Q: I'm a traditional talk therapist, who'd like to explore using mind-body techniques to help clients calm down, but I don't know how to begin. What can I do that doesn't involve learning a whole new set of esoteric skills?
A: Sometimes, the simplest methods are the most effective. I've long been interested in the mind-body connection in psychotherapy, but was never quite comfortable introducing some of the more elaborate touch-oriented approaches. Several years ago, I went to a workshop and learned some hands-on techniques, but they worked best if the client was lying on a table. Definitely not my style! More recently, I attended a workshop about the current scientific knowledge about the connections between the mind and the body—the interplay of the emotions and the brain, how the body remembers trauma, the impact of stress hormones on health. It was all very interesting, but offered me nothing in the way of specific clinical techniques.
I've meditated for many years and have learned directly how helpful meditation can be in calming myself down and improving my mental and physical well-being. During this time. I've also explored a variety of different mind-body approaches, looking for those I might use as an adjunct to therapv. In all this searching. I haven't found a single technique that works better than one I've long used during meditation, and which I began teaching my clients some years ago. It also happens to be the simplest technique to use, the easiest to teach, and possibly the most profound single step clients can take to experience the mind-body connection.
What is this amazing technique I give my clients? I teach them to breathe. Whether it's called "natural breath," "deep, relaxed breathing," or "abdominal breathing," teaching clients this relatively humble skill has had a greater impact on my practice than any other technique I've used.
I began to use deep breathing some years ago to help me in my meditation practice, and soon learned that it also enabled me to slow down my sometimes frantic inner pace during the day. Then I began to study qigong, a practice that combines postures and meditation to balance one's energy and promote physical and mental health. Learning qigong and Taoist philosophy made me realize that breathing could be used independently of other meditation techniques to enhance psychotherapy.
One of the first clients with whom I used the breathing technique was a bright, intellectual Jesuit priest. Whenever any emotionally laden material came up, he'd engage in quasitheological discussions that confused and exacerbated me and didn't help him get at the emotional roots of his problems. His inner tension was clear in the way he spoke—loudly and very fast, while sitting rigidly on the edge of his chair, hands clenched in his lap. Not knowing what else to do, I asked him to sit back, breathe deeply, and simply try to pay attention to the air coming in and going out. It soon became apparent to both of us that when he focused on his breathing, his body relaxed. When he spoke, his speech was softer and slower, and he could begin to focus on what he was feeling, rather than on the convolutions in his head.
At first I taught my clients to breathe to help them feel less defensive and give me time to think. But soon I began to notice that deep, natural breathing sometimes moved them past their defenses onto a more productive therapeutic course. So I began to use this technique whenever clients had a hard time focusing on difficult material, or when they were distracted and couldn't be emotionally present in a session.
The effectiveness of this simple technique has surprised and delighted me and my clients many times. It not only gets clients past many "stuck" places, it can also help them open themselves up to their own emotional vulnerability. Just today I used it with a client who was ranting about her husband's failings and growing more agitated by the minute. I suggested she stop, relax, and quietly breathe. Soon she'd detached herself from her anger and began to cry from a longing for him and a deep sadness about the state of her marriage. Another client, bitter about his parents' lack of concern about his unemployment, began an old diatribe about how his parents had never been available for him. After I taught him the breathing technique, he could look past his rage at his parents and begin to see how his chronic bitterness was poisoning his life.
When clients focus on their own breathing, they're making the most fundamental mind-body connection. Regardless of what they're talking about—childhood trauma, a painful marriage, or just the struggle to be open with you in the session—breathing can help them get in touch with their immediate experience and be fully present, for the moment, in their own lives.
I frequently combine breathing with visualization. As in many of the Eastern traditions, Taoists believe that the way we use our minds controls our lives, for better or worse. It's surprisingly easy to fool the central nervous system with the mind—to alter our physical sensations and emotional experiences by what and how we think. The trick is to learn how to hold positive thoughts, rather than allow our minds to be overrun by negative ones. Anyone who's done a guided meditation has probably felt the peace and serenity of resting on a tranquil ocean beach or near a trilling woodland stream while actually sitting upright in a conference room. When visualization is used along with deep, relaxed breathing, the mind and the body work together. It's as if the physical energy of the breath were giving the visualized image great power, and the association of breath and image enhances the mind's capacity to maintain a positive state.
I used this breathing-visualization combination successfully with a client who complained incessantly about her disappointment with her mother. She spoke at length about her mother's neglect, but there was something querulous and inauthentic about her recitation of grievances. Both of us sensed that there was something important that she wasn't getting at. After many sessions of working on this issue, I guided her into deep, relaxed breathing for about five minutes. When she was relaxed, I suggested she visualize a scene she'd often recounted to me—sitting with her mother on the porch of her childhood home, and feeling resentfully that her mother wasn't really "there" with her, but off in her own world. This time, once she settled into the breathing and visualization, instead of the old. nagging complaints, she burst into tears. She cried for some time, and when she was finally able to talk, she said she was weeping for her mother's terrible life, the losses and abuse she had suffered as a child. This compassion for her mother, which took us both by surprise, helped her move beyond her resentment to more fruitful therapeutic work.
I suggest to clients that they continually reinforce an image or visualization with their breath when they're doing their own guided meditation. One of my clients, having grown up in a violent home, suffers from depression and panic disorder. He used to get very anxious when he became angry, fearing that he'd become violent toward his children. He's since learned to breathe and visualize his heart as open and loving. This not only calms him down, it gives him the time and inner space to look at his anger with more detachment and think about options for resolving it. Another client, who's almost always tense and stressed, is learning to breathe and visualize her new grandson asleep in her arms. After some practice, she's beginning to be able to relax no matter where she is, by breathing into that image.
I use three simple breathing techniques with my clients: (1) I have the client watch and become aware of his or her breathing—nothing else. This works with people who need a way of distracting themselves from their racing thoughts and emotions, but aren't ready for anything more complex. (2) I ask clients to "sink down" into their bodies and breathe. This usually helps them get out of their heads and more grounded in their bodies. Most clients instinctively know what I mean and can do this with little coaching. (3) I teach abdominal breathing. When I think clients are ready and willing to use breathing as an ongoing approach to stress management in their lives, I encourage them to regularly practice deep breathing at home. In some cases, I encourage clients to breathe deeply at home while visualizing a ball of energy in the middle of their bodies behind the navel. I tell them to gently and slowly inhale, visualizing the air going all the way down to the ball of energy, and then to exhale, visualizing the air leaving the ball of energy. I usually don't breathe with my clients when I'm teaching them, because it can be distracting for them.
Learning to breathe myself and teaching my clients to breathe has helped me become a better clinician. It's a simple, profound, and inexpensive tool that can last a lifetime. It's a great relief to know I don't need to be a master therapist or a Taoist master to keep sessions flowing and help clients better structure their own lives.
This blog is excerpted from "Breathing Lessons," by Patrick Dougherty. The full version is available in the September/October 2002 issue, Brain Therapy: The Neuroscience Discoveries That Can Change Your Practice.
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