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Breathing Exercises to Manage Stress: Four Stage Breathing

Dr. Joti Samra

March 12, 2020

Resiliency

Breathing Exercises to Manage Stress

Breathing exercises can be very helpful tools for managing symptoms when our “fight-flight-freeze” stress response is triggered. And the great thing about breathing techniques is they’re easy – once we master the steps. One of my go-to breathing exercises, which we teach to many clients in our clinical practice group, is “four stage breathing”. This is a variant of the more common box breathing approach. Both can be equally effective approaches – it’s just about finding a style that works for you!  

What is Four Stage Breathing? 

Four stage breathing is a type of breathing technique that slows down our breathing actively and intentionally. It’s called four stage breathing as there are – surprise! – four stages to each full breath: two parts to the inhale, and two parts to the exhale. 

Why do breathing exercises work? And why is it important? 

Stress triggers our “fight-flight-freeze” response and when this response is triggered, we tend to shallow breathe.

So why is shallow breathing a problem? Shallow breathing can lead to a whole host of physiological symptoms – including for example, changes in body temperature, lightheadedness or dizziness, or feelings of derealization or depersonalization (where distance/perception can be altered).   

These symptoms can mimic anxiety – and so shallow breathing can inadvertently make subjective feelings of anxiety or stress worse. Four stage breathing helps anxiety by providing control over the physiological symptoms – and this, in turn, helps calm the emotional symptoms.

The technique: How to do four stage breathing   

 

First, ensure you are breathing in through your nose and out through your mouth. This naturally slows down the pace of our breathing.

Second, make each full breath last at least 10 seconds – 5 seconds on the inhale, and 5 seconds on the exhale.   

Break each inhale and exhale into two parts: On the first inhale, fill up most of your lungs; on the second inhale, think about ‘topping up’ your lungs with air. On the first exhale, push out most of the air, and on the second exhale think about fully emptying your lungs. This helps to maximize our lung capacity.

Repeat this cycle for 3-5 minutes.

When you are first learning four stage breathing, it’s important to practice when you are already relatively calm or feeling low stress – this can help build mastery. Then, over time, use it as a tool when you feel your stress or anxiety increasing.

How I incorporate Four Stage Breathing into my daily life 

  1. First thing in the morning. I’m a snoozer so I find it’s a great time to do a few minutes of breathing while lying in bed before getting going for the day. This can set the pace for the day.
  2. Before sleep. When my mind is spinning with all the day’s activities and next day’s to-do’s. This helps me wind down physiologically and start to get prepared for sleep.
  3. When I notice my body tensing up. For me personally, my neck and shoulders creep up, and that’s a great signal for me to relax my posture and do some breathing.

There is a very strong evidence-base on the benefits of breathing to reduce the frequency and intensity of the physiological symptoms associated with stress and anxiety-related. I encourage you to try four stage breathing regularly for a week – just a handful of times a day, for just a handful of minutes at a time and see how you feel.

Remember: when we are experiencing stress, the best thing we can do is focus on the things within our domain of control and breathing is one of them. 

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