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Respiration is primarily regulated for metabolic and homeostatic purposes in the brainstem.
However, breathing can also change in response to changes in emotions, such as sadness,
happiness, anxiety or fear. Final respiratory output is influenced by a complex interaction
between the brainstem and higher centres, including the limbic system and cortical structures.
Respiration is important in maintaining physiological homeostasis and co-exists with emotions.
In this review, we focus on the relationship between respiration and emotions by discussing
previous animal and human studies, including studies of olfactory function in relation to
respiration and the piriform–amygdala in relation to respiration. In particular, we discuss
oscillations of piriform–amygdala complex activity and respiratory rhythm.
(Received 22 February 2008; accepted after revision 16 May 2008; first published online 16 May 2008)
Corresponding author I. Homma: Department of Physiology, Showa University School of Medicine, Hatanodai 1-5-8,
Shinagawa-ku, Tokyo 142-8555, Japan. Email: ihomma@med.showa-u.ac.jp
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1012 I. Homma and Y. Masaoka Exp Physiol 93.9 pp 1011–1021
Emotional breathing in humans 2000), that is, matter of life or death. Anticipatory
anxiety, which has been defined as the time between
Emotional breathing and the amygdala. Emotions
the warning presentation and stimulation, increases the
involve physiological changes within the entire body.
respiratory rate; this change is not related to changes in
Animal and human studies have shown the autonomic
O 2 consumption, that is, changes in metabolic demand
and behavioural responses during fear and the anxiety
(Masaoka & Homma, 2001). Thus, respiratory changes in
state (Davis, 1992). In humans, the relationship between
response to anxiety are affected by higher centres related
emotions, increases of heart rate and blood pressure
to the emotion. Respiratory rate has also been positively
have been investigated (Hugdahl, 1995). Relationships
correlated with individual trait anxiety scores (Fig. 1;
between emotions and respiration have shown more
Masaoka & Homma, 2001).
rapid breathing during an arousal state (Nyklicek et al.
Functional neuroimaging studies have investigated the
1997; Boiten, 1998). Relationships between emotions and
neuroanatomical correlates of negative emotions of fear
respiratory reactions to natural noises or unpleasant
and anxiety (Adolph et al. 1994; Morris et al. 1998). These
sounds have been explored (Masaoka & Homma, 1997;
studies have revealed that the amygdala plays a crucial
Gomez & Danuser, 2004). Respiration also changes when
role for processing these negative emotions. In humans,
subjects look at photographs, which induces emotional
there are limitations to investigating the link between
changes. Respiration is one of the physiological processes
the amygdala, emotions and respiration. However, recent
altered by emotions (Boiten et al. 1994). In respiratory
technology has advanced the study of functional anatomy
patterns, respiratory rate is changed dramatically by
of the human brain using non-invasive methods of
emotional changes. It can also be emphasized that changes
functional brain mapping. Electroencephalogram (EEG)
of respiratory rate are related to individuality; Masaoka &
dipole tracing is one method of neuroimaging that can
Homma (1997) have shown the personality differences in
determine neural activation triggered by physiological
the patterns of breathing during mental stress and physical
activities (Homma et al. 1994, 2001). If the subjective
load. Levels of individual anxiety affect respiratory rate,
feeling of anxiety increases the respiratory rate, electrical
especially the expiratory time (Masaoka & Homma, 1999).
current sources synchronized with the onset of inspiration
It is fathomable that identical twins breathe in similar ways
during anxiety are present in the limbic areas. From 350
(Shea et al. 1989). Anxiety is regarded as a basic emotion
to 400 ms after the onset of inspiration, in the averaged
and is associated with defense mechanisms (Öhman,
EEG activities triggered at the onset of inspiration, a
positive wave is observed in the averaged potentials.
This positive wave is referred to as respiration-related
anxiety potentials (RAP; Fig. 2). A dipole tracing method
that incorporates a scalp–skull–brain head model has
estimated the source location of the RAP to be in the
right temporal pole, whereas it is in the right temporal
pole in subjects with low anxiety and left amygdala
in the most anxious subjects (Masaoka & Homma,
2000).
Recently, respiratory-related activities have been
estimated in the human brain using functional magnetic
resonance imaging (fMRI). Many studies have shown
activities in the limbic system. During the sensation of
air hunger (an uncomfortable urge to breathe) induced by
mechanical ventilation at a low tidal volume, the limbic
and paralimbic loci are activated in normal subjects (Evans
et al. 2002). Respiratory unpleasant sensation, usually
described as dyspnoea or breathlessness, depends on the
affective state of the subject. Respiratory sensation and
changes in respiratory pattern are involved or elicited by
anxiety and distress (Wilhelm et al. 2001).
Functional anatomical studies of disability of the
limbic system have been performed in patients with
Figure 1. Relationship between respiratory frequencies (f) and mediotemporal lobe epilepsy. Lesions of the amygdala
individual trait anxiety scores during anticipatory anxiety
All subjects were tested for anxiety levels by using Spielberger’s
impair recognition of a fearful face (Adolph et al. 1994).
State-Trait anxiety Inventory. A positive correlation between trait scores Masaoka et al. (2003) have shown that anxiety levels and
and increase in respiratory frequency (f) was observed. Reproduced respiratory rate during anticipatory anxiety are reduced
with permission from Masaoka & Homma (2001). after lesion of the left amygdala in patients who show
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Exp Physiol 93.9 pp 1011–1021 Breathing and emotion 1013
foci of epileptic spikes in the left amygdala. Electrical or vice versa. The centre for these two outputs may
stimulation applied to the amygdala produces emotional be in the limbic system, paticularly in the amygdala.
responses of fear (Halgren et al. 1978). A stimulation The respiratory-related anxiety potential recorded in
study has also been performed in mediotemporal lobe EEG activities may be produced in the amygdala or the
epileptic patients. Direct electrical stimulation of the left temporal pole. The temporal pole is included in paralimbic
amygdala, in a patient with deep electrodes installed to areas involved in evaluation of environmental uncertainty
evaluate the location of epileptic spikes, shows a decrease or danger (Reiman et al. 1989). If anxiety increases
in total respiratory time (Fig. 3). After the test, the subject respiratory rate, these areas may be activated before the
reported that during stimulation she had experienced the onset of inspiration. It is assumed that an increase in
feeling of losing the distinction between herself and an respiratory rate is caused by unconscious evaluation in
external object and had a fear of losing herself (Masaoka the amygdala and that these two activities occur in parallel.
& Homma, 2004). Stimulation of the amygdala produces a rapid increase in
Harper et al. (1984) reported in an animal study that respiratory rate followed by a feeling of fear and anxiety
electrical stimulation of the amygdala increases respiratory (Masaoka & Homma, 2004). A period of 350–400 ms of
rate. Electrical stimulation of the amygdala elicits specific RAR after the onset of inspiration may be required for the
signs of fear, which include various autonomic and conscious representation or labelling of the physiological
physiological responses. event. Unconscious activation of the amygdala and an
uncertain feeling before labelling may represent emotion,
Emotion of anxiety. The above studies lead to the and later an interpretation of the physiological event may
question of whether anxiety enhances respiratory rate represent feeling.
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1014 I. Homma and Y. Masaoka Exp Physiol 93.9 pp 1011–1021
Respiration and emotion: why are they related?. In extend from the cell body into the nasal mucosa. The
various perceptions of sensations that influence or axons carry impulses from activated olfactory receptors
produce emotion, the perception of odours is dependent to the olfactory bulb. The olfactory bulb sends signals
on respiration; our sense of smell is enhanced by inhalation to the prepiriform and piriform cortex, which include
or inspiration. Olfactory cells have cilia (dendrites) that the primary olfactory cortex, anterior olfactory nucleus,
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Exp Physiol 93.9 pp 1011–1021 Breathing and emotion 1015
Figure 5. Inspiration phase-locked α-band oscillation (I-α) and source generators of I-α estimated by a
dipole tracing method during unpleasant odour recognition
Dipoles were estimated in accordance with time after inspiration onset and were superimposed on a subject’s
coronal MRI sections (lower panel). RMS; mean absolute potentials recorded from 19 electrodes. Reproduced with
permission from Masaoka et al. (2005).
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1016 I. Homma and Y. Masaoka Exp Physiol 93.9 pp 1011–1021
waves can be observed, and the waves are phase-locked the evaluation in the olfactory limbic areas (Masaoka et al.
to inspiration (Masaoka et al. 2005). These waveforms, 2005).
referred to as inspiration phase-locked α-band oscillation
(I-α), are not observed during the expiratory phase or
during breathing of normal air. The EEG dipole tracing
Slow-wave oscillations and respiration
method has estimated the location of source generators of
I-α to the entorhinal cortex, amygdala, hippocampus and Slow-wave oscillations. Neurons and neuronal networks
orbitofrontal cortex (Fig. 5). At 300–400 ms, the dipole produce various rhythms in the brain, and activities
converges most in the orbitofrontal cortex. At this time, are synchronized and desynchronized with each other.
recognition and identification of the odour occurs after Synchronized neuronal rhythms are associated with
Figure 7. Optical recordings of spontaneous activity in the rostral cut surface of the limbic brainstem–
spinal cord preparation
A, left, optical image of the cut surface of the piriform–amygdala region at the time of burst initiation in the
piriform cortex (dark vertical bar in right panel). Abbreviations: BM, basomedial amygdaloid nucleus; Ce, central
amygdaloid nucleus; ec, external capsule; La/BL, lateral and basolateral amygdaloid nucleus; Pir, piriform cortex;
PRh, perirhinal cortex; and RF, rhinal fissure. Right, fluorescence changes at the two locations indicated in the left
panel: blue, dorsal part of the lateral amygdala; red, piriform cortex. Upward deflection (calibration arrow) denotes
a decrease of fluorescence intensity (i.e. depolarization) and corresponds to red in the pseudocolour calibration.
The fluorescence change is expressed as the ratio (per cent, fractional change) of fluorescence intensity to that of
the reference image. The C4 trace represents inspiratory activity of the C4 ventral root. Although this recording
appears to show occasional coactivation of C4 and piriform–amygdala activity, statistical analysis was required
to show significance. B, spatiotemporal pattern of the spontaneous burst activity. Numeric values at the bottom
left of each image denote time (in seconds) after burst initiation in the piriform cortex (time 0 in A). Propagated
activity terminated in the dorsal part of the lateral amygdala. Reproduced with permission from Onimaru & Homma
(2007).
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functions or behaviours, but a detailed characterization between the thalamus and the neocortex. Slow oscillation
of these associations except for breathing rhythm has remains after thalamectomy and therefore is produced in
yet to be reported. In the human brain, rhythmic the neocortex (Steriade et al. 1993). Slow depolarization
neuronal activity can be observed by EEG. Oscillations and hyperpolarization are alternately repeated in neuronal
appear as alterations in amplitude or frequency and are networks of the neocortex in the absence of sensory
synchronized broadly or locally and temporally. The origin afferents (Timofeev & Steriade, 1996). During deep sleep,
of EEG potential wave oscillations is generally believed the brain is isolated from environmental stimuli, and
to be in the thalamocortical networks, and oscillations sensory coding via the thalamus is absent (Averbeck &
can be classified into fast waves with frequencies >1.5 Hz Lee, 2004). Sanchez-Vives & McCormick (2000) showed
and slow waves with frequencies <1.5 Hz. Fast oscillations in neocortex slice experiments that a slow oscillation with a
show low amplitude and are observed during awake or frequency of 0.1–0.5 Hz arises in response to an excitatory
rapid eye movement (REM) sleep. Slow oscillations show interaction of pyramidal neurons which propagates to the
high amplitude during non-REM slow-wave sleep and neocortex. The functional significance of this oscillation
while under general anaesthesia (Steriade, 2000). During is unclear; it has generally been believed that this slow
deep sleep, inhibition of synaptic transmission arises oscillation is related to the process of attention or memory
in thalamocortical neurons, blocking communication (Engel et al. 2001; Ward, 2003). Slow oscillations during
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1018 I. Homma and Y. Masaoka Exp Physiol 93.9 pp 1011–1021
slow-wave sleep are thought to consolidate synapses olfactory bulb and piriform cortex, in ketamine–xylazine-
(Sejnowski & Destexhe, 2000; Steriade & Timofeev, 2003). anaesthetized rats and reported a strong relationship
The origins of slow oscillations in the neocortex between the occurrence and timing of slow oscillations
are of interest. Electroencephalography studies with and on-going sensory input resulting from respiration;
256 channels in humans have indicated that the they concluded that there is a strong relationship between
distribution of slow oscillation potentials on the scalp the timing of respiration and brain rhythm. The piriform
is not uniform and is localized exclusively in the cortex is part of the paleocortex, which is the primitive,
orbitofrontal area of the prefrontal cortex and conducted common cortex among species. Olfactory information is
to the anteroposterior area (Massimini et al. 2004). a major emotional input in animals. Primates engage in
Cerebral blood flow also decreases in this area during non- rapid sensing of environmental danger, identification of
REM sleep (Braun et al. 1997). food and recognition of sex differences; this is performed
via the olfactory system and enhances the immediacy of
Slow oscillation in the limbic system. Slow oscillations responses to impending events. Fontanini et al. (2003)
have been recorded in pyramidal cells in the neocortex suggested that the fundamental neuronal architecture of
in both in vitro and in vivo animal experiments; they the cerebral cortex was first evolved in the context of the
have also been recorded in the perirhinal cortex and olfactory system and was adapted for uses in other sensory
showed a good correlation with those recorded in the systems via evolutionary development of the neocortex.
lateral amygdala in ketamine–xylazine-anaesthetized cats Low-frequency oscillations have also been recorded in
(Collins et al. 2001). Lesion experiments have indicated the frontal cortex in slices of the neonatal immature rat
that the perirhinal cortex and the amygdala cortex are cortex (Peinado, 2000; Calderon et al. 2003). The evolution
associated with memory encoding (Buckley & Gaffan, in neonates of the piriform cortex to the frontal neocortex
1998). Slow oscillations with frequencies <1 Hz have been is unclear, but an early close relationship between olfaction
recorded in other neocortices as well (Lledo et al. 2005; and the forebrain has been demonstrated (Aboitiz
Buonviso et al. 2006). Fontanini et al. (2003) examined et al. 2003). Slow oscillations have been recorded in
slow oscillations in the olfactory system, paticularly in the the entorhinal and perirhinal cortices in newborn rats
(Garashuk et al. 2000). Oscillatory waves induced by
a calcium influx regulate long-distance wiring in the
immature cortex by promoting synchronized neuronal
development over large cortical areas (Garashuk et al.
2000). Recent in vivo experiments have shown slow
intervals of recurrent calcium transients in the temporal
and parietal cortices of newborn mice (Adelsberger et al.
2005).
Onimaru & Homma (2007) reported an origin of the
slow wave and its propagation in a limbic brainstem–
spinal cord preparation in newborn rats. This preparation
is an intermediate between an in vitro and in vivo
preparation. The brainstem–spinal cord preparation
was first developed by Suzue (1984) and is currently
used worldwide. The preparation allows simultaneous
recordings of spinal motor output and neural activities in
the brainstem. Unlike the slice preparation, the brainstem–
spinal cord preparation can identify neurons from the
motor output. Characteristics of various respiratory
neurons, in particular pre-inspiratory (pre-I) neurons in
the medulla, have been examined with this preparation
(Ballani et al. 1999). The primary area of respiratory
rhythm generation has also been shown optically with
the use of a voltage-dependent dye (Onimaru & Homma,
2003).
Activations of the limbic and paralimbic systems,
including the piriform cortex, amygdala and
Figure 9. Schematic representation of connections of
orbitofrontal cortex (OFC), amygdala (AMG), piriform cortex
hippocampus, can be detected at the rostral surface
(Pir), entohinal cortex (Ent) and hippocampus (HC) with of coronal sections of the limbic brainstem–spinal
respiratory rhythm cord preparation. This preparation is appropriate for
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Exp Physiol 93.9 pp 1011–1021 Breathing and emotion 1019
the examination of characteristics of limbic system connections between the entorhinal cortex and the
neurons (Fig. 6). Spontaneous rhythmic activity has been amygdala have been identified in animal experiments. This
reported in the piriform cortex and amygdala in the system may be involved not only in odour stimulation
limbic brainstem–spinal cord preparation. Optical signals but also in various emotional states (Fig. 9). Breathing
appear initially in the piriform cortex and propagate and emotion are linked with meditation, especially in East
mediolaterally to terminate in the lateral amygdala Asia (Fontanini & Bower, 2006). Breathing and emotion
(Onimaru & Homma, 2007). The piriform–limbic are also linked with culture. Homma et al. (2006) have
system rhythmic activity is associated with inspiratory shown in actors of Japanese traditional ‘Noh’ drama that
activity of the C4 ventral root (Fig. 7). Rhythmic activity the internal expression of the mind is generated in the
remains after complete separation of higher brain regions amygdala with breathing rhythm.
from the lower brainstem by sectioning at the level of
the pons, but rhythmic activity is independent of C4
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Citation: Sarkar AA. Functional correlation between breathing and emotional states. MOJ Anat Physiol. 2017;3(5):157‒158. DOI: 10.15406/mojap.2017.03.00108
How We Breathe Affects Our Thoughts and Emotions,
Northwestern Researchers Find
bigthink.com/philip-perry/how-we-breathe-effects-our-thoughts-and-feelings-northwestern-
neuroscientists-find
4. siječnja 2017.
Zelano and colleagues discovered that the rhythm in which we breathe directly affects
activity in our brain. Yet, there are a lot of factors involved such as how deep or shallow
our breathing is and whether we do so through our nose or mouth. Inhaling through the
nose stimulates the brain, it was found. Doing so through the mouth however causes
little stimulation.
