TIPP Skills for Distress Tolerance

Topic from Clinical Director Dr. Lana Farina: TIPP Skills for Distress Tolerance

Over the past month, Stevenson students have continued to work on DBT skills by expanding their repertoire of distress tolerance skills. As a reminder, distress tolerance offers temporary relief to problems that can’t be solved right away. They help us get through painful situations as skillfully as possible while resisting the urge to act quickly in a way that might make things worse.

Sometimes, when emotions run high, it can be hard to think clearly and remember to use skills. It may even seem like nothing works and lead to panic. When in a heightened state of emotional distress, TIPP skills can work quickly and buy you enough time to calm down and think of what to do next. TIPP skills work to quickly “tip” your body chemistry without doing harm like from drinking or using substances. So how do they work? When we feel very stressed or threatened, our body’s sympathetic nervous system (SNS) is activated and gets our body ready for action. This is also referred to as the “fight or flight” response. TIPP skills activate our parasympathetic nervous system (PNS) and help us rest and slow down. Changing our physical response can change our emotions. Here are the TIPP skills:

Temperature: Tip the temperature of your body with very cold water. When we put cold water on our face, it activates the dive reflex. Our heart slows down when immersed in very cold water without oxygen. *This should not be used by people who have heart issues, eating disorders, or an allergy to cold. One way to use this skill is to immerse your face up to your temples in very cold water for 10-20 sec, lift your face and breathe, and repeat 3x. As an alternative, you can sit in a chair with an ice pack, cold gel eye mask, or a cold compress or beverage on your cheekbones below your eyes, or take a cold shower. Standing, bending over and holding your breath at the same time can increase the effect.

Intense Exercise: Engaging in intense aerobic exercise for 10-20 minutes can quickly impact your mood. Examples of high intensity exercise include running, jumping rope, and going up and down stairs. Once you stop, your PNS activates and your heart rate goes down.

Paced breathing: Slow down and deepen your breath, making your exhalation longer than your inhalation. Aim for 5-6 breath cycles per minute. This is a skill that can easily be practiced anywhere.

Progressive Muscle Relaxation: Focus on one muscle group at a time from your head to your toes.  Start by getting into a comfortable position. Tighten each muscle group and hold the tension for about 10 seconds, then release it. This teaches your body the difference between states of tension and relaxation.