MORE THAN THERAPYTHE RESOURCE LIBRARY

MODULE 18 / 24 · Distress tolerance · 15–25 MINUTES

TIP / TIPP: Body-Based Distress Skills

Explore temperature, suitable exercise, paced breathing, and paired muscle relaxation safely.

Try the worksheet

Understand the skill

TIP/TIPP commonly refers to Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation. 'Intense sensations' is not the exercise component. Progressive muscle relaxation is a related practice. Pain, breath-holding, and extreme sensations are not required.

Practice step by step

  1. Check what is medically suitable with your clinician; choose a gentle option when uncertain.
  2. If comfortable, try ordinary cool contact such as a cool cloth, or suitable movement within your usual limits.
  3. Allow a slower, comfortable breath without forcing depth or holding it.
  4. Gently release muscle tension if suitable, then check whether you can choose a next step.

TRY IT · SOLO OR WITH A GROUP

A practice activity

Gentle body-skills menu: compare a cool cloth, comfortable movement, natural slower breathing, and relaxing the shoulders. Select or imagine one, then identify reasons to stop. No immersion or strenuous exercise is prescribed here.

Group option: Work from a fictional example for five minutes, rehearse or compare choices for five minutes, then discuss one useful adaptation. Pass, write, observe, or work alone.

Your practice worksheet

Writing is optional. Responses stay in this open tab and are not submitted or automatically saved. Closing or refreshing clears them. Avoid names or identifying details. Printing or downloading includes your words.

Use paper or discuss the prompts if you prefer.

Recovery connection

Body-based coping may support an existing recovery plan during distress; it cannot treat withdrawal or intoxication.

Facilitator notes

Do not lead facial ice-water immersion, breath-holding, or exercise challenges. Offer seated external grounding and an opt-out.

Adaptation and care: Heart or breathing conditions, temperature sensitivity, fainting, pregnancy, injury, eating-disorder concerns, or other health needs may require clinician guidance before temperature or strenuous exercise techniques. Stop for pain, dizziness, breathlessness, or discomfort.

Between-session practice: Choose one manageable situation to try this skill. Notice the context, what you did, and what helped or needs adjusting. An attempt counts as practice even when feelings do not change.

Background and sources

DBT skills concepts originate in Marsha M. Linehan's work. These are original More Than Therapy activities, not reproductions of official worksheets or endorsed materials.

References inform the skill framework; they do not validate these particular exercises. Life-structure modules are DBT-informed applications, not additional standard DBT core modules.