Despite the somewhat exotic name, box breathing is a very simple and even familiar type of stress management exercise. If
you've ever found yourself inhaling and exhaling to a rhythm while you run or listen to music, you've taken the first steps.
Box breathing is a type of paced breathing that follows a certain rhythm, and it can help you to minimize stress.
How box breathing works
Box breathing, also known as four-square breathing, involves exhaling to a count of four, holding your lungs empty for a
four-count, inhaling at the same pace, and holding air in your lungs for a count of four before exhaling and beginning the
Box breathing doesn't carry the physical benefits of exercise or the long-term mental and resilience benefits of meditation,
but it definitely has its place as a stress management technique. For one thing, it's very simple to learn and to practice.1
Also, it can be practiced virtually anywhere and anytime—when you're showering, watching tv, or even working.
You can give it a try anywhere when you're overly distracted or exercising so strenuously that you can't talk through it.
Also, you can practice box breathing for only a minute or two and experience the immediate benefits of a calm body and a more
relaxed mind, or you can practice for several minutes and experience that plus the longer-term benefits of meditation, including
increased resilience to stress, decreased feelings of depression, increased positive feelings, and more.
What the research says
Unfortunately, there's not a lot of research specifically on box breathing, as this is a relatively new technique. However,
there is quite a bit of research on breathing exercises in general, and on paced breathing as well,2 which is the category of
breathing exercise this would best fit.
There is also research on visualization and meditation,3 of course, and the practice of box breathing can facilitate both of
these. For visualization, simply imagine that you are inflating and draining a balloon with each cycle, for example. For meditation,
you can add affirmation as you breathe.
How to practice box breathing
Box breathing is exceedingly simple to practice. Simply relax your body and do the following:
- Let out all of the air in your lungs to the count of four.
- Keep your lungs empty for a count of four.
- Inhale for a count of four.
- Keep your lungs full for a count of four.
That's it! You can vary this in a few different ways. As mentioned before, you can invite in the silent repetition of an affirmation
by syncing it with your breath rather than counting to four. "Mississippi," or something with four syllables can work well —
"I feel so calm," "I'm here right now," or even just "O-o-m-m," stretched out to four counts can work.
Another variation is to visualize four sides of a box changing to a new color, one after the other, or in a line as though the box
is being traced by a colored pen you hold with your mind, making this into a visualization exercise. If you practice for
longer — 10 to 20 minutes, for example — it can fall under the umbrella of meditation practices. Research on the possible
benefits of box breathing is still needed, but incorporating meditative practices into your life may have lasting benefits.
Apps to try
There are several apps that can help you practice box breathing or other types of paced breathing for stress relief. What's
great about these apps is that they can add a visual element to your practice.
If you're a visual learner, you can practice these breathing techniques with the app to the point that you really connect with
them, then visualize what you experience in the apps even when you're not using them, like in the shower or while driving. This
makes it easier for many people to both learn the techniques, and enjoy them more. Here are a few of the top apps for box
breathing and other types of paced breathing exercises:
Box Breathing App: This one can be downloaded for Apple or Android devices, and has nine levels of use that can help you to
really get a firm grasp on the practice of box breathing and make it part of your daily routine. The makers of this app also
stress that this technique can also help you achieve a flow state which is an additional benefit you'll enjoy besides the
stress management referenced earlier.
Breathe 2 Relax: This app is also available for both Apple and PC—oriented users and has a wide range of timed breathing
exercises to use. It was developed by the National Institute for Telehealth and Technology, an organization within the U.S.
Department of Defense. One of its strong points is that it has a graph feature that can help you to determine where much
of your stress originates.
Universal Breathing: This is also available for iOS and Android users, and has a variety of visual exercises that work with
your breathing. They become increasingly challenging, helping you to gain more complex skills with your breathing exercises.
This can be particularly enjoyable for those who love a challenge and may become bored with an app that may feel repetitive,
but want the benefits of practicing calming techniques like breathing exercises.
1. Malchiodi CA. Trauma and expressive arts therapy: brain, body, and imagination in the healing process.
The Guilford Press. 2020.
2. Zaccaro A, Piarulli A, Laurino M, et al. How breath-control can change your life: A systematic review
on psycho-physiological correlates of slow breathing. Front Hum Neurosci. 2018;12:353. doi:10.3389/fnhum.2018.00353
3. Fontana D. Creative Meditation and Visualization. Penguin Random House; 2012.