The American Institute of Stress

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Volume 7 Number 2 June 2018 In this Issue: The Healing Power of the Breath

3 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org The mission of AIS is to improve the health of the community and the world by setting the standard of excellence of stress management in education, research, clinical care and the workplace. Diverse and inclusive, The American Institute of Stress educates medical practitioners, scientists, health care professionals and the public; conducts research; and provides information, training and techniques to prevent human illness related to stress.

AIS provides a diverse and inclusive environment that fosters intellectual discovery, creates and transmits innovative knowledge, improves human health, and provides leadership to the world on stress related topics. Your source for science-based stress management information CONTENTMENT We value opinions of our readers. Please feel free to contact us with any comments, suggestions or inquiries. Email: [email protected]

Editor In Chief: Managing Editor Daniel L. Kirsch, PhD, DAAPM, FAIS Kathy Schoop

Editor: Creative Director: Heidi Hanna, PhD, FAIS Krissa Brewer

Contentment is a quarterly magazine published in March, June, September and December with news and advertising designed with the general public in mind. It appeals to all those interested in the myriad and complex interrelationships between stress and health because technical jargon is avoided and it is easy to understand. Contentment is archived online at stress.org. Information in this publication is carefully compiled to ensure accuracy. Copyright© 2018 the American Institute of Stress (AIS). All rights reserved. All materials on AIS’ website and in AIS’ newsletters are the property of AIS and may not be copied, reproduced, sold, or distributed without permission. For permission, contact [email protected]. Liberal use of AIS fact sheets and news releases is allowable with attribution. Please use the following: “Reproduced from the American Institute of Stress website [or magazine], © AIS [year]:’

AIS Daily Life Stress Board Chaired by Dr. Michel Woodbury-Farina, the role of this board is to develop initiatives and communications to serve the stress management needs of all people.

Michel Woodbury-Farina, MD, FAIS Cynthia Ackrill, MD, FAIS Heidi Hanna, PhD, FAIS David Sollars, MAc, LAc, HMC, DAIS Daniel L. Kirsch, PhD, DAAPM, FAIS CONTENTS

4 The Health Benefits of Nose Breathing

10 Healing Power Of The Breath

18 The Setup Breath: Exhaling Deeply First

19 Re-Association: Fusing Awareness and Sound with Deep Breathing Practices

23 Take A Deep Breath 26 Yogic Breathing: Ancient and Modern 32 One-Minute Relaxation Exercise for Busy People

3 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org The Health Benefits of Nose Breathing

“For breath is life, and if you breathe well you will live long on earth.” -Sanskrit Proverb

By Dr. Alan Ruth, BSc, MA, PhD, MBA, FAIS, FRSB

reathing is one of the most breathing continues on its own, fundamental things we do, without our awareness, it does not Bday in and day out. Most necessarily mean that it is always people take it for granted that they functioning for optimum mental and do it correctly. Breathing is the physical health. The opposite is often only human act that we can do true. The problem with breathing is completely consciously or completely that it seems so easy and natural that unconsciously. Most people, of we rarely give it a second thought.” course breathe unconsciously the Although breathing is a tural vast majority of the time. function of human beings, it can be It has been estimated that approximately one-third of people negatively influenced by many factors don’t breathe well enough to sustain of modern living such as stress, normal health. These people do not sitting at a desk all day, eating get enough oxygenation of their processed foods, and excessive cells, tissues and organs. In the talking. book Behavioural and Psychological In the modern world, many people Approaches to Breathing Disorders, continuously over-breathe. Typical Dr. Chandra Patel describes the characteristics of over-breathing problem with breathing as follows: include mouth breathing, upper chest “We start life with a breath, and the breathing, sighing, noticeable process continues automatically for breathing during rest, and taking large the rest of our lives. Because breaths prior to talking.

JUNE 2018 CONTENTMENT 4 The American Institute of Stress www.stress.org A Vital and Much Underrated Organ breathing through the mouth most of the time was not nature’s intention. The nose is a vital and much Many studies have demonstrated underrated organ. To realize its that chronic mouth breathing can importance, we only need to reflect result in a number of adverse health on when we last suffered from a bad consequences (see Table 1). cold. Nasal congestion and a runny According to Jefferson (2010): nose have a noticeable effect on our “The vast majority of health care ability to breathe, our energy level, professionals are unaware of the our ability to sleep, and our general negative impact of upper airway ability to function. According to otolaryngologist obstruction (mouth breathing) on Dr. Pat Barelli: “The role of the nose in health and Chronic mouth breathing in respiration has been greatly may contribute to: neglected by physicians.” (Timmons and Ley, 1994, p 47) • Introduction of unfiltered, poorly humidified air into the lungs Nose Breathing Versus • Upper-chest breathing (inefficient and tiring) Mouth Breathing • Chronic over-breathing • Greater incidence of snoring and sleep apnoea “Then the LORD God formed a • Bad breath, dental decay, gum disease man from the dust of the ground and breathed into his nostrils the breath of • Dysfunction of the jaw joint (Temporomandibular life, and the man became a living Joint Disorders) being.” • Narrowing of the dental arch, jaw and palate -Genesis 2:7 • Crowded and crooked teeth • Open bite, malocclusion (teeth not fitting The human nose was designed for together properly) breathing (and smelling) whereas the mouth was designed for eating, • Greater potential for relapse of orthodontic drinking and speaking. However, it corrections has been estimated that up to • Dysfunctions of the muscles around the jaw 30-50% of modern adults breathe and lips through the mouth, especially during • Loss of lip tone with the lips becoming flaccid the early morning hours. • Noisy eating, speech and swallowing problems Mouth breathing is common in individuals whose nasal passages are • Trauma to soft tissues in the airways blocked or restricted. A deviated • Enlarged tonsils and adenoids nasal septum or small nostril size can Table 1: Possible Adverse Consequences of lead a person to breathe through their Chronic Mouth Breathing. Adapted From mouth instead of their nose. However, Graham, T. (2012)

5 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org normal facial growth and physiologic results in pollutants and germs being health. Children whose mouth drawn directly into the lungs. Cold breathing is untreated may develop and dry air in the airways makes the long, narrow faces, narrow mouths, secretions thick, slows the cleaning high palatal vaults, dental cilia, and slows down the passage of malocclusion, gummy smiles, and oxygen into the blood stream. many other unattractive facial Breathing through the nose has features… These children do not many health benefits (see Table 2). sleep well at night due to obstructed According to Cottle (1958), the nose airways; this lack of sleep can has at least 30 health protecting adversely affect their growth and functions/roles. These include academic performance. Many of the following: these children are misdiagnosed with attention deficit disorder (ADD) • It warms, humidifies, and cleanses/ and hyperactivity.” filters air to prepare it for delivery Mouth breathing adversely affects the way the tongue works. It develops to the lungs. a ‘tongue thrust.’ This affects speech, • The structures within the nose swallowing and chewing. A tongue regulate the direction and velocity thrust occurs as a result of the tip of of the air stream to maximise the tongue resting against or between exposure to a network of fine the front teeth, and the tongue is arteries, veins, lymphatics, and positioned low in the mouth. The nerves, and to the mucous blanket. tongue should rest in the top of the mouth (with mouth closed) and • Nose breathing imposes provide an internal support for the approximately 50 percent more upper jaw. resistance to the air stream, as Mouth breathing plays a critical compared to mouth breathing. This role in asthma, especially exercise- results in 10 to 20 percent more induced asthma. In a study published oxygen uptake. There must be in the American Review of Respiratory sufficient nasal resistance during Disease, young asthma patients had inhalation to maintain elasticity of virtually no exercise-induced asthma the lungs. after exercising while breathing through their noses. However, they • Nose breathing results in the air experienced moderate bronchial passing through the nasal airway constriction after exercising while being slowed down by shelf-like mouth breathing. bony structures in the nose called Mouth breathing results in the turbinates. This allows the mixing mouth becoming dry. This increases of the air with an amazing gas the risk of mouth and throat called nitric oxide produced in the infections. Mouth breathing also nasal sinuses (see later).

