September 7, 2012


One of the greatest tools that we have to address anxiety and stress is the breath.

Given the relationship between stress and almost all illness, the importance of this simple remedy cannot be overemphasized.   Dr. Andrew Weil, medical pioneer and director of the University of Arizona’s Integrative Medicine Program,  has remarked that if he were allowed only one tool to treat illness, he would use breath work.  Breathing is the nexus between the conscious and the unconscious mind, the connection between the mind and the body.  It is no coincidence that in many cultures the words for breathe and spirit are the same, like the Sanskrit word prana, and why most spiritual practices begin with a focus on breathing. 

Breathing sits on the interface between consciousness and unconsciousness.  You can consciously control your breathing to a degree- holding your breath, breathing deeper, hyperventilating- but if you don’t pay attention, your breathing takes on a life of its own unconsciously.  Breathing is controlled by two different sets of nerves and muscles- voluntary and involuntary.  As a result of this dual control mechanism, you can actually influence your unconscious through conscious breath work.  Indeed, it is the only function through which you can influence the involuntary nervous system.

Your involuntary, or autonomic, nervous system is divided into (at least) two components- the sympathetic and the parasympathetic.  The sympathetic nervous system controls your fight-flight-fright-freeze response. It is designed to keep you alive in the case of a threat or danger and goes into overdrive in cases of PTSD (think permanently on).   This system prioritizes survival, and increases heart rate, increases blood pressure, slows digestion, and diverts blood from the skin to your large muscles (like to your legs for running away).   The parasympathetic nervous system is its foil and counteracts the sympathetic surge, slowing heart rate, decreasing blood pressure, increasing digestion, and increasing blood flow to the surface.   This balance between the sympathetic and parasympathetic regulates the autonomic nervous system.

Unfortunately, sympathetic overdrive abounds in our society (see my post on Simplicity Parenting for some ideas as to the whys).  It is this imbalance that underlies many of our medical problems today. Hypertension, for instance, has an overactive sympathetic tone at its root.   Anxiety may itself be sympathetic hypertrophy.

As a treatment, breath work helps to regulate the autonomic nervous system and bring it back into balance.    When you inhale, your sympathetic nervous system is activated; when you exhale, your parasympathetic nervous system is triggered.

A simple exercise to help alleviate anxiety consists of a 4-7-8 sequence. With the tip of your tongue grounded against the back of your top teeth (yogic posture), breathe in through your nose for a 4 count, hold it for a 7 count, and exhale through your mouth for an 8 count.  Four of these routines constitutes a set (and only do 1-2 sets per session).   If you are paying attention to  your breathing and counting, you cannot think about what is stressing you at that time.  Over time, with practicing this technique (think about starting and ending your day this way), your parasympathetic tone will increase and your anxiety will lessen.  And best of all, it is free, simple, requires no equipment, no prescriptions, no worries for dependence or addictions, no risk of rebound anxiety, and is entirely portable and covert.

A focus on breathing begins the first step towards moving within, which is where all work in psychiatry and mental health should lead.