Category: trauma

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Why Is It So Important to Learn to Exhale?

Wait a minute, I already know how to exhale. I do it hundreds of times a day, without even realizing it! Why would I need to learn how to exhale?

Good question.

As I work with my patients, the comment I often get is, “wow, I didn’t realize that I was never really exhaling!”

But how can that be? Read onwards, my friend, and I’ll explain it all.

When we breathe, we have many degrees to which we can move air in and out. There is simple survival breathing, which is just enough air to keep us alive, some may call this a “shallow breath.” This is how many of us breathe when we are still and not moving.

If we spend a lot of time still and not moving, or if we have life events that put our nervous system in a state that tells us we are not safe, and we should be as still as possible as a survival mechanism, we can get stuck in a shallow breath.

“Form follows function and function follows form” is a tenet of how our physical structure adapts to our environment. When we don’t breathe deeply, our ribs and surrounding structures don’t move. When our ribs don’t move, it’s harder to breathe well.

Oh, well the solution to that is easy, just breathe deeper!

For some reason, our common societal belief is that to breathe deeper, we need to take more air in.

While this is true for some people, it’s definitely not true for many. And, almost EVERYONE needs to first get air OUT before you can effectively get air back in.

This Ribcage is Too Big!

Some ribcages are “hyperinflated.” Barrel-chested, military posture, ribs pushed up in the front, all these positions indicate that there is some dead air hanging out in those lungs, for who knows how many years.

How are you supposed to get new fresh air in if your lungs are already full of dead air?

These people can’t get air OUT.

Think of it this way. Your lungs are a balloon (this is a gross analogy, but just go with it 🙂 ). You fill the balloon with air (inhale), then let a tiny bit out (exhale). Next breath, you need to fill the balloon with air again because you need oxygen to survive. But still, you let out just a little. Over time, that balloon will get bigger and bigger, despite feeling like you need more and more air!

Of course it would feel like you need to inhale, because each breath in is so small since those lungs are already packed full. But what you really need to do is get that dead air out!

Getting a complete exhale, all the way to the bottom, gets that dead air out. For these individuals, when they feel that they have exhaled completely, they are often surprised to find that there was still more air in there to exhale.

Once that dead air is out, the ribcage and diaphragm positions can return to normal, and functional breathing can be restored.

This Ribcage is Too Small!

Some ribcages become rigid and small, collapsed in on themselves. They can’t get air in OR out. Their diaphragms can’t do the magnificent action they were designed to do, simply because there is no room to do it.

People with this kind of ribcage absolutely need to invite some expansion into their lives, but in order to do that, a diaphragm needs to be awakened and revitalized.

Achieving a complete, relaxed exhale triggers the reptilian brain to restore the breathing pattern that is primally wired within each of us.

Getting all your air out in a relaxed way is like a reset button for your nervous system.

When you reset in this way, you don’t need to try to get air in, it just flows in! You may need to do some specific exercises to open and expand your chest wall and lungs and bronchi (in certain places and directions, but I won’t get into all that here), but by simply getting your air out, you’ve already done an amazing thing for your whole system.

How does air just “flow in” after a complete exhale?

When you exhale completely, you let all the air out of your lungs. This creates a vacuum- air HAS to flow into that space due to the laws of physics- air will flow from an area of higher pressure to lower pressure.

It’s like when you open a hot oven and all the heat blasts out- the high pressure hot air must flow into the lower pressure cooler room. You don’t have to do anything the make the hot air flow out, you can’t even stop it flowing out! It just happens.

When we try to actively pull air in, we end up using accessory muscles, i.e. your neck. Just trust me on this one, you don’t want to breathe with your neck. Your neck has enough work to do already managing your head on the rest of your body. Using your ribcage to breathe is a much better way to go.

This Ribcage is Juuuust Right.

The human body is an amazing design! Sometimes it’s just hard to get out of our own way and let it do what it needs to do.

Allowing air to move out completely has so many more benefits than simply restoring ribcage and diaphragm position (although the restoration of those contributes to all these other factors I will share with you).

Benefits of Exhaling Well

  • Decreased heart rate (by stimulating “rest and digest” nerve fibers).
  • A more balanced inhale to exhale ratio, which reduces stress levels.
  • Reduced states of hyperinflation.
  • Improved digestive action of the gut.

So the question is, why wouldn’t you wan to exhale well?

Remember, exhaling is about softening, releasing, and letting go. Sometimes (or a lot of the time?) this can be harder to do than tensing, clinging, and holding on. So give yourself some patience and grace as you work towards a fuller exhale, and eventually a more expansive breath (and life!) as a result.

Here is a short video on how to get some air out, based on the primary breathing method from the Postural Restoration Institute, or PRI for short.

Be well, my friend!

Kindly,

Dr. Derya

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“Be Balanced” FREE Summer Challenge: 3 Weeks to a Calmer, Happier You

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Summer is fast approaching and what a whirlwind of a year 2020 has been already. There has been so much going on, viruses, economic downturns, political uprisings, and to top it all off…murder hornets!

No matter who you are, I am sure you have been affected in some way. And it is healthy to feel the icky feelings, because they encourage us to take action and make changes.

