Distress Tolerance
TIPP Skills Log
TIPP is your rapid-response toolkit for high arousal. Change your body chemistry first so your mind can catch up.
Tip: jot notes below, then print or “Save as PDF.”
How to practice it
Move through each step slowly. Notice what the skill asks for and how you can experiment in real life.
T
Temperature Change
Lower your body temperature fast. Hold an ice pack, splash cold water, or submerge your face in cool water for 15–30 seconds. (Skip if you have cardiac concerns.)
I
Intense Exercise
Burn off adrenaline with a short burst of movement—jumping jacks, sprinting in place, dancing with full effort—for 60–90 seconds.
P
Paced Breathing
Inhale through your nose for a count of 4, exhale slowly through pursed lips for a count of 6–8. Repeat for at least one minute.
P
Progressive Muscle Relaxation
Tense one muscle group at a time while inhaling, then release on the exhale. Start at your hands, move up your body, and finish at your face or scalp.
Real-world examples
Try spotting moments like these in your week. Notice how the skill changes the ripple effect of a tough situation.
A panic spike hits before a presentation. You hold an ice water bottle to your neck, jog in place for 45 seconds, switch to 4-6 breathing, and finish with hand/shoulder tension-release. Your heart rate drops enough to deliver your slides.
You feel rage boiling after a tough conversation. You splash cool water on your face, do burpees for a minute, breathe slowly on the kitchen counter, then loosen clenched fists and jaw with progressive relaxation before re-engaging.
Practice Activity
Design your personal TIPP sequence so you can run it without thinking. Choose tools you have access to at home, work, and on the go.
Temperature: What quick cooling method is realistic for you?
Intense exercise: Which 60–90 second activity works in your space?
Paced breathing: Which count (4-6, 4-7) feels best in your body?
Progressive relaxation: Which muscle groups will you focus on first?
Want to practice distress tolerance with the WithMarsha app?
WithMarsha guides you through this skill in real time, keeps track of your practice, and helps you build your DBT toolkit day by day.
Download WithMarsha