Yoga and breathing

e o o o o o o o o

C. Gilbert
Abstract Many breathing exercises originating within the yoga tradition have broad value

for therapeutic and rehabilitation purposes. They are generally based on sound
physiological principles, and though designed for more esoteric goals, can serve well for
promoting relaxation, optimal lung function, emotional balance and self-regulation of
various kinds. Fundamental principles of yogic breathing are discussed (diaphragmatic
breathing, nasal vs mouth breathing, slow exhalation with pauses, smoothness and
steadiness, self-observation of breathing). Four basic exercises are described: three-part
complete breath, alternate-nostril breathing, post-exhale pause, and 'skull shining'.

Breathing

Introduction

Christopher Gilbert PhD,

Social Science and Human Services, Ramapo College
of New Jersey, Mahwah, NJ 07432, USA
Correspondence to: Christopher Gilbert. 10 Wilsey
Square, #14, Ridgewood, NJ 07450, USA Tel./Fax.: +1
201 444 3088; e-mall: cgilbertl juno.corn
Received September 1998
Accepted September 1998
Revised October ]998

Journal of Bodywork and Movement Therapies (1999)

3(1 ),44-54
Harcourt Brace & Co. Ltd 1999

JOURNAL

Yoga is vast; it is difficult to evaluate

a discipline whose goals range from
loosening tight neck muscles to
merging with the cosmos. Yoga has
extremely ancient origins and
transcends cultures and language. It
certainly represents the most
organized system for extending our
domain over the body. Even modern
instrument-based biofeedback relies
heavily on methods originally
developed by yogis to produce results.
The accurate observations of
physiology by the early yogis, having
no instruments except their senses,
give their prescriptions and
proscriptions added credibility. Yoga
may represent our species' bestdeveloped attempt to expand
consciousness and escape our
automatic sense-bound existence.

OF BODYWORK

AND MOVEMENT

THERAPIES

The body of knowledge, beliefs, and

practices comprising yoga emphasizes
control of breathing as central to its
ideals and its goals. The fact that
control of breathing is also central to
most methods of relaxation,
meditation, and body control indicates
at least that it is popular, and it is
probably popular because it works.
Many of the claims for yoga have not
been tested yet by current standards of
science, and some of the variables are
so intangible that testing seems futile.
But physiological and medical
research is confirming many of the
claims based originally on observation
and tradition.
However, controlled breathing is not
patented; yoga doesn't own breathing
any more than Christianity owns
charity. Anyone who closely observes
the breathing process for a long time

JANUARY

1999

Yoga and breathing

would probably discover many of the
principles and procedures which yoga
has developed, because they are based
on good body mechanics, respect for
the body, and understanding of the
profound interaction between body and
mind. Practitioners of bodywork and
movement therapies should consider
experimenting with and applying
breath control techniques regardless of
their actual training or beliefs about
yoga.
There are religious components to
yoga, and since it evolved largely
within the Hindu culture its
vocabulary is in Sanskrit. Many
esoteric aspects of yoga are hard to
reconcile with our current mechanistic
and reductionistic approach to life.
There is the matter ofprana, the
hypothesized universal life force, and
there are the chakras, the seven
hypothesized centers of energy
distribution located along the spine
and brain. But one does not need to
accept the entire set of goals and
beliefs to derive benefit from yoga's
basic procedures. In the process of
preparing yoga students for higher
adventures, yoga has developed
techniques which are excellent for
improving and maintaining health,
flexibility, and optimal bodily
functioning.
There are several schools within
yoga, each emphasizing different
paths to a reunion with a higher state.
Hatha yoga -- the 'yoga of health' -is the most familiar to most
Westerners, and focuses on postures
called asanas which prepare both the
body and the mind for the rigours of
serious meditation. Therefore, yogic
work on the body is seen as almost
remedial. Control of breathing is an
integral part of asanas, but there are
also stand-alone breathing exercises.
The more advanced ones are intended
to serve as pathways to higher
consciousness, and lie well beyond the
scope of this article. But the simpler
ones are very useful, whether
considered as remedial or as aids on
the path of self-development.

JOURNAL

This article presents some basic

breathing methods taught in hatha
yoga which are safe for beginners yet
should have relatively rapid and
noticeable effects. Collectively they
are called pranayama. Many breathing
exercises not included here require
caution, have prerequisites, and
benefit from the guidance of a yoga
teacher. Major deviations from normal
breathing can put a strain on the
unprepared body. Yoga teachers warn
of disruption of the autonomic control
of breathing, deleterious effects on the
heart and blood pressure, and
premature activation of certain
transformations of the nervous system.
Margabandhu, director of the
Integral Yoga Institute in Fair Lawn,
New Jersey and a yoga teacher of 30
years' experience, recommends staying
with the simpler exercises until one is
ready to accept certain 'austerities' in
line with yoga teachings, including
changes in one's diet, mental outlook,
behaviour, and morality. The cautions
often amount to respect for the body's
warning signs, moderation, and
common sense. Before moving ahead
to advanced breathing techniques such
as breath retention and bhandas, or
locks: 'the mind first has to hang out in
a different neighborhood.'
The much-photographed advanced
postures discourage beginners because
they are difficult and require great
flexibility. The advanced breathing
exercises, on the other hand, offer less
of a barrier to premature
experimentation because we have
access to all the controls of breathing.
'Going straight to the top' appeals to
individuals looking for instant results.
But yoga requires patience and
discipline, and should be primarily
process-oriented, not results-oriented.
How can you justify teaching yoga
techniques without being a yoga
teacher? Learn how to do it yourself,
do some background reading, and try
some things with a few clients. Your
familiarity with basic therapeutic
bodywork should give you an
advantage and protect you from major

OF B O D Y W O R K A N D M O V E M E N T T H E R A P I E S

mistakes. Consultation or referral to a

yoga teacher is available in most
communities. The directions in this
article are rudimentary but sufficient
to get you started.

