Ever feel like how you feel is the TIPP of the iceberg?
That it will take just one more feeling, emotion, or memory to TIPP you over? (Ok, you’ve gone too far with the puns already)
That you’ve just reached your TIPPing point? (Seriously, dude, stop it.)
That it’s a long way to TIPPerary – oh, sorry, that’s the wrong type of Tipp.
Anyway, you get the point (and thank God I’ve stopped punning).
I’m going to tell you all about the TIPP skills, how you can use it to calm down and regulate yourself, why it’s useful, and my personal experience using it.
Strap yourself in and lets TIPP the scales (ok, I’m leaving) in your favour! BOOM!
Let’s do it.
Table of Contents
What are the TIPP Skills?
Okay, the first thing to consider is what TIPP stands for.
DBT is full of acronyms and TIPP is another acronym. Yay, acronyms!
T in TIPP stands for temperature,
I stands for intense exercise,
P stands for paced breathing,
and the second P stands for progressive muscle relaxation.
So that’s a four-in-one exercise. Now, that’s what I call VALUE!
Now you don’t have to do all of them at the same time, in fact, I think you’d really struggle to do that (try holding your breath whilst underwater and pace your breathing at the same time), but looking at them each individually is really useful.
This skill is used when you’re feeling intense emotion and you’re trying to tolerate the distress that you’re being caused. That’s why it’s in the distress tolerance skills in Dialectical Behavior Therapy (DBT).
It helps you to manage your feelings and emotions by:
lowering your temperature,
lowering your heart rate,
distracting you,
helping you with your breathing,
decrease emotional intensity.
Really, just to manage the stress, bring yourself down into a place where you can be more mindful and act with a wise mind.
It’s used in moments of crisis just to reground and help you be in the moment rather than acting out or behaving in a way that you might regret later on.
Reasons You Need to Know the TIPP Skills
This skill stood out to me when we practised it in DBT, as it is one that I can use daily.
I’ve practiced this plenty of times and I want to share what I’ve learned, what it means and how you can benefit from it.
Mainly it’s important and relevant because it helps manage your feelings and emotions, helps you tolerate distress and gives you a leg up over the crisis when you’re in a moment like that.
So, are you ready? I’m going to line up step-by-step instructions on how to master this skill and go through each part of it bit by bit, along with some ideas and examples for you to follow.
Step-by-Step Instructions to Master the TIPP Skill
Okay, I’m going to go through each part of this skill. We’ll start with temperature, then move on to intense exercise, pace breathing, and progressive muscle relaxation. You’ll find that all of this helps reduce intense emotions.
Let’s do it!
Temperature
Okay, T stands for temperature. Now, it’s not just that you sense or feel the temperature; actually, you’re changing the temperature of some part of your body.
This affects the parasympathetic nervous system – which is responsible for the flight/fight/freeze mechanism. So, by altering your temperature, you’re bringing this back into control.
You can try this in lots of different ways.
One way I like to do it is to go to the bathroom, turn on the cold water, and run my wrists underneath the cold tap.
Or you might like to fill the sink with cold water and splash some of it on your face.
The other thing you can do if the sink is quite deep is lean forward and dunk your head into the water. Make sure that your temples are covered if you do this.
At the same time, hold your breath, count as high as you can, and then finally remove your head from the sink again.
If you don’t fancy any of that, you can take a cold shower, but be careful not to make it too cold.
Or if it’s cold outside you can go outside for a walk.
If you’re near the freezer, say in your kitchen, you can grab an ice cube and hold it in your hand, put it in your mouth, or rub your face with it.
Bear in mind that colder temperatures decrease your heart rate. Now why would you want to decrease your heart rate?
Well, if you’re feeling emotionally overwhelmed, then your heart rate probably is going faster.
So when you splash your face with water or dunk your head in the water you’re actually initiating what’s called your dive response [1].
On the flip side, higher temperatures increase your heart rate. So if you’re feeling depressed, sad, or anxious, maybe your heart rate is a bit low.
In this case, you could take a hot bath, drink some tea, or go outside on a hot day if you need to increase your heart rate.
Just be careful, though. Cold exposure can drop your blood pressure, and heat exposure can raise it. So, if you have a medical condition that might make this a problem, maybe don’t do this step or definitely consult your doctor first.
