“There is one way of breathing that is shameful and constricted. Then, there’s another way: a breath of love that takes you all the way to infinity.” ~Rumi
Our breath manifests within us as a physical embodiment of our life force, ever coming and going like waves. When we check to see if someone is alive, we listen for the breath. When our life force leaves us, it leaves with our last breath. The word “spirit” (derived from its Latin root spir)means “breathe.” Spir also brings us dynamic words of becoming such as aspire, transpire, and inspire. In Sanskrit, prana refers to the vital energy intrinsic to all forms of creation and is also the word for breath. In Chinese, the word is qi.
Breathwork––the practice of manipulating the breath for a desired physical, mental, or spiritual effect––has found its way into the common vernacular and mainstream communities hungry for effective, accessible self-care techniques that help alleviate stress, unleash potential, and cultivate wellbeing. There is most definitely a need.
In 2016, the World Health Organization (WHO) ranked depression as the number one cause of disability internationally. Anxiety was ranked 6th. In 2018, a large study revealed that 1 in 3 adults in Britain had contemplated suicide in the previous year. Burnout is now considered an occupational disease in nine European countries. Sadly, “death by overwork” has a name in Japan: karoshi. They also have a name for work-related deaths by suicide: karojisatsu. As we struggle to achieve balance in our modern lives, we find ourselves at a disadvantage. Globally, despite the relative prosperity many of us enjoy, we are suffering and in much need of relief.
Thanks to research in the fields of neurobiology and neuropsychology, doctors and therapists now confidently recommend breathwork as an effective, non-pharmacological evidence-based tool to support physical and mental health. With this validation, the practice has emerged as an effective, free, and accessible option for improving wellbeing. Moreover, it can be easily incorporated into a daily routine, which may be as relevant to our health as brushing our teeth.
You may remember from high school biology that when we inhale, we bring oxygen (O2) into our bodies, and when we exhale, our bodies are relieved of carbon dioxide (CO2). The human body is made up of around 37.2 trillion cells, all of which need oxygen to survive. Simply put, breathing is nothing more than pulling air into the body to bring in O2 and then letting it out of the body to relieve it of excess CO2. If we look at breathing more closely, however, we cannot help but be impressed with the complexity of the process, and the role breathing plays in a number of bodily functions.
Cellular Respiration = Energy
The process of cellular respiration begins when O2 enters the blood via its interface with the membranes of billions of tiny air sacs in our lungs called alveoli. The molecules pass through these membranes, bond with the hemoglobin in red blood cells, and are carried to the various regions of our bodies, where they are taken in as needed by our cells. Tiny organelles within our cells called mitochondria then combine glucose from the food we eat with the O2 delivered by the blood and produce adenosine triphosphate (ATP)––the primary energy carrier in all living things. Water and carbon dioxide, the byproducts of this process, are then carried off by the blood to be filtered through the kidneys, or in the case of CO2, released back into the lungs and expelled from the body.
Interestingly, it is not the body’s demand for oxygen that causes us to hunger for breath, but rather the buildup of CO2 in our tissues as a byproduct of cellular respiration. CO2 buildup causes tissues to become slightly more acidic. Thus, the body is highly regulated at maintaining a balanced pH within the body (pH is a measure of acidity and alkalinity). Our bodies, therefore, rely on shifts in breathing rate and volume to keep everything operating within required parameters.
As CO2 builds within the body, we are inspired (no pun intended) to take a breath. Then, our bodies engage in a primarily unconscious coordinated effort of muscles (including the diaphragm, intercostal muscles, and various support muscles) to shape the thoracic cavity (the area inside the ribs) so that air is drawn into the lungs. Corresponding muscles, along with the elastic properties of the affected tissues, assist air back out. In this way, in about 12 breaths per minute, breathing helps the body maintain homeostasis.
