Therapist Led Breathing Techniques

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated February 19, 2024by BetterHelp Editorial Team

Breathing or respiratory practice can be utilized in a therapeutic setting to enhance respiratory health and calm your nervous system. In a healthcare setting, it can help you breathe more effectively while partaking in physical activity, overcoming disorders, increasing lung capacity, or managing lung disease. However, registered respiratory therapists can also teach patients how to use conscious breathing to improve mental health and overall wellness. 

Breathing practice is a central tenet of mindfulness, a movement growing out of humanistic psychology. Mindfulness involves focusing your mind and body on specific experiences, thoughts, or sensations. It can help individuals reduce stress and symptoms of many mental health conditions, like anxiety and depression. Respiratory therapy may help individuals feel in control of their bodies and reduce physical symptoms related to anxiety.

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Respiratory therapist

A certified respiratory therapist is a medical professional trained to provide respiratory care and treat patients with cardiopulmonary disorders, such as lung disease, asthma, reduced lung function, and sleep apnea. 

According to the US Bureau of Labor Statistics, careers in respiratory therapy are growing and respiratory therapists are in demand. A registered respiratory therapist works and treats patients in various settings, including the following. 

Hospitals

In hospitals, respiratory therapists may offer the following care: 

  • Essential life support in emergency rooms 
  • Neonatal intensive care for premature infants 
  • Diagnostic tests, treatments for lung conditions, and lung cancer, blood-gas analysis, and measurements of carbon dioxide levels within a medical setting 

Nursing homes

In nursing homes, respiratory therapists may: 

  • Assess the clinical components of respiratory health in patients 
  • Work with other healthcare professionals to educate patients about lung wellness
  • Provide respiratory therapy for the aging population
  • Implement respiratory therapy programs to help assess lung capacity and provide quality care

Cardiopulmonary rehabilitation centers

Due to their knowledge of human anatomy, many respiratory therapists work in outpatient rehabilitation centers treating patients and providing chest physiotherapy to individuals who have had accidents, experienced lung or pulmonary disease, or require respiratory care. 

Respiratory therapists and mental health

In psychology, respiratory therapists may help you recognize your breath patterns, bringing awareness to your body, thoughts, and feelings. Working with respiratory therapists may help you develop skills for reducing anxiety or panic attacks. 

Mindfulness therapy

Mindfulness is an increasingly accepted and widespread meditative practice borrowed from Buddhism. It is a combination of practices promoted by humanistic psychologists that began in the mid-20th century and was used by various Eastern religions for centuries.

The fact that some elements of mindfulness exercises derive from religious or spiritual practices does not necessarily mean that breathing techniques are considered religious. The techniques used in meditation and mindfulness can be practiced in a secular form and may or may not be connected to your religion or spirituality. 

Stress can restrict lung function, and mindfulness promotes awareness of breath to increase this function. This idea was first introduced to psychology by the humanistic psychologist Carl Rogers. Rogers, the founder of "person-centered therapy," promoted his version of mindfulness, which he called existential living, as one of his five critical elements of person-centered therapy. To Rogers, existential living meant being aware of and appreciating the present without trying to tie its significance to past or future events.

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Mindfulness practice

Many people experience racing thoughts and may notice that their mind continues to think throughout the day, even when they are not trying to. While you are doing the dishes, taking a shower, driving, or watching TV, you may notice thoughts come and go. However, you might notice that you do not consciously focus on your bodily functions. They may just occur. In Buddhism and other practices, this phenomenon may be called the "monkey mind." 

The monkey mind concept is similar to the "subconscious mind" idea proposed by Sigmund Freud in the early 20th century. You may not always be aware of what your mind is thinking or the way you are acting. As a result, mindfulness can train the mind to be more aware of every action and to stay in the present moment. One popular method of awareness is mindfulness exercises. 

Mindfulness therapy exercises to try 

Breathing is a tool in mindfulness meditation and respiratory therapy because it can be noticeable but not distracting. As a result, focusing on your breath may help you increase focus in general. Below is information about the exercises you can try to increase your body and mind awareness and calm yourself in a stressful situation.  

Mindfulness therapy at home 

Adding breathing practices to your daily routine can have benefits for your mental health. To practice these, do the following: 

  1. Sit or lie down in a comfortable position for the duration of your practice. Your legs should lay straight or bend at the knees with your feet flat on the floor. Whatever position you pick, try to maintain it once you begin your meditation. 
  2. Next, settle into the pose and focus on your breathing. You do not have to try to breathe in a certain way. Continue to breathe naturally, and note how it feels as you breathe in and out.
  3. Focus on how your mental state or sensations change as you breathe. 
  4. Consider focusing on other senses as well, such as the feeling of sitting or a breeze from a window. 
  5. Repeat the process for as long as necessary. 

