Off the Couch

Thoughts about the therapeutic process, and the dynamics of client-therapist interactions.

Are you breathing?

A little breath work can make you a lot more patient

Recently I have been learning about breathing. I know, it sounds a little crazy. I do already know how to breathe, and so do all of my clients. But here’s what one conference with Dr. Richard Brown offers:

Based on extensive research, this workshop combines a variety of effective breathing techniques to    relieve stress and improve mood, mental focus, and cardiorespiratory health. These benefits have been enjoyed by health-care practitioners, yoga teachers, military veterans, individuals with anxiety, depression, PTSD, ADD, cancer, Lyme disease, toxic exposures, and victims of terrorism, war, and natural disasters.  (http://www.haveahealthymind.com/brown-bio.html  BREATHE AND HEAL...WITH THE POWER OF BREATH CONFERENCE)

Historically, psychotherapists and medical professionals tended to separate body and mind. But these days we know that the body and the mind are not really separate entities, but are mutually influenced and influencing parts of the same bio-psycho-social system that makes up all human experience. And it’s not just professionals who know this. Even in some of the detective novels that I read for rest and relaxation, characters talk about things like “yoga breathing” and meditation to calm themselves and focus their minds.    

I do yoga and a lot of breathing work on my own. But although I am an advocate of integrating various approaches to developing a healthy body-mind, and I know that there is a wide body of research showing that techniques that help an individual become more physically as well as psychologically relaxed – including yoga, massage, acupuncture, zero balance, meditation, mindfulness and others – can enhance the work of psychotherapy, I am sometimes a little shy about doing it with a client. So I think I will try the conference and see what it might have to offer my work.

But sometimes clients help me make a leap that I might not have made all on my own.

For example, one day Janie*, who had been working on issues related to anxiety and self-assertion, and who was always punctual for her appointments, arrived at my office late and extremely upset. She had been in plenty of time, she said breathlessly, so she stopped to buy herself a treat at a coffee bar near my office before coming for her session. There was a line, but she had occasionally bought something at this shop and had never had to wait long, so she waited her turn, ordered, and paid. And then waited some more. Finally realizing that something was not right, she saw that the cashier was the only person on duty and was working extremely slowly. It was clear that Janie would not get her coffee in time for her appointment; but she could not bring herself to ask for her money back, nor was she willing to walk out without either her money or her coffee. So she stood there, becoming more and more agitated and enraged – not only with the young woman behind the counter, but also with the shop, the other customers, and of course, with herself.

“I was so angry,” she said, “I didn’t know what to do.” To make things worse, when she finally did get her drink, she dropped some change into the cup for tips. “What’s the matter with me?” she said. “I didn’t want to tip the woman. But I couldn’t not do it!” She started to cry. “I hate feeling like this!” she sobbed. “And now I’m not only late, but my whole therapy session is going to be ruined by this stupid thing!”

Sobbing and unable to catch her breath, she could not talk to me or respond to any of my questions. When it became clear to me that Janie was having difficulties soothing herself enough to even think through what had happened, I asked if she felt up to doing a breathing exercise with me. She nodded, still sobbing.

I told her to put her hands in her lap and both feet on the floor, and to try to relax back against the back of the couch. Janie was already crying a little less.  I said, “Close your eyes. Now, without changing anything, just pay attention to your breathing.” Janie’s ragged breathing started to even out, although tears still streamed down her cheeks.

“Are you breathing through your nose or your mouth? Congested? Are you breathing quickly or slowly?” I asked.

She started to answer, but I told her not to try to talk yet, just to keep noticing.

 “Do you breathe in or out more deeply? Are you breathing into your chest? Your neck or stomach? Your back?” I continued.

Then I told her that I’d like her to breathe in and out through her nose, four counts in and four counts out. I counted the first few breaths for her, then asked her to do it on her own for a few breaths.

At the end of the four breaths, I told Janie to let her breath return to normal; and after a few breaths, to slowly open her eyes.

She looked at me. “Wow,” she said. “I actually do feel calmer.”

From there we went on to talk about a problem she had asserting herself at work. We did some good work understanding what made it hard. “I’m always afraid that someone will get angry at me,” she said. “But maybe I can do a little of this breath work before I approach my supervisor.”

Breathing. We all do it. But I have just learned that when it’s integrated into the therapeutic process, it has a little extra something to say.

*names and identifying information changed to protect privacy

Teaser image source: http://www.controlyourcash.com/2012/08/15/remember-to-breathe-228...

 

F. Diane Barth, L.C.S.W., is a psychotherapist, teacher, and author in private practice in New York City.

more...

Subscribe to Off the Couch

Current Issue

Let It Go!

It can take a radical reboot to get past old hurts and injustices.