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Pro TIPP for Managing Distress

Updated: Aug 7, 2018

Immerse your face in cold water for 30 seconds to reduce your heart rate and stress level.

Dialectical Behavior Therapy (DBT) is a style of therapy that is rich with skills that can help people tolerate distress. In DBT, the term "dialectic"refers to the way that two things that seem like opposites can be true at the same time. The main dialectic in DBT is between acceptance ("I am doing the best I can," "This is really how life is right now") and change ("I need to try different things to feel better," "I need to put more effort into this").

We all experience situations that are outside of our control, that are difficult to tolerate, and sometimes, that make us feel as if we are emotionally spiraling. TIPP can be a valuable tool in your distress tolerance toolkit for occasions just like this. It stands for:

  • Temperature

  • Intense Exercise

  • Paced-Breathing

  • Paired Muscle Relaxation


While holding your breath, submerge your face in a cold water for 30 seconds. A large bowl or sink works well. If you can't submerge your face, you can hold a cold pack over your eyes and cheeks for a similar effect. This will trigger the diving reflex (all mammals have this) and your heart rate will lower. Be sure to keep the temperature above 50 degrees Fahrenheit to avoid damaging your skin.

Intense Exercise

Try running, brisk walking, playing basketball, lifting weights, or any other physical activity you are healthy enough to do. It does not have to be long, but it should be vigorous. Intense exercise helps your body use energy and can stimulate the release of endorphins (chemical messengers associated with pleasure).

Paced Breathing

Breathe deeply. If you place a hand on your abdomen, you should feel your belly rising as you inhale and falling as you exhale. As best you can, try slowing your breathing down to 5 or 6 breaths per minute. Check this post out if you need a visual guide. If you remember one thing, remember to breathe OUT for longer than you breathe IN. Doing this will lower your heart rate.

Paired Muscle Relaxation

You will amplify the calming effect of deep breathing if you pair it with muscle relaxation. By tensing and releasing your muscles, your heart rate lowers and your muscles end up being more relaxed than when you started. Check out my post on Quick Tensing and Releasing for a step-by-step guide to relax your muscles.

Keep Practicing!

Before you give up and decide that this skill doesn't help you, remember that most people need to practice before they get good at any skill. You've. Got. This.

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