"Why do I struggle with breathwork?"
"Why do breathing exercises feel so unnatural?"
"Why do I feel anxious or like I'm going to have a panic attack when I focus on breathing?"
"I try so hard in yoga class to breathe and relax but it makes me more anxious"
“I've been practicing breathwork in pelvic floor therapy and feel like I haven’t made progress. Why?”
Breathwork.
It can be an amazing tool to help people relieve tension in their pelvic floors, calm anxiety, and feel more grounded. BUT that isn't the same for everyone. Breathwork can also make you feel like you're being suffocated, like your heart beats faster and louder than before and can make you feel more anxious than calm. If you're the latter, this one is for you.
How Well are You Breathing? Your BOLT Score.
A BOLT Score (Body Oxygen Level Test) is a quick and useful way to determine your blood volume…or how well you are both inhaling and eexhaling. In order to determine your BOLT, sit in a comfortable position. Gently exhale through your nose and pinch your nose with your fingers to hold your breath. Time the number of seconds until you feel the first desire to take a breath or the first sign of stress within your body. As you do so the natural chemicals in your body will fluctuate and your brain will send signals to your body that you need to breathe again. This may feel like a gentle tightening of the throat, contractions in neck or stomach, or air hunger (the urge to take in air). Let go of your nose and continue breathing through your nose. How many seconds did you breathe before needing to take a breath? How long you can hold your breath before you feel the gentlest urge to breathe (that's my nice way of telling you to not push through it and force it)? That is your BOLT score.
A BOLT score below 20 highlights that you most likely have a breathing dysfunction --whether it's stress, anxiety, sleep apnea, coughing, wheezing, asthma, congestion, snoring or even over breathing when working out.
Improving your BOLT score (more details later on) will help not only increase your BOLT score, but will help you decrease the tension, anxiety and stress that can come with breathing.
How NOT to Breathe 101
First off, I know you're fully capable of breathing. If you weren't breathing, you wouldn't be reading this. I'm here to help you understand how to breathe optimally with confidence rather than angst.
You've probably heard about the importance of "belly breathing" or "deep breathing". Those terms were coined as a way to prevent people from taking quick shallow breaths into only the chest. In theory that's great. In theory…
In reality, that often leads to people only letting their belly move when they breathe in and not letting their chest move at all. Or they force the deep breath so much that they forcibly push the gut out when breathing, almost causing them to bear down with every breath. If this is you, you may feel like something is stuck in your throat or you can't get a full inhale.
Fun fact: you are NOT supposed to tense other muscles in order to breathe. So if you just caught yourself clenching your jaw, holding on tight to your butt muscles, forcing and squeezing your abs, scrunching your toes or tensing your shoulders to your ears in order to focus on breathing, this is a sign you might benefit from changing how you breathe.
How do I breathe for pelvic floor relaxation and decreased anxiety?
Instead of chest breathing, belly breathing or deep breathing, another way to think of the breath is as a relaxed, mid-body breath with 360 degrees of expansion. It's not just the belly, its not just the chest and while it is deep, we don't want it forced.
The pressure change from your diaphragm is actually what's doing the work to make everything expand outwards. The diaphragm is the key while the abs, low back and pelvic floor basically hop on for the ride.
As you take a breath in your diaphragm expands down and out, allowing your lower ribs to expand down and out, your low back and mid body expand outward. The pelvic floor slightly elongates or lengthens with the breath. Letting go of your belly and abs allows it to naturally expand outward. Your chest moves gently outward to "catch" the breath without moving up towards your ears.
A side note- it's also important to pay attention to what your tongue is doing when you're practicing breathing. The majority of your tongue should be gently resting on the roof of your mouth with your teeth slightly apart and lips resting together softly. The tongue should create a gentle suction on the roof of the mouth allowing you to breathe in and out of your nose more easily. This resting tongue posture helps open up your airway allowing you to get a full breath. If you are forcing the breath, your tongue is hanging on the floor of the mouth or you’re trying with all of your might to suction the tongue to the roof of your mouth, this can be contributing to those icky feelings.
How did I get these funky breathing patterns?
I wish there was one answer for all but that isn't reality. We are all unique. You may have one cause or three…and that's okay. Here are some common reasons you may have developed funky breathing patterns:
*Genetics: If you're a bendy person (think "double jointed" or "super flexible" or "really clumsy") or have been diagnosed with Ehlers Danlos Syndrome or hypermobility or low muscle tone these can all relate to funky breathing patterns. This is because as someone who has more mobility than the typical person, you often need a higher baseline of stability. If you don't have that stability your body is going to "steal it" from elsewhere. Your body prioritizes the breath so it will steal the movement from anywhere else in order to make sure you are breathing.
