Living in the Breath: Breathing as a tool for professionals in health care, interpersonal work, teaching and guidance

When introducing people to the breathing school method, I have often started by describing my professional background and the history of psychophysical breathing therapy, because I believe these explain why I use breathing as an important tool and pathway in my psychotherapeutic work.

I began my career as a physiotherapist. Through my hobbies, gymnastics and dancing, bodily aspects played a significant role in my childhood and youth. Working with people attracted me and, gradually, I wanted to learn to understand the structure and functioning of the human mind, as well as interacting with people. So I studied psychology, and towards the end of my studies I actively sought an arena where I could draw on both physical and mental resources.

That took me to breathing school instructor training, which I knew many physiotherapists and psychologists had taken part in. I sensed that the psychophysical approach might offer a means of combining both my professional skills and the worlds of the body and the mind. Breathing school did, indeed, come to form the basis for my subsequent psychotherapeutic work. I later obtained two qualifications in psychotherapy, in cognitive-analytic and psychophysical psychotherapy.

In breathing school, through my own experiences, I became interested in how emotions affect breathing patterns and how bodily changes, in turn, structure and calm the mind. The personal upheaval I experienced during the year of training was significant and convinced me that I was on the right path. At the same time, practical studies of the body, interaction, emotions and group therapy revived the theoretical psychological knowledge I had gained at the university. All the theory related to early interaction and object relations, in particular, revolved in my mind.

Psychophysical breathing therapy took its first steps at a time when the treatment of anxiety appearing as panic attacks and somatic symptoms was not understood as well as it is today. People suffering from such symptoms did not appear to benefit from the treatments then available. At that time, i.e. at the beginning of the 1980s, special psychologist Päivi Lehtinen read an article about hyperventilation that showed a good understanding of the situation of patients with such symptoms. She began to realize that ways of breathing and resulting reactions in the body can cause or sustain somatic symptoms of anxiety that many patients consider frightening.

Päivi Lehtinen knew Maila Seppä, a movement therapist who she knew used breathing as one of her main tools in her body-centred therapy. Together they started to develop a short-therapy group method which they called breathing school. Later on, we started calling the method psychophysical breathing therapy because it was being applied in many other arenas in addition to group therapy. Psychophysical breathing therapy has been used in the fields of physical exercise, music, performing arts, teaching, guidance and self-care, for example.

About 20 years after the development of the method first began, I met Maila Seppä and Päivi Lehtinen and asked them to write a book about breathing school, including all their extensive understanding of breathing, interaction, self-regulation and therapeutic work. I got my wish and, to my surprise, they asked me to join the group of authors. Another member of the group was Tiina Törö, a graphic artist who produced the illustrations and also wrote parts of the book. The writing process took a total of ten years. During that time, the original Finnish books (the first version consisting of separate text and exercise books) were written and published twice.

Alongside the writing process, Maila Seppä started passing on her life’s work as a trainer to me. For several years, we worked together as master and apprentice, training numerous groups of professionals around Finland. My work with my patients (individual and group psychotherapy) and the work done with Maila Seppä in training, writing and learning in interaction further deepened my understanding. In association with my work, I participated in some international congresses, where I gave presentations about my use of breathing as a tool. I received feedback saying that the book should be translated into English. Many people realized the uniqueness of our method and the possibility of combining it with various other approaches. The dream came true when we found Hilkka Salmén, a skilled translator who joined the team, and later a publisher for the book.

Some literature has already been published in English on the psychosomatic aspects of breathing and psychophysical treatment methods in which breathing plays a central role. However, it has been difficult to perceive the wide significance of breathing based on such literature. Furthermore, the literature describing the psychophysical aspects of breathing has not reached the mainstream of medically and theoretically founded treatment. Treatment methods applying breathing may have been considered weird or unconvincing. This book aims to fill the gap by taking a many-sided, comprehensive look at breathing, psychophysical breathing therapy and the use of breathing as a tool in many professions and in many problem areas.

The book is primarily intended for the training of professionals in health care and psychotherapy. Its main target group is professionals whose patients have functional breathing disorders, symptoms of anxiety, social anxiety or stress. Practitioners working with patients with respiratory or other somatic diseases, as well as midwives and doctors helping women to give birth, may also learn new ways of thinking and acting from the book.

The book is also suitable for professionals outside health care, such as school and kindergarten teachers, pastoral workers and others engaged in social or educational work or nursing. It will be useful for professionals in fields where breathing and use of voice are important, such as musicians and people working in the theatre, teachers, educators and other people using their voice at work. It is also suitable for people offering physical training or guiding relaxation or mindfulness exercises.