With so much going on, it is also helpful to have some strategies to find some balance emotionally, mentally and physically, especially when so many impactful events occur in close succession.

That’s why I decided to challenge myself to be more balanced this summer. Will you join me?

Each week for three weeks, I am going to put some energy and awareness into being just a little more present and a bit more in my body.

But the key to making it work, for me anyway, is that it has to be super simple! Because if it’s an elaborate 20 minute process each day, I’m probably not going to do it.

What I need are some things that I can quickly do throughout my day. And, in my experience, the little things we do all day are much more impactful than doing a big chunk of something now and then.

It’s like learning a language…

Usually, when learning a new language, you spend a few hours several times a week in focused study. But you quickly forget what you learned in that hour chunk of time and have to keep coming back and reviewing. This way, you will learn the language, but it will be slow and hard to apply.

But what if you were suddenly living in a country where they only spoke the language you were trying to learn? Over three weeks, you would learn the language much faster and in a much more practical way than you would if you were studying a book or taking a class a few times a week.

You are immersed in it, so you get it better and faster.

That is what I hope to do with this challenge! Each technique, one per week, will be simple, quick, and applicable throughout your day. You’ll be doing little bits all the time – it’s a DIY balanced lifestyle immersion.

It’s never a bad idea to learn how to be more in your body, and more at peace with your world. Especially now, the world could use a few more people who are acting from a place of calm and groundedness.

So, will you join me?

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I’ll see you on the other side!

With love,

Derya

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What you Need to Know About Creating a Vibrant Life: How to Contract and Expand

Last year I was dealing with some health issues, and I felt that working long days was contributing to my symptoms. After much deliberation, I reduced my hours in hopes of finding some relief and more time for rest. At first it was great. I had more time to nap, rest, and do other things that felt restorative to me.

But it wasn’t long before I started filling that free time with more “stuff.”

Before I knew it, I had eaten up all that time with classes, volunteer work, and self-imposed deadlines and projects. I was just as busy (if not more so!) than before I reduced my hours!

Bewildered, I asked myself, “how did this happen?”

It was as if part of me could not STAND having time to be quiet and relax. There was an inherent guilt to resting, to having time that wasn’t “productive.”

All over again, I ended up giving away all of myself, to the point where it wasn’t sustainable.

It wasn’t my job that was draining me, it was my own inability to save a little of my power for ME.

You could even say that I was opening my heart TOO MUCH.

My life was missing a natural oscillation that is present in all of nature, that play of intensity and calm, of effort and ease.

It was seeming to me that my whole life, and the messages I was getting from the society around me, was all about effort and opening; doing as much as you possibly can…

without the bit about quieting, softening, and going inward.

Peter Levine, an industry leader in studying and treating trauma, describes this process as “pendulation.”

He believes that rediscovering expansion and contraction is the key to living a full and abundant life, with the ultimate goal of living a more expanded life.

Too much contraction is undesirable, this is established. Thinking too much, worry, fear, over planning, narrow focus (staring at a computer)… this creates a contracted state.

You can feel that contraction in your body- your neck, shoulders, face and maybe lower back become tense.

On the other hand, expansion is always desirable, and always the goal. This happens when you consciously relax your body, get a wider view (look out a window for 30 seconds and notice how your body changes), and settling into the present moment by noticing your breath and bodily sensations.

However, there is a trap that I call “FAKE expansion,” which is also undesirable and can even be harmful.

So what is “fake expansion?”

Over filling your life with STUFF and convincing yourself that it’s REALLY important (cringe, yup, that’s me!) at the expense of your own wellbeing.

Fake expansion is “opening your heart” in a situation where you feel exhausted and unbalanced.

It’s saying yes to so many things that you don’t leave any room to take care of yourself. It’s giving more than you have to give.

We do this ALL THE TIME. Sorry ladies, but women do this more than men, but the guys definitely do their fair share.

And maybe instead of asking how you can open your heart more, you should be asking “can you make space inside your heart for YOU before opening it up to everyone else?”

A.k.a. how do you keep some of that loving care and attention for yourself, so that when you give to and care for others, you can do it from a place of love and joy instead of burnout and martyrdom?

One way you can make space for your own heart is by physically changing the shape of your body to encourage more space in the BACK of the heart area.

Interestingly, as we open the back of our hearts physically, our decisions tend to reflect this and become more in support of self nurturing instead of over reaching.

Breathe into your Back

Our bodies are so fascinating. The sympathetic nerve ganglia, which is a fancy way of describing the nerves that make you feel anxious, stressed, worried, angry…generally amped up…live between the vertebrae in your upper back spine. So, if you are always “opening your heart” by pushing your chest up and trying to stand or sit up really straight and never going the other way (rounding your back) you’re going to have a heck of a time getting your brain and body to relax.

Not to worry! You can do a simple exercise to expand the back of your heart. Here’s how to open your upper back:

Re-Establish Physical Boundaries:

Another way to encourage healthy expansion is by re-discovering the boundaries of your physical body, which reminds the mind to keep a little of that loving energy for yourself.

