Chapter 17

The Power of Breath

“As newborns we enter the world by inhaling
and when we leave at life’s end we exhale.”

—Christophe Andre, in Scientific American

Breathing is so identified with life itself that it plays an important role in many cultures and religions around the world. And for at least three thousand years, sages and healers have recognized that controlling the breath can improve health and well-being. The earliest traditions of yoga in ancient India were built around controlling breathing to increase longevity.

The primary purpose of breathing is to exchange gases in our body. Breathing brings in oxygen for our cells, and then carries away the waste product, carbon dioxide. Your breathing pattern changes when you are in pain or under stress. Your breaths become small and shallow. Shallow breathing, especially with rapid breaths (hyperventilation), can prolong your discomfort. It actually worsens the physical manifestations of stress and pain.

That’s because breathing has the power to instantly change your nervous system. There are two parts of your nervous system, the part you control and the part you don’t. You control the somatic nervous system, the part that activates the muscles that we can voluntarily move. You can raise your arm, scratch your nose, or clench your fist. The part you don’t control is the autonomic nervous system. It is involuntary. It automatically regulates the functions of your bodily organs and their responses. If you become embarrassed, you blush. If you smell something delicious on the grill, you salivate. These things are involuntary.

Interestingly, breathing is the big exception to the rule. It is both voluntary and involuntary. Most of the time breathing happens automatically, especially when we are sleeping. But when we want to control it, we can. Go ahead and take a deep breath. Our voluntary control over the breath gives us a way to modify the autonomic nervous system and central nervous system—parts that are otherwise outside of our control.

The ancient wisdom of the power of breathing is now being scientifically supported by an increasing body of research. Studies on the physiological effects of modified breathing are showing a wide range of benefits. Breathing exercises can increase oxygenation, improve blood circulation, and lower blood pressure. It can also increase heart rate variability, an important measure of the balance and health of your autonomic nervous system. Breathing can improve the functioning of your immune system by reducing the levels of stress hormones in your system. Ultimately it can bring a feeling of increased physical energy and enhanced feelings of calm and well-being.

Why Is Breathing Important
for Relieving Pain?

How can something as simple as a breathing technique have such a powerful effect on physical and emotional distress?

When you take a deep breath and exhale, the “magic” happens in part because the exhalation activates the vagus nerve. The vagus is the longest of the cranial nerves, extending from the head down to the abdomen. It is also highly connected to the function of the parasympathetic branch of the autonomic nervous system, the part that calms you down. An activated vagus nerve prompts the parasympathetic system to decrease alertness, lower blood pressure, and reduce the heart rate, thereby increasing calmness. This is one of the central physical correlates of the relaxation response. Understanding this helps to explain the effectiveness of Lamaze breathing techniques. They have been used over the last half-century by expectant mothers to reduce the pain and anxiety of labor and childbirth.

There is a powerful relationship between breathing and various physical and emotional responses. This is evident when I observe patients with breathing difficulties. It is estimated that about 60 percent of those with COPD (chronic obstructive pulmonary disease) have anxiety or depressive disorders. This is likely due to multiple contributing factors. We know that breathing in a shallow, faster pattern can decrease the quality of the oxygen supply and aggravate physical discomfort and anxiety. Breathing disturbances often trigger anxiety and even panic attacks.

The link between breath and emotional responses can be seen in those situations when you are on the verge of tears, and you don’t want anyone to know. Remember our discussion about how emotions can only be experienced in the body? When you try not to show your grief, you instinctively constrict the muscles in your face, neck, and torso. Importantly, this includes tightening the diaphragm, the large dome-shaped muscle that separates your chest from your abdominal cavity. This is the major muscle for breathing. It contracts and expands rhythmically and continually—usually involuntarily. When you contract your diaphragm, it follows that your breathing becomes shallower, and you begin to feel progressively more uncomfortable. Likewise, we tend to instinctively hold our breath when we feel anxious or sad. And when we are experiencing pain, we tend to breathe in a shallow fashion and tighten and brace whatever area hurts. This is a good example of how the word feel applies both to sensations and emotions. When we are trying to not hurt so badly, we tighten our muscles and constrict our breath as the physical correlate of getting away from the pain.

