By Dr. Sumer Aeed
Breathwork involves intentionally controlling the way you breathe. Breathwork is a holistic, mind-body approach to mental health and well-being. It can be done simply and on your own, or it can be structured and part of a formal program. Its purpose is to directly influence your body’s inner workings to reduce stress, anxiety, and other challenges, increase calm, and encourage well-being.
Physiologically, long slow, deep breathing creates a cascade of physical and neurological responses that result in a powerful state of relaxation that can be accessed anytime, anywhere by anyone.
Whether you are seeking to heal your mental health, deal with chronic pain or a physical diagnosis, increase your ability to be non-reactive, enhance your spirituality, quiet your mind, strengthen your connection to your inner self, become more intentional, focus your skills as an athlete or professional, or simply desire to be more present, breathwork has something to offer you.
Prāṇāyāma, or intentional breath control, has been a part of yoga since its origins thousands of years ago. Prāṇa, life force and yama, to control, is an impactful way of learning to harness the benefits and power of our breath. Although many of the types of breathwork stem from yoga they can be practiced as a stand-alone activity and are used by athletes, mental health communities, and others who value the benefits to mind body, and spirit.
The primary purpose of breathwork is to activate the body’s relaxation response, although it can also be used to increase the body’s energy if needed. Through breathwork, we can learn to better manage our autonomic nervous system and adjust to whichever state best serves our current goal.
Interestingly, people practicing breathwork seem to find a sweet spot at around six breaths a minute. This appears to bring about markedly greater relaxation through a positive feedback loop between the lungs, the heart, and the brain.
Many repetitive spiritual practices across cultures, such as the Ave Marias of rosary prayers and the chanting of yogic mantras. It has been theorized that these practices evolved by recognizing this restorative breathing rhythm and how it can aid all of us in a relaxed and focused state of mind.
Learning to be intentional about our breath helps with reactivity being lowered, sleep, appetite, focus, physical and mental health, and increased positivity in social connections. Prāṇāyāma and other breathwork practice can enhance and/or heal mental health concerns, can be easily learned, is free to try, has no side effects, can be done anywhere, and is useful for all physical conditions and ages.
Where Does Breathwork Help?
There is a multiplicity of benefits to breathwork that research continues to uncover. The benefits for mental health include managing PTSD symptoms, decreasing anxiety and depression, managing social anxiety, lowering anger responses, reducing fear, helping manage big emotions, reducing chronic pain, helping with sleep and appetite, and teaching us to better tune into our body and make a mind/body connection.
In our current culture, so many of us are unconsciously disconnecting from our bodies and our breath regularly. The incidence of disassociation is high among most adults and the experience of being present in our breath and body can be a novel experience for many. Body mind and spirit can all benefit from exploring our breath and the power that brings to our lives.
Being able to better regulate our central nervous systems is the primary road to managing all of our mental health concerns as well as maximizing our social and relational functioning. Breathwork allows us to slow down our reactions, be more aware of our emotions, and be more cued into our choices in how we show up rather than simply being unconscious or reactive. As Dr. Gerbard, a Harvard Psychiatrist reminds us, “By changing patterns of breathing we can change our emotional states, how we think, and how we interact with the world.”
Another benefit of being able to better manage our central nervous system is lowered cortisol and adrenaline which reduces stress and inflammation in our bodies. Slowing and managing our breath also reduces disease, is a preventative factor in many hereditary illnesses, and allows us to be more present and aware of what is happening in our physical bodies.
Regular breathwork can also increase core strength, lower blood pressure, and manage digestion concerns as well as increase oxygen levels in the body. We are better able to gauge what ‘speed’ to use for activities which allow the chemical that best serves each activity to be present which allows our bodies to be more efficient in all activities and experience less stress overall. Dr. Ananada Bhavvanni, researcher and yoga therapist states, “Animals such as the rat and rabbit have fast breathing and so are extremely nervous, mentally unstable, emotionally restless, and live only for a short period of time. In contrast, the elephant and turtle are slow, deep breathers and consequently have calmer personalities and longer lives.”
Breathwork can be used primarily for emotional or physical benefits, however, a long legacy of breathwork across cultures is in deepening spiritual awareness and connection. In fact, the English word “spirit” originated from the word for “a breath” in Latin. When we do slow deep breathing theta waves are increased which can increase our sense of connection with nature, creativity, and the unconscious mind. Breathwork can reduce the feeling of separation often experienced in our current culture and create more of a sense of belonging and integration or wholeness. – Thich Nhat Hanh, Buddhist monk, meditation teacher, & author reminds us that, “Breath is the bridge which connects life to consciousness, which unites your body to your thoughts. Whenever your mind becomes scattered, use your breath as the means to take hold of your mind again.”
