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TIPP Skill in DBT

TIPP uses brief body-based strategies to reduce very high physiological arousal before a person chooses the next action.

TIPP stands for Temperature, Intense exercise, Paced breathing and Paired muscle relaxation. It is a crisis-survival skill, not a treatment for the underlying problem and not a substitute for emergency care.

  • Temperature: Use a safe cooling method, such as cool water on the face, only when medically appropriate. Extreme cold or heat is not required.
  • Intense exercise: Use brief movement appropriate to health, mobility and fitness. “Intense” is relative; vigorous exercise is not suitable for everyone.
  • Paced breathing: Slow the breathing rate gently, often allowing the exhale to be somewhat longer than the inhale. Avoid forceful breathing or prolonged breath-holding.
  • Paired muscle relaxation: Gently tense and release selected muscle groups while breathing, without causing pain.

Medical precautions

Seek individual medical guidance before using temperature change or vigorous exercise if you have cardiovascular, blood-pressure, respiratory, neurological, pregnancy-related, fainting, eating-disorder or other relevant health concerns. Stop if you experience chest pain, faintness, severe breathlessness, confusion or pain.

Use the TIPP worksheet guide or return to Distress Tolerance Skills.

Reference

Linehan, M. M. DBT Skills Training Manual, Revised Edition. Guilford Press, 2025.

Evidence and editorial note

Resource type: Educational overview of a DBT skill or skills module. It supports learning and practice but is not comprehensive Dialectical Behavior Therapy.

Evidence basis: Marsha M. Linehan’s DBT Skills Training Manual, Revised Edition (2025), official Behavioral Tech training information, current NICE guidance and peer-reviewed evidence reviews where treatment claims are discussed.

Review status: Written and evidence-checked by the CounselorAid editorial team. Last evidence review: 3 August 2026. No named independent clinical reviewer is being claimed. Please report factual or safety concerns through the contact page.

Important: This information cannot diagnose a condition, assess personal risk or replace care from an appropriately qualified professional. In an immediate crisis or medical emergency, use local emergency or crisis services.