Mindfulness, relaxation & coping strategies
Practical exercises and techniques to help in times of anxiety or worry
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This section contains a range of tips, techniques and strategies for coping with difficult feelings, including anxiety and worry.
Because we are all different,‘what works’ for us is different too. Some of the strategies or techniques here may also be easier or harder to do depending on your physical health or abilities.
Start by seeing what interests you as something to try. Stick with it for a bit, and if it works for you, add it to your ‘self-care toolkit’.
Breathing exercises
Practising a simple breathing technique every day can help to reduce feelings of anxiety generally.
Regular practice also means you can build your skill and confidence in techniques before you need to use them in a situation that is stressful or upsetting.
Box Breathing
This is a good exercise you can do anywhere to help stay calm.
Imagine a square. Close your eyes if you prefer.
Visualise the bottom right corner of the square.
Gently exhale.
Inhale to a count of 4 (visualise moving up the right hand side of the square).
Pause your breath for a count of 4 (going along the top of the square).
Exhale to a count of four (coming down the left hand side of the square).
Pause your breath for a count of 4 (along the bottom of the square).
Repeat as often as needed.
Deep Breathing
Put your hands on your stomach.
On a steady count of 3, breathe in through your nose as deep as is comfortable.
Feel your tummy inflate like a balloon.
Exhale even slower through your mouth, for a count of 4.
Gently squeeze your stomach muscles do help you expel all the air if you can. Feel your tummy deflate.
Feel your shoulders relax.
Practice for a few minutes every day if you can.
Managing worry
Worrying can be exhausting. If a ‘worry’ is not something that can be straightforwardly addressed, it might be important to find a way to ‘put it aside’ for a while in order to find some relief.
These techniques can help with that.
The worry jar
This is a helpful technique (for either adults or children) to help put worries aside for a while, and know they are ‘kept safe.’ It is particularly helpful for worries which are about imagined situations, or that have no straightforward solutions.
Find a nice bottle, container or jam-jar.
Decorate it, and label it ‘Worry Jar’.
Whenever you have a ‘worry thought’, write it on a small piece of paper.
Fold the paper up, and pop carefully in the jar.
Once a month/week, go through the jar and read out your worry notes aloud.
Throw away any worries that are no longer bothering you, or didn’t happen.
Put back into the jar any ‘worry notes’ still on your mind to keep them safe to return to and review another time.
Worry time
Choose a day, time and place for ‘worrying’. Try not to use your bed, or a favourite chair but somewhere ‘neutral’ if you can.
Designate a notebook as a ‘Worry Book’.
When a worry ‘visits’ your mind during the day, write it down.
Thank your mind for bringing it to your attention. Tell it you do not have time to ‘worry properly’ right now and will ‘worry much better’ later when you can give it your full attention.
Close the book.
Return your focus to the task at hand that was interrupted by the worry.
At an allocated time in the day (at least an hour away from bedtime) look at your worries one at a time for at least 30 minutes.
Decide which ones to keep on your list and what is no longer relevant (if you no longer feel worried about something, skip this step).
At the end of the overall allotted time, stop.
Cross off any worries you no longer feel so concerned about, or you feel able to let go. Leave others on as necessary.
Close the book, and make sure you have a transition activity to look forward to like a cup of tea, a walk or crafting, watching TV or listening to music.
Repeat as needed.
Let the ‘Worry Train’ keep on travelling
Some worrying and/or anxious thoughts just keep coming back and hovering about.
If they have no easy answers they might need to be ‘sent on their way’.
Imagine a train pulling into a station.
Picture the troubling or unhelpful thought getting on the train.
In your mind, imagine the train pulling out of the station and into the distance, with the thought on board.
Let it go.
Do this as many times as you need to until a worrying thought ‘gets the message and gives up.’
Do something afterwards to distract and distance yourself. For example make a cup of tea, move rooms, focus on a task, go outside, watch TV or play music.
Managing anxiety
The techniques below can help you deal with anxiety, or ‘panicky’ feelings.
Remember: If anxiety or ‘panic attacks’ are a feature of your rare condition, do also follow any advice or medications from your medical team.
Techniques for managing worry can also help manage anxiety and vice versa.
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This is a really helpful technique for if you are having (or need to prevent) a panic attack, or acute anxiety.
It is also a great game just to play with children. You can then use it together if they are feeling worried or anxious at any later point, or remind them that they can use it themselves at school, in appointments etc.
