, your body may feel like it needs to do something.

Brief exercises can help you use up some of this excess physical energy.

This could include:

• Fast walking
• Running
• Jumping jacks
• Squats
• Basketball
• Biking
• Dancing
• Another form of safe vigorous exercise

According to DBT resources, activities including running, fast walking, jumping, basketball, and weightlifting are examples.

Example of Using Intense Exercise after Conflict:

For instance, your parents take your phone away after an argument.

You feel extremely angry.

You wish to bang the door shut and send a nasty message to somebody.

However, you spend some minutes running or doing other physical activities.

Your body will feel less activated as a result.

You have not fixed the issue.

But you may now be able to discuss it without increasing the conflict further.

That is what matters.

To conclude, TIPP does not resolve the issue. It gets you to a state where you can address it properly.

What Does the First “P” in TIPP Stand For?

Well, the first “P” in “ TIPP” stands for Paced Breathing

Paced breathing entails controlled and deliberate breathing.

When you are emotionally disturbed, you may have faster and shorter breaths. Paced breathing helps you direct your attention from the emotional disturbance to something that you can control.

Guidance in DBT involves paced breathing where breathing slows down, and exhaling takes longer than inhaling. One way of doing this is to take five seconds of inhalation followed by seven seconds of exhalation.

Course of Simple Paced Breathing Exercise:

Here is how:

1. Sit in a place where you feel secure.
2. Let your shoulders relax.
3. Breathe in slowly.
4. Breathe out even slower.
5. Do this several times.
6. Pay attention to the physical feeling of breathing.

There is no need to take big breaths.

However, if deep breathing leads to feelings of dizziness or discomfort, revert back to your normal breathing.

In the end, it is not about maximum breathing; it is about breathing comfortably.

What Does the Second “P” in TIPP Stand For?

P = Progressive Muscle Relaxation

According to the National Center for Complementary and Integrative Health (NCCIH), progressive muscle relaxation and deep breathing techniques decrease sympathetic nervous system activation, which helps reduce heart rate and alleviate physical tension in the body during stress.

So, Progressive muscle relaxation is the process of tensing and relaxing different muscle groups purposefully.

For instance, you will:

1. Tighten the shoulders for several seconds.
2.  Notice the tension in the shoulders.
3. Release the muscle groups.
4. Notice the change.
5. Repeat with other muscle groups.

One can do progressive muscle relaxation on the whole body, from the hands up to the arms, shoulders, jaw, legs, and feet.

Why Is Muscle Relaxation Helpful?

Stress makes the body physically tense even when one does not realize this.

For instance, stress can cause one to clench the jaw, raise the shoulders, ball the fists, and tense the legs. 

The Cleveland Clinic says that through progressive muscle relaxation, people can effectively learn how to release this built-up physical tension.

So, in progressive muscle relaxation, there is a way to detect this tension and let go of it.

When Should Teens Use TIPP Skills?

Well, the TIPP method works well when one is dealing with strong emotions and trying to move through an immediate situation.

It would work well in situations where you feel:

• Excessive anger
• Panic
• Overwhelmed
• Very anxious
• Emotionally flooded
• Extreme rejection
• Extreme frustration
• Feeling out of control
• Intense impulse to act

For instance:

Situation: You get a hateful comment, or you get brutally trolled on the Internet.

Reaction: You get extremely furious, your heart starts beating fast, and you want to reply aggressively straight away.

TIPP: However, by following TIPP techniques, you move away from the phone, do a temperature technique, walk for a few minutes, calm down your breathing, and relax your muscles.

The next step: You decide whether you really have to reply to that comment once you are done controlling your nerves.

So, that last step is important.

TIPP is not about avoiding issues. It is about gaining distance from the situation for a moment and then acting wisely.

TIPP Skills vs Regular Coping Skills

Well, it is not necessary that every coping strategy works equally well during an emotional crisis.

For example: Journaling can assist you in discovering why you’re feeling upset.

However, if you’re currently stressed out and just about to blast out an angry message, you may have trouble starting to journal.

At that time, try a brief TIPP strategy and then move on to journaling.

TIPP Skills vs STOP Skill

TIPP and STOP are both DBT techniques, yet they have different objectives.

STOP refers to:

• Stop
• Take a step back
• Observe
• Proceed mindfully

STOP skill is helpful in creating a pause before doing something.

However, TIPP is more concerned with lowering physical and emotional arousal.

They can be used together.

For instance:

STOP: Put your phone away.

TIPP: Breathe slowly and apply another distress tolerance strategy safely.

Next: Figure out what you need to do.

Distress tolerance and emotional regulation strategies include TIP/TIPP and STOP in DBT.

TIPP Skills vs. ACCEPTS

Another DBT distress-tolerance strategy is ACCEPTS.

ACCEPTS stands for:

A — Activities

C — Contributing

C — Comparisons

E — Emotions

P — Pushing Away

T — Thoughts

S — Sensations

ACCEPTS is more about temporary distractions and shifts in your focus as you bear with the challenging situation.

