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C. Shaffia Laue, M.D.
Holistic Psychiatry

C. Shaffia Laue, M.D.
Holistic Psychiatry and Nutrition
1425 Oread West Suite 101, Lawrence, KS 66049
785-841-1243

Breath and Chronic Illness
by C. Shaffia Laue, M.D.

Most physicians don’t think in these biological terms, but the amount of oxygen in your blood can have an important impact on recovery from chronic illness, psychological and/or physical.  If the lab values are “within normal limits,” a patient is often told that “nothing is wrong” and there is no explanation for their symptoms.  They have not yet connected the lab values with anything the patient can do to make a difference, they only think in terms of drugs or giving oxygen through a tube.  Since the body is always making compensatory measures, several lab values can be “within normal limits,” but out of balance in relationship to one another.  Very few doctors consider this possibility, even though every one has studied the body’s capacity to change the pH by changing the breathing patterns. 

In my practice I give people a detailed biological explanation for why breathing abdominally will help their physical well-being.  Perhaps some of you, who have had the opportunity to play a wind instrument, sing in a choir or practice yoga or other types of meditative exercises, have already had the chance to experience the difference that breathing deeply can make.   It is possible that you have felt a difference, not only while you do those activities, but also as you expand it out to other areas of your life.  Breath can be used as a tool, and it is a most wonderful tool that is with you every moment and can be used without anyone else knowing that you are using it. Breath is the key to the autonomic nervous system.  This part of our nervous system was named autonomic because scientists believed that it was automatic and not under voluntary control.  Elmer and Alyce Green did some of the groundbreaking research to scientifically prove through biofeedback methods that exquisite voluntary control could not only be attained, but also maintained through conscious endeavors.  When people realize how helpful breathing can be, it is often confusing to them how their breath became so unbalanced from the natural state in which they were born.  Because of this I will begin my discussion by looking at the changes in an infant's breathing during a crying episode. 

A baby breathing peacefully will unconsciously allow his/her abdomen to rise as s/he breathes in and the muscles will contract to help push the diaphragm up during exhalation.  A crying baby on the other hand, unconsciously contracts all the muscles in the upper torso and arms and abdomen. The child will hold his/her fists near either side of the neck and the extreme tension forces the breath to occur only in the top 1/4 of the lungs.  This in turn, with the tension in the voice box, produces a high-pitched cry to which human adults are biologically tuned to respond.  Unfortunately "culture" can intervene in the form of "experts" who tell newborn parents that "the child needs to exercise his/her lungs," or "you'll spoil her if you pick her up, or “he needs to become independent sometime, so start now and let him cry himself to sleep." 

Thousands of years ago, as our physiology developed, it was important that an unattended crying baby not attract possible untoward attention.  A fail-safe aspect of our biology protects against the dangers in the wild.  An infant crying and using the top 1/4 of his lungs is actually hyperventilating.  S/he is exhaling sufficient CO2, but not inhaling enough oxygen.  Since the brain tracks carbon dioxide levels as a way of monitoring blood oxygen, the brain is unaware of the slow decline in blood oxygen and the infant loses consciousness (i.e. faints) and returns to a more natural breathing pattern.  The child is usually so exhausted from the exertion of crying that he then goes into a sleep state and we state that "he cried himself to sleep," when the truth is that he lost consciousness due to lack of O2.  If the child was crying because of pain, s/he will probably repeatedly reawaken due to the pain stimulus.  If s/he was only crying because s/he was scared and lonely, then it is more likely that s/he may remain asleep.

There are third world cultures that live more in tune with biological cycles and some of them do not allow their infants to cry.  Someone is always there to hold an infant.  In spite of this "spoiling," these children grow up to be independent, yet compassionate and caring about the feelings of others and the survival of their community.  Allowing children to cry repeatedly without comfort teaches them that the world is a harsh place and that they cannot expect their emotional needs to be met.  Unconsciously they learn to hold this body tension in their lungs, chest, diaphragm, and stomach because they have learned that it is never completely safe to relax.  Unprocessed feelings, emotional wounds, vulnerability and fear can be held in these tense muscles long after the initial insult has past.

Our culture further reinforces this physical tension when we insist that children stand straight, chest out, stomach in.  One can't look like a model and breathe abdominally, so many young adults learn to breathe with their stomachs always in.  The lungs have insufficient space to expand on the inhalation and like the crying infant the blood oxygen level is slowly decreased.  Except now it happens so slowly that they stay conscious in spite of low normal oxygen levels. A person will function  at this level of low oxygen until some small additional stress causes a small increase in body tension and then other pathways kick in to detect a lower oxygen level.  Physical "symptoms" in an effort to correct the situation fall like dominoes.  The heart starts racing to pump more blood, but in turn it uses more oxygen.  The breath rate becomes faster in an effort to get more air, but the breathing becomes shallower yet, which again decreases the O2 intake.  The "fight or flight" mechanisms turn on creating more muscle tension which in turn use more O2 and narrow the vascular beds in the muscles so that the heart has to pump harder and use more O2 to get the blood around. 