What you may not have learned in biology class, however, is that moment to moment, and breath by breath, breathing also serves to regulate other core aspects of our biology, including elements of body chemistry that are directly related to our emotions, our ability to respond appropriately to stress, and even our potential to bond with others.
Breath and the Nervous System
Beyond our physical need for breath, we instinctively know our breath can help us manage pain and strong emotions. For example, women in childbirth are given breathing exercises to help with the pain of labor. Most of us have heard at one time or another the instruction to “Slow down . . . Breathe.” Through its direct influence on the nervous system, our breath can calm us, or it can excite us.
Subconscious changes to breathing pace and volume are triggered by the activity of the autonomic nervous system (ANS), the branch of the nervous system that regulates bodily functions of which, for the most part, we don’t have direct control. In addition to breathing rate and volume, the ANS is responsible for heart rate, blood pressure, blood flow, digestion, pupil dilation, and more.
One branch of the ANS, the sympathetic nervous system (SNS), is generally considered an accelerator. When the SNS is dominant, we are usually engaged in dynamic movement, work, exciting play, or active problem-solving. In addition, the SNS is famously responsible for our body’s physical reaction to danger, known as the fight, flight, or freeze response. When the SNS is activated, our breathing rate and volume increase, and oxygen-rich blood is diverted from the brain and, less immediately vital organs, to the skeletal muscles in preparation for whatever effort (fight, flight, or freeze) that may be required to preserve life. In addition to increasing heart rate and blood pressure, the SNS triggers the release of the “stress hormones” adrenaline and cortisol.
In a healthy person, once the stimulus that triggered the fight, flight, or freeze response is no longer present, the SNS calms, and the parasympathetic nervous system (PNS) becomes more active. The PNS is associated with a more relaxed bodily state. Breathing and heart rates slow, muscles relax, and blood is diverted to the visceral organs and brain to support processes such as digestion, reflection, and tissue repair.
Breathing is the one function of the ANS that we can also voluntarily control. Therefore conscious manipulation of the breath directly affects our nervous system. In other words, our breath can be actively employed to help us down-regulate an overactive SNS and recover from a stressful or traumatic event.
In addition to breathing’s relationship to the ANS, certain breathing exercises alter neurological activity and brain chemistry. For example, in the case of alternate nostril breathing, the right nostril is associated with left-brain activity and the left nostril with right-brain activity. Also, various breathing exercises have been shown to assist in producing certain brain wave patterns and in inhibiting or promoting the release of certain neurochemicals.
Breath and Our Health
In addition to helping us manage more acute moments of duress, breathwork can help us to resolve the biological and psychological effects of stress that have become chronic. Chronic stress is associated with inflammation in the body. The two together are risk factors for many diseases, including cardiovascular dysfunctions, diabetes, cancer, autoimmune syndromes, and mental illnesses such as depression and anxiety disorders.
In the presence of chronic stress, the biological markers described in the fight, flight, or freeze response linger, interfering with bodily functions that are optimized during PNS activation. Chronic stress responses can even alter how our minds perceive and interpret experiences. For example, when certain regions in the brain are active, a situation or event may be perceived as threatening. Whereas when other brain structures are involved, the same stimulus may be interpreted differently. This could be one reason why we can exhibit patience for a minor traffic infraction by a fellow driver on a given day, and the same infraction can throw us into a rage on another day.
Although breathing techniques have long been used in treatments for respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD), psychologists and allopathic doctors are just coming to recognize the value of sharing breathing tools as a way of supporting patients in managing chronic stress.
To take it a step further, it is theorized that poor breathing habits, such as ones caused by poor posture, a sedentary lifestyle, or restrictive clothing, may encourage breathing styles associated with stress, such as shallow chest breathing. Although shallow chest breathing is considered a symptom of an overactive SNS, maintaining this breathing style throughout the day for reasons unrelated to stress may perpetuate a stress response in the body.