JUNE 2018 CONTENTMENT 6 The American Institute of Stress www.stress.org • Nasal breathing (as opposed to and the relaxation of the smooth mouth breathing) increases muscles surrounding airways and circulating blood oxygen and blood vessels. It also in effect acts carbon dioxide levels, slows the as a catalyst for the release of breathing rate and improves overall oxygen from the hemoglobin in lung volumes. red blood cells. In commenting on a recent study carried out at the University of The Importance of Carbon Dioxide Warwick, Professor Nick Dale said: “The exciting implication of our Contrary to popular belief, carbon study is that carbon dioxide is much dioxide is not just a waste gas more than just a waste product: it can because it performs a number of directly signal physiological essential functions in the body. These information, and our work shows include the maintenance of blood pH the mechanism by which this

Nose breathing is beneficial because it:

• Warms, moistens and filters the air • Traps large particles with the nose hairs & small particles via mucous membranes • Facilitates inhalation of nitric oxide – a vasodilator & bronchodilator that increases oxygen transport throughout the body • Helps prevent colds, flu, allergic reaction, hay fever, irritable coughing • Retains some moisture from exhaled air, preventing nasal dryness • Provides a sense of smell • Regulates (slows) airflow because of the nose’s intricate structures • Facilitates correct action of the diaphragm • Promotes activity of the parasympathetic nervous system, which calms and relaxes the body, slows the breathing and the heart, promotes digestion • Allows the correct position of the tongue (against the upper palate) and lips (together), assisting formation of the natural dental arches & straight teeth • Reduces likelihood of snoring and apnea

Table 2: Benefits of Nose Breathing. Adapted from Graham, T (2012)

7 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org happens via Connexin 26 (a protein nose breathing, higher carbon dioxide that in humans is encoded by the in the blood decreases the affinity GJB gene).” between oxygen and hemoglobin, “As Connexin 26 is present in many resulting in greater oxygenation of tissues and organs, for example the tissues and organs. brain, skin, inner ear, liver and the uterus during pregnancy, this Nitric Oxide and Nose Breathing discovery should herald a re-evaluation of the potential for Nitric oxide is a gas that is often carbon dioxide signalling in many only regarded as an environmental different processes such as the pollutant. However, in 1998, three control of blood flow, breathing, American scientists were jointly hearing, reproduction and birth.” awarded a Nobel Prize for their There is only 0.03% carbon dioxide discoveries concerning nitric oxide as in the atmosphere today. Healthy a signalling molecule in the human beings require about 6.5% cardiovascular system. These carbon dioxide in the alveoli of the scientists originally named this gas lungs. This means that the body has ‘Endothelium Derived Relaxing to produce and store carbon dioxide Factor’ (EDRF) because they in the lungs and blood. discovered that a continuous The major determinants of the generation of it occurs in the oxygen content of arterial blood endothelium of blood vessels. (CaO2) are the arterial oxygen Sometime later EDRF was identified saturation of hemoglobin (SaO2) and as nitric oxide. the hemoglobin (Hb) concentration. Enzymes responsible for nitric Over 95% of oxygen carried in the oxide production have been blood is attached to hemoglobin. demonstrated both in the nose and in When capillary PCO2 (carbon dioxide the paranasal sinuses. Nitric oxide is partial pressure) rises, there is a potent bronchodilator and increased unloading of oxygen in the vasodilator. Therefore, it helps lower tissues (the Bohr Effect). However, a blood pressure and significantly reduction in carbon dioxide partial increases the lungs’ oxygen- pressure strengthens the bond absorbing capacity. It is also known between oxygen and hemoglobin, to be antifungal, antiviral and resulting in less oxygen being antibacterial. released into the tissues and organs. According to Lundberg (2008): Mouth breathing is a typical “Nitric oxide gas from the nose and characteristic of over-breathing. sinuses is inhaled with every breath When an individual over breathes, too and reaches the lungs in a more much carbon dioxide is lost from the diluted form to enhance pulmonary blood and this results in reduced oxygen uptake via local vasodilatation. oxygenation of tissues and organs. In In this sense nitric oxide may be contrast, when breathing volume is regarded as an “aerocrine” hormone reduced towards normal, through that is produced in the nose and

JUNE 2018 CONTENTMENT 8 The American Institute of Stress www.stress.org sinuses and transported to a distal References site of action with every inhalation.” 1. Brown, R P and Gerbarg, P L (2012) The Healing Power of Chang (2011) named nitric oxide the Breath, Boston: Shambhala Publications, Inc 2. Chang, HR (2011) Nitric Oxide, the Mighty Molecule: Its the “Mighty Molecule” and noted that Benefits for Your Health and Well-being, Jacksonville, FL: it is an active component of the The Mind Society cardiovascular, endocrine, and 3. Cottle, MH (1958) Rhinology, 1900-1910, Archives of Otolaryngology, 67, 327-333 immune systems, and is an extremely 4. Fried, RL (1999) Breathe Well, Be Well, New York: John Wiley versatile and significant factor within & Sons Inc and throughout the human body. The 5. Graham, T (2012) Relief from snoring and sleep apnoea, Melbourne: Penguin Group (Australia) fact that nitric oxide plays a 6. Honl, TJ (2013) Chronic Mouth Breathing: A serious Health significant role in cardiovascular Concern, Stevens Point Journal, Column 12, February 23 health is evidenced by the fact that 7. Ignarro, LJ (2005) No More Heart Disease: How Nitric Acid Can Prevent – Even Reverse- Heart Disease and Strokes, one of the Nobel Prize winners New York: St. Martin’s Press mentioned earlier wrote a book titled 8. Jefferson, Y (2010) Mouth Breathing: Adverse effects on No More Heart Disease: How Nitric facial growth, health, academics, and behaviour, General Oxide Can prevent - Even Reverse Dentistry, January/February 2010, 18-25 9. Juliano, ML et al (2009), Polysomnographic findings are – Heart Disease and Strokes. associated with cephalometric measurements in mouth- breathing children, Journal of Clinical Sleep Medicine, Dec 15: 5(6), 554-61 Changing from Chronic Mouth 10. Khalsa, D S (2009) Meditation as Medicine: Activate the Breathing to Nose Breathing power of your natural healing force, New York: Atria Paperback, A Division of Simon & Schuster, Inc 11. Lundberg, JO (2008) Nitric oxide and the paranasal sinuses, There is little awareness and The Anatomical Record, Nov: 291(11):1479-84 understanding within the medical 12. McKeown, P (2013) Close Your Mouth, Moycullen, Co. Galway: Buteyko Books profession of the adverse health 13. O’Hehir, T and Francis, A (2012) Mouth Vs Nasal Breathing, implications of chronic mouth Hygienetown, September, 7-12 breathing. A conscious effort to ensure that people predominately nose breathe would likely result in a About the Author healthier population and a resultant decrease in healthcare expenses. The Dr. Alan Ruth BSc, MA, PhD, earlier chronic mouth breathing is MBA, FAIS, FRSB is an Irish based, identified the easier it is to change to nose breathing. Such a change can stress and anxiety specialist. He is a be facilitated by ‘breathing retraining.’ Fellow of the Royal Society of This is a simple process of identifying Biology and a Fellow of the incorrect breathing habits and American Institute of Stress. replacing them with the correct ones. Formerly, he was Managing Director The best-known forms of breathing (Ireland) for an American multi- retraining are the Buteyko Method, the Papworth Method, and national pharmaceutical company pranayama (in yoga, this is the and CEO of a health products regulation of the breath through manufacturers’ trade association. certain techniques and exercises).

