Articles

ARTICLES BY MARYLOU GANTNER

THE BODY'S MIRACULOUS PLAN FOR STRESS CONTROL

Breathe Deeply (Breathe With The Diaphragm) and Let Tension Go

By Marylou Gantner, Published in Natural Awakenings – Central Florida/Orlando Edition – February 2013The American Institute of Stress e-magazine, “Contentment” Spring 2018

Several years ago the Journal of the American Medical Association listed 27 symptoms due to tension and improper breathing. Doctors warned of an over-reliance on anti-anxiety drugs that often lead to crippling dependency. I agree – there is a better way! For 35 years I've successfully worked with thousands of clients who suffer from anxiety/tension disorders and stress by using scientific relaxation skills, diaphragmatic breathing techniques and EMG biofeedback.

In my own life, anxiety nearly overwhelmed me at an early age. Through the years nothing I tried worked. Marriage, family, religion, meditation and therapy offered only brief periods of respite. In my junior year at Rollins College, I undertook independent studies in Psychology at the University of Florida. One morning I heard the renowned psychiatrist Dr. Joseph Wolpe speak. He was world-famous for his groundbreaking treatment of anxiety and stress disorders. He said, “If you are relaxed, you can't be anxious and tense. Relaxation is a technical skill. Anyone can learn it.” Hearing these words changed my life.

I asked Dr. Wolpe to train me personally at his behavior therapy unit at Temple University School of Medicine. Later I worked at Orlando Regional Mental Health Center as a mental health trainee. I noticed what was called the “revolving door syndrome.” Patients went from one crisis to the next, returning in six to eight weeks for more counseling. With my supervisor's encouragement and Dr. Wolpe's help, I developed training programs for the Center and began working directly with patients. To my delight, even the most difficult patients benefited from the training.

The technical skill I taught is called Progressive Relaxation (also referred to as Scientific Relaxation). This Relaxation Response was discovered in the early 20th century by the brilliant internist, psychologist and physiologist Edmund Jacobson. As a young boy, he became curious about nervousness he felt in himself and saw in others. As a young man, Jacobson entered Harvard Graduate School in the departments of Psychology and Philosophy with the hope of understanding and correcting this human condition. Instead, he found his professor, the famous psychologist William James, to be extremely nervous and unclear about its cause or what to do about it. Jacobson was further disheartened to learn that James was the author of what was referred to as “The Bible on Relaxation.”

Inspired that so few understood the condition of nervousness, Jacobson made three landmark discoveries in the early 20th century. These truths are the backbone of my practice. Jacobson's first discovery confirmed that when we think or imagine, it is a whole-body experience, involving the brain, nerves and muscles. The body is impacted by our every thought!

I train my clients to be aware of urgent, fearful, negative thoughts that the body transforms into extreme body tension. This condition is known as Canon's “fight or flight” response. Over time, negative thoughts translate into chronic physical symptoms in the cardiovascular, gastrointestinal and immune systems. Further, mental clarity is diminished and psychological symptoms surface, such as crippling anxiety.

Jacobson's second discovery — a universal message of hope — assures us that no matter how stressed or tense, the body has an innate ability to release tension and unlearn chronic habits. Nature wired it into our nervous system! Jacobson developed a teachable skill and named it Progressive Relaxation. By practicing this simple skill, we return our body to a healthy equilibrium.

Jacobson's third discovery was really an invention, the result of a collaboration with Bell Laboratories: the EMG biofeedback machine that measures muscles tension. I find people are simply unaware of the extraordinary tension they carry in their bodies. The beauty of this tool is that it gives the person's brain immediate feedback when they succeed in releasing tension. In fact, 70 years of Jacobson's impeccable research shows that we waste 30 to 60% of our energy in chronic tension and shallow breathing habits.

Clients arrive in my office with a list of symptoms. What they soon discover is that their discomfort is largely fueled by excess tension in their muscles and the habit of shallow breathing. This style of breathing deprives us of adequate oxygen and the rhythmic diaphragmatic action needed to nourish our inner organs.

Most people find Progressive Relaxation training interesting. They appreciate learning a skill that puts them in control of their emotions and life energy. In our first session, I teach clients to make friends with diaphragmatic breathing. Most find it very relaxing and energizing. Next we begin an educational process of identifying tension and releasing certain muscle groups, working especially on areas that feel specific to their symptoms (i.e. tension in a tight jaw or grinding their teeth, perhaps shoulder and neck tension patterns that create headaches).

