Breathing is one of the few bodily functions which can be done consciously and unconsciously. As a HANDLE® Certified Screener and owner of Cascades Yoga & Neurotherapy, I teach and emphasize the importance of efficient breathing for general well being especially as a non drug way to manage chronic pain, respiratory health and anxiety.
Frequently I hear comments in yoga classes that, through yoga, people understand how often they hold their breath in the course of a day, especially when under stress and how beneficial yogic breathing is on a daily basis.
There is a centuries old practice of mindful breathing related to hatha (physical) yoga called pranayama. In this article I would like to discuss how pranayama or yogic breathing practice is useful to many HANDLE clients and why.
The one issue specifically addressed here is paradoxical or shallow breathing. There are various causes for paradoxical breathing. Some causes include chest injury, thoracic surgery and lung disease.
Also, many people, women especially, are taught to "suck it in" and over years of doing so invert normal breathing patterns to become, over time, paradoxical breathers (as articulated repeatedly in yoga classes over the last fifteen years). In the course of my work with HANDLE clients I've seen a direct correlation between proprioceptive challenges and paradoxical breathing.
Diaphragmatic breathing is most efficient and is emphasized in yogic practice. The diaphragm, the most important muscle engaged in respiration, is a large dome shaped muscle located at the base of the lungs. On inhaling the diaphragm pulls air into the lungs. It looks like an inverted umbrella, then, returns back to its dome shape on the exhale. Upside down umbrella on the inhale and back to dome on the exhale.
Yogic breathing can involve different ways to increase awareness and develop the muscles involved in efficient respiration, especially the diaphragm. Paradoxical breathing is sometimes referred to as shallow breathing or chest breathing.
When people breathe in this manner, the diaphragm's ability to move downward, bringing in the breath, is undermined by the sucked in belly taking the diaphragm's place because the abdominal muscles are contracting inward occupying space otherwise occupied by the diaphragm. In other words, the diaphragm is attempting to expand downward into the abdominal cavity while the abdominal muscles are contracting inward, occupying the same space, leading to very constricted breathing. Some refer to this as "frozen diaphragm." This can lead to a number of problems.
Digestion, elimination and the menstrual cycle can be negatively impacted due to intra‐abdominal pressure. Chronic tightening of the muscles in the chest, neck and lower back can lead to chronic pain.
Over time tightening and shortening of the back muscles, especially in the back extensors, shifts the position of the ribcage preventing the diaphragm from moving freely. Instead of the ribs expanding and contracting with each breath, the ribcage moves up and down as a static movement. This can also cause the back to tense resulting in difficulty relaxing, which can lead to chronic back pain.
Chronic, poor ventilation of the lungs can lead to carbon dioxide build up and oxygen depletion in the blood leading to, among other things, a vulnerable respiratory system. (I've successfully helped asthmatics reduce their symptoms with yogic breathing.) And then there is anxiety!
While there are at least four identified types of anxiety, for the sake of brevity, I will address the physical forms of anxiety that include, besides holding the breath, shaking hands, sweating, feeling faint, upset stomach or nausea, loose bowels or diarrhea, tingling hands and legs, pins and needles, light headedness, and visual disturbances.
Also, feelings of being detached from oneself, that the world is flat or unreal, feelings of numbness emotionally or physically, and forgetting past events. A non-‐drug antidote can be full torso yogic breathing.
If I suspect shallow breathing I teach full torso breathing, breaking it down into three parts then putting it all together.
I ask my client to relax supine with her legs and feet cushioned on a chair, pillows or bolsters underneath her knees.
Sometimes a small towel rolled to support her neck curve and her head slightly elevated is required if her chin tilts up when she lies down. Then I will ask her to close her eyes or place an eye wrap over her eyes, if she wants that, and watch her breathe, through her nose (if she can). What I am looking for is rapid, shallow breathing usually, but not always, confined to high or chest breathing.
First, I teach the low or belly breath. I start with light weights (I use warmed river stones of various weights) placed on a folded towel or blanket on the belly (with prior permission). Then I ask her to breathe the stone up and down. This can take some practice. Weights can be too much or uncomfortable for some. If that is the case, always requesting prior permission, I use my hand instead or place her hand on her belly or simply use no weight.
Next, I verbally direct each and every breath including inhalation, stop, exhalation, stop, etc. paying very close attention to make sure no stress is involved. I will do this for up to ten minutes, using HANDLE's Gentle Enhancement®. Before beginning, make sure mutual trust is established. Allow for complete rest for a few minutes after this session.
A second session involves placing a weight on the sternum and verbally directing each breath as above. This time encourage lifting the stone or weight with the breath. I encourage the client to actively lift her ribcage at the end of the inhale. Again, this is not something that can always be achieved or felt, but the increased awareness can begin changing old patterns of shallow breathing. Again, no more than ten minutes, generally, and complete rest after.
A third session can involve weighting the area just below the rib cage. Stones tend to fall off, but a small folded towel below or even a bag of beans or rice can be useful, otherwise a hand. This is very subtle. I will ask my client, after playing gently with this, to gently pull her stomach in at the end of the exhale and then relax her belly completely as she inhales.
Again, a reassuring hand, verbal descriptions of the process and careful observations for any signs of stress must be employed with sensitivity.
Finally, using stones or hands to help develop full torso or the yogic complete breath involves engaging low, middle and high breathing using tactile or proprioceptive aids like hands and stones to engage and direct the breath fully into the torso. There is much written about this, but my own experience demonstrates that working with people where they are is most effective.
Play with three part breathing (high, middle and low) in some different ways until the client finds one that is most comforting. If starting with the low breath feels easiest, then make sure that she does not bloat her belly on the inhale as that curtails the ability to fully engage the torso.
Encourage a playful, nurturing, loving exploration of the self, using the breath.
Avoid rigidity and judgment.
Over the years I hear repeatedly from clients that learning to breathe efficiently is one of the greatest gifts to their sense of well being.
I recommend different forms of pranayama, or yogic breathing to almost all of my HANDLE clients because it can be done anywhere and becomes especially useful in stressful moments at work, home, school or anywhere else. It is a beautiful complement to HANDLE's gentle approach.