Nose Breathing vs. Mouth Breathing
There are significant benefits to breathing through the nose. The nasal passages warm, humidify, clean, and slow incoming air, preparing it for the lungs. In addition, paranasal sinuses—air-filled cavities within the bones of the skull located above, below, and between the eyes—produce nitrous oxide (NO) and continuously release the gas into the nasal passages. NO has antibacterial, antiviral, antiparasitic, and antifungal properties. Its presence helps protect the body from outside invaders, and it also dilates blood vessels, contributing to improved transport and absorption of oxygen.
In healthy individuals, breathing through the mouth is not a problem. The body naturally opts for mouth breathing when there is a need to shift from breathing through the nose in favor of a more efficient way to get oxygen to the lungs, such as when exercising or when congested due to a cold or sinus infection.
Breathing habits that incorporate chronic mouth breathing, a state in which one habitually breathes both in and out through the mouth, can have long-term health effects that include snoring, sleep apnea, increased allergies, dry mouth, and halitosis. People who suffer from frequent sinus infections, chronic allergies, or asthma sometimes continue mouth breathing even between bouts of congestion, simply from habit. Chronic over-breathing, a condition where one breathes through the mouth as if short of breath, can interfere with O2:CO2 ratios in the blood.
Breath and Physical Performance
The application of breathing exercises to enhance physical aptitude has increased in popularity in recent years as high-performing athletes reach performance ceilings for endurance and strength, and trainers look for new ways to help their athletes improve. An internet search will bring up hundreds of articles promising athletic gains as a result of practicing the breathing technique du jour.
Generally, studies on breath and exercise focus on strengthening respiratory muscles and increasing lung capacity for measured gains. To that end, a wide variety of research has been done on different types of breathing, including diaphragmatic, nose versus mouth, and rhythmic or timed breathing, to name a few. Research in this area lacks in both consistency and quality, however, and more studies need to be done before any clear conclusions can be drawn. That said, breathing techniques show promise as a component of any exercise program, especially for athletes who have not reached peak performance levels, and certain breathing exercises may decrease recovery time between bouts of intense exercise.
Breath and the Emotions
You may be familiar with the saying, “choke back tears.” Sometimes in order to keep our emotions inside us, we must literally restrict our breathing. Free the breath, and you free emotion. If expressing emotion is our body’s natural way of processing intense experiences, then resisting emotional expression interrupts our ability to fully integrate and move on from the events that cause us distress.
Unfortunately, it is not always appropriate to express our emotions freely in certain settings. If, as children, however, we receive messages that there is never an appropriate time for emotional release and that expressing our emotions is socially undesirable, dangerous, weak, immature, or shameful, we become experts at subverting them. The result is emotional rigidity and a limited capacity to heal, grow, and trust, which inevitably interferes with our ability to see ourselves and others clearly.
Emotional release is often a precursor to profound personal insight. Certain breathing practices serve to untangle latent emotions that have been kept at bay. Although it can feel scary at first, when emotions arise, it’s generally appropriate to loosen the reins a little and allow for them. A good breathwork teacher will have the skills to coach a student through an emotional release that occurs in a session so that the body can metabolize the emotion(s), and the brain can integrate the experience(s) that triggered them.
What About Trauma or Mental Illness?
Almost all of us, without exception, have experienced some sort of trauma. It is often these experiences, especially if they occurred when we were young, that shaped our worldviews. To survive childhood trauma, we had to develop strategies to keep ourselves safe. Those strategies often no longer serve us in adulthood yet tend to, at least subconsciously, play out in our lives anyway. When we engage in deeply somatic healing work such as breathwork, unresolved traumas, along with other strong emotions, may surface.
As described above, when old or suppressed memories and the feelings that go with them rise to the surface, teachers and therapists tend to welcome them as they present an opportunity for emotional release and reflection. In the presence of a qualified coach, intense emotions, including trauma, can be effectively understood, integrated, and ultimately resolved.
