These days, I end up talking about anxiety management with every client I have, regardless of why they are seeing me. They don’t always call it anxiety; sometimes they say it’s “stress.” Or sometimes they don’t name it at all, they just tell me about how they’re “not doing well” and I have to pull out the details about their anxiety symptoms. I teach everyone about breathing to manage anxiety and stress because when stressed, breathing is one of the first things impacted.
Learning to breathe correctly is also one of the simplest and easiest ways we can regulate strong emotions. You always have your breath with you; no props needed. You can practice calming breathing with your eyes open or closed. Breathing can be done alone, or in a room full of people. It can be done in a bathroom stall, or in the middle of giving an important presentation.
Why is my anxiety getting worse lately?
By the time my clients with anxiety disorders start therapy, they usually know when they’re feeling anxious. But still, many wonder why things are so much harder for them lately. Especially if they have been relatively unfazed by the pandemic and all the other stressors of 2020, and everything seems pretty ok in their life right now. Even so, experiencing increased stress and difficulty managing things actually makes a lot of sense.
To validate why so many of us are struggling, consider this questionnaire, which is often administered in health care settings to determine one’s risk of developing stress-induced health problems. It asks about events experienced in the past year. For 2020, ALL of our scores would be high. The recent stressors of a pandemic, economic volatility, social unrest, and multiple natural disasters have pushed us to the edge this year. We can’t help but take in the collective hurt and stress of those around us. So, it makes sense that your body and brain have noticed, and have a hard time settling down.
I’ve talked about the Window of Tolerance before, in this blog post about ending binge eating and emotional eating. This window relates to how much stimulation our nervous system can manage to function well. It’s different for everyone. If you are a born worrier, have experienced trauma, or you suffer from anxiety (or any mental health problem), you might always hang out at the edges of your window of tolerance. The events of this year have certainly been enough to push you out that window. No wonder you feel more anxious! So let go of the self-judgment, and let’s talk about what to do about it.
What do you do in anxiety counseling?
In anxiety counseling, we work together to address three main areas: the MIND, the BEHAVIOR, and the BODY. To address the mind, I help clients identify the anxiety-related thoughts that may be creating a vicious cycle of worry (“It’s NEVER going to work out… this is terrible!” or “Eating is the ONLY way I can feel better!”) Then they practice new ways of thinking that may have less impact on feelings and behaviors. If we can train our brains to think more rationally, this goes a long way toward managing anxiety.
To address behavior, I help clients identify the specific things they do that are problematic or not working well (obsessing over how painful things are or turning to alcohol or food to numb out). We then practice ways to curb these behaviors and find effective alternatives.
To address the body, we identify the physical sensations in the body that occur when feeling anxious. Then we can work on calming that sensation. Many clients report feeling tension in the neck or shoulders, or chest tightness. This is where breathing exercises get introduced.
Why do we start with the body to manage anxiety?
For many clients, the body is the easiest place to start. In the beginning, it’s often too challenging to accept that our thoughts are problematic. Thought patterns are so ingrained that it’s hard work to give them up! Maybe it wasn’t safe in your home to express your feelings, or your caregivers didn’t model this for you. Starting with the body may feel more neutral and safer.
Also, most of my clients who struggle with anxiety can easily acknowledge their physical symptoms, as this is often what alerted them to the problem in the first place. The symptoms are there, easy to see or feel all day long. Using your breath to calm your body and mind is something you can learn quickly, and use easily.
Breathing as a mindfulness skill
Pretty much any kind of therapy these days builds on a foundation of mindfulness. I love this simple definition of mindfulness from mindful.org: “The basic human ability to be fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us.” Ultimately, you have to pay attention to the things you want to work on in counseling for anxiety or counseling for eating disorders.
Breathing exercises can be an effective stand-alone coping skill for anxiety, especially for panic attacks. Calm breathing slows us down physically by slowing our rapid breathing, heart rate and blood pressure. Breathing is also a stepping stone to other important emotional and cognitive work in therapy to manage anxiety and stress. Focusing on the breath can get you back into your window of tolerance. Once there, you have easier access to parts of your brain that allow you to think more rationally and problem solve. Then you can work on fixing things that need to be fixed. Of course, sometimes things can’t be fixed. In this case, the calm could allow your mind to open, resulting in surrender and accepting the things you can’t change.
Various breathing techniques to manage anxiety
There are many ways you can practice using your breath to manage anxiety and stress. Below are several favorites that I teach to clients in therapy for anxiety and eating disorders.
This is also known as abdominal or belly breathing. The focus is to get a full, deep breath, rather than the shallow breathing we often do when stressed out. It simply requires that you focus on taking slow, deep breaths, filling your chest and belly. Focus on feeling your stomach rise on the inhale, and then fall again as you breathe out. You can place one hand on your chest and one on your stomach as you breathe, to make sure you are fully breathing in and out. One great way to make sure you’re doing it right is to visualize a balloon filling up as you inhale: expanding in the bottom section first, then into the top.
You can find a pace that’s comfortable for you, but make sure it feels relaxed and smooth. It can help to count as you inhale and exhale to keep your mind focused on your breath. You can also imagine blowing out a candle to ensure your breathing is calm and steady, not too rushed.
Here is a great short video to demonstrate:
Box breathing or Navy Seal breathing
My therapy clients love this one! This technique, which involves breathing and visualization, is taught to Navy Seals to help them calm and focus during the chaos of battle. In this exercise, you inhale to the count of 4 or 5 as you visualize one side of a box; then exhale to the count of 4 or 5 as you visualize an adjacent side of the box. You repeat this with the remaining sides. Below is a video to demonstrate this. Some people don’t like holding their breath, so I recommend skipping this part of the exercise, just alternating inhales and exhales as you visualize the box.
Here is a video to demonstrate:
Lengthening the exhale
This breathing technique involves extending the length of your exhale longer than the inhale, which can lead to even greater calm and manageability of anxiety. You can simply count longer on the exhale, or you can try the “4-7-8” technique, in which you breathe in for 4 counts, hold your breath for 7 counts, then exhale for 8 counts. Here is an explanation for why this works to enhance calm.
Here is a video to demonstrate:
Final words about breathing to manage anxiety
Over time I teach clients many different breathing techniques because not everything works the same for everyone. I start with basics and encourage clients to combine techniques to individualize them for their needs. We practice in session, create a reasonable plan for practice on their own, then tweak as needed over time.
Breathing techniques are easy to learn. The hard part is keeping it up. Just like learning ANY new skill, consistency is key. Don’t beat yourself up for having a hard time practicing these skills consistently! In my next post, I discuss tips for creating a plan for successfully using breathing to manage anxiety. If you need someone to coach you on coming up with a plan for managing anxiety better and helping you to stay accountable with this plan, give me a call!
If you need help creating a plan for managing your anxiety better, I’d love to help. I OFFER VIDEO COUNSELING FOR YOUR CONVENIENCE!! If you’re looking for counseling in Plano, Texas contact me here or at 469-850-2420 or email@example.com for a free 15-minute phone consultation. My name is Danesa, and we can see if we’re a good fit! I’m also happy to connect you to another great therapist in the area.
My specialties include anxiety, depression, eating disorders such as anorexia, bulimia, binge eating; overeating or compulsive eating, and body image issues. My counseling office is in Plano, Texas, and conveniently located near Frisco, Allen, and McKinney.