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The Art of Breathing

By Angela Marie Bernhardt, BSW

Do you remember the first time you heard the phrase, “Let’s relax with some deep breaths”? My first attempt at deep breathing left me lightheaded, dizzy, and nauseated. So why do therapists focus so much on deep breathing? Because it can be an invaluable skill.

In the spring of 2009 I worked for a well-known eating disorder treatment center, which opened an inpatient Anxiety and Obsessive Compulsive Disorder program. As a behavioral health technician, I received intensive training on Dialectical Behavior Therapy, Cognitive Behavior Therapy, and Exposure with Response Prevention. The clinical treatment team recommended patients practice “mindfulness” during their non-program hours. Mindfulness is “doing one thing at a time with awareness” (Linehan, 1993, p. 69). One valuable tool that is accessible all the time is our ability to breathe. On several occasions patients would complain that deep breathing doesn’t work. The key to mindfulness is to begin slow and practice often.

In my training, a psychologist introduced me to a biofeedback machine, the Stress Eraser. A childhood of asthma prevented me from maintaining the biofeedback rhythm: inhale for 4 seconds and exhale for 8 seconds. How was I going to teach if I could not breathe correctly? Despite my personal struggles with the Stress Eraser, I witnessed remarkable healing with it.

I worked with an adolescent who had severe anxiety around death. Prior to her treatment, her breathing was overtly audible and distracting within conversation. Due to her abnormal breathing, she isolated from relationships and school. Under the supervision of a psychologist, the patient began working with the Stress Eraser for 5 minutes each day. The patient’s motivation to practice deep breathing allowed freedom from her anxiety.  Upon discharge from the program, the patient was able to breathe normally while engaging in conversations.

Why did the Stress Eraser work for some patients but not all? We are unique individuals and learn in a variety of ways. For me, the main problem was the intensity of my breaths. A staff psychologist at the treatment center explained, “Breathe slowly in through your nose until you feel full; then slowly exhale through your mouth.” I realized through daily practice I was able to breathe deeper and remained focused. Here are some more ideas to try:

  • Begin with 10 breaths each day; gradually build frequency and duration of exercise
  • Use a focal point while breathing (candle, music, scents, peaceful scenario)
  • Incorporate mediation or prayer

When do you practice deep breathing? I recommend incorporating mindfulness breathing into mundane activities. Then you’ll have practiced for the more stressful situations. Keep in mind deep breathing is not the sole key to reduce stress; rather it is a skill to keep you in the “present state.”

Healthy Futures has groups that provide education and discussion on Dialectical Behavior Therapy skills. Mindfulness, breathing, and distress tolerance being some of the many skills taught. Our professionals will walk along side you toward a “healthy future.”

References: Linehan, M. (1993). Skills training manual for treating borderline personality disorder. NY: Guilford Press.

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