However, it should be noted that breathwork coaching, counseling, or instruction is a burgeoning but non-regulated industry in every country. Techniques vary dramatically. Thus, the scope of practice for a practitioner may have been poorly defined in their training, or it may even be non-existent. Although most forms of breathwork are safe for most individuals, one should always check with a medical professional before beginning a breathing practice. Anyone who has a breathing-related injury or disease, such as asthma or COPD, or anyone suffering from mental illness including anxiety, depression, bipolar disorder, psychosis (especially a recent psychotic episode), recent trauma (less than one year), or posttraumatic stress disorder (PTSD) should consult a physician or psychiatrist before beginning a breathwork regime.
Those concerned about trauma or mental illness should select their practitioner thoughtfully and have access to alternative support in the form of a psychologist, spiritual advisor, or family member who is available to step in should strong emotions linger or become overwhelming, or if they begin to impact one’s ability to function in daily life.
That said, most individuals who engage in regular breathing practices find them to be healing and report immediate and long-term benefits to mental health, especially with regards to improving mood.
Breath for Spiritual Evolution
Beyond its physiological and psychological benefits, breathwork comes to us through Eastern contemplative practices such as yoga, Buddhism, and martial arts, where it continues to have a place as an integral component of theological systems that prioritize self-discovery, self-knowing, and an aspirant’s desire to access higher states of consciousness. Within these systems, the breath is usually used to expose practitioners to altered states of consciousness believed to promote and sometimes amplify spiritual focus. Like other somatic meditations and embodied practices, breathwork invites us to shake hands with that part of us that some call spirit, some call soul, and some call consciousness or divine intelligence.
Specific breathing practices are presented in the ancient texts and teachings of Sufism, Hinduism, Buddhism, and Classical and Tantric Yoga. In addition, the vast tradition of Chinese Medicine and its philosophical and practical branches of Taoism and Qigong all speak to the importance of the breath and offer specialized practices to aspirants. In the words of Lao Tzu:
“The space between heaven and earth is like a bellows. Human beings are born by virtue of the energy of heaven and earth; respiration is the mechanism of the bellows.”
Breath for Wellbeing
For those who prefer to steer clear of the spiritual, alchemical, or transcendental lens, we can look to breathwork as a somatic modality supportive of a more general sense of wellbeing. Breathing techniques promote embodiment and reawaken us to the subtle rhythms and movements toward which our bodies naturally gravitate. Every moment we are breathing, the body is in motion. This means that every moment we are alive, we are moving.
We are designed to breathe, move, and feel our way through life as we respond dynamically to life’s challenges, opportunities, and rewards. Stifle the breath, and you stifle this movement. Stifle the breath to the extreme, and you stifle life itself.
By degree, failing to breathe well may reduce one’s capacity to live fully. Not only might poor breathing habits inhibit access to the energy and vitality that would otherwise be available through the improved physical functioning that results from better breathing, inefficient or unconscious breathing habits may inhibit access to one’s full intellectual, creative, and emotional range.
Most breathing exercises, regardless of their origins, fall into the following categories. Most systems adapt and group techniques for desired effects, tailor them to their purposes and philosophies, and may call them by different names.
Breath Awareness: Probably the most straightforward and accessible practice, breath awareness is the act of simply paying attention to the breath. This brings the unconscious act of breathing into conscious awareness.
Belly Breathing: Sometimes referred to as “diaphragmatic breathing,” belly breathing focuses on mobilizing the diaphragm, the dome-shaped muscle between the thoracic and abdominal cavities while breathing. During diaphragmatic breathing, the belly distends on the inhale and relaxes or is actively drawn in on the exhale.
Ribcage Breathing: Sometimes referred to as “chest breathing” or “costal breathing,” ribcage breathing prioritizes the movement of the ribcage by employing the skeletal muscles between the ribs, as well as various support muscles in the chest, neck, back, and shoulders to increase and decrease rib cage volume.