In this situation, an individual usually feels as though they are suffocating, which may seem strange because they are breathing rapidly.  (Sometimes noted as hyperventilating.)  Most times the response appears totally out of line for the stressor, if they even recognized that a stress was there on a conscious level.  Sometimes this cascade of symptoms is called a Panic Attack and medication is prescribed to decrease the symptoms, but nothing is done to increase the oxygen level so if the medication is removed, the symptoms immediately come back.  Stress reduction techniques that encourage the use of one's full lung capacity are of great help in reducing the problem.  Whether you use yoga, meditation, biofeedback, progressive relaxation or some other breathing technique is not important.  What matters is that you practice regularly to help your body develop a natural pattern.  Doing it once a week in a class or therapists office is no help in a crisis.  You can't use a bicycle to escape a dog unless you have already learned to ride a bicycle.  You can't use breathing to diffuse a crisis unless you have spent some time rehearsing in a quiet private place for this public performance. 

Not only is this an essential aspect in the treatment of panic disorders, but it also has a role in the physiology of depression and many chronic illnesses with a component of depression.  An individual who has been given the diagnosis of endogenous (coming from within) depression will often find that their breathing pattern is reversed.  That is, they tighten the abdomen on inhalation and relax it on exhalation.  Although they may or may not experience the full-blown panic attack, they often have a chronic (long term), graded ( very slowly decreasing) hypoxia (low oxygen level).  Since O2 is one of the main ingredients necessary for the manufacture of neurotransmitters, they then experience symptoms of depression, difficulty concentrating, sleep problems, fatigue, lack of interest in life.  Sometimes these people consider suicide even though their rational mind may believe that life is not that bad.  The stresses of life that caused the initial body tension can be explored in therapy, but may not relieve the depression if the body's tension and biochemistry are not addressed.  Antidepressants can help increase the level of neurotransmitters in the brain by different methods of blocking their reuptake from the neuronal junction between nerve cells.  However they do not repair the metabolic pathways that make neurotransmitters.  This can only be done by looking at where the pathways may be broken down, (lack of O2, of raw materials such as L-tryptophan, or co-enzymes such as vitamin B 12.) 

Some therapists may tell their clients that they need to be on antidepressants for the rest of their life simply because the therapist doesn't understand what other options are available.  In addition many people have reversed their breathing, but do not have sufficient tension built up in their body to produce these symptoms.  Yet, taking the time to develop better breathing habits may be the best investment in your health that you could do all year.  And when you incorporate your breathing practice into your exercise routine you are training your body to breathe more naturally. The improved breathing pattern will be yoked by habit to the movement of your muscles, just as the unhealthy habits have been yoked for all these many years.  Then when you exercise the new patterns will be habitual so that you can allow breathing to come from an unconscious level again, but now it will be in a healthy pattern. 

If we look at a deeper level, inspire, to breathe in, comes from the Latin root meaning spirit.  That is why when we breathe in, “we inspire”; but when we “are inspired,” it is because of the connection to divine spirit in our life.  When we expire, we breathe out, but when a person “has expired", the spirit has left the body and they have died in the physical realm.  If we consciously remember the spirit that surrounds us at every moment, then we can consciously breathe in that spirit with each breath.  When we consciously connect with spirit, however we define it, we connect ourselves to a healing force beyond our own physical limitations. 

Try taking five minutes when you first wake up in the morning to quietly focus your thoughts and be aware of breathing deeply with your diaphragm.  As you breathe in your diaphragm lowers (moves towards your feet) and the abdomen will protrude slightly.  It's okay.  As you breathe out, contract your abdominal muscles, which will help the diaphragm push the air out of your lungs.  When you breathe in again feel the rebound in your abdomen as the muscles relax pulling down on the diaphragm and allow the atmospheric pressure to push more oxygen deeper into your lungs.  Develop a comfortable relaxed rhythm that is balanced between the inhalation and exhalation.  For example, breathe a slow count of three inhaling, then a slow count of three exhaling.  Adjust the count so that it is comfortable and relaxing, but still balanced.  Once you have relaxed your body and deepened your breathing, focus on the sacred meaning that your spiritual beliefs represent for you.  Consciously breathe in the spirit of that meaning into your whole body.  Give yourself the gift this year of infusing your self in this spirit every morning by setting the alarm five minutes earlier.  It may turn out that instead of becoming another "should" on your long "to do" list, you acquire the ability to sort out the items which do not fulfill your desire for spirit filled days.  When the day wears on and you experience yourself becoming overwhelmed, close your eyes for a moment and reconnect with the spirit you touched that morning.  Welcome your new outlook on life with a breath of fresh air.  It may end up giving you a more healthy body in which to experience your life!

References:
The Breath Connection by Robert Fried, Ph.D.
Beyond Biofeedback by Elmer and Alyce Green
Nutritional Influences on Mental Illness by Melvyn Werbach, M.D.s

Copyright, 2000 C. S. Laue, M.D.

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Updated 11/18/13