Breathing exercises are often the first strategy recommended for anxiety. From box breathing to deep belly breaths, they’re widely promoted as simple, effective ways to calm the nervous system.
And sometimes, they truly are.
But for people whose anxiety is rooted in trauma, breathing techniques can feel ineffective, and they can even intensify symptoms. This can leave individuals feeling frustrated, discouraged, or as though they are “doing it wrong.”
The reality is more nuanced: breathing works differently depending on how anxiety is encoded in the nervous system, particularly when trauma is involved (van der Kolk, 2014).
Why Breathing Is Often Recommended for Anxiety
Breathing directly influences the autonomic nervous system (ANS), which regulates stress and relaxation responses.
Research shows that slow, intentional breathing can:
- Activate the parasympathetic nervous system
- Reduce heart rate and blood pressure
- Improve vagal tone
- Lower subjective anxiety levels (Porges, 2011; Lehrer & Gevirtz, 2014)
For situational anxiety or generalized stress, breathing exercises are often effective and accessible.
However, trauma changes how the nervous system responds to these cues.
Trauma, Anxiety, and the Nervous System
Trauma is not just a psychological experience—it is a physiological imprint stored in the body and brain (van der Kolk, 2014).
After trauma, the nervous system may remain locked in:
- Fight or flight (hyperarousal)
- Freeze or shutdown (hypoarousal)
- Rapid oscillation between the two (Ogden et al., 2006)
When this happens, the body may not interpret slow breathing as calming. Instead, it may interpret it as a loss of vigilance, which can feel unsafe.
This helps explain why some individuals experience:
- Increased panic when focusing on the breath
- Dizziness or air hunger
- Heightened heart rate
- Dissociation or emotional numbing
These reactions are nervous system responses, not personal failures (Schauer & Elbert, 2010).
When Breathing Does Help Trauma-Related Anxiety
Breathing techniques are most effective when certain conditions are present.
1. When Nervous System Activation Is Mild
Breathing works best when anxiety is present but not overwhelming—for example, during early stress responses rather than full trauma activation (Lehrer & Gevirtz, 2014).
2. When There Is a Sense of Safety
Trauma research consistently shows that felt safety must come before regulation (Porges, 2011).
Breathing is more helpful when:
- Eyes are open
- The environment feels safe
- The person is oriented to the present moment
- The breath is not forced or controlled
3. When Breathing Is Used Gently
Trauma-informed approaches emphasize allowing the breath rather than manipulating it (Siegel, 2020).
Helpful variations include:
- Lengthening the exhale slightly
- Breathing while moving
- Counting breaths without changing depth
- Pairing breath with grounding cues
When Breathing Doesn’t Work — or Makes Symptoms Worse
1. During Intense Trauma Activation
When the brain’s threat system (amygdala) is highly activated, top-down strategies like breathing may not access the survival response (van der Kolk, 2014).
In these moments, the body needs bottom-up regulation first.
2. When Breath Is Linked to Trauma
For some individuals, trauma involved:
- Suffocation or choking
- Medical or dental procedures
- Sexual or physical assault
- Being restrained or silenced
In these cases, breath-focused practices can activate implicit traumatic memory, intensifying anxiety rather than reducing it (Ogden et al., 2006).
3. When Dissociation Is Present
For individuals prone to dissociation, focusing inward on the breath may increase detachment rather than grounding (Schauer & Elbert, 2010).
This may show up as:
- Numbness
- Feeling unreal
- “Floating away”
- Loss of time or awareness
Trauma-Informed Alternatives to Try First
Research supports beginning with body-based and sensory regulation before introducing breathwork.
Grounding Through the Senses
Sensory grounding helps orient the nervous system to the present moment (Siegel, 2020):
- Naming visible objects
- Feeling feet on the floor
- Holding a textured or weighted item
- Listening to neutral sounds
Gentle Movement
Movement supports nervous system discharge and regulation (van der Kolk, 2014):
- Walking
- Stretching
- Rocking
- Turning the head to orient visually
Bottom-Up Therapeutic Approaches
Evidence-based trauma therapies that work with the body include:
- EMDR
- Somatic Experiencing
- Internal Family Systems (IFS)
- Trauma-informed mindfulness
Once regulation and safety increase, breathing can become a supportive tool rather than a triggering one.
A Trauma-Informed Reframe
If breathing has not helped your anxiety, it does not mean:
- You are resistant
- You are failing
- You are incapable of calming yourself
It means your nervous system adapted to survive.
Healing anxiety after trauma is not about forcing calm—it’s about building safety, capacity, and trust within the body(Porges, 2011).
When to Seek Professional Support
If anxiety feels persistent, overwhelming, or connected to past trauma, working with a trauma-informed counsellor can help address symptoms at their root.
At Trauma and Stress Counselling, we specialize in helping individuals understand their nervous systems, gently restore regulation, and heal trauma-related anxiety using evidence-based approaches.
You don’t have to breathe your way through trauma alone.
References
- Lehrer, P. M., & Gevirtz, R. (2014). Heart rate variability biofeedback: How and why does it work? Frontiers in Psychology, 5, 756.
- Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. W. W. Norton.
- Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. Norton.
- Schauer, M., & Elbert, T. (2010). Dissociation following traumatic stress. Zeitschrift für Psychologie.
- Siegel, D. J. (2020). The developing mind (3rd ed.). Guilford Press.
- van der Kolk, B. (2014). The body keeps the score. Viking.