General principles of
yogic breathing
Certain principles run through most of
the exercises, and are considered
fundamental to good breathing
whatever the circumstances:
Abdominal breathing is better than
chest breathing
Breathing through the nose is
preferable to breathing through the
mouth
Slow breathing without rushing the
exhale is beneficial
Smooth steady breathing is
preferable to irregular choppy
breathing
Observing one's breathing is good.

Abdominal vs chest breathing

The ideal 'breathing space' for the
human body can be symbolized by a
triangle with apex upward. This
reflects the shape of the trunk, the
shape of the lungs, and the functional
dynamics of the breathing apparatus.
During emotional stress or preparation
for exertion, people generally breathe
in the reverse pattern: the triangle is
inverted, and the apex points down. A
triangle resting like this is inherently
unstable (see Fig. 1)
Some people breathe habitually as
if they are about to cry, run away, or
burst into action in some way, and it
can have real consequences for body
functioning The reasons seem to be
due to inappropriate emotion and a
semiconscious preparation for action.
Because of our great ability to displace
ourselves in time mentally, we can
anticipate events far in the future and
recall events long since finished. With
a thought, we can alert and commit our
bodies to prepare for the imagined
event in the present. Consciously, we

J A N U A R Y 1999

Gilbert

Nasal vs mouth breathing

A b d o r n inal - stable

Chest

unstable

Fig. 1 Abdominal vs chest breathing. Abdominal breathing uses the diaphragm primarily, and
is congruent with the shape of the lungs and the capacities of the breathing muscles. It processes
the most air with the least effort, and is associated with mental stability and calmness. Chest
breathing utilizes primarily intercostal muscles plus 'accessory' breathing muscles: trapezii;
scalenes; pectorals; sternomastoids. It is less efficient, aerates less of the lungs, fatigues the neck
and upper chest if used habitually, and is associated with urgency and anxiety.

understand that our thinking is

hypothetical or retrospective, but the
physiology seems unable to appreciate
this distinction, like firemen who
cannot distinguish between a false
alarm and a real one. They must rush
away in their noisy trucks every time
the alarm sounds.
Why does the breathing change to
the inverted-triangle pattern? What
purpose could this serve? These are
guesses, but there is wide agreement
as to why:
1. Abdominal-muscle bracing would
protect internal organs from
damage through impact or
penetration of the external
abdominal wall. Therefore, under
threat the rectus abdominis and
obliques develop isometric tension.
This restricts abdominal expansion
so that the lower part of the lungs is
not allowed to expand fully, and the
expansion area is forced upward.
2. The shoulders rise: trapezii,
scalenes, even the SCM contract to

JOURNAL

raise the shoulder girdle and the

clavicles. This has two obvious
functions:
a) shoulder bracing provides a stable
platform for movement of the
arms, and prepares the hands for
action.
b) shoulder bracing removes some
weight from the chest and permits
freer upward expansion for a fuller
breath, given the constraints on
abdominal expansion
When training anyone in breath
regulation, it is helpful to have them
visualize the breathing space as a
triangle with the apex up, and
directing each inhale downward
toward the base. Most people will feel
physically more stable and balanced
with abdominal breathing, especially
when standing. Martial arts training
usually emphasizes focusing one's
attention on a point just below the
navel, directing the breath there in
order to stay balanced physically and
mentally.

OF B O D Y W O R K A N D M O V E M E N T T H E R A P I E S

Yoga emphasizes that breathing in

most situations should be through the
nose, both inhaling and exhaling. The
reasons are related first to the benefits
of the nasal passages: warming,
filtering, and humidifying the inhaled
air and recovering heat and moisture
from the exhaled air. More effort is
required for nasal breathing than for
mouth breathing, but the system
depends on that effort to keep the
diaphragm strong. Also, the lung
vacuum routinely created by nasal
breathing facilitates oxygen absorption
in a way that mouth breathing does
not. It is easier to reduce the speed of
the exhale and retain air longer when
nasal breathing predominates.
Mouth breathing is associated
psychologically with urgency and
often with perception of threat. When
asked to take a deep breath most
people will do it through their mouths,
showing that this is the route for
voluntary takeover of breathing. But
that is appropriate only when speed
counts and exertion is only seconds
away. Bypassing the nose routinely
dumps untreated air directly into the
fragile alveoli, thinner than tissue
paper. Just as our automobiles and
water supplies have filters, we also
have noses for good reason. We can
drink directly from puddles if needed,
but it is better not to; similarly, we can
breathe through our mouths, but it is
better not to.
Beyond the physical advantages of
breathing through the nose, yoga
philosophy focuses on absorption of
prana. Channels for circulation of
prana run throughout the body, but
two very important ones are situated
in the upper part of the nostrils
directly below the brain. Maximum
absorption ofprana from the air is
said to be through the nose, not the
mouth. Finally, the cyclic alternation
between left and right brain
dominance is facilitated by nasal
breathing.

