Some days anxiety and stress can get the better of us. Whether it’s a job interview, public speaking or an exam, we’ve all had times when knowing how to handle anxiety and stress is in our best interest.

Cognitive Behavioral Therapy, or CBT for short, is a therapy method that is commonly used for anxiety and mood disorders like PTSD, OCD, GAD, and Bipolar Disorder, but can also be used in everyday situations that cause anxiety and stress. These exercises can be done at home or at work or school and may give almost immediate relief from your overpowering emotions.

CBT is a treatment that’s skills-focused, aiming to change thoughts and behaviors. Don’t worry that CBT is just a passing fad, though, it’s been proven to really work through various empirical studies and has been called the gold standard in psychotherapy (I can also personally attest to it working!). It can also be traced back to researchers like F.B. Skinner and Joseph Wolpe who were behavioral therapy pioneers in the 1950s.

The most common strategies used in CBT for anxiety relief

Two of the most common strategies used in CBT to relieve anxiety, are:

  • Breathing exercises
  • Progressive muscle relaxation

Breathing exercises: Square breathing

When we’re anxious, we breathe faster. Slower breathing “tricks” our bodies into relaxing and neuro-chemicals are also released that help with this relaxation. So-called “square breathing” or “relaxation breathing” is an easy technique to master and has been shown to help in the long run when practiced daily. It is also an easy – and silent – exercise you can easily do at work, school, or in public. It’s quick to complete, only taking 10-15 minutes.

Note! You should first consult your healthcare provider if you have any cardiovascular problems, asthma, or other illness which could affect your respiratory system. 

How to do square breathing:

  • Square breathing is best done in a quiet place where you can sit without being distracted.
  • First, notice – without trying to change it – how fast you’re breathing. Count how many seconds every inhale and exhale takes. This is your baseline measurement.
  • Next, slow down your inhale and exhale by one second each.
Note! This breathing exercise shouldn’t make you feel uncomfortable or be difficult. If you feel uncomfortable or like you need to gasp for air, you’ve slowed down your breathing too much too fast.  
  • Once you’re comfortable with your new breathing pace you can slow it down some more. Continue as long as possible in this way without starting to feel uncomfortable.
  • Now that you’re breathing slowly, pause after each inhale and exhale. Start with a one second pause and work your way up to no more than ten seconds. Again, you shouldn’t feel uncomfortable, so don’t push yourself to take pauses that are too long – especially when you’re just starting out.
  • Continue breathing slowly in this way for 10-15 minutes and you’ll soon find that the anxiety starts to melt away.

Progressive Muscle Relaxation (PMR)

Also called Jacobson’s Relaxation Technique, PMR consists of tightening and relaxing muscle groups to get relief from the tension that builds up because of anxiety and stress. You can start at either your head or your feet and work your way through your body. This takes about 20 minutes. You can add some breathing exercises as well, if you like, or play some meditative music or white noise while doing the exercises.

PMR Technique: Tense each group of muscles for the count of 5 (or 5 seconds) before relaxing those muscles for the count of 10-20 (10-20 seconds) before moving on to the next group of muscles. Inhale slowly while tensing the muscles and exhale slowly while relaxing your muscles.

How to do full-body PMR, starting at your feet:

Note: PMR shouldn’t hurt, so don’t tense your muscles so much that they ache or start cramping.
  • Feet – Start by pointing your toes and bending your foot downwards. Hold for five seconds then return your foot to its “neutral” position for 10 – 20 seconds before bending your foot and toes towards you and holding for five seconds. In each stretched and tensed position, be sure to focus on how the muscles are feeling. Remember that this shouldn’t hurt, so don’t push too hard. You don’t have to point like a prima ballerina!
  • Calves – Tense your calves next, focusing on how the muscles feel while they are tensed and the relief when you relax your muscles. This will very likely be more obvious than the tension and relief in your feet were.
  • Knees – Press your knees together and hold for five seconds before relaxing.  Be careful – if you have arthritis, a knee injury or something similar, you may need to skip this step to keep from exacerbating the injury.
  • Thighs – Tense your thigh muscles next, holding for a count of five. Slowly relax the muscles as you exhale and pause for 10 – 20 seconds.
  • Hands – Move on to your hands next, balling them into fists and holding for five seconds. Remember to keep your arms relaxed during this time. Relax your hands and pause before moving on to your arms.
  • Arms –  Keeping your shoulders and hands relaxed, tense your arms for the count of five while slowly inhaling. Exhale and relax your arms and pause for 10 – 20 seconds.
  • Buttocks – Squeeze your buttocks together and hold for five seconds before relaxing. Remember to keep the rest of your body relaxed while doing this.
  • Abs – Moving on to your abdomen, tense your abdominal muscles while inhaling and keeping the rest of your body relaxed – no need to do crunches – and hold for 5 seconds before relaxing the muscles and staying fully relaxed for 10 – 20 seconds.
  • Chest – Tighten your chest for the count of five – don’t do this if you have asthma or any other pulmonary illnesses. Definitely speak to your healthcare practitioner first.
  • Shoulders – Bring your shoulders up to your ears and hold for five seconds before relaxing them and bringing them down to their “neutral” position again while exhaling.
  • Face – Purse your lips together for the count of five before relaxing your face for 10 – 20 seconds and then frowning in order to tense your facial muscles. Also hold this frown for five seconds before relaxing.
Tip: If you want to start with your head, simply work the above list backwards, starting with your face, followed by your shoulders, etc.

CBT can also be used in conjunction with other relaxation techniques

Relaxation techniques that CBT can be used in conjunction with, include:

  • Listening to calm music or white noise
  • Meditation
  • Yoga
  • Massage

More CBT Resources for Anxiety and Stress