“It’s totally private. Nobody knows you’re doing it.”
Alex J. Reyes
Although venture capitalist and author Scott Amyx has given speeches before thousands of people at companies and organizations around the world, he's often filled with anxiety before he goes onstage. To calm himself but also keep his mind clear, he regularly turns to a breathing practice he learned several years ago from a sports psychologist.
By doing this practice for up to 30 minutes every morning, plus one more time before he goes onstage, Amyx says, “I’m able to manage my anxiety and turn that nervous energy into a powerful presentation.”
Anyone who's been to a yoga class knows that breathwork is common at the beginning or ending of a class. That’s because the ancient yogis recognized that we can either calm or arouse ourselves by changing the depth and pacing of our breath. Over the past few years, though, mental-health professionals have begun to discover this as well. Some have begun recommending breathing techniques to their patients with anxiety, post-traumatic stress disorder, and depression.
Cynthia Stonnington, chair of the department of psychiatry and psychology at the Mayo Clinic in Phoenix, Arizona, says she often introduces clients to breathwork because “many people find benefit, no one reports side effects, and it’s something that engages the patient in their recovery with actively doing something.”
The type of breathwork emerging as one of the most beneficial is so simple you can learn it in minutes. You’ll have learned it, actually, by the time you’re done reading this article. Called resonant breathing or Coherent Breathing (a trademarked term) it’s been promoted by a pair of psychiatrists in New York City who found it to be so valuable for even severe mental conditions that they’ve used it with survivors of genocides, earthquakes, tsunamis, and other global disasters. The breath technique is also being used by veterans in at least two Veterans Administration Hospitals in the US.
This form of breathwork emerged after years of studying the ancient breathing practices of indigenous people around the world, from yoga and qi gong to African, Hawaiian, and Native American traditions, explains Patricia Gerbarg, assistant clinical professor of psychiatry at New York Medical College, who studies the technique along with her husband Richard Brown, associate professor of clinical psychiatry at Columbia University College of Physicians and Surgeons.
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“We wanted to identify a short program that could be quickly given to people, that they would have immediate relief within five or ten minutes, and that over time would produce long-term changes,” Gerbarg says. Small but important studies are documenting the value of this technique. One study published in the Journal of Alternative and Complementary Medicine in 2017, led by researchers at Boston University, asked 30 patients with major depression to regularly practice the breathing method, along with Iyengar yoga. After three months, depressive symptoms had significantly declined, as measured by a standard depression inventory test.
A key benefit of this breathing is that you can do it anywhere. It simply involves taking regular breaths in and out the nose, at a pace of five breaths per minute. (This translates into a count of six—one per second—for each inhalation and exhalation.) Initially, it helps to do the breath with your eyes closed, but once you become experienced, you can keep them open. That way, if you find yourself anxious, depressed, or stressed at any time during the day, you can sit at your desk or in a meeting and do a few rounds. “It’s totally private. Nobody knows you’re doing it,” Gerbarg says.
The breath should be gentle, Gerbarg explains, because the aim is to balance the sympathetic (“fight or flight”) with the parasympathic (“rest and digest”) branches of the nervous system. When they first started looking into the restorative power of the breath, the prevailing rationale was that it sent extra oxygen to the brain. But the couple knew that explanation couldn’t justify the profound effects they were observing in people who did breathing practices. What’s more, some types of breathwork actually decrease oxygenation.
The real reason it works, Gerbarg and Brown now believe, is because the vagal nerves—which connect the brain to the body, telling organs when to beat, breathe, digest, and the like—have been found in recent years to actually send even more messages in the other direction: from the body to the brain. “These ascending messages strongly influence stress response, emotion, and neurohormonal regulatory networks,” they wrote in a chapter on resonant breathing in the 2015 book, Yoga Therapy: Theory and Practice.
“Respiration is the only autonomic function we can voluntarily control,” Gerbarg says, so it makes sense to change the pattern of breath in order to shift the messages the brain receives. The equal pacing of this balanced breathing tells the brain to simultaneously relax and stay alert, allowing you to remain calm but still socialize or get your work done—or, in Amyx’s case, to give a big speech.
The calm, even breaths send messages of safety, Gerbarg says, which reduces anxious or depressive thoughts, and allows more loving and sociable emotions to emerge. Adverse reactions from this breathing are rare. However, people with severe asthma may find that at first, the breathwork may narrow their airways a bit, which can exacerbate breathing problems. For this reason, it's best for them to try this practice only under the supervision of an expert.
To keep track of the timing, it’s best not to count aloud, or even to use a visual cue like a blinking light, because those put too much gas into the sympathetic side of the equation. Stephen Elliott, a biofeedback practitioner who trademarked the term Coherent Breathing, has created a timekeeping app, called “two bells” (download from the website Coherence.com), which features distinct Tibetan bells alternating every six seconds to alert you that it’s time to inhale or exhale.
Gerbarg and Brown also teach periodic weekend workshops around the country called Breath-Body-Mind, which include repeated rounds of resonant breathing along with simple qi gong movements and meditations.
Stonnington believes more psychiatrists should embrace this breathwork. “It could entice more patients to seek care because the option of using a variety of modalities, not all involving medications, is appealing to many people,” she says.
Of course, the biggest challenge for someone with depression is motivating themselves to do it in the first place, especially if other techniques have failed them. While Gerbarg recommends sessions of 15 or 20 minutes or even longer as the ideal, any amount is valuable. If you can only get yourself to take two or three breaths, that’s enough to start moving in a healthier direction.
Correction: A previous version of this article failed to attribute the trademarked term Coherent Breathing to Stephen Elliot.
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