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From DBT Skills Training Handouts and Worksheets, Second Edition  by Marsha M. Linehan. Copyright 2015 by Marsha M. Linehan. Permission 
to photocopy this handout is granted to purchasers of this book for personal use only (see copyright page for details).« Distress tolerance Han Do ut 6  (Distress Tolerance Worksheet 4)
TIP Skills: Changing Your Body Chemistry
To reduce extreme emotion mind fast. 
Remember these as TIP  skills:
TTI P Th e T emPer aTu re of your face with C old wa T er*  
(to calm down fast)
• •Holding your breath, put your face in a bowl of cold water,  
or hold a cold pack (or zip-lock bag of cold water) on your eyes and cheeks.
• •Hold for 30 seconds. Keep water above 50°F.
IInTenSe  exer C ISe*   
(to calm down your body when it is revved up by emotion)
• •Engage in intense exercise, if only for a short while.
• •Expend your body’s stored up physical energy by running, walking fast, jumping, 
playing basketball, lifting weights, etc.
P

PaCed Bre aThIn g  
(pace your breathing by slowing it down)
• •Breathe deeply into your belly.