9 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org The Healing Power of the Breath

By Marylou Gantner, Scientific Relaxation Specialist

his article is about something heart is enclosed in a membranous more personal to you than your bag attached to the top of the Tname. The subject is something diaphragm. When you breathe ninety-nine percent of us have correctly, it gets a gentle squeeze probably never thought about. Most with each inhale. Another little- likely you have never read any recognized benefit: Each time the commentary about it either. Yet your diaphragm descends downward, it physical health and emotional well- massages the liver, offering a gentle being, even your longevity, depends massage for all the internal organs, on understanding and mastering its including many ductless glands. natural function. It is more precious to you than gold, and no matter where Breathing with the diaphragm creates you go on earth you are never apart a gentle therapeutic rhythm in this from it. It has been with you since the deep inner region of the body. first moment of your life and it will Breathing this way, allowing the remain with you until your last. If you breath to soothe our bodies, is known live an average lifespan, you directly as the ‘relaxation response.’ It has engage with it a billion times. been the privilege of my long career We are talking about your breath. to teach people how to access these The moment-by-moment habit of two healing powers. But before we ‘hugging your heart’ through proper consider a new way of breathing, let’s breathing can save your life. Your review the way we breathe now.

JUNE 2018 CONTENTMENT 10 The American Institute of Stress www.stress.org The High Price of Over-Breathing incredible tension in our muscles and tissues. On this subject, I agree with Without realizing it, most of us the great Catholic philosopher, have modified this essential function, Thomas Merton who said: starving our bodies of nutrients and “There is a pervasive form of oxygen and destroying well-being. contemporary violence... (and that is) This modification is called shallow activism and overwork. The rush and breathing. We don’t notice we are pressure of modern life are a form of using only our neck, upper back and violence, perhaps the most common clavicle muscles to breathe. We wear form of its innate violence. To allow our shoulders high - as if defending oneself to be carried away by a against an unexpected threat. This multitude of conflicting concerns, to chest breathing fails to draw oxygen surrender to too many demands, to into the lower lobes of our lungs commit oneself to too many projects, where it can be distributed to want to help everyone in throughout the body. When the brain everything, is to succumb to violence.” is under pressure, our body is eager We react to this ‘violence’ with a to keep us alive by escalating our vicious circle: anxiety, shallow breathing rate. Many of the clients I breathing, more anxiety and more see are on full alert, unaware they are tension, and more shallow breathing. living in the fight-or-flight response. As you grew older, no one taught you Despite being warned by scientists the profound need to breathe using and doctors for the past half-century the diaphragm and through the nose. of the deleterious effects of stress, The good news, I tell my clients, is we stay in a deadly whirlwind. We that it’s never too late to begin breathe rapidly and unconsciously, healing themselves. A 90-year old making ourselves sick and nervous. I client who learned to breathe properly find few clients understand the role of began to sleep through the night for poor breathing in the downward spiral the first time in 20 years. into physical disease and psychological In an article by Heidi Hanna in the disorders. March 2016 issue of Contentment, I have worked with thousands of she notes that the American Institute stressed and anxious clients over the of Stress estimates that 75% to 90% past 40 years. I have come to these of medical visits are stress related. conclusions: People are born Since I first came to my career in breathing properly. Then in late stress management in the mid ‘70’s, childhood, they are thrust, I have watched studies slowly climb unknowingly and innocently, into to these current figures. This is an what I call the ‘effort-fatigue’ society. alarming trend, and we know it is not We work, or ‘effort’ at tasks until we sustainable. People are simply drop. While we resist society’s hard- illiterate about their bodies and driving customs and traditions, we unaware of the healing benefits of participate anyway, thus building correct breathing.

11 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org Dr. James Gordon wrote in the Fall unchanging, grasping need for security 2003 issue of Biofeedback Journal: is built into human psychophysiology “The illness, symptoms and conditions and does not change. I see it daily in seen in health clinics today are most my office. But there are well- often related to lifestyle, nutrition, and researched relaxation techniques that stress. In my 40 years of experience in can alleviate troublesome symptoms stress management education this calls and prevent deteriorating health. for a kind of radical patient education One of my early teachers, Edmund we rarely, if ever, see.” I hope, in my Jacobson, writes in his book, Anxiety lifetime, to see physicians and and Tension Control, that we can healthcare providers educating continue to live in this ancient fight-or- patients on the benefits of proper flight body response, wasting as much breathing for stress-related symptoms 60% of our energy daily, and and illness. exhausting ourselves. We can continue As early as the 1930, three pioneer to build an unbearable amount of body clinical researchers, Drs. Kerr, Dalton, tension and anxiety, doing serious Gliebe, reported in the Annals of damage to our health. We can continue Internal Medicine that America’s to age our heart muscle beyond our economic, moral and social changes of years. the time were resulting in “ever I often remind my clients they can increasing numbers of patients who choose to be the cause of their own manifest symptoms intimately suffering and develop symptoms that associated with the struggle for security, for independence, or for force them to the doctor for a whatever state presumed to assure the diagnosis. Many already suffer serious spiritual and material happiness of the health issues. Some may even become individual.” In the same article, Dr. Kerr one of the tragic statistics. Or they can stated that he frequently found the choose to bring their ‘past history’ symptom of hyperventilation in his (their conditioned stress response) up patients and this symptom stemmed to date and learn ways to calm from anxiety states. He further themselves and live efficient lives. commented these anxious patients You may need a breathing coach, “haunt the offices of physicians and but there’s much you can do by specialist in every field of medical educating yourself about your breath. practice.” The road to recovery of healthy body One can readily see there is function and emotional self-regulation something in human psychophysiology is possible. I tell my clients their lives that remains fearful and uncertain of will change when they become one’s well-being and safety no matter interested in the way they breathe. And what the century, circumstance, or many become fascinated by the age. Dr. Kerr’s 1930 report could just journey. Nothing is more rewarding to as well be the report of a contemporary me than watching a client master their physician - almost 85 years later. The life by mastering their breath.

JUNE 2018 CONTENTMENT 12 The American Institute of Stress www.stress.org Many scientists believe that chest Understanding the value of carbon breathing is the single greatest threat dioxide is essential to the student of to our short and long-term health. breath: it is not entirely a waste gas Robert Fried says in his book Breathe and plays a vital role in health. We Well, Be Well, “The single most deplete this precious gas, a source of stressful thing we can do is to breathe calm and stability, when we bypass with the upper chest muscles.” When the diaphragm and fall into rapid, a new client arrives in my office, shallow breathing. chances are they are chest breathing Hyperventilation is the most and very anxious. Their problems are exaggerated, lives are overwhelming, common of the stress related and they often feel desperate. breathing disorders. (Hyper, meaning Shallow breathing alters the brain’s rapid chest breathing) My educated respiration center, producing chronic guess is a large number of ambulance body tensions and depression. calls to emergency rooms is for this breathing disorder. A client of mine Your Wondrous Diaphragm reported regular ER visits due to panic attacks fueled by In my practice, I’ve found that few hyperventilation. I can easily identify clients know where this life-giving stress in people who frequently sigh; muscle is located. When asked to they are shallow breathing with little, identify the diaphragm, most hesitate. if any, diaphragmatic action involved. Sometimes using a circular hand motion, they point somewhere at the midsection, “I think, it’s somewhere around here?” It helps to know the diaphragm’s exact location, how to engage it, and its role in correct breathing techniques. I tell clients that ignoring the diaphragm is perilous to their health. Simply put, shallow breathing causes us to breathe off too much carbon dioxide. The lack of carbon dioxide speeds up the heart and is a major cause of anxiety. I recall, during my training at Temple University’s Behavior Therapy Unit, my professor, Dr. Joseph Wolpe, a world authority on anxiety, kept tanks of oxygen and carbon dioxide in his office. Often, he would gently administer a mixture of these gasses to calm a tense patient so therapy could proceed.