JANUARY

1999

Yoga and breathing

Slow breathing
The yogi is taught to value slow
breathing and learn to make it as
automatic as possible. There is good
reason for this; oxygen can be
effectively absorbed from an inhaled
breath for at least 10 seconds. Air
when inhaled contains 21% oxygen,
and when exhaled, 16%; we ordinarily
absorb only 5%, and the rest is
exhaled unused. Absorption per breath
can be vastly improved by simply
exhaling more slowly. This takes
some attention, but improves
oxygenation and spares breathing
effort by making each breath more
efficient. Individuals with emphysema
and other respiratory disorders in
particular learn to improve their
breathing in this way.
The ideal breath rate according to
yoga is around six per minute; this rate
is hard to establish as a habit but can
be easily achieved with conscious
control. At this rate there is a more
harmonious synchronization with the
heart rhythm. Current research on
cardiorespiratory synchrony (Lehrer et
al. 1997) has supported this concept
which yogis developed 3000-4000
years ago.
Apart from slowness, the usual
recommendation is that everyday
breathing whenever possible should
follow the ratio of 1:2; that is, twice as
long for the exhale as for the inhale.
This may be done by prolonging the
exhale or pausing a bit before the next
breath. This ratio will shift toward 1:1
during anxiety, grief, anger, or
exercise. Some breathing exercises
recommend for special purposes a 1:1
ratio, but in that case the healthy body
automatically reduces the volume of
air breathed or number of breaths per
minute to avoid hyperventilation.
When breath retention is introduced at
a more advanced level, the ratio 1:4:2
is commonly recommended; that is,
breathe in for one count, hold for four,
breathe out for two.
The benefits of slow breathing for
mental and emotional equilibrium are

JOURNAL

well known to laymen. Common

advice to an agitated person is
something like 'Take a deep breath-calm down.' Even a single breath can
help, although a minute or two of slow
deep breathing would be better. The
effect is probably a combination of
physiological stabilization and mental
focusing on something under the
person's control.

Irregular, choppy, erratic

/VVVVVV
Steady, smooth, regular

Smooth vs irregular breathing

Slow exhalation generally will
smooth out the breathing rhythm, but
it is worth focusing separately on the
quality of smoothness. Smooth
breathing is correlated with a steady
mind. The term 'correlated' is used
here intentionally because it does not
imply any cause-effect relationship,
only that the two factors are related to
each other, or co-vary. A
fundamental principle of yoga is that
mind-body influence is bidirectional. A further tenet is that
breathing reflects the nature and the
progress of thought: if thinking
proceeds in an orderly fashion, not
hurried and without excessive detours
and interruptions, then the breathing
rhythm is likely to be the same. It
works the other way as well: smooth,
steady breathing makes for a calm
mind. This is easy to experiment
with: try breathing in an erratic, stopand-go manner and notice how
smooth your thinking is.
Breath-holding, interrupting the
breathing rhythm, is a natural response
to surprise, alarm, distraction, or
intense concentration. Those states of
mind may occur more often than
desired; if so, developing the habit of
smooth breathing should reduce the
amount of surprise, alarm, distraction,
and intense concentration. Breathstopping is often followed by a gasp or
sigh rather than simple resumption of
the natural breathing rhythm, and
inappropriate muscle tension is likely
to occur at those times. Donna Farhi,
in her excellent The Breathing Book

OF BODYWORK

AND MOVEMENT

THERAPIES

Fig. 2 Irregular vs steady breathing.

Breathing patterns are easier to measure than
thinking patterns, but yoga doctrine holds
that the two domains affect each other
strongly so that when one domain is altered,
the other will follow.

(Farhi 1996) devotes a whole chapter

to the intricacies of breath-holding and
its remedies.

Observe the breathing process

The final general principle is that
focusing attention on one's breathing
has value. For one thing, it can
constitute a 'mini-meditation' - a
minute or two of simply witnessing
anything with detachment may bring a
pleasant calmness, but concentrating
on one's breathing seems to link mind
and body together for the mutual
benefit of both. A parallel would be
attending to your horse's condition as
you ride it, or looking at the gauges on
your car's instrument panel. This
brings your attention firmly into the
present, where things are generally
better than in the fantasy 'what-if'
world of the future or the troubled
memories of the past. Beyond these
psychological advantages, yoga
doctrine goes farther and postulates
that attending to one's breathing
improves absorption ofprana. Being
able to direct this life energy to
various locations in the body for
purposes of healing starts with
observing the breath.
Margabandhu, previously quoted,
emphasizes the value of observing
breathing in students, not only as an

J A N U A R Y 1999

Gilbert

indicator of comfort, but also of the

'fit' between the person and a
suggested movement. This is as
relevant for physiotherapy and for
movement therapy as for a yoga
lesson. If, when trying a new move or
posture, the breathing is irregular,
stopped, or primarily thoracic, the
movement is not being adopted well
and the individual is expressing
distress. He considers it a signal to
inquire, reconsider, go more slowly, or
change tactics.
What follows now are some
specific pranayama exercises, good
introductions to the area of breath
regulation the yoga way.

Breathing exercises
Complete three-part breath
This basic yoga procedure involves
enlargement of the natural breathing
form in order to temporarily maximize
oxygen intake and waste-gas
exhaustion. All parts of the lungs are
aerated. Yoga philosophy holds that
more life energy, prana, will be
absorbed this way, and the more prana
we store the better off we are. This
complete breath also exercises and
stretches the muscles of respiration
beyond the requirements of ordinary
breathing. Finally, it draws the
student's attention to the style and
location of breathing and sets the stage
for better self-regulation, or
'conscious living.'
The complete breath is more an
exercise than a model for how to
breathe all the time; it is considered
cleansing because of the thorough
aeration of every area of the lungs.
To do it, follow the directions in
Box 1.
This complete breath clears the
lungs of carbon dioxide ('dead air')
and takes in so much oxygen that three
or four breaths like this per minute are
sufficient for the body's needs (the
normal breathing rate is 12-16 per
minute). It may seem to resemble a

