What is the TIPP skill in pyschology?

What is the TIPP skill in pyschology?

DBT (Dialectical Behavior Therapy)

Are you struggling to cope with overwhelming emotions and looking for ways to manage them? DBT and the TIPP skill might be the solution for you. Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy that was originally developed to treat individuals with borderline personality disorder. It has since been adapted for other mental health conditions, including bipolar disorder. Within DBT, there are four modules- Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance. Each of these modules is designed to help individuals manage different aspects of their lives, including the use of DBT skills like TIPP. One of the techniques used within the Distress Tolerance module is TIPP, i.e. the TIPP skill.

In this blog, we will explore what the TIPP skill is, its importance in managing overwhelming emotions, and break down the four elements involved in the technique. The TIPP skill is intended to change your body chemistry quickly in order to reduce the effects of an overwhelmed emotional mind; where your thinking and behaviors are controlled by your overwhelming emotions.

It is important to remember that this should not be used in place of professional help. If you’re struggling with a mental health condition, it’s always best to seek out the help of a qualified mental health professional. We will also introduce bobi, a breathing companion that is the perfect embodiment of TIPP. Join us as we delve into how utilizing bobi in your therapeutic practice can improve your mental health.

Origin and Purpose of DBT

DBT, which stands for Dialectical Behavior Therapy, was developed by Marsha Linehan and has its roots in the broader field of cognitive behavioral therapy (CBT). This evidence-based psychotherapy, influenced by the philosophical perspective of dialectics, was initially designed to assist individuals struggling with borderline personality disorder (BPD) and other mental health conditions, such as post-traumatic stress disorder (PTSD). The main objective of DBT is to provide individuals with the necessary skills to effectively manage their emotions, cultivate healthier relationships, and ultimately improve their overall quality of life in the best way possible.

By integrating the principles of cognitive-behavioral therapy with mindfulness practices, DBT equips individuals with a wide range of skills, including acceptance skills and change skills, such as dialectical behavioral therapy. These skills can be applied to various areas of their lives. With the guidance of a trained DBT therapist and the support of a consultation team, individuals are able to learn new techniques for emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness exercises. Through a combination of individual therapy, group therapy, skills training, and homework assignments, DBT offers an effective treatment option for those struggling with BPD and other mental health challenges, such as binge-eating disorder.

The Four Modules of DBT

Four modules of DBT

DBT is based on four key modules that form the foundation of treatment:

  1. Mindfulness: Involves being present in the moment and observing thoughts and emotions without judgment
  2. Distress tolerance: Focuses on learning ways to tolerate difficult emotions and situations without resorting to harmful coping mechanisms, such as self-harm or substance abuse
  3. Emotion regulation skills: Helps individuals develop skills to identify and understand emotions, as well as learn how to effectively regulate them
  4. Interpersonal effectiveness: Aims to improve communication and interpersonal relationships by teaching effective communication skills, setting boundaries, and maintaining self-respect

These modules are designed to provide individuals with the necessary skills, including self-soothing techniques, to navigate through challenging situations and ultimately enhance their overall well-being.

What is the TIPP skill in DBT?

TIPP in DBT refers to Temperature, Intense Exercise, Paced Breathing, and Paired Muscle Relaxation. The TIPP skill helps individuals manage intense emotions and distress. By engaging in these four elements, one can regulate their emotional state and cope with difficult situations.

Temperature Control in TIPP

The temperature skill is a powerful technique that can help regulate emotions by changing the body’s temperature. One effective way to use this skill is by splashing cold water on your face or dunking your head in cold water. The physical sensation of cold helps activate the body’s mammalian dive reflex, which slows down the heart rate and calms the nervous system. Another option is to use an ice pack on your face, particularly around the eyes and cheeks, to help regulate your body temperature and emotions. This can be particularly helpful in times of crisis or high emotional intensity.

However, it is important to note that if you have heart problems, bulimia, or anorexia nervosa, it is crucial to consult with a doctor before using this skill. Cold water exposure may not be suitable for individuals with these conditions, as it can potentially exacerbate their health issues.

