By: Dr. Rinju George
Sometimes, getting through the moment is more important than solving the problem in that moment.
Many of us struggle to manage difficult moments when someone behaves in a way that feels unacceptable or upsetting to us. We may become angry, frustrated, anxious, or overwhelmed. Our heart may race, our muscles may tense, our breathing may change, and we may feel a strong urge to react immediately.
When emotional intensity is very high, trying to solve the problem immediately can sometimes make things worse. We may say things we later regret, react impulsively, or make decisions based on the intensity of the moment.
What Is Distress Tolerance?
Distress tolerance skills help us get through a crisis or highly distressing situation without making it worse. They help us manage the intensity of the moment until we can think more clearly and respond effectively. These skills are not meant to solve our life problems. Instead, they help us tolerate the difficult moment without acting impulsively or creating additional problems.
STOP First, Then TIPP
It can be helpful to combine STOP with TIPP, but they serve different purposes. Use STOP when you notice an immediate urge to react—such as yelling, arguing, sending an angry message, or acting impulsively. STOP gives you a moment to pause rather than automatically acting on the urge.
If you have paused but your body is still highly activated—your heart is racing, breathing is fast, muscles are tense, or you feel unable to think clearly—use TIPP to reduce the physiological intensity.
Strong urge to react → STOP
Still highly activated → TIPP
Feeling calmer → Return to the problem
TIPP works with the body first. TIPP targets the body rather than asking you to think your way out of intense distress. When we are highly distressed, telling ourselves to “think positively” or “use logic” may not be enough. Our body is already in a heightened state, making it harder to think clearly. TIPP uses a bottom-up approach: we work with the body first, and as the body settles, the mind can follow.
Let’s take a closer look at each part of the TIPP skill and how you can practise it during moments of intense distress. You do not need to use all four skills at once. Choose one that feels safe, practical, and appropriate for the moment.
T – Temperature: Hold your breath and put your face in a bowl of cold water, or hold an ice pack over your cheeks and around your eyes for about 30 seconds.
I – Intense Exercise: Use brief, vigorous activity such as fast paced walking, running, playing basketball, jumping, weight lifting etc to release some physical energy.
P – Paced Breathing: Slow your breathing and make your exhale slightly longer than your inhale.
P – Paired Muscle Relaxation: Gently tense and then release different muscle groups while breathing slowly to reduce physical tension.
TIPP is not about avoiding the problem. It helps you get through the peak of the emotional moment so you can respond rather than react. Once the intensity comes down, you can return to the problem with a clearer mind.