Ok, what’s next? Time to SWEAT!
Intense Exercise
The next part of the TIPP skill is Intense exercise. There’s a direct link between exercise and being calm [2]. That’s science, yo [3].
The idea with this is to get your heart rate up for up to about 20 minutes.
This is a good idea because if you have some pent-up or built-up energy whilst experiencing overwhelming emotions, it’s a good idea to vent that energy. Cardio is a fantastic way of getting all of this out.
Now, you don’t need any specialised equipment for this.
Run on the spot or do star jumps.
If you do have equipment, then hop on your treadmill or exercise bike. Whatever works.
Other options:
Go for a run outside,
Walk really fast around your house or outside,
Lift weights (bring out your inner Arnie),
Try a jump rope (bring out your inner Rocky – ADDRRIIAAAAAAN)
I guarantee that after you do this, you’ll feel a little bit tired, and the overwhelming emotions will become more balanced.
What I like to do is wear my smartwatch and check what my heart rate is before I start.
I build it up to 150 or 160 BPM so I really know I’m working. I let it settle at that for a few seconds, slow down again for a bit and then build it back up again to 160.
Doing this will make sure that my attention is really shifted onto the cardio and not focusing on my emotions.
Now, if you don’t have a smartwatch, you can still do something like this.
Here’s an idea for you: As you’re starting to work out, talk to yourself (Ah, the voices!) or to someone with you. If you’re struggling to get full sentences out in between breaths, then you’re at your upper limit.
So that’d be the time to slow down a bit and then ramp up again. Guarantee this works every time. I’d sell my mother for that bet!
Another thing to try: Write down the level of emotions on a scale of 1 to 100 before you start the exercise. Then write down again after you’ve finished the exercise what your emotions feel like.
Cool. So you’re sweating now, right? It’s time to BREATHE!
Paced Breathing
The P from the TIPP skills stands for Paced Breathing.
Controlling your breathing helps reduce and tolerate feelings by eventually decreasing your heart rate.
So paced breathing is when you breathe out slower and longer than when you breathe in [4].
You’re pacing parts of your breathing.
So you could start with a 1-second difference and then increase that as you carry on with the exercise.
Example: Breathe in for 3 seconds and then out for 4 seconds. Once you’ve done that a few times you could increase the breath to 4 seconds for the breath in and 5 seconds for the breath out.
Find whatever works best for you.
So what this is doing in the background is telling your body that you’re safe.
When we’re triggered, sometimes it can lead our bodies to think that we’re in danger.
But if you use paced breathing, you’re telling your body, “Hey, chill. I’m okay. I’m safe enough to take the time to breathe like this. Therefore I’m safe.”
I find using an app on my phone is useful and holds my attention for longer:
I recommend Paced Breathing for Android and Breathe Easy for iPhone.
This is good to practice even when you’re not trying to tolerate or live with any distressing emotions or feelings. It’s just a nice practice to be in.
With these skills and exercises, practice makes perfect. The more you do them, the more effective they’ll be when you actually need them.
Don’t forget to rate the intensity of your emotions before and after you do this as well.
Sweet! I’m ready for the next part.
Progressive Muscle Relaxation
Now the final part of the TIPP skill is progressive or paired muscle relaxation.
This is great to try not just to reduce overwhelming feelings of anxiety but even to help with insomnia [5]
Basically, you work from your head or your toes or vice versa and tense up your muscles as hard as you can. Hold it for a few seconds and then release.
While you’re tensing, you breathe in. and tense it as hard as you can while you breathe in.
Then, when you breathe out, you say the word relax in your head and release the tension in your muscles.
Take a step back then and feel how relaxed your muscle feels now.
Aim to go through your entire body muscle group by muscle group until you feel calmer and more relaxed.
This works because it helps you relax the tense muscles that you experience when extreme emotions arise.
The main thing is that you’re aware of your muscles and how you feel, and you deliberately tighten them for a few seconds.
Again, it’s a great way to let go of extra energy that you’ve built up with emotions (and you’ll end up with killer buns).
Here’s a list of the muscle groups that you can try this with:
Hands and Forearms – Clench your fists, feel the tension, then release and notice the relaxation.
