Use brief body-based strategies to reduce extreme physiological arousal before solving the larger problem.
TIPP is a DBT distress-tolerance skill involving temperature, brief intense exercise, paced breathing and paired muscle relaxation. It is designed for short-term regulation, not avoidance of the underlying issue.
Quick facts
| Purpose | Reduce acute physiological arousal |
|---|---|
| Time | 2–15 minutes |
| Evidence label | Established DBT crisis-survival skill |
| Support | Best learned with appropriate clinical guidance |
TIPP components
- Temperature: Use cool water or another safe cooling method.
- Intense exercise: Use brief movement suited to your health and ability.
- Paced breathing: Slow the breath, often with a longer exhale.
- Paired muscle relaxation: Gently tense and release muscle groups while breathing.
Example
Before an important conversation, a person notices shaking, rapid breathing and an urge to leave. They use two minutes of paced breathing and gentle movement, then reassess whether they are able to continue safely.
Safety
Temperature changes and intense exercise may be unsafe for some people. Avoid extreme cold, breath-holding or strenuous exercise when you have relevant heart, blood-pressure, respiratory, neurological, pregnancy-related or other medical concerns. Seek medical advice when uncertain.
Related resources
Evidence and source
This worksheet practises a skill described in Marsha M. Linehan’s DBT Skills Training Manual, Revised Edition (2025). The CounselorAid worksheet has not been independently validated as a treatment or outcome measure.
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.