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  • Noelle Deckman, Ph.D.

Breathing Exercises

Updated: Mar 12, 2021

Using Breathing Exercises for Psychological Disorders

During these stressful and unprecedented times, many people are finding themselves overwhelmed and unsure of the future. When we let our negative thoughts run wild by thinking about all of the “what if’s?”, it’s very common to start experiencing negative symptoms, such as anxiety, depression, fear, hopelessness, etc. Caving into these negative thoughts and emotions can create a downhill spiral that can feel impossible to escape. However, with hard work and practice, you can climb out of that hole and regain stability in your life.

Some people may be able to apply some of the coping skills I’ll be discussing entirely on their own and recover. However, it is also common and completely normal for people to also need a little extra help to move forward depending on what’s going on in their lives, so please keep this in mind if you feel you’re struggling too much on your own. Professional help is always available and being willing to reach out is a highly courageous act in itself. If you feel like you are doing generally well overall and would just like some information on how to practice basic coping skills, then this is the place for you.

Beginning to work on yourself can seem like an impossible feat. Where would you even begin? That’s why I always encourage people to begin with basic coping skills. No matter how stressful your life gets, trying the simple things, such as basic coping skills, can often help by reminding yourself to slow down and pay attention to your thoughts, feelings, and behaviors, which are the core of cognitive behavioral therapy (CBT). After all, how can we change something as complex as the way we are thinking if we are unable to even recognize our thoughts?

That is why coping skills and self-care are such popular concepts you’ve probably heard about related to therapy. So, what are coping skills and how are they different from self-care? I like to think of coping skills as the foundation to therapy. Just as you would never build a house on a shaky foundation, neither should you dive into your deeper, underlying issues without creating a stable foundation for your mind. Coping skills can include breathing exercises, mindfulness practices, grounding techniques, meditation practices, and a variety of other skills to help reduce your emotional distress in the moment. In CBT, often times, the purpose of using coping skills is to help you reduce strong, negative emotions in the moment, so that you are better able to think about the situation more clearly. This increases your ability to then use your cognitive or “thinking” skills to work through the situation more effectively, or, depending on the issue, so that you may be more equipped to face certain situations you may be avoiding due to anxiety, fear, etc. (e.g., during exposure exercises).

Coping skills differ from self-care in the sense that coping skills are essentially tools used in the moment to manage stressful situations or overwhelming emotions, whereas self-care activities are considered healthy, scheduled restorative activities used to prevent and alleviate stress on a regular basis. There is definitely overlap in these skills or activities since, for example, one could practice breathing exercises on a daily basis for self-care (e.g., practicing breathing exercises for 5 minutes per day each morning) and also in the moment during a stressful situation to reduce strong emotions (e.g., using breathing exercises as a tool to cope and reduce tension during an argument with your partner). I will often use these terms interchangeably, but it is good to know the difference so you can be more aware of how you are practicing these newly learned skills. I will also discuss more on cognitive skills and self-care in later posts, but for now, we’re just focused on one of the most basic coping skills: breathing.

Before I discuss the breathing exercises I most commonly teach people in my sessions, I want to start by saying to always practice these exercises initially only while you are calm. By doing so, you are helping your brain create an association of calm with the exercise (vs only practicing breathing when you are in distress). I usually recommend practicing until you feel you have developed mastery of the breathing exercise, or any skill for that matter, before practicing when you are overwhelmed with emotions. This typically takes a few weeks if you’re practicing daily. The only exception would be if you are in a crisis, meaning a harm to yourself or others, then please call 911 or go to your nearest emergency room.

Diaphragmatic Breathing

Diaphragmatic breathing, also known as Belly Breathing, involves taking slow, deep breaths through your diaphragm. An easy way to identify whether you’re breathing through your diaphragm is to place one hand on your belly and one hand on your chest, then as you begin to breath, try to breath into your belly so that the hand on your belly rises and falls with each breath and the hand on your chest remains still. Here are the basic steps to practice diaphragmatic breathing:

1. Lie on your back on a flat surface, such as your bed or a couch. Feel free to put a pillow under your head if needed for comfort.