The temperature skill is a quick and effective way to manage overwhelming emotions. By incorporating this technique into your coping repertoire, you can have a powerful tool at your disposal to help regulate your emotions and promote a sense of calmness and control in difficult situations.

The Role of Intense Exercise in TIPP

Engaging in intense exercise is a valuable skill for managing emotions and promoting overall well-being. Whether it’s a cardio workout, a high-intensity interval training (HIIT) session, or a run in the park, intense exercise, specifically aerobic exercise, can release pent-up energy and help balance emotions. Just 20 minutes of intense exercise can make a significant difference in how you feel.

Intense exercise works by redirecting your focus away from overwhelming emotions and onto the physical sensations of movement and exertion. It releases endorphins, the body’s natural feel-good chemicals, which can boost mood and reduce stress. By engaging in intense exercise, you can release frustration, improve your mental clarity, and energize yourself with physical energy.

Remember, even a quick 10-minute workout can be beneficial. The goal is to get your heart rate up and challenge your body. Find activities that you enjoy and that get you moving. It could be dancing, kickboxing, cycling, or any other form of exercise that gets your blood pumping. The key is to find what works for you and make it a regular part of your routine.

Understanding Paced Breathing

Paced breathing is a simple yet powerful technique that can help calm both the mind and body. By focusing on slow, deliberate breaths, we can activate the parasympathetic nervous system, which promotes a relaxation response in the body. This technique is particularly effective in reducing stress and anxiety, as it helps regulate our heart rate and brings a sense of calmness.

To practice paced breathing, find a comfortable seated position and take a deep breath in through your nose, filling your lungs. As you exhale, slowly release the breath through your mouth. Allow your breath to flow smoothly and evenly, focusing on the sensation of the air entering and leaving your body.

Take a moment to observe how your body responds to each breath. Notice the rise and fall of your chest or the feeling of your abdomen expanding and contracting. As you continue with your paced breathing, you may find it helpful to count your breaths, inhaling for a count of four, holding for a moment, and exhaling for a count of four. This rhythmic pattern can help anchor your focus and deepen your relaxation.

The Importance of Paired Muscle Relaxation

Paired muscle relaxation is a powerful technique for promoting relaxation and reducing muscle tension. By practicing this skill, individuals can effectively manage their emotions and alleviate anxiety and stress. This relaxation technique involves tensing and relaxing different muscle groups in the body, allowing individuals to develop a deeper awareness of their physical sensations and achieve a state of profound calm.

When practicing paired muscle relaxation, it is important to focus on one muscle group at a time. Begin by tensing the muscle group for a few seconds, and then release the tension completely. As you tense and release each muscle group, including the importance of progressive muscle relaxation, pay attention to the sensations you experience, allowing yourself to fully relax and let go of any tension or stress. This process can be performed in a seated position, making it easily accessible in various settings.

Regular practice is key to mastering the paired muscle relaxation skill. By incorporating this technique into your daily routine, you can train your body to respond to stress in a more relaxed manner. Over time, you will become more proficient at identifying and releasing muscle tension, facilitating a greater sense of physical and emotional well-being.

bobi as the embodiment of TIPP

bobi can play a vital role in enhancing DBT and specifically the skills taught through TIPP.

Importantly, bobi addresses each of the fundamental concepts of the TIPP skill and can used as a tool to manage intense emotional responses.


Bobi Cold Palmpad prototype

bobi has been designed to incorporate a removable palm pad. A key feature of the TIPP strategy is “temperature” change whereby ice, or cooling material, can be used to redirect focus and thereby manage distressing emotions. bobi’s ‘Ice Palm Pad’ represents a unique feature whereby the ‘Temperature’ intervention can be used in the same way as ice, or similar. Simply place the bobi ‘Ice Palm Pad’ in the freezer for 10 minutes and then swap it onto bobi when ready to use.

Intense Exercise

bobi integrates a crucial form of exercise known as isometric hand exercise that can be used as a feature of the device. Isometric exercise involves the contraction of a muscle without any subsequent movement. Essentially, isometric hand exercise involves somebody contracting their hand (at approximately 25% overall strength) and holding that position for several minutes. This form of exercise has recently been found to be the most effective in reducing blood pressure.