In addition to these groups, anyone interested in their well-being and balanced breathing may benefit from the information and self-care ideas provided in the book. Everyone suffers from imbalanced breathing every now and then when facing rush, demands, severe stress, anxiety, fears or other difficult feelings or emotions. In some people, such experiences of distress may recur frequently, and it may be difficult for them to regain their balance. They may feel drained and have many types of problems in their relationships.

Breathing is a no-man’s land and yet belongs to everybody. No-one can declare themselves the owner of the correct way of breathing. The concept of affecting well-being through breathing is thousands of years old. Nevertheless, breathing is a resource that is quite insufficiently utilized in western culture, self-care and health care. The approach we describe does not involve complicated methods or learning a correct breathing technique but rather a way of being that anyone committed to working with themselves can learn either independently or, particularly, with support.

The book describes balanced and imbalanced breathing and how you can learn to recognize and listen to the state of your breathing and being. The book opens up a view of what leads to laboured breathing and what makes breathing flow more freely. At the end of the book, numerous examples are given of everyday exercises that can be done to improve the well-being and relationships of a patient, student or other person being guided.

Psychophysical breathing therapy involves numerous interwoven aspects. It is based on the significance of breathing for physical and mental well-being. Breathing affects bodily reactions and sensations by several mechanisms, such as physiological changes and the way muscles work, becoming tense and relaxing. These lead to many kinds of sensations that, in turn, are associated with feelings and their intensity. Experiences, on the other hand, such as feelings of safety or fear, affect the way of breathing. There are many connections between mind and body.

Relationships to the self and to others are constructed through interactive experiences. People usually learn self-regulation and the regulation of emotions unconsciously. Such learning occurs in daily life as a result of recurrent situations, where habits are conditioned, and become automatic and ingrained. No-one is born skilled in calming himself down or encouraging himself. Such skills are learned in interaction: “this is how you can calm down”. On the other hand, behaviours such as “this is how you can get all worked up” can also be learned.

Many people know that balanced, calm breathing is based on optimum work of the diaphragm. What they may not know is that if you tell your diaphragm what to do and try to control your breathing, you often disturb natural breathing according to your needs. Like a tiny, sensitive child, breathing easily gets upset if it is told what to do. It may be appropriate to perceive your breathing as your inner child and see your getting to know it as approaches by a sensitive, interested adult. The best way to get your breathing to calm down is to allow it to keep to its own, appropriate, pleasant rhythm and depth.

Flowing, fluent and balanced breathing can be recognized from a feeling of pleasure spreading all through the body and the mind. This is an immensely satisfying feeling. It is nice to be alive and exist, breathing in your very own way that is suitable for yourself. Breath being allowed to flow freely is associated with a feeling of sufficient safety reflecting how trustingly we can exist in relation to the earth. Whenever you lose contact with gravity, that is, when you cease to be grounded, a break occurs in the natural flow of breath. When you are tense, afraid or anxious, you often unconsciously use your muscles to lift yourself up from the ground.

If you lose contact with your feelings, experiences and memories, the flow of breath may also be disrupted. At the beginning of psychophysical breathing therapy, you are given permission to let go of demands that may disturb the balance of your breathing: you do not have to be able to relax or concentrate, you do not need to breathe right or control your breathing. Just let yourself be. However, it is important to arouse curiosity about your experiences. Work with breathing still does not mean just calming down; we gradually playfully introduce more dynamics, power and expression of emotions into the process. The process helps to open up many kinds of developmental deadlocks, to proceed and deepen your self-knowledge. In today’s psychotherapeutic language, we could say that the method revives both implicit and explicit mentalization abilities.

While developing the method further and working with people, we have gradually come to understand something about how the regulation of breathing develops in interaction and about the task of breathing in self-regulation. Throughout life, breathing patterns form an important part of communication and the regulation of a person’s own and other people’s states. Breathing is the bridge linking body and mind or soul, the conscious and the unconscious, as well as the self and others.

Minna Martin is a psychologist and psychotherapist with advanced level special training in cognitive-analytic therapy (CAT) and training in psychophysical psychotherapy. In 2015 she was named Psychologist of the Year in Finland. Her first professions were physiotherapist and physical education instructor. Along with her work as a psychologist in student health care, Minna works as a psychotherapist and trainer. She provides training for professionals in the use of the psychophysical breathing therapy method and leading of social anxiety groups. In addition, she has given lectures on these topics at international congresses. She has developed both individual therapeutic approaches and various types of group work based on psychophysical breathing therapy. Minna has written articles for professional journals and books, as well as guide books for patients with various problems.

Her book, Breathing as a Tool for Self-Regulation and Self-Reflection, c0-written with Maila Seppä and Päivi Lehtinen, and translated by Hikka Salmen, with text and illustrations by graphic artist Tiina Törö, has recently been published by Karnac.