Breathwork
There are many amazing benefits to breath work and breath focus. It can be used to down regulate our nervous system and bodies into calm grounded state; it can also create a more balanced centered state or even up regulate us increasing energy and readiness. I note in each technique what the primary focus is and where appropriate the why it works physiologically from my “medic” perspective.
Basic Breath Focus
Purpose: Grounding and centered
When using our breath as the centering focus of meditation one technique is to note where the breath is rising and falling. Is it the chest, the diaphragm, both?
When I focus on my natural breathing I found I could feel the air moving through my trachea and bronchial tubes in the center of my sternum. Especially when employing Ujjayi breathing. Like a gentle rush with the rise and fall of my diaphragm. That’s where my breathing naturally centered, yours could be different. As you sit find what you gravitate too.
** A medic note - we breathe most efficiently with our diaphragm or belly first then expanding the chest. The movement of the diaphragm creates the negative pressure to draw the air in. Bigger movement, bigger negative pressure, bigger breath.
Box Breathing
Purpose: Down regulating
Most breathing techniques originate from yogic practices and because of their effectiveness have propagated throughout the work and found their way into all walks of life. Special forces operators, mixed martial artist and first responders have adopted the box breathing technique as a simple down regulating tool that creates focus and calm.
Here are the steps:
1. Take a slow deep cleansing breath in through the nose and out through the mouth.
2. Inhale through the nose for a count of 4.
3. Hold the breath for a count of 4.
4. Exhale through the nose or mouth for a count of 4. I prefer nasal breathing throughout this technique.
5. Hold after the exhale for a count of 4.
6. Repeat for 4 or more rounds.
Experiment with different count lengths and number of rounds, 4 is just a starting point. As always, it’s your practice find what works best for you.
Hatha Yoga Pradipika
“When the breath wanders the mind also is unsteady. But when the breath is calmed, the mind too will be still.”
Ram Dass
“Be still. The quieter you become, the more you can hear.”
The Responder’s Breath
Purpose: Down regulating, immediate physiological calming effect
There is a 3 step down regulating breath that I’ve called “The Responder’s Breath”. I call it this because it’s a technique I use when responding to high stress or serious calls. It’s actually an ancient breath work technique in the Eastern practice space. The Huberman Lab podcast made it much more famous than I ever could. In the Freediving world it’s also called a physiological sigh.
When I’m stepping out of the ambulance and putting my gloves on I’ve created the habit of using this breath to focus and calm my mind. If appropriate, I also teach it to patients who are having a panic attack, are in a mental health crisis or need something to focus on to bring calm.
So here it is, the responder’s breath:
1. Breath in through your nose and pause.
2. At the pause continue to breath in filling your belly and chest in the biggest breath you’ve taken all day
3. Exhale slowly for 6 or more seconds. The exhale should last essentially anything longer than the 2 stage inhale.
Medic note, why this works: It’s a down regulating breath work technique because the second and third stage triggers a vagal response. The vagus nerve is one of the largest nerves in body and a key part of the parasympathetic nervous system. Also called the rest and digest system. The vagus nerve carries the signals from your brain to your heart and digestive system. Stimulating this nerve slows the heart rate amongst other physiological reactions.
Ujjayi Breathing or “Ocean Breath”
Purpose: Down regulating with sustainable balanced calm
Ujjayi breathing is a yoga breath that involves slightly constricting the back of the throat when breathing. The purpose is to provide calm, focus and generate internal heat. It’s often used in flow yoga when moving between to poses and synchronizing the breath with each movement or asana. In meditation I’ve found that it creates a gentle, warm continuous focus that’s sustainable for a longer period of time over the shorter more immediate responder’s breath. It can be performed seated, standing, lying, walking or even running.
Here’s the steps:
1. Straighten the spine and relax the shoulders and begin breathing naturally through the nose.
2. Start with a deep inhale through the nose leading with the belly, then chest, then throat.
3. On the exhale, slightly constricting the throat as if saying “ha” or imitating Darth Vader, just more subtle. The constriction creates a soft, barely audible ocean sound. The exhale is preferably through the nose but can be through the mouth to start if continuous nasal breathing is difficult for you.
4. While maintaining the light constriction, continuing breathing seeing if you can also maintain it on the inhale as well as the exhale. The inhalation and exhalation are either equal in time or preferably with a longer exhalation. If it helps, try counting at least a 4 count on the inhale and exhale or better yet a 4 count inhale and 6 count exhale.
Medic note, why it works: Like the responder breath, this technique engages the vagus nerve. Unlike the responder breath it does it more gently. This light engagement of the parasympathetic systems is why it’s sustainable over longer periods of time.