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April 2, 2016 By Admin

Use of Breathing Techniques – Do a Polyvagal Test

Use of Breathing Techniques – Do a Polyvagal Test First

Polyvagal Test

The polyvagal theory (S.Porges) and polyvagal functions are complex, highly important, evolutional processes with powerful influences on human survival, overall physical health, and emotion regulation.  The tenth cranial nerve (from scull base to anus) functions in various ways, the most important of which deal with primitive survival-based immobilization behaviors and more complex processes of stress response, social communications, and emotional self-soothing practices. In clinical populations, polyvagal knowledge and skills may impact stress vulnerability, arousal, heart-respiratory rate, emotional patterns, and cortisol level. Vagal implications involve everything from complex cardiac functions (life or death) to more discrete aspects of attention, motivation, feeding, communication, emotion, vocalization, and the entire muscle array of the human face, head, throat and neck.  Since human primary emotions are directly related to various autonomic functions, right brain polyvagal_MindfulHappinessactivity, and brain stem medullary structures, the vagal nerve system can be used positively in well-informed psychotherapy for improving various emotion-regulation conditions leading to suffering.  One primary link in the polyvagal interactions deals with breathing via satisfaction of oxygen demands of the human living system.  Since it is now common in more advanced body-mind therapies to include breathing retraining, the more a competent therapists knows about using polyvagal skills the better.

I have one caution: Be sure to do a basic polyvagal test before initiating breathing retraining, especially deep, slow, abdominal breathing practices.  I have created this test to safeguard client welfare in various forms of breathing retraining as part of their therapy process. If the client’s improvement in emotional regulation requires breathing retraining, you want your client to experience only positive outcomes from the experiences. Negative emotional outcomes will dampen motivation to continue.

The Breathing Retraining Polyvagal Test (A. R. Quintiliani, 4-4-2016)

  1. Ask: “Have you ever experienced serious negative outcomes when doing deep, slow abdominal breathing? If the answer is “no” simply continue your breathing retraining process, but observe mindfully if any negative emotional reactions occur in the process. If so, discuss these reactions in detail and safely Vagus_tenthcranialnerve_MindfulHappinessproceed.
  2. If the answer is “yes” follow the steps below to ensure improved skill and protection for your client.
  3. Gently negotiate for a very brief deep, slow, abdominal breathing event – that is “one-breath” ONLY. Use a SUDs score of 0 to 100 for the experienced level of discomfort in the client during this “ONE breath” activity. NEVER force a clint to do breathing practices! Discuss the SUDs score and the client’s subjective experience in the “ONE breath” practice.  If the SUDs score is in the 40’s of below, continue the breathing retraining with caution.  If the SUDs score is in the high 50’s or more, STOP the breathing retraining for now and use shorter, far more indirect and intermittent breathing methods as part of your on-going therapy.
  4. If both you and your client are successful in phased-in breathing retraining, continue the process by slowly extending the time duration in breath retraining for abdominal breathing (as a first breath skill). For example move to two, then three or more breaths per training experience.  Eventually,  expand the depth and time in the abdominal breathing experiences.  Over time deeper and slower is the goal.  Continue to use SUDs scores for any negative outcomes, and begin to use SUPs scores (by A. R. Quintiliani, 1-1-2000) for positive outcomes. SUPs scores are also 0 to 100 but this time it measures subjective units of pleasure in the client’s experience.
  5. Continue the breathing retraining program, slowly moving to more complex and more powerful breathing techniques. Always check with your client regarding comfort and effects.  Use SUDs and SUPs scores. Go slow! Keep it positive!
  6. Note that this informal “test” is based solely on common sense knowledge about the realities of breathing retraining and not on reliability and validity studies.

For more information on breathing retraining practices refer to  Angelo, J. (2010). Self-Healing with Breathwork…Rochester, VT: Healing Arts Press, pp.28-30; Graf Durkheim, K. (2004 edn.). Hara: The Vital Center of Man. Rochester, VT: Inner Traditions, pp. 122,178; Johnson, W. (2012). Breathing Through the Whole Body… Rochester, VT: Inner Traditions, pp. 238-29; and, Rosen, R. (2006). Pranayama: Beyond the Fundamentals.  Boston: Shambhala, pp. 62-68.

By Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

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April 3, 2015 By Admin

Ten Breathing Techniques to Re-Deploy Attention

mindfulbreathing-mindfulhappinessA major part of suffering comes with the inability to shift unhelpful, negative focus on troubling thoughts and feelings.   This cognitive reality is common in all the major mental health problems people suffer from: anxiety, depression, trauma, substance abuse, and eating disorders. Due to the lack of “wise-mind” skills most people suffering from these conditions hope their medication/s will help (and sometimes they do), and they become experts in self-medicating with short-term reinforcement (substance use, eating, anger, cutting, mindless consuming, etc.).  The self-medication habit simply leads to more suffering; after short-term relief, not only is the original problem the same but now new problems develop (addictions, obesity, consequences of outbursts, escalating self-mutilation, debt, etc.).  Mindful use of the breath can counteract this stuck attention, and prevent it from becoming secondary suffering – suffering more because of my thoughts and feelings about suffering now.   Note that heavy smokers will have difficulty doing these breathing techniques.  Before engaging in breath retraining work, check with your client to see (1) if they have a respiratory or cardiac condition, (2) if they  suspect that past unresolved trauma may cause intense limbic reactivity, (3) if they are aware of having any polyvagal dysfunction, and (4) if they suspect that a prior brain injury has impacted their breathing process. Implementing breath retraining in such cases will require much greater care and awareness on the part of the helper, and may necessitate a medical consultation..

The techniques noted here may be helpful for relaxation or stimulation as well as diverting stuck attention on unhelpful thoughts and feelings.  Always remind your client that they can stop at any time they feel discomfort beyond their coping capacities. After each practice, process outcomes with the client. Periodically check in with the client to see if they wish to continue. It helps to do the same breathing technique the client is doing. Now to the ten techniques.

1) Mindful awareness only: In this practice paying close attention to the way the breath is right now without any evaluations of adjustments.  Just paying close attention to breath as it is now.  Continue the practice for about ten full breaths as they are.

2) Deep, Slow, Calm Inhalation: In this practice simply ask the client to breathe in a deep, slow, calm manner.  They need to pay close attention to the inbreathe only.  Continue to six deep, slow, calm inhalations.  For most people inhalation is a little energizing.

3) Deep, Slow, Calm Exhalations: Do the same breath, but this have the client pay complete attention to only the exhalation phase.  For most people exhalation is relaxing. Do six breaths.

4) Short Hold on Inhalation: Do breath technique number 2, but this time have the client hold for the count of four at the end of inhalation.  Do five breaths.

5) Short Hold on Exhalation: Do breath technique number 3, but this time have the client hold for the count of four at the end of the exhalation. Do five breaths.

6) Slightly Extend Exhalation: Do breath number 3 again, but this time have your client slightly extend their exhalations for the count of four.  Lungs should fill accordingly, so they can continue to extend their exhalations to the count of four but not beyond.  Do four breaths. Observe carefully, since clients who extend beyond the count may experience light-headedness – very uncomfortable. It will limit any interest they may have in learning breathing techniques.

7) Square Breathing: Have clients do deep, slow, calm breathing and at the same time imagine following (with attention) their breath by making a square going right from the top of the lungs , down the right side, going left across the lower belly, and moving up the left side of the lung. Slow this down a bit. Complete five breaths.

8) Basic Three-Part Breathing: Have your client focus attention on the feeling of air flowing in and out through the tips of their nostrils for three breaths. Then move attention to the feeling of air flowing into and out of the lungs for three breaths – usually “felt” in the chest. End with attention being focused on the lower belly as it moves when lungs fill with and empty out air for three breaths.  End with the client following the flow of air sensation in their body from nostrils, though lungs/chest, and ending in belly. Complete four breaths.  This is good interoception training; such training allows clients to expand their inner body awareness.  Such expansion is sometimes required in body based trauma work as well as the feelings of the anxious and depressed body.

9) Mantra Breathing: Use either a brief ancient mantra or simply make one up that may help your client.  Your client may want to make up their own self-help mantra. Do deep, slow, calm breathing – but on the inhalation begin to say a private speech mantra like “I am good,” or “I can do this,” or “impermanence ends suffering,” or “over-attachment causes suffering.” or anything the client thinks may be helpful to them.  Continue the subvocal statement to the exhalation. Complete five mantra breaths.

10) Excitation Breath: For some depressed and/or fatigued clients a brief experience with stimulating, excitation breath may be helpful.  Do not do this if your client has a history of hyper-ventilation, respiratory or cardiac problems.  Complete three to four to five breaths, then check in to see if continuation is warranted.  Do very rapid, shallow breathing. See if it helps with mood.  Do not do more than two sets of breaths.

Hopefully your clients may benefit from learning ways to shift their stuck attention on problematic negative thoughts and feeling – and at the same time enjoy the many benefit of variation in breath.  Remember to consult medically if you have any information suggesting this should occur.

By Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness

CLICK HERE to Order!

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