Breathe In, Breathe Out

The Sensation of Breathing

By Barry Kapke

Originally published in Massage & Bodywork magazine, April/May 2004.

Breathing is the first action we take as an autonomous being, and we continue to do so until we give up this body. From the first breath to the last, we exist dependent upon an energetic exchange between inner and outer environments. Without breath, we perish. We can survive for weeks without food, for days without water, but we will die if deprived of air for more than a few minutes. To live is to breath.

Respiration is the only life support system that functions on autopilot, but which can be overridden by conscious volition. As an adult, we breathe between 12 and 16 breaths per minute.1 The breathing rate in a newborn is approximately 35 breaths per minute, a rate that gradually decreases until establishing an adult pattern at around age 20. Men breathe slightly slower, about 12 to 14 times a minute, while women’s rate is typically 14 to 15.2 With an average respiratory rate of 14 breaths per minute, we are breathing 840 times an hour, or 20,160 times a day, for the duration of our lives. For the most part, this activity, whether we are awake or asleep, is happening automatically and unconsciously. We don’t have to remember to breathe and, in fact, if we did we’d be in serious trouble. However, we can consciously choose to alter our breathing patterns for limited periods of time and affect each of the 75 trillion cells that make up our body, as well as change our mental and emotional states.

While breathing is fundamental, our life experiences can alter the pattern of this natural process, distorting its rhythm and flow. When this happens, whether brought about by stress or simply how one comes to inhabit one’s body/mind, breath’s life-affirming, energizing, and nourishing capacities are disrupted and physical, mental, emotional, and spiritual disharmonies may result. Shallow chest-restricted breathing is pandemic in our culture. Holding or restricting the breath is a common — and unhealthy — response to effort and to physical or emotional pain or duress. We live in a time of tight bodies in tight clothes adhering to tight schedules. The more we try to rigidly control, the more we constrict. The more we constrict, the less we breathe.

Re-learning to breathe simply and naturally can have tremendous benefit to overall health, energy, and outlook. Breathwork — bringing conscious awareness to breathing and the reshaping of breathing habits and patterns — has been found to improve a variety of conditions, including migraine headaches, chronic pain, hypertension, epilepsy, asthma, panic attacks and hyperventilation syndrome, menopausal hot flashes, and coronary heart disease, particularly when combined with other bodywork such as massage, biofeedback, or yoga.3 Traditional Asian Medicine emphasizes that the lungs, the skin, and the colon share important functions — bringing nourishment into the body and moving toxic wastes out of the body; natural, relaxed breathing will benefit all three organs. Healthy breathing has an immediate and direct effect on stress levels and can be an invaluable aid in processing difficult emotions. It can enhance mental concentration and physical performance, boost energy levels and stamina, and facilitate processes of personal growth. Breath is a dynamic bridge between body and mind and between mind and spirit.

Gateway to Breath

Breath in. Breath out. Bring attention to the sensation of breathing. Feel the passage of air through the nostrils.

The nose is the gateway through which breath normally enters and leaves the body. An intricate and complex structure responsible for nearly 30 distinct functions,4 the nose is essential to proper breathing.

The external nose is obvious, hence the expression “clear as the nose on your face.” It has a central role in processing the air that sustains us. Air needs to be near body temperature, somewhat humid, and free from contaminants in order to benefit the body. The nose acts to, among other things, warm, moisten, and filter the air, making it fit for consumption. The shape of the external nose is significant in performing these tasks. Inhabitants of cold climates, as well as climates where the air is very dry, tend to have longer, larger noses due to the greater need to condition the air. By contrast, those born into tropical and other warm moist climates tend to have more compact noses with wide, open-flared nostrils, since the air needs little preparation.

The external nose is designed to gather and direct the air. The base of the nose is bony, comprised of frontal, nasal, and maxillary bones, but the bulk of the nose is cartilaginous and flexible. This mucus membrane-lined compartment into which air is first drawn is called the vestibule, formed by the two nostrils (nares). The nostrils lead into an open internal space called the nasal cavity. Air is pulled through the external nares, passing along the coarse nasal hairs,5 which trap larger particles of dust and other airborne matter, before further entering the nasal cavity.

Air is directed in different ways within the nose for different purposes. In order to smell, the flow of air needs to be directed upward toward the roof of the nasal cavity. The roof of the internal nose, formed by a small portion of the frontal bone and the ethmoid and sphenoid bones, is the floor of the frontal lobes of the brain and the ocular orbits. It is an area sensitized by the nerve endings of the first cranial nerve, the olfactory nerve. When we actively sniff, we stiffen the nostrils, rapidly sucking the air inward through both nostrils and upward toward the olfactory-optimized part of the nasal cavity.

When we breathe in a normal, passive way, the nostrils barely move and air tends to be drawn inward, often primarily through one nasal passageway.

Inhaling, notice the sensation of coolness as the air contacts the inner walls of the nose. Exhaling, feel the sensation of warmth as the breath passes out through the nostrils.

The cavity at the back of the nose is divided into sections by three thin, curled ridges of bone called the nasal conchae, or turbinates. The grooved passageway between each concha is called a meatus. These structures churn up a certain amount of turbulence in the air as it enters the nose, circulating it over a greater area. As the inhaled air passes across the blood-enriched mucous membranes lining these walls, the air is both warmed and moistened. This helps prevent a shock to the delicate tissues of the lungs, the organ most readily affected by the external pathogenic factors of hot, cold, dry, damp, and wind.