Biceps and Upper Arms – Bend your elbows, tense your biceps, hold, then relax.
Shoulders – Shrug your shoulders up towards your ears to create tension, hold, and then relax.
Forehead – Raise your eyebrows as high as possible, creating tension in your forehead, hold, then relax.
Eyes and Nose – Close your eyes tightly and scrunch up your nose, hold, then relax.
Jaw and Cheeks – Clench your jaw and tighten your cheeks, hold, then relax.
Neck – Gently tilt your head forward, pressing your chin down to your chest to stretch the back of your neck, hold, then relax.
Chest – Take a deep breath and hold it, feeling the tension in your chest and shoulders, then release slowly.
Back – Arch your back gently, without straining, to create tension, hold, then relax.
Stomach – Tighten your stomach muscles as if preparing for a punch, hold, then relax.
Buttocks and Thighs – Squeeze your buttocks together and tense your thighs, hold, then relax.
Calves – Point your toes away from you to tense your calf muscles, hold, then relax.
Feet and Toes – Curl your toes downward to create tension in your feet, hold, then relax.
Okey doke. That’s the TIPP skill in essence. If you read no further, then I wish you well! Read on, though, to see an example of how doing this can save your day.
Key Considerations For Successfully Using and Mastering the TIPP Skill
I thought I’d share my own personal experience of using this skill to help me reduce the feelings I had.
Example of using this skill:
This morning I woke up and felt rubbish. I was just empty and down.
For the last two days, it’s been raining outside. I remembered that around the same time ago last year I felt really depressed and was trying to live with the tough situation that I have with my Dad.
Thinking about these things caused me to be depressed and I didn’t want to even get out of bed. I couldn’t get up, I didn’t want to go to work or do anything.
Eventually, I dragged myself out of bed but I just kept on getting more and more depressed and feeling more empty.
So I used the TIPP skill.
T, temperature. I took a hot shower, something that made me feel warmer. I felt warmer physically but it also affected my emotions as well. I was self-soothing in a way.
After that, I did some Intense exercise. I hopped onto my exercise bike, set the resistance to max, and just went at it for 10 minutes. I should have done this first before I had my shower because I needed to take another hot shower afterwards!
After this, I spent 2 minutes practising the Paced breathing technique. Just focusing on my breathing really helped me stop ruminating thoughts and dwelling on emotions.
For the last P, Progressive Muscle Relaxation, I lay down and went from head to toe following the instructions. In the middle of the step, I already felt better.
I felt like the TIPP technique helped me recover my day, and I went on to enjoy it.
Remember that the TIPP skills won’t remove your emotions but will help turn the volume down on your feelings.
They’ll just help you reset so you can perhaps be mindful of how you’re feeling.
Instead of reacting to the emotions with an outburst of anger, for example, it just lets you take a step back.
Practice makes perfect – do this when you’re not upset.
I find it really helpful to explain a skill to someone else who doesn’t know about it, so my poor wife is usually the subject of these things.
Explain in detail what each letter in the acronym means, and then ask if you can go and practice with that person.
You can make it fun. Get the water gun out and get your own back on them if they’ve ever upset you. I’m just kidding. Have fun with this, though.
Wrapping Up and My Experience With the TIPP Skill
There you have it. I hope you’ve found this useful and valuable.
As I said before, practice makes perfect.
The TIPP skill is one you can revisit time and again, but it’s best to practise it when you’re not distressed or dealing with difficult emotions.
Even if you don’t do all parts of the skill one after the other, even try one of them.
For instance, try the paired muscle relaxation technique when you’re sitting on the bus or you’re lying down in your bed before you fall asleep.
You’ll feel a soothing, calming effect. Just give it a whirl; you’ll be surprised at the results.
If you’re interested, the STOP skill will help you in super tough situations. Click on the link to read more about that skill.
References:
1 – https://www.ncbi.nlm.nih.gov/books/NBK538245/
2 – https://www.health.harvard.edu/staying-healthy/exercising-to-relax
3 – https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469
4 – https://www.healthline.com/health/box-breathing
5 – https://www.webmd.com/sleep-disorders/muscle-relaxation-for-stress-insomnia
