T.I.P.P.s for Coping with Distress
5 minute read.
If you’ve historically had difficulty finding coping skills that reliably work for you, you are not alone. If you haven’t tried or heard of using TIPP skills for coping with distress, I’m hopeful they may be the thing that finally helps.
Regain Control of Your Emotions & Responses
TIPP skills are distress tolerance techniques that come from dialectical behavior therapy (DBT). This kind of therapy is based on cognitive behavioral therapy (CBT), adapted for those who feel deeply and intensely. Ideally, DBT validates those who may’ve been made to feel chronically dismissed or misunderstood. DBT’s aim is to understand and accept feelings, as well as learn skills to manage them. The main DBT skills are (1) mindfulness, (2) interpersonal skills, (3) distress tolerance, and (4) emotion regulation.
TIPP skills are a set of accessible skills that encourage you to change your body chemistry to regain control of your emotions and responses. TIPP skills are often best used when in “fight-or-flight” and/or crisis (and you may want support from a therapist to make sense of what this looks like for you). TIPP skills work by decreasing the activity of our sympathetic nervous system, or our fight-or-flight response, and activating our parasympathetic nervous system, or our “rest” state. We are best able to regulate our emotions when we’re in this “rest” state.
Rating Your Distress
It may be helpful to become familiar with rating your distress on a scale of “0-10,” where “0” is no distress or neutral and “10” is the most distress you can imagine. Like most coping skills, TIPP skills probably won’t relieve your distress completely and entirely. However, they should relieve enough distress that you can notice it. For example, it may be helpful to notice when a “10” decreases to a “7” after practicing TIPPS. That small but noticeable change might mean the difference between having a panic attack or being able to prevent one, or it may mean that you feel more confident to address or face a stressful situation.
TIPP Spelled Out
TIPPs is an acronym that stands for this set of chronological skills.
T: Temperature Shock
Cold water exposure activates the vagus nerves. The vagus nerves are the main nerves of your parasympathetic nervous system, and when they’re activated, they slow down our breathing and heart rate. By changing our body temperature, we can quickly and reliably decrease the intensity of an emotion. Here are some ideas to try:
Splash cold water on your face and/or hands.
Drink cold water.
Step outside on a chilly fall or winter day.
Place an ice pack on your face and/or the back of your neck.
Source: Mammalian Dive Reflex
I: Intense Exercise or Movement
When we’re experiencing intense emotions or are in “fight-or-flight,” our body wills us to do just that—fight or flee. Many, many, many years ago, when we were in “fight-or-flight,” it was often the result of a life-or-death situation. We don’t want to lose this response as it is a great resource in situations when our lives are actually being threatened. However, if we’re fearful about making a phone call, our body can sometimes trick us into feeling as if something very bad is going to happen. Typically, a phone call is not a life-threatening situation. Our body wants to protect us (and wants us to move)!
Especially if we’re struggling with anxiety, we can acknowledge this and trick our own body by engaging in intense cardio and/or aerobic exercise. Ideally, try to engage in movement or exercise for 20 minutes or more, but if that’s not possible, do whatever you can. I often encourage my therapy clients to try jumping jacks or even “Jazz hands!” Try different things and listen to your body to decide what movement makes the most sense for you.
P: Paced Breathing
TIPP skills are best used in order as there’s a reason breath may not work at first. Again, our body wants to move when we’re in crisis! For some, breathing can also be associated with distress so be cautious with this skill. You may want to consult your therapist for what this looks like for you. If you can, try to slow your breathing down. I often recommend the 4-7-8 breath method—where you inhale for 4-seconds, hold your breath for 7-seconds, and extend your exhale to last 8-seconds.
Another option is called “hand breathing.” In “hand breathing,” you hold your hand up to your mouth, breathe in and out through the mouth so that your exhale lands in the palm of your hand and, here, you’ll notice the qualities of your breath (Is your breath warm or cold to the touch?)
P: Paired Muscle Relaxation
Finally, try to practice tensing your muscles as you breathe in. Notice that feeling. Then relax them as you breathe out, while paying attention to how that feels. Be mindful of the difference between the feeling of tension and the feeling of relaxation. For example, clench your fist while taking a few conscious breaths. When you’re ready, on an exhale, slowly release your clenched fist.
Give Yourself Grace
Please give yourself grace as you develop these techniques. For nearly everyone, these skills need to be practiced at one’s non-activated baseline, over and over again, for them to be accessible in moments of crisis. For many people, this means practicing them daily for a minimum of a week, and often longer than that is required to find true relief. Whether or not you are struggling with your mental health, the ability to adapt and cope is incredibly beneficial. No one is immune to adversity, and finding reliable stress management techniques contributes to the cultivation of a stronger, more resilient self.
If you would benefit from support and/or are considering therapy, please contact or call us for a free 15-minute consultation at (215) 323-4244.
Hi, I’m Lexi!
I’m a licensed clinical social worker at Evergreen Counseling & Wellness. Read my bio to learn more about me and how I may help to provide support on your path to wellness.
