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Breathing To Balance The Stress Response System

Learn How To Use Breath Work To Alleviate Anxiety


One of the most effective practices to employ when working with clients who suffer from mood-related issues is also one of the simplest: Just breathe.

Richard Brown and Patricia Gerbarg—authors of The Healing Power of the Breath—demonstrate several different therapeutic breathing techniques and explain how to incorporate them into your clinical work in their upcoming session from our new webcast series, Integrative Mental Health.

In a quick preview clip, Patricia talks about the importance of getting an anxious client to balance their stress response system, followed by a demonstration of an easy breathing exercise that can help them do just that. Watch the video below to see this technique in action and begin using it with your anxious clients (or yourself on those stressful days!).

I hope you can join us for my conversation with Richard Brown and Patricia Gerbarg this Wednesday. They wrap up this invaluable series with an in-depth look at how simply changing breathing patterns can help to alleviate a host of issues, such as anxiety, anger, aggression, and depression.

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4 Responses to Breathing To Balance The Stress Response System

  1. Brian Whelan says:

    I understand that this is only a preview into working with the breath, but as someone who works with the breath I see this clip as an what is wrong with breath work that is used in psychotherapy. It is based upon pseudo science and not the real psychophysiology of breathing and balancing the autonomic nervous system. First of all, there is no magic number that is representative of autonomic balance. While statistically breathing at 5 breaths per minute leads to a majority of people increasing the “resonant frequency” of their heart rhythm, it is not the ideal pacing for everyone. Lehrer advocated determining the correct frequency for each client. This may be 4, 5, 6, or 7 breaths per minute depending on each individual client.

    Additionally, she instructs the client to take a “deep relaxing breath” as if this breat were universally defined, universally implement able, and would result in relaxing everyone who took it. As someone does “breath work” while measuring blood gases (CO2 and O2) using a pulse ox and a Capnometer I know that such breaths are rarely regulating and most often daysregulating. What this means is that the optimum levels of CO2 are usually lowered outside the range necessary to support proper cellular function. As one gets outside this range a whole series of things can happen, including a full blow panic attack, activation of the Amygdala and HPA axis, and reduced blood flow to the heart and brain. While the counting breaths are less likely to dysregulate someone’s proper ratio of CO2 and O2, it depends on their personal physiology, current metabolic demands, and actual volume of air moved per minute(not the actual breaths per minute). I should note that I often find individuals can get high HRV/resonant frequency with paced breathing but lowers their CO2 at the same time to a severe state of hypocapnia. If you don’t understand what I am talking about, I encourage you to understand these concepts before you implement the strategies above.

  2. Patricia Ziebka says:

    I am curious about your credentials, Brian! Since you are so critical about psychotherapy, please tell us a bit more about yourself. Are you in the field of Pulmonology? Just asking.

    • Brian Whelan, LCSW, CST, CMT, SEP says:

      I am not critical of psychotherapy. I am a psychotherapist, massage therapist, biofeedback therapist and somatic trauma therapist. I specialize i working with PTSD and anxiety disorders. The above mentioned breathing techniques have the potential to cause panic, anxiety, activation of the HPA axis,etc by inducing hypocapnia. I am not critical of psychotherapy, I however do not want psychotherapists to apply breathing techniques without understanding the basics of respiratory physiology and acid base balance. Even if I was in the field of pulmonology and I recognized that a psychotherapist was inducing a state of hypocapnia via their techniques, my critique would still be relevant, as inducing hypocapnia is not a good thing no matter what your professional orientation.

  3. Brian Whelan, LCSW, CST, CMT, SEP says:

    I will elaborate on my concern with what I see as a widespread misunderstanding of the role of breathing for relaxation purposes. The purpose of breathing is not “relaxation” but support of proper cellular function and respiration. It is the brainstem which primarily detects levels of CO2 and O2 in the blood. When metabolic activity increases, more O2 and glucose is converted to ATP which produces a biproduct of CO2. CO2 is the primary factor involved in inducing respiratory drive which is controlled by the brainstem and diaphragm reflex. The rate and depth of breathing is supposed to be based upon CO2 concentrations and varies minutely from one breath to another based upon these CO2 levels. Additionally, inhalation is primarily sympathetically mediated and the exhale is parasympathetically mediated. When you accentuate the in breath, as he does in the video, you are activating the sympathetic nervous system. Additionally, when you rapidly inhale, you are sucking a large volume of air into the lungs. Hyperventilation or overbreathing is cause by overventilating above what metabolic demands require. Overventilation can occur through short, shallow rapid breathing or by deep inhales. Overventilation is achieved by moving more volume or air per minute that exceeds metabolic demands, and this can be achieved through shallow rapid breaths or deep slow breaths. What matters is have you breathed off too much CO2 and interfered with the ability of the hemoglobin to release O2 to the cells that need it. Overventialation results in vasoconstriction, reduced oxygen delivery to all parts of the brain and body, and activation of the HPA axis and centers that register life threat (i.e. not getting enough O2). In psychotherapy we are wanting to keep a clients prefrontal cortex on line and inducing a hypocapnic state takes these centers offline. Often clients experience relief from overbreathing because it induces a dissociative state caused by depriving the brain and body of O2. If one has uncomfortable emotions of sadness, anger or past trauma, overbreathing can effectively thwart the successful integration and processing of these emotions. This is a relief to some clients, but it delays their symptoms ultimate resolution. If you can hook your clients up to both a capnometer and O2 sensor I think you will find that many (not all) individuals would be dysregulated ( i.e. lower their CO2 to a hypocapnic state) by the implementation of the first breathing technique that was described. I would be glad to put you in touch with Peter Litchfield, PhD or Bob Whitehouse, PhD if you wanted to rent a capnometer to discover what I am saying for yourself. Warmly, Brian

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