13 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org Carbon Dioxide is Your Friend! in a busy airport. The diaphragm has a partner to help you to stay in It’s a fascinating fact that maximum good health, and that’s insufficient levels of carbon dioxide in the nose. the blood create an overly-strong electric bond between the red blood Nose Breathing: Home Base cells (hemoglobin) and the oxygen to Relaxation molecules. Due to this overly-strong bond, the red blood cells cannot The nose is home base for another release the oxygen to nourish the important gas called nitric oxide tissues. This is known as the “Bohr which keeps the blood vessels Effect.” It takes as little three minutes relaxed. I teach my clients that the of shallow, rapid chest breathing to mouth is for eating and talking; the dramatically reduce oxygen levels in nose is for breathing. Nose breathing the brain and heart muscle. The body has been revered by the yoga compensates by raising the blood traditions in their ancient writings that pressure and increasing the heartbeat claim many functions take place in to make up for these deficiencies. the nose. The one function that Years of breathing poorly can bring amazes me is how quickly a breath of about a whole host of physical and air in minus zero temperatures can be emotional symptoms. When a new heated to body temperature in a client arrives in my office for stress nanosecond. The lungs would turn to management, I’m always interested in a block of ice otherwise! their fatigue level, a sure sign that I love to quote from a podcast they are not engaging the diaphragm where the Irish breath expert, Patrick when they breathe. McKeown, who trains world class But it’s more than fatigue that athletes, says: “Your first and best should concern us. Carbon dioxide stress reduction skill and health care impacts metabolic processes and plan is learning to breathe slower, energy levels. It determines how the breathe less and a little quieter, and body utilizes vitamins and enzymes. always breathe through your nose. It Low levels of carbon dioxide increase is reported by the experts who have the excitability and arousal of the made a life study of respiration that as nervous system, causing us to over- high as 90% of people have unnatural react in frustration to situations breathing habits that lead to physical beyond our control. and mental symptoms. What (these Learning to breathe with the people) don’t realize is that they are diaphragm has incredible benefits: breathing two to three times more With adequate carbon dioxide in our than the medical norm.” It still blood, we can do more exercise surprises me to see children and without feeling out of breath. We can adults breathing with open mouths. accomplish more on our to-do lists, Our nose filters out dust particles, and remain calm and centered even viruses and bacteria, keeping when we’re running to catch a flight our lungs in pristine condition.

JUNE 2018 CONTENTMENT 14 The American Institute of Stress www.stress.org It’s Never Too Late to Learn few as five minutes, two to three to Breathe times a day - the relaxation response begins to take root. The breath will I am not sure why so many aren’t slow down. Your body will begin to aware of the life-giving muscle, the calm. After a few days, you may be diaphragm, and the healing power of better able to control your emotions. slow breath. Or why they don’t You’ll probably discover you have breathe through the nose. Few more energy. Strangely, you may even primary care physicians examine a feel happier. Life will begin to take on patient for breathing disorders, yet a different, saner pace. You may find, every system in the body is as clients tell me, “I get more done in connected to the breath. Perhaps this my day and don’t feel exhausted by explanation in an ancient book titled mid-afternoon.” And so often I hear, The Science of Breath by Yogi “Why hasn’t anyone told me about Ramacharaka is true: “Our only fear this before?” is that its (proper breathing) very But the best response I ever got simplicity may cause some to pass it was from a nine-year-old client. I was by as unworthy of attention while they reviewing the respiration function with pass on their way searching for him. He listened attentively. His something ‘deep’, mysterious and non-understandable.” attention to detail seemed remarkable When we watch our respiration for his young age. He was clearly closely, we can easily see how fascinated by his own breath. When determined the body is to keep us we finished, I asked him what he alive. I tell my clients: As soon as you thought. He replied: “I think it’s a begin to take the time to practice - as privilege to be alive.”

15 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org Getting Started… • Next, place a three-pound book on your navel area. For a time let both NOTE: If you are being treated for hands rest lightly on your chest to any symptoms, please consult with discern if you are still using your your physician before beginning the chest muscles on the inhale. Then following breathing exercises. place your arms to your side and • The first order of things is to locate allow them to relax. Began to your diaphragm. Start by sniffing breathe into the book. Be patient, three times and pause briefly. this will take a little time. Many Repeat this until you locate a times, your diaphragm is tight from inactivity. This exercise will begin movement in your midsection. No to strengthen it. hurry. You will feel your diaphragm move in your midsection each time • You may also do your breathing you sniff. practice sitting in a chair. This will help to carry over your attention to • Relax the abdominal muscles. Try diaphragmatic breathing as you go sitting at a table. Place your arms about your day at work, driving, on the table and rest your head on having conversations, exercising, your arms. Now let your stomach or watching television. muscles relax. You will get this quickly. Recall this relaxed feeling • For beginners, I suggest three five- as you do your breathing minute practices a day. Later you exercises. can increase it to 12 minutes early afternoon and early evening. • It is best to begin breathing practice lying down with a small • It helps to have a trusted partner round pillow under your knees and place their hands on your a small one under your head. You shoulders from behind. If your might also place your legs on a shoulders lift, you are likely still chair or couch. Experiment, doing chest breathing. Shift your determine which position makes awareness to your diaphragm and you feel more comfortable. try again. • Now place one hand on your chest People need to understand and one hand over your belly button everything we need to live a healthy where you felt the movement of life is hard-wired in our brain and your diaphragm. Watch your nervous system. As a clinical breathing come and go. No hurry. educator and scientific relaxation Soon you will notice your chest specialist, it is my passion to educate rising as you inhale. Just watch. people to use their innate ability to After a few minutes of observing, live productive lives without apply light hand pressure on your destroying their health. If this article chest and notice if your other hand has inspired you, take your time, be at your belly button becomes a little patient, and remember you are more active. changing a lifetime breathing habit.

JUNE 2018 CONTENTMENT 16 The American Institute of Stress www.stress.org About the Author illness. Many of her clients are referred by physicians, lawyers, and Marylou Gantner is a Scientific mental health therapists. Marylou Relaxation Specialist with over 40 graduated from Rollins College in years in private practice in Orlando, 1973 and completed courses in her Florida. She was certified by world field at the University of Florida, renowned psychiatrist Joseph Harvard University, the University of Wolpe, M.D., at Temple University Central Florida, and Temple School of Medicine Behavior Unit, in University. She has a passionate Philadelphia. She trains clients to belief that people can develop a high restore mental and physical well- level of wellness and personal being by identifying and relaxing excellence by practicing the basic excessive neuromuscular tension skills of Scientific Relaxation in patterns that create symptoms and daily life.

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17 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org Beginning a conscious breathing practice on an inhale often keeps a person in the same state they were just in for a longer period of time, however, exhaling deeply first creates a feeling of letting go and releasing. Start to practice this consciously and take a few moments in the day that are comprised of just taking a few deep breaths to relax or put on a favorite breathing exercise. From here The Setup Breath: on out, however, I invite you to emphasize a deep exhale first, every Exhaling Deeply First time. In the modality Life Force By Rabia Hayek Mastery that I teach, we call it a Setup Breath. After a slight inhale, let t is common, almost colloquial, that go and expel the breath inside you by when you ask someone to take a blowing it out until you are empty. As Ideep breath or relax and enjoy a you create space for the next fresh sweet, conscious breath that they will breath to enter and fill, check-in with begin on an inhale. As soon as you your posture and adjust into what you make the invitation to do so, the would consider excellent posture. We person almost instantly begins to all have different body types, shapes breathe in. However, this may be and sizes, but there is a relative counter-intuitive to what is actually excellent posture that allows you to most beneficial for stress reduction, expand your breathing apparatus creating relaxation and inducing correctly and efficiently. This allows states of calmness. When we inhale, you to deliver Life Force into your our heart beats faster; as we exhale body efficiently. our heartbeat slows down. This is Go ahead and apply the Setup general but true and so, think about Breath, compare and see which one it. We live in a society where we are feels more relaxing. Right now, just constantly moving fast and everything take three deep, slow breaths, BUT from our communication devices to begin by exhaling a deep, long exhale the marketing in front of our eyes by blowing the air out of your mouth makes for a steadily fast-paced as a Setup Breath to begin. When rhythm in our world. Therefore, you’re done, try the same thing again wouldn’t it make sense to exhale but do it without the deep exhale first deeply first, so as to slow the heart and see how different it is. Once you rate down, empty the lungs out to try it for yourself, you may see why create an excellent space and then and choose to enjoy this one simple, breathe? powerful tip for the rest of your life.