*Anxiety: This is a double-edged sword because anxiety can cause shallow breathing and shallow breathing can increase anxiety so it's a vicious little cycle of altering the breath. If I'm being honest, this is a chicken-or-egg situation where we don't really know which one came first. What we do know is that they are related so by working on one we can help the other.
*Previous Illness: If you have asthma or chronic allergies then your body may have developed these patterns to keep you safe by still breathing. When you are ill and struggling to breathe your body protects you by altering how you breathe to make sure you are still capable of breathing. A non-optimal breathing pattern is better than a failing pattern. Your body did its job to keep you safe and alive during the illness but didn't get the memo that it was safe to go back to the other breath.
*You "forgot" to exhale: Okay. I know you didn't actually forget to exhale. But oftentimes we focus so much on getting air in that we don't fully exhale. So if you catch yourself stuck in shallow breaths or feel like you can't get a full breath try to focus on the exhale instead and let it fully go. There's a general rule of thumb that you should be able to exhale twice as long as you inhale. So if you breathe in for 2 seconds try to exhale for 4 seconds.
*Altered proprioception or interoception: Proprioception is a fancy word for knowing where you are in space. Interoception is another fancy word for being able to sense the internal signals from your body. Sometimes our brains are wired differently and we need more/less proprioception than the average person to feel grounded. This is common when you aren't getting enough feedback and information from the environment and you end up clenching muscles and tightening muscles so you can feel where your body ends and space begins.
*You try too hard: If you've been using all of your might in order to force the breath into your belly or to travel deep, it's no wonder you feel worse doing so! When you bear down it can actually put pressure on the nerves in the neck and abdomen and instead of calming the system it can increase your heart rate, lower your HRV and increase your blood pressure all while clenching the pelvic floor. So if you've been practicing breathing and feel exhausted doing so, try to not try so hard. And don't worry, I'll give more ideas below to help with that.
*Calm Doesn't Equal Safety in Your Brain: Oftentimes breathwork means sitting in one spot, still, not moving with your eyes closed. For many this can actually be triggering and cause hypervigilance. Instead of perceiving calm and safety, your body may actually be perceiving a threat!
*Trauma: Breathing can be healing because it allows us to tap into the subconscious. The subconscious is actually where a lot of healing takes place. While this is great, you may benefit from someone who is trained in Somatic Processing to help guide you through the breathwork safely. You may also need small doses of breathwork to build up a tolerance as you aren’t used to breathing and feeling these sensations. It’s not uncommon to not feel safe in our bodies due to trauma and once we are finally brought into that space it can be uncomfortable. This doesn’t mean it’s bad, it simply is and we need to respect those changes to find a balace between stepping out of the comfort zone and into a safe space.
*Breathing Detox: If you had a low BOLT score, you will most likely experience more discomfort with breathing as you re-learn how to breathe. Your body has become accustomed to certain levels of chemicals and when these chemicals change, even for the better, it can cause temporary stress on the body. The good news is that this is NOT harmful and actually a good thing as the body is adjusting to ideal. You can think of it as the body shifting from breathing for survival to breathing for thriving.
How can I practice breathing in a way that calms me?
The most important thing is to pick the exercise that works for you! If your breathwork makes you dizzy, your limbs tingle, causes chest pain or shortness of breath, ringing in the ears or clouded vision, it isn't the best exercise for you (at least at this moment). I'm listing ideas but it's important to try different techniques because what works today may not work for you next month and what works next month might not work for you today.
The rules of breathwork:
*You can stop a breathwork practice at any time for any reason!
*Acknowledge where you are today. Not everyone likes breathwork. It's OK if you don't feel comfortable doing it or if you don't like it. Try to focus on what you can do rather than what you can't do. It's also important to remember that if you didn't eat or sleep well, your body may have a lower tolerance for change and breathwork can be harder. This is why some days may feel easier (or harder) than others. This is NORMAL!
*You can choose the position and what you do with your body. Even if a breath practice tells you to close your eyes, you have the right and ability to modify to meet your needs. You are always welcome to keep your eyes open if it helps you feel safe. You can sit instead of lie down.
Breathing Practices You May Try to Help It Become More Natural
*First, make sure you can breathe through your nose! This might sound silly but I could write an entirely different blog on the beneifts of nasal breathing. Long story short….make sure you can breathe through your nose! It helps reduce the body's natural fight-or-flight response.
*Physiological sigh: As a note, when you are doing any of these exercises you may notice your body naturally takes two quick inhales followed by a line exhale. This is something called a physiological sigh. You can try this as a standalone breathwork practice for 5 minutes a day. It is also a normal response your body may express as it is releasing CO2 allowing you to be calmer, less tense and more focused.