In fact, there is an exact synchronicity between these two processes. The Northwestern
team delved further and found that three major areas of the brain are affected by
breathing: the hippocampus which is responsible for memory, the amygdala—our
emotional center, and the piriform cortex, which controls our olfactory system or our
sense of smell. These are all part of the limbic system which is responsible for our basic
emotions such as anger and fear, along with our instinctual drives such as hunger, the
sex drive, and caring for offspring. The limbic system is also responsible for our higher
emotions.
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Top articles1/5READ MORE
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The limbic system. By BruceBlaus. Blausen.com staff. "Blausen gallery 2014". Wikiversity
Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. (Own work) [CC BY 3.0], via
Wikimedia Commons
These neuroscientists also discovered that there are major changes in brain activity
when you inhale. Inhalation effects the amygdala, hippocampus, and piriform cortex.
Now, researchers moved into a second phase. Here, 70 participants between the ages of
18 and 30 were recruited. Each was asked to look at images of faces on a computer
screen that only lasted about a second, while hooked up to a machine that monitors
breathing.
Recruits were to determine whether the face expressed surprise or fear. The scientists
wanted to know if inhalation or exhalation through the nose versus the mouth changed
the participant’s recognition capability in any way. They discovered that when breathing
in through the nose, participants could recognize a scared face a fraction of a second
earlier.
In a third portion of the study, 42 recruits were shown objects on a computer screen and
were told to remember them. They were hooked up to a breath recorder at this time.
Later, participants were asked what they remembered. This was meant to gauge
memory, specifically how breathing affected the hippocampus. Those who breathed in
when they saw the objects tended to remember better than those who breathed out.
Also, inhalation through the nose made recall five percent more accurate.
So how can you use this knowledge to your advantage? Cognition may work better when
we inhale through our nose, especially when worried or scared. This can help us react
better to situations. Deep breathing exercises can also improve our memory and help us
to make better decisions where our emotions are a central part of evaluation. So should
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you stay with a partner whom you love, even though they don’t ever want to get married
and you do? Breathe in deeply through your nose while you think it over. It should help
you sort it out.
Jay Gottfried is a professor of neurology at Northwestern and the senior author of this
study. Gottfried said that these practices are already an essential part of focused
breathing and meditation. But now we come to understand why they work on a
biological level. “When you inhale, you are in a sense synchronizing brain oscillations
across the limbic network,” he said. Though these findings are exciting, this study utilized
a small participant pool. A much larger study must be conducted to find out the
intricacies of how breathing and brain activity are interrelated and how one effects the
other.
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How heart rate variability affects emotion regulation brain
networks
ncbi.nlm.nih.gov/pmc/articles/PMC5761738
PMCID: PMC5761738
NIHMSID: NIHMS931316
PMID: 29333483
and
The publisher's final edited version of this article is available at Curr Opin Behav Sci
See other articles in PMC that cite the published article.
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Individuals with high heart rate variability tend to have better emotional well-being than
those with low heart rate variability, but the mechanisms of this association are not yet
clear. In this paper, we propose the novel hypothesis that by inducing oscillatory activity
in the brain, high amplitude oscillations in heart rate enhance functional connectivity in
brain networks associated with emotion regulation. Recent studies using daily
biofeedback sessions to increase the amplitude of heart rate oscillations suggest that
high amplitude physiological oscillations have a causal impact on emotional well-being.
Because blood flow timing helps determine brain network structure and function, slow
oscillations in heart rate have the potential to strengthen brain network dynamics,
especially in medial prefrontal regulatory regions that are particularly sensitive to
physiological oscillations.
Having high heart rate variability (HRV) is associated with higher emotional well-being
[1–3], including being correlated with lower levels of worry and rumination [ 4], lower
anxiety [5], and generally more regulated emotional responding [ 6]. Thus, individuals
with higher HRV appear to be better at regulating their emotions. However, it is not clear
from these correlational studies if HRV is simply an output measure of regulatory brain
health, or whether it somehow increases prefrontal regulation effectiveness. In healthy
individuals, high HRV is not simply the result of random variability. Instead, much of the
variability is due to the heart responding to physiological oscillatory signals such as
breathing and blood pressure feedback, such that heart rate slows down and speeds up
in a rhythmic fashion at certain frequencies. In this paper, we review findings that
suggest that such oscillations in heart rate play a causal role in improving emotion
regulation processes. Furthermore, we propose that high amplitude oscillations in heart
rate modulate brain oscillatory activity, especially in brain regions associated with
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emotion regulation, and that daily episodes of synchronized activity within these
networks can lead to enhanced functional connectivity strength in these emotion
regulation networks even when HRV is not high.
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Emerging research indicates that emotion regulation and HRV are associated via the
common brain regions involved in both systems [7]. For instance, in a meta analysis, HRV
was significantly associated with regional cerebral blood flow in ventromedial prefrontal
cortex (including anterior cingulate regions) and the amygdala [7]. In both younger and
older adults scanned while at rest, higher HRV (measured used the root mean square
successive differences; RMSSD) was associated with higher medial prefrontal cortex and
amygdala functional connectivity [8; see also 9], a pattern associated with emotion
regulation [10]. In addition, among younger and older adults, greater structural thickness
in prefrontal regions was associated with greater HRV [11; see also 12; 13].
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High HRV could be associated with better emotion regulation simply because the same
brain regions are involved in regulation of both systems, allowing HRV to serve as an
indicator of the functioning of brain regulatory systems. However, recent findings [for
review see 14] suggest that HRV itself influences brain and emotional function. In these
studies, participants are taught to increase their HRV by breathing at around 10 s per
breath. This .1 Hz frequency is a “resonance” frequency at which paced breathing
induces oscillations in heart rate at an especially high amplitude [15]. shows an example
of heart rate at rest in a healthy individual (panel A) followed by heart rate during paced
breathing at their resonance pace (panel B). In resonance breathing HRV biofeedback
studies, participants get feedback on how successfully they are increasing heart rate
oscillations [15]. They typically engage in HRV biofeedback for at least 20 minutes a day
for several weeks. A recent meta-analysis of 24 studies revealed that HRV biofeedback
reduced self-reported stress and anxiety with a large effect size [16]. For instance, in one
study, basketball players scoring high on anxiety were randomly assigned to HRV-
biofeedback during resonance paced breathing, to an active control, or a no-contact
control condition [17]. Participants completed sessions 10 days in a row for 20 minutes
in each session and were tested before and after the 10-day intervention and again a
month later. The intervention reduced state anxiety, and increased performance on
standardized tests of basketball dribbling, passing and shooting. HRV biofeedback also
has other positive effects on emotions. Coronary artery disease patients randomly
assigned to HRV biofeedback during resonance breathing instead of a wait-list control
showed decreased expressive and suppressive hostility and these effects were
maintained a month after the 6-week intervention ended [18]. Likewise, veterans with
post-traumatic stress disorder randomly assigned to HRV-biofeedback during resonance
breathing showed reduced symptoms after 8 weeks of HRV-biofeedback whereas those
assigned to treatment as usual did not show significant reductions in symptoms [19]. In
addition, patients with post-stroke depression randomly assigned to treatment-as-usual
in addition to HRV biofeedback during resonance breathing showed greater reductions
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in some indices associated with depression than those not assigned to HRV biofeedback
[20]. Thus, in these studies, a series of HRV-biofeedback sessions using resonance paced
breathing enhanced emotional outcomes.
A. An example of heart rate variability during about a 2.5 minute time period during
quiet rest. B. The same person’s heart rate during resonance breathing during another
2.5 minute time period.
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The studies reviewed above using HRV biofeedback during paced breathing take
advantage of the fact that two physiological rhythms that have a strong influence over
the heart rate can be coordinated to induce high amplitude heart rate oscillations. The
first of these physiological rhythms is the baroreflex. The vascular branch of the
baroreflex has a lag time of approximately 10 seconds [21]. When vessels are stretching,
baroreceptors signal via the brainstem to the heart to slow down the pace of heartbeats.
There is a few-second delay in this feedback loop [between 4–6.5 s; 22] that creates
oscillations in heart rate that take twice as long as the delay (from 0.075–0.12 Hz,
depending on the individual) to complete a full oscillatory cycle [14; 22]. The second
major influence over HRV is breathing. As we breathe in, heart rate tends to increase and
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as we breathe out, heart rate tends to decrease [23], although with a phase delay [24].
We usually breathe at a faster frequency (between .15 and .4 Hz) than the baroreflex.
However, unlike the baroreflex, which has a fixed frequency, we can alter the pace of our
own breathing. When breathing is slowed down to the same frequency as the baroreflex
feedback loop, this creates resonance, a non-linear effect that is greater than an additive
effect of the two influences. Thus, at an individual’s resonance frequency, there is the
potential for high amplitude oscillations in heart rate.
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We propose that episodes of high amplitude oscillations in heart rate (like those
observed during meditative practice or HRV biofeedback) promote functional
connectivity between certain brain regions, in particular among brain regions involved in
emotion regulation. Why might this be the case?
First of all, brain activity is fueled by oxygen transported by blood, and so should be
affected by oscillations in blood flow. Indeed, heart rate contributes to blood-oxygen
level dependent (BOLD) fluctuations during functional magnetic resonance imaging
(fMRI) [31–33]. Strong phase coupling of heart rate interval and BOLD oscillations have
been observed in the mid cingulate and posterior cingulate regions at around the .1 Hz
frequency [34]. These hemodynamics are likely to impact neural activity. In particular,
oscillations in blood flow may lead to oscillations in the sensitivity of local cortical circuits
to sensory stimuli [35].
Different brain regions vary in how long it takes for blood to reach them, with distant
brain regions sometimes having similar vascular delays. Estimating vascular delay times
for each voxel in an fMRI image and then running independent component analyses
reveals components that resemble commonly identified resting state networks [36].
Resting state networks reflect brain regions that activate in correlated fashion at slow
frequencies [<.1 Hz; 37]. It is intriguing that just knowing the vascular delays of different
brain regions provides enough information to partially reconstruct resting state
networks [36]. Indeed, part of what may lead some brain regions to develop coordinated
network activity with each other may be their similar timing of blood delivery. Increasing
the amplitude of blood flow oscillations via resonance breathing increases the impact of
these coordinated vascular activities and thereby further stimulates networks that were
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shaped in part by blood flow patterns. Repeated brief episodes of coordinated activity
within a network can strengthen its internal pathways, promoting greater functional
connectivity during rest [e.g., 38; 39].
In addition to timing, regional differences in blood flow volume are also associated with
functional connectivity [40]. Brain regions with high resting cerebral blood flow also show
high functional connectivity with other brain regions, and the correlation between
functional connectivity strength and blood flow is higher for measures of long-range
than for short-range functional connectivity [40]. Brain regions showing strong cross-
subject correlations between functional connectivity strength and blood flow include
medial prefrontal cortex, anterior and posterior cingulate, and insula [40]. Thus, brain
regions associated with emotion regulation are among those that experience high
regional blood flow and serve as hub regions for brain functional connectivity. Thus,
oscillations in blood flow are especially likely to impact these brain regions.
Breathing also influences brain rhythms. Breathing volume and pace help determine
arterial CO2, which is a cerebral vasodilator and is expelled during breath exhalation.
Brain regions differ in the timing and strength of their responses to these CO2
fluctuations, likely related to their proximity to large vessels, with strong correlations
seen in insula and midline cingulate regions [41; 42]. Breathing causes respiration-
synched oscillations across much of the neocortex and gamma power waxes and wans
depending on the respiratory oscillation phase [43]. Breathing through one’s nose
synchronizes oscillations in olfactory cortex as well as the amygdala and hippocampus
[44]. In these limbic regions, nostril breathing entrains higher frequency oscillations in
the delta, theta and beta ranges to the respiratory phase [44]. Thus, the breathing
component of resonance breathing biofeedback practice should also contribute to
neural oscillatory activity, especially in the limbic regions during nostril breathing.
Heartbeats also cause EEG responses known as heartbeat-evoked potentials that are
particularly prominent in brain regions associated with interoceptive sensation and
emotion, including medial prefrontal cortex, cingulate cortex, insula, and amygdala [45;
46]. Thus, heartbeats should be especially likely to influence brain rhythms in these brain
regions. Consistent with this, BOLD activity in the ventromedial prefrontal cortex
covaries with heart rate more than does activity other brain regions [47], and as already
reviewed, in general, medial prefrontal/anterior cingulate regions show activity
associated with HRV [7].
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In the previous section, we laid out the case that resonance breathing is likely to lead to
oscillations in brain activity. Here we argue that, in addition to provoking oscillations at
the same frequency, resonance breathing should also modulate faster oscillatory
activity. The power density of EEG is inversely proportional to frequency, such that more
powerful and widespread slow oscillations can modulate weaker but faster local
oscillations [49; 50]. Slow oscillations are also critical for brain networks, because the
limited number and speed of neuronal connections connecting distant regions mean
that large-scale brain networks can only oscillate in tandem during slow oscillations [50].
The ability of lower frequency oscillations to modulate the phase of higher frequency
oscillations leads to a hierarchical structure for EEG. For instance, in awake macaque
monkeys, delta phase (1–4 Hz) modulates theta phase (4–10 Hz) and theta modulates
gamma phase (20–50 Hz) amplitude, with these oscillations controlling baseline
excitability and leading to phasic oscillations in responsiveness to stimuli [51]. Activity at
one frequency is especially likely to modulate activity at other frequencies that are
multiples of that frequency, a phenomenon known as harmonic frequency. Indeed, one
speculative proposal is that the heart rate is the basic frequency and scaling factor for
EEG frequency domains [52]. EEG is categorized into a set of different frequency bands
(delta, theta, alpha, beta, gamma). The center frequency of each of these frequency
bands (estimated at 2.5, 5, 10, 20 and 40 Hz, respectively) is twice as high than the
previous lower frequency [52]. If the harmonic sequence of EEG frequency bands is
extended down from delta to slower oscillations, the next lower one is 1.25 Hz, which, at
75 beats per minute, is close to the average resting heart rate [e.g., 53], suggesting that
heart rate may be a basic frequency that serves as a scaling factor (depending on
individual differences in average heart rate) for the EEG frequency domains [52].
Furthermore, if one continues going down to the subharmonic frequencies, one of the
frequencies overlaps with high frequency HRV range influenced by breathing and
another overlaps with the low frequency HRV range influenced by baroreflex feedback
[52]. Consistent with these harmonic relationships, during sleep high frequency HRV
shows synchronization with each of the different EEG frequency bands [54].
Furthermore, during wakefulness, the EEG spectral peak frequency is correlated with
heart rate and this correlation decreases as sleep depth increases [55].
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Go to:
Stimulation of the baroreflex with resonance paced breathing is also likely to modulate
brainstem arousal pathways. As already touched upon, as part of their feedback loop,
baroreceptors project to the nucleus of the solitary tract and stimulate both
sympathoinhibitory and a vagal cardioinhibitory pathways that decrease heart rate [59].
In addition to its effects on the heart, the baroreflex pathway also interacts
bidirectionally with brainstem and forebrain regions that regulate arousal [59]. Breathing
also stimulates brainstem arousal centers and breathing and blood pressure signals
interact in affecting sympathetic activity [e.g., 60]. Thus, resonance breathing should
modulate arousal. Most likely, these effects will involve oscillatory influences. Consistent
with this possibility, during slow breathing, muscle sympathetic nerve activity decreases
in a phasic fashion, reaching the same peak level as in control conditions but showing
phasic segments of suppression [61–63]. If inducing high amplitude oscillations in heart
rate phasically suppresses sympathetic action while stimulating parasympathetic action,
this could help explain the stress- and anxiety-reducing effects of resonance breathing
[16].
Go to:
Past research has focused on heart rate variability as a downstream measure, rather
than something that itself affects emotion regulation. For instance, the Neurovisceral
Integration Model proposed that the medial PFC along with a core set of neural
structures integrates information from different system to regulate the heart, and that
HRV provides an index of the effectiveness of this “core integration” system [7].
Furthermore, previous research has not distinguished whether it is random noise or
increases in the amplitude of oscillatory activity that is the key component of HRV that is
associated with better emotional outcomes. The findings we outlined in this paper
suggest that heart rate oscillations can enhance emotion by entraining brain rhythms in
ways that enhance regulatory brain networks.
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How resonance breathing could lead to improved emotional well-being by stimulating
functional connectivity of emotion regulation networks within the brain.
Highlights
Breathing at a 10-s (.1 Hz) rate typically increases amplitude of heart rate
oscillations.
Slow (~.1 Hz) oscillations can also modulate interactions among faster neural
frequencies.
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Work on this review was supported by NIH grant R01AG057184.
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Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As
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Mara Mather, University of Southern California.
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Julian Thayer, Ohio State University.
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61. Mozer M, Fadel P, Johnson C, Wallin B, Charkoudian N, Drobish J, … Wehrwein E.
Acute slow-paced breathing increases periods of sympathetic nervous system
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The breathing conundrum – interoceptive sensitivity and
anxiety
ncbi.nlm.nih.gov/pmc/articles/PMC3805119
PMCID: PMC3805119
NIHMSID: NIHMS517481
PMID: 23468141
, MD1,2
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The publisher's final edited version of this article is available at Depress Anxiety
See other articles in PMC that cite the published article.
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Cognitive and affective processing has been the central focus of brain-related functions
in psychology and psychiatry for many years. Much less attention has been paid to, what
could be considered the primary function of the brain, to regulate the function of the
body. Recent developments, which include the conceptualization of interoception as a
process consisting of integrating the information coming from the inside of the body in
the central nervous system (CNS) and the appreciation that complex emotional
processes are fundamentally affected by the processing and regulation of somatic
states, have profoundly changed the view of the function and dysfunction of the brain.
