Here’s a TIPP for Stress Management

Have you ever sat in the moment and noticed the physical sensations you are experiencing when you get stressed? Many people feel such intense physical pain when they are under extreme stress, frequently bringing them to their primary care physician’s office, an emergency room, or the urgent care. When we are anxious, scared, angry, or experiencing any other uncomfortable emotions, our body has a physical reaction. Our brain and nervous system signal to our body to respond physically when we are under stress. It’s part of our nervous system’s innate response to protect us when it experiences something it perceives to be a safety risk (think of our early ancestors trying to stay safe from carnivores while hunting or foraging in nature). Common physical responses to stress include increased heart rate, muscle tension, increased body temperature, or sweating. Any of this sound familiar? When I sit with my clients and we explore their uncomfortable emotions, I ask them, “What do you feel physically while experiencing that emotion?” This awareness helps us to move forward and address physical stress held within the body. Once we have an awareness of our how body is responding, we can implement one of my favorite Dialectical Behavioral Therapy (DBT, developed by Marsha Linehan, 1993) techniques for distress tolerance – TIPP.

TIPP stands for:

  • Temperature change
  • Increased activity level
  • Paced breathing
  • Paired muscle relaxation

By implementing these various strategies, we can directly address the physical responses our body is experiencing and signal to our brain (which is directly in communication with the nervous system) to relax a little bit. So, let’s look at specific examples of how to implement TIPP.

Temperature Change:

  • Drink ice cold water
  • Hold an ice pack to your skin (ideally on your upper chest)
  • Hold an ice cube in your hand
  • Open a window or go outside when temperature is cooler/cold
  • Splash cold water on your face

Increased Activity Level:

  • Do a couple of sprints
  • Do some jumping jacks, jump rope, or push-ups for a minute
  • Go for a run, swim, or brisk walk
  • Walk up and down a flight of stairs a few times

Paced breathing:

  • Inhale for 4 seconds, hold for 2 seconds, and then exhale for 6 seconds. Repeat. Exhales are recommended to be longer than your inhales. Focus on feeling your breathing in your belly. The goal here is to increase oxygen into your brain so you can think more clearly (better decision making) and to slow down your heart rate.

Paired muscle relaxation:

  • Intentionally tense a muscle group in your body, breathe in, and then intentionally relax the muscle group as you breathe out. Focus on one problem area or complete this from head to toe for your entire body, focusing on various muscle groups together.

Many times, my clients and I problem solve how to use this in various environments – at school, work, home, in the car, or out in the community so that they have various options. By coming up with strategies that work for you, you too can help manage stress by targeting physical symptoms. Create a list of ways to implement these in various environments and try to plan ahead when you know you might have to go into a stressful or overwhelming environment or situation. Although this skill set will not eliminate the emotions entirely, it will definitely help to alleviate the intensity of the physical and emotional response one is experiencing giving an additional way to cope with intense emotions.

*Please be sure to consult your physician regarding any medical conditions that could be impacted by sudden intense temperature change, heart rate changes, or intense physical exercise.