Exploring the Path of Breathwork
Prāṇāyāma is part of the yogic tradition and simply means intentional breath control. If you practice yoga on your own or as part of a class and you are prompted to breathe in a certain way, you are engaging in prāṇāyāma to enhance the flow of energy and release energy blocks. 1
You can also use this breathwork outside of yoga and entirely on your own to reap numerous physical, mental, and spiritual benefits. It can be as simple as noticing when you’re stressed, anxious, or otherwise out-of-sorts and pausing to close your eyes and take a few slow, deep breaths.
Breathwork refers to any type of breathing exercise that involves intentionally changing or controlling your breathing pattern, whereas specific breathwork programs involve learning particular exercises in a special setting or for a targeted purpose. There is a vast multitude of breathwork exercises and practices, here is a small sampling of some to try on your path of exploring.
A Sampling of Breathwork Options
Breathwork tools are a deep box of options so below is an exploration of just some of the more common types that may be used to explore the power of breath.
Simply begin to pay attention to how you breathe to catch yourself breathing shallowly or too quickly. When you notice this chest breathing, deepen and slow your inhalations and exhalations. You can begin to explore feeling the breath as you breathe in your nose and out or out of your mouth. You may play with slowing down your breathing or pausing in between inhales and exhales.
Diaphragmatic Breathing, Dīrgha Prāṇāyāma
Often known as belly breath, here you simply relax your shoulders and inhale fully so that your abdomen expands outward as it fills with air. Feel your belly expand with each breath, and feel the tension leave your body with each out-breath. You might say in or out as you breathe or let and go, either inhaling and exhaling for the same count or exhaling for a few more counts than you inhale.
Your breath count can be in for 4 and out for 6, and this can be increased up or down based on your comfort level and experience. A helpful practice is to do this 2-5 times every morning before getting out of bed to start the day and then to do the same before going to sleep at night.
Bhrāmarī Prāṇāyāma, The Humming Bee Breath
The yoga breath Bhrāmarī, also known as the humming breath or humming bee breath, is meant to clear a buzzing mind. Practicing this breath balances the body’s circulation and vital energy while improving mental and emotional awareness.
To practice, sit in an upright seated position. Bring a slight contraction to the back of your throat and inhale through your nose, as you would for an Ujjāyī breath. As you exhale through your nose, produce a humming sound in your throat for a long, slow breath. Practice the humming breath for ten deep breaths. To feel more resonance in your heart, you can block your ears during the exhale.
Alternate Nostril Breathing, Nāḍī Śodhana
Place one hand over your nose, with your thumb gently above or over one nostril and a finger gently over the other. Hold one nostril shut and inhale slowly through the other. When you have a full inhale, pause, pinch that side shut, and exhale through the other nostril. Pause briefly and inhale through that same nostril, switching again before exhaling. Continue this cycle for several minutes.
Two fast breath techniques are often used in yoga, the breath of fire (kapālabhāti) and the bellows breath (bhastrikā). These are controlled-breathing techniques done to improve digestive and respiratory health and reduce stress.
These can be more advanced techniques and if you deal with anxiety maybe not be the best fit for your practice. Those with depression may find this breath increases their focus and energy. While the opposite of slow, deep breathing, rapid breathing techniques can also positively affect the brain and body. Breath of fire focuses on the exhale as you breathe out sharp, quick puffs of air. Bellows breath involves quick, forceful inhalations and exhalations. Both of these are generally practiced for shorter periods of time.
This is a more formal, guided breathwork. Holotropic breath involves a 20-60 minute session of rapid, rhythmic breathing. It is designed to induce an altered state of consciousness and emotional catharsis in a group setting although also helpful in individual settings. This breathwork general involves a trained guide to begin and then may be practiced solo.
Wim Hof Breathwork
Wim Hof introduces some of the more extreme breathwork which has been widely used among athletes as well as the mental health community. Done to enhance well-being and connection to the natural world, this technique uses meditation and intentional, controlled breathing while experiencing cold water, snow, or ice. We can make use of naturally occurring cold water in pools or oceans or even purchase cold plunges or make use of smaller cold water interventions from the sink or bowls of ice to experience the benefits of this method.
Ocean Sounding Breath, Ujjāyī Prāṇāyāma
Sanskrit for “victorious breath,” ujjāyī is another prāṇāyāma technique. Ujjāyī generates a “haaa” sound.
It’s recommended that you do ujjāyī prāṇāyāma while sitting up.
First Inhale through your nose.
- As you slowly exhale, contract your throat and make a “haaaa” ocean sound. For beginners, it’s easier to make the sound while exhaling with your mouth open. A helpful cue for this is to imagine using your breath to try and fog up a window.
- As you become advanced, try exhaling without opening your mouth. When you get good at this you will likely sound somewhat like Darth Vader.
