it in any way. Notice the rise and fall of every breath.” After a few moments, I asked her what she had observed.
“I don’t like this exercise,” she responded. “It’s making me anxious and self-conscious.”
I replied, “Please hang in there with me. It can be frustrating to practice this at first, but I promise it will get easier and feel better if you give it a chance.”
Learning abdominal breathing proved to be challenging for Anne because of a lifetime of smoking and her discomfort with these new bodily sensations. Typically, whenever her anxiety kicked in, Anne reached for a cigarette. Now, she needed to train herself to intercept this behavior and learn alternatives for regulating her emotions.
Abdominal, Belly, or Deep-Breathing Strategy
Sit comfortably with spine supported. Breath flows more freely when the body is aligned.
Release the low back into the chair, lift up the chest bone, and relax the shoulders.
Put one hand on your low belly and the other on your chest.
Inhale through the nostrils and feel the belly expand. The chest hardly moves.
Exhale and feel the hand on the belly move in.
Breathe out completely without forcing the breath.
Take twice as long to exhale as to inhale.
Practice several times a day or whenever feeling the first signs of stress.
The Three-Part Breath
Anne’s breathing remained rapid and shallow over the next few sessions. I suggested she practice the three-part breath so that she had another technique that might be easier to learn. For the three-part breath:
1 Breathe into your low belly.
2 Let the oxygen move into your diaphragm, and then your chest.
3 When you exhale, breathe out from your low belly, diaphragm, and chest.
The three-part breath is deeper than the abdominal breath. It is a good way to begin a meditation or visualization exercise, as it quickly sends a message to the brain to relax mind and body. This breath is not intended for regular use; about five of these breaths are optimal to initiate a relaxation response. I thought it would be good for Anne to feel the immediate physiological effects from this powerful breath.
Unlike abdominal breathing, the three-part breath is not to be used all the time because it involves taking your fullest breath possible. Respiration deepens and lung capacity improves from the practice of this way of breathing.
I instructed Anne to sit comfortably in good posture and place one hand on her heart or upper chest and the other on her low belly. “Relax your shoulders and upper torso,” I instructed. “Inhale slowly through the nostrils, feel the low belly expand, then the diaphragm, and, lastly, feel the air traveling into your upper chest. As you exhale, breathe out completely from the low belly, diaphragm, and chest. The inhalation and exhalation are about the same length.”
Three-Part or Complete Breath Strategy
Sit comfortably in good posture; lie down if necessary.
Take a few belly breaths to relax.
Inhale slowly and steadily.
Fill the belly, expand the diaphragm, and breathe fully into your lungs and chest.
Exhale slowly and steadily.
Breathe out from the low belly, diaphragm, and chest. Chest and ribs come back to a neutral state.
Notice the sensations and return to abdominal breathing.
Practice five of these breaths once or twice daily.
Anne followed my instructions, and her breathing deepened and became slightly more rhythmic. Still, she coughed and squirmed a bit in her seat as she practiced. At our next session, I decided to show her “constructive rest,” an antigravity position that helps put abdominal breathing into action in the most natural way possible, by lying in a supine position. I knew that Anne would eventually learn abdominal breathing by having all of these methods at her disposal.
Constructive Rest
“Another good way to learn abdominal breathing is to get into the ‘constructive-rest’ position,” I suggested. “If you’re okay with this, I’d like you to lie on the floor mat.” I handed her a small pillow to support her neck and a couple of larger ones to place beneath her knees.
After an awkward silence, Anne agreed to lie on the mat and I helped her place the pillows. “Now, put one hand on your lower belly, the other on your chest, and think about breathing abdominally and sending the oxygen to your belly. Remind yourself to breathe in fully and exhale fully. Imagine that as your breath deepens, your muscles relax, your body lengthens, and your chest and abdomen expand.”
Anne’s breath immediately began to deepen, and I noticed a shift in her facial muscles. The lines in her forehead began to smooth and her jaw released. Her eyes softened, her delicate hands loosened their grip, and she seemed more at ease, more present. I reminded her to watch the rise and fall of her belly. “Remember to breathe out completely, because relaxation occurs on the exhalation.”
Anne’s eyes began to water, and I asked if she wanted to talk about what was going on. “No, but it seems like I understand how you are telling me to breathe and I’m more aware of feeling certain emotions when I breathe this way. I’m not sure this will necessarily be good for me, but I’m willing to try.”
Constructive-Rest Strategy
Lie down on your back on a firm surface.
Keep your knees bent and feet on the floor about hip width apart.
Support your head with a small pillow or rolled-up towel.
Bend your arms at the elbow and rest your hands on your belly or by your sides.
Relax your muscles, scanning from the top of your head to your toes.
Think about “letting go” rather than engaging any of your muscles.
Focus on abdominal breathing, which happens easily in this antigravity position.
Observe the rise and fall of your belly as you breathe.
Allow your body to lengthen and expand.
Rest in this position for five to twenty minutes once or twice daily.
Notice how you feel after each session.
Constructive rest, sometimes called “active rest,” is a good position for learning the abdominal or three-part breath. However, you want to get to the point where you are able to practice these belly-breathing methods while sitting, standing, or walking. Ten to twenty minutes of practice yields mental, physical, and emotional benefits. While constructive rest is a relaxation technique unto itself, it is also beneficial as a prelude to sleep or when having difficulty remaining asleep.
As we ended the session, I gave Anne the assignment of breathing in the constructive-rest position for ten to twenty minutes, once a day. “Notice what comes to mind