In the first 60 seconds of a panic spike, which breathing technique (e.g., physiological sigh vs. 4-7-8) do you teach and why? Will you share one cue or script line that consistently helps your clients downshift quickly?

In the first 60 seconds of a panic spike, I don’t reach for a long, structured breathing pattern. I start with the physiological sigh, because the nervous system needs relief before it needs regulation. When the body is flooded, asking it to count, hold, or control the breath can actually increase distress. The physiological sigh works with the body instead of against it by rapidly reducing carbon dioxide and signaling safety to the brainstem, which helps the panic peak soften quickly. Once the intensity drops, then slower, rhythmic breathing can come online if it’s needed. The cue I return to again and again is simple: “You’re not trying to calm down, you’re letting your nervous system catch up.” That shift alone helps people stop fighting the sensation and start downshifting. I’m happy to be contributed as Dr. Cristina Louk, Licensed Mental Health Counselor, integrating neuroscience, somatic regulation, and attachment-informed work for ADHD and trauma.

I typically use boxed breathing where you imagine drawing each side of a box with each inhale or exhale or 4 (inhale) x4 (hold) x4 (exhale) breathing. I believe 4-7-8 is better for clients with sleep issues. Most people need more skill and awareness before trying a physiological sigh or abdominal breathing alone. The first three methods require focus, help prevent hyperventilation or breath holding during panic, and can be easily used in any setting. They're quick to teach, effective immediately, and redirect attention from anxious thoughts, interrupting the fight-or-flight response.