Even though the body has over a thousand voluntary muscles, the beauty is that they work in groups. Clients learn to identify the few locations necessary to let go of tension and relax. 

This relaxation generalizes to the smooth muscles of their inner organs. I assign daily practice based on a person's schedule and their commitment. From the biofeedback machine, I get a profile of the client's baseline level of tension. As training progresses, we see these readings improve and symptoms become less intense and less frequent.

PROGRESSIVE RELAXATION

Progressive Relaxation releases tension more deeply than many hours of restful sleep. It minimizes the cumulative effects of stress, restores energy and promotes mental clarity. With daily practice the body literally releases stores of chronic tension from the muscles and nervous system. The benefits of this practice generalize to our waking, active day. Most people find this deep state of relaxation for the first time completely foreign and a “wonderful experience.”

DIFFERENTIAL RELAXATION

In addition to Progressive Relaxation, I teach a second skill called Differential Relaxation. The client learns to selectively relax those muscles not needed to perform a certain task. Clients begin to notice when they feel tense, rushed or anxious. While breathing deeply, they learn to scan their body and release unnecessary tension. Let's think about the task of driving a car. Most drivers waste a significant amount of energy behind the wheel; they grip the steering wheel when all that is required is that the person's arms comfortably guide the wheel. After learning Differential Relaxation, people don't drop in exhaustion at the end of the day. Having read this, you can see how we simply need to stop tensing our muscles unnecessarily. 
The Relaxation Response is our natural state of being! The very fact that nature has wired this response into our nervous system indicates we have the potential to help ourselves! After one of my presentations, a doctor remarked: “The Relaxation Response is the best-kept secret in medicine.” Sometimes clients say to me, “Why haven't I heard of this before?” I feel it is my mission to educate people. It concerns me that most people live their lives ignorant about how to optimize their mental and physical health with this simple skill. A skill that is designed into their very cells!

SIMPLE STRATEGIES FOR REDUCING TENSION

Sleep

To get sleep, wet two cotton balls with a drop of water and place one on each eyelid. You will receive “feedback” when you think. Relax your eyes and let your tongue relax into the floor of your mouth. Be patient, keep trying night after night, sleep with come.

Scotch Tape

On a day you are home alone, place a piece of scotch tape across your brow. Notice as it tugs at your brow as you began to “effort” or think anxious thoughts. Relax your brow and mental images.

Smile

Smile, even when no one is around. It is true that it relaxes 42 muscles on your face. Start at the corners of your mouth and feel it lift up your cheeks and light up your eyes.

Neck and shoulder tension

For a relief from neck and shoulder tension, provided you have no neck problems: Allow your head to fall forward for only one minute. Try this several times a day.

Exercise

The benefits are plentiful. If you can't start a formal program, choose simple ways like taking the stairs or walking briskly to your destination.

Basic nutrition

Eat breakfast. Minimize caffeine and sugar intake. Eat regularly.

Be kind

Be unusually kind to everyone your meet. You never know what difficulties a person may carry.

The Quick Version of Progressive Relaxation

To experience a modified version of Progressive Relaxation, lie flat with a pillow under your knees, or place your legs on a chair. Take a couple of deep breaths and let go best you can. Watch your breath: on exhale mentally and physically let go. If you go to sleep, what you had was a nap. Try again another day. Eventually you will remain awake and experience the mental quiet.
The Healing Power of the Breath

By Marylou Gantner, Scientific Relaxation Specialist
The American Institute of Stress e-magazine, “Contentment” Summer 2018

This article is about something more personal to you than your name. The subject is something ninety-nine percent of us have probably never thought about. Most likely you have never read any commentary about it either. Yet your physical health and emotional well-being, even your longevity, depends on understanding and mastering its natural function. It is more precious to you than gold, and no matter where you go on earth you are never apart from it. It has been with you since the first moment of your life and it will remain with you until your last. If you live an average lifespan, you directly engage with it a billion times.

