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  • Writer's pictureDr Joanne Stuart

Four Square or Box Breathing

Four Square or Box Breathing

Breathing is a fundamental element of our anxiety/calming system in the body. Here we will discuss how 'box' breathing can help to calm the body.


The systems involved in this process are known as the Parasympathetic and the Sympathetic nervous system. All we really need to remember is that we can not be completely relaxed and highly anxious at the same time...the two systems in the body work in opposition to each other. If you imagine an on and off switch. When one is switched on the other is switched off and visa versa. For evolutionary purposes, this system has helped us humans to survive but we really do not need it so much in this day and age.


In order to have some control over our 'anxiety' system, we need to try to trigger our 'calm' system. Look again at the picture...she radiates calm. Ideally this is how we would be all of the time. Unfortunately, however, often our brain decides there is danger around and triggers our anxiety system. At those times, our 'calm' breathing changes to 'anxiety' breathing. Sometimes this can happen without us even noticing it but at other times it is very noticeable and it feels difficult to catch our breath.


Four square or box breathing can be used at times when we need a significant distraction from our surroundings and when our anxiety is high. I have also found that for those where the 'relaxed breathing' does not really work, box breathing can help. Navy SEALs in the US use this type of breathing when they are plunged into freezing water to stop them from dying...good to know.


It is simple but again, useful to practice thoroughly throughout the day so that it becomes familiar to us. When we are highly anxious, it is difficult for us to remember things and so the more familiar something is the better.


Basically, you breathe gently in for four seconds. Try to imagine there is a balloon in your stomach and as you breathe in you fill the balloon. Then hold this breath for four seconds. Then breathe out for four seconds. Then hold for four seconds and repeat.


I have often been asked whether people should breathe in or out through their mouths or noses. There is no right or wrong way - try different ways and see which one works for you.

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