How to Breathe

You may ask yourself, if I didn’t already know how to breathe, I surely wouldn’t be alive to read this blog post, would I?  But what many of us don’t think about is that the way we breathe can have profound effects on our levels of stress and anxiety.  Short, shallow, rapid breathing may give us the energy needed for “fight or flight” when danger is near,  but when we need to calm down and think things through, then short, shallow and rapid is not the best way to go.

Many psychotherapists teach their clients breathing techniques to help  with anxiety, panic, depression or stress.  There are many breathing strategies which can be very effective; it’s possible to sample a smorgasbord of breathing strategies and choose the one or two that work best for you.  We asked several Psych Choices therapists to describe their favorite breathing techniques.

Noah Freedman, M.D.:  “Coherent breathing” is a technique developed by scientist Stephen Elliott about 10 years ago.  It helps to regulate the cardiovascular system by increasing “heart rate variability” (HRV). This provides an expansion and contraction of all your blood vessels and your heart because the heart will speed up on the in-breath, increasing blood pressure, and slow down on the out-breath, lowering blood pressure.   It calms the nervous system as well through its balance of relaxation and activation (parasympathetic and sympathetic nervous systems),

Coherent breathing means breathing at the rate of about 5 to 6 breaths per minute, with equally spaced in-breaths and out-breaths.  This is easiest to do if you count to 5 as you breathe in, and again to 5 as you breathe out. If 5 does not work, use a number that works for you, 3 or 4, up to 5 or 6.  Breathing through the nose helps to slow your breath down.  If you are congested, I suggest just leaving your mouth just slightly open.  As you count silently to yourself, your mind quiets with its focus on the numbers.  As you drift off into your thoughts, just bring your mind back to the numbers.  Do not judge yourself for losing focus.  Do not judge yourself for judging yourself.

Coherent breathing can be done anytime you have a few minutes to yourself.  It can help settle you down for sleep as it can easily be done while in bed.  But do not do it while driving.

Dave Tomlinson, LCSW:  The best breathing “technique” is no technique at all! The Buddha’s teaching on using the breath emphasizes normal in- breaths and out-breaths. This approach to conscious breathing, attending to each in and out-breath, knowing that one is breathing in or out, whether the inhalation is long or short and aware of all the subtle qualities of the breath (smooth or ragged, deep or shallow), while maintaining proper posture with the body still, is the practice of shamatha meditation. This approach to use of the breath helps reduce excessive (discursive) thinking, settle and still the mind, promote a sense of inner calm, and enhance concentration.

Elizabeth King, LPC:   My favorite ways to teach breathing techniques are fun and creative. Sometimes, I ask people to blow bubbles for a few minutes, and before they know it, they have slowed and deepened their breathing without even trying. Teaching a child deep breathing from their diaphragm can be a challenge, but with the help of a balloon for illustration children quickly learn new skills.   As an art therapist, I employ art making to explore the quality of a client’s breath. For example, I may ask a client to use lines, shapes and colors to symbolize their breathing. Is it long/short, quick/slow, shallow/deep? Then, I will lead the client through a relaxation exercise while teaching deep breathing skills. Next, new artwork can be made symbolizing the new (and hopefully changed) quality of breath.  With awareness, education and practice, we are able to change our experience of distress by changing the quality of our breathing.

Connie Opfell, LCSW: I teach abdominal or “belly breathing” to help calm the mind.  First, sit or lie so that your spine is in its natural curve, allowing your lungs room to fully expand.  Then, gently place one hand on your chest and one hand on your belly to help you notice your breathing.  Notice where your torso expands as you breathe – are you more of a chest breather, or does your abdomen expand when you inhale normally?  Now breathe out fully in a long, slow, smooth exhale.  When you inhale, try to direct the breath to the lowest part of your lungs.   Notice that when the diaphragm drops to pull air in to the bottom of the lungs, your belly expands.  If you have trouble with this, try raising both hands up over your head; this move helps direct the air down into the bottom of your lungs.  Exhale fully, and repeat several times.

Nate Prentice, LCSW, CAS-PC:  I teach a “cleansing breath” which is especially good in preparation for any kind of meditation.  The simplest version is to breathe deeply all the way in, hold the breath for a moment, then let it go very slowly until there is no more breath at all – so that if you were asked to speak, you wouldn’t be able to.  After that breath, go back to breathing normally.  

A tension-reducing variation is to imagine that as you inhale deeply, you are moving all the physical and emotional tension that you have into a single part of your body (any part, you choose: your hand, your elbow, whatever you like).  When you are holding your breath, try to increase the tension even further.  Then when you breathe out, do 3 things: (1) give the tension your permission to leave; (2) give yourself permission to let it go, and (3) imagine your tension leaving your body, and also leaving the physical area where you are.

A final variation is from the world of clinical hypnosis.  Do the tension reducing breath just described above, while observing, with non-judging curiosity, just how relaxed and free of tension you can become as you exhale.  Take a mental snapshot of what you discover to be the point of most relaxation (Point One).  Then inhale again, building up the tension only up to the point of your deepest relaxation that you reached on your first breath (back to Point One).  On the next exhale, see how much further and deeper you can go with relaxation (Point Two).  On the next inhale, just build up the tension to where you left off at Point Two, etc.  Repeat as needed.  This is especially good to promote sleep.


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