DBT TIPP Crisis Grounding

Use the DBT TIPP crisis grounding framework to reduce intense distress, orient your senses, and return to physical stability.

6 time blocks, 20 minutes in total.

Time blocks

Cold Water Temperature Switch: 2 min
Splash cold water on face or hold an ice pack to calm nervous system
Intense Exertion Burst: 3 min
Do jumping jacks or fast walking to discharge high emotional energy
Paced Exhale Breathing: 4 min
Breathe in deeply and make exhales noticeably longer than inhales
Paired Muscle Relaxation: 5 min
Tense muscles on inhale and release tension completely on exhale
Five Senses Orienting: 3 min
Name 5 things you see, 4 touch, 3 hear, 2 smell, 1 taste
Support Connection: 3 min
Contact a trusted friend, family member, or crisis support line

About this routine

Dialectical Behavior Therapy includes a set of distress tolerance skills known by the acronym TIPP, widely used for DBT TIPP crisis grounding. Created by Dr Marsha Linehan, this approach changes body chemistry quickly to reduce extreme emotional activation.

The sequence begins with temperature changes and brief exertion to calm the physical fight or flight response. Next, paced breathing and muscle relaxation stabilize the heart rate before sensory orienting and reaching out to support contacts.

Practicing this structured sequence during moments of acute stress provides a reliable anchor. Using a routine timer can help guide you step by step through each beat without requiring you to keep track of time.

Why this routine works

Triggers the mammalian dive reflex to lower elevated heart rate
Discharges excess kinetic energy caused by panic
Restores nervous system balance through extended exhales
Orients attention away from overwhelming thoughts back to sensory reality

FAQ

What does TIPP stand for in DBT?

TIPP stands for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation.

How long does DBT TIPP grounding take?

This grounding sequence takes 20 minutes to complete across all six steps.

When should you use the DBT TIPP skills?

Use TIPP skills when emotional distress is high and logical processing is overwhelmed by anxiety or panic.

Sources

DBT Skills Training Manual, Second Edition, Marsha M. Linehan
DBT Distress Tolerance Skills, Behavioral Tech

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