This review focuses on the relationship between breathing and anxiety. Several anxiety
disorders have been associated with altered breathing, perception of breathing and
response to manipulations of breathing. Both clinical and experimental research studies
are reviewed that relate breathing dysfunctions to anxiety. Altered breathing may be
useful as a physiological marker of anxiety as well as a treatment target using
interoceptive interventions.
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Anxiety is an emotional state associated with a (a) cognitive component of increased
attentional focus on threat to the integrity of the individual [1], (b) a complex
sympathetic arousal response [2], and (c) behaviors aimed to avoid stimuli or contexts
predictive of threat to the individual [3]. Breathing is one of the most fundamental
physiological functions of the human body. Moreover, it is an integral component of
interoceptive processing, i.e. the sensing of the physiological condition of the body [4],
the representation of this internal state [5] within the context of ongoing activities, and
the initiation of motivated action to homeostatically regulate the internal state [6].
Changes in breathing can be both the consequence of an increased level of anxiety (e.g.
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[7]) as well as the source of threat experienced by the individual, which, in turn, leads to
increased anxiety [8]. Thus, assessing breathing might be a useful physiological marker
of the level of anxiety but can also serve as an experimental tool to influence anxiety
levels. The elucidation of the physiological mechanisms and neural pathways regulating
breathing can help to better delineate how an emotional state emerges from the
interaction between the body and the brain.
We have recently refined [9] a previously proposed insular model of anxiety [10]. The aim
of this model is to integrate emerging neuroanatomy of interoception with a process
focused formulation of anxiety to provide a novel heuristic for the development of
assessments and interventions. In this model, we considered that anxiety is a result of an
increased anticipatory response to the potential of aversive consequences, which
manifests itself in enhanced anterior insular cortex processing. Specifically, when anxious
individuals receive body signals they cannot easily differentiate between those, which are
associated with potential aversive (or pleasant) consequences versus those, which are
part of constantly ongoing and fluctuating interceptive afferents. As a consequence,
these individuals imbue afferent interoceptive stimuli with motivational significance, i.e.
an increased tendency to plan and act upon the reception of this input. Specifically, an
internal body signal, e.g. an inspiratory breathing sensation, is associated with negative
valence and linked to belief-based processes, e.g. “I am not getting enough air”, which
results in an increased “fight/flight” response and potential withdrawal or avoidance
behaviors. As a consequence of this noisy amplification, top-down modulatory brain
areas such as the anterior cingulate, dorsolateral prefrontal cortex, and orbitofrontal
cortex are engaged constantly to differentially amplify or attenuate signals that are
predictive or not predictive of future states, respectively. This relative “overactivity” of
cognitive control related brain areas is subjectively experienced as increased production
of thoughts and associated beliefs, which provide prediction-enhancing propositions.
Practically, these cognitive processes result in “worrying”, which is aimed at providing
increased prediction accuracy. This model relies on the notion of “accurate” processing of
interoceptive afferents in general and breathing in particular. However, it is unclear at
what level inaccurate processing of interoceptive afferents occurs in anxious individuals.
This review aims to delineate the current status of knowledge about the physiological
and neural pathways of breathing perception to provide a background and potential
targets of research as well as opportunities to modulate breathing in order to decrease
anxiety
Previous investigations have shown that individuals with anxiety disorders show altered
breathing characteristics [11; 12] or altered responses to manipulating breathing [13].
The focus of this review is to provide insights into the physiology of breathing, its
underlying neural circuitry, challenge paradigms, and its relation to emotional
processing. In particular, the focus is on changes in breathing load, i.e. the degree to
which individuals experience breathing resistance during inspiration. Other studies,
which will not be reviewed here, have focused primarily on the regulation of carbon
dioxide and its contribution to anxiety (e.g. see [14; 15]). The goal is to provide clinicians
and researchers with information that can be useful to better understand why breathing
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is so closely linked to anxiety or to consider modulation of breathing as a mode of
treatment and to develop a program of research aimed at better understanding the
pathophysiology that relates breathing changes to anxiety.
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The sensation of breathing and its impairment is a complex process that is modulated by
both peripheral and central nervous factors. From a peripheral perspective there are at
least seven sensory airway receptors, which have been characterized electrophysiological
[16] that contribute to the sensation and regulation of breathing. Among these are
slowly and rapidly adapting receptors, bronchial and pulmonary C-fiber receptors, high
threshold Aδ-receptors, cough receptors and neuroepithelial bodies. This diversity of
afferents gives rise to a complex representation of breathing in the brain. Thus, emotions
such as anxiety can profoundly influence the subjective experience by amplifying
particular afferent sensory components of breathing. On a subjective level, individuals
are able to separately assess work of breathing, the degree of breathing coordination,
the sense of suffocation, and the sense of struggling for air. Evidence from statistical
analyses support the idea that these subjective experiences can be subsumed into two
super-ordinated clusters, which have been termed perceived breathing effort and air
hunger, both of which contribute to the overall sensation of dyspnea [17]. Thus, even on
a basic neurophysiological level breathing is a complex sensation that emerges from the
interplay of multiple sensory afferents. The relationship between levels of anxiety and
experienced breathing effort or air hunger may be bi-directional. First, genetic or
molecular heterogeneity in the afferent breathing pathway may give rise to differential
amplification of perceived breathing effort or air hunger, which become associated with
increased levels of anxiety. Second, anxiety levels may act to amplify breathing afferents
thereby generating a subjective experience of increased breathing effort or air hunger.
In an important review of the neural systems underlying breathing, Davenport [ 18] has
argued that there are two primary cortical pathways, which he has termed the
discriminative pathway, which is related to respiratory proprioception, and the affective
pathway related to the qualitative assessment of breathing. Whereas the former
processes the awareness of the spatial, temporal, and intensity of the breathing
sensation, the latter is concerned about the evaluative or emotive aspects of breathing.
Not surprising, the discriminative pathway includes the somatosensory cortex,
associated thalamic nuclei, and higher order association areas. In comparison, the
affective pathway involves the limbic circuitry including the amygdala and the insular
cortex as well as thalamic relay nuclei. This circuit contributes to the perception of effort
of breathing, interoceptive perception of ventilatory status [18], and is thought to be
altered in individuals with high trait anxiety [19; 20] or panic disorder [21]. Finally, this
affective dimension of the perception of breathing is particularly vulnerable to emotional
influences, irrespective of objective lung function [22]. However, it is unclear whether
anxiety in general and pathological anxiety states in particular selectively affects the
discriminative or evaluative pathway or whether modulation of these breathing-specific
pathways can alter levels of anxiety.
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Until recently, investigations of the neural basis of breathing have relied mostly on
electroencephalogram (EEG) methodology. The ability of humans to program and control
breathing related movements in the EEG is accompanied by a low-amplitude negativity
starting approximately 2.5 s before inspiration that is best known as a
Bereitschaftspotential (BP). The presence of this BP is considered to be a regulatory
marker that is modulated by different inspiratory breathing resistance and is thought to
be generated as part of the cortical involvement during ventilatory behavior [23].
Another approach to examine the contributions of the different brain areas on breathing
and disruption of breathing is to examine the electrophysiological signature associated
with breathing efforts. Respiratory-related evoked potentials (RREP) can be elicited by
inspiratory occlusions and have a number of component waves, which can be modulated
by voluntary attention, changes in resistance to inspiration and pulmonary disease state
[24]. In particular, respiratory sensory gating has been demonstrated with the RREP
using different levels of intensities and frequencies of respiratory stimuli [24]. Finally,
modulation of these peaks using various experimental approaches can be mapped to
differences in respiratory perceptions [25]. Taken together, the electrophysiological
studies show that the sensation and regulation of breathing occurs on different levels
and can be mapped onto specific ERP signatures.
Consistent with the notion that anxiety plays an important role in the perception of
breathing, von Leupoldt and colleagues [8] found that whereas low anxious individuals
showed the expected pattern of reduced magnitudes of later RREP components P2 and
P3 during the unpleasant compared to the neutral affective context higher anxious
individuals showed greater magnitudes of P2 and P3 during the unpleasant compared to
the neutral affective context. In comparison, earlier components of the RREP (Nf, P1, N1)
were not affected by anxiety. During an anticipatory anxiety situation, high trait anxiety
relative to low trait anxiety individuals showed an increase in flow of breathing and a
decreased expiration time [26] but greater tidal volume increases [27]. Similarly,
anticipatory threat cues can elicited significant startle potentiation, enhanced skin
conductance, heightened corrugator EMG changes, and pronounced “fear bradycardia”
consistent with defensive activation in the context of threatened respiratory dysfunction,
which are enhanced in high trait anxious individuals [28]. Others have reported an
altered temporal pattern of breathing consisting of an increased variability and
unpredictability in panic disorder patients [21], which was significantly attenuated after
treatment with a serotonin-specific reuptake inhibitor [29]. This underlying respiratory
vulnerability in PD seems to constitute a subtle, unstable trait, which may be subject to
significant environmental modulation [30]. There also appears to be a relationship
between breathing patterns as indexed by breath holding duration and level of
avoidance symptoms in patients with Post-Traumatic Stress Disorder. Specifically, lower
breath-holding duration was associated with greater PTSD Avoidance symptom severity
[31]. Finally, subjects a specific phobia of fear of flying were more accurate in detecting
the loads, thereby indicating higher interoceptive awareness [32]. Together, these
findings support the idea that EEG-derived measures of breathing and breathing
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manipulations may be useful to characterize individuals with anxiety disorders. However,
little is known whether these can serve as a physiological marker of fluctuations of
severity of predictors of outcomes to interventions.
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Manipulating breathing opens the possibility for both assessing the significance of
specific physiological pathways in anxiety and as a technique to intervene in order to
lower anxiety levels. Resistive load, i.e. restricted inspiration, was first introduced by
Lopata [33] and Gottfried [34], is an airflow-dependent load [35] and a simple but
powerful experimental approach to induce an altered interoceptive state. In contrast to
expiratory breathing load which affects C0 2 [33], inspiratory breathing load results in
stable, unchanged carbon dioxide levels [36]. Inspiratory breathing loads can be used to
examine experienced breathing effort and generate respiratory-related evoked
potentials with several peaks that indicate the transition from an early sensory
component to a later cognitive aspect [37-40]. Moreover, resistive loads generate pre-
motor potentials that reflect the involvement of higher cortical motor areas [41], they
decrease systolic blood pressure [42], they differ for males and females [ 43], they are
perceived less intense in older individuals [44], they generate load-dependent increases
of unpleasantness [45], and the subjective effects can be modified by attentional
distractions [46]. Thus, inspiratory breathing load provides a powerful experimental
approach to examine the relationship between breathing as a form of interoceptive
processing and anxiety.
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Go to:
The physiology and neurobiology of breathing is a rapidly progressing field that provides
an experimental scaffold to study the biological basis of how the body and the brain
interact. More importantly, the experimental tools available enable one to begin to
delineate how specific emotions emerge as a consequence of the body brain interaction.
There are some intriguing initial findings of altered breathing perception, different
breathing patterns, and changes in the neural signature related to breathing in
individuals with high anxiety or anxiety disorders. However, much work needs to be done
to better delineate the direction of the relationship between breathing and anxiety as
well as to evaluate how brain systems respond to the modulation of breathing as a
powerful intervention to attenuate levels of anxiety. A deeper understanding of anxiety
and associated disorder can emerge from investigating the molecular characteristics of
peripheral lung receptors to the influence of controlled breathing during mindfulness.
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14. Griez E. Experimental models of anxiety. Problems and perspectives. Acta Psychiatr
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The Effect of Diaphragmatic Breathing on Attention,
Negative Affect and Stress in Healthy Adults
ncbi.nlm.nih.gov/pmc/articles/PMC5455070
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Breathing practice, also known as “diaphragmatic breathing” or “deep breathing,” is
defined as an efficient integrative body–mind training for dealing with stress and
psychosomatic conditions. Diaphragmatic breathing involves contraction of the
diaphragm, expansion of the belly, and deepening of inhalation and exhalation, which
consequently decreases the respiration frequency and maximizes the amount of blood
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gases. Benefits of diaphragmatic breathing have been investigated in association with
meditation and ancient eastern religions (such as Buddhism) and martial arts (Lehrer et
al., 2010). It is considered to be a core component of yoga and Tai Chi Chuan (TCC) and
contributes to emotional balance and social adaptation (Sargunaraj et al., 1996;
Beauchaine, 2001; Porges, 2001), as well as special rhythmic movements and positions.
The shared physiological basis of attention and breathing can be detected in part in the
autonomic nervous system of patients with ADHD (Beauchaine, 2001), but more
evidence is provided by electroencephalographic (EEG) studies and functional magnetic
resonance imaging (fMRI) studies (Lutz et al., 2004). For instance, EEG studies have
suggested that regular breathing practice during yoga and meditation can increase β-
activity in the left frontal, midline, and occipital brain regions (Bhatia et al., 2003; Snayder
et al., 2006), which has been associated with enhanced cognitive performance, such as
during attention, memory, and executive functions (Freeman et al., 1999). In addition,
fMRI studies have also detected a significant increase in activation in the bilateral inferior
frontal and temporal regions under meditation, as compared to a relaxation condition.
Such studies implicated the right inferior frontal cortex/right insula and right
middle/superior temporal cortex as the regions involved in meditation (Hernández et al.,
2015).
Although breathing practice offers an integrated benefit for mental and physical health,
the results of studies on this topic are inconsistent, because of methodological
limitations in the experimental design, a lack of measurable breathing feedback, and
limited sample sizes. Most cross-sectional and longitudinal studies have focused on how
breathing treatment benefits individuals with particular conditions, such as women
during pregnancy (Schmidt et al., 2000; Booth et al., 2014) and clerks experiencing job
burnout (Salyers et al., 2011), rather than on its health promotion function in a healthy
population. Most importantly, most studies have investigated physiological effects,
emotional benefits, and cognitive benefits separately, which prevents an understanding
of the possible mental and physiological mechanisms of breathing in terms of its
potential benefit for both mental and physical health.
The present study was a pilot RCT with visible feedback breathing recordings used to
monitor the breathing performance overall and to evaluate the outcomes of breathing
practice. The aims of this study were to investigate the mental benefits and the hormone
levels in healthy volunteers who completed an 8-weeks breathing training scheme. An
emotional self-reporting scale and cognitive tests were used to measure mental benefits.
Additionally, cortisol a major HPA-axis-related stress hormone in humans (Matousek et
al., 2010), was also measured to examine whether the breathing practice could be a
buffer for modulating stress levels in the working population. We hypothesized that an 8-
weeks breathing training course would significantly improve cognitive performance, and
reduce negative affect (NA) and physiological stress.
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Participants
Participants were recruited from a local IT company in Beijing, China. The Institute
Review Board of Beijing Normal University approved this study. This study was
performed in accordance with the ethical standards laid down in the 1964 Declaration of
Helsinki and its later amendments. The procedure of the study was fully explained to the
participants, and informed written consent was obtained from each participant before
the study.
All participants completed the following screening forms: (1) a health approval from a
recent physical check-up at a medical center and (2) a demographic questionnaire that
included basic demographic information and mind–body training experience.
Participants who had a history of physical health problems, such as cardiovascular or
cerebrovascular diseases, respiratory diseases, autoimmune diseases, diabetes,
neuropathy, and drug or alcohol abuse, were excluded from the study. In addition,
participants who had yoga, TCC, or Qigong experience, as well as other mind–body
training, were excluded.
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Experimental Protocol
All interventions and tests were performed in a sunny, soundproof, open-air conference
room at the IT company rather than in our laboratory. We reasoned that this would
avoid any potential anxiety that could be brought on by rushing from the workplace to
the laboratory. Participants sat comfortably in leather armchairs throughout the study.
A final total of 40 participants were included in this study. They were assigned to a
breathing intervention group (BIG, 10 females and 10 males) or a control group (CG, 10
females and 10 males) by alternating the order of their registration. Gender balance was
also taken into consideration during this sampling procedure.
The BIG learnt basic knowledge and essential skills about diaphragmatic breathing, and
became familiar with experiencing breathing in as deeply as possible and then exhaling
almost all the air from the lungs, slowly, in a self-controlled, slow rhythm, under the
guide of a coach. All participants were instructed to focus on their breathing and the
sensations produced in the body, while sitting comfortably in chairs with their eyes
closed. Participants were considered as performing diaphragmatic breathing if their
respiratory rate decreased while their respiratory amplitude increased in waveform.
After this learning phase, both groups completed the baseline tests. These included the
Positive and Negative Affect Schedule (PANAS), the Number Cancellation Test (NCT), and
a cortisol test. Thereafter, the BIG received 20-sessions of breath-controlling
intervention. Each intervention involved a 15-min resting breathing session and a 15-min
diaphragmatic breathing session consequently. The diaphragmatic breathing session
began with general verbal guidance from the breathing coach, who spoke at a slow
speed to help participants to become more easily involved. A final test, similar to the
baseline test, was implemented at the end of the 20th intervention. In contrast, the CG
received only an introduction of breathing and rest, a baseline test, and a final test,
without any other intervention.
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breathing from 20 participants were collected on the first day of training and on the last
day of training. Before and after the entire training, the two groups completed the
PANAS, NCT, and cortisol level test (Figure ).
Breath Recording
Synchronous breathing signals were recorded using breathing monitors (Dongtuo
Science and Technology Ltd., Beijing, China) that recorded participants’ respiration with a
high temporal resolution. All data were collected by inductive sensors (JD/PW-5; Boda
Electron Co., Beijing, China), which were kept against the chest of each participant during
the rest condition, or alternatively against the abdomen during diaphragmatic breathing.