JOURNAL

Tiffs is basic yogic breathing, designed to use all areas of the lungs. Breathing should be
through the nose, with full attention on the process:
a In a sitting position with waist restrictions loosened, breathe down toward the hips so that
: iltheabdomen swells to the:front and sides
: bi :C0ntirme inhaling so that the fibs and chest expand for:the incoming air
I : d.: COntinue inlmiing: so that:the upper chest begins to fill. Lift the shoulders a little to expand
I: : :: :ihe Upper chest Still more, and pull the abdomen in to force air upward

I
[ : d~ WithtUi pads ing; release the a!rlin reverse orde!: lower the shoulders, relax the chest, and
[ : ::: relax the: abd0~en Try: to make the exhale las t twice as long as the inhale. Repeat 15-20

sigh or gasp, but there is a big

difference in that the abdomen is filled
first; very few people sigh this way.
The complete basic yoga breath
includes the chest but makes full use
of the abdomen. The natural elasticity
of the lungs plus the springiness of the
chest cavity will accomplish the
exhale with no effort at all.
A major use of this complete
breath is to make an individual aware
of the breathing space: how it feels to
breathe fully and consciously and
how it feels to breathe into the
abdomen. For many people this
simple exercise will represent the first
intrusion of their conscious minds
into the domain of autonomic control.
No other automatic body function can
so easily be modified by extending
the will.
This exercise can be done lying
down, prone or supine, or standing.
Experimenting with each of these
positions will enlarge one's
understanding of how breathing
occurs. Placing hands on the abdomen,
chest, or clavicle/neck junction will
increase awareness of one's breathing
style and potential for control.
Abdominal breathing can be
ascertained with a hand near the navel.
Chest breathing can be felt distinctly
in the middle back and the lower ribs.
During clavicular breathing the
trapezius can be felt contracting above
its attachment on the lateral part of the
clavicle.

OF BODYWORK AND MOVEMENT THERAPIES

Alternate nostril breathing

This procedure can be done with or
without background explanation. What
follows is the background; see Box 2
and Figure 3 for the procedure. The
philosophy behind it includes the goal
of raising kundalini, a kind of ultimate
energy believed to lie dormant at the
base of the spine. Breathing equally
through both nostrils is thought to
purify two channels which run on
either side of the spine parallel to the
sympathetic ganglionic chain.
This preparation encourages the
prana to rise instead through the
central canal in the spine and ascend
to the top of the head, followed by
ecstasy. To achieve this takes months
if not years, and requires in addition
other purification and balancing
techniques. Nutrition, proper living,
and practice of asanas are all part of
this preparation.

Background
In the healthy person there is actually
a dominant and a non-dominant
nostril; this designation shifts every
1-1.5 to 3 hours. The spongy nasal
tissue covering the turbinate bones
alternates between relative congestion
and constriction. This can be easily
ascertained by testing each nostril for
volume of air flow every few hours
during the course of a day.
When one nostril is more open or
dominant, the opposite hemisphere is

J A N U A R Y 1999

Yoga and breathing

a. In a sitting position hold One hand at the nose so that each nostril can be closed by pressing
on its side with the thumb or the ring finger. Fold the index and middle fingers down
b~ :Block the left nrstril and breathe in through the right=:nostril : ;:

. . . . . . .

c:! B:lrckthe:right nosttii: ~:exh~t~"ihrr~h ~ i e f t h~g~i' ::: : :i' ::: : : : : : ; : :: : ::::

'& Keep the fighi ~ostril:Ndcked' a~a :ih~aie:through:the left nosi~l =:: : :::;:::::

Fig. 3 Alternate-nostril breathing. The air

stream is directed alternately through the
each nostril by gently occluding the opposite
nostril. This is thought to harmonize the two
hemispheres of the brain, creating a balance
between sympathetic and parasympathetic
dominance.

slightly more active and the individual

has better access to the specialized
skills of that hemisphere. Yogis
devoted to studying and manipulating
the breath, called ' swara yogis', make
remarkably specific claims for the
value of observing, for instance, the
shape that the exhaled breath makes on
a mirror. Certain activities are thought
to be best performed when one nostril
or the other is dominant. For instance,
playing a musical instrument should be
done when the left nostril is more
open, and writing text when the right
nostril is more open.
The early yogis were astute in
observing a subtle difference in
functioning depending on which
nostril was more open. They
considered the left hemisphere more

: ::: ::::::::::

::
::

associated with increased general

arousal, active rather than passive
activities, speaking and writing, and
assertiveness; also the rational and
analytic faculties, with increased body
heat, and orientation toward the
external world. The fight hemisphere
was more associated with passivity,
relaxation, inner-world absorption,
feeling, creativity, non-verbal
imagery, and recovery or restoration
of energy. Relative dominance of
these two sets df properties is linked
with which nostril was dominant.