Try to take a couple of long slow breaths ‘in and out’ to the count of 5 . This will help steady your breathing.
Then bring your attention to :
5 things you can see (eg. table, chair, dog)
4 things you can hear (eg. clock, voices, birdsong, traffic)
3 things you can touch (eg. ground under foot, phone, your own knee)
2 things you can smell (eg. perfume, furniture, clothing)
1 thing you can taste OR imagine tasting that you like (eg. lip balm, toothpaste, coffee, chocolate, chips)
Repeat as necessary, or alternate with the Box Breathing exercise above.
‘Back to the present’ exercise
Find somewhere calm and quiet.
Close your eyes. Bring your awareness to the present moment.
Bring your focus to the physical sensations around you eg the chair/bed beneath you, your feet on the floor, arms in your sleeve, your breathing and the associated movements of your mouth, nostrils, chest and stomach.
Just notice them.
If your thoughts race or drift off, don’t worry or stop them, just notice.
Bring your attention back to your body and the sensations of the moment.
Do this for a few minutes.
Use a simple phrase such as ‘you are ok’ , with your hand resting on your chest can help too.
Self Soothing
‘Self-soothing’ is a way of comforting yourself if you are feeling upset, anxious or low. It is a way of helping calm your nervous system generally, and can also be really good to teach children to use too.
Self hugging
Physical contact and comfort such as hugging, and affectionate touch all help reduce stress hormones. It’s one of the reasons children often come for a cuddle when they are upset. There may not always be someone available to you as an adult, so ‘self-hugging’ is also really effective.
- wrap your arms firmly around your upper arms or shoulders in a self hug
- hold a firm squeeze.
- if you want, you can also repeat a phrase such as ‘we’ve got this’ or ‘I’m here for you’ or ‘I’ve got you’
Sensory care
Find a large comfortable blanket, or a favourite jumper – if it is one that you also enjoy the smell of, even better.
Wrap yourself up inside it. If you feel cold or shakey, the warmth of a hot water bottle or warm drink might also be very comforting too.
MIND have further resources and tools here for understanding and managing anxiety
Anxiety UK have a helpline, and additional tips and resources to help cope with anxiety.
Therapist Tip
Anxiety and worry can feel very similar. Generally though, anxiety is often felt very ‘physically’ in our bodies whereas ‘worry’ is more located just in our ‘thinking’.
Journalling
Writing can be a really helpful way of getting experiences and feelings ‘out of your head’, or help you process difficult thoughts or experiences.
It can also help you work out what you are feeling with more clarity, or explore why you are feeling as you do if it is not clear.
Both can be very validating.
Get a nice notebook and pen. You can use an electronic device if you need or prefer to, but the physical action of hand-writing is sometimes more effective.
Some people like to write everyday, others just when they need to. A journal doesn’t need to have any particular structure, it’s just a place to hold your own personal /private thoughts and feelings. It might contain drawings or ‘doodles’ too.
You might start with a question like ‘What is on my mind right now? What have I been thinking about or feeling?
Mindfulness techniques
Mindfulness is a technique or type of meditation that helps you to stay in the present moment rather than getting caught up in worrying, anxious or negative thoughts.
There is a lot of evidence that using it regularly can help you manage pain levels, reduce stress, and support your mental wellbeing generally. The basis of mindfulness involves bringing your thoughts and focus back to the ‘present’ rather than either allowing your mind to race ahead to a future that is as yet ‘unknown’, or, to be preoccupied with a past that cannot be changed.
Practising mindfulness techniques regularly you will begin to notice the benefits. It can be incorporated into daily life through ‘mindful moments’, but also as part of a wider meditation practice too.
Therapist Tip
If an exercise or technique brings up any difficult feelings at all, use the ‘self-soothing strategies’ above.
Mindful moments
Slowing down and doing something ‘mindfully’ can help manage stress and help you feel calmer. Just about any activity during your day eg making a meal, exercise, or caring for your child can all be done ‘mindfully’, by bringing to it your full attention and focus.
This can feel a little strange to start with! Bringing your attention ‘fully’ to an activity or situation can feel difficult. However, learning how to do this effectively can relieve the ‘stress and strain’ of a busy mind.
Mindful moment 1 – brushing your teeth
- Bring your attention fully to the taste of the toothbrush and toothpaste.
- Try to bring your attention to the activity as if it’s the first time you have ever done it, or ‘noticed’ it.