2. Place one hand on your belly and one hand on your chest.

3. Take a slow, deep breath inward through your nose, so that your belly rises with your breath, while the hand on your chest remains still. I recommend breathing at a rate of about 4-5 seconds for your in-breath.

4. Exhale slowly through your mouth, noticing the hand on your belly fall with your breath, while the hand on your chest continues to remain still. I recommend breathing at a rate of about 6-7 seconds for your out-breath, slightly slower than your in-breath.

When you first practice diaphragmatic breathing, it is normal for it to feel a little awkward and you may even experience a slight feeling of being lightheaded. It will start to feel more natural over time though and often helps create a feeling of relaxation as you are getting increased oxygen throughout your body. I usually tell people to start practicing for at least 5 minutes per day, a few times per day if possible, and increase your time as you acclimate to this skill. Everyone has a slightly different breathing rate as well, so please feel free to adjust the rate of your breaths a little if needed. Although it’s good to start practicing while lying down as you get used to diaphragmatic breathing, you can also start to practice while seated and work up to practicing while you’re standing up or walking around. Always try to maintain a relaxed body posture whenever practicing, releasing the tension in your shoulders, head, and neck.

There are many benefits to diaphragmatic breathing, including those I’ve already mentioned, such as reducing stress, increasing relaxation, and decreasing overwhelming emotions. Additional benefits include strengthening your diaphragm, stabilizing your core muscles, reducing your oxygen demand, and decreasing your breathing rate, heart rate, and blood pressure. It is also important to note that our brain sets off a “fight, flight, freeze” response when we are in survival mode, such as being chased by a bear. However, in modern day life, we are rarely being chased by bears, but our brains have developed to set off this stress response in many situations even when our lives are not truly in danger, such as when we are experiencing everyday stressors, which creates a “false alarm” (e.g., experiencing intense anxiety during a social event). I’ll discuss the stress response in another post, but it is worth knowing that diaphragmatic breathing is a helpful skill that helps decrease this response and promote relaxation.

Mindful Breathing

Mindful breathing is another way to practice breathing that simply involves paying attention in the present moment to your breath, without forming any judgements on how you’re breathing. I will discuss mindfulness in full detail in another post, but with mindful breathing, you really just want to observe yourself, almost as an outsider, breathing in and out in a natural way. There is no need to control or count your breaths as you would with diaphragmatic breathing. Just breath as you normally would and pay attention, trying not to make any negative criticisms or judgements on how you are breathing. Here are a few simple steps to practice mindful breathing:

1. Sit or lie down in a comfortable position.

2. Close your eyes and gradually shift your attention to your breath.

3. Pay attention to your breathing without trying to breath at a certain pace or in a certain way. Just simply observe your breath.

4. Notice any sensations that arise as you are paying attention to your breath. What is the temperature of your breath as you breath in? How about when you breath out? What does it sound like? Do you notice any smells or notice any other physical sensations while breathing?

5. Your mind might start to wander during this exercise, but that’s okay, that’s just what our minds do. Try not to pass judgment and get frustrated at your mind if it wanders. Just pay attention and notice that your mind has wandered and bring your attention back to your breath.

6. When you are nearly done with your mindful breathing exercise, keep your eyes closed for a few seconds longer and try to visualize the room or environment you’re sitting in. Notice the weight and feel of your whole body sitting on your chair or lying down on a bed or couch. When you’re ready, open your eyes.

I recommend practicing mindful breathing, or any other mindfulness exercise, for at least 5 minutes per day with the goal of increasing your time spent being mindful to build your practice and help increase your awareness. As you get more comfortable with this exercise, you are welcome to get more creative with it, such as practicing while you’re taking a walk.

These are just a few ways to practice breathing exercises that I suggest you try to help create your own solid foundation. Please remember that it takes time to build a coping skills practice – which is exactly why it’s called a practice. These are skills that need to be practiced regularly if we are to notice any benefits. I like to think of coping skills as the entry way into therapy, allowing us to slow down and observe ourselves so we can pay attention and work on deeper issues if needed. If you decide you would like some professional help learning coping skills in more detail, or you would like to work on other issues, please feel free to contact me today.

Please note:  This blog is for informational purposes only.  It does not represent a therapeutic interaction.  If you are experiencing a psychiatric emergency, please call 911 or go to your nearest emergency room.

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