Research support
The odd thing about these claims is
that many are being confirmed by
modern research. Observations by
yogis predated by many centuries the
discovery that the two cerebral
hemispheres are specialized for
different types of tasks and for
different types of perception, and also
that there is a rhythmic alternation
between their dominance (Rossi 1991,
Shannahoff-Khalsa 1991). For
example, relative performance in
verbal (left hemisphere) and spatial
(right hemisphere) tasks has been
found to vary according to which of
the subject's nostrils is dominant
(Shannahoff-Khalsa et al. 1991, Jella
& Shannahoff-Khalsa 1993, Block et
al. 1989). EEG amplitudes from right
vs left hemispheres correlate with
which nostril is dominant (Klein et al.
1986), supporting the idea that
cerebral hemispheres are differentially
stimulated by whichever nostril is

more open. Heart rate and other

indicators of sympathetic nervous
system activity rise with right-nostril
breathing (Telles et al. 1994, 1996,
Shannahoff-Khalsa & Kennedy 1993),
as predicted. Emotional tone, or
affectivity, was found in one study
(Schiff & Rump 1995) to be more
negative with left-nostril breathing
(the right hemisphere is known from
other research to be more associated
with negativity, low mood, caution,
and pessimism). Subjects also scored
higher on ratings of anxiety when the
left nostril was dominant.
The neurological research to date is
basically consistent with yoga
doctrine. Sympathetic nervous system
dominance can be manipulated to
some degree; selectively boosting
verbal or non-verbal/spatial skills or
even altering emotional tone can be
done by switching the dominant
nostril. A few minutes of uni-nostril
breathing is sufficient to switch
dominance. One can also observe
which nostril is dominant and then
perform the tasks most suited to that
condition.
Under normal circumstances this
fine-grained self-observation mad
manipulation may not be worth the
trouble. Nostril dominance is a mild,
transient effect. But the fact that it has
been validated experimentally should
at least generate respect for the ancient
yogis who discovered these subtle
connections using no instruments
except their own senses. Cool air
coursing through a nostril apparently
affects the hemisphere directly above
it, suppressing its dominance and
allowing the opposite hemisphere to
prevail. This 'infradian' rhythm seems
to represent a process of internal
balancing, probably necessary for
normal functioning of the nervous
system.
There are basically two kinds of
exercises which yogis use to control
nostril air flow, both done by using the
fingers or thumb to occlude on nostril
at a time:

JOURNAL OF BODYWORK AND MOVEMENT THERAPIES JANUARY 1999

Gilbert

1. 'Alternate-nostril breathing': the

two nostrils alternate, breath by
breath, in an attempt to balance
nasal air flow and equalize
stimulation of each hemisphere.
2. 'Unilateral-nostril breathing': air
flow is directed through one nostril
only. This is done to activate the
opposite hemisphere, usually to
activate one or another of its
specialized functions.
As to recommending this to clients:
raising one's kundalini may sound
appealing but is not easy to achieve,
and in any case is not what the
average client comes to the average
clinician for. Moreover, fine
musicians maintain careers without
ever checking or manipulating their
nostril dominance before
performances. However, more
mundane benefits of alternate-nostril
breathing as an exercise are plentiful,
and focus around creating a state of
emotional balance and maintaining
equilibrium between excitation and
relaxation.

Balance
Another tenet of yoga philosophy
holds that balance is good, and
balance often means rhythmic
alternation rather than a static balance.
In this case of alternate-nostril
breathing the goal is to equalize the
dominance of both hemispheres. The
smooth coordination of both sides of
the brain sounds like a fine idea,
theoretically, yet the natural condition
is for dominance to alternate, so one
must ask: what are the consequences
of meddling with this rhythm by
trying to equalize the participation of
the two hemispheres?
According to yoga, balancing the
two hemispheres is desirable because
the intrinsic alternating rhythm is
disturbed in many people, and doing
this exercise restores a balance;
whether of the flow ofprana or
something else is still subject to
research. The nasal tissues are
susceptible to changes in congestion

due to many factors. Lying on one

side for 10 minutes will switch the
dominance, but the brain seems
equipped to handle this. The system is
robust and adaptable. In any case,
alternate nostril breathing is an easy
exercise to do, and is considered very
effective for creating calmness and a
feeling of emotional balance,
sharpening concentration, and
stabilizing the nervous system in
general. Gay Hendricks, in his book
Conscious breathing (1995), calls
alternate-nostril breathing the '5minute miracle.'

The pause
Prolonging exhalation and stopping
the breath at either end of the
breathing cycle are parts of yoga's
method to increase absorption and
control ofprana. There are many
breath retention techniques which are
useful in meditation. Mastery of
breathing reflexes is the goal; this is
thought to lead to control of other
reflexes and better control of the body
in general.
Physiologically, reducing breathing
leads to a build-up of carbon dioxide
in the bloodstream, increased acidity
in the blood and dilating cerebral
blood vessels. It is not clear why a
hypoxic, acidic condition should
enhance meditation. Advanced yogis
learn to reduce their breathing rate
considerably and to retain their breath
for long intervals, ostensibly to
conserve energy. Metabolism can be
lowered by breath-retention
manoeuvres and oxygenation
improves, which may compensate for
slowed respiration.
Brena (1972) has this to say:
In time, the ventilation rate becomes very
slow -- around 4 to 6 per minute in a
trained Yogi -- perfectly regular, with
frequent periods of prolonged expiratory
apnoea. This consciously induced expiratory
arrest is experienced as a feeling of extreme
peace in the mind and in the body, with no
air hunger whatsoever.

And elsewhere:

...the pulse can drop from the 70 beats per

minute ... down to 40 to 30 beats per minute
during the practice of Pranayama. The
physical sensation of the 'silence of the
heart' is wonderful in its relaxing
equivalence and cannot be described.

