Kate Binnie, yoga teacher and music therapist, writes:
We’ve all experienced the shortness of breath associated with fear, nerves, anger and distress. Think of a tired little boy dropping his Mr. Whippy on the sand after a long hot day in the sun. The mouth opens, the eyes close, the face screws up, and the in-breath comes in jags; in, in, in… and then “waaah!”, an outbreath, quickly interrupted by more jagged in-breaths. Hopefully, someone he loves will come along and hold him, make calming noises, down-regulating the poor lad’s nervous system and encouraging him to take longer exhales (think of the way mothers croon, “It’s aaaall right” into a long, almost sung phrase). Quite soon, his breathing will return to normal and the storm has passed.
As adults, we may not express our distress quite so publicly or vocally, but we will all experience difficult things that will affect our breathing patterns, whether we are consciously aware of this or not. Many of us learn to ‘keep it together’ by literally holding the body’s respiratory muscles tight in defensive mode. We are frozen, as if making ourselves very still and small like a baby animal sensing the shadow of a hawk overhead will keep us safe. Alternatively, we may hyperventilate, a bit like the little boy losing his ice-cream, keeping ourselves in a state of high agitation and alert, pumped with unnecessary fight/flight hormones even when there is no immediate threat. Sometimes we flip-flop between the two.
What most of us want is to live in peace. Universally, within our communities and families, and also within ourselves. We wish for intra- as well as inter-personal peace. This doesn’t mean doing or achieving nothing, sitting about in the lotus position all the time. Active peace requires discipline, reflection, connection and action. When I think of peace, I think of something I need to practice and which is connected to a sense of spaciousness, harmony and integration.
The yogis were onto this at least five thousand years ago. I find it comforting to read ancient texts and discover that people then were just as petty, anxious, stressed and confused as we are now. Buddhism evolved in the pre-Christian era from yoga, and has found its most recent incarnation as mindfulness, currently popular as a ‘third wave’ of cognitive-behavioural interventions used to manage stress and depression and prescribed on the NHS. Yoga is most-often understood (in the West) as a series of stretches and postures that can be learned in a gym class or yoga studio. Its physical practice is popular with supermodels, actresses and vegetarian pop stars, but also with sportsmen and women keen to avoid injury and maintain flexibility.
However, yoga was explicitly designed to ‘calm the fluctuations of the mind’ (Patanjali’s Sutras, verse 1:2) and none of the early texts describe any poses other than finding a ‘comfortable seat’. As the tradition developed, more practices (some weird, some useful) evolved and now we have a plethora of yoga styles, catering for all ages, body-types, cultures and conditions.
So is it all good? Is it all safe? What’s mumbo-jumbo, what’s fancy stretching, and how can we take, test and evaluate the good stuff without losing its extraordinarily flexibility of application? What are the key components of this thing, yoga, that can be roughly translated from the Sanskrit as ‘to yoke’? I prefer to think of it as ‘to integrate’ (body, mind, spirit) and describe yoga as a holistic wellbeing intervention, with a credible place in the arena of public health interventions.
My sense, as I sift through a growing body of evidence and talk to practitioners, researchers and teachers from all traditions, is that it’s the breath that is the common thread. This autonomic function (breathing) seems to be the key for keeping the orchestra of the limbic system tuned, aware, connected and regulated. In learning how to watch, relax into, rest inside and trust the breath (even and especially when we have an illness that means we can’t take it for granted), we are honing a tool that will help us to manage common symptoms we will all experience in our lives at some point such as pain, anxiety, sleep issues, and distress.
For people who are breathless (and I work with many patients with advanced COPD), the effects of yoga breathing are almost immediate. Similarly, in the hospice I use yoga breathing with patients in distress and pain and again, the down-regulating effects are apparent within about five rounds of slow, grounded, full breaths along with verbal instructions to relax face, shoulders, belly, feet.
It’s almost exactly what the mother is doing with her little boy, weeping over his ice-cream, and what the neuropsychologist Allan N. Schore calls affect regulation. His work on the neuroscience of early attachment and trauma describes the soothing behaviours of a mother with her over-stimulated infant and the effects on the baby’s limbic system. What is happening in the mother-infant dyad is, I believe, similar to what is happening between yoga therapist and patient (a guided and relationally-driven practice, regulating the breath, creating a sense of safety) and then moving from the inter-personal to the intra-personal as the practice becomes self-soothing, as people learn to do this for themselves.
Perhaps we could think about utilising this approach; teaching people very simply to engage with their breath, the conductor of the limbic system orchestra. This could help not only breathless patients, but anyone living with chronic pain or other condition that causes the body, breath and mind to fall out of harmony with each other, shut down, or flare up into discord and dis-ease.
Kate is a music therapist and yoga practitioner who works with patients suffering from anxiety, breathlessness and pain. She works independently and at two palliative care hospices and Maggie’s cancer centre in Oxford.