Paired Muscle Relaxation

The most commonly used instruction for paired muscle relaxation is this: “Tense your muscles when breathing and relax them when breathing out”.  bobi is perfectly designed to coach and guide anyone through paired muscle relaxation.  Gently breathe in as you slowly squeeze bobi.  Then, gently breathe out as bobi naturally expands in your hand.

Paced Breathing

bobi time selector for paced breathing

bobi’s core feature is the capacity to guide and coach users to develop a slow, controlled, breathing rate. With three discrete settings allowing for different rates of breathing, bobi is uniquely designed to provide assistance in maintaining a slow breathing rate, especially during times of distress.


Integrating bobi into DBT practice enhances the accessibility and effectiveness of this evidence-based treatment approach. By incorporating bobi, individuals are provided with a valuable tool to support and guide them in managing distress and improving their mental well-being. Through bobi, individuals can develop and strengthen the skills necessary for navigating challenging emotions and maintaining overall mental wellness. bobi offers a discrete and highly effective calming tool for individuals to utilise in virtually any environment. Embracing bobi as part of their journey empowers individuals to take control and build resilience in the face of adversity.

In conclusion, bobi represents the closest embodiment of the TIPP skill possible. It therefore is a highly valuable tool for managing intense emotions and achieving emotional regulation. Through temperature control, intense exercise, paced breathing, and paired muscle relaxation, individuals can learn to effectively cope with distressing situations. Utilizing bobi as an adjunct to DBT can significantly support any person’s journey to mental well-being. If you’re interested in incorporating bobi into your therapy journey, then click here to purchase your own bobi!

bobi breathing companion device


  1. What is Dialectical Behavior Therapy (DBT)?

Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy initially developed to treat individuals with borderline personality disorder. It has since been adapted for other mental health conditions like bipolar disorder and PTSD. DBT focuses on four modules: Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance. These four modules help individuals manage their emotions and improve their quality of life.

  1. What are the Four Modules of DBT?

The four modules of DBT are:

Mindfulness: Being present in the moment and observing thoughts and emotions without judgment.

Distress Tolerance: Learning ways to tolerate difficult emotions and situations without harmful coping mechanisms.

Emotion Regulation: Developing skills to identify, understand, and effectively regulate emotions.

Interpersonal Effectiveness: Improving communication and interpersonal relationships through effective communication skills, setting boundaries, and maintaining self-respect.

  1. What is the TIPP skill in DBT?

TIPP stands for Temperature, Intense Exercise, Paced Breathing, and Paired Muscle Relaxation. It is a skill within the Distress Tolerance module of DBT designed to help individuals manage intense emotions and distress.

  1. How does bobi relate to TIPP and DBT?

Bobi is a breathing companion designed to embody the principles of TIPP. It incorporates features like a removable palm pad for temperature control, isometric hand exercise, and paced breathing settings. Bobi aims to assist individuals in managing intense emotional responses and is considered a valuable tool in DBT practice.

  1. Is DBT a substitute for professional help?

No, DBT should not be used in place of professional help. If you’re struggling with a mental health condition, it’s always best to seek out the help of a qualified mental health professional.


Jørgensen, M. G., Ryg, J., Danielsen, M. B., Madeleine, P., & Andersen, S. (2018). Twenty weeks of isometric handgrip home training to lower blood pressure in hypertensive older adults: a study protocol for a randomized controlled trial. Trials, 19. Link.


Written by Damien Thomas BA(Psych); GradDipPsych; MPsych(Org), MAPS

Mr. Damien Thomas completed his Master in Organisational Psychology at Macquarie University, Sydney. He has over 20 years’ experience as a psychologist and has specialised in the field of adolescent psychology. Damien also worked within the field of national security, including counter terrorism operations, and war crimes investigations. Through his previous work he has featured in numerous international media publications including: The Australian, The Globe and Mail, New York Times, and BBC (radio).

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