Data were transferred to the host computer (Lenovo, M4600 P3.0HT 25640VN) via
Bluetooth and expressed on-screen as continuous visual waveforms. The height of the
wave crest represented the amplitude of a single breath, while the wavelength indicated
the duration. Each computer was connected to two inductive sensors; 10 recordings
were made simultaneously.
All five research assistants were postgraduate students in psychology. They attended a
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meeting in which training was given and breath recording was practiced for
approximately 1 week prior to the formal experiment, in order to standardize the data
collection procedure. Each of them monitored breathing processes for two participants
concurrently and ensured that data input and output proceeded smoothly.
Throughout the breathing process, all participants kept their eyes closed and breathed
through the nose. The assistants supervised their recordings and obtained the help of
the coach if the recording vibrated or if the breathing frequency remained higher than 6
breaths/min by 2 min after the intervention began. The coach offered special guidance to
help these participants attain diaphragmatic breathing.
Psychological Measurements
All participants were asked to complete behavioral measurements before training and
after training. The behavioral measurements included the PANAS and the NCT. The
PANAS (Watson et al., 1988) is a 5-point Likert scale that measures participants’ feelings
during the past week. It includes 20 self-reported items that are equally divided into a
positive affect (PA) subscale and a NA subscale. Items are scored on a scale of 1–5,
indicating very slightly or not at all, a little, moderately, quite a bit, and very much,
respectively. The PANAS scale is highly internally consistent, largely uncorrelated, stable,
and reliable across cultures, and can distinctively estimate PA and NA at the same time
(Thompson, 2007).
The NCT includes one short practice sheet and four test sheets for evaluate attention
sustainability, which is reflected by the scores generated according to the accuracy in the
test. Each sheet contains 200 single digits with special symbols below or above them. The
targets are “9” digits with two symbols below, above, or on either side. Participants were
asked to cross out targets with a slash and ignore targets placed subsequent to a “5” as
quickly as possible, within 1 min for each sheet. Participants had a 10- to 20-s interval
break between two sheets. The final scores were yielded by the sum of the correct
number of target digits for each sheet.
Neuroendocrine Test
Salivary cortisol was collected four times with the Salivette ® Cortisol (Art. No. 51.1534)
(Sarstedt AG and Co., Nümbrecht, Germany) at two time points: before and after
diaphragmatic breathing at baseline, and before and after the diaphragmatic breathing
at the final test. All salivary cortisol samples were processed according to the
manufacturer’s instructions. Before collection, all participants were required to take a 5-
min break. Each participant was asked to refrain from eating or drinking (except water)
within 20 min before saliva collection. In both the BIG and CG, the saliva sample was
collected between 11:00 and 12:00 to control for the variation in cortisol levels over the
circadian rhythm.
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Demographic Characteristics
Demographic characteristics of all the participants in each group are summarized in
Table . The paired t-tests showed that there were no between-group differences in
terms of age [t(38) = 1.31; p = 0.56, Cohen’s d = 0.420], years of education [ t(38) = 1.47; p
= 0.56, Cohen’s d = 0.465], or work experience [ t(38) = 1.05; p = 0.22, Cohen’s d = 0.331].
These results indicate that the BIG and CG were well balanced in age, years of education,
and work experience.
Table 1
Demographic characteristics in the breathing intervention group (BIG) and control group
(CG).
Respiratory Rate
Descriptive statistics showed the average respiratory rate to be 4 times/min in the
diaphragmatic breathing condition (M ± SD = 3.45 ± 1.86) and 17 times/min in the resting
breathing condition (M ± SD = 17.51 ± 5.02) (Table ).
Table 2
Respiratory rate in resting breathing and diaphragmatic breathing.
Session
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Resting breathing ( n = 19) Diaphragmatic breathing ( n = 19)
Session
A 2 × 2 mixed repeated measures analysis was conducted to analyze the change in the
respiratory rate between the resting and diaphragmatic breathing conditions across time
points and groups (see Figure ). The within-group factor was the intervention session
(baseline test and final line test), while the between factor was group (BIG vs. CG). The
reduction of breathing frequency between diaphragmatic and resting conditions was
employed as the measure. This analysis revealed a significant main effect of condition,
F(1,36) = 23.36, p = 0.000, η2p = 0.39, and an interaction between condition and groups,
F(1,36) = 7.66, p = 0.009, η2p = 0.175. A simple effect measurement was conducted and
revealed that there was no significant between-group difference during resting
breathing, MD = 0.43, p = 0.861, but diaphragmatic breathing frequency was significant
lower than that during resting breathing, MD = 7.12, p = 0.000. The respiration frequency
in diaphragmatic breathing was significantly less than that in resting breathing in the
BIG, MD = 9.19, p = 0.000, but no similar result was detected in the CG, MD = 2.50, p =
0.153. These results indicated that the diaphragmatic breathing intervention was
effective in both the BIG and the CG, but a significant breathing frequency decrease was
only observed in the BIG.
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Respiratory frequency changes in breathing intervention group (BIG) under different
breathing conditions. Diaphragmatic breathing frequency was significantly lower than
that in the resting breathing condition in BIG.
Negative affect (NA) score changes after intervention. Negative affect scores are
significantly decreased in the breathing intervention group (BIG) compared to the control
group (CG).
Sustained Attention
A 2 × 2 mixed repeated measures analysis was conducted to analyze the change in the
NCT score across the intervention (see Figure ). We measured between-group
differences (BIG vs. CG) in the NCT score change at the baseline and final tests. The NCT
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result revealed a significant interaction between time and group, F(1,37) = 9.68, p = 0.004,
η2p = 0.21. A simple effect measurement was conducted and revealed that the BIG
showed a significant increase in the NCT score after the intervention, MD = 6.728, p =
0.000), and similar results were detected in the CG, MD = 4.19, p = 0.000. The main effect
of time was significant, F(1,37) = 191.48, p = 0.00, η2p = 0.84, so was the main effect of
group, F(1,37) = 0.01, p = 0.93, η2p = 0.00.
Number cancellation test (NCT) score changes after intervention. The BIG showed higher
scores in sustained attention than did the CG after training, while there was no
significant difference between these two groups after training.
Salivary Cortisol
A 2 × 4 mixed repeated measures analysis was conducted to analyze the change in
salivary cortisol concentration across the intervention (see Figure ). The between-group
factor was group (BIG vs. CG), while the within-group factor was test time (test 1, test 2,
test 3, and test 4). The salivary cortisol samples were collected before and after
diaphragmatic breathing for both baseline and final tests. The concentration result
revealed a significant interaction of time and group, F(3,111) = 9.06, p = 0.000, η2p = 0.20.
A simple effect measurement revealed that the BIG showed a significant decrease in
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salivary cortisol concentration after the intervention, whereby the concentration was
significantly lower in test 3 and test 4 as compared to test 1 and test 2, MD 1-3 = 1.32, p =
0.003, MD 1-4 = 1.39, p = 0.002, MD 2,3 = 1.59, p = 0.00, MD 1-3 = 1.66, p = 0.00. However, no
similar result was found in the CG, p > 0.05. The main effect of time was significant,
F(1,37) = 4.17, p = 0.008, η2p = 0.10, but there was no significant main effect of group,
F(1,37) = 0.01, p = 0.92, η2p = 0.00.
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Using a randomized controlled design, the present study examined whether 8 weeks of
intensive diaphragmatic breathing training, a core component of mind–body practices,
could influence cognition, emotion, and physiological responses. As expected, the
lowered frequency of respiration after the intervention suggested that the diaphragmatic
breathing intervention had been inculcated. The NA score decreased after the
intervention, but the PA did not change. Sustained attention scores increased after the
intervention. Moreover, a significant time effect of diaphragmatic breathing on cortisol
levels was observed (before training vs. after training tests), although no group
differentially influence cortisol. We interpret the findings as illustrating the potential
benefits of diaphragmatic breathing practice for improving cognitive function and
reducing negative affect and physiological responses to stress in healthy adults.
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2002; Tsang et al., 2015; Chen et al., 2016). However, in most studies of mind–body
intervention, diaphragmatic breathing worked as a latent component or an essential
preparation for the core intervention regime, such as meditation, TCC, or yoga (Telles et
al., 2000; Oakley and Evans, 2014). In the present study, we monitored the breathing as
an independent mind–body intervention form to discuss the health contribution to
cognition, emotion, and stress response when respiration slowed. In order to achieve
this aim, we adopted a unique breathing control method, which combined a monitoring
device and coach supervision simultaneously.
In previous studies, practice duration and times were key characters for depicting an
intervention protocol, but these seldom reported the final breathing rate and the
manner in which respiration frequency decreased. In a study of slow-breathing training
on chronic heart failure (Drozdz et al., 2016) reported its protocol as a 10–12 weeks’ (15
min per day) slow-breathing training with a breathing rate at 6 breaths/min, which meets
the key requirements of diaphragmatic breathing. A clear respiration frequency provides
a reliable and reproducible operation standard for estimating whether the intervention
successfully decreased the respiration frequency. In the present study, the significant
difference in respiration rate between the diaphragmatic breathing and resting
breathing conditions confirmed that participants correctly followed the protocol for
diaphragmatic breathing. The non-significant between-group difference in the
respiration frequency in the resting breathing condition confirmed the distinction
between the two breathing conditions. In addition, the continuous decrease in
respiration rate observed in the BIG represented the process of learning and practice. All
these results indicate that the change in respiratory rate could be attributed to the
effectiveness of the diaphragmatic breathing practice over the 8 weeks. They also
indirectly implied that the positive effects in this study were induced by intensive
diaphragmatic breathing practice, rather than any confounding variables.
The present study employed a breathing monitor with results visualized on a screen and
with a senior yoga coach providing professional guidance and instruction. Previous
studies have demonstrated that most participants could follow self-paced breathing
instructions via audio or video cues. Clinical studies usually adopt a breathing device with
quantitative feedback parameters, such as respiratory rate or HRV (Sherlin et al., 2010).
Respiratory sinus arrhythmia biofeedback has also been used to examine the effect of
breathing practice on HRV and symptoms of PTSD, which revealed a significantly greater
reduction in depressive symptoms and increases in HRV indices for individuals with
respiratory sinus arrhythmia (Zucker et al., 2009). These breathing devices with feedback
parameters have an advantage over visual or auditory instructions, without feedback
(Brown et al., 2013), and have been widely applied in treatment for physical and mental
disorders. Inviting a senior breathing coach is an alternative solution for breathing
practice and control (Drozdz et al., 2016). In the present study, the coach strictly guided
and monitored the entire process of diaphragmatic breathing during 20 sessions in a
previous study. These two methods guaranteed that the participants breathed properly
under two conditions under specific supervision during training. Having an appropriate
monitor was another problem that was encountered in breathing practice studies.
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Breathing Practice to Decrease Negative Affect
Emotional improvements have been reported to be the most obvious benefit of mind–
body interventions (Stromberg et al., 2015). It has been suggested that the detrimental
effects of stress and negative emotions could be counteracted by different forms of
breathing techniques, meditation, and relaxation (Jerath et al., 2015), as well as by yoga
and TCC (Benson, 1996; Telles et al., 2000; Oakley and Evans, 2014). A non-randomized
study suggested that a 1-week breathing practice decreased the mean of Post-traumatic
Checklist-17 (PCL-17), Beck Depression Inventory (BDI-21), General Health Questionnaire
(GHQ-12) in survivors of the 2004 South-East Asia tsunami. Their results indicated an
equivalent effect of breathing practice with a traumatic incident reduction exposure
therapy. Moreover, the effects persisted for at least 24 weeks after the intervention had
finished (Descilo et al., 2010). As a non-pharmaceutical treatment, breathing control
therapy is now wildly used in dealing with depression (Tsang et al., 2006), PTSD (Descilo
et al., 2010), insomnia (Manjunath and Telles, 2005), and other relevant mental disorders
(Brown and Gerbarg, 2005a). It is also applied as an adjuvant treatment for patients with
physical disorders, including stroke (Marshall et al., 2014) and cancer (Hayama and
Inoue, 2012). All these lines of evidence confirmed the efficacy of diaphragmatic
breathing in clinical conditions, but we have shown its benefit for healthy individuals. A
previous study has also reported that a better breathing technique was associated with
greater reductions in anxiety (Sherlin et al., 2010). A 6-weeks’ breathing training course
was long enough to cause a significant decrease in anxiety levels in healthy adults
(Chandla et al., 2013). Evidence from diaphragmatic breathing studies suggested a
significant reduction in the state anxiety after an 8-weeks’ intervention measured using
the Beck Anxiety Inventory Assessment in adults (Chen et al., 2016), and a decrease in
self-reported feelings of state anxiety and test performance in primary school students,
by a pre-test/post-test, training-versus-control experiment (Khng, 2016). In the present
study, our 20 sessions of diaphragmatic breathing practice significantly decreased the
NA scores in the BIG. This is consistent with previous results and suggested a relief of
basic NA in individuals’ daily lives. Although we did not detect the time point at which the
emotional benefit occurred, previous studies suggested that even a one-time
intervention could reduce stress, disengaged coping (Arsenio and Loria, 2014), and could
provide certain curative alleviation of job burnout, as well as other emotional disorders.
In that case, it remains unknown whether the reduction of NA occurs after the first
intervention or after a significant reduction in respiration frequency. This could indicate
that diaphragmatic breathing can provide an emotional improvement as a potential
health care effect in healthy volunteers.
Previous studies have hypothesized that perceptual improvements (MacLean et al., 2010)
and stress reduction (Jensen et al., 2012) are the mechanisms by which attentional
improvement is gained. Combining the increase in the NCT score and the decrease in
the NA observed in the present study, we propose that relaxation gained from
diaphragmatic breathing improved the attention test performance (Amon and Campbell,
2008; Sonne and Jensen, 2016). From the point of view of neuroscience, adjusting the
imbalances in the autonomic nervous system is the unique contribution provided by
breathing intervention, and was directly supported by TCC research. It indicated that the
HRV increased when diaphragmatic breathing was performed, which indicated an activity
balance between the sympathetic and parasympathetic systems (Wei et al., 2016).
Therefore, it is reasonable to infer that diaphragmatic breathing might modulate
cognitive performance by predominantly exerting its influence on the autonomic
nervous system. Although the neuro-mechanism remains to be clarified, it is likely that
deep breathing could link mind and body together to regulate the information
processing related to attention.
Cortisol is also closely associated with the HPA axis ( Clow et al., 2010), which can
involuntarily control metabolism, immunity, and some mental processing, including
memory and emotional appraisal (Pariante and Lightman, 2008), and can easily be
affected by breathing (Argyropoulos et al., 2002). Its association with attention (van Honk
et al., 1998), as well as breathing practice, cognitive processing, and emotional arousal is
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strong. It has been suggested that the sympatho-vagal stress response returns to an
optimal balance at 4.5–5.5 bpm breathing in most adults (Lehrer et al., 2010), but no
direct evidence has illuminated the potential mechanism of this physiological effect.
A hypothesis provided by Jerath et al. (2015) suggested that breathing stimulates vagal
activation of GABA pathways from the prefrontal cortex and insula, to inhibit amygdala
over-activity (Brown et al., 2013). A tuning function of the brain toward a
parasympathetically driven mode and positive states was observed in the left insula and
left orbitofrontal cortex with increasing yoga experience (Villemure et al., 2015). Evidence
from brain imaging studies has supported this hypothesis. These results suggested that
long and regular breathing-involving meditation practice significantly deactivated the
limbic system (Kalyani et al., 2011) and rostral prefrontal cortex (Tomasino and Fabbro,
2016), and increased the activation of the right dorsolateral prefrontal cortex (DLPFC)
while performing an attention-focused task. Moreover, specific changes, such as an
increased cortical thickness (Wei et al., 2013), prefrontal-hippocampus functional
connectivity (Tao et al., 2016), and a decreased regional homogeneity in the DLPFC (Wei
et al., 2014), were also detected during the resting state among TCC senior practitioners.
A structural change was proposed according to the autonomic nervous evidence, and
was supported by an absence of age-related gray matter decline in senior yoga
practitioners, as seen on structural MRI (Villemure et al., 2015). All these results
suggested that the prefrontal cortex served as the predominant commander,
supervising the activity from the limbic system, and modulating the activity of the
autonomic nervous system.
Limitations
In the present study, we employed healthy volunteers as our target population. In that
case, we estimated the improvement in mood and cognition and the physiological
response of stress, rather than clinical symptoms, such as anxiety, depression,
attentional impairment, or other stress-related pathological symptoms. In comparison to
a previous study, our results investigated the application of diaphragmatic breathing as a
daily health care for health population. Some of the limitations of the present study
should be acknowledged. First, we discussed the diaphragmatic breathing benefits from
the points of view of emotion, cognition, and physiology, respectively, rather than by
combining these three aspects together to obtain further mechanism-related results.
Therefore, we have deduced a limited contribution to elucidating the underlying
associations between cognitive progressing, affective improvement, and physiological
change. Moreover, in terms of the neuroendocrine response, the cortisol levels were
reduced after a 20 interventions, but no reference criteria were provided to demonstrate
whether this decrease resulted in a real physiological benefit or was only statistically
significant.
Go to:
The present study illustrates the potential for diaphragmatic breathing practice to
improve cognitive performance and reduce negative subjective and physiological
consequences of stress in healthy adults. Despite the promise of diaphragmatic
breathing practice in supporting function and health, further investigation is needed to
delineate mechanisms that underlie these benefits.
Go to:
The effect of diaphragmatic breathing exercise on attention, negative affect and stress
level: a preliminary randomly controlled study on occupational population was approved
by the ethical broad of school of psychology, Beijing Normal University. The method,
experiment design, and safety of participants were strictly approved by the ethical broad
of school of psychology, Beijing Normal University.
