The TIPP exercise is a skill from Dialectical Behavior Therapy (DBT) designed to help individuals manage extreme emotional distress and regain emotional equilibrium quickly. It stands for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation.

For someone with BPD, using TIPP is most beneficial during moments of acute emotional distress or when noticing the early signs of emotional escalation. It’s a tool that can be used to preemptively manage potential crises, improve day-to-day emotional stability, and support long-term therapeutic goals.

The TIPP exercise offers a practical and accessible way for individuals with Borderline Personality Disorder to manage their intense emotional experiences. When integrated into a treatment plan, TIPP can significantly contribute to the journey toward emotional stability and improved quality of life.

How TIPP Helps and When It’s Best to Use

How It Helps:

• Rapidly Reduces Emotional Intensity: TIPP techniques can quickly bring down heightened emotional arousal, making it easier to think clearly and respond effectively to distressing situations.
• Increases Mindfulness and Present Moment Awareness: By focusing on physical sensations, such as the feel of cold water or the rhythm of breathing, TIPP can help ground you in the present moment, reducing rumination and worry.
• Activates the Parasympathetic Nervous System: Techniques like paced breathing and paired muscle relaxation activate the body’s relaxation response, counteracting the stress response and promoting a state of calm.

When It’s Best to Use:

• During Episodes of Intense Emotion: When feelings become overwhelming or hard to manage, such as during panic attacks, acute stress, or intense anger.
• To Prevent Emotional Escalation: At the early signs of distress, using TIPP can prevent emotions from spiraling out of control.
• To Improve Coping Skills: Regular practice of TIPP techniques can enhance overall emotional regulation skills, making it easier to handle stress and emotional challenges over time.

TIPP is most effective when tailored to individual preferences and needs, and it’s recommended to practice these techniques during times of calm so that they’re more accessible during moments of distress.

How to Do the TIPP Exercise

1. Temperature

• Change your body temperature to alert your brain to a change in environment, which can help it shift out of its current emotional state.
• Use cold water to achieve this: splash your face with cold water, take a cold shower, or hold a cold pack on your face or neck.
• Aim for a significant temperature change for a brief moment. This activates the mammalian dive reflex, which helps to decrease your body’s physical arousal and bring calmness.

2. Intense Exercise

• Engage in brief, intense exercise to help reduce high levels of emotional arousal and distract you from distressing thoughts or feelings.
• Choose an activity that increases your heart rate: running, brisk walking, doing jumping jacks, or any aerobic exercise that is safe for you.
• Exercise for a short period, about 5-15 minutes. This can help burn off some of the body’s stress chemicals and decrease overall emotional intensity.

3. Paced Breathing

• Slow down your breathing to reduce stress and anxiety.
• Focus on taking slow, deep breaths. Inhale slowly through your nose. Hold this breath for a few seconds and then exhale slowly through your mouth.
• Aim for 5-6 breaths per minute, which often means inhaling for about 4-5 seconds and exhaling for 6-7 seconds.
• Paced breathing can help activate the body’s relaxation response.

4. Paired Muscle Relaxation

• Combine muscle relaxation with paced breathing to further reduce physical tension and emotional intensity.
• Tense each muscle group as you take a deep breath in, hold for a few seconds, and then relax the muscles as you exhale slowly.
• Work your way through different muscle groups in the body, starting from your toes and moving up to your forehead.
• Focus on the contrast between tension and relaxation, which can help reduce overall stress levels.

Final Thoughts

The TIPP exercise emerges from the article as a vital, evidence-based intervention for individuals with Borderline Personality Disorder. By offering immediate, effective strategies for emotional regulation and coping, TIPP empowers those with BPD to navigate their emotional landscape with greater agency and resilience, marking a significant step forward in the management of BPD symptoms.

When paired with other DBT Skills, TIPP can help someone with BPD improve their coping skills and emotional responses tenfold.

Like most things in life, practice makes perfect. It can take several attempts before you fully feel the benefits, which is why we recommend practicing TIPP even in moments of calm so that you have the rhythm of the exercise down when you most need it.