- Feel the sensation of the bristles in your mouth, and the handle in your hand.
- Notice the movements of your hand as you move the brush around your mouth.
- Listen to the sounds around you, both in the distance, of the electric whirr, or the tap running.
- Notice the feel of the water in your mouth as you swill it around, and the feel of the towel as you then dry your face.
Notice how you feel now? Do you feel any different? In what way?
Children may enjoy this exercise before bed too, as part of ‘winding down’ time with you.
Mindful moment 2 – drinking tea
This is an exercise to help engage all your senses. It can also be a really helpful way to break a chain of worrying thoughts, or manage stress.
- Pay attention to the sound and look of water heating and boiling in the kettle. Really notice everything that is happening.
- Notice your environment: how do your feet feel on the floor/in a chair? Notice any sounds outside, or inside like a clock, music or voices.
- Pour the tea onto a teabag/pot.
- Notice how the water changes colour, its movement – any steam, sound or smell?
- Remove the teabag.
- Feel the weight and shape of the spoon and bag. Pay attention to the sound, colour or shape of any bin or bowl you put it in. Notice if you start to go to ‘auto-pilot’ too.
- Add the milk and sugar to your cup. Notice how they change the tea.
- Bring the cup to your lips. Notice how your hand and arm know what to do without you ‘telling them’ to.
- Take a sip.
- How does the tea feel in your mouth, against your tongue and lips?
If there are thoughts, let them enter into and then pass through your mind without following them.
Try to stay with the tasting.
- Notice without judgement any desire to rush the drinking, and any impatience that comes.
- When you decide to swallow the tea, notice how and when that decision is made.
- Notice how the tea is now part of you. How do you feel about this?
Pause.
Notice any feelings of irritation, or thoughts such as: ‘that’s enough, things to do!’
Or perhaps you feel relaxed, and calm…….there is no right or wrong way to feel.
Open your eyes, and gently re-engage with your surroundings.
Useful links
The NHS recommends Mindfulness and has produced a short helpful video to explain more about it.
The Oxford Mindfulness Centre also has a wide range of free resources, videos and audio files to explore
Befriend your body
This is a short exercise to help manage frustration, anger or disappointment with your body if you feel let down by it, angry with it, or it is not behaving as you would wish.
This exercise is also helpful for children when they are frustrated by things that they can’t yet physically or cognitively do, annoyed at a limitation of their body or brain, or are learning a particular skill.
- Close your eyes.
- Put your hand on your tummy or chest as you prefer (or think of this action if it’s not possible).
- Say to your body: ‘I know you are doing the best you can, body. I’m sorry I get cross and impatient with you. We are in this together.’
- Take several slow deep breaths with eyes closed and hand in place.
- Imagine sending warmth from your hand to the rest of your body.
Stop when you are ready.
Calming self-talk
This is a technique to ‘be the person you need’ for yourself in the moment.
Helpful phrases might be:
“Even if this feels uncomfortable right now, it will come to an end soon.”
“I won’t have to deal with this on my own. I will have help.”
“I have got through difficult situations before. I will again”
“I am more than my fear; it is a feeling that will pass.”
It can also help to use a self-soothing technique at the same time.
Relaxation techniques
Relaxation is a skill. Learning to relax helps your body not to be always held in a state of tension, which can be exhausting. That tension can sometimes cause other bodily aches and pains too.
A favourite place
- Find somewhere comfortable to sit or lie.
- Close your eyes, imagine somewhere that you have felt happy or relaxed. This could be an indoor place, outdoor, or even somewhere imaginary.
- Wherever you choose, use all your senses to recreate that place.
- In your imagination, bring this place to mind.
- Notice the environment around you.
- What you are standing on, walking through, sitting or lying on. How does this feel?
- Is the place warm or cold?
- Is there any breeze on your face?
- Any sounds such as birds or the sea?
Guys and St Thomas’ NHS Trust have produced a series of relaxation exercises to listen to.
Camden and Islington Psychological Therapies Service have produced useful leaflet on lots of different relaxation and breathing techniques.
Related pages
Difficult Feelings
Ways to understand and cope with difficult feelings
Managing Stress
What stress is, and how to cope both short and longer term
Wellbeing basics
Important foundations for mental wellbeing
Mindfulness, relaxation & coping strategies
Practical exercises & techniques to try out and see ‘what works for you’