We are talking about your breath. The moment-by-moment habit of ‘hugging your heart’ through proper breathing can save your life. Your heart is enclosed in a membranous bag attached to the top of the diaphragm. When you breathe correctly, it gets a gentle squeeze with each inhale. Another little recognized benefit: Each time the diaphragm descends downward, it massages the liver, offering a gentle massage for all the internal organs, including many ductless glands. Breathing with the diaphragm creates a gentle therapeutic rhythm in this deep inner region of the body. Breathing this way, allowing the breath to soothe our bodies, is known as the ‘relaxation response.’ It has been the privilege of my long career to teach people how to access these two healing powers. But before we consider a new way of breathing, let’s review the way we breathe now.

The High Price of Over-Breathing

Without realizing it, most of us have modified this essential function, starving our bodies of nutrients and oxygen and destroying well-being. This modification is called shallow breathing. We don’t notice we are using only our neck, upper back and clavicle muscles to breathe. We wear our shoulders high - as if defending against an unexpected threat. This chest breathing fails to draw oxygen into the lower lobes of our lungs where it can be distributed throughout the body. When the brain is under pressure, our body is eager to keep us alive by escalating our breathing rate. Many of the clients I see are on full alert, unaware they are living in the fight-or-flight response. Despite being warned by scientists and doctors for the past half-century of the deleterious effects of stress, we stay in a deadly whirlwind. We breathe rapidly and unconsciously, making ourselves sick and nervous. I find few clients understand the role of poor breathing in the downward spiral into physical disease and psychological disorders.

I have worked with thousands of stressed and anxious clients over the past 40 years. I have come to these conclusions: People are born breathing properly. Then in late childhood, they are thrust, unknowingly and innocently, into what I call the ‘effort-fatigue’ society. We work, or ‘effort’ at tasks until we drop. While we resist society’s hard driving customs and traditions, we participate anyway, thus building incredible tension in our muscles and tissues. On this subject, I agree with the great Catholic philosopher, Thomas Merton who said: “There is a pervasive form of contemporary violence... (and that is) activism and overwork. The rush and pressure of modern life are a form of violence, perhaps the most common form of its innate violence. To allow oneself to be carried away by a multitude of conflicting concerns, to surrender to too many demands, to commit oneself to too many projects, to want to help everyone in everything, is to succumb to violence.” 

We react to this ‘violence’ with a vicious circle: anxiety, shallow breathing, more anxiety and more tension, and more shallow breathing. As you grew older, no one taught you the profound need to breathe using the diaphragm and through the nose. The good news, I tell my clients, is that it’s never too late to begin healing themselves. A 90-year old client who learned to breathe properly began to sleep through the night for the first time in 20 years. 

In an article by Heidi Hanna in the March 2016 issue of Contentment, she notes that the American Institute of Stress estimates that 75% to 90% of medical visits are stress related. Since I first came to my career in stress management in the mid ‘70’s, I have watched studies slowly climb to these current figures. This is an alarming trend, and we know it is not sustainable. People are simply illiterate about their bodies and unaware of the healing benefits of correct breathing. 

Dr. James Gordon wrote in the Fall 2003 issue of Biofeedback Journal: “The illness, symptoms and conditions seen in health clinics today are most often related to lifestyle, nutrition, and stress. In my 40 years of experience in stress management education this calls for a kind of radical patient education we rarely, if ever, see.” I hope, in my lifetime, to see physicians and healthcare providers educating patients on the benefits of proper breathing for stress-related symptoms and illness.

As early as the 1930, three pioneer clinical researchers, Drs. Kerr, Dalton, Gliebe, reported in the Annals of Internal Medicine that America’s economic, moral and social changes of the time were resulting in “ever increasing numbers of patients who manifest symptoms intimately associated with the struggle for security, for independence, or for whatever state presumed to assure the spiritual and material happiness of the individual.” In the same article, Dr. Kerr stated that he frequently found the symptom of hyperventilation in his patients and this symptom stemmed from anxiety states. He further commented these anxious patients “haunt the offices of physicians and specialist in every field of medical practice.” 

One can readily see there is something in human psychophysiology that remains fearful and uncertain of one’s well-being and safety no matter what the century, circumstance, or age. Dr. Kerr’s 1930 report could just as well be the report of a contemporary physician - almost 85 years later. The unchanging, grasping need for security is built into human psychophysiology and does not change. I see it daily in my office. But there are well researched relaxation techniques that can alleviate troublesome symptoms and prevent deteriorating health.

One of my early teachers, Edmund Jacobson, writes in his book, Anxiety and Tension Control, that we can continue to live in this ancient fight-or-flight body response, wasting as much 60% of our energy daily, and exhausting ourselves. We can continue to build an unbearable amount of body tension and anxiety, doing serious damage to our health. We can continue to age our heart muscle beyond our years.

I often remind my clients they can choose to be the cause of their own suffering and develop symptoms that force them to the doctor for a diagnosis. Many already suffer serious health issues. Some may even become one of the tragic statistics. Or they can choose to bring their ‘past history’ (their conditioned stress response) up to date and learn ways to calm themselves and live efficient lives. 

You may need a breathing coach, but there’s much you can do by educating yourself about your breath. The road to recovery of healthy body function and emotional self-regulation is possible. I tell my clients their lives will change when they become interested in the way they breathe. And many become fascinated by the journey. Nothing is more rewarding to me than watching a client master their life by mastering their breath. 

Many scientists believe that chest breathing is the single greatest threat to our short and long-term health. Robert Fried says in his book Breathe Well, Be Well, “The single most stressful thing we can do is to breathe with the upper chest muscles.” When a new client arrives in my office, chances are they are chest breathing and very anxious. Their problems are exaggerated, lives are overwhelming, and they often feel desperate. Shallow breathing alters the brain’s respiration center, producing chronic body tensions and depression.

Your Wondrous Diaphragm

In my practice, I’ve found that few clients know where this life-giving muscle is located. When asked to identify the diaphragm, most hesitate. Sometimes using a circular hand motion, they point somewhere at the midsection, “I think, it’s somewhere around here?” It helps to know the diaphragm’s exact location, how to engage it, and its role in correct breathing techniques. 

I tell clients that ignoring the diaphragm is perilous to their health. Simply put, shallow breathing causes us to breathe off too much carbon dioxide. The lack of carbon dioxide speeds up the heart and is a major cause of anxiety. I recall, during my training at Temple University’s Behavior Therapy Unit, my professor, Dr. Joseph Wolpe, a world authority on anxiety, kept tanks of oxygen and carbon dioxide in his office. Often, he would gently administer a mixture of these gasses to calm a tense patient so therapy could proceed. 

Understanding the value of carbon dioxide is essential to the student of breath: it is not entirely a waste gas and plays a vital role in health. We deplete this precious gas, a source of calm and stability, when we bypass the diaphragm and fall into rapid, shallow breathing.

Hyperventilation is the most common of the stress related breathing disorders. (Hyper, meaning rapid chest breathing) My educated guess is a large number of ambulance calls to emergency rooms is for this breathing disorder. A client of mine reported regular ER visits due to panic attacks fueled by hyperventilation. I can easily identify stress in people who frequently sigh; they are shallow breathing with little, if any, diaphragmatic action involved. 

Carbon Dioxide is Your Friend!

It’s a fascinating fact that insufficient levels of carbon dioxide in the blood create an overly-strong electric bond between the red blood cells (hemoglobin) and the oxygen molecules. Due to this overly-strong bond, the red blood cells cannot release the oxygen to nourish the tissues. This is known as the “Bohr Effect.” It takes as little three minutes of shallow, rapid chest breathing to dramatically reduce oxygen levels in the brain and heart muscle. The body compensates by raising the blood pressure and increasing the heartbeat to make up for these deficiencies. Years of breathing poorly can bring about a whole host of physical and emotional symptoms. When a new client arrives in my office for stress management, I’m always interested in their fatigue level, a sure sign that they are not engaging the diaphragm when they breathe. 

But it’s more than fatigue that should concern us. Carbon dioxide impacts metabolic processes and energy levels. It determines how the body utilizes vitamins and enzymes. Low levels of carbon dioxide increase the excitability and arousal of the nervous system, causing us to overreact in frustration to situations beyond our control. 

Learning to breathe with the diaphragm has incredible benefits: With adequate carbon dioxide in our blood, we can do more exercise without feeling out of breath. We can accomplish more on our to-do lists, and remain calm and centered even when we’re running to catch a flight in a busy airport. The diaphragm has a partner to help you to stay in maximum good health, and that’s the nose.

Nose Breathing: Home Base to Relaxation

The nose is home base for another important gas called nitric oxide which keeps the blood vessels relaxed. I teach my clients that the mouth is for eating and talking; the nose is for breathing. Nose breathing has been revered by the yoga traditions in their ancient writings that claim many functions take place in the nose. The one function that amazes me is how quickly a breath of air in minus zero temperatures can be heated to body temperature in a nanosecond. The lungs would turn to a block of ice otherwise!

I love to quote from a podcast where the Irish breath expert, Patrick McKeown, who trains world class athletes, says: “Your first and best stress reduction skill and health care plan is learning to breathe slower, breathe less and a little quieter, and always breathe through your nose. It is reported by the experts who have made a life study of respiration that as high as 90% of people have unnatural breathing habits that lead to physical and mental symptoms. What (these people) don’t realize is that they are breathing two to three times more than the medical norm.” It still surprises me to see children and adults breathing with open mouths. Our nose filters out dust particles, viruses and bacteria, keeping our lungs in pristine condition. 

It’s Never Too Late to Learn to Breathe

I am not sure why so many aren’t aware of the life-giving muscle, the diaphragm, and the healing power of slow breath. Or why they don’t breathe through the nose. Few primary care physicians examine a patient for breathing disorders, yet every system in the body is connected to the breath. Perhaps this explanation in an ancient book titled The Science of Breath by Yogi Ramacharaka is true: “Our only fear is that its (proper breathing) very simplicity may cause some to pass it by as unworthy of attention while they pass on their way searching for something ‘deep’, mysterious and non-understandable.” 

When we watch our respiration closely, we can easily see how determined the body is to keep us alive. I tell my clients: As soon as you begin to take the time to practice – as few as five minutes, two to three times a day - the relaxation response begins to take root. The breath will slow down. Your body will begin to calm. After a few days, you may be better able to control your emotions. You’ll probably discover you have more energy. Strangely, you may even feel happier. Life will begin to take on a different, saner pace. You may find, as clients tell me, “I get more done in my day and don’t feel exhausted by mid-afternoon.” And so often I hear, “Why hasn’t anyone told me about this before?” 

But the best response I ever got was from a nine-year-old client. I was reviewing the respiration function with him. He listened attentively. His attention to detail seemed remarkable for his young age. He was clearly fascinated by his own breath. When we finished, I asked him what he thought. He replied: “I think it’s a privilege to be alive.”

Getting Started…

NOTE: If you are being treated for any symptoms, please consult with your physician before beginning the following breathing exercises.

  • The first order of things is to locate your diaphragm. Start by sniffing three times and pause briefly. Repeat this until you locate a movement in your midsection. No hurry. You will feel your diaphragm move in your midsection each time you sniff.
  • Relax the abdominal muscles. Try sitting at a table. Place your arms on the table and rest your head on your arms. Now let your stomach muscles relax. You will get this quickly. Recall this relaxed feeling as you do your breathing exercises.
  • It is best to begin breathing practice lying down with a small round pillow under your knees and a small one under your head. You might also place your legs on a chair or couch. Experiment, determine which position makes you feel more comfortable.
  • Now place one hand on your chest and one hand over your belly button where you felt the movement of your diaphragm. Watch your breathing come and go. No hurry. Soon you will notice your chest rising as you inhale. Just watch. After a few minutes of observing, apply light hand pressure on your chest and notice if your other hand at your belly button becomes a little more active. 
  • Next, place a three-pound book on your navel area. For a time let both hands rest lightly on your chest to discern if you are still using your chest muscles on the inhale. Then place your arms to your side and allow them to relax. Began to breathe into the book. Be patient, this will take a little time. Many times, your diaphragm is tight from inactivity. This exercise will begin to strengthen it.
  • You may also do your breathing practice sitting in a chair. This will help to carry over your attention to diaphragmatic breathing as you go about your day at work, driving, having conversations, exercising, or watching television.
  • For beginners, I suggest three five-minute practices a day. Later you can increase it to 12 minutes early afternoon and early evening.
  • It helps to have a trusted partner place their hands on your shoulders from behind. If your shoulders lift, you are likely still doing chest breathing. Shift your awareness to your diaphragm and try again.
People need to understand everything we need to live a healthy life is hard-wired in our brain and nervous system. As a clinical educator and scientific relaxation specialist, it is my passion to educate people to use their innate ability to live productive lives without destroying their health. If this article has inspired you, take your time, be patient, and remember you are changing a lifetime breathing habit.
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