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Remember right before an exam in school? You weren't sure if you had studied enough for the test and started to worry about failing? What was happening to you at that moment, or moments similar to that? I'm talking about anxious, stressful, worrisome moments in your life. You were thinking about something in a negative way, and it caused you to physically feel tense all over.

I go through this several times a week for a variety of reasons (will I provide safe care to my patients, will my family remain healthy, etc.). It's happening less and less, though. The thing that helps me is reaching into my bag of experience and using the things that have worked for me in the past. Deep diaphragmic breathing is one of those things. I actually wanted to post this before the article on progressive muscle relaxation because it goes really well with that script. I usually had my clients practice this deep breathing exercise before going into the muscle relaxation script, but it can be extremely useful on its own if you're experiencing tension or anxiety.

When We're Anxious, We Take Shallow Breaths

Think of when you watch a scary movie or when you feel apprehensive (like when the boss is about to see that you're surfing the web instead of working). Your breathing becomes short and shallow; that is, your lungs are not fully expanding. This initiates a domino effect of sorts. Shallow breathing leads to less oxygen, which leads to rapid breathing pattern accompanied by a feeling of constriction. We interpret the constriction negatively, which can lead to increased fear. This then perpetuates a vicious cycle of shallow breathing, increased tension, and increased anxiety.

There are other things that feed and contribute to this process physiologically, but we'll leave it in a basic form for easier understanding. Just know that when we are able to fully expand our lungs when we breathe, we are able to instigate a chain reaction of events within us that lead to calmer and more relaxed states of being. We can control our reaction to stress and in effect keep ourselves healthier.

The Evaluation

For the sake of ease of demonstration, it's helpful to:

1. Sit in a comfortable chair. Loosen any restrictive clothing (belts, undo the top bottom of your shirt, etc.). Place your feet flat on the ground. Keep your spine straight.
2. Put one hand on your chest. If you're a righty, use this hand. If not, use your left.
3. Put one hand on your belly. If you only have one hand, then lean a book against your belly.
4. Breath and observe. Like most people, you will probably see you're top hand move outward while your bottom hand (or book) stays relatively still. This is what we want to change.

When your chest is the only thing that moves when you breathe, only the top potions of your lungs are getting oxygen. The lungs are not fully expanding. This means that your body is not getting the full benefit of the breathing process. Think of those Discovery Channel shows where an emergency room patient is intubated and connected to a breathing machine. Does the machine only fill the upper portions of his lungs so that we only see his chest move? Not at all. His chest and his belly move up and down. This is the type of breathing that is most healthful for us to do. It helps promote a sense of well-being while supplying the body with ample amounts of material necessary to promote healing an calmness.

The Routine

Now, again:

1. Sit in a comfortable chair. Loosen any restrictive clothing. Place your feet flat on the ground. Keep your spine straight.
2. Put one hand on your chest. If you're a righty, use this hand. If not, use your left.
3. Put one hand on your belly. If you only have one hand, then lean a book against your belly.
4. Exhale one breath. This will help empty your lungs in preparation of taking in a good amount of oxygen.
5. Breath in and observe. This time, I want you to move your belly outward first as you breathe in. You should see your hand over your belly move outward as you fill your lower lungs with air. This is good.
6. Now make your chest move outward. Complete a full deep diaphragmic breath by filling up the upper portions of your lungs with air. You will see your top hand move outward.
7. Breathe the air out slowly. Once your lungs are fully expanded with air, slowly let the air out. It helps to use the pursed lips technique. Pucker your lips or pretend that you have a straw in your mouth. Breathe out through pursed lips. This helps set the tone for a relaxed pace of breathing while allowing the lungs enough time for gas exchange.
8. Repeat. Repeat steps 5-7 as often as you like until you feel more relaxed.

Once you feel comfortable with the steps, you'll see that the process takes place pretty smoothly. When you breathe in, first your belly rises, then your chest rises. You can pretend that you're "filling up your belly" with air followed by filling up your chest with air, if that helps. The point is to try to maximize the amount of air getting into your lungs. Visualizing your belly getting filled up with air before your chest helps to accomplish this.

Health and Personal Growth

Personal growth involves not only branching outward, but taking care of your inner needs. This includes your personal health. If your goal is to be the best person you can be in order to help others, then you must attend to yourself first. Feed yourself before you feed others. Take time to relax properly and healthfully. Mind the temple that houses your spirit. Eat the foods that help you grow, both physically and mentally. Exercise as often as you can. Don't be stagnant. Pay attention to your body's needs when it calls you (don't put off going to the bathroom because you're in the middle of work; there's a reason why your body wants to get rid of the stuff). A healthy and refreshed body can help transport you to anywhere you want to be in life.

-RY