It's among the most important physical functions our bodies perform—we do it about 20,000 times a day—and still, somehow, most of us get it wrong. Breathing properly is a secret health weapon rarely spoken of by mainstream physicians or mental health practitioners. Yet nothing could be more vital. "If I had to limit my advice on healthier living to just one tip, it would be to learn to breathe correctly," says Andrew Weil, MD, a well-known pioneer in the field of integrative medicine.
Eastern traditions have long extolled the importance of chi or prana—the life forces associated with breath—and science is finally catching up. "Medicine is just recognizing the importance of energy to health," says Richard P. Brown, MD, an associate clinical professor of psychiatry at Columbia University. "And our most critical source of energy is oxygen."
For the past 30 years, Brown has been a lone voice in the psychiatric wilderness calling for attention to breath work research. He has authored over 80 scholarly articles (half of those with his wife, Patricia Gerbarg), and published numerous books on subjects ranging from integrative approaches for the treatment of anxiety, depression, mood disorders, cognitive and memory impairments, Attention Deficit Disorder, sexual dysfunction, to medical illnesses, schizophrenia, and substance abuse. A longtime practitioner of yoga, meditation and martial arts, he created a workshop called Breath Body Mind that combines berath and movement practices from yoga, chi gong, coherent breathing, and open focus meditation.
Patricia Gerbarg is an Assistant Clinical Professor in Psychiatry, New York Medical College who, along with her husband, lectures on natural treatments, including herbs, nutrients, and mind-body practices at the American Psychiatric Association Meetings and many other conferences. Dr. Gerbarg practices Integrative Psychiatry, combining standard and complementary treatments. Her research focuses on mind-body practices for reducing the effects of stress and trauma, particularly in survivors of mass disasters, including the Southeast Asia Tsunami, 9/11 World Trade Center attacks, 2010 earthquake in Haiti, war in Sudan and Rwanda, Gulf Horizon Oil Spill, and veterans.
These forward thinking, humanitarian doctors took time out of their busy schedules recently to talk to me about the most commonly misunderstood (and important) habit in our daily life.
MM: Can you explain the connection between the breath and stress and negative emotions?
DG: There’s a reciprocal relationship between breath and emotions — every emotion is accompanied by a different breath pattern, so for example, when you’re excited, your breathing is rapid. It’s possible to change how you feel and even how your mind is working by slowing down to a gentle pattern of four to six breaths per minute. This has a calming effect on the emotions while enhancing attention, clarity, and mental focus.
MM: This is just from breathing?
DB: Just from breathing. We have found that breathwork is useful even with extreme psychological trauma. We have worked with male patients who had been quite violent. If they were not violent to others, they had very disturbing suicidal thoughts. After three or four sessions, I asked them what changes they were experiencing in their lives and they told me, “You know, I don’t have these thoughts of wanting to hurt people or myself. I can go down the street and I just feel so much freer instead of being tortured by these thoughts that I couldn’t stop, and that my medication didn’t stop.” I found the same thing with veterans who were troubled with post-traumatic stress disorder and terrible anger and suicidal thoughts. I’ve taught doctors in different VA centers simple breathing exercises that could stop suicidal thoughts within a couple of minutes. I believe the foundation of our healthcare is to take care of ourselves and do things that can empower us to be stronger, healthier, more resilient, and more connected to others. There are many kinds of powerful breathing practices that can make us feel more connected to ourselves and to other people. I find we’re all more disconnected from each other these days, and with breathing, wherever you are, you’re just more fully aware of what’s going on around you—and inside you.
MM: Why has the breath been ignored in Western treatment paradigms? Something so simple that can help so radically?
DG: We are an action-oriented society. When Eastern health practices were transplanted to Western cultures, much of the wisdom of breath practices was lost because many of these practices were considered to be too sacred, secret, or powerful to teach westerners. Also, in our action-oriented point of view, breathing is too quiet or subtle. It seems like we aren't doing anything. Movement is overvalued and breathing isn't even on the radar.
MM: What are the most common mistakes that people make with breathing.
DB: When you watch babies or animals like cats, they breathe in a really beautiful way. But as we grow up and we have to learn how to survive and fight to succeed, our breathing, becomes dysfunctional—it’s too shallow, or it’s too hard, or too tense—and it’s pretty easy to change this. Proper breathing is very smooth, continuous, gentle and effortless. When people have been stressed, it stops and starts and it’s a lot of work because the muscles are so tense. Some people have more trouble on the in breath, while others have more trouble with the out breath, and some people have trouble with both. If someone is nervous or worried, their breathing is shallow or too fast and more in the chest than in the belly. Some people may hold their breath on and off without realizing it. Often people will hold their breath for a moment when they stand up or sit down—or when they’re scared.
DG: Most of the time we’re breathing too fast because we’re in some degree of stress, and this contributes to imbalances in the stress response system and has other negative health consequences.
MM: What can we do right now to get better in terms of our breathing, our anxiety and the sort of waking up effect that you’re talking about?
DB: You can do some movement, which helps you relax and get physical stress out of the body. One of the kinds of breathing I teach is a sophisticated form that was developed by Russian Orthodox monks. It was passed down through the ages from person to person. And it is never too soon to start. There’s interesting data that kids at around eleven or twelve years old are very stressed out, and they’re beginning to develop severe anxiety and depression, which correlates with substance abuse in their twenties and severe mid-life depression. So starting early, around the age of ten or eleven can be beneficial.
MM: Dr. Gerbarg, please tell me about your work with trauma victims in Sudan.
DG: One of our students who had been doing the breath work for several years asked if she could teach some basic practices to survivors of war and slavery in South Sudan. She found it was easy for them to learn, and it gave them some relief in just minutes.
She asked Dr. Brown to go to Sudan with her to teach groups of recently liberated slaves, who had been held in extremely abusive captivity—some for 10 or more years. They had only 20 minutes to teach breath and movement to a group of 200 liberated slaves just arriving at the clinic who were exhausted by their long journey on foot to freedom. But once they followed his lead, they began to loosen up, and then laugh and hug one another. Two days later, Dr. Brown taught a group of 400 survivors with the same effect. He also gave a group of women who had been doing the practice for two years some more advanced healing techniques, and now this core group of women are teaching in the surrounding villages and at a nearby orphanage.
MM: What would you like people to do to help themselves—and further the awareness of these methodologies? Where can we begin? (With our medication practitioners and with our own breathing practices)?
DG: The best way to have a deep experience is to go to a two-day Breath~Body~Mind Workshop. However, for those unable to attend in person, there is a book and CD set called The Healing Power of the Breath published by Shambhala. It teaches the basic breath practices with some gentle movements to reduce the effects of stress and rebalance and improve energy, mood, sleep, mental focus, relationships, and performance.
What it is: Breathing that involves expanding the belly, which gives the lungs room to take in more oxygen.
How it can help: Improves circulation; eases stress-related and anxiety disorders; speeds recovery from chemotherapy.
How to start:
1. Lie on your back with your knees bent. Place one hand just below your rib cage and the other on your upper chest.
2. Breathe in slowly through your nose so that your stomach pushes against your lower hand.
3. As you exhale through pursed lips, tighten your abs and let them fall inward. (Throughout inhalation and exhalation, the hand on your chest should remain as still as possible.) Do this exercise three times a day for five to ten minutes, then gradually increase that amount. With enough practice, you should begin to breathe this way automatically.
What it is: A yogic technique designed to promote relaxation.
How it can help: Reduces blood pressure; may have an anti-obesity effect; boosts cognitive function on spatial tasks.
How to start:
1. With your right thumb, close your right nostril and inhale slowly through your left nostril.
2. Now close your left nostril with your pinky and ring fingers, release your thumb, and exhale slowly through your right nostril.
3. Keep the right nostril open, inhale, then close it; open the left nostril, and exhale slowly through the left. That's one round. Start with three rounds, and add a round each week until you are up to five. Then practice whenever you're feeling stressed out.
The Bellows Breath
What it is: An exercise aimed at increasing alertness.
How it can help: Provides a boost in energy comparable to the high you feel after a workout.
How to start:
1. With your mouth closed, inhale and exhale quickly and evenly through your nose. Aim for three in-out cycles per second, but stop after 15 seconds on your first attempt.
2. Keep practicing, increasing your time by five seconds, until you reach a minute. When you feel your energy dipping, try this technique for 60 seconds.