Resistance Breathing: Applying resistance to the breath as it moves into and out of the body is a technique used to control the pace of breathing and strengthen the respiratory and cardiovascular muscles. In breathwork, resistance breathing is generally produced naturally by pursing the lips or curling the tongue, or narrowing the aperture of the glottis––the throat area that houses the vocal cords and larynx. Resistance breathing happens naturally when we talk, whisper, or sing.
Fast Breathing: We inherit two common fast-breathing techniques from yoga traditions. The breath of fire (kapalabhati) focuses on exhalation and encourages a rapid and continuous contraction and release of the abdominal muscles to expel and recover short puffs of air. This technique relies on the elasticity of the tissues after exhalation for the return of air back into the lungs. Bellows breathing (bhastrika) is a more aggressive diaphragmatic technique that employs a rapid, forceful exhalation and inhalation. Both fast-breathing techniques encourage a state of hyperventilation, temporarily reducing CO2 in the bloodstream and increasing the ratio of oxygen comparatively.
Alternate Nostril Breathing: Borrowed from age-old yoga traditions, alternate nostril breathing (Nadi Shodhana) is a technique in which the practitioner uses the thumb and third finger to alternately close or block one nostril for a complete breath cycle. Traditional yoga energy theory references two central energy channels (nadis) that are thought to be stimulated by variations of this breathing technique.
Timing and Suspending the Breath: A counting structure that regulates the pace of breathing is referred to as timing. A variety of breath timings and breath holds or suspensions have long been common to eastern breathing systems and have more recently become popularized in the West. For example, celebrity doctor and holistic medical proponent Andrew Weil popularized the 4:7:8 breath for its relaxing properties and as an aid for sleep. In this technique, the breath is inhaled for four counts, held for seven counts, then exhaled for eight counts.
The Breath Wave or Circular Breathing: Known as anulom valom (with the grain) in Sanskrit, circular breathing is considered the foundation of yoga pranayama. It encourages a coordinated effort of all of the musculoskeletal structures that come into motion when we breathe in order to utilize full lung capacity. At the start of inhalation, the practitioner actively distends the abdominal muscles to support diaphragmatic activation. As inhalation continues, the practitioner encourages an ascending, sequential expansion of the rib cage from the lowest to the highest ribs. During exhalation, the practitioner engages with a descending contraction from the highest ribs to the lowest. Toward the end of exhalation, the abdominal muscles pull in, supporting the natural upward movement of the diaphragm.
Breathwork is a practice independent of traditional systems such as yoga, Qigong, Buddhism, or martial arts, which have grown in popularity in recent years. Research demonstrating the positive benefits of breathing practices and improved breathing styles is plentiful and promising. New techniques and systems pop up every day as practitioners explore new methods and adapt old ones. A quick internet search will reveal a plethora of facilitators and coaches offering virtual breathwork sessions and certifications. In addition, a number of smartphone applications, including Breathwork, Calm, Insight Timer, Steady, and Strategic Breathing, now offer daily breathing exercises.
It should be noted that due to the lack of regulation in the field of breathwork coaching and the proliferation of breathwork certification courses that vary from a single weekend workshop to the equivalency of a several years’ degree program, the oversight, internship, mentorship, or hourly experience a given practitioner may have may not be adequate to qualify them to work with individuals with medical conditions, trauma, or mental health issues. Therefore, as mentioned before, those interested in working with a breathwork coach should select a practitioner thoughtfully.
The following is a list of some well-known contemporary breathwork systems, schools, and techniques:
Alchemy of Breath, Biodynamic Breathwork, Breathing Space, Breathology, Clarity Breathwork, Conscious Connected Breathwork, Evolutionary Breathwork, Holotropic Breathwork, Inner Resources Breathwork, Integrated Breath Therapy, Maitri Breathwork, Rebirthing Breathwork, Shamanic Breathwork, Transformational Breath, Wim Hof Method Vivation,
You can also learn more about breathing in my book Breathwork: A 3 Week Breathing Practice to Gain Clarity, Calm, and Better Health