*Breathe Light to Breathe Right: This is an excellend starting exercise by Patrick McKeown, author of Oxygen Advantage and Buteyko provider. For this exercise it's important to slow down and relax so give yourself 4-5 minutes. Sit up straight with your shoulders relaxed. Imagine you are a marionette doll, with a string that has pulled you up towards the ceiling to sit nice and tall. As you inhale, place your hands along your low ribs and feel as they softly open and widen. Now, place one hand on your chest and one just above your belly button. Feel your abdomen GENTLY move outward as you inhale and gently move in as you exhale. As you breathe, apply a gentle pressure with your hands against your abdomen and chest to create resistance in your breathing. Breathe against your hands and bring your hands closer together each time. Try to make your inahle last a second shorter than you naturally started, decreasing by one second each inhale. Breathe out with a relaxed exhale…allowing your lungs and diaphragm to fully move.
*Progressive muscle relaxation/guided meditation: Yep, I'm cheating. Progressive relaxation isn't technically a breathing exercise but oftentimes as we are able to focus on relaxing different parts of the body our breathing will naturally calm itself and be more efficient. So if you loathe breathwork, try progressive relaxation instead. And like most things there's more than one label for this so if yoga is your thing, look for yoga nidra. If you're looking for a science-based approach then Andrew Huberman's NSDR protocol is for you.
*Focus on something outside the body as you breathe: Blow up an actual balloon, play with kinetic sand in your hand, squish your toes on carpet, work on the garden…it doesn't actually matter. Sometimes we simply need to get out of our heads to not hyperfocus on the breath so simply do something that calms you down or brings you joy as you start to take notice of your breath.
*Focus on long, deep, relaxed exhales: oftentimes we focus so much on the inhale that we don't fully exhale. I mentioned it earlier, but try to exhale 2x as long as you inhale. Try to inhale for 2 seconds, pause 2 seconds, then try to exhale for 4 seconds, pause 2 seconds and then inhale. At the beginning this may be really hard so you can start at 2-2-2-2 and move up to 2-2-3-2 until you reach 2-2-4-2 breathing. As you practice you can increase these numbers to 3-3-6-3 and then 4-4-8-4. The key is to not push yourself and meet your body, brain and breath where they are today.
*Hum while you exhale. Humming helps activate the nerve in the back of the throat called the vagus nerve. It helps relax the body so if you find you
*Visualizations: if you're a person that forgets to exhale and just holds onto the breath, visualizations may be helpful. You can visualize blowing on a candle flame making it dance around but not actually blowing it out or visualize a pinwheel spinning with your breath changing the speed of the pinwheel from fast to slow. As you inhale you can visualize your mid-body as a balloon filling with air in all directions.
*Move: If you're someone who is Type-A or you struggle to sit in one spot for too long (or you go to yoga class and come out more agitated because you wrote a mental to-do list while you were suppose to be relaxing), then it may help for you to practice breathing on the move. You can practice breathing anywhere and while doing anything. So go for a run, walk the dog but tap into your conscious breath, hang upside down off a couch or drape yourself over an exercise ball, go swimming and see how many bubbles you can blow out (side note, if you crave proprioception, this can be doubly beneficial for you).
*Walk and don't breathe: Trust me, it isn't as intense as it sounds. Take a small breath in, take a small breath out. Hold your nose and walk for 10-15 steps. Rest for 30 seconds to 1 minute. Repeat a few times. This will start to alter the chemicals we mentioned earlier but is an active way to help your body process those changes without focusing on what is actively happening in your body.
*Tap into your other senses: Do you have a sound or smell that you love? If so, bring those into your breathwork practices. If you love the smell of citrus and waterfalls, or lavender and Frank Sinatra, use those to help you feel more comfortable. You don't have to do breathwork in silence and darkness. Do you love to do art or bake? Next time you're creating your masterpiece, notice what your breath is already doing. You may find that your breath has slowed and relaxed as you are doing something you love.
*Change the Thermostat: If you’re struggling to find a calm breath in your everyday life you can try to change the environment- practice your breathwork in a sauna, ice bath, contrast shower (hot water, cold water, hot water, cold water) or even while splashing your cheeks with cold water for 6 seconds. Sometimes a change in environment is what our bodies need to reset and allow us to get out of our brains and into our bodies.
*Rule out anemia: Remember those chemicals I mentioned with the BOLT score? Well, those chemicals are a direct representation of your blood. If you are anemic, or iron deficient without anemia, it can make breathwork more difficult. If you have sleep issues, it's important to look at ferritin. I highly recommend working with a provider that understands ferritin levels for sleep and breathing should be between 75 and 100, rather than the lab acceptable value of 13. That's a big difference in oxygen carrying capacity and it is important to work with a provider who understands your specific needs.
As always, there isn’t ONE right way to breathe. The key is to figure out what you need at the present time. If you need any help figuring that out, let me know. I'm here to listen and support you.