The 3-3-3 rule for anxiety

The 3-3-3 rule is everywhere. In its most common version, you name 3 things you can see, 3 things you can hear, and move 3 parts of your body. It's simple and free, and you can do it anywhere.

Short answer: it can help you feel grounded in the moment, though I couldn't find a study of the rule itself. Here's my honest take, and a small step you can add if you want.

How to do the 3-3-3 rule

1. Look around and name 3 things you can see. Say them in your head, or quietly out loud: the lamp, the window, my blue mug.
2. Listen and name 3 things you can hear: traffic, the fridge, my own breath.
3. Move 3 parts of your body: roll your shoulders, wiggle your toes, open and close your hands.

That's it. It takes about a minute.

What it does, and what it doesn't

Imagine you're driving and the engine starts making a scary noise. The 3-3-3 rule is like pulling over and looking at the view for a minute. It gets you off the road, and sometimes that's exactly what you need: you stop reacting to every noise and give yourself a moment.

I've never used it myself. To me it seems like a way to distract the mind: it takes your focus away from the problem of the moment, the anxiety or the panic, but it doesn't help you deal with it. For me, focusing on the breath is what helps, even to make a panic attack less strong.

That's my view, not the last word. UCLA Health describes the rule as a coping strategy rooted in mindfulness, and the Cleveland Clinic says grounding can interrupt the stress response, with different techniques suiting different people. If your thoughts are racing, it can be hard to find your breath. The senses can be an easier way in. Attention doesn't have to rest on the breath. It can rest on many things, even the beauty of a landscape. So if the senses are what work for you, use them. Many people find grounding really does calm them, and you don't need to add anything. If you're curious, UCLA Health says you can also add gentle breathing.

Try this now: 3-3-3, then 3 slow breaths

Use the 3-3-3 rule to get out of your head. Then use the breath to settle your body.

1. See 3 things. Name them slowly.
2. Hear 3 things. Take your time with each sound.
3. Move 3 parts. Shoulders, hands, feet.
4. Now feel the ground. Your feet on the floor, or your body on the chair. Sense it holding you up, without any effort from you.
5. Take 3 slow breaths. In through the nose, out slowly through the nose or soft lips, longer out than in. Let the shoulders drop on every breath out.
6. Keep going if you need to. 3 breaths can become 10. Count them if it helps, or just let each breath out run a little longer than the breath in.

If focusing on your breathing makes you more anxious, stay with the sounds, the sights and the feeling of the ground instead. That's fine too.

How long: about 2 minutes in total. How often: whenever anxiety starts to build. The breath part may come more easily if you practice it daily, for example with the 2-minute long exhale timer, which guides you through 4 seconds in and 8 seconds out.

When the 3-3-3 rule is a good choice

• When your thoughts are spinning so fast you can't focus on anything. The senses give you something very concrete.
• In public, when you need something quick and invisible.
• With kids: some parents use it as a simple game to get them out of a worry.

When it isn't enough

• When your body is in full alarm, heart pounding and breathing fast. I'd go to the breath sooner. See breathing into a paper bag for why slowing down matters.
• When you use it every time and the anxiety keeps coming back. Grounding can get you through the moment, but on its own it may not change the pattern. Daily practice and, if needed, proper help do.

FAQ

What is the 3-3-3 rule for anxiety?

It's a grounding technique: name 3 things you can see, 3 things you can hear, and move 3 parts of your body. It brings your attention out of anxious thoughts and into your senses, and back to the present.

Does the 3-3-3 rule work?

Many people find it takes the edge off in the moment. But it's an informal technique, and I couldn't find a study that tested it on its own. You can use it alone, or follow it with a few slow breaths if that helps you.

Can you use the 3-3-3 rule for a panic attack?

You can. For me, focusing on the breath is what helps, even to make a panic attack less strong. A simple way to do that: breathe in gently, then let the breath out run longer than the breath in. If chest pain or trouble breathing doesn't settle, get medical help.

Keep going

• How to calm your nervous system in 2 minutes: the cyclic sigh.
• Long exhale breathing: the full technique.
• Waking up with a panic feeling: the first minute.
• Free 10-minute practice for the evening.

Sources: F. Lenoir, Rallenta, ascolta, respira (attention can rest on many things, even the beauty of a landscape) · J. Hall, Breathe (Breath Awareness to Release Anxiety: sensing the ground) · M. Pistono, Breathe How You Want to Feel (longer exhales) · UCLA Health: the 3-3-3 rule · Cleveland Clinic: grounding techniques · Alessio's own view.