Go to:
G-XW and Y-FL designed the work, drafted and finalized the manuscript. XM, Z-QY, HZ, N-
YD, Y-TS, and Z-QG collected and analyzed the data, and revised the manuscript.
Go to:
The authors declare that the research was conducted in the absence of any commercial
or financial relationships that could be construed as a potential conflict of interest.
Go to:
We thank Mr. Ying Lu for his technical help in providing support on the devices used and
for recruiting participants, and Miss Xiangshu Cui for data collection.
Go to:
Funding. This work was supported by grants from the MOE (Ministry of Education in China) Project of
Humanities and Social Sciences (No.16YJC890012) and the National Natural Science Foundation of China
(31671163).
Go to:
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Articles from Frontiers in Psychology are provided here courtesy of Frontiers Media SA
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Change How You Feel: Change How You Breathe
psychcentral.com/lib/change-how-you-feel-change-how-you-breathe
But those same emotions can be so intense it feels as if they’re both tearing us apart
and, at the same time, controlling our lives. Emotions can be powerful drivers of our
behavior. In the grip of an emotion such as anger we tend to repeat old behavior
patterns, patterns we know won’t serve us well. Yet we feel powerless to change what
we’re doing.
Managing emotion is, therefore, a vital life skill. If we want to perfect that skill, it’s helpful
and often essential to get to the source of our feelings.
From psychologist William James in the 1880s to today, scientists have tried to work out
what causes us to experience emotion. Because emotions are felt in the body and have
obvious physiological components — shaking, crying, a racing heartbeat — James
believed the physiological phenomenon gave rise to the emotions. We don’t cry because
we feel sad; we feel sad because we cry.
Over the centuries since James, scientists have put forward a range of theories: emotions
are caused by the way we interpret physical responses to events … or by interpreting the
events themselves through the prism of our past experience … or by hormones … or by
all of the above.
Cognitive-behavioral therapy links our emotions to our thought processes. If, for
example, I think people are out to get me, I may feel anxious and fearful. If I think
everyone loves me, I am likely to feel joyful or happy. From this perspective, emotions
are almost like symptoms generated by our thoughts. But according to a joint study
carried out by staff from the University of Quebec and the University of Louvain, William
James might have been onto something. The findings show a clear and direct link
between emotions and breathing patterns.
The study, entitled “Respiratory Feedback in the Generation of Emotion,” involved two
groups of volunteers. Group 1 was asked to produce four emotions (joy, anger, fear and
sadness) through the use of memory, fantasy and by modifying their breathing pattern.
For each of the emotions under examination, scientists monitored and analyzed the
various breathing components — speed, location in the lungs, amplitude — and used
their findings to draw up a list of breathing instructions.
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These instructions were then given to a second group of volunteers who had been told
only that they were participating in a study of the cardiovascular impact of breathing
styles. Members of Group 2 were asked to breathe according to the instructions drawn
up from the earlier experiment. At the end of the 45-minute breathing session,
participants completed a questionnaire designed to elicit a range of information,
including details of their emotional responses. The results were unmistakable. To varying
but significant degrees, the four breathing patterns induced the anticipated emotional
responses.
This is important information for anyone struggling to manage his or her emotional life.
When caught up in the intensity of an emotion, particularly the so-called “negative”
emotions — anger, sadness, fear and its low-lying cousin, anxiety — it is difficult to
observe one’s own breathing pattern. But to a detached observer the patterns are
obvious. When we’re sad we sigh frequently. When angry, we breathe rapidly. In the grip
of fear our breathing is shallow and from the top of the lungs. And sometimes we hold
our breath without realizing that’s what we’re doing.
My experience as a therapist tells me the source of our emotions can be complex. They
can be linked to thought patterns, old memories and unconscious belief systems, as well
as physiological changes in the body. Plumbing these depths alone can be daunting and
we often need the support of a therapist. But the element of our emotions that we can
manage by ourselves is breathing. We can do this in two ways:
Reference
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Breathing: The Little Known Secret to Peace of Mind
psychologytoday.com/us/blog/feeling-it/201304/breathing-the-little-known-secret-peace-mind
“A few weeks ago shooting, cars exploding, screaming, death, that was your world. Now
back home, no one knows what it is like over there so no one knows how to help you get
back your normalcy. They label you a victim of the war. I am not a victim... but how do I
get back my normalcy? For most of us it is booze and Ambien. It works for a brief period
then it takes over your life. Until this study, I could not find [the] right help for me,
BREATHING like a champ!” Those were the words of a 25 year old marine, a veteran of
the war in Afghanistan who partook in the research study I ran with Dr. Richard
Davidson at the University of Wisconsin-Madison. Whereas therapeutic and drug
treatments had not helped many of the participants who volunteered for my study, a
breathing practice - the intervention we used - did. One of the veterans in our study has
since gone on to become an instructor so he can share the practices he learned with
other veterans. "Thank you for giving me my life back," he told us.
We have an intuitive understanding that the breath can regulate our mind and emotions.
Most of us have either told others or been told ourselves to "take a deep breath” when
things got challenging. Most clinical psychologists use some kind of breathing practice
with patients. However, because breathing happens automatically, many of us don’t give
the breath as much attention as it deserves nor have we learned to harness its full
potential to calm our minds.
One of the reasons why breathing can change how we feel is that emotions and
breathing are closely connected. A revealing research study by Pierre Phillipot showed
that different emotional states are associated with distinct respiration patterns. In
Phillipot's study, participants came in and were instructed to generate emotions like
sadness, fear, anger and happiness to the best of their ability. While they were
experiencing the emotions, Phillipot's team requested participants to closely observe
and report on their own respiration patterns. The research team found that each
emotion was associated with a distinct pattern of breath. For example, when the
participants felt anxious or afraid, they breathed more quickly and shallowly and when
they felt happy, they breathed slowly and fully. Even more interesting was the follow-up
study in which the researchers invited in a different group of participants into their lab
and instructed them to breathe in the patterns they had observed corresponded to
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emotions. The researchers literally told the participants how to breathe and then asked
them how they felt. Lo and behold, the participants started to feel the emotions that
corresponded to the breathing patterns!
This finding is revolutionary: We can change how we feel using our breath! Given the fact
that it is so difficult to change one’s emotions using thoughts alone - try "talking yourself
out of" intense anger or anxiety - , learning to use the breath becomes a very powerful
tool. Since it is so difficult "talk" our way out of our feelings, we can learn to "breathe" our
way through them. After participating in a 6-day workshop, veterans who said they had
felt “dead” since returning from Iraq said they felt alive again. 2 years later, they are
spokespeople for the program, volunteering to encourage other veterans to learn to
breathe again.
Several studies suggest that controlled yogic breathing has immediate and positive
effects on psychological well-being, as well as on physiological markers of well-being,
such as blood pressure and heart rate. Within minutes you will feel better and place
your body in a significantly healthier state. The long-term effects of a daily breathing
practice are even more pronounced. By activating the part of our nervous system
associated with “resting and digesting” (the parasympathetic nervous system), breathing
practices may “train” the body to be calmer. For example, preliminary studies have found
that regularly practicing breathing exercises lowers one’s level of cortisol — the “stress
hormone.” Having lower levels of this hormone may be indicative of an overall calmer
state of being, which may translate into less reactivity in the face of inevitable life
stressors and less risk of heart disease. Although substantial studies of yogic breathing
and the brain have yet to emerge, preliminary brain studies of meditation and the breath
suggest that they activate brain areas involved in the control of the autonomic system,
such as the insula. Control of the breath appears to activate brain regions that guide the
parasympathetic, or “rest and digest,” processes of the body, perhaps thereby inducing
its calming effects. Deep breathing has even been found to reduce pain.
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To practice, place the index and middle finger of the right hand on the center of the
eyebrow, and place the thumb on the right nostril, and the ring finger and pinky on the
left nostril. The left hand rests on the lap, palm facing up. Take a deep breath in and,
closing the right nostril with your thumb, breathe out through the left nostril. Then take a
deep breath in through the left nostril, close the left nostril with your ring finger and
pinky at the end of the inhale, and exhale through the right nostril. Take a deep breath in
through the right nostril and, closing the right nostril with the thumb, exhale on the left
side, and start over. Do this with your eyes closed for about five minutes. Notice the
effects on your body and mind.
The veterans I worked with learned the practices taught in the Project Welcome Home
Troops workshop which teaches Sudarshan Kriya Yoga. The International Association for
Human Values offers this program programs for veterans (www.pwht.org), in schools
(http://www.youthempowermentseminar.org), and in prisons (
http://www.prisonsmart.org/). This practice is also taught for the general population by
the Art of Living Foundation, see artofliving.org. Elementary yogic breathing practices can
also be learned in general yoga classes. Kundalini yoga classes, for example, place a
particular emphasis on breathing practices.
article continues after advertisementTo stay updated on the science of happiness, health
and social connection, see emmaseppala.com.
Emma is the founder of Fulfillment Daily, science-based news for a happier life.
Also see the Center for Compassion and Altruism Research and Education at Stanford
University, ccare.stanford.edu
3/3
Relaxation techniques: Breath control helps quell errant
stress response
health.harvard.edu/mind-and-mood/relaxation-techniques-breath-control-helps-quell-errant-stress-
response
The term "fight or flight" is also known as the stress response. It's what the body does as
it prepares to confront or avoid danger. When appropriately invoked, the stress
response helps us rise to many challenges. But trouble starts when this response is
constantly provoked by less momentous, day-to-day events, such as money woes, traffic
jams, job worries, or relationship problems.
Health problems are one result. A prime example is high blood pressure, a major risk
factor for heart disease. The stress response also suppresses the immune system,
increasing susceptibility to colds and other illnesses. Moreover, the buildup of stress can
contribute to anxiety and depression. We can't avoid all sources of stress in our lives, nor
would we want to. But we can develop healthier ways of responding to them. One way is
to invoke the relaxation response, through a technique first developed in the 1970s at
Harvard Medical School by cardiologist Dr. Herbert Benson. The relaxation response is a
state of profound rest that can be elicited in many ways, including meditation, yoga, and
progressive muscle relaxation.
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Breath focus is a common feature of several techniques that evoke the relaxation
response. The first step is learning to breathe deeply.
For many of us, deep breathing seems unnatural. There are several reasons for this. For
one, body image has a negative impact on respiration in our culture. A flat stomach is
considered attractive, so women (and men) tend to hold in their stomach muscles. This
interferes with deep breathing and gradually makes shallow "chest breathing" seem
normal, which increases tension and anxiety.
Shallow breathing limits the diaphragm's range of motion. The lowest part of the lungs
doesn't get a full share of oxygenated air. That can make you feel short of breath and
anxious.
Deep abdominal breathing encourages full oxygen exchange — that is, the beneficial
trade of incoming oxygen for outgoing carbon dioxide. Not surprisingly, it can slow the
heartbeat and lower or stabilize blood pressure.
First steps. Find a quiet, comfortable place to sit or lie down. First, take a normal breath.
Then try a deep breath: Breathe in slowly through your nose, allowing your chest and
lower belly to rise as you fill your lungs. Let your abdomen expand fully. Now breathe out
slowly through your mouth (or your nose, if that feels more natural).
Breath focus in practice. Once you've taken the steps above, you can move on to regular
practice of controlled breathing. As you sit comfortably with your eyes closed, blend
deep breathing with helpful imagery and perhaps a focus word or phrase that helps you
relax.
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Ways to elicit the relaxation response
Several techniques can help you turn down your response to stress. Breath focus helps with
nearly all of them:
Creating a routine
You may want to try several different relaxation techniques to see which one works best
for you. And if your favorite approach fails to engage you, or you want some variety,
you'll have alternatives. You may also find the following tips helpful:
Choose a special place where you can sit (or lie down) comfortably and quietly.
Don't try too hard. That may just cause you to tense up.
Don't be too passive, either. The key to eliciting the relaxation response lies in
shifting your focus from stressors to deeper, calmer rhythms — and having a focal
point is essential.
Try to practice once or twice a day, always at the same time, in order to enhance
the sense of ritual and establish a habit.
Try to practice at least 10–20 minutes each day.
Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of
archived content. Please note the date of last review on all articles. No content on this site,
regardless of date, should ever be used as a substitute for direct medical advice from your
doctor or other qualified clinician.
3/3
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Authors' notes
The studies presented in this paper have been made possible by a grant from the "Fonds
National de la Recherche Scientifique de Belgique" 1,5,041,94F.
The authors appreciate helpful comments of Robert S. Feldman, Ursula Hess, Arvid
Kappas and two anonymous reviewers on earlier drafts of this paper.
Correspondence regarding this paper should be addressed to Pierre Philippot who is at
Faculté de Psychologie, Université de Louvain, place du Cardinal Mercier, 10, B- 1348
Louvain-la-Neuve, Belgique. Electronic mail may be sent via Internet to
"Philippot@clis.ucl.ac.be".
Respiratory Feedback 2
Abstract
This article reports two studies investigating the relationship between emotional
feelings and respiration. In the first study, participants were asked to produce an
emotion of either joy, anger, fear or sadness and to describe the breathing pattern that fit
best with the generated emotion. Results revealed that breathing patterns reported
during voluntary production of emotion were (a) comparable to those objectively
similar across individuals and (c) clearly differentiated among joy, anger, fear and
sadness. A second study used breathing instructions based on Study 1’s results to
This manipulation produced significant emotional feeling states that were differentiated
according to the type of breathing pattern. The implications of these findings for
emotion theories based on peripheral feedback and for emotion regulation are discussed.
Respiratory Feedback 3
Russell, 1991; Scherer, 1984). One of the oldest debates in emotion psychology
addresses the specification of the relations existing among these different components.
Historically, this debate can be traced back to William James' (1884) peripheral theory
of emotion, which stated that subjective feeling states were merely the
phenomenological result of body state. This position was vigorously counter-attacked
by Cannon (1927) who attempted to prove that body changes followed subjective
feeling states. As reviewed at the occasion of the centennial anniversary of William
states is not only a function of their evaluation of the situation but also of the intensity
of their state of arousal). Research in this area has focused on the effect of the
manipulation of undifferentiated arousal on the intensity--but not on the quality--of
strong and consistent finding from this line of research is the intensification of the
emotional feeling state following exposure to an arousing stimulus, an effect known as
proposes that body changes in emotion are a function of cognitive appraisal (e.g.
Scherer, 1984; Pecchinanda & Smtih, 1996; Smith & Kirby, 2000) or of the direct
output from appraisal, action readiness (Frijda, 1986). More precisely, this model
suggests that the activation of a specific appraisal dimension would induce specific
body changes. For instance, novelty appraisal would induce a pause in breathing and a
deceleration followed by an acceleration of heart rate. The pattern of body changes with
a specific emotional state would be the sum of the changes induced by each appraisal
component. As different feeling states result from different appraisal patterns, they are
explicitly stated and definitely marginal, the central role being played by cognitive
appraisal.
A third conception, which we will label the “central network model” states that
emotions are centrally organized by neural or cognitive networks that connect the
different emotion components together. For some, these networks are innate neural
structures (e.g., Ekman, 1999; Izard, 1979; Tomkins, 1980); for others, they are
cognitive networks or schemata that develop as a function of individuals’ experiences
(e.g., Lang, 1979, 1984; Philippot & Schaefer, 2001; Teasdale, 1996). Though the
theories we gather under the central network model differ in many ways, they all share
similar features with respect to the patterning and function of body changes in emotion.
First, they all postulate that patterns of body changes are differentiated according to the
type of emotion experienced, even if cognitive network theories predict more
idiosyncratic patterns than theories postulating innate neural structures. Second, they
posit that the activation of the body state typical of an emotion elicits that emotion, a
process known as peripheral feedback. Third, they suggest that peripheral feedback
research area investigating the "facial feedback hypothesis." A wealth of evidence has
documented that manipulating facial expression affects feeling state (Laird, 1984;
Manstead, 1988; Matsumoto, 1987; McIntosh, 1996). The effect size of the so-called
facial feedback is generally small (around 13% of explained variance) but reliably
significant. The impact of facial muscle manipulation has been extended to
physiological changes, such as heart rate or skin temperature (Hess, Kappas, McHugo,
Lanzetta & Kleck, 1992; Kappas, 1989; Levenson, 1992; Levenson, Carstensen,
Friesen, and Ekman, 1991; Levenson, Ekman & Friesen, 1990). Further, Stepper and
Strack (1993) have documented that manipulating posture also has an impact on
subjective feeling states and affects later judgment of valenced material, extending
previous findings from Duclos, Laird, Shneider, Sexter, Stern, and VanLighten (1989)
showing that posture affects mood. Overall, there exists empirical evidence that
manipulating facial or postural muscles affects subjective feeling states, and possibly
physiological states, outside of individuals’ awareness of the process. Still, the
underlying mechanism of facial feedback is the object of a controversy (e.g., Izard,
1990; Laird, 1984; McIntosh, 1996) and the interpretation of the effect of facial
of the relationship between body state and subjective feelings: First, are subjectively
differentiated feeling states characterized by different body states? Second, does body
state influence the intensity and/or the quality of subjective feelings? Third, does this
body changes may not relate to actual body changes (Rimé, Philippot & Cisamolo,
Respiratory Feedback 6
1990; Philippot & Rimé, 1997) and as several recent theories issued from the central
network model are based on a distinction between implicit and explicit processing (e.g.
