Home » Training » ACT in Depth

Awareness of Breath

Being aware of one’s breath can complement the well-known tool of ‘controlled breathing’. Controlled breathing allows clients to slow their breathing and in doing so regulate their emotions in a quick and controlled way.

Psychologists, social workers, counsellors and other mental health professionals often use controlled breathing when helping their clients manage panic attacks. While this can be effective, it can also be useful to bring in a component of awareness of breath, in addition to controlled breathing.

Traditionally, a client will learn controlled breathing and be taught to practice this throughout a panic attack episode. However, the client may end up focusing on the discomfort they are experiencing, and so have a tendency to attach to the uncomfortable sensations and fight them – sometimes causing more panic or distress.

Breathing on its own is not enough; we want to make the technique of controlled breathing more robust and something that a client can use to both eliminate the feelings of panic and to assist in becoming grounded in the here and now. Awareness of breath can help with this and be an important adjunct to controlled breathing.

There are three phases of awareness in the present moment. The instructions for your clients should go something like this:

First, inhale. Breathe through your nose; notice the air coming in through the nose, the abdomen rising and falling, and your posture. Hold your shoulders back to allow the lungs to fill.

Now, pause. (This is the second phase. Count to one – zero, one – to ensure they notice the pause.)

Now, exhale. Release the breath as slowly as possible through the mouth. I want you to notice your mouth, the length of the process, how the breath feels as it is expelled through your mouth, the temperature of the breath, and the impact on the abdomen as the air is expelled.

You can practice this awareness of breath in session so clients can be grounded when doing controlled breathing. Remember to ask them to stop and take notice how they are feeling in that moment. 

Awareness of breath exercise:

It may be beneficial to introduce some ‘first aid’ elements to bring your clients safely to the present moment. These can be done standing up or sitting down. Your instructions to your clients will go something like this:

Step 1 – Sit down or stand up, whatever makes you feel more comfortable, and gently hold your shoulders back. This frees your upper body and lungs for deep breathing.

Step 2 – Take deep breaths while noticing your breath coming into the body; how it feels in your lungs and affects the rise and fall of your abdomen. Observe each phase of breathing in, holding the breath, and breathing out.

Step 3 – If you would like, pour a glass of water. Take a sip, slowly. Notice how that feels in your mouth, down your throat. (Clients may find this grounding, bringing them to the here and now.) 

Step 4 – Begin to notice things in this room. Use any or all of your five senses to notice what you can see, smell, taste, touch and hear, and even any tastes in your mouth.

Awareness of the breath and controlled breathing together are more robust in dealing with panic attacks than controlled breathing alone.


Connect with Nesh on: