Breathwork 101: 5 Techniques to Boost Your Health and Wellness
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“I like living, breathing better than working... Each second, each breath is a work which is inscribed nowhere, which is neither visual nor cerebral. It's a kind of constant euphoria.”
-Marcel Duchamp
Take a moment to notice your breath. Now, take a short breath through your nose and then a long exhale, again, through your nose. Great job. You just did breathwork.
Breathwork techniques are nothing new. They’ve been practiced among different cultures for thousands of years. Recently, however, it’s been having its moment in the sun as new research shows how powerful those purposeful breaths can be.
What Are Breathwork Techniques?
Breathwork is the act of changing our breathing patterns in order to create changes in our mental and physical health. We breathe about 22,000 times per day. Manipulating the speed, depth, and awareness of these breaths are traits of breathwork techniques which have very powerful benefits.
Our autonomic nervous system is divided up into two parts: the sympathetic nervous system (fight, flight, or freeze) and the parasympathetic nervous system (rest, digest, repair). When we perceive a situation to be stressful, our sympathetic nervous system kicks in. As a result, our blood pressure and heart rate increase, our eyes dilate, and hormones like cortisol and epinephrine (adrenaline) are sent surging through our bodies. This can happen both in acute situations (you’re late for a meeting, kid is crying) or chronic situations (you’re generally anxious, you perceive your job as stressful).
On the flip side, when our parasympathetic nervous system is activated, acetylcholine is released, our blood is diverted away from our muscles and to our GI system, and our heart rate and blood pressure decrease. This can also happen in acute situations (during a massage or listening to a calming song) or in chronic situations (difficulty having an erection or ejaculating for men, vaginal dryness for women; sweating too much or too little, and blurry vision).
“When the breath is unsteady, all is unsteady; when the breath is still; all is still. Control the breath carefully. Inhalation gives strength and a controlled body; retention gives steadiness of mind and longevity; exhalation purifies body and spirit.“
– Goraksasathakam
Taken individually, the sympathetic and the parasympathetic nervous system are neither good nor bad. We have these separate branches because each serves a purpose depending on the context. Need to run from a lion? Sympathetic mode activated. Eating dinner with family and friends? Parasympathetic mode on.
We are not, however, limited to simply breathing as a symptom of how our nervous system is reacting. We have the ability to regulate our autonomic nervous system through two pathways: our vision and our breath. I’ll save the focus on the vision for another day. Today, let’s jump into why and how we should use breathwork.
Benefits Of Breathwork Techniques
Maybe the topic sounds a bit fluffy or woo-woo but the science (and plenty of self-experimentation) can help back up its efficacy. Yes, you breathe throughout the day and you’re here as a testament to its effects, however, just because you breathe does not mean you breathe well. Breathing poorly has profound effects that shorten our life and impact our well-being. Consciously changing the rate and depth of your breath, on the other hand, can provide many holistic benefits.
Decreases inflammation
Improves sense of well-being (in patients with cancer and GERD)
How To Use Breathwork Techniques
The first step to engaging in a breathwork practice is having an awareness of the state of your autonomic nervous system. Are you in a stressed state or a relaxed state?
The next step is to determine which autonomic state you want to achieve (parasympathetic or sympathetic). If you’re looking to wind down before bed or calm your mind while waiting in a long line at the store then you need to activate the parasympathetic nervous system. If you’re feeling sluggish after lunch or you want to get amped up to crush a workout then you want to activate the sympathetic nervous system.
The final step is to then choose the appropriate technique and let the lungs do their job. The general rule of thumb is that breathing that emphasizes slow exhalations triggers the parasympathetic nervous system and breathing that focus on short and quick inhalations triggers the sympathetic nervous system. I identify the appropriate use for each strategy below.
Tips:
I don’t provide information on what position to be in when using these strategies. It’s typically recommended you do these in a cross-legged position in a non-distractible area but don’t limit yourself to this. The more important thing is just practicing the techniques.
At the end of the instructions for each method, it simply states “repeat.” A good rule of thumb is to shoot for 8-10 rounds of each technique unless otherwise stated. Some people feel the benefits after 5 rounds and others after 30 minutes. Use your discretion.
5 Breathwork Techniques
Box Breathing
Box breathing (a.k.a. square breathing) is an approach focused on a slow, rhythmic pattern often visualized as a square (4-4-4-4). Mark Devine, a Navy SEAL, first created the technique in 1978 to help the special operation community remain calm under pressure. Box breathing is used to improve attention, stress resilience, and performance.
Instructions:
Inhale through your nose for 4 seconds.
Hold for 4 seconds
Exhale through your nose for 4 seconds
Hold for 4 seconds
Repeat
See this video for a tutorial.
Science: A 2021 study showed that box breathing improves both lung function and reduces stress after practicing for a 30-day period.
When to do it: Use it to help periods of high stress (e.g. during cold showers), to manage anxiety, or as a way to reset your mind during mundane tasks (e.g. in meetings, while walking).
Bellows Breath
Bellows breath (a.k.a. the stimulating breath technique) is adapted from yogic breathing techniques. It uses rapid diaphragmatic breathing to increase alertness.
Instructions:
Inhale and exhale rapidly through your nose at a rate of 3 inhales/exhale cycles per second.
These noisy breaths should be equal in duration and as short as possible.
Start with 10-second bouts with 15 seconds of normal breathing between.
Increase each bout by 5 seconds.
Repeat as needed.
See this video for a tutorial.
Science: Research has shown the bellows breath to improve lung function after having participants do the breathwork 6 days a week for a month. A 2020 study measuring the effects of bellows breath on anxiety reported that performing the breathwork for just 4 weeks could “significantly reduce the levels of anxiety and negative affect, and that these changes are associated with the modulation of activity and connectivity in brain areas involved in emotion processing, attention, and awareness.”
When to do it: Use it to increase energy and alertness in any situation such as before a big lift at the gym, during a post-lunch crash, or first thing in the morning. Because of the force required for bellows breath, it is a great way to improve the strength of your diaphragm and subsequently improve your lung strength. You can also use it to help manage periods of anxiety such as prior to social situations.
Holotropic Breathwork
Holotropic breathwork uses quick and controlled breaths to alter the state of consciousness. In Greek, “holos” means wholeness, “trepein” means “to turn towards” and holotropic, therefore, translates to “moving toward wholeness.” It was developed in the 1970’s by a pair of psychiatrists–Stanislav and Christina Grof. Their goal was to use breathwork to mimic the effects of LSD (which had been recently outlawed in 1968) to elicit strong emotional and physical releases. Holotropic breathwork sessions are often practiced in group settings, coordinated to music, and last 2-3 hours. This practice has been used to treat a variety of conditions including depression, chronic pain, trauma, and PTSD. Because of the intensity of the breathing, it is recommended that you talk to your doctor before trying this.
Of note, teaching this breathwork is trademarked and, therefore, it can only be conducted by a trained and certified breathwork practitioner. You can look for an official Grof Foundation certified instructor here.
Instructions:
You are paired with another person. One is the “sitter” who leads this and the other is the “breather.”
Lie down on your back with your eyes closed
Begin to take very rapid, deep, and even breaths through your nose. There should be no time between the inhales and exhales and your lungs and belly should alternate filling up as much as possible.
Gradually speed up this process
Continue this for minutes to hours.
Science:
Holotropic breathwork’s “secret” to feeling elation and an altered consciousness is through chemistry. Through these very quick breaths, also known as hyperventilation, the sympathetic nervous system (fight, flight, freeze) is activated and epinephrine (adrenaline) is released. This hyperventilation also expels CO2 from the body which alkalinizes the blood (known as respiratory alkalosis). This causes dizziness, lightheadedness, and tingling. This can be uncomfortable for some people so you shouldn’t do this if you’re prone to panic attacks.
That being said, one study followed 24 people over 6 months and used this technique to determine if there were any therapeutic benefits. Two groups of 24 people were placed into either the psychotherapy + holotropic breathwork group or just a psychotherapy group for 6 months. The breathwork group showed “significant reductions in death anxiety and increase in self-esteem compared to the Therapy Group.”
A 2015 study following 20 participants through 4 holotropic breathwork sessions concluded that this practice improves temperament and it has positive effects on the development of character, measured as an increase in self-awareness.” A 2007 “hypothesis-proposing paper” reported that holotropic breathwork might be beneficial for the treatment of common psychiatric disorders such as depression and anxiety in conjunction with psychotherapy.
When to do it: Finding a trained therapist is your best bet for maximizing the psychological benefits of holotropic breathwork. In addition to managing your psychological state, weave this technique into a weekly or monthly routine to increase your stress tolerance. You can also use it to increase your alertness, mental clarity, and creativity.
Triangle Breathing
Triangle breathing uses the shape of a triangle to coordinate a breathing ratio just as square breathing does.
Instructions:
Inhale for 4 seconds
Exhale for 4 seconds
Hold the breath for 4 seconds
Repeat
For a balanced nervous system use this 4:4:4 ration
For a sympathetic nervous system ratio use 4:1:4
For a parasympathetic nervous system ratio use 4:8:8
See this video for a tutorial.
Science: There are no triangle breathing-specific studies to the best of my knowledge. Similar to the box breathing approach, this pattern of breath-holding and controlled inhales and exhales can improve lung capabilities as well as decrease stress as extrapolated from research on box breathing.
When to do it: Use triangle breathing to readjust your nervous system based on your current state. Play around with the ratios to find one you like. Or do a pyramid within the triangle by adding one second on (per side of the triangle) for 5 rounds and then decrease for the next 5 rounds.
Wim Hof Method
Wim Hof, a.k.a. the Iceman, is a beast. He gained popularity by breaking 21 Guinness World Records including swimming 66 meters under ice, running a marathon barefoot and only in shorts above the Arctic circle, and standing in a container of ice cubes for 112 minutes. He developed the Wim Hof Method which consists of three pillars: meditation, cold therapy, and breathing. His breathing technique is similar to the Tummo meditation technique. There’s also a Wim Hof Method app to guide you through.
Instructions:
Lie down on the floor
Forcefully inhale through the nose
Gently exhale through the mouth without forcing it
Repeat this rhythm for 30-40 breaths
After 30-40 breaths exhale and hold your breath as long as you can. It is common to be able to hold this breath for 3-4 minutes (longer with practice).
When you feel the “air hunger” need to breathe, inhale fully and hold for 15 seconds
Repeat this entire cycle 3-4 times.
Do not make it forced, or as Wim says “no force. Feeling is understanding.
See this video for a tutorial.
Science: Similar to holotropic breathwork, the Wim Hof method uses hyperventilation to stimulate the sympathetic nervous system, offload CO2, and achieve the desired effects. This site has a table breaking down the evidence of the Wim Hof method claims into probably, possible, and no evidence according to cardiologist Rohin Francis. The supportive claims include, but are not limited to, benefits to the immune system (short term), stress, sleep, arthritis, and cold tolerance.
Researchers have studied the way in which Wim Hof is able to use this breathing method to thermoregulate his body to tolerate extreme conditions. They concluded that “Our results provide compelling evidence for the primacy of the brain (CNS) rather than the body (peripheral mechanisms) in mediating the Iceman's responses to cold exposure.“ A 2021 study had sprinters do the Wim Hof method prior to an exercise of repeated running sprints and found that it did help or hinder performance.
When to do it: Use the Wim Hof method as a way to increase your resilience to stress. Similar to holotropic breathwork you can use it to increase your alertness, mental clarity, and creativity. Don’t do it before exercising.
What I Do
I consider breathwork techniques tools in my toolbox which I whip out based on the situation. If I’m anticipating--or in the midst of--a stressful situation then I use extended exhales or resonance breathing. If I’m feeling sluggish before a workout or tired during a car ride then I use the bellows breath and versions of the Wim Hof method (Note: I do not do very long breath holds when driving or in other potentially unsafe situations like in the water).
I also incorporate various types of breathwork into my meditations, especially when my attention is lacking and I’m just mind-wandering. These breathwork strategies help to keep me more focused. I’ve noticed that some form of counting—such as with box or triangle breathing—also helps when my ADHD kicks in during a meditation.
Takeaway
You can either use breathwork as a tool or you can be used by it. Breathwork techniques are a powerful way to support both your mental and physical health. Pick an approach and then move on to another until you find one you like. Start by using it when you’re relaxed and not distracted. Practice it often.
Then, when you’re looking to engage your sympathetic nervous system (for a quick pick-me-up before a workout or during that afternoon slump) use the bellows breath, holotropic breathwork, or Wim Hof methods. If you’re noticing your sympathetic system engaged when you don’t want it to be (due to the looming work deadline or the jerk tailgating you) then use the box breathing and triangle breathing techniques. Play with these types of breathwork by adjusting the timing and depth of the breath and do what works for you.
Control your breath and control your life.
Which breathwork techniques do you use on a regular basis any for what purpose?