If we stop breathing, we die, so breathing is pretty important. We can breath intentionally or automatically, and deep, deliberate breaths can bring down big feelings and help us regulate our emotions. Many therapists have several breathing exercises to choose from that we share with our clients, like square breathing or wave breathing.
But breathing is just one skill, and there are many other ways to relax and bring down strong feelings. When we feel tense, it might be difficult to take full breaths, so it’s important to have alternatives. Plus, some clients might not feel that a breathing activity is a good fit for them. For some clients, being told to breathe or take a deep breath could be a trauma trigger.

It’s always good to have other options, so here are four centering, de-escalating, calming activities that don’t involve telling your client to take deep breaths. The activities presented here are ones that I have used with kids in my practice, but they could be tailored to adult clients if needed.
Blow Up A Balloon
If someone has difficulty with being prompted to breathe but benefits from breath-based activities, blowing up a balloon can cue the act of taking a deep breath without putting the focus on the breath itself. This can be done with actual balloons in your office, or you can imagine blowing up a balloon at times when one isn’t available.
Five Senses Grounding Activity
This is a common mindfulness activity that emphasizes bringing one’s attention to the external environment rather than noticing what’s going on inside their body. This can be helpful for those for whom internal focus is unpleasant, painful, or uncomfortable but still want to bring their attention to the present moment.
For this activity, the client is prompted to name:
- 5 things they can see
- 4 things they can hear
- 3 things they can feel
- 2 things they can smell
- 1 thing they can taste
Feel Your Pulse
This activity can be done with a smart watch or by simply finding a pulse point on your body. While your client feels anxious, escalated, frustrated, or another Big Feeling, have them check their pulse, then notice if they can release tension from their body and lower it as they calm down.
This intervention can be a great way to teach people how to monitor their emotions as they occur. Set a schedule for the client to check their pulse on a regular schedule and keep track. This can help them notice when their body is starting to become tense or when a feeling might be getting bigger.
Note: people with certain medical conditions might not be a good fit for this specific method for monitoring feelings, since their heart rate may be affected by the health issue rather than emotional responses.
Emotional Freedom Technique (EFT) Tapping
EFT Tapping is a technique to reduce anxiety or trauma responses through a series of body taps. This is something I have learned about recently and am still exploring the research on it, but so far it seems like a great way to regulate.
There are many descriptions of EFT online – I found this one that breaks down the process and how it works in a user-friendly way. Here is a demo of the technique for practice. The demonstration includes cues to take deep breaths, so if you are avoiding breathing activities, you can simply cue your client another way, like with the Five Senses activity or checking pulse.
What coping skills activities have helped your clients?
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