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Does Breathing Help...or Hurt?
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David Carbonell, Ph.D.
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Mar 31, 2009 15:25 PST
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THE ANXIETY COACH®
Helping People Thrive in an Anxious World
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Volume 10, Issue 3
IN THIS ISSUE
Dr. Carbonell answers a reader's question about breathing
exercises in treating panic. His therapist does not believe
in using them, and he asks for Dr. Carbonell's opinion.
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INDEX
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1. Dave's Note
2. Does Breathing Help...or Hurt?
3. About The Anxiety Coach®
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Dave's Note
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March 31, 2009
Dear Reader,
I'm preparing to start another class for people with a fear
of flying this spring. The class, which includes a group
flight, will meet weekly in Rolling Meadows for five weeks,
so it's suitable only for people who live in the Chicago
area. For information, send a blank e-mail to:
fly-@anxietycoach.com
If you're a professional therapist, you may be interested
in my day-long workshops on treating anxiety disorders.
CEU credits are available for the different professions.
Information and registration is at http://pesi.com/
Here's the upcoming schedule:
Lincoln, NE April 27
Omaha, NE April 28
Davenport, IA May 6
Cedar Rapids, IA May 7
Des Moines, IA May 8
Allentown, PA May 11
King of Prussia, PA May 12
Cherry Hill, NJ May 13
Tucson, AZ July 13
Phoenix, AZ July 14
Scottsdale, AZ July 15
And my self help book, Panic Attacks Workbook: A Guided
Program for Beating the Panic Trick, is available here:
http://www.anxietycoach.com/book.htm
See you next month!
Dave Carbonell
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Does Breathing Help...or Hurt?
by David A. Carbonell, Ph.D.
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A Reader wrote in with this question:
My therapist does not believe in the efficacy of breathing
exercises. His position is that the latest research suggests
that breathing exercises are a form of avoidance in phobic
situations. I understand the importance of accepting the
anxiety symptoms and going with them, and that avoidance just
brings more anxiety. You, Aaron Beck, and others seem to
suggest that breathing is useful as far as the behavioral
part of creating anxiety and not simply in reducing or
avoiding the symptoms. I just want to know what you think
about the role of breathing exercises for me. I get panic
and anxiety on airplanes, subways, and other enclosed spaces.
My reply:
Yes, there is some clinical research in the treatment of
panic disorder which suggests that teaching people a
breathing exercise may slow their progress by encouraging
them to rely on breathing as a form of protection from
panic. People try to protect themselves from panic in a
variety of ways - the company of a "safe" person, the
presence of "safe" objects like cell phones and water
bottles, the use of distraction, and so on. These efforts
(usually called "safety behaviors") generally make the panic
problem more persistent, because they lead the person to
believe that they had a "narrow escape" from a terrible fate,
and feel more vulnerable as a result.
I can certainly see that some people could use a breathing
exercise in a similar way, and get similar results. When
people are frightened by panic, they naturally latch onto
anything that seems to offer shelter. I see the same effect
with clients who use my panic diary. They find that as soon
as they start filling out a diary, their symptoms diminish.
People often become big fans of the panic diary as a result!
But in my heart of hearts, I can't see withholding the use
of a good breathing exercise. People with panic tend to
breathe badly. They tend to breathe in a way which
promotes physical anxiety. And their instinctive efforts to
correct their breathing by trying harder to "take a deep
breath" almost always make the problem worse. So I continue
to offer breathing as an important part of my treatment of
panic disorder and, just as I do with the panic diary and
other elements of my treatment, work with my clients to
ensure that they don't come to think of these heplpful
devices as "life savers".
While I'm on the subject of breathing, I want to make one
more point. If you experience panic attacks, the instruction
you are likely to get about breathing from most therapists
and self help books will not be very helpful, because it
leaves out a crucial step. I've read most of the books - they
don't really tell you how to solve the breathing problem,
because they leave out this key step. I teach workshops on
panic and anxiety for therapists all around the country.
Once they've tried the breathing exercise the way I use it,
they often express amazement at how useful it is, and wonder
why they never heard of this before.
What is this key step? It's starting your breathing exercise
with a gentle exhale, rather than an inhale. For a full
explanation and instructions, see the diaphragmatic breathing
section of my web site at:
http://www.anxietycoach.com/breathing.htm.
++++++++++++++++++++++
THE ANXIETY COACH®
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The Anxiety Coach® is a publication of the Anxiety
Treatment Center, Ltd. The Center is a small group of
clinical psychologists who specialize in the treatment of
anxiety problems. The Center has several offices in the
Chicago area.
Dr. Carbonell, a licensed psychologist, is the founder and
director of the Anxiety Treatment Center.
The information contained in this publication is not a
substitute for consultation with healthcare professionals.
Each individual's health concerns should be evaluated by a
qualified professional.
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SUBSCRIPTION INFORMATION
++++++++++++++++++++++++++
If you received this copy from a friend or colleague and
want your own (free) subscription, you can subscribe at
http://www.anxietycoach.com/newsletter.htm
To unsubscribe, follow the link at the very end of this
newsletter.
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CONTACT INFORMATION
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David A. Carbonell, Ph.D.
Anxiety Treatment Center, Ltd.
E-mail: dire-@anxietycoach.com
Web: http://www.anxietycoach.com
5105 Tollview Drive
Suite 103
Rolling Meadows, IL 60008
847.481.5251
© 2009, Anxiety Treatment Center, Ltd.
All rights reserved.
Anxiety Coach® is a registered mark of Anxiety Treatment
Center, Ltd.
Distribution Rights: The above material is copyrighted,
but you may retransmit or distribute it to whomever you
wish as long as not a single word is changed, added or
deleted, including the contact information. However, you
may not copy it to a web site without prior permission.
Reprint permission will be freely granted, upon request,
to periodicals and non-profit educational and service
organizations.
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