At the beginner level, simply

learning to let the exhale taper off to a
moment of stillness can be a
considerable challenge. Voluntary
control of the breath is quite
rudimentary in many individuals, who
can barely hold their breath for 10
seconds, breathe in and out on
command, or hold their breath after an
exhale. This deficit may be
comparable to not being able to
balance on one foot or touching finger
to nose without looking.
Both pausing before the inhale and
exhaling more slowly may be hard to
achieve for those who need it most.
Both strategies are beneficial.
Learning to prolong the exhale and
delay the next breath can be aided by
the following strategies:
a) pursing the lips to increase
resistance to the flow of air
b) breathing out through a drinking
straw
c) 'bending' a candle flame, trying to
make it flutter as long as possible
without extinguishing it.
Cappo and Holmes (1984)
conducted a representative study
which compared subjects breathing
with: a) short inhale, long exhale; b)
long inhale, short exhale; c) inhale and
exhale of equal duration. All subjects
were threatened with electric shock at
one point in the testing, and their
arousal was measured by change in
skin resistance and subjective report.
Only the first condition, prolonged
exhale, was consistently effective in
counteracting the arousal which
occurred in the other conditions. The
only difference was in the pattern of
breathing, used as a model coping
mechanism. This result is entirely
consistent with yoga teaching.
Introducing a short intentional
pause after the exhale, if it can be
achieved without distress, creates a

J O U R N A L OF B O D Y W O R K A N D M O V E M E N T T H E R A P I E S J A N U A R Y 1999

Yoga and breathing

moment in which the breathing
apparatus is motionless. This is the
'rest point' of the system, and it may
facilitate deep relaxation because, as
Van Lysebeth (1971) pointed out,
'Every other point in the breathing
cycle involves muscle tension; so
absolute relaxation can occur only
when the exhale is complete.' Cutting
short the end of the exhale means that
the exhale is incomplete and that the
breathing muscles never quite relax
between breaths. When the lungs do
not empty fully, dead air is retained
and takes up space that could be
occupied by fresh air. So the next
inhale is less complete than it would
otherwise be. Some people maintain a
state of hyperinflation in which the
external intercostals do not quite
relax before initiating the next breath.
This incomplete exhalation is often
correlated with hypertonic shoulder
and neck muscles.

Behavioural and emotional

correlates
A parallel between mental and
physical events is a basic tenet of
yoga, the general doctrine being that
thoughts and emotions can either
influence the body in a positive or
negative way, and the reverse is just as
true: the body state influences the
thoughts and emotions. So since slow
steady breathing is associated with
mental calmness, one can steady the
mind by steadying the breathing. This
is less commonly understood than the
idea that the breathing will become
steady when the mind becomes calm,
but it works both ways (Fig. 3).
In learning to create and appreciate
this pause, it helps to experiment with
it by varying it. One may discover
that there is a quality of thought
closely coupled to the end of a full
exhale; this mental state has
something to do with patience,
allowing an action to take its full
allotted time instead of rushing it.
This habit of rushing and cutting
things short can be very pervasive
(Box 4).

JOURNAL

.
.
' =:When paused
in your car to. let a pedestrian
cross the street:, do you wait the minimtlm

: amount: of time before driving through, or do you until the walker is on the curb before:

When a person is overstressed and

'internally accelerated' then the
breathing is bound to be also affected.
The acceleration may be manifested as
abrupt, jerky movements, pressured or
staccato speech, a darting glance, and
irregular breathing. Behaviour such as
this is not separate from muscle pain
or some other symptom; it is all
happening in the same organism!
People in a room together will affect
each other's feeling state; this has
been called 'emotional contagion.'
Body systems within an individual
influence each other in a similar way.
So introducing the concept of
'pause' is valuable because it goes
beyond breathing itself to a mental set
which maintains the urgency and
breathing 'short-cut.' The patient may
resent inquiry about this mental set;
you may feel uneasy addressing the
larger pattern of attitude and
behaviour related to the underlying
anxiety or urgency. In that case, it
may be easier to simply suggest a
breathing experiment -- reestablishing a natural pause at the end
of the exhale. If that is too difficult,

OF BODYWORK

AND MOVEMENT

THERAPIES

: :

suggest counting to five mentally on

the exhale. If the person has difficulty
allowing this pause or even waiting
for the exhale to naturally taper off,
this is all the more reason to persist.
The benefits of this procedure may be
felt within a minute.
Another way to convey this change
is to offer the idea: 'Let the body
breathe on its own.' When one
breathes with a patient attitude,
perhaps even savouring the breathing
process, there will generally be a
slight pause after which the inhale will
indeed seem to start on its own.
Allowing the body to choose when to
inhale permits fine-tuning of the
respiratory mechanism. When not
disrupted by emotional alarms, the
body will regulate the details of
respiration depending on energy
demand at the moment. When one
witnesses one's own breathing in this
way, there is a quieting of the entire
system. The slowing of the flow of
thoughts and allowing a thought to
finish before rushing to the next one is
a natural consequence of breathing in
this manner.

JANUARY

1999

Gilbert

releasing the muscles of exhalation

allows inhalation to occur naturally
because the exhale has gone past
the 'rest point' of the system (Box 5;
Fig. 5). The rest between 'rounds',
during which you should breathe
normally for 5-10 breaths at least, is
important; this allows the body to
correct for any hyperventilation with
its associated deficit in carbon
dioxide. Otherwise, light-headedness
and weakness may occur and cerebral
hypoxia may be mistaken for
enlightenment.

/k/k/kAJVVV
(a)

(b)
.

(c)

Treatment vs training

Fig. 4 Respiratory patterns, a) Relaxed

breathing, but no pause. Ratio 1: I. b)
Prolonged exhale. Ratio 1:2. This allows each
breath more time in the lungs, and helps
makes the mind still, c) Pause after each
exhale. Ratio 1:1:1. This is an alternative to
the prolonged exhale; the pause should be
gentle and passive, like a bit of goose down
floating and coming to rest.

