Improving your Distress Tolerance, One TIPP (or two) at a Time

In the last post, we talked a lot about what distress tolerance is. We also talked about the science behind why we need to improve our distress tolerance levels. This post is all about a couple of my favorite Distress Tolerance skills: TIPP and IMPROVE.

What is TIPP?

TIPP is one of my very favorite distress tolerance skills. I teach it to every client, and I also use it myself. When we use TIPP, we are engaging both our brains and our bodies to help our darn amygdala see we are still in control.

This skill can take about 30-60 minutes to walk through, because it uses so many different physical components to assist the whole body with distressful feelings. When you practice it regularly (there I go again with that idea of actually using the skills), even if you are not in distress, you slowly rewire your brain to communicate better and automatically turn to these skills. Practicing them daily for 66 days will help it become the healthy habit you dream of.

There are some great worksheets attached to this post to help you on your journey to mental wealth. Click Here to learn more

Temperature Change

Okay, enough about why we should practice the skill, lets go over how to use it. First up, we have temperature change. When we feel as if we are in distress, we often start to feel it physically before we feel it emotionally. Suddenly changing our temperature allows our prefrontal cortex to override the message that darn amygdala is sending because it is a physical change. That physical change instantly tells our darn amygdala “hey stupid! something is happening that we should pay attention to.” Suddenly changing our body temperature can be simple. My favorite way is running your hands under cold water and describe the sensations you are experiencing as you are feeling that water on your hands. Many people have squeezed ice cubes, taken a cold shower, or even stuck their face in a snow pile. The key here is to describe and focus on the physical sensation to help give your prefrontal cortex the evidence it needs to tell that darn amygdala to slow down.

Intense Activities

The next letter, I, stands for intense activity. Many people think that intense activity means intense exercise. It can mean that, however, I like to use intense activity as there are some people out there who might not be able to intensely exercise. Participating in an activity that requires your full concentration and attention allows that darn amygdala to shut up for a minute and focus on what you are physically doing. By participating in an intense activity for at least 15 minutes, your brain will start to release serotonin and dopamine. That means that the stress neurotransmitters adrenaline and norepinephrine will also decrease in their production. Soon, your brain will start to release endorphins to start decreasing the emotional strain you are experiencing. These intense activities can include exercise, putting together a craft, gardening, cooking, playing a video game, or even playing an instrument. As long as your body is in motion, your brain will be able to produce the serotonin and dopamine.

Paced Breathing

Paced breathing should sound a bit familiar. I discussed paced breathing a bit in the post Mindfulness: the Art of Becoming Calm, Cool, and Collected. Paced breathing (also known as mindful breathing) helps control the rate of our breathing, which decreases our heart rate and our blood pressure. In turn, that decreases the brains triple F response and decreases the release of adrenaline and norepinephrine. Paced breathing also increases the amount of oxygen in our body, which fuels the prefrontal cortex and strengthens it against that darn amygdala’s stupidity. If you remember, that means our brain will release serotonin and dopamine as we breathe! To recap paced breathing, here are the basic steps:

  • sit in a comfortable position
  • Slowly inhale through your nose and into your diaphragm ( to make it simple, breathing so that your belly expands) for 6 seconds
  • Hold that process in your belly for two seconds
  • Slowly at exhale out of your mouth for eight seconds, or until you feel like you have no breath left
  • Repeat this pattern of breathing for 3 to 5 minutes (or how long it takes for you to feel calm).
  • If you want evidence the deep breathing is working, take your heart rate before you start the deep breathing. After each minute of practicing the breathing, take your heart rate again. Your heart rate will go down!

Progressive Muscle Relaxation

Progressive muscle relaxation rounds off TIPP. Out of these four steps, progressive muscle relaxation is my favorite skill out of this acronym because it is (in my eyes) the most comfortable one to do. What you do in progressive muscle relaxation is tense up a muscle group (that’s right, tighten those already tight muscles) and then slowly release them. As we do this, it is key to focus and describe the physical sensations you are experiencing as you tighten release the muscles. While you are hard at work, your brain starts to release oxytocin. If you recall, oxytocin not only helps us feel connected, but also helps us feel amazing when we are actively physical. This, along with the release of endorphins, allows our body to naturally relax when it’s feeling distressed.

Want a great resource for progressive muscle relaxation? Check out Dartmouth College’s free resource!

Progressive Muscle Relaxation | Student Wellness Center (

How to Practice TIPP

Practicing TIPP is something that should be done every day (even if you are not feeling distressed) so you can feel it more impactfully when you are stressed. That’s right, I said it again, practice is key to helping the brain rewire itself. At first, this skill set can take up to an hour. With practice, you can see that some of these skills may work better than others for you. In those pinch-hit moments, you may only choose to use one or 2 of the letters in the acronym and be successful with it. Again, this happens with practice!

Thank you for taking the time to learn how to improve your distress tolerance skills. Over the next few weeks, I plan to outline more distress tolerance skills to show the versatility of this particular skill set. Remember, you are worth the work to make your mental health feel like mental wealth.

To recap this post:

– TIPP is a distress tolerance skill that calms the brain and body

– IMPROVE helps you bring your focus back to what is in your control

Bonus Material

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  • Linehan, M., M., (2014). DBT Training Manual. New York, NY: The Guilford Press. Reviewed June 14, 2021


6 responses to “Improving your Distress Tolerance, One TIPP (or two) at a Time”

  1. […] hard for them to connect with what you really need. This is where practicing some good old fashion distress tolerance prior to asking for help can improve your […]

  2. […] Improving your Distress Tolerance Skills, One TIPP (or two) at a Time […]

  3. […] through our challenges and difficult emotions, and it can give us the tools to better manage our feelings of distress. Therapy can also help us improve our ability to cope with life’s curveballs, build insight into […]

  4. Ha! I did this last night and didn’t even realize it! I got me a warm cup of tea (I get cold when I’m anxious), I put in a challenging video game. I matched my breathing with my relaxed daughter. And sat in my comfy bed to help with the muscle tension.

  5. I need so much to practice TIPP today! Thanks!

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