Damasio, 1994; Teasdale, 1996; for a review see Philippot & Schaefer, 2001). The
undifferentiated arousal model postulates that emotional body states are undifferentiated
and have an explicit impact on feelings intensity but not quality. The central network
model posits that emotional body states are differentiated and influence the quality of
feeling states and that these effects can occur at an implicit level. The cognitive
appraisal model is vague and unspecific about whether and how changes in
physiological patterns might influence emotional feeling states.
conclusions (Levenson, 1992; Stemmler, 1992; Zajonc & McIntosh, 1992). With
respect to the second and third questions, the activation transfer research mentioned
above has shown that arousal can explicitly affect the intensity of feeling state,
providing that it is attributed to an emotional cause; the facial and postural feedback
research has demonstrated that muscular feedback can influence subjective feeling state
outside of individuals’ awareness of the process. Yet, despite its theoretical importance,
the possibility of a visceral--and not solely muscular--feedback on the quality of
emotional feelings has not been pursued at an experimental level. From this
perspective, physiological state should be manipulated, not in intensity but in quality, in
order to observe the impact of such manipulations on the nature rather than the intensity
of feeling states. Further, it should be established whether this effect occurs without
individuals explicitly using body state as a source of information to determine their
emotional feeling state. The present studies aim at exploring these neglected questions.
four reasons. First, like facial musculature, breathing is under both voluntary and
automatic control, allowing for the same types of manipulation as the ones commonly
used in facial feedback research. Second, clinical evidence has repeatedly confirmed
Respiratory Feedback 7
relations between breathing and at least one feeling state, anxiety (e.g. Beck & Scott,
1988). Moreover, these studies have also demonstrated the clinical efficacy of
between positive or negative feeling states, as well as tense or relaxed feeling states
(Boiten, Frijda & Wientjes, 1994). Fourth, while they can easily be achieved non
vascular changes or skin conductance. They thereby constitute an easy but potent
avenue to manipulate the whole physiological state of the organism.
the available studies are fraught with methodological shortcomings. As a result, they
conclude that “it is difficult to draw specific and detailed conclusions concerning the
influence of emotion upon respiration” (Boiten et al., 1994, p. 119). Yet, they were able
to identify some consistency across studies that can be summarized as four types of
breathing related to emotional state. Fast and deep breathing was associated with
excitement, such as in anger, fear, or sometimes even joy. Rapid shallow breathing was
typical of tense anticipation, including concentration, fear, and panic. Slow and deep
breathing was most often observed in relaxed resting state. Finally, slow and shallow
breathing was associated with states of withdrawal and passiveness, such as depression
or calm happiness.
As can be seen from these descriptions, few of the four types of breathing
identified can be unequivocally associated with a specific emotional state. Two remarks
concerning these observations are of importance. First, that psychophysiological
research has not identified specific breathing patterns differentiating basic emotions
Respiratory Feedback 8
does not necessarily means that such patterns do not exist. This lack of definitive
measures only frequency (see the discussion by Boiten et al. [1994] in this respect) or to
problems in inducing emotion in psychophysiological experiments (see the discussion
(a) fast and deep breathing might characterize anger, (b) rapid shallow breathing might
characterize fear, (c) slow breathing whether deep or shallow might characterize a state
of relaxed happiness, and (d) slow and shallow breathing might characterize sadness.
These propositions have to be considered cautiously, as, for instance, pattern (a) might
also characterize joyful or fearful excitement and pattern (d) might also characterize
calm happiness. In sum, although suggestive, the results of Boiten et al.’s review do not
provide an empirical basis precise enough to construct breathing instructions specific to
basic emotions.
Another source of information regarding emotional breathing patterns pertains to
pattern.” The respiratory components of the patterns were derived from visual
communication], the original report [Bloch & Santibanez, 1972] cannot be obtained).
The patterns obtained with this procedure differ in several respects from the
observations of Boiten et al (1994). Bloch’s et al. (1991) joy pattern, referring to
laughter, (quick and deep nasal inspiration, followed by oral expiration with small jolts)
is quite different from the pattern associated with calm happiness by Boiten, although it
presents some similarities with Boiten’s pattern of excitement, but for inspiration only.
Respiratory Feedback 9
Bloch’s et al. anger pattern (regular, quick, and deep nasal breathing) corresponds to our
prediction derived from Boiten et al. With respect to fear, Bloch et al. propose a quick
and shallow inspiration through the mouth, followed by a pause and a long expiration.
In contrast, our prediction based on Boiten et al. is that fear is characterized by shallow
and fast breathing. Finally, Bloch’s proposition for sadness (quick nasal inspiration
with jolts followed by a quick expiration through the mouth) does not correspond to our
prediction derived from Boiten et al. (i.e., slow and shallow breathing).
In their work, Bloch et al. (1991) have demonstrated that extensively training
actors to reproduce these emotional effector patterns results in the induction of the
respiratory, facial, and postural changes, and (b) informed of which emotional effector
pattern was intended to induce which emotion. Hence the effect of these manipulations
on feeling states may simply be the result of experimenter's demand. Further, breathing
was not manipulated independently from posture or facial expression, hence preventing
state. We replicated the study of Bloch et al. (1991) for four emotions (joy, anger, fear,
and sadness) with two major changes. First, in order to avoid experimental demands,
we used a procedure in which participants were oblivious to the fact that the actual topic
of the study was emotion or emotion induction. Second, in order to disentangle the
effect of facial and postural feedback from those of a possible respiratory feedback, we
only manipulated breathing, keeping facial expression and posture constant. The results
revealed that participants tended to report the target emotion in the joy and anger
breathing condition1, F(9,153) = 1.97, p<.10.
Respiratory Feedback 10
In sum, the findings of Bloch et al. (1991) are only partially replicated in the
breathing conditions of joy and anger. There are three possibilities accounting for these
weak results. First, respiratory feedback may have no effects on emotional feeling
states. Second, it is possible that respiratory feedback alone is not a sufficient condition
to induce emotional feeling state; It may additionally require the corresponding facial
and postural pattern. Along this line, Bloch (personal communication, July 16th, 1994)
argues that not only the whole respiratory, facial and postural pattern needs to be
activated, but also that no emotion can be induced if the “correct “ pattern is not exactly
reproduced. (This notion of correctness has also been debated in the context of the
facial feedback hypothesis, see for instance, McIntosh [1996].) Finally, a third
possibility is that the respiratory instructions used by Bloch et al. (1991) are not the
most appropriate to induce discrete emotions. Indeed, it is unclear how Bloch et al.’s
respiratory patterns were originally established (i.a., no statistical analysis are reported
and the original report [Bloch & Santibanez, 1972] cannot be obtained). Further, the
breathing patterns for joy attempts to mimic laughter, while the one for sadness attempts
to mimic crying. While expressive emotional components such as laughter or tears tend
to be associated with joy and sadness respectively, this does not necessitate that they
determine the breathing patterns associated with these emotions.
Study 1
Study 1 was designed to investigate whether different, more precise and accurate
breathing instructions than those used by Bloch et al. (1991) could be established. It
and report the corresponding breathing patterns. These subjective reports were to be
compared with the results of Boiten’s et al. (1994) review of the studies that
investigated objective respiratory parameters. Our expectations were that (a) the
information obtained from subjective reports would offer more details and a greater
differentiation among emotions than the information issued from Boiten’s et al. review,
and (b) the subjective reports would be concordant with the breathing patterns derived
from Boiten et al., the latter thus validating to some extent the former. The rationale
Respiratory Feedback 11
was that if, and only if, predictions (a) and (b) were met, Study 1’s results could provide
possibility would be void if either of the two predictions were not met.
Participants were invited to produce four emotional feeling states (of joy, anger,
fear, and sadness), following a procedure adapted from the one described by Hess et al.
(1992). When participants felt that they had reached the desired state, they were invited
parameters.
Method
were aged between 18 and 29 years (mean age = 23.8) and they participated individually
in the experiment. The experimenter told them that the purpose of the study was to
investigate how emotions could be expressed via respiratory patterns. They were
simply instructed to produce an emotion--either joy, anger, fear, or sadness, in a random
order--by modifying their respiration. They were also encouraged to maximize the
intensity of their emotions and they were told that they could help themselves with
personal memories or fantasies. Participants performed the experimental trials standing
up alone in a laboratory room. The experimenter was in an adjacent room and contact
was maintained with an interphone system. When participants judged themselves to
have reached their best production of the target feeling state, participants reported in a
questionnaire the characteristics of the specific respiratory pattern they had performed to
express the emotion and, on a 7-point scale, the degree to which they felt they were
feeling states they had experienced during the trial (from 0: no emotion at all to 6: the
most intense emotion possible). This scale included the following items: concentrated,
joyful, sad, angry, afraid, anxious, disgusted, scornful, surprised, ashamed, guilty and
Respiratory Feedback 12
happy. Only the six relevant items were retained for the data analysis (joyful, sad,
Respiration questionnaire
Based on a pre-test study, a questionnaire investigating several respiratory
parameters was constructed. Participants were asked to describe their inspiration and
their expiration separately on five items: Was their respiration diaphragmatic, thoracic
or both? Did they breath through their nose, their mouth or both? Did the frequency
change (from “-3” = much slower to “3” = much faster), did the amplitude change (from
“-3” = much more shallow to “3” = much deeper), and did they pause (from “0” = not at
all to “4” = a lot)? Additional questions were asked for the whole respiratory pattern:
Were there sighs, tremors, or tensions in the thorax (from “0” = not at all to “4” = a lot),
and did the regularity of the respiration change (from “-3” = much more irregular to “3”
= much more regular)?
Results
Manipulation check
pattern (mean = 4.48) was easier to produce than patterns of sadness, fear, and anger
breathing patterns subjectively related to the target emotion, but they also reported
feeling the corresponding subjective state. Indeed, a 4 X 6 MANOVA with emotion
condition and emotion item of the DES as within-subject factors and sex as a between-
subjects factor revealed main effects of emotion and emotion item, respectively, F(3,63)
= 3.99, p < .02, F(5,105) = 6.93, p < .0001, that were qualified by an emotion X
emotion item interaction , F(15,315) = 34.01, p < .0001. The pattern of the results and
Respiratory Feedback 13
the post-hoc analyses represented in Table 1 clearly demonstrate that the manipulation
-------------------------------------------------------------
Insert about here Table 1
-------------------------------------------------------------
Respiratory patterns
The central question of the present study was whether people can report
respiratory patterns that differentiate among each basic emotional feeling state. Thus, to
investigate the effect of emotion condition on the different parameters of inspiration and
of emotion was significant, F(3,20) = 29.22, p < .0001, and F(3,20) = 16.54, p < .0001,
respectively. For the pause parameters, only the interaction between inspiration-
expiration and emotion reached significance, F(3,20) = 3.70, p < .03. Post-hoc analyses
detailed these effects. As shown in Table 2, respiratory frequency increased for anger
and fear, decreased for joy and did not change from baseline level for sadness.
Respiratory amplitude increased dramatically in joy and, although to a lesser extent, in
anger. For fear and sadness, amplitude remained at baseline levels. For pauses, post-
hoc analyses revealed that the interaction was accounted for by the fact that while
people reported more pauses after expiration in joy, F(1,22) = 4.80, p <.04, they
reported less pauses after inspiration in fear, F(1,22) = 3.61, p <.07.
-------------------------------------------------------------
Insert about here Table 2
-------------------------------------------------------------
The effects of emotion on regularity, sighs, tremors, and thoracic tension were
examined with a single factor (emotion) MANOVA. It appeared that all these
.0001, for regularity; and F(3,20) = 45.89, p < .0001, for thoracic tension. Post-hoc
Respiratory Feedback 14
associated with sadness. In joy, respiration is more regular and presents much less
thoracic tension than in anger and fear. Sadness falls in between this pattern and is
characterized by tremors, which are totally absent in joy and moderately present in
respectively, χ 2 = 40.29, p < .001, χ 2 = 29.82, p < .001, for inspiration and expiration
in joy, and χ 2 = 34.77, p < .001, χ 2 = 25.39, p < .001, for inspiration and expiration in
sadness. Respiration also tended to be nasal in anger, although to a lesser extent, χ 2 =
5.82, p < .10, for inspiration and χ 2 = 10.76, p < .01, for expiration. No significant
trend appeared for fear. As regards the diaphragmatic or thoracic quality of the
respiration, participants reported that expiration was predominantly diaphragmatic in
Second, these subjective patterns are congruent with the objective patterns reviewed by
Boiten et al. (1994); Third, the explicit manipulation of respiration combined with
Previous research has already shown that people report experiencing different body
sensation profiles for different emotions (Lyman & Waters, 1986; Rimé et al., 1990;
Philippot & Rimé, 1997). Yet these studies had all considered a rather global
specifically as in the present study. Thus, previous findings can be extended to note that
people experience a very fine differentiation of body state during emotion, not only for
the body as a whole but also for very specific changes, at least including breathing
changes. In addition, these body sensations are quite homogenous across individuals
inherited from Schachter’s (1964) theory. They are congruent with cognitive appraisal
models and central network models such as the Somatovisceral Afference Model of
Emotion (SAME) proposed by Cacioppo et al. (1992).
with regular, moderately deep and slow breathing through the nose and with minimal
thoracic tension, tremors, and sighs. The breathing tends to be diaphragmatic or both
thoracic and diaphragmatic. This pattern is parallel to the slow and deep breathing
Boiten et al. (1994) observed in a relaxed resting state. Yet, these authors report that
calm happiness (as well as depression) is associated with slow but shallow breathing,
whereas excited joy (as well as anger or fear) is associated with fast and deep breathing.
Bloch’s et al. (1994) joy pattern (quick and deep nasal inspiration, followed by oral
expiration with small jolts) is different from the pattern associated with joy by the
participants of the present study as well as from the three patterns associated with
positive states by Boiten et al. As mentioned above, Bloch’s et al. joy breathing pattern
deep nasal breathing with marked thoracic tension, minimal sighs, and some tremors.
The expiration was diaphragmatic. This pattern corresponds to the fast and deep
breathing Boiten et al (1994) associated with excitement, including angry excitation. It
also parallels to some degree Bloch’s et al. anger pattern (regular, quick, and deep nasal
breathing), except that our participants reported irregular rather than regular breathing.
Respiratory Feedback 16
With respect to fear, our participants reported fast, irregular, rather shallow
breathing, with much thoracic tension, some tremors, and minimal sighs. More thoracic
breathing was reported for fear than for any other emotions. This pattern corresponds
very well to the rapid, shallow breathing associated with tense anticipation by Boiten et
al. It has also basic features in common with Bloch’s et al. fear pattern. Yet, the latter
has additional specifications not reported by our participants : for Bloch et al. the
Finally, for sadness, our participants reported nasal breathing with average
amplitude and frequency, marked with sighs and tremors as well as some thoracic
tension and irregularity. Of the four types of breathing proposed by Boiten et al., the
present pattern is closest to the slow and shallow breathing associated with state of
withdrawal and passiveness. It shares some similarities with Bloch’s et al. sadness
pattern (inspiration with brief jolts through the nose and expiration at one time through
the mouth), specifically, normal frequency and amplitude, but also marked
dissimilarities, including oral expiration, jolts in the inspiration and expiration in one
time through the mouth for Bloch et al. As mentioned above, Bloch’s et al. sadness
pattern attempts to imitate crying and might not be specific to sadness.
In summary, as predicted, the emotional breathing patterns reported by the
participants of the present study are characterized by a clear and detailed differentiation
among emotions. Moreover, they are congruent with the results of Boiten’s et al.
(1994) meta-analysis. This suggests that, in their attempts to produce emotional states
by manipulating their respiration, our participants have relied on breathing patterns that
are similar to observations of psychophysiological studies investigating respiratory
changes during emotion induction. As the conditions of clear differentiation among the
four emotions investigated and congruence with Boiten’s et al meta-analysis are met,
the data of the present study can provide a valid basis for the construction of different
sets of breathing instructions that would be specific to the discrete emotions of joy,
anger, fear, and sadness.
Respiratory Feedback 17
The third finding of the present study is precisely related to emotion induction.
Indeed, the analysis of the emotional feeling state questionnaire revealed that specific
and rather intense emotions have resulted from the explicit instruction to produce
emotion by manipulating respiration. This observation is in line with the report of Hess
et al. (1992) that people have the ability to produce rather intense and specific emotions
“on demand.” Future research should examine whether the instruction to alter one’s
results. In addition, Study 2 investigated whether this effect could occur implicitly, this
is, without participants explicitly using breathing changes to infer their emotional
feeling state. Participants were told that they were participating in a health psychology
unknown to them, were characteristic of joy, anger, fear, and sadness. Their feeling
state was recorded by disguised items hidden in a questionnaire supposedly addressing
Method
Participants and procedure
Respiratory Feedback 18
Twenty one female and 5 male students aged between 17 and 23 years (mean
age: 19.2) volunteered for the study. They participated individually in the experiment
the first session and the actual data collection took place during the second session.
During the first session, the experimenter explained the cover story. Participants
were told that the study had been designed to investigate the effects of breathing on
mechanical level. They were told that the hypothesis was that these effects could also
influence subjective physical sensations. Then, the experimenter explained the
procedure. The experiment consisted of four trials. Each trial was preceded by a short
relaxation period during which participants had to close their eyes, breathe smoothly,
relax every muscle, and visualize an imaginary circle inflating and deflating at the
rhythm of their respiration. After relaxation, participants were to perform a respiratory
pattern for two minutes and, immediately after, to complete a questionnaire on physical
sensations. The experimenter explained that various respiratory and cardio-vascular
measurements would be taken during the breathing exercises. He showed the
transducers (a respiratory belt and the FinaPress sensor of the Ohmeda 2300 blood
pressure monitor2) and explained how this equipment operated.
Once the procedure was explained, the experimenter gave the breathing
instructions, showed how to perform them and gave feedback to the participant about
his or her performance. After having ascertained that the participant understood the
breathing instructions, the experimenter affixed the transducers and went to the adjacent
technical room. Communication with the participant was maintained throughout the
measurements, the rehearsal of the procedure began. The experimenter gave the
relaxation instructions, then reminded the participant of the breathing instructions, had
the participant perform them for two minutes, and asked to the participant to fill in the
Respiratory Feedback 19
computer screen the respiratory movements of the participant and check whether the
procedure. Then the experimenter affixed the respiratory belt and the FinaPress sensor
and went to the technical room. The four trials were performed in a random order.
