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Distress Tolerance

TIPP Skills Log

The TIPP worksheet helps you lower emotional intensity fast with temperature, intense exercise, paced breathing, and paired muscle relaxation.

What this worksheet is for

TIPP is your rapid-response toolkit for high arousal. Change your body chemistry first so your mind can catch up.

How to use it

  1. Read the full skill once before writing.
  2. Use the examples below to spot where it fits real life.
  3. Complete the reflection page using the answers you already typed or by writing directly on the PDF.

At a glance

Primary topic: tipp dbt worksheet

Worksheet type: Priority worksheet

Best for: High-arousal moments when you need your body to settle before any reflective skill will work.

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Worksheet overview

How to practice it

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

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.

Before you write

Pick one situation you are actually likely to face this week. The activity page works best when you complete it for a real moment instead of a hypothetical one.

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Practice guide

Worksheet activity

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.

Reflect and write

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?

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Reflection page