Why I don't always start with breathing exercises

Specialist CBT therapy for anxiety, OCD, depression and more in West London

Breathing exercises can be useful for some people, in some moments. They can also be uncomfortable, ineffective or simply not the place to begin. A blog cannot determine why someone feels breathless, panicky, tense or overwhelmed, and it cannot decide whether a particular breathing exercise is appropriate for them. Breathlessness, chest discomfort, dizziness, fainting, palpitations or changes in breathing can have physical as well as psychological causes. New, severe, persistent or worrying symptoms need appropriate medical assessment rather than being automatically labelled anxiety. If someone is having a medical emergency, they should call 999 or attend A&E. In therapy, the question is not whether breathing is universally good or bad. It is what is happening for this person, in this situation, and what they hope the exercise will do. For one person, a breathing practice may be a welcome way to pause. For another, focusing on the breath may increase fear of bodily sensations. For someone else, it may become part of a pattern of reassurance or avoidance. These are possibilities to explore, not conclusions a website can make. If CBT is appropriate, an assessment can look at thoughts, emotions, body responses, behaviour, health, safety and the context of the difficulty. The treatment plan is collaborative. It may include psychoeducation, grounding, activity work, cognitive approaches or carefully planned behavioural work, depending on the person’s needs. Exposure based work is not a technique to self prescribe from a blog. A clinician helps decide whether it is suitable, how it can be paced and how learning will be reviewed. The aim is not to remove every uncomfortable sensation or promise that anxiety will stop. It may be to help a person respond with more understanding and flexibility, while taking appropriate medical or practical steps where needed. It can also be useful to notice the meaning given to a breathing exercise. Is it being used to create a moment of steadiness, to check whether the body is safe, to avoid a sensation, or because someone feels they must do it perfectly? There is no correct answer in advance. These details can guide a conversation about what support is appropriate and what needs further assessment. For related information, read about <a href="/therapy/anxiety/">CBT for anxiety</a>, <a href="/therapy/panic attacks/">CBT for panic</a> and the <a href="/guides/panic attacks comprehensive guide/">panic attacks clinical guide</a>. The Lyceum Clinic offers assessment led CBT online and in West London, and a first conversation can help clarify what support may be appropriate.