'Skull shining'
The term Kapalabhati in Sanskrit
means approximately 'skull shining'
and refers to a popular breathing
exercise also sometimes called the
'breath of fire.' According to various
authors, 'skull' could refer to the nasal
passages, the face, or the brain. It is a
purification exercise intended to rid
the lungs of stale air; it aerates the
upper parts of the lungs in a way that
other breathing exercises do not. It is
also invigorating, clears the mind, and
improves concentration at least
temporarily. Correct movement of the
diaphragm is a prerequisite, so until
the abdomen expands easily during the
inhale, this exercise should be
postponed.
The main feature of this exercise is
a forceful exhale, through the nose, by
contracting the external abdominal
muscles. The goal is simply to empty
the lungs, fast. Abdominal flattening is
not enough; the muscle should be
pulled in at the end of the exhale as if
being punched by a fist. Immediately

JOURNAL

Individuals who consult 'practitioners'

for 'treatment' are used to looking for
instruction as to what to do for a given
symptom. Yoga practitioners
generally do not consider their goals
as specifically therapeutic; they do not
'treat' illness and dysfunction directly,
and so their literature is not organized
in the usual medical-model style in
which a certain procedure is indicated
by certain symptoms. Healing of
various kinds is seen as a natural
consequence of yoga discipline, and
training is a more appropriate term
than treatment - even though it may
not be entitled to health insurance
coverage.
There is much generalization of
effect with yoga exercises, in line with
the principle that different bodily
systems are interrelated to a large
degree. Yoga postures, or asanas,

have broad rather than isolated effects;

unlike a specific muscle exercise that
an exercise physiologist or
physiotherapist might use for a certain
result, yoga exercises are intended to
affect the endocrine, circulatory,
muscular, and nervous systems in a
broad way.
Brena (1972), an American
physician appreciative of yoga,
describes yoga's overall goals as
'cosmic rehabilitation.' A full yoga
program includes following careful
and wise rules of nutritional, mental,
and moral hygiene; the postures, or
asanas, prepare the body further for
operation with less waste and more
energy; finally, the breathing
techniques begin the process of
mastering the flow ofprana. In spite
of this imposing discipline, some of
the breathing techniques do offer rapid
relief from excess emotionality, poor
concentration, a scattered mind, and
other disturbances, and there is no
good reason why they cannot be used
piecemeal and on demand.

I I Restpoint
Fig. 5 'Skull-shining' exercise. The air is
forcefully exhaled past the rest point at which
the breathing muscles are in equilibrium. The
inhale is a passive rebound, and slower. This
exercise clears the lungs, and is energizing.

CAUTION: Do not do fight after meals, during pregnancy or menstruation, or if you have
lower-back disk problems.
:
a.: In a sitting position exhale :sharply through the nose by contracting, sucking inward the
abdominal muscles
b. : Relax immediately;allow the inhale to occur on its own. This will be slower than the
::: exhale. The time ratio should be approximately 1:4
:ci:::Repeat the forceful exhale and passive inhale. Do this 15-20 times followed by normal,
unregulated breathing for a minute
This constitutes orie 'round' - - w o r k up to three rounds. Stop if dizzy or light-headed

OF BODYWORK AND MOVEMENT THERAPIES

J A N U A R Y 1999

Yoga and breathing

Back pain
Yoga - based breathing can be
especially helpful in alleviating and
preventing low back pain related to
muscle imbalance and misuse. The
rationale is roughly as follows:
Full, rhythmic contraction of the
diaphragm during full breathing
offers an internal massaging action,
which stimulates blood flow and
affects all local muscles as well as
spinal nerves.
Lower back muscles tend to mirror
tension in the abdomen, causing
overall bracing of the trunk. The
external abdominal muscles must
relax in order to permit full
abdominal breathing.
Breathing in a relaxed manner
calms the mind and reduces the
anxiety associated with pain or
expectation of pain; therefore a
pain-anxiety-muscle spasm cycle
may be prevented.
Correct breathing is a part of every
asana, so the back muscles in general
should benefit from most yoga
exercises. Farhi (1996) discusses
applications to back pain in more
detail, and suggests in addition a quick
diagnostic technique: have the client
simulate a 'gasp of pain' as might
occur naturally and notice whether the
back discomfort gets worse. If so, then
the reaction to the pain is likely to be
bound up with creating and
maintaining the pain.

Yoga breathing and the heart

The heart and the lungs are close
together in both location and function.
In cases of heart transplant the donor' s
lungs are often transplanted as well,
since in many ways they operate as a
cardiorespiratory unit. The diaphragm
is attached by fascia to the heart
(pericardium) in such a way that
diaphragmatic movement provides a
massaging action to the heart. In
addition, the vena cava, which returns
blood to the heart from the lungs,

JOURNAL

passes through the diaphragm and is

alternately squeezed and released
during breathing. This action promotes
a periodic acceleration of blood flow
toward the heart. As Andrew Thomas
(1993) states: 'The fully and correctly
operating diaphragm is thus a second
heart.'
There is also evidence of
association between nondiaphragmatic breathing habits and
heart disease (Hymes & Nuernberger
1980) as well as evidence that training
heart attack survivors to breathe better
reduces their chance of another second
heart attack (Van Dixhoorn 1990). So,
particularly when working with
persons with cardiac problems,
emphasizing the value of
diaphragmatic breathing seems
medically justifiable.
Finally, acupuncture theory links
diaphragm movement with the heart
meridian. From this point of view too,
the heart receives rhythmic
stimulation of an energetic nature
from proper breathing. Because of this
link, one consequence of poor
breathing may be sensations which are
mistaken for symptoms of heart
trouble, but are actually due to
diaphragm dysfunction.