- Continue the breath until you feel less stress or more parasympathetic nervous system response.
Box Breath, Sama Vṛtti Prāṇāyāma With Antarā Kumbhaka and Bāhyā Kumbhaka
Box breath, also known as square breathing or 4-4-4-4 breathing, is a technique that helps to focus on taking even, slow, deep breaths. It’s used by a variety of doctors, mental health, speaking professionals and athletes for stress reduction and to enhance performance. This breath was designed by a Navy Seal Commander.
To prepare for this exercise, sit up straight and attempt to push the oxygen out of your lungs by breathing slowly out of your mouth.
- Slowly breathe in through your nose for a count of 4. Focus on the air filling your lungs.
- Hold your breath for another count of 4.
- Breathe out through your mouth for a third count of 4. Pay attention to the sensation of the air leaving your body.
- Hold your breath again for a final count of 4.
- Continue to repeat these steps as much as desired.
4. 4-7-8 Breathing
4-7-8 breathing allows users to gain control of their breath, aid in reducing stress,
and can even work as a sleep aid.
Here’s how to do it:
- As you part your lips, breathe out through your mouth while making a
- Close your mouth and inhale through your nose to the count of 4.
- Hold your breath for a count of 7.
- Make another whooshing sound as you breathe out your mouth for a count
- Repeat these steps as much as desired.
Equal or Circular Breathing – Sama Vṛtti
This is a breath that focuses on making your inhales and exhales the same length. This is done to make your breaths smooth and steady and to help you achieve a sense of balance and equanimity. It is known to engage the parasympathetic nervous system and ease anxiety and stress.
Here’s how to do it:
- Sit down in a comfortable position.
- Breathe in and out through your nose.
- Count your inhales and exhales to make sure that they are the same length. If this is uneasy, select a word or phrase to mentally say with every inhale and exhale.
- You can also take a short pause between each inhale and exhale if this is helpful.
- Continue this exercise for as long as desired.
Resonant Breathing or Coherent Breathing
This breath is known for helping to maximize your heart rate variability. It involves breathing 5 breaths a minute and has been linked to lowering depression and blood pressure. This is one of the simplest exercises that can be done anywhere at any time.
Here’s how to do it:
- Get into a comfortable position of your choice.
- Breathe in for a count of 5.
- Breathe out for a count of 5.
- Continue these steps as desired.
Some Breathwork Guidelines and Suggestions
Set an intention and goal to practice
Don’t expect to wait until difficult moments to begin the benefits of breathwork. Know there will be a learning curve and the best way to gain mastery and get the most benefits is a simple small daily practice. Sent an intention of a specific time or times each day to commit to breathing. You can do it on your own or follow a guided practice.
Find the way that feels best to your body to practice breathwork. You may sit up or lie down or even stand or slowly walk if that feels best. Create a space where there are few distractions so that you can comfortably tune into your body. If closing your eyes triggers you simply lower your gaze or focus on one object and soften your gaze.
Give It Your Full Presence
Mindful breathing simply refers to paying attention to the act of breathing, and
noticing how the air sounds and feels as it enters and leaves your body. 2 Mindfulness helps focus and calm the mind because you are paying attention on purpose to what you are doing rather than multitasking, zoning out, or remaining caught up in troublesome thoughts.
Many mindfulness meditations involve sitting in stillness and paying attention to breathing. Your mind will wander, and when it does, simply notice it and return your attention to your breath.
Accept the Imperfection of Breathwork Practice
Go slow and explore different types of breath that feel right for you. Know that there is no wrong way to do breathwork or any one size fits all approach.
Breathwork is a practice and learned behavior so give yourself grace in practicing over time to get the benefits.
Be willing to use technology.
Make use of apps such as Calm, Headspace, Insight Timer or using YouTube, and more to seek guided audio or video of breathwork exercises. This can help you get the techniques down as well as the added benefit of having someone else guide you through the process which can reduce distractions and ‘monkey mind’.
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Regulation: Exploring the Neurocognitive Mechanisms behind Mindfulness. BioMed Res Int (2015) 2015:670724. doi: 10.1155/2015/670724
- Sudarshan Kriya yogic breathing in the treatment of stress, anxiety, and
depression: part I-neurophysiologic model. Brown RP, Gerbarg PL.
J Altern Complement Med. 2005 Feb;11(1):189-201. doi:
PMID: 15750381 Review.
- Tiwari N, Baldwin DS. Yogic breathing techniques in the management of anxiety
and depression: Systematic review of the evidence of efficacy and presumed
mechanism of action. Mind Brain (2012) 3(1).
- Vempati RP, Telles S. Yoga-based guided relaxation reduces sympathetic
activity judged from baseline levels. Psychol Rep (2002) 90:487–94. doi: