How to Use TIP Skills as a Coping Mechanism During Crisis

During moments of intense emotion, it’s imperative to have healthy, easily accessible, and effective coping mechanisms in your back pocket. With this thought in mind, I want to discuss TIP skills, a popular distress tolerance tool

During times of crisis, it’s natural to feel like your low point will never end.

Feeling trapped in this desperate mindset, you may turn to unhealthy behaviors, such as binge eating, purging, or self-harm, as a way to escape or block the emotion. To help you avoid this path of destruction, Marsha Linehan, PhD, the founder of Dialectical Behavior Therapy (DBT), developed distress tolerance skills that are clear and easy to access, allowing people practical and health-affirming alternative coping mechanisms. 

As a distress tolerance tool, TIP skills are extremely important.

TIP is an acronym that stands for: 

  • Temperature 
  • Intense exercise
  • Paced breathing
  • Progressive muscle relaxation

These skills require us to change our body chemistry in order to regain control of our emotions and behavior. 

T: Temperature

Have you ever tried the mammalian dive reflex? Lean over a sink or a countertop and place cold water or an ice pack over your temples, eyes, and upper nose region for about 30 seconds. This dive-like stance triggers a reflex that naturally occurs when mammals submerge themselves in cold water. 

Think about a time when you dove into a cold pool at the beginning of summer. You may recall the sensation of slowly cutting through the water with your arms, that feeling of slowed time as you drifted back to the surface. When you dive face first into cold water, your heart rate slows and your breathing regulates to conserve your energy. You experience a calming effect as you engage your parasympathetic nervous system.

When you feel activated, distressed, upset, or angry, try running cold water on your forearms, taking a hot or cold shower, chewing on ice, or just holding an ice cube in your hand. By briefly changing your temperature, you ground yourself in the present moment and refocus your attention.

I: Intense Exercise

Brief bursts of exercise are also helpful in the grounding process. This action physically uses up some of the energy that is fueling those feelings of anger or anxiety. During low-energy states (i.e. when you’re feeling down, depressed, and/or lethargic), getting your heart rate up reinvigorates you. 

Of course, it’s important to note that exercise can be a sensitive topic for individuals struggling with eating disorders. If you’re at place in your treatment process where you need to limit exercise, try another TIP skill instead. 

P: Paced Breathing

Have you ever been told to take a deep breath during a moment of crisis? Well, there’s a reason for that! When you slow and regulate your breath by breathing deeply into your lungs and diaphragm, you activate your parasympathetic nervous system. As you slow the pace of your in- and out-breaths, you may achieve only five to six thoughtful breaths per minute. 

Some individuals refer to this practice as “having a pill in their pocket.” It’s a highly accessible skill that’s available to you at all times, no matter where you are. When your emotions are riding high, use your breath to steady you.

P: Progressive Muscle Relaxation

This behavior goes hand-in-hand with paced breathing. As you take those deep, thoughtful breaths, tense and relax muscle groups throughout your body to promote a feeling of relaxation. You can also try to mindfully tense all of your muscle groups at once and then drop your weight into a chair. As you move from head to toe, focus on one area at a time and pay close attention to the sensations in your body.

Through the application of these DBT principles, you learn how to survive a crisis or sharp escalation of emotion in a healthy way.

These coping mechanisms can help you navigate emotional and physical pain and can be used in situations where few alternatives are available to help you feel better.

If you or a loved one is struggling with an eating disorder, please reach out to our team at to discuss treatment options.