Circulation
Adequate circulation is essential for
maintaining health throughout all
systems. Circulatory functions include
oxygenation, removal of waste
products, and absorption of carbon
dioxide, which is the 'ash and smoke'
of the body. Hatha yoga practices
promote full circulation of oxygen via
the bloodstream, and claim to
maximize circulation ofprana as well.
This is the vital life force and
substance which permeates all cells,
and restricting its flow leads to
trouble. Prana is at present
unmeasurable by scientific
instruments; to this objection yogis
would reply that the human body is
the proper instrument for detecting it.
Prana as described sounds

OF B O D Y W O R K A N D M O V E M E N T T H E R A P I E S

suspiciously like oxygen, but yogi

adepts assert that they are not the
same, and denying the existence of
prana is like fish denying the
existence of water.
Whether we speak of circulation of
blood, oxygen, lymphatic fluid, or
prana, the goal is the same: to avoid
restricting movement of anything that
flows through the body. Shallow,
irregular breathing will lead to a kind
of stagnant physiological confusion as
natural cycles and rhythms are
disrupted.
Margabandhu, previously quoted,
emphasizes the value of observing
breathing in students, not only as an
indicator of comfort; but also of the
'fit' between the person and a
suggested movement. This is relevant
for any type of physiotherapy or
movement therapy, not only for a
yoga lesson: when trying a new
movement or posture, if the breathing
is choppy, irregular, or primarily
thoracic, the action is not being
adopted well and the individual is
expressing distress.

Conclusions
For individuals with chronic or
frequently-recurring problems, selfregulation is ultimately more useful
than 'going for treatment.' Many
disorders can be conceived in fact as
deficits of self-regulation: poor body
usage; bad habits; and inappropriate
responses to the challenges of living.
Anything the practitioner can do to
enlist the individual's own resources
has potential for long-term benefit.
Recommending yoga is within this
domain, as are exercise, dietary
changes, postural alterations,
ergonomic adjustments, etc. If the
client already has some experience
attending yoga classes, so much the
better. If not, the structure and
moderate cost provide an easy entry.
Barring that level of commitment,
instructing clients in a few breathing
exercises may bring substantial
results. Control of breathing by

J A N U A R Y 1999

Gilbert

methods perfected by yoga has so

many effects on so many systems,
including the emotional and cognitive
realms, that it comes close to a
behavioural 'magic pill.'

REFERENCES
Block RA, Arnott DP, Quigley B, Lynch WC
1989 Unilateral nostril breathing influences
lateralized cognitive performance. Brain and
Cognition 9(2): 181-190
Brena SF 1972 Yoga and medicine. Julian
Press, New York, p 91
Cappo BM, Holmes DS 1984 The utility of
prolonged respiratory exhalation for reducing
physiological and psychological arousal in
non-threatening and threatening situations.
Journal of Psychosomatic Research 28(4):
265-273
Farhi D 1996 The breathing book. Henry Holt,
New York
Hendricks G 1995 Conscious breathing. Bantam
Books, New York
Hymes A, Nuernberger P 1980 Breathing
patterns found in heart attack patients.

JOURNAL

Research Bulletin of the Himalayan

International Institute 2(2): 10-12
Jella SA, Shannahoff-Khalsa DS 1993 The
effects of unilateral forced nostril breathing
on cognitive performance. International
Journal of Neuroscience 73(1-2): 61-68
Klein R, Pilon D, Prosser S, Shannahoff-Khalsa
D 1986 Nasal airflow asymmetries and
human performance. Biological Psychology
23(2): 127-137
Lehrer P, Carr RE, Smetankine A e t al 1997
Respiratory sinus arrhythmia versus
neck/trapezius EMG and incentive
inspirometry biofeedback for asthma: a pilot
study. Applied Psychophysiology and
Biofeedback 22(2): 95-109
Margabardhu 1998 Personal communication
Rama S, Ballentine R, Hymes A 1979 Science
of breath. The Himalayan International
Institute, Honesdale, PA
Rossi E 1991 The twenty minute break: using
the new science of ultradian rhythms. Jeremy
Tarcher, Los Angeles
Schiff BB, Rump SA 1995 Asymmetrical
hemispheric activation and emotion: the
effects of unilateral forced nostril breathing.
Brain and Cognition, 29(3): 217-231
Shannahoff-Khalsa DS, Boyle MR, Buebel ME

OF BODYWORK

AND MOVEMENT

THERAPIES

1991 The effects of unilateral forced nostril

breathing on cognition. International Journal
of Neuroscience 57(3-4): 239-249
Shannahoff-Khalsa D 1991 Lateralized rhythms
of the central and autonomic nervous system.
International Journal of Psychopysiology
11(3): 222-251
Shannahoff-Khalsa DS, Kennedy B 1993 The
effects of unilateral forced nostril breathing
on the heart. International Journal of
Nemoscience 73(102): 47-60
Telles S, Nagarathna R, Nagendra HR 1994
Breathing through a particular nostril can
alter metabolism and autonomic activities.
Indian Journal of Physiology and
Pharmacology 38(2): 133-137
Telles S, Nagarathna R, Nagendra HR 1996
Physiological measures of right nostril
breathing. Journal of Alternative and
Complementary Medicine 2(4): 479-484
Thomas AP 1993 Yoga and cardiovascular
function. Journal of the International
Association of Yoga Therapists 4:39-4 1, p 40
Van Dixhoorn J 1990 Relaxation therapy in
cardiac rehabilitation. Den Haag: Doninklijke
Bibliotheek, Netherlands
Van Lysebeth A 1971 Yoga self-taught. Harper
and Row, New York, p 32

JANUARY

1999