Conversely, when you take deeper breaths, it is more likely that you will more fully feel whatever emotion may be residing within you. This almost always proves to be helpful in resolving difficult emotions. Similarly, breath techniques can also reduce the intensity and intrusiveness of physical pain.

Basic Breathing Techniques

For maximum effectiveness, find a quiet, relaxed environment where you won’t be disturbed for at least five to ten minutes. Also, to notice the change that occurs, be sure to rate the level of tension/agitation that you feel on a 0−10 scale before you start the exercise, and then again after you finish.

Diaphragmatic Breathing

This is a good, basic technique to introduce you to the benefits of mindful breathing.

1.Either lie down or sit up comfortably.

2.Place one hand on your chest and the other on your abdomen. Notice that your chest and abdomen are moving while you breathe.

3.Concentrate on your breath and try to breathe in and out gently through your nose. Your chest and stomach should be still, allowing the diaphragm to work more efficiently. Eventually you will feel your abdomen begin to rise with each breath, while your chest rises less.

4.With each breath, allow any tension in your body or mind to slip away.

5.When you have done this for three to five minutes, sit quietly and enjoy the sensation of physical and mental relaxation.

Now, take three to five minutes to practice diaphragmatic breathing. Describe below what you experienced after doing this, such as a difference in sensations in various parts of your body.

4-4-8 Breathing

In this exercise you will learn to combine the physiological benefits of slow, deep breathing with the mind-quieting benefits of focusing on a target—in this case, numbers. The synergy that results is greater than if you were to strictly do either the breathing or the counting alone.

1.Settle into a comfortable position, either sitting or lying down. Close your eyes.

2.Breathe in through your nose while counting to four.

3.Hold your breath for four counts.

4.Exhale through your mouth for eight counts.

5.Repeat this cycle of 4-4-8 for two minutes or longer.

As you do this, it is important that you keep your attention focused on the counting. For this exercise and all the other techniques here, if your mind gets distracted during the practice, then just keep bringing your attention back to the counting once more.

Take three to five minutes to practice 4-4-8 breathing. Describe below what you experienced after doing this, such as a difference in sensations in various parts of your body.

Somatic Focus Breathing

In this exercise you will achieve a calmer, more comfortable state while focusing the sensations of breath in three parts of your body: your abdomen, your chest, and your nostrils.

1.Sit or lie down in a comfortable position and start breathing at your normal rate and rhythm. There is no need to breathe more deeply or change your breath in any way.

2.As you breathe, focus your attention specifically on your abdomen. See how closely you can notice the various sensations there as your abdomen expands on the inhale and deflates on the exhale. Pay attention in this way for sixty seconds.

3.Next, switch your attention to your chest, breathe normally, and notice the sensations similarly to what you did in step two, again for sixty seconds.

4.Next, switch your attention to the rim of your nostrils and pay attention for sixty seconds.

5.Now, choose the part of your body that was the easiest to focus on, whether abdomen, chest, or nostrils. For the next five minutes, refocus your attention closely on that spot. Again, if you get distracted, just gently guide your attention back to the physical sensations in your area of choice.

Take three to five minutes to practice somatic focus breathing. Describe below what you experienced after doing this, such as a difference in sensations in various parts of your body.

30-to-1 Breathing

This exercise is another effective way to synergize the benefits of nervous system modulation and mental calming.

1.Start either sitting or lying down comfortably. Close your eyes.

2.Take a slow inhalation, and as you do, think the number 30.

3.Take a slow exhalation, and as you do, think the number 30.

4.Take a slow inhalation, and as you do, think the number 29.

5.Take a slow exhalation, and as you do, think the number 29.

6.Continue this pattern of slow inhalation and exhalation as instructed above, with the number 28 and counting down to 1.

Take three to five minutes to practice 30-to-1 breathing. Describe below what you experienced after doing this, such as a difference in sensations in various parts of your body.