JUNE 2018 CONTENTMENT 18 The American Institute of Stress www.stress.org Re-Association: Fusing Awareness and Sound with Deep Breathing Practices

By Rabia Hayek

issociation occurs when the again after the feeling cultivates, has mind and body are no longer been found to assist in healing Dcommunicating or alienation and has shown a understanding each other. In cases of powerful ability to create Post-Traumatic Stress Disorder association. (PTSD) and high levels of In addition to the use of accumulative stress, deep breathing practices and the body and mind shut off the awareness of what is communication and a feeling of happening viscerally, adding in alienation occurs that doesn’t allow the use of sound can be the the person to understand what is ingredient that makes the mind finally happening to them, even in seemingly let go. Entraining your mind to follow simple moments. Confusion, the sound of your breathing for longer contraction, distraction, feelings of and longer periods of time can give embarrassment, violence, anger and you greater power over mind chatter resentment can all be the result of and the rhythms of an overactive what happens when the mind and mind. The use of Tibetan singing body stop talking to each other bowls or crystal bowls and gongs can because the person is too stressed. also be very effective, but we are How do we then create association currently studying how the sound of where there was alienation? Deep one breath can bring back a breathing exercises create a dynamic primordial connection to having been change in the nervous system that in the womb. Allowing ourselves to can be detected by the breather. lean back into the nature of hearing When these state changes are the sound of our own breathing and noticed from within, they allow the now using it to hone in on greater person to put their awareness on powers of awareness. what they have detected as a visceral We are finding through this shift in the body. Accompanying a practice that there is something shift in the body with a shift in the extremely potent about each time mind and noticing both as they are someone notices that they are in happening, then acknowledging them control of creating state change using

19 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org this fusion of breath, sound and continued to show that there are awareness. It isn’t as detectable pathways through the body and when people use shallow breathing mind, using the breath and the sound techniques or ones that are too slow of it, as a bridge that we are only in their movements. I used the word beginning to understand. dynamic to describe the applications The great news is that people that of breathing that move the nervous were suffering debilitating stress and system into a visceral change or shift feeling alienated in their own daily in a relatively short period of time. lives, are able to be guided back to In my own practice I have been an empowering knowingness. That guiding people through achieving they can feel in control of their these beneficial state changes. They nervous system and create beneficial are finding newfound control over state changes that nurture their breath flow and then using connections in the body, that awareness to heighten daily re- ultimately lead to vibrant living and a association. This approach has higher quality of life.

JUNE 2018 CONTENTMENT 20 The American Institute of Stress www.stress.org About the Author behind his breathing education company Omnibreath (Omnibreath. Rabia Hayek is visionary founder com) where they teach optimal and and co-creator of Do As One and conscious breathing through his Life Omnibreath. As a speaker and Force Mastery breathing modality. breathworker, Rabia travels the Hayek is passionate about developing globe teaching people how to use ways to bring conscious breathing breathing in ways they never have, in practices into daily life, using order to awaken their life force to its technology to connect us rather than full potential. In 2006, Rabia had a separate us. Rabia is a member of powerful vision to unite 1 billion the International Breathwork people to consciously breathe Foundation and is currently leading together. On 7/7/7 (July 7, 2007) efforts to add ‘breathwork’ & DoAsOne.com was born to facilitate ‘breathworker’ to the dictionary. this massive connection and give the Rabia is also a professional power of breathing together back to musician, spoken word artist and humanity. Rabia is the driving force alchemic elixir inventor.

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21 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org Help us reduce the negative impact of stress in our world as we work together to extend our reach into the public to ENGAGE, EDUCATE and EMPOWER the global community with science based stress management information, tools and techniques, so we can live more peaceful, happier, healthier and longer lives.

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Memberships starting at $45/year. Become a member today at stress.org. Take a Deep Breath By Jodi Sternoff Cohen

eep diaphragm breathing, with How Essential Oils Help Breathing long deep exhaling breathes, is Dthe easiest way to help calm the The lungs are one of the most nervous system. As you exhale, your powerful channels into the body. vagus nerve, which runs through the When you breathe, air enters your diaphragm, signals the brain to help body through your nose or mouth and transfers to the air passages, which you drop into the healing “rest and carry oxygen to your lungs. Your digest” parasympathetic state of the lungs then pass oxygen into your nervous system, calming the “fight or bloodstream where is it transported to flight” sympathetic nervous system. tissues and organs. Therefore, anything Take a deep breath, inhaling slowly you inhale via the lungs quickly travels to every cell of the body. In fact, the into the diaphragm. Then hold it for a entire process from the initial inhalation moment and slowly exhale. Slow, deep, of an essential oil to a corresponding intentional breathing is one of the best response in the body can happen in a things you can do for your health. Deep matter of seconds. breathing not only allows us to take in The effectiveness of this delivery oxygen and expel waste, it can also channel explains why cocaine is snorted through the nose and why help us drop into the parasympathetic anesthesia is delivered via inhalation. “rest and digest” state. Slow deep When remedies are inhaled, they go breathing tells the nervous system that straight into the bloodstream via blood there is no emergency and that it’s safe vessels in the nasal cavity. Upon to downshift into the parasympathetic entering the bloodstream, the remedy can travel quickly to the brain, thus state. eliciting a host of intense effects shortly Slow deep breathing can boost our after snorting. physical and mental energy, help us In addition to it being the fastest release toxins and waste, and activate channel into the body, the inhalation the parasympathetic state. To help you channel allows remedies to bypass the take advantage of all these benefits, I digestive tract and the liver, where it would be subjected to digestive wanted to arm you with tools to help processing. Read more about why open your lungs and expand your inhalation is the most effective method capacity breathe deeply. of consuming Essential Oils HERE.

23 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org Essential Oils for Breathing Breathe™ can also be inhaled using steam inhalation (Place 2 to 3 cups Our lungs inhale and exhale an boiling water + 5 drops of Breathe™ in a average of 16,000 times a day. If you’re bowl, cover your head with a towel, experiencing any respiratory problems, close eyes and bring face close to the ranging from allergies, a cold or indoor bowl and gently inhale the steam) or air pollution to more serious conditions used with a hot wet towel compress to like asthma, sinusitis, bronchitis or the lungs and throat areas. pneumonia, you may have difficulty Lung Support™ The lungs serve as a breathing which may leave you feeling fundamental source of life energy – mentally and physically fatigued and transporting oxygen from the can compromise your immune system, atmosphere into the capillaries so they ability to detoxify and to drop into the can oxygenate blood – as well as an parasympathetic state. Essential oils, important channel of elimination – with their natural anti-inflammatory and releasing carbon dioxide from the decongestant properties, can help you bloodstream into the atmosphere. breathe easily again. Similarly, emotions like feelings of grief, Breathe™ blend contains three bereavement, regret, loss, remorse can different types of Eucalyptus oil, a obstruct the ability of the lungs to potent antiseptic, expectorant and accept and relinquish, impeding their decongestant that can help clean and function of “taking in” and “letting go.” strengthen the lungs. Breathe also Grief that remains unresolved can contains Peppermint™ Essential Oil become chronic and create disharmony whose expectorant qualities may help in the lungs, weakening the lung’s support upper respiratory congestion function of circulating oxygen around caused by asthma, bronchitis, allergies, the body. When lung function is cold or flu. impaired, it leads to shortness of To use, apply 1- 2 drops topically on breath, fatigue and feelings of throat and upper chest (Breathe™ melancholy. Lung Support™ helps contains a lot of hot oils and can turn overcome grief and let go of negative the skin red. We therefore recommend experiences. diluting with castor oil, coconut oil or Apply 2- 3 drops over the lungs. olive oil before topical application). Allow yourself to deeply exhale any grief as you apply the blend. A normal and healthy expression of grief may be expressed as sobbing that originates in the depths of the lungs, including deep breathes and the expulsion of air with the sob. The parasympathetic state of the Autonomic Nervous System is influenced by external factors like breathing. In fact, deep breathing can trigger the parasympathetic state by stimulating the vagus nerve, which originates in the brain stem and winds through the throat and upper body,

