PR3: Diaphragmatic Breathing
Virtual Coach
Work step-by-step through the Problem-Solving, Coping & Relapse-Prevention exercise with the virtual coach.
Introduction
When stress hits, breath shifts up into the chest, heart-rate climbs, and the sympathetic “fight-or-flight” system floods the body. Diaphragmatic (belly) breathing does the biochemical opposite: a slow inhale that pushes the belly outward, followed by an even longer exhale, activates the vagus nerve and releases acetylcholine—dropping pulse, blood pressure, and cortisol within 60 seconds. Regular practice rewires baseline arousal and gives you an on-demand calm switch for exposures, problem-solving, or relapse-prevention moments.
Instructions
Goal: Practice two 5-minute sessions daily for 14 days + one “in-the-moment” set whenever distress ≥ 6 / 10.
Step 1: Set Posture
Sit or lie with spine straight, one hand on chest, one on belly.
Pro-tip: Chair works fine—feet flat for grounding.
Step 2: Count 4-7-8 Cycle
Inhale through nose 4 sec → hold 1 sec → exhale through pursed lips 8 sec.
Pro-tip: Longer out-breath is the secret vagal lever.
Step 3: Feel Belly Rise
Chest hand stays still; belly hand lifts on inhale, falls on exhale.
Pro-tip: Picture inflating a balloon in your abdomen.
Step 4: Repeat 10 Cycles
That’s ~ 2 minutes; continue to 5 min if time allows.
Pro-tip: Use a timer so you’re not clock-watching.
Step 5: Rate Distress
SUDS 0–10 before & after; log in worksheet.
Pro-tip: ≥ 2-point drop = good run.
Step 6: Anchor Cue Word
Whisper a cue (“Calm”) on each exhale—pairs breath with cognition.
Pro-tip: Cue becomes a quick rescue later.
Quick-Deploy Version (30 sec)
- Inhale 4 sec → exhale 6 sec × 3 cycles
- Silently say cue word (“Calm”) on each exhale
Use this between exposure rungs or during STOPP Card (PR2).
FAQs
I get dizzy—am I doing it wrong?
Slow the inhale to 3 sec or skip the 1-sec hold. Dizziness usually fades after a week’s practice.
Can I practice while walking or driving?
Yes—skip hand placement, keep back straight, count beats silently. Never close eyes when mobile.
Does belly size or fitness level matter?
No—diaphragmatic movement is mechanical, not aesthetic. Everyone has a diaphragm; everyone can engage it.
How soon before a presentation should I breathe?
Run one 2-minute cycle 5-10 minutes beforehand, then one 30-sec quick deploy right as you’re waiting to speak.
Disclaimer
If you have any behavioral health questions or concerns, please talk to your healthcare or mental health care provider. This article is supported by peer-reviewed research and information drawn from behavioral health societies and governmental agencies. However, it is not a substitute for professional behavioral health advice, diagnosis, or treatment.