Respiration was recorded during relaxation and trial periods. Finally, participants were
debriefed and the actual purpose of the experiment was explained. They were
specifically asked whether they suspected that the experimenter attempted to modify
emotion induction, or about the fact that the questionnaire measured their emotional
feeling state. Thus, if an effect on feeling state is observed, it can be considered as
occurring outside of the participants’ awareness of the process, i.e. the awareness of a
relationship between breathing and feeling state.
Questionnaire
The questionnaire consisted in 22 items comprising different sensations. Items
were "vertigo," "nausea," "paresthesia," "lump in the throat," "headache," "impression
of unreality," "stomach sensations," "feeling cold, shivering," "feeling hot," "racing
heart," "muscular tension," "perspiration," "goose flesh," "blushing," "weak knees," and
"general activation." Mixed among these items, four scales indexed emotional feeling
states: "feelings of fear, anxiety,” for fear; "feelings of sadness, depression," for
sadness; "positive feelings, good spirit," for happiness; and "feelings of aggressivity,
feeling for this item. The dependent measures consisted of millimeters from the zero-
point on each scale.
Physiological measures
Respiratory Feedback 20
chest. A sound of 575 Hz emitted at one end of the tube is received at the other end.
The phase of the sound received varies according to the length of the tube which is itself
determined by the respiratory movements of the ribcage. A coupler monitors these
phase changes and outputs a signal varying in tension as a function of tube length (1.2
cm/V). Technical aspects of this system are described in van Rossum (1988). The
through-put to hard disk while maintaining a real time display directly on the host
computer's monitor. In addition, after the acquisition, data can be displayed on the
Anger: "Breathe and exhale quickly through the nose; slightly deeper than
regular breathing amplitude. Your breathing is slightly irregular with some tremors and
your ribcage is very tense."
Fear: “Breathe and exhale quickly from the top of your ribcage; with a normal
amplitude. Your breathing is slightly irregular with some tremors and your ribcage very
tense.”
Sadness: “Breathe and exhale through the nose with a normal amplitude and
pace. Your ribcage is slightly tense, and there are some sighs in your expiration.”
subject factor were computed on the differences scores (mean during the trial minus
mean during relaxation) for the indices of frequency, amplitude and ratio of inspiration
and expiration times. As can be seen in Table 3, the effect of breathing condition was
clearly significant for each index. Post-hoc analyses using the Bonferroni procedure
revealed that participants followed the instructions (see subscripts in Table 3).
Respiration time was longest during the joy condition, slightly shorter for the sadness
condition and much shorter in the anger and fear conditions, with fear respiration being
slightly faster than anger respiration. The amplitude increased in the joy condition,
remained at baseline levels for the anger and sadness conditions, and was shorter during
fear. Finally, the ratio of inspiration and expiration times increased for anger, fear, and
sadness but stayed at baseline level in joy.
-------------------------------------
Insert Table 3 about here
-------------------------------------
Second, the impact of breathing condition on emotional feeling state was
examined. A MANOVA with breathing condition and feeling scale as within-subject
factors was computed on the measures of the four feelings. A significant effect of
breathing condition indicated that, overall, some breathing patterns induced more
intense feeling state than others, F(3,23) = 9.02, p<.0004. Similarly, some feeling states
interaction indicated that feeling state varied according to breathing conditions, F(9,17)
= 8.73, p<.0001; This effect accounts for 40% of the variance.
(see Table 4). MANOVAs with feeling scale as within-subject factor were computed
for each breathing condition. The effect of feeling scale was significant for each
condition, indicating that each breathing condition induced a differentiated feeling state,
Respiratory Feedback 22
F(3,22) = 13.32, p<.0001, for joy; F(3,22) = 7.20, p<.001, for anger; F(3,22) = 5.71,
p<.004, for fear; and F(3,22) = 4.10, p<.02, for sadness, respectively. These effects
were specified with paired t-test using the Bonferroni procedure. As can be seen in
Table 4, the joy breathing condition induced significantly more positive feeling than any
other condition and more than any other feeling within this condition. The same is true
for the feeling of anger in the anger breathing condition. It should be noted that this
breathing pattern also induced feelings of fear and anxiety, although to a lesser degree
than anger feelings. The fear breathing condition induced feelings of anger and of
fear/anxiety at a similar intensity level. Yet, the feelings of fear/anxiety induced in this
condition are not more intense than those induced by any other conditions. Finally, the
were the most intensely reported, as the three other breathing conditions induced no
feeling of sadness at all.
--------------------------------------------------------
Insert Table 4 about here
--------------------------------------------------------
In sum, it appears that the joy and anger breathing conditions successfully
induced the target feeling state. The fear and sadness breathing conditions induced a
mixed pattern of fear/anxiety and anger for the former and of positive state and sadness
for the latter. These blends in pattern could be explained in two different ways. One
possibility is that these breathing conditions indeed induced a blended emotional feeling
with a given feeling state, while others responded with another feeling state. For
instance, some participants may have felt joy while performing the sadness breathing
feeling scales. In the fear condition, anger and fear were positively correlated (r(27) =
.58, p < .002), indicating that the fear breathing pattern did indeed induce a blended
Respiratory Feedback 23
emotional feeling state. In contrast, in the sadness condition, positive state and sadness
were negatively correlated (r(27) = -0.32, p < .10). Thus, it seems that different
individuals reacted with different feeling states to the sadness breathing pattern. A
possibility is that, given the similarity in breathing instructions between the sadness and
joy breathing conditions, some participants performed a breathing pattern closer to the
joy breathing patterns, while other performed a “purer” sadness pattern. If this were
true, based on data presented in Table 3, "happy responders" in the sadness breathing
condition should evidence longer respiration time and amplitude, and smaller ratio of
inspiration/expiration time than "sad responders". Pauses parameters, however, should
not discriminate between these two groups. To test these hypotheses, respiratory
parameters were compared with t-tests between "sad and happy responders".
Participants who reported more happiness than sadness in the sadness breathing
condition were classified as "happy responders". If the opposite was true, they were
finding suggests that the quality of the feeling state observed results directly from the
breathing pattern performed rather than from any other factors. Future research might
Study 1 has indicated that people experience respiratory changes that are
without participants’ awareness of the process. The intensity of the feeling states
Respiratory Feedback 24
induced in Study 2 was not trivial: Mean ratings of joy, anger and fear were of 54, 55,
and 47 on a scale in which 100 indicated the strongest intensity that participants could
imagine feeling. The amount of variance accounted for by this effect (40%) is larger
than the one accounted for by facial feedback (13%, in Matsumoto [1987]). To our
knowledge, this is the first demonstration that the alteration of respiration is sufficient
to induce emotion. It extends to visceral feedback the effects of body feedback on
emotional states established for facial expression (e.g. Matsumoto, 1987) and posture
(e.g. Stepper & Strack, 1993). These observations support the notion that body
feedback plays a role in the determination of the quality of emotional feeling state and
perspective described in the introduction. They are not congruent with the
undifferentiated arousal model that postulates that emotion is characterized by a state of
undifferentiated arousal that uniquely influences the intensity of feelings, provided that
the individual is aware of the arousal and consciously attributes it to an emotional
cause. Indeed, in Study 2, although individuals were aware of their body changes, they
did not consciously relate them to an emotional state, as confirmed by a thorough
debriefing on the matter. Thus, the present results indicate that body changes might
influence feeling states independently of one’s awareness of the process. Still, it is
uncertain whether the awareness of the body state is necessary or not for peripheral
Considering more specifically our results, it appears that joy, anger, and sadness-
-provided the execution of the proper breathing pattern--were successfully induced with
instructions derived from the observations of Study 1. However, mixed results were
observed for fear, which was not differentiated from anger. This observation raises the
emotions (e.g. Ekman, 1984; Levenson et al., 1990) or by moving it along dimensions
of pleasantness and activation (e.g. Feldman Barrett & Russell, 1998). Indeed, of the
four states induced, only fear and anger were in the same quadrant of unpleasant, high
arousal state. Anger was successfully induced, though accompanied by some fear,
discrete emotions and the fear breathing instructions derived from Study 1 were
incomplete or inadequate. This possibility can only be examined by further
alone would not be sufficient to induce differentiated states of anger and fear because
additional feedback from other body functions is necessary. According to the SAME
model proposed by Cacioppo et al. (1992), one source of peripheral feedback might not
be enough to produce a discrete somatovisceral pattern that specifically refers to a
specific emotion. A third possibility is that peripheral feedback is not capable of such
fine distinctions, the latter requiring more cognitive appraisal processes. Finally, as
suggested above, it may be that feeling states are organized dimensionally (Feldman &
Russell, 1998) and that Study 2 results simply reflect this reality. Future research is
needed to decide among these possibilities. To test the second possibility, we are
presently planning studies in which facial, postural, and respiratory feedback will be
respiration), such manipulations allow for testing the Somatovisceral Afference Model
and fear-anxiety, as induced by rapid breathing. Indeed, it is remarkable that the fast
and deep breathing normally expected to induce more hyperventilation (Beck & Scott,
1988; Huey & West, 1983)--and consequently, more anxiety--than the fast and shallow
Respiratory Feedback 26
breathing actually induced more anger than anxiety. The fast and shallow breathing
might be as strongly related to anger and hostility as to fear and anxiety. This is
congruent with the observation that people who panic, for whom hyperventilation is
functional, score higher on hostility (Dadds, Gaffney, Kenardy, Oei, et al., 1993). The
anxiety produced by hyperventilation might thus originate in a hostile coping attitude in
challenging situations.
Thus, attempts to regulate emotion in one physiological system (facial muscles) resulted
in increased manifestation in other body channels (visceral arousal) in some studies and
in decreased manifestation in other studies. Also relevant to this question, a wealth of
clinical evidence has shown that feelings of anxiety can be alleviated by specific
breathing exercises (Lum, 1981). It is therefore unclear whether the control of one body
channel necessarily results in increased manifestations in other channels. It might be
that the direction of the effect depends upon the body channel and the type of control
considered. The findings of the present studies encourage future research to examine
the regulatory effects of specific breathing instructions in people exposed to emotional
situations.
In sum, the present studies have shown an implicit influence of respiratory
feedback on the induction of emotional feeling state. They thus offer further support to
those theories of emotion stating that the quality of emotional feelings are, at least in
part, modulated by body feedback, without necessity of individual’s awareness of the
state along pleasantness and arousal dimensions. Finally, we propose that the
Respiratory Feedback 27
respiratory feedback effect constitutes a rich avenue for future research in emotion
regulation.
Respiratory Feedback 28
References
Beck, J.G. & Scott, S.K. (1988). Physiological and symptom responses to
141-154.
Bloch, S., & Santibanez-H, G. (1972). Simposio Latino-Americano de
Damasio, A.R. (1994) Descartes' error: emotion, reason and the human brain.
Sons.
Feldman Barrett, L., Russell, J.A. (1998) Independance and Bipolarity in the
Press.
Gross J.J. (1998) Antecedent- and response-focused emotion regulation:
Ninth Annual Meeting of the Society for Psychophysiological Research, New Orleans.
Kirouac, G. (1995). Les émotions. Québec: Presses de l'Université du Québec.
Laird, J. (1984). The real role of facial response in the experience of emotion: a
reply to Tourangeau and Ellsworth, and others. Journal of Personality and Social
Psychology, 47, 909-917.
Levenson, R.W., Ekman, P. & Friesen, W.V. (1990). Voluntary facial action
363-384.
Lum, L.C. (1981). Hyperventilation and anxiety state. Journal of the Royal
Society of Medicine, 74, 1-4.
Lyman, B. & Waters, J.C.E. (1986). The experiential loci and sensory qualities
Wagner (Ed.), Social psychophysiology and emotion: Theory and clinical application.
Wiley.
Manstead, A.S.R. (1991). Expressiveness as an individual difference. In R.S.
G.A. Bonano (Eds.), Emotion: current issues and future directions. New York: Guilford
Press.
Reisenzein, R. (1983). The Schachter theory of emotion: Two decades later.
Rimé, B., Philippot, P., & Cisamolo, D. (1990). Social schemata of peripheral
process model of emotion elicitation. In J.P. Forgas (Ed). Feeling and thinking: The role
Teasdale, J.D. (1996). Clinical relevant theory: Integrating clinical insight with
Guilford.
Tomkins, S.S. (1980). Affect as amplification: some modification in theory. In
R. Plutchik & H. Kellerman (Eds.), Theories of emotion (pp. 141-164). New york:
Academic Press.
Zajonc, R.B. & McIntosh, D.N. (1992). Emotions research - Some promising
Guilford.
Respiratory Feedback 34
Notes
1
It should be noted that only 20 participants took part in this study and that, although it
data were thus not recorded. Given the strong impact of breathing on cardiovascular
parameters, such data would have been useless in the present context.
Respiratory Feedback 35
Table 1.
Only emotional feeling states items relevant to the emotion conditions are presented in
this Table.
Respiratory Feedback 36
Table 2.
Emotion.
Respiration Emotion
Parameter Joy Anger Fear Sadness
Note. Means with different subscripts differ at least at the 0.01 level of significance
Table 3
Table 4.
SD 33 8 12 25
Anger Mean 1c II 55a I 47b I 7c II
SD 2 37 32 12
Anxiety, Fear Mean 1b II 40a II 39a I 8b II
SD 2 35 34 13
Sadness Means 5b II 12b III 13b II 21a I
SD 13 16 26 27
Note. Means with different subscripts differ at least at the 0.01 lsmithevel of
significance according to t-test using Bonferroni’s correction. Alphabetic subscripts
indicate a comparison between breathing conditions for a given feeling state; Roman
figures subscripts indicate a comparison between feeling state for a given breathing
condition.
HEALTH
27 JUL 2016
It’s literally the most boring thing you do every day. And thank goodness - if breathing
weren’t completely rote, we’d all be dead.
But if you’re like me, your inhales and exhales seem to be inexplicably linked with your
state of mind. When I’m stressed, I steal antsy, shallow sips of air and puff them out
quickly. When I’m relaxed, on the other hand, I breathe in gently and deeply, before
letting go of the air slowly.
Studies suggest that I’m not the only one who’s noticed a link between their emotional
state and their breathing.
While rapid breathing can often be a symptom of stress or anxiety, research shows that
taking control of our breathing can also influence how we feel.
Consciously taking deep, slow breaths, for example, may calm us down by convincing our
minds that we’re already in a state of relaxation, Dr. Martin Paulus, a professor of
psychiatry at the University of California San Diego professor, writes in a 2013
manuscript in the journal Depression and Anxiety.
Unfortunately, many of us are used to breathing in a way that tends to be bad for us.
1/2
"For many of us, deep breathing seems unnatural. There are several reasons for this. For
one, body image has a negative impact on respiration in our culture. A flat stomach is
considered attractive, so women (and men) tend to hold in their stomach muscles," write
the folks at the Harvard Medical School in a recent blog post.
"This interferes with deep breathing and gradually makes shallow ‘chest breathing’ seem
normal."
These quick inhalations and exhalations can actually make us feel more tense. But there
are plenty of ways to change this pattern - and plenty of research that supports doing so
too.
A 2012 randomised controlled study of 46 male and female musicians who were briefly
trained in deep breathing and biofeedback suggested that a single 30-minute session of
slow breathing (with or without the biofeedback component) helped reduce symptoms
of anxiety before a performance, particularly in musicians who said they tended to get
very anxious.
The benefits may extend to people with more severe anxiety as well. The authors of
a small 2014 study of male veterans with PTSD found that those who did three hours
each day of a breathing-based meditation program for a week experienced a decrease in
PTSD symptoms and anxiety.
If you’ve never tried deep breathing before, Harvard has some tips for giving it a shot.
First, find a quiet, comfortable place to sit or lie down. Then, inhale slowly through your
nose, letting your chest and lower stomach expand.
Finally, exhale slowly through your mouth or nose. It also can be helpful to count while
you’re breathing as a way of helping to even out your inhales and exhales.
2/2
Short communicationMechanisms of mindfulness:
Emotion regulation following a focused breathing
induction
sciencedirect.com/science/article/abs/pii/S0005796705002743
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Outline
1. Abstract
2. Keywords
3. Introduction
4. Method
5. Results
6. Discussion
7. References
Figures (2)
1.
2.
Tables (2)
1. Table 1
2. Table 2
a ab 1/3
Joanna J.Archa Michelle G.Craskeab
https://doi.org/10.1016/j.brat.2005.12.007Get rights and content
Abstract
The current study investigated whether a 15 min recorded focused breathing induction
in a normal, primarily undergraduate population would decrease the intensity and
negativity of emotional responses to affectively valenced picture slides and increase
willingness to remain in contact with aversive picture slides. The effects of the focused
breathing induction were compared with the effects of 15 min recorded inductions of
unfocused attention and worrying. The focused breathing group maintained consistent,
moderately positive responses to the neutral slides before and after the induction,
whereas the unfocused attention and worry groups responded significantly more
negatively to the neutral slides after the induction than before it. The focusing breathing
group also reported lower negative affect and overall emotional volatility in response to
the post-induction slides than the worry group, and greater willingness to view highly
negative slides than the unfocused attention group. The lower-reported negative and
overall affect in response to the final slide blocks, and greater willingness to view
optional negative slides by the focused breathing group may be viewed as more adaptive
responding to negative stimuli. The results are discussed as being consistent with
emotional regulatory properties of mindfulness.