JUNE 2018 CONTENTMENT 24 The American Institute of Stress www.stress.org connecting the lungs to the brain. This breathing troubles such as wheezing, is a bi-directional signal, meaning that severe coughs, asthma, or hiccups. actively focusing on your breath and The goal is to balance, not block, the the movements of your diaphragm, can histamine response as histamine help trigger the parasympathetic state performs critical functions in body, and that inducing the parasympathetic contributing to HCL production and state can help enhance deep breathing. neurotransmitter signals. To trigger the parasympathetic state, To help reduce over-active histamine simply apply a drop of the reactions and allow healthy breathing Parasympathetic™ blend to the vagus patterns, apply 1 – 2 drops of nerve (behind the earlobe on the Histamine Balance™ behind your ears, mastoid bone). on the back of your neck, or on your Sinus Support™ The sinuses make sternum to open airways. up the upper part of your respiratory tract from your nose into your throat. Any sinus-related issues that lead to About the Author restricted, congested or inflamed nasal Jodi Sternoff Cohen is a best- passages can contribute to breathing selling author, award-winning difficulty. Sinus Support™ helps to clear journalist, and founder of Vibrant and open the nasal passages and Blue Oils, where she has combined supports the relief of sinus pressure her training in nutritional therapy and from chronic sinus infections and/or aromatherapy to create unique pro- sinus issues related to allergies. prietary blends of organic and To help open sinus passages and wild-crafted essential oils that improve breathing, apply 2 – 3 drops of helped her heal her own anxiety, Sinus Support™ to a Q-tip and insomnia, and autoimmunity. swabbing the inside of the nasal Her #1 bestselling book Healing passages 2 – 6 times daily. For optimal with Essential Oils has been widely effectiveness, you can leave the Q-tip praised as one of the most well- in the nasal passage for up to 20 researched consumer books in minutes. years. In it, Jodi synthesizes Histamine Balance™ Histamine is a decades of leading scientific chemical substance that can be research to save you from years you released in the lungs and cause might have spent researching your narrowing of the bronchial tubes and health issues, and gives you the difficulty breathing. While the release of knowledge and tools to ‘take action’ histamine is a normal defense immediately. mechanism, an exaggerated histamine Download a free chapter of her response can contribute to chronic book, Healing with Essential Oils at inflammation of the nasal passages, https://vibrantblueoils.lpages.co/ sinuses and lungs contributing to

25 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org Yogic Breathing: Ancient and Modern

By Dr. Alan Ruth, BSc, MA, PhD, MBA, FAIS, FRSB

Introduction breathing should be abdominal breathing in a slow and rhythmic oga originated in ancient India pattern, rather than chest breathing. about 5,000 or more years ago. The ancient yogis and yoginis believed YThe name yoga is derived from a that this form of breathing facilitates the Sanskrit word which means “to yoke or flow of prana. join together.” The Five Principles of Original yoga manuscripts, for Yoga are the basis for attaining a example, Hatha Yoga Pradipika, healthy body and mind through the Gheranda Samhita and Shiva Samhita practice of yoga. One of these advocate restraining, keeping in, principles is proper breathing calming, and holding the breath. They do not make any mention of deep (big) (pranayama). Today, there are breathing. numerous types of yoga and it is To illustrate, below I have listed difficult to know how many types are some translated quotations from Hatha being practiced around the world as Yoga Pradipika: different variations and/or combinations “Respiration being disturbed, the of elements could represent a ‘new’ mind becomes disturbed. By restraining type of yoga. respiration, the Yogi gets steadiness of mind.” Ancient Yogic Breathing “So long as the (breathing) air stays in the body, it is called life. Death “For breath is life, and if you breathe consists in the passing out of the well you will live long on earth.” - (breathing) air. It is, therefore, necessary Sanskrit proverb to restrain the breath.” “Just as lions, elephants and tigers Yogic breathing is called are controlled by and by, so the breath ‘pranayama.’ Pranayama means “to is controlled by slow degrees, control the breath” or “mastering the otherwise (i.e., by being hasty or using life force.” According to the ancient too much force) it kills the practicer philosophy of yoga, breathing controls himself.” the flow of prana, the cosmic life force “The air should be expelled with in the body. Also, according to ancient proper tact and should be filled in texts, the nose is the proper instrument skillfully; and when it has been kept for breathing rather than the mouth and confined properly it brings success.”

JUNE 2018 CONTENTMENT 26 The American Institute of Stress www.stress.org You may access an English You may access this book via this translation of chapter 2 (on pranayama) link: http://www.arfalpha.com/ of Hatha Yoga Pradipika via this link: ScienceOfBreath/ScienceOfBreath.pdf http://terebess.hu/english/ HathaYogaPradipika1.pdf Modern Yogic Breathing Interestingly, Dr. Artour Rakhimov, a Canadian based Buteyko Breathing Recently, I visited Dublin’s 3 biggest Method expert and author, has book stores and scanned the content reported that Professor Buteyko, (including the indexes) of about 40 during one of his public speeches, modern books on yoga. In only 3 of mentioned that prana was simply CO2. these books was I able to find any Dr. Rakhimov has gone on to state: mention of nose/nasal breathing. One “... if one reads old Hatha yoga of these books was co-authored by Dr. books, while substituting ‘CO2’ instead Georg Feuerstein, an internationally of ‘prana,’ deep physiological sense in renowned Yoga researcher. Under the traditional yoga teaching, can be heading ‘Breathing through your nose found.” (most of the time)’ this book, titled The There is an interesting book titled Complete Idiot’s Guide to Yoga states: The Hindu-Yogi Science of Breath by “No matter what anybody else tells Yogi Ramacharaka. Yoga Ramacharaka you, yogic breathing typically occurs is a pseudonym for William Walker through the nose, during both Atkinson (1862-1932) who left his law inhalation and exhalation. For practice in Chicago to practice Yoga. It traditional yogis and yoginis, the mouth is thought that he had an Indian co- is meant for eating and the nose for author. This book contains 2 interesting breathing.” chapters on breathing. In one of these Having said this, the book makes chapters (chapter 6, page 20) it states: the point that a few classical “One of the first lessons in the Yogi techniques for breath control require Science of Breath; is to learn how to you to breathe through the mouth. breathe through the nostrils, and to The second book, by Adriana overcome the common practice of Sobi-Wilderman states, under the mouth-breathing. The breathing heading Breathe correctly: mechanism of man is so constructed “Most pranayama exercises are that he may breathe through the mouth done through the nose, and very rarely or nasal tubes, but it is a matter of vital ever through the mouth. Further, importance to him which method he almost all exercises require you to follows, as one brings health and breathe into your abdomen, what is strength and the other disease and known as belly-breathing. Only in some weakness. It should not be necessary cases will the breath be taken into the to state to the student that the proper chest. You must therefore learn to method of breathing is to take the isolate your breathing properly. Unless breath through the nostrils, but alas! otherwise specified, keep your lips the ignorance among civilized people closed and your jaw relaxed. If you’re regarding this simple matter is doing the latter correctly, there should astounding.” be a gap between your upper and

27 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org lower teeth. The tip of your tongue done through the mouth and not the should also be pressed against the nostrils. These are called Sitali back of your upper teeth.” Pranayama and Sitakari Pranayama. The third book was written by Bellur The pranayamas cool the system. In Krishnamachar Sundararaja Iyengar, Sitakari Pranayama the breath is drawn better known as B.K.S. Iyengar. Bellur with a hissing sound between the two was the founder of the style of yoga lips. known as “Iyengar Yoga.” He was While the other books I scanned considered one of the foremost yoga made no mention of nose/nasal teachers in the world. In the book titled Light on Pranayama, under the heading breathing; statements in the main text Hints and Cautions he states: of some of these books advocated “Breathing in pranayama should such actions as bigger, deeper always be through the nose, except breathing, breathing more, and where otherwise stated as in Ch. 24.” expelling “toxins” like CO2. Indeed, in Chapter 24 of his book refers to two a book titled Bikram Yoga by Bikram pranayamas in which inhalation is Choudhury (described in his book, as