Try starting with at least two minutes and gradually increasing to ten minutes. Aim to practice this two or three times each week. You might also benefit from daily practice. Studies show that ten minutes of mindfulness or meditation daily can benefit your mental health. 

If you get distracted by your thoughts, acknowledge the thought and return to your practice. If it continues to repeat, continue acknowledging it and sending it on its way until it stops. When your practice is done, consider the thoughts that entered and what they might mean. 

Diaphragmatic practice 

Diaphragmatic breathing is the scientific term for belly breathing. The goal of this is to slow down and use less energy to breathe. It gets the name from the deep inhales that make the abdominal muscles expand with air. 

To practice diaphragmatic breathing, close your eyes or relax your focus. Take a long slow breath through your nose. Note how many seconds you spend inhaling and try to exhale for a second or two longer than you inhale. Repeat if necessary. 

Think about the breaths filling your lungs from the bottom through the top and completely emptying your lungs from top to bottom. Ensure you allow your abdomen and chest to move in and out with each breath. Your chest and abdomen may expand when you inhale and contract or "deflate" when you exhale. 

One of the benefits of this technique is that you do not have to be sitting in a chair. Diaphragmatic breathing can be done anywhere, in any position, and takes seconds instead of minutes. Further, while you may find it soothing to practice daily, you can practice any time you feel stressed. There may be apps you can download for your smartphone which also guide you. 

Holotropic 

Holotropic breathwork involves the body, mind, and spirit in harmony, unity, stability, and unbrokenness. During this therapy, patients lay on their backs while the respiratory therapist induces consciousness alteration by playing music and guiding the participants through specific exercises. The mental remedy may be conducted in groups so patients can serve as support for each other. 

Total capacity of lung health may be required before participation is allowed in a holotropic practice, as it is focused on mental health and not physical health. 

After the deep respiration and bodywork sessions, patients may discuss what they have learned about themselves with the professional instructor.

Pursed lip 

Pursed lip breathing is a therapeutic technique that can be used to increase respiratory performance to full capacity while slowing down. During anxiety attacks and other mental health episodes, people may experience shortness of breath. Studies have shown that these exercises can help people regain control of their ventilation and oxygenation. To practice this, inhale deeply through the nose and exhale through puckered lips. 

Stress responses 

Stress can be a natural and healthy biological response to external stimuli that allows individuals to focus and work efficiently. However, in extreme circumstances, or for people with anxiety disorders and related conditions, the stress response can be incongruent with the circumstances or become chronically hyper-aroused. In these cases, counseling with a respiratory therapist may be beneficial. 

When you are in a stressful situation, your body's automatic response system changes your heart rate to increase your ability to fight, flee, or freeze. However, this response can cause your breath to be shallow and ineffective. You may influence the unconscious controls that occur when you are under stress by working with a respiratory therapist. Work like this can help you understand your conscious control of breath. 

Diaphragmatic breathing may reverse the body's stress response to prevent a panic attack before it begins. The process allows your diaphragm comes down and pushes your stomach into place. This stimulates the vagus nerve, which can initiate an immediate calming response throughout the body. 

The role of respiration

These exercises may not only control panic attacks by stimulating the vagus nerve. These techniques could also help your body rid itself of toxins. Respiration is the action performed by our lungs when we breathe in oxygen and breathe out its waste product, carbon dioxide. This exchange of oxygen and carbon dioxide can help cells carry out their purpose. 

When you take quick, shallow breaths, it may prevent your lungs from working as usual. If your oxygen and carbon dioxide levels are imbalanced, you may feel restricted in your lungs or experience headaches. Diaphragmatic breathing may allow you to maintain proper oxygen balance by increasing the amount of oxygen you take with each breath while ensuring that you are ridding your body of carbon dioxide. 

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Takeaway

You can use several practices to manage your breathing or prevent anxiety and fear. However, if you experience frequent panic attacks, feel unable to focus, or experience distressing thoughts, it may be beneficial to contact a trained mental health professional. A therapist may have further techniques to support you in increasing your respiratory and mental health. You can also find a therapist online if you face barriers to in-person treatment.   

A therapist who works through an online platform can offer breathing and talk therapy.Research published in the Journal of Medical Internet Research shows that people who used BetterHelp experienced a significant reduction in depression symptoms. Through many online platforms, like BetterHelp, you can match with a counselor and gain worksheets, therapeutic suggestions, and mental health webinars through your device. You can get matched with a therapist in 24 to 48 hours.
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