TIP the Temperature-One of the "TIP" Skills

In Dialectical Behavior Therapy (DBT), TIP skills are essential for quickly reducing intense emotional distress. These skills work by engaging your parasympathetic nervous system, which helps calm you down. When emotions are running high, it can be challenging to use other coping strategies, so TIP skills provide a fast and effective way to lower emotional arousal.

The DBT TIP skills include: Tip the Temperature, Intense Exercise, and Paced Breathing, along with Paired Muscle Relaxation. Today, we’ll focus on the Tip the Temperature skill. This method leverages the dive reflex, a response that slows the heart rate when a person is submerged in cold water. By activating the parasympathetic nervous system, it helps to decrease emotional overarousal caused by an overactive sympathetic nervous system.

To practice this skill, wrap ice packs in paper towels and place them over your eyes and under your eye area. Lower your head, hold your breath, and stay in this position for 30 seconds. This simulates the experience of diving underwater, triggering the dive response. Your heart rate slows down, blood flow is reduced to nonessential organs, and more blood is directed to your brain and heart, which helps regulate your emotions. This technique is particularly useful for managing distressing emotions and strong urges to engage in harmful behaviors.

*Caution: Using ice or very cold water can rapidly decrease your heart rate. Consult your healthcare provider before trying this technique. If you have any heart or medical conditions, a low baseline heart rate due to medications, take beta-blockers, are allergic to cold, or have an eating disorder, you should reconsider using this technique.