JUNE 2018 CONTENTMENT 28 The American Institute of Stress www.stress.org the world’s foremost authority on Hot “You can practice yoga for months Yoga), he states: and years (the way it is now taught by “For most of the postures I tell you leading health yoga gurus), and your to breathe normally: As you begin to health may not improve or even can move into each position, inhale as fully get worse. Why does modern yoga as possible, trying to fill the lungs 100 provide very limited benefits? Why was percent; then exhale the breath it successful in the past? To put it completely when you achieve the simply, modern yoga leaders and yoga posture. Continue inhaling and teachers do not know how to breathe!” exhaling fully while maintaining the According to the Indian Yogi, Swami posture – this is normal breathing.” Rama (1925 – 1996), simple breathing “Pranayama breathing feels strange exercises such as diaphragmatic at first, because your lungs are not breathing can be healthy and helpful. used to maximum expansion and However, in order to really practice contraction. They will feel tight and pranayama, the knowledge and small, which is perfectly normal. It application of the bandhas is might even be impossible for you to important. Bandhas are “practices for inhale fully for six counts (roughly 6 unfolding, controlling, and re- seconds). But with each class, you will channeling the finer force that is find that your breath becomes deeper awakened through some of the and fuller.” vigorous pranayama exercises done Following my ‘research,’ based on by yogis.” the books I found written by modern Without the application of the Yoga ‘gurus’ and my extensive bandhas, pranayama practices can be research using the World Wide Web, I injurious to health. Importantly, Swami concluded that modern Yoga ‘gurus’ Rama also noted that the majority of generally appear to lack knowledge on breath practices and pranayama healthy breathing and they appear to techniques are intended for relatively equate ‘breathing’ with ‘breathing healthy individuals. exercises’ performed in a yoga studio According to him: or at home. There appears to be no “..., the most widespread caution recognition of the importance of is that one must never force or ‘overdo’ correct breathing on a 24/7 basis. any breathing exercise. Creating discomfort of any sort is an immediate Pranayama and Hyperventilation cue to release the effort, return to natural breathing and only begin again Although numerous studies show if it can be done with ease.” beneficial health effects of pranayama breathing, some studies show that fast Precautions and Contraindications breathing pranayama can cause hyperventilation, which may hyper- Dr. Shirley Telles and Dr. Nilkamal activate the sympathetic nervous Singh of the Patanjali Research system, stressing the body more. Foundation, India have noted that Indeed, according to Dr. Artour some pranayamas are associated with Rakhimov: precautions and contraindications.

29 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org These include the following: they are practiced incorrectly they can Pranayama practices involving have adverse psychological effects. changes in breath rate e.g. They also note that such techniques kapalabhati. Based on clinical should be avoided in hypertension, observations, the precautions and coronary artery disease, and in people conditions which are contraindicated on a medication for a psychiatric are: condition. • Hypertension According to Judith H. Lasater (in the book titled The Joy of Yoga): • Coronary Artery Disease “The highest form (of pranayama) is • Recent Abdominal/thoracic surgery, to remain completely aware of the and breath, allowing it to come and go • Epilepsy (as it can provoke an without injecting control into the attack) process… This ability to remain aware The practice may result in over- of the breath and yet not control it is at breathing. Therefore, it should be the heart of meditation. Virtually all avoided in individuals who have a systems of meditation begin with tendency to hyperventilate e.g. simple breathing exercises or with a individuals who have panic attacks. technique to make you aware of the Pranayama involving changes in breath.” which nostril (left, right, or alternate) Although Lasater considers not is breathed through – Based on controlling the breath to be an aspect research findings, of the 3 practices, of what she calls the highest form of there are contraindications for right pranayama, from a health standpoint, nostril breathing alone. The technique such lack of control would seem should be avoided in those with, or inappropriate for someone with predisposed to hypertension. dysfunctional breathing habits. Bumblebee breathing (Bhramari Dr. Ines Steward, a New Zealand pranayama) – This practice is generally Buteyko Breathing Method expert has considered safe but based on clinical a lot of personal experience with observations is best avoided in tinnitus. pranayama. In June 2016, she posted Bellows breathing (Bhastrika an interesting piece on her website pranayama) – According to Telles and titled ‘On Yogic Pranayama Breathing Singh, this practice results in over- Practice.’ Among the points she made breathing and is best avoided in in this article were the following: individuals who hyperventilate or have “Yogic pranayama at its best teaches an anxiety disorder. Also, according to healthy diaphragm use and at its worst the Chopra Center, other strengthens a pre-existing breathing contraindications are: pregnancy, dysfunction or causes symptoms of uncontrolled hypertension, epilepsy, ill-health. It all comes back to the seizures, or panic disorder. knowledge a yoga teacher has about Pranayama with breath breathing mechanics, breathing holding – Certain pranayama physiology, breathing habit techniques involve breath holding. development and maintenance, as well According to Telles and Singh, breath as how perceptive he or she is and how holding techniques are not much time he or she can spend to recommended for beginners because if focus on an individual client.”

JUNE 2018 CONTENTMENT 30 The American Institute of Stress www.stress.org “All too often, people with an you know that your breathing is unidentified breathing dysfunction dysfunctional e.g. you know you are attend a yoga class and believe the a chest ‘breather’ well-meaning but under-educated teacher. This may have undesirable and Conclusion potentially harmful consequences.” For the ancient yogis and yoginis, “If a person has dysfunctional proper breathing involved nose breathing habits with low CO2 levels breathing during both inhalation and then doing pranayama could reduce exhalation. It also involved abdominal these levels further and symptoms may (diaphragmatic) breathing in a slow, arise. This is particularly the rhythmic pattern, as opposed to chest case when doing an over-breathing breathing. Only a few classical practice at rest e.g. before meditation. techniques for breath control require Symptoms may include chest tightness, breathing through the mouth. constriction in the throat, stuffy or runny Unfortunately, many modern Yoga nose, heart pain, feeling dizzy, teachers lack knowledge on what headache, or trouble concentrating constitutes healthy breathing and what during meditation. Probably the worst- constitutes unhealthy breathing. Also, case scenario would be an asthma they seem to equate ‘breathing’ with attack or an anxiety attack.” ‘breathing exercises’ carried out in a Ines has outlined what she calls ‘The Yoga session, as opposed to correct Breathe Right and Live Better breathing 24/7. Principles for Your Yoga Practice.’ Some types of pranayama involve These are: fast breathing or over-breathing (hyperventilation). Unfortunately, and • Breathing silently at all times – the somewhat worryingly, there appears to steam train approach is be a lack of knowledge among many counter-productive Yoga teachers that pranayama’s of this • Use your diaphragm predominantly type may be contraindicated for • Breathe gently and slowly individuals with certain medical conditions or have to be performed • Breathe rhythmically – alternate with caution. Most pranayama’s are nostril breathing is a great practice if intended for healthy or relatively healthy the breath is not forced in any way people. However, individuals who do • Breathe evenly – when inhale and not fall into one of these categories, exhale are the same length then a need to be wary of well-meaning coherent heart rate pattern can teachers who are under-educated in develop relation to breathing and may instruct • Enjoy a natural pause after the exhale their students to perform certain pranayama’s that could result in • Allow your own breathing reflex to potentially harmful consequences. As a decide when to breathe in again general rule, Yoga students who have a – after all your body knows better significant health problem should never than your head how to self-regulate overdo any breathing exercise or do its chemistry one that is physically very demanding • See a breathing therapist if for them. A good maxim is “If in doubt, pranayama causes symptoms or if leave it out.”

31 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org when entering or leaving a place. It consists of three steps and three breaths.

