Feeling Extreme Emotions? Try a Survival TIPP

Esme Shaller, PhD, Associate Professor of Psychiatry, UCSF
What: This is a set of four strategies taken from dialectical behavior therapy (DBT). These are called TIPP (temperature, intense exercise, progressive muscle relaxation, paced breathing)
Paced breathing examples:
DBT TIPP Skill - Paced Breathing Practice - • DBT TIPP Skill - Paced...
Triangle breathing, 1 minute - • Video
Box Breathing Exercise | TAKE A DEEP BREATH | Pranayama Series - • Box Breathing Exercise...
Progressive muscle relaxation examples:
Progressive Muscle Relaxation Training - • Progressive Muscle Rel...
Progressive Muscle Relaxation - Male Voice - • Progressive Muscle Rel...
Progressive Muscle Relaxation - • PMR (Progressive Muscl...
Warnings for using temperature: Ice water decreases your heart rate rapidly. Intense exercise will increase heart rate. If you have a heart or medical condition, lowered base heart rate due to medications, take a beta blocker, or have an eating disorder, consult your health care provider before using these skills. Avoid ice water if allergic to the cold.
When: When your physical anxiety or stress level is about to boil over and you need a quick reset, or use when you are struggling with disconnecting from emotions and transitioning to sleep at the end of a long day
Effectiveness: Research has shown that distress tolerance skills can help us get through situations we can’t control without making the situation worse. The TIPP skills help by quickly switching our body chemistry (activating the parasympathetic nervous system) in order to give us a quick restart when we don’t have time or ability to get to the root of the problem.
For more distress tolerance tips, try: Spradlin, S. (2003). Don’t let your emotions run your life. Oakland, CA: New Harbinger.
Dr. Esme Shaller is a psychologist who specializes in treating adolescents in situations of acute stress or multiple stressors. She directs the dialectical behavior therapy program for teens and young adults in the Child and Adolescent Psychiatry division at UCSF.