Cold water on your face can trigger the body’s dive reflex, which slows the heart. DBT uses this to take the edge off very intense emotion. Please read the safety note before you start.
Splash cold water on your face or hold an ice pack wrapped in a cloth against your cheeks and temples.
TIPP stands for Temperature, Intense exercise, Paced breathing and Paired muscle relaxation — four Dialectical Behaviour Therapy (DBT) skills for moments when emotion is so strong you can’t think clearly. This tool guides the temperature skill:
Cold water on the face while holding your breath triggers the mammalian dive reflex, which slows the heart through the vagus nerve. When the body calms down quickly, very intense emotion often becomes easier to manage. The effect is short-lived — it is a bridge that buys you time to use other coping skills, not a long-term fix.
Important: very cold water lowers heart rate quickly. Check with a doctor before using this skill if you have a heart condition, a low resting heart rate, take medication that lowers heart rate (such as beta-blockers), or have an eating disorder. Don’t put ice directly on your skin, and keep exposure to about 30 seconds. If you are in danger or thinking about harming yourself, contact emergency services or a crisis line now: call or text 988 in the US, or Samaritans on 116 123 in the UK and Ireland.
Temperature, Intense exercise, Paced breathing and Paired muscle relaxation. They are DBT distress-tolerance skills for quickly lowering very high emotional arousal.
It needs to feel cold. DBT handouts suggest water colder than about 10°C (50°F). A cold pack wrapped in a cloth over the eyes and cheeks also works.
Many people notice a change within a minute, but responses vary and the effect wears off, so plan what you will do next.
It is designed for intense emotional distress. For panic, you may also find the panic helper useful. Seek urgent medical help for chest pain, severe breathlessness or fainting.