This fall I began working with an eight-year-old girl named Luz with a history of anxiety, who was experiencing crying spells, restless sleep, and intrusive thoughts, especially of death. This was making daily life a challenge for her. It was hard to concentrate in school while worrying what heaven would be like. For her parents, too, it was challenging, when she didn’t want to let them out of her sight.

I knew immediately that much of our time together would involve mindfulness and relaxation techniques. The first was the easiest and one of the best, a particular method of controlled deep breathing that I learned from the Medical University of South Carolina’s online TF-CBT training. It involves laying one hand over the heart, the other above the bellybutton, breathing deeply in through the nose to swell the belly and move that hand, then breathing slowly out through the mouth, all the while keeping the heart-hand still. Diaphragmatic breathing, in other words, but with an added component that is meant to stimulate oxytocin release in the body.

To explain the technique in terms familiar to Luz, I referenced the Pledge of Allegiance. Doing things by rote tends not to foster deep thinking, so despite my own childhood experience of that rituala daily recitation in school made with one hand on the chestit’s only now, thinking of this breathing technique, that I’m struck by the symbolism of the gesture. True patriotism would seem, indeed, to involve the heart, and deeply I do love this country, meaning the landscape itself, its original contours and ecosystems and the wisdom we might glean from them.

But I digress. With the sweet alacrity of children, Luz not only adopted this method of breathingwhich her parents prompt her to practice before bedbut she gave it the name that made sense. Now when we talk about her therapeutic homework, and all the skills she’s learning, she refers to her breathing as The Pledge. She recently made a drawing depicting it, which I will cherish for years to come: a girl with two ovals for feet; long lashes above wide-open eyes; a broadly smiling mouth, as if singing; hair flying out in happy wings; and a chubby hand over the heart. Calm and confident. Luz’s breath, a pledge worth making and keeping.


To maintain confidentiality, “Luz” is a pseudonym.

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