Box Breathing: breathing with intention & purpose

What Is Box Breathing—and Why It Matters
Box breathing (also called square breathing or 4‑4‑4‑4 breathing) is a simple, rhythmic breathing technique that looks and feels like tracing the sides of a box:
§  Inhale (through the nose) for 4 seconds
§  Hold for 4 seconds
§  Exhale (through the mouth or nose) for 4 seconds
§  Hold for 4 seconds
Keep repeating the cycle until you feel calmer, more focused, or centred...perhaps 4 cycles may be a good starting point. 
§  If you notice you start to feel dizzy, then allow yourself to pause. There is no rush...start small and gradually increase the time that you practise for.

​🌱 Origins & Why It Works
Originally popularised by the US Navy SEALs as a high-stress performance tool, box breathing is now widely used in therapeutic and wellness settings for its powerful calming effect
Here’s how it works:
§  It stimulates the vagus nerve, the main pathway of the parasympathetic nervous system—our built‑in relaxation switch. Research shows that slow, controlled breathing increases vagal tone and improves heart rate variability (HRV), both markers of stress resilience.
§ By slowing the breath rate (~4–6 breaths per minute), you activate the parasympathetic system and downregulate the stress-driven sympathetic response—a shift supported by autonomic neuroscience research by Montana State

credit: sketchplanations

🧠 Research Highlights (Since 2020)
§ A study in Frontiers in Neurology (2022) compared meditative diaphragmatic breathing—similar to box breathing—with vagus nerve stimulation as a treatment for pain and found that both significantly boosted parasympathetic activity and reduced arousal in patients with fibromyalgia.  Frontiers MDPI.
§  In Sensors (2022), researchers compared deep breathing and non-invasive vagus nerve stimulation in patients with rheumatoid arthritis and lupus. Deep breathing slightly outperformed in increasing parasympathetic tone while relaxing muscles. MDPI.
§  Another study with young adults practising box breathing twice daily for 30 days showed improved lung function and mood, along with better regulation of the autonomic nervous system. RENEW Program.

💡 How to Do Box Breathing: 
1. Posture: Sit comfortably—feet grounded, spine upright, hands relaxed.
2. Visualization: If you can, picture a square or lightly trace one with your finger.
3. Breathing cycle:
    §  Inhale through the nose for ~4 sec
    §  Hold comfortably for ~4 sec
    §  Exhale slowly through the mouth for ~4 sec (creating a gentle “whoosh”), or    
        through the nose if that feels more soothing or controlled
    §  Hold again for ~4 sec
4. Repeat the cycle comfortably for 3–5 minutes. You can adjust the rhythm to    
    3‑3‑3‑3 or 5‑5‑5‑5 as needed.
§  If you notice you start to feel dizzy, then allow yourself to pause. There is no 
    rush...start small and gradually increase the time that you practise for. 
§  4 cycles may be a good starting point. 

Why nose-inhale / mouth-exhale? 
Inhaling through the nose filters, naturally moistens, and slows the breath—optimising vagal engagement. Exhaling through the mouth can feel more releasing and grounding. If someone prefers nose-only breathing, it’s fine as long as the rhythm feels steady and comfortable. ​

Let me know in the comments below how you get on with this technique or if you have other techniques, involving the breath, that you find beneficial.

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I’m Naomi Taylor, an integrative therapist working with adults and couples worldwide. I offer counselling, couples therapy, and online sessions. If you’d like to explore working together, you can book a session here.