Through the exhalation phase of the breath cycle, the conchae, which were cooled and dried by the in-breath, are now re-warmed and re-moistened by the humid temperate air leaving the lungs. In this way, the incoming air is conditioned to protect the lungs and the out-going breath helps conserve heat and fluids, restoring the conditions for the next in-breath.

Breathing in — smell, taste, and feel the outside world that you take in and which becomes a part of you. Breathe in vitality; breathe in what you can use. Breathe out — release what you do not need and cannot use.

Breathing is an intimate act. With each inhalation we are inviting the external world to join us. We are bringing into our bodies the vital energy (qi) and oxygen that fuels and sustains us, but we are also bringing in airborne debris, microbes, pollutants, aromatic molecules, and some sloughed cells from the person sitting next to you. Fortunately, we have an efficient filtration system, which, under natural circumstances,6 helps to deliver reasonably clean air to the lungs.

Mucous membranes line the entire respiratory tract. The nasal mucous membranes secrete slightly less than a pint of mucus every day and are covered with thousands of tiny hairs called cilia. This sticky mucus traps dust and debris, including bacteria, viruses, molds, fungi, and whatever else may be riding the air currents, and, through the coordinated movements of the cilia, eliminates them. The thin coating of mucus, carrying unwanted effluents, is in continuous motion across the nasal cavity walls to the throat, where it is swallowed, dissolving both mucus and microbes in the intestinal tract.

From a Western point of view, respiration is gaseous exchange. We extract oxygen from the air, absorbing it through the inner lining of the lungs into the bloodstream, where it is transported to every cell of the body. This is where breathing really takes place — at the cellular level. The exhalation of the cells sends carbon dioxide and other volatile wastes back through the blood to the lungs, to be eliminated by way of the nose.

This exchange of gases is critical to life. However, in the bigger picture, it is useful to understand our interconnection with all things and to recognize that we are not separate, standing outside of our environment. The environment is in us and we are in it. David Suzuki,7 environmentalist and professor emeritus of genetics, points out that the air we breathe is the same ocean of air that has existed since the beginning of time. Every molecule of air we breathe has been breathed countless times by other living creatures over the entire world and through the millennia. We are connected via the breath to every breathing being that ever walked or crawled on this earth. We breathe in the same air that they breathed — and we also breathe in molecules of their bodies, in timeless recirculation — molecules of Buddha, Christ, Mohammed, Hitler, Genghis Khan, dinosaurs, and wooly mammoths. There is no new air. The chemical pesticides sprayed in another country on the other side of the world, the fossil-fuel gases we billow into the air of our own cities — it’s all the same air. We are what we breathe.

Observe the air as it enters the body, filling, and as it empties out, releasing. Notice beginning. Notice ending.

Helping the Breath

We’ve all heard the admonition to “keep your nose clean,” meaning to stay out of trouble. In the most literal sense, keeping our nose clean may be an important step to avoiding trouble. The nasal douche can be a beneficial addition to our self-care regimen, helping to keep the sinuses open, flushing away encrustations of dried mucus, and aiding the mucus membranes to function properly.

Jala neti,8 or the nasal douche, is uncomplicated and not at all unpleasant. The traditional lota, or neti pot, looks like a miniature teapot. If you don’t have a lota, you can use a teapot but simply place the spout against the nostril; do not try to force it. Fill the lota or teapot with warm distilled water, close to body temperature, and add a pinch of non-iodized sea salt. The water should ideally have a salinity similar to tears, in order to not dry or irritate the mucous membranes, and so there is no osmosis between the mucous membranes and the water. Place the spout slightly within, or against, the left nostril, tilting the head to the right and slightly forward while breathing through the mouth. Allow the mouth to be slightly open and relaxed, breathing calmly. Gravity should enable the solution to flow easily out the opposite nostril. After the pot empties, exhale forcefully through both nostrils to clear the nose of excess water and mucus. Do not close off one nostril when blowing or you could force water into the ear. Fill the pot again and repeat the procedure through the other nostril.

Jala neti activates the mucus glands and goblet cells of the nasal epithelium, which secrete mucus. Immediately after, there may be a feeling similar to having a slight cold, with excess mucus and the need to blow the nose; this will pass quickly, followed by a feeling of openness and an enhancement of the senses, particularly that of smell and taste, and sometimes an acuity of vision. The practice of jala neti has been found to cure many sinus problems and it helps to make the nasal passages resistant to infections and irritations. It is very helpful for respiratory allergies and for people prone to catching colds. In a sense it clears out the “cobwebs,” and there is a resultant feeling of well-being in the head.

I’ve focused here on the significance of the nose as a gateway to the lungs and breath, but certainly to work with breath it is also important to bring attention and awareness to the musculature of breathing and to the breath’s rhythms and cycles. That is another article.

Massage provides a wonderful medium, as does yoga, to witness the body and to feel the waves of breath rolling through it — or not. Working with clients, it is always beneficial to bring breath awareness into the work you do. When we lay our hands quietly on the body, almost always the breath rises to meet them. Where attention goes, energy follows. We can do tremendous good simply by leading the breath to places where it does not go, increasing its volume and depth. We begin, by tuning in to, and learning about, our own breath. Every moment of our life we are breathing. Learn to be attentive to it. It begins and ends at the nose.