The TIPP technique, on the other hand, aims at physical arousal.

Therefore, it is a good idea to first use TIPP and follow up with ACCEPTS.

For instance:

High emotional intensity → TIPP → less intensity → ACCEPTS → coping with the rest of the challenging situation.

A Practical TIPP Example for Teens:

Let’s understand TIPP with a practical example.

The Situation:

You have been studying hard for a test, but you got a poor score.

Your immediate reaction is:

“I’m stupid. I’ll never pass.”

You feel frustrated, embarrassed, and overwhelmed.

You want to throw your books.

Step 1: Temperature

Wash your face with cool water or apply a safe cooling stimulus that can help break off the physical response.

Step 2: Intense Exercise

Go for a fast walk or do any other safe form of physical exercise.

Step 3: Deep Breathing

Slow down your breathing and extend the length of your exhalation.

Step 4: Progressive Muscle Relaxation

Release the tension from your shoulders, hands, jaw, and any other tight muscles.

Step 5: Re-evaluate

Now think:

• What happened here, really?
• Am I failing this course, or did I fail one particular test?
• Can I ask my teacher what I have missed?
• What will be different next time?

So, here you haven’t made your emotional problem vanish by magic.

But now you have some extra space in your brain to deal with it properly.

How Long Do TIPP Skills Take to Work?

Well, there is no set timeframe.

A few teenagers can experience the effect of this technique within a few minutes. There are those who will require more time, or even those who might realize that a particular method does not suit them.

TIPP is not a magic “calm down button.”

The goal here is to lower the intensity to a point where there is no urge to act impulsively.

DBT encourages the practice of skills in dealing with distress before a crisis situation.

Should You Practice TIPP When You’re Calm?.

Well, this is among the most applicable lessons. One can practice it and master it before facing any stressful situation.

No doubt, trying to remember TIPP during the time when you are emotionally overwhelmed makes it hard for you to recall how you are supposed to do it.

Rather, do it when you are calmer.

Like:

• Do paced breathing before sleep.
• Learn PMR during the afternoon when you are alone.
• Determine a form of exercise that is safe.
• Decide where you can go when you want to.
• Write down the four TIPP steps.
• Then, it will be easy to follow the procedure.

You can say it is just like doing a fire drill. You don’t do it when the building is already on fire.

What If TIPP Doesn’t Work?

Well, that’s fine. No worries if TIPP doesn’t work.

Not every coping skill works for everyone.

There are other DBT skills you can use, including:

• STOP
• ACCEPTS
• Self-soothing
• IMPROVE
• Radical acceptance
• Problem solving
• Mindfulness

The Distress Tolerance Model incorporates various distress tolerance skills because different situations require a different approach.

You might realize that the problem you’re experiencing is caused by an issue that requires you to resolve the issue, not tolerate it.

If you are facing bullying every day, then breathing exercises won’t help you.

Are TIPP Skills a Treatment for Mental Health Conditions?

No. The skills of TIPP do not offer a comprehensive solution to the mental health problem, as they are just a coping mechanism.

Distress tolerance skills are used in DBT as one element of the therapy.

When a teen feels that he experiences strong emotions, impulses to hurt himself, extreme anxiety, depression, and serious relationship issues, it is important to seek professional help for such extreme distress.

So, only a therapist will be able to find out what leads to such mental states and teach proper skills within the framework of the right treatment.

Important Safety Considerations for Teens:

Remember, the TIPP skills are just to handle distress safely.

Never use them to punish yourself.

Examples include:

• Avoid exercising to the point of exhaustion.
• Do not engage in excessive temperatures.
• Do not intentionally hurt yourself.
• Do not hold your breath for an extended period of time.
• Do not use cold exposure when it causes pain, fainting, or any other negative reaction.
• Do not use TIPP skills to avoid seeking help for your problems.

Moreover, if you are about to hurt yourself or others, then TIPP skills are not a good alternative to emergency services. Consult an adult you trust or the local emergency/crisis service.

How TIPP Skills Fit Into Emotional Regulation?

TIPP addresses the immediate problem. However, emotion regulation skills take things further.

A teenager will eventually develop skills such as the ability to:

• Recognize emotional triggers
• Be aware of early warning signs
• Understand emotional patterns
• Question unproductive thoughts
• Convey their needs
• Tackle problems
• Enhance relationships
• Cultivate effective patterns of behavior
• Limit emotional vulnerability

And that is why DBT covers multiple areas of skill development, which include mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

So, TIPP is just one of the tools used within DBT.

TIPP Skills for Teens: Key Takeaway

Wrapping up, TIPP skills involve the use of some rapid DBT distress tolerance strategies that aim to assist adolescents in coping with episodes of intense emotional distress. The strategies include Temperature, Intense Exercise, Paced Breathing, and Progressive Muscle Relaxation, which aim to address the physical manifestations of stress in the body. It brings a pause between the intense emotion and any impulsive actions.

However, it is not about getting rid of the emotions or pretending like all is well. Instead, it is about surviving the difficult episode of emotional distress to think rationally about how to proceed.