My heart is beating faster and faster. My face feels warm and irritated. My nose is so itchy. I stare at this computer screen and I can’t figure out what went wrong. I am staring at a page of code with colorful error messages. As I try different things, the errors just multiply. I am not fixing anything. The rubber duck on my desk hears expletives as I explain my coding error. I am hoping that I will figure it out. I know I am getting out of control with my anxiety. I wanted to finish this today. And I was supposed to be done with it by now. Then I remember to turn to my first aid techniques for anxiety and I turn away from the computer screen. My eyes are closed and I begin to breathe more deeply. I can’t fix the code if my brain is in emergency mode. When I stare at those colorful error messages, my sympathetic nervous system sees a predator, not a syntax error. My prefrontal cortex, the part of my brain I actually need to solve the problem, has gone offline. To bring it back, I have to address the physical heat I’m feeling. Technique 1: Sitali Breathing – The System Coolant Technique 1: Sitali Breathing – The System Coolant In my medical practice, I see how frustration physically manifests as heat. Sitali is an ancient technique used to lower the body’s temperature and calm the "fire" of anger or irritation. How to do Sitali breathing: How to do Sitali breathing: The "U" Shape: Curl your tongue into a "U" shape and stick it out slightly past your lips. If your genetics won’t let you curl your tongue, simply purse your lips as if you are holding a very thin straw.The Cold Inhale: Breathe in deeply through the tube of your tongue (or your pursed lips). You will feel the air turn cold as it hits the back of your throat. This is a literal "heat sink" for your internal temperature.The Silent Release: Close your mouth and exhale slowly through your nose.Repeat: Do this four more times. The "U" Shape: Curl your tongue into a "U" shape and stick it out slightly past your lips. If your genetics won’t let you curl your tongue, simply purse your lips as if you are holding a very thin straw. The "U" Shape: The Cold Inhale: Breathe in deeply through the tube of your tongue (or your pursed lips). You will feel the air turn cold as it hits the back of your throat. This is a literal "heat sink" for your internal temperature. The Cold Inhale: The Silent Release: Close your mouth and exhale slowly through your nose. The Silent Release: Repeat: Do this four more times. Repeat: As I finish the fifth breath, the itchiness on my nose fades. My face doesn't feel like it's glowing anymore. I haven't fixed the code yet, but I’ve fixed the developer. My heart rate has gone down. Technique 2: Box Breathing – The Regulator Technique 2: Box Breathing – The Regulator Now that I have cooled my system down, I need to explore ways to make myself feel more steady. I pause the Sitali breathing to enter 4-4-4-4 or Box Breathing. I have learned that Digital First Aid is just as important as my vitamins or my weekly weigh-in. These breathing techniques are maintenance for the most important hardware you own: your brain. Box Breathing I learned box breathing a while ago and when I have talked about it in speeches or in classes I have taught, nearly everyone knows about it. Inhale for a count of 4.Hold for a count of 4.Exhale for a count of 4.Hold for a count of 4. Inhale for a count of 4. Inhale Hold for a count of 4. Hold Exhale for a count of 4. Exhale Hold for a count of 4. Hold Performing box breathing really steadies you and brings you mindfully back into the moment. It helps clear your mind to be able to solve difficult problems. It is a regulator. Technique 3: 4-7-8 Breathing – The System Tranquilizer Technique 3: 4-7-8 Breathing – The System Tranquilizer After the cooling of Sitali and the steadying rhythm of the Box, I sometimes find there is still a lingering irritation in my nerves, a leftover hum of that initial panic. To fully exit that state of anxiety, I use the 4-7-8 technique. 4-7-8 technique In my practice, I often refer to this as a natural tranquilizer for the nervous system. While Box breathing is about focus and regulation, 4-7-8 is about deep sedation of the fight or flight response. How to perform the 4-7-8 Reset: How to perform the 4-7-8 Reset: The Inhale: Breathe in quietly through your nose for a count of 4.The Hold: Hold your breath for a count of 7. This allows the oxygen to fully saturate your blood and forces your heart rate to slow.The Whoosh: Exhale completely through your mouth, making a "whoosh" sound for a count of 8.Repeat: Cycle through this four times. The Inhale: Breathe in quietly through your nose for a count of 4. The Inhale: 4 The Hold: Hold your breath for a count of 7. This allows the oxygen to fully saturate your blood and forces your heart rate to slow. The Hold: 7 The Whoosh: Exhale completely through your mouth, making a "whoosh" sound for a count of 8. The Whoosh: 8 Repeat: Cycle through this four times. Repeat: The Result: A Successful Reboot The Result: A Successful Reboot By the time I finish these three techniques, the colorful error messages on my screen haven't changed, but my relationship to them has. I am no longer a victim of the computer code; I am a physician, a coder, and a builder who is simply looking at a puzzle. I reach for my water, take a small sip, and look back at the code. The solution doesn't feel impossible anymore. It just feels like work.
