4 ways to ground yourself during an anxiety attack

Anxiety attacks are very common, and many people experience them at one point in their lives. When you are in the middle of an anxiety attack, your heart races, your thoughts spiral, and everything around you can feel overwhelming. The good news is there are tools and practices using DBT (Dialectical Behavior Therapy), and evidence-based strategies for moments like these. 

Tip 1: Box Breathing 

Deep, controlled breathing, also known as paced breathing, helps an individual release stress and distracts the mind from panic. It anchors someone in the now, allowing them to focus on their breathing. Box breathing occurs when you inhale for 4 seconds, hold your breath for 4 seconds, exhale for 4 seconds, and hold again. You can repeat this cycle until you feel calm, safe, and fully present. In DBT, this technique is part of the distress tolerance skill set, helping individuals manage intense emotional states without restoring impulsive behaviors. 

Tip 2: 54321 Grounding 

This technique that clinicians use falls under the mindfulness module. This skill enables an individual to utilize their five senses to distract themselves from the anxious thoughts filling their mind. For example, someone can pick five things they see, four things they feel, three things they hear, two things they smell, and one thing they taste. This helps put someone back into their body and reconnect them with their environment, increasing the awareness of their surroundings. 

Tip 3: Temperature 

TIPP in DBT stands for temperature, intense exercise, paced breathing, and paired muscle relaxation, which all benefit emotional regulation. Cold items or sensations can ease someone’s physical body response to anxiety, especially when the nervous system is overstimulated (Partington, 2025). Splashing water on your face or holding an ice cube in your hand can shock your system and gradually lower your heart rate. 

Tip 4: What is True?

When an individual experiences anxiety, their emotional mind can take over and say things that are distorted or exaggerated. An essential lesson in DBT is accessing the wise mind, which is the balanced awareness of your emotional mind and reasonable mind (Greene, 2024). Practicing saying or writing the “truth” or “reality” of a moment can help a person feel more centered and grounded. Examples can vary from “I am safe”, and “I am uncomfortable, but this feeling will pass”, acknowledging the anxiety while reminding yourself that you will get through it. 

Conclusion

There are many more distress tolerance techniques that DBT therapists practice to disrupt anxiety attacks. These techniques help people navigate intense emotions without turning to harmful coping strategies (Counseling Center Group, 2025). Whether you are using your breath, engaging in your senses, or grounding your mind, each skill is a step toward resilience. It is always important to remember that you are not alone if you experience anxiety, and with the right strategies, you can find strength in the process. 

References

Greene, P. (2023, June 28). What exactly is “wise mind” in DBT? Manhattan Center for Cognitive Behavioral Therapy. https://manhattancbt.com/wise-mind-dbt/

Counseling Center Group. (n.d.). DBT for panic attacks. Counseling Center Group. https://counselingcentergroup.com/treatments/dbt-for-panic-attacks/

Partington, D. (2025, April 21). Ice and anxiety. Psychology Today. https://www.psychologytoday.com/us/blog/dbt-for-daily-life/202504/ice-and-anxiety