1. Feel the body from toe to head. 2. Release the tension from head to toe. 3. Take a panoramic view from your brain’s camera.

Why don’t you follow along? Remember when I ask you to bring at- tention or feel a part of the body, don’t just think about that, actually feel the sensations in that part of the body. Step 1: As you feel your feet touch the floor, bring attention to your feet. Notice how it feels in your toes. Are they warm or cold? Notice how the floor feels under your feet. Is it soft or hard? Notice how your feet feel. Are they dry or One-Minute sweaty? Notice if you are wearing shoes or slippers or socks or are your feet bare? Now move your attention to your Relaxation Exercise calves and feel how they feel. Are they tense or relaxed? Next bring attention to for Busy People your knees, then thighs and then hips. Feel the sensations and notice how Dr. Rozina Lakhani each part of the body feels. Bring atten- tion to your tummy. Does it feel hungry re you a busy person? Is it difficult or full? Bring attention to your chest and to find long stretches of time to sit notice how you are breathing. Bring Adown and do long meditations to attention to your shoulders. Are they relax on a regular basis? How would you hunched up or relaxed? Move your like to learn one of the most effective attention to your upper arms, then lower techniques to calm your body and your arms, then hands and fingers noticing mind in less than a minute? each part how it feels. Bring attention to Let me share an exercise with you your neck, then your face and then your that you can do anywhere, anytime, and head. Enjoy a nice, smooth breath. without needing anything extra. Feels good? Right. Let’s do the second Something, that can bring more focus, step. more joy and more life to your life! Step 2. When I ask you to take the Although it only takes less than a second breath, I would like you to tense minute (once you have practiced a few your whole body when you inhale and times) it combines the power of some of when I ask you to release, release the the most effective techniques. I call it tension fast starting from your head to “Feet to Floor” to give you a cue each toe with an ‘ahh’ sound. Ok. Let’s take a time your feet touch the floor, especially deep breath and make your body tight

JUNE 2018 CONTENTMENT 32 The American Institute of Stress www.stress.org as if you are a big piece of log from a causing illness and suffering. If you do, tree. Hold the breath for the count of 3. you would be able to manage your 1,2,3 and let go while saying “ahh”! As stress better and enjoy your life fully. you do that feel all the tension moving You can get a FREE audio guide for from your head, through your body, this exercise by signing up at https:// down your legs and into the earth drrozina.com where you can also get through your feet. Feel all the tension more tools like this from the blogs, the and worries leave your body and mind in #1 bestselling book Stress to Joy; Your that instant. Feels good? Good. Let’s Toolkit to Restore Peace of Mind in move to third step. Minutes and the online course “Stress Step 3. Now open your eyes and as if to Joy in 21 days”. you are taking a picture from the To your Health and Happiness. camera, take a panoramic view of your surroundings. See everything as if you are seeing things for the first time (the About the Author colors, the shapes, the movement), hear Dr. Rozina Lakhani’s mission is to whatever sounds you hear, smell and promote health and happiness. She is notice all the smells, notice even the the bestselling author of the book; absence of any smell, feel the taste in Stress to Joy; Your Toolkit to restore your mouth, is it dry or salivating, expe- Peace of Mind in Minutes. She works rience the kinesthetic feel of the air as a psychiatrist at Shifa Health, a touching your body or the feeling of clinical professor at the University of warmth or cold on your skin. Say a Washington and Medical Director at ‘Thank you’ in your heart for all your Residence XII Women Drug Treatment blessings (your life, your body, all your Program. Dr. Rozina received her senses and abilities), bring a crescent medical degree from the Aga Khan moon smile on your face and you are University in Pakistan and completed done. Move on with whatever you were her Master of Public Health degree and doing intentionally and mindfully. her residency in Psychiatry from the How did you feel? Do you feel that University of Illinois in Chicago. She is your mind is clearer? Does your body feel a little more relaxed? a diplomate of American Board of Most people feel less stressed and Psychiatry and Neurology. She is also are able to focus on and enjoy their next a member of the American Stress activity better. It is like wiping the black- Institute and offers talks and trainings board clean instead of writing over an to various groups. already full blackboard. Although it took Today, Dr. Rozina lives with her me 3 minutes to give the full instruction husband and 2 children in the Pacific the first time, as you practice you would Northwest. be able to do it in less than a minute. She is passionate about helping I am sure you have your own ways to people reduce stress and dreams of a clear your mind and release the tension world where people pursue a happy in your body. Use whatever works for life with love and purpose. you but keep breaking the cycle of For more information visit Dr. stress by taking these breaks. It you Rozina’s website at https://drrozina. don’t, stress can increase to the point of com/.

33 JUNE 2018 CONTENTMENT The American Institute of Stress www.stress.org Faster Than Drugs and Without Their Side Effects Prescription drugs can come with a long list of nasty side effects. Alpha-Stim provides an option that is fast and safe, with no lasting side effects and no risk of addiction. It is proven effective in improving mood and sleep even in the most dif cult patients, as evidenced by the recent study of advanced cancer patients at The University of Texas MD Anderson Cancer Center.

The brain functions electrochemically and can be readily modi ed by a mild electrical current. Alpha-Stim utilizes cranial electrotherapy stimulation (CES) to deliver the only patented waveform for a medical device of its class, with more than 100 clinical research studies over 37 years. It’s easy to use by simply wearing earclips for 20-60 minutes a day while doing normal activities at home or work. LATEST RESEARCH: The University of Texas MD Anderson Cancer Center, “Cranial Electrotherapy Stimulation for the Management of Depression, Anxiety, Sleep Disturbance, and Pain in Patients with Advanced Cancer” DECREASED ANXIETY INCREASED SLEEP TIME DECREASED DEPRESSION

9.5 Hospital Anxiety and Depression Scale Pisburgh Sleep Quality Index Hospital Anxiety and Depression Scale p<0.001 11 6.5 6.36 9 8.81 p=0.055 p=0.024 es es es 10.5 10.23

8.5 or or

or 6 10 5.67 Sc 8 Sc y ia 9.5 7.5 5.5 5.27 5.34 mn xiet 7 6.89 9 8.7 4.97 so An 6.42 8.4 5 In 8.5

6.5 6.24 6.16 Depression Sc an

an 8 6 an Me 4.5 Me 7.5 5.5 Me 5 7 4 Baseline Week 1 Week 2 Week 3 Week 4 Baseline Week 2 Week 4 Baseline Week 1 Week 2 Week 3 Week 4

REFERENCE Yennurajalingam S, Kang D-H, Hwu W-J, Padhye NS, Masino C, Dibaj SS, Liu DD, Williams JL, Lu Z, Bruera E. Cranial electrotherapy stimulation for the management of depression, anxiety, sleep disturbance, and pain in patients with advanced cancer: a preliminary study. Journal of Pain and Symptom Management. 2018 Feb; 55(2): 198-204. HELP FOR YOU IS HERE. To get started and to see more clinical data, visit www.Alpha-Stim.com/AIS or call 940-463-5422.

Alpha-Stim and the Alpha-Stim logo are registered trademarks, and LET NOTHING STOP YOU is a trademark of Electromedical Products International, Inc. © 2018 Electromedical Products International, Inc. All rights reserved. Alpha-Stim is proven safe and effective with more than 100 studies conducted over 37 years. Read a full disclosure of the minor and self-limiting risks here: alpha-stim.com/risk. NotNot a subscriber?a subscriber?

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TheThe American American Institute Institute of Stress 2206387B Adams Camp Drive, Bowie Ste Blvd 280 #334- #224 FortWeatherford, Worth, TX TX 76116 76068 www.stress.org [email protected] [email protected] Main:Main: (682)239 (682) 239-6823-6823 Fax:Fax: 817(817)394-0593-394-0593 The American Institute of Stress is a qualified 501(c)(3) tax-exempt organization. The American Institute of StressISSN is # a 108 qualified-148X 501(c)(3) tax-exempt organization. ISSN# 108-148X