Introduction to Dialectal Behavioural Therapy: The TIPP Skill

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At Footprints we have a program called ‘Peer Based Group Supports’.  These groups are different to other community groups as peers run them. At Footprints, our Peer Facilitators all have lived experience of their own Mental Health journeys and recovery.  We teach skills that we actively use in our own lives which we hope to inspire and encourage all our participants to use.

One of our most popular groups is our ‘Introduction to DBT (Dialectal Behavioural Therapy)’ Group.  This is a condensed version of the full DBT program that participants can go on to complete if they feel DBT is right for them. This group is great for learning practical skills on how to manage behaviour that you are finding disruptive to your life. We discuss and explore reasons on why this behaviour may come up in the first place and offer examples of these skills working in our own personal lives.

One of our favourite DBT skills is called ‘TIPP’.  TIPP stands for – Temperature –Intense Exercise –Paced breathing and – Paired muscle relaxation.  This is a super easy skill to use in times of crisis or high emotional states like when you feel overwhelmed and your emotions are going to consume you. It is also used for insomnia or when your thoughts just will not stop when you are trying to sleep. It is great for anxiety, for rumination and to increase or energise your mood during those times of depression. What I like most about the TIPP Skill is that it works as well and as fast as other unhelpful behaviours (or fast acting medication) that we tend to turn to when we want to calm down and feel more in control of our emotions, but they don’t have any negative short or long term effects!

Below I have outlined how to use each skill:

Temperature: change the temperature. This can be done many ways, such as splashing cold water on your face, filling a sink up with very cold water, or you could even use water from the fridge or add ice cubes to your tap water.  When doing the sink technique, lean forward and dunk your head into the water, making sure your temples are covered, hold your breath and count to the highest number that you are comfortable with and then remove your head from the sink to breathe again. Please do NOT use the Temperature skill without talking to your doctor if you have heart problems, bulimia or anorexia nervousa.

Intense exercise: Preferably, you would do aerobic exercise for at least 20 minutes. I have found even a quick intense run on the spot or some star jumps can help me if I don’t have 20 minutes free at the time. This one is great for releasing built up frustration or anger, it’s also great to bring a low mood up and energise you.

Paced Breathing: This is when you breathe out slower and longer than when you breathe in. You can start with a 1-second difference and work your way up. For example; breathing in for 4 seconds and out for 5 seconds. Once you are comfortable with this you can increase the breath in for 5 seconds and out for 7 seconds. Finding what works best for you. This action communicates to your body that you are safe. Sometimes we get triggered and our body truly thinks we are in danger, by using our paced breathing we are communicating to our body that ‘if I am safe enough to take the time to breathe like this, then I am safe’.

Paired Muscle Relaxation: this is great for relaxing at night time or if you are feeling anxiety on something like public transport. You can work from toe to head or head to toe or pick body parts that work for you.  Notice the tension in your muscle, then tense that muscle as hard as you can while you breathe in, as you breathe out say the word ‘relax’ in your mind and release the tension. Notice how much more relaxed the muscle feels now.

This is a very brief outline of the TIPP skill. You will be able to find much more information on the internet! Or come and attend our DBT Group to find out more. Or download our TIPP Skills resources.

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