Keywords
Emotion regulation
Behavioral willingness
Mindfulness
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3/3
Proper Breathing Brings Better Health
scientificamerican.com/article/proper-breathing-brings-better-health
As newborns, we enter the world by inhaling. In leaving, we exhale. (In fact, in many
languages the word “exhale” is synonymous with “dying.”) Breathing is so central to life
that it is no wonder humankind long ago noted its value not only to survival but to the
functioning of the body and mind and began controlling it to improve well-being.
As early as the first millennium B.C., both the Tao religion of China and Hinduism placed
importance on a “vital principle” that flows through the body, a kind of energy or internal
breath, and viewed respiration as one of its manifestations. The Chinese call this energy
qi, and Hindus call it prana (one of the key concepts of yoga).
A little later, in the West, the Greek term pneuma and the Hebrew term rûah referred
both to the breath and to the divine presence. In Latin languages, spiritus is at the root of
both “spirit” and “respiration.”
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Recommendations for how to modulate breathing and influence health and mind
appeared centuries ago as well. Pranayama (“breath retention”) yoga was the first
doctrine to build a theory around respiratory control, holding that controlled breathing
was a way to increase longevity.
1/8
In more modern times, German psychiatrist Johannes Heinrich Schultz developed
“autogenic training” in the 1920s as a method of relaxation. The approach is based partly
on slow and deep breathing and is probably still the best-known breathing technique for
relaxation in the West today. The contemporary forms of mindfulness meditation also
emphasize breathing-based exercises.
In fact, every relaxation, calming or meditation technique relies on breathing, which may
be the lowest common denominator in all the approaches to calming the body and
mind. Research into basic physiology and into the effects of applying breath-control
methods lends credence to the value of monitoring and regulating our inhalations and
exhalations.
Yoga and meditation have inspired many of the breathing exercises used today. The
benefits of controlled respiration were first theoretically posited centuries ago by the
practitioners of pranayama yoga. Credit: Getty Images
This power is evident in patients who have breathing difficulties. When these difficulties
are sporadic and acute, they can trigger panic attacks; when they are chronic, they often
induce a more muted anxiety. It is estimated that more than 60 percent of people with
chronic obstructive pulmonary disease (COPD) have anxiety or depressive disorders.
These disorders probably stem in part from concerns about the consequences of the
disease (what could be more distressing than struggling to breathe?), but purely
mechanical factors may contribute as well: the difficulty these patients experience often
leads to faster breathing, which does not necessarily improve the quality of their oxygen
supply but can aggravate their physical discomfort and anxiety.
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Rapid breathing can contribute to and exacerbates panic attacks through a vicious circle:
fear triggers faster breathing, which increases fear. In 2005 Georg Alpers, now at the
University of Mannheim in Germany, and his colleagues observed significant and
unconscious hyperventilation when people who had a driving phobia took their vehicles
on the highway (where they might not be able to pull over if they become agitated).
Whether anxiety derives from breathing problems or other causes, it can be eased by a
number of breathing techniques derived from traditional Eastern approaches (see “Six
Techniques for Relieving Stress”). For example, “follow your breath,” an exercise that
focuses attention on breathing, is one of the first steps in mindfulness meditation,
whereas alternate nostril breathing comes from yoga. Combining reassuring thoughts
with breathing is an approach incorporated into sophrology, a technique that
emphasizes harmony of body and mind and that borrows exercises from many
approaches, including yoga and mindfulness.
Overall, research shows that these techniques reduce anxiety, although the anxiety does
not disappear completely. Breathing better is a tool, not a panacea. Some methods have
been validated by clinical studies; others have not. But all of those I describe in this
article apply principles that have been proved effective. They aim to slow, deepen or
facilitate breathing, and they use breathing as a focal point or a metronome to distract
attention from negative thoughts.
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A typical cardiac coherence exercise involves inhaling for five seconds, then exhaling for
the same amount of time (for a 10-second respiratory cycle). Biofeedback devices make it
possible to observe on a screen how this deep, regular breathing slows and stabilizes the
beats. (The space between two heartbeats on the display is never exactly the same, but it
becomes increasingly more consistent with this technique.) Several studies have
confirmed the anxiety-diminishing effect of these devices, although the equipment
probably has more influence on the motivation to do the exercises (“It makes it seem
serious, real”) than on the physiological mechanisms themselves. Simply applying slow
breathing with the same conviction and rigor could well give the same result.
Some versions of cardiac coherence recommend spending more time on exhaling than
on inhaling (for example, six and four seconds). Indeed, your heart rate increases slightly
when you inhale and decreases when you exhale: drawing out the second phase
probably exerts a quieting effect on the heart and, by extension, on the brain. This
possibility remains to be confirmed by clinical studies, however.
Other work suggests that the emotional impact of the breathing done in cardiac
coherence and various other kinds of exercises stems not only from effects on the
periphery—on the parasympathetic nervous system—but also from effects on the
central nervous system. Breathing may well act directly on the brain itself.
In 2017, for instance, Mark Krasnow of Stanford University and his colleagues showed in
mice that a group of neurons that regulates respiratory rhythms (the pre-Bötzinger
complex in the brain stem) controls some of the activity of the locus coeruleus, a region
involved in attention, wakefulness and anxiety. Breathing techniques may influence this
seat of emotions by modulating the activity of the pre-Bötzinger complex.
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Beyond any direct effects produced by slowed breathing, the attention given to inhaling
and exhaling may play a role in the brain’s response. In 2016 Anselm Doll and his
colleagues, all then at the Technical University of Munich, showed that this attentional
focus eases stress and negative emotions, in particular by activating the dorsomedial
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prefrontal cortex, a regulatory area of the brain, and by reducing activity in the
amygdala, which is involved in these emotions.
In addition, paying attention to breathing causes most people to slow it down and to
deepen it, which as I have mentioned, is soothing. Cognitive resources are limited, and
so when individuals concentrate on breathing, they are not thinking about their worries.
Those who practice mindfulness learn to notice when their attention drifts away from
breathing and goes back to their concerns, and they train themselves to return
periodically to their breathing. This refocusing has a relaxing effect on anyone and helps
to combat ruminative thinking in people who have anxiety or depression, especially
those who are particularly prone to negative thoughts that run in a loop.
These exercises may also help when insomnia strikes. In 2012 Suzanne M. Bertisch of
Harvard Medical School and her colleagues reported, based on survey data, that more
than 20 percent of American insomniacs do these breathing exercises to sleep better.
They may be on to something. In 2015 Cheryl Yang and her team at National Yang-Ming
University in Taiwan showed that 20 minutes of slow breathing exercises (six respiration
cycles per minute) before going to bed significantly improves sleep. Insomniac
participants went to sleep faster, woke up less frequently in the night and went back to
sleep faster when they did wake up. On average, it took them only 10 minutes to fall
asleep, almost three times faster than normal. The investigators attributed the results
both to the calming mediated by the parasympathetic system and to the relaxing effect
of focused breathing.
But respiratory techniques do not work only for acute stresses or sleep problems; they
can also relieve chronic anxiety. They are particularly effective in people with psychiatric
disorders such as phobias, depression and post-traumatic stress disorder. In 2015
Stefania Doria and her colleagues at Fatebenefratelli e Oftalmico Hospital in Milan, Italy,
offered 10 training sessions of two hours each, spread out over two weeks, to 69
patients with anxiety or depressive disorders. The training included a varied set of
breathing techniques (such as abdominal breathing, acceleration and deceleration of
rhythm, and alternate nostril breathing.), combined with some yoga stretches. The
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researchers observed a significant decrease in symptoms at the end of the protocol.
Even better, improvement was maintained two and six months later, with follow-up
sessions just once a week and some home practice during this period.
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Breathing exercises also help to counter the accumulation of minor physical tension
associated with stress. Therapists recommend doing them regularly during the day,
during breaks or at moments of transition between two activities: you simply stop to
adjust your posture and allow yourself a few minutes of quiet breathing. Therapists
often suggest the “365 method”: at least three times a day, breathe at a rhythm of six
cycles per minute (five seconds inhaling, five seconds exhaling) for five minutes. And do
it every day, 365 days a year. Some studies even suggest that, in addition to providing
immediate relief, regular breathing exercises can make people less vulnerable to stress,
by permanently modifying brain circuits. In a practice that may seem counterintuitive,
however, counselors may encourage some anxious patients to breathe rapidly instead of
slowly, as part of an effort to train them to cope with their anxieties (see box “Inhale for
Panic!”).
But why confine breathing techniques to negative emotions? It is also worth applying
them during pleasurable moments, to take the time to appreciate and remember them.
In short, one can pause and breathe for enjoyment as well as to calm down.
Open Questions
Tradition and experience encourage the use of respiratory-control techniques, and
scientific studies increasingly suggest that it is a good idea. Nevertheless, further
research is still needed, particularly given that some studies lack control groups. One
exception stands out: focusing on breathing often is not a good idea for people having a
panic attack that stems from anxiety over their physical state (also known as
interoceptive anxiety). In this case, focusing on physiology, such as muscle tension or
breathing, may actually amplify panic (“Now that I’m paying attention to it, my breathing
doesn’t seem regular. Am I choking? What will happen if I suddenly stop breathing?”) For
these people, breathing techniques should be tested and practiced under the
supervision of a therapist.
In fact, I am mystified that controlled breathing is not recommended and practiced more
widely. Perhaps it is perceived as too simple, commonplace and obvious to be a remedy.
Faced with the complexity of negotiating the ups and downs of human life, many people
may assume that simple solutions cannot be effective.
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Or maybe we are intimidated by the sacred aspect of breathing, by its connection to life
and, especially, to death. In the 1869 novel The Man Who Laughs, Victor Hugo wrote:
“Generations are puffs of breath, that pass away. Man respires, aspires, and expires.”
Ultimately, we don’t like to think that we are nothing more than “puffs of breath.”
Here are some commonly used breathing techniques. Five to 10 minutes of exercise can
relieve sporadic stress and even fend off panic attacks. More regular practice can lower
the daily levels of anxiety.
Stand Up Straight
Posture is important for breathing: hold yourself straight, without stiffness, shoulders
back, sitting or standing. This body posture facilitates the free play of the respiratory
muscles (of the diaphragm and between the ribs). Good posture enables your body to
breathe properly on its own.
Abdominal Breathing
Breathe “through your stomach” as much as possible: start by inflating your belly by
inhaling, as if to fill it with air, then swell your chest; as you exhale, first “empty” your
stomach, then your chest. This type of breathing is easier to observe and test while lying
down, with one hand on your stomach.
Rhythmic Breathing
Near the end of each inhalation, pause briefly while mentally counting “1, 2, 3” and
holding the air before exhaling. This counting while not breathing can also be done after
exhaling or between each inhalation or exhalation. It is often recommended for anxious
patients to calm anxiety attacks because it induces a beneficial slowing of the breathing
rate.
Alternate Nostrils*
Breathe in and out slowly through one nostril, holding the other one closed using your
finger; then reverse and continue by alternating regularly. There are many variations of
this exercise—for example, inhaling through one nostril and exhaling through the other.
Research suggests that what is most important, aside from slowing the breathing
rhythm, is breathing through the nose, which is somewhat more soothing than breathing
through your mouth.
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Think Reassuring Thoughts While Breathing
With each breath, think soothing thoughts (“I am inhaling calm”). With each exhalation,
imagine that you are expelling your fears and worries (“I am exhaling stress”).
Whereas slow breathing soothes, overly rapid breathing can induce feelings of stress
and anxiety. This phenomenon is used in behavioral therapy sessions to train anxious
patients to confront their emotions directly. By deliberately hyperventilating, patients
artificially trigger an unpleasant anxiety, which they get accustomed to feeling and learn
to put in perspective. This technique also enables them to see that poor breathing habits
amplify their fear.
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Take a deep breath — no really, it will calm your brain
theverge.com/2017/3/30/15109762/deep-breath-study-breathing-affects-brain-neurons-emotional-state
When you’re stressed, people often advise you to take a deep breath — and for good
reason, a new study shows. Slowing your breathing calms you, and now scientists may
have figured out how you can relax your brain through your breath. It has to do with
your brain’s pacemaker for breath.
For anyone looking for ways to deal with stress and negative emotions, that’s big news.
Although it’s been generally known that breathing exercises can have a calming affect on
emotions, the researchers’ findings could provide a scientific explanation for why
hyperventilation makes us anxious, or why breathing slowly can calm us down.
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“It’s a tie between breathing itself and changes in emotional state and arousal that we
had never looked at before,” says Feldman. “It has considerable potential for therapeutic
use.”
In their research, the scientists identified and studied 175 of these preBötC neurons. By
eliminating these neurons in the mice, the mice’s major breathing patterns were
unchanged, but they became significantly calmer. That finding led to the discovery of a
link between the preBötC and another brainstem structure which affects arousal, called
the locus coeruleus. In other words, they found the neural circuit that causes us to be
anxious when we breathe rapidly, and calm when we breathe slowly.
"The discovery was not what the scientists had initially set out to find"
That discovery, however, was accidental. When the scientists started their work, they
wanted to identify key neurons involved in generating the breathing rhythm, according
to Yackle, the lead author of the study and a faculty fellow at the University of California-
San Francisco. When they targeted these specific neurons, they expected them to be
important for breathing.
“So initially I was very disappointed to find that they were not involved in generating the
breathing rhythm, but then very surprised when we found that they are instead
important for controlling the arousal state of the animal,” says Yackle in an email
statement to The Verge. “Although in retrospect we might now appreciate that this neural
circuit would exist, I would have never predicted it going into these studies.”
The ties between these neurons and brainstem structures have different practical
applications. Many people already use pranayama, the meditative breathing exercises
found in several varieties of yoga, in order to enter a calm emotional state. Some of us
might be deliberately utilizing these pathways on a regular basis by intentionally slowing
our breathing to relax ourselves.
"“By changing patterns of breathing, we can change our emotional states and how we
think and how we interact with the world.”"
Slowing one’s breath through breathing exercises is already in use for some kinds of
anxiety disorders, and has been systemized by some organizations such as Breath-Body-
Mind. Led by Patricia Gerbarg, an assistant clinical professor in psychiatry at New York
Medical School and author of a 2009 study on pranayama, the group has teamed up with
therapists in locations such as Berlin to relieve stress, anxiety, depression, and trauma in
refugees by using movement, breathing and meditative practices.
“By changing patterns of breathing, we can change our emotional states and how we
think and how we interact with the world,” says Gerbarg. “That’s a very powerful tool for
psychological practices.”
The newly discovered neural pathways, however, might be targets for drugs, especially
for panic and anxiety disorders which can be triggered by hyperventilation, according to
Yackle. By designing drugs that specifically target the place in the brain where anxiety
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and hyperventilation are linked, scientists may be able to help people with these
disorders to lower the likelihood of panic attacks — which are typically characterized by
difficulty maintaining normal breath.
"Yackle plans to continue studying the breathing pacemaker region, and hopes to
identify the neural types that generate breathing rhythm"
Gerbarg, however, warns that much more work need to be done before the study’s
findings are fully applicable to humans. In part, this is because you can’t ethically knock
out nerves in humans. “It takes a few more steps to get it to a clinical matter,” says
Gerbarg.
Some of these next steps might include silencing this neural circuit, and seeing if that
prevents anxiety caused by hyperventilation, says Yackle. He plans to continue studying
the breathing pacemaker region, and hopes to identify the neural types that generate
breathing rhythm.
For many of us, the practicality of these findings boils down to having scientific evidence
that confirms what we already know: our breathing is related to our emotional state, and
slowing breath really can calm you down. So if you’re worried about Congress clearing
the way for internet providers to sell your web browsing history, it might be time to take
a few deep breaths — that way you won’t panic.
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You've been breathing all wrong
businessinsider.com.au/how-to-relax-by-breathing-2016-7
But if you’re like me, your inhales and exhales seem to be inexplicably linked with your
state of mind. When I’m stressed, I steal antsy, shallow sips of air and puff them out
quickly. When I’m relaxed, on the other hand, I breathe in gently and deeply, before
letting go of the air slowly.
Studies suggest that I’m not the only one who’s noticed a link between their emotional
state and their breathing.
While rapid breathing can often be a symptom of stress or anxiety, research shows that
taking control of our breathing can also influence how we feel. Consciously taking deep,
slow breaths, for example, may calm us down by convincing our minds that we’re already
in a state of relaxation, Dr. Martin Paulus, a professor of psychiatry at the University of
California San Diego professor, writes in a 2013 manuscript in the journal Depression
and Anxiety.
Unfortunately, many of us are used to breathing in a way that tends to be bad for us.
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“For many of us, deep breathing seems unnatural. There are several reasons for this. For
one, body image has a negative impact on respiration in our culture. A flat stomach is
considered attractive, so women (and men) tend to hold in their stomach muscles. This
interferes with deep breathing and gradually makes shallow ‘chest breathing’ seem
normal,” write the folks at the Harvard Medical School in a recent blog post. These quick
inhalations and exhalations can actually make us feel more tense.
A 2012 randomised controlled study of 46 male and female musicians who were briefly
trained in deep breathing and biofeedback suggested that a single 30-minute session of
slow breathing (with or without the biofeedback component) helped reduce symptoms
of anxiety before a performance, particularly in musicians who said they tended to get
very anxious.
The benefits may extend to people with more severe anxiety as well. The authors of a
small 2014 study of male veterans with PTSD found that those who did three hours each
day of a breathing-based meditation program for a week experienced a decrease in PTSD
symptoms and anxiety.
If you’ve never tried deep breathing before, Harvard has some tips for giving it a shot.
First, find a quiet, comfortable place to sit or lie down. Then, inhale slowly through your
nose, letting your chest and lower stomach expand. Finally, exhale slowly through your
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mouth or nose. It also can be helpful to count while you’re breathing as a way of helping
to even out your inhales and exhales.
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