T (Temperature)
I (Intense Exercise)
P (Paced Breathing)
P (Paired Muscle Relaxation)
100

This reflex slows your heart rate when your face hits cold water

What is the dive reflex

100

This is the minimum amount of time needed for intense exercise to shift emotion.

What is 60 seconds.

100

An example of a helpful paced breathing ratio in DBT (inhale to exhale second amounts).

What is inhale 4 to exhale 6 (any number combo as long as the inhale is less than the exhale). 

100

This is the ideal length of time to hold a gentle muscle tension before releasing.

What is about 3–5 seconds.

200

True or false: You need ice to use the temperature skill.

What is false.

200

Name one movement someone can do even while seated.

What are rapid leg lifts, fast tapping, seated marching, etc.

200

Name one visual anchor someone could use while breathing.

What is a plant, window, lamp, pet, or object in the room.

200

Name a common area of the body that Paired Muscle Relaxation can help relieve tension from.

What is jaw, shoulders, brow, etc.

300

Name one body area where cold works fastest.

What are cheeks, neck and wrists

300

This is the main goal of using intense exercise in TIPP.

What is to burn off excess physiological arousal

300

This is the best posture for paced breathing:

  1. Slouched
  2. Rigid
  3. Relaxed and upright

What is 3

300

This is the recommended intensity of the tension during PMR:

  1. As hard as possible
  2. Gentle but noticeable
  3. Barely any tension at all

What is B: gentle but noticeable.

400

This is the main reason temperature works so quickly on panic.

 What is rapid parasympathetic activation.

400

True or false: Intense exercise works even if you don’t feel motivated to do it.

What is true.

400

This type of breathing pattern forms a square shape when visualized.

What is box breathing

400

This is the best way to choose which muscle group to start with during PMR.

What is starting where you feel the most tension.

500

Give one creative, everyday item someone could use for the “T” in TIPP.

What is a cold drink, frozen veggies, snow, cold air from freezer or outside, etc.

500

Name a situation where intense exercise might not be the best first choice.


What is when someone is dizzy, dissociated, or physically limited.

500

This simple adjustment makes paced breathing more effective.

What is extending the exhale.

500

This is the key internal skill that makes PMR more effective over time: noticing tension early before it builds.

What is body awareness.