Between each expelling exhalation, we exhale and inhale once without visualizing, and then we perform the visualization again where we see our negative thoughts as black vapour. We do this three times, first with our right hand on our right side and then the exact same procedure on the left side using our left hand. After having expelled our negative mental states three times on the right side and three times on the left, we then make two vajra fists and press both of them into the channels of our left and right legs. We then breathe in and expel our negative mental states three times through both nostrils.
[Depicted from "Life as Practical – Practical Instruction to the Lay Practitioner - Part 19" May 2015, Canada.]