It seems a bit silly to tell someone how to breathe. After all, everyone breathes. But,”take a deep breath” is something people have been saying to others for generations when trying to help them calm down. What is the connection between breathing and healing, or potential healing in connection with DID?

Therapists have clued in on yoga and meditation as having some benefits in the psychological healing and restoration process. Many therapists encourage patients to engage in breathing exercises and “controlled” breathing. They usually connect this to mindfulness; meditation stripped of its spiritual/religious context. Previously, I posted on the risks of mindfulness meditation with DID; https://www.engagingmultiples.com/mindfulness-meditation-and-did/. In my experience with patients, the benefits are not so automatic as some people say. And, there are risks.

Breathing is governed by the brain’s respiratory center. While you can control your breathing as a voluntary act, your brain will continue to instruct your body to breathe without you having to continually give conscious instructions to do so. Beyond that, even though one can willfully hold one’s breath, the eventual lack of oxygen and accumulation of carbon dioxide in the lungs causes the brain’s respiratory center to overwhelm your will: You breathe again whether you want to or not. The point here is that breathing is governed both involuntarily as well as voluntarily.

Breathing patterns change when a person is under stress. A person under stress, any person, is likely to automatically to hold his breath or to breathe laboriously. In a genuine panic attack, one often feels as if one has to catch their breath, or as if one cannot breathe at all. A person in a panic usually takes very shallow and very fast breaths. This comes back to the common message we all get – to “take a deep breath” in order to calm down.

In my opinion, “take a deep breath” is the wrong phrase to use. I preferred to tell my patients to slow down their breathing. Why not tell them to take a deep breath? There are two reasons. First, I want to avoid encouraging already panicking patients to continue with their rapid breathing, just try to grab more air as you pant.. That doesn’t address the panic – the patient continues to panic. As a therapist, you are then encouraging them to experience their panic attack like a drowning person trying to suck in all the air they can. Second, and most important as a therapeutic intervention, panic attacks are about experiencing a loss of control. Fear is coupled with that sensation of the loss of control. Therapeutic intervention needs to address the physiological connection between breathing, fear and the loss of control

It is my experience that enabling a patient to reclaim control over their physiological response to fear gives them a tool for coming back to the present moment. It is often a very effective tool that opens a door to escaping the entrapment of the triggered physiological panic response. Go back to the fact that breathing is a blend of voluntary and involuntary control by the brain: It is within your power to slow down your breathing. One can start by slowing the breathing down just a little bit. With practice, a patient can utilize their voluntary control of breathing in a gentle way to slowly bring themselves back to a place of psychological safety. That is enabling a patient to connect with and rely upon their own fundamental strength. That is empowerment – the opposite of loss of control.

Slowing down the breathing, rather than fighting the gasping for air head-on, allows the brain to blend back the voluntary control back into the involuntary panic driven breathing. Going from 100% involuntary control of panicked breathing to 98% involuntary control and 2% voluntary control can happen without inducing further panic responses. Then one can slowly increase the percentage of voluntary control, perhaps to 5% voluntary control and then maybe 10%, and so on. So, for me and my patients, the key phrase was “slow down the breath.”

Once the patient is willing to try to slow down the breathing, even asserting only 2% voluntary control, they then have the direct experience of being able to assert some level of control over their breathing. That small level of control is the experience of having power over the impact of the past trauma – even just that little bit. The patient discovers the fact that it is possible, through one’s own breathing, to regain control over their body – which is taking control away from the past trauma.

Slow breathing is always associated with a sense of “equanimity and tranquility.” In slowly breathing out, one activates the parasympathetic nervous system and engenders in the body a trophotropic state – a state where the body rests and recovers its energy. It is a physical sensation that enables the distressed person to discover such feelings in the midst of chaos and fear. This is the way to redirect one’s attention from the impact of past outside trauma to the genuine sensation of inner well-being.

Phrases like “take a deep breath” or ” controlled breathing” are action-oriented. I choose to use more laid-back expressions that suggest lack of confrontation, expressions that call to mind receptivity and awareness. Encouraging a patient to slow down their breathing a little bit at a time lacks any harsh quality of an external command by the therapist. It remains as it should, a suggestion that we can tap into our strength safely. Putting it simply, all is not lost when you are still breathing.

In recent years, there is strong scientific evidence for the benefits of mindful breathing. Mindful breathing is a spiritual practice thousands of years old that is used in many religious traditions. But traditional instructions on mindful breathing are not about control, they are about letting go of the thoughts that tend to take one away from the present moment. The instructions are, effectively, to ride the breath, in and out, as the vehicle to do that letting go.

In the West , as Allen Watts pointed out, it is difficult to understand the concept of “being” as distinct from “doing.” Broadly speaking, in the Judeo-Christian Western world it is uncomfortable to “just be.” It seems that one has to be doing something at all times. The story used to explain this involves  a group of villagers debating what a man, a distant figure far away, is doing. When they approached the man, asking him exactly that. He replied, ” I was just standing here.” That’s it. One does not have to be doing something in the active sense to justify one’s existence. One can “just be.” Arriving in a new place, one can just absorb the experience of sound, sight, smell and taste of the land he is visiting.

While numerous neurological studies have concluded that prolonged practice of meditation can actually change brain structures and alter its way of reacting to stress, DID individuals must approach it slowly, gently and with protections in place. Again, in my experience, start by slowing down the breath when you panic. Practice that slow control mechanism until it becomes a habit. In that way, you are always enhancing your ability to protect your connection to safety in the present moment.