Box Breathing: How a Simple Technique Helps Control Stress

Maria Medina was fifteen hundred miles from home when the earthquakes hit La Guaira, Venezuela. She was in Florida, where she had lived for the past fifteen years, and the distance made the helplessness worse. Two months after the tremors, she still couldn't sleep. She would lie in bed at night, staring at the ceiling, thinking about the people she'd left behind—her family, her friends. The worry kept her awake.

Then she tried box breathing. It was a technique she'd first learned in 2020, back when she was juggling a master's degree and full-time work, and the pandemic had pushed her stress past the breaking point. A therapist had shown her how to do it: inhale for four seconds, hold for four seconds, exhale for four seconds, hold for four seconds again. Then repeat. The pattern is simple enough that anyone can learn it in a minute, but the regularity is the point. Each phase must last exactly as long as the others. That symmetry is where the technique gets its name.

Box breathing has become fashionable in recent years—Navy SEALs use it before entering hostile situations, and lifestyle influencers post animated guides online showing people how to follow along. But what's driving its popularity now is not just anecdotal enthusiasm. A study published in June in the journal Comprehensive Psychoneuroendocrinology, conducted by researchers at Texas State University and the University of Toronto Mississauga, found that box breathing could prevent large spikes in heart rate and other physiological markers of stress in people facing high-pressure situations. The technique appears to work, and the science is starting to catch up to the hype.

Dr. Helen Garr, a general practitioner who treats doctors and nurses struggling with mental health issues, has begun recommending it to many of her patients. She calls it one of the most powerful evidence-based tools available for taking control of stress and the nervous system. The key, she explains, lies in the final hold—the moment after you exhale when you pause before breathing in again. During that pause, your body retains carbon dioxide. When your brain detects the rising CO2 levels, it triggers a panic response, an urge to breathe. But if you train yourself to sit with that discomfort, to hold steady through it, you become better equipped to handle elevated CO2 in your system. You learn to tolerate the sensation without spiraling. That's where the real change happens physiologically. People breathe differently when they're stressed, which alters their body's CO2 balance. Box breathing retrains the system, teaching it to accept variations in carbon dioxide without interpreting them as danger.

Brittany Lamm, a twenty-eight-year-old life coach in California, discovered box breathing a few years ago when she was going through a difficult personal period and searching for ways to manage the stress. She does it every morning now, sometimes right after waking up, sometimes before important calls with clients. She's found it so effective that she's incorporated it into her work—she has a degree in psychology and is training to be a licensed therapist. When she starts sessions with clients, especially before diving into heavy topics like relationship problems, she guides them through the breathing. Nine out of ten people she works with report feeling significantly better afterward. She acknowledges that some people are skeptical about whether breathing techniques actually make a difference, but she urges them to try. Breathwork isn't one-size-fits-all, she says. There are many different techniques for whatever someone might be feeling.

Maria uses box breathing before bed or when she wakes in the night and can't fall back asleep. The earthquakes in Venezuela killed at least six thousand three hundred people. Her immediate family survived, but her best friend lost her home. She knows people who lost family members. The sleepless nights still come sometimes, but now she has something concrete she can do when overwhelm threatens to take over. She's recommended the technique to friends and colleagues going through stressful periods. What strikes her most is how simple it is, how easy it is to forget that something so basic—intentional breathing—can shift what happens in your body and mind. We underestimate it, she says. We forget to really breathe.