By re-establishing the boundaries of our bodies, we learn to expand. Here are some ways to develop and be aware of the boundaries in your body. This embodiment of where you end and the rest of the world begins teaches your nervous system how to create healthy boundaries in your life.

Here’s how to establish the boundaries of your body:

Are you are needing to create a little (or a lot) more space in your heart for you, so that you can give from a whole and rested place? Or do you need to remind your nervous system what it means to have meaningful boundaries? Or perhaps you’re like me, and you really needed both.

Whatever the case, the fact is that our society drives us to do more, push harder, be better, all the time. And that doesn’t honor the law of nature, it doesn’t honor pendulation.

Try introducing a little more space for you into your life, and see if that allows you to expand a little more. We not only deserve some space for ourselves, we need it to be sustainable.

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Improve Your Breath to Improve Your Life

I used to hate hiking and running. I was always the slowest one, gasping for air, my neck and shoulders for some reason aching and killing me. I could really relate to the term “sucking wind.”

It just felt like I couldn’t get enough air.

Even when I would diligently hike and run more often, I never got a sense that I could breathe better. I was getting better conditioned, but it always felt very hard. I didn’t understand why, even though I trained regularly, friends of mine who hardly ran or hiked at all would zoom past me up the trail.

I thought, “there must be something wrong with me.”

After I had a pretty severe bike accident, my symptoms became much worse. Instead of just feeling out of breath, when I got left behind in the group my lungs would literally close up. I couldn’t breathe. I thought I might die. “Is this asthma?” I thought.

These days, I am the one zooming up the trail.

I surprise myself at how sometimes, even after I haven’t been training at all, I can easily hike or run without getting out of breath. I never get that feeling of my lungs closing up. Now it’s way more enjoyable to run and hike, and I look forward to it! I feel that I am getting fitter and can go further each week.

So what was going on with me?

Two things. The first was poor lung compliance and perfusion, a.k.a. my ribcage and therefore my lungs weren’t moving well, which didn’t allow me to exchange enough oxygen into my blood stream.

So, even though I was constantly exercising, my tissues weren’t getting the oxygen they needed. No wonder I always felt out of breath!

Turns out the reason my neck and shoulders hurt while hiking and running was because I was trying to pull air in with my neck! My ribcage, lungs and diaphragm weren’t working well together to pump air efficiently in and out, so my neck and shoulders decided to take over.

The second thing holding me back was trauma.

Since my bike accident, if I exerted myself too much, especially with other people around, my body would go into a state of “freeze.” I would check out mentally, close off socially, my lungs would seize up and I would have to sit on the floor and gasp until I could get up again. I think some people might call this a panic attack.

I know now that my ribcage mobility and my trauma were related.

Because I didn’t breathe well in the first place, it was harder for me to breathe and sense the fluctuating rhythms in my body.

Through a lot of trial and error, I eventually found that PRI techniques, in addition to working with a skilled somatic therapist, I was able to overcome both of these obstacles. And because of the huge impact it has had on my life, I now I help others do the same.

The way our bodies work is NOT like a mechanical machine.

We can’t pretend that a breathing issue only affects our lungs. We are constantly affected by what’s going on inside of us and around us, both physically and mentally. We need to be able to shift side to side in our lungs, our bodies, our minds, and our spirits. Stuck ribcages prevent lungs shifting. Stuck mindsets prevent bodies shifting. Stuck beliefs and trauma prevent our spirits from shifting.

The reason overcoming stuck patterns in the body and mind is difficult is because it’s about softening and letting go.

This means allowing air in and out instead of forcing our bodies to breathe a certain way. Releasing tension instead of holding on.

So many of my patients struggle with softening and letting go (myself included).

If I tell someone to tense a muscle, they can almost always do that. But if I ask them to soften and relax a muscle, it is much harder.

Similar to how our muscles become rigid, our minds can do the same thing. Here’s an example:

Someone asks you about an issue that you are strongly against. Very likely, you get worked up and talk fervently about all the reasons you think it is wrong. But if you are asked to see where the other person is coming from, and why they might feel the way they do, it will probably be much harder for you to give an answer.

This is just one way we become rigid- with our beliefs. It’s much harder to change the way we think about something than it is to keep thinking what we always have.

Can changing the way our lungs move help us overcome trauma?

Trauma is a state of being disconnected from our bodies. It’s a survival mode where there’s no room for feeling, because before our feelings were so terrifying and painful that we don’t want to risk going there again.

Trauma lives in our bodies, not in our thoughts.

We can’t think our way out of trauma. But we most certainly can feel our way out.

Sensing the breath is one way to sense our bodies again, which is the first step to overcoming trauma. We must learn to sense the ever-changing flow that is always occurring in our bodies. And at the center of our bodies lie our lungs, whose function is to manage flow. Flow of air in and out, flow of oxygen to our tissues, flow of byproducts back out into the world.

*Please note that sensing the breath is not appropriate for everyone who is working with trauma. So, if you find that noticing your breath feels uncomfortable for any reason, take a break for now and consult with a provider to help guide you in this process.

Our lungs remind us of how connected we are to everyone and everything around us.

We use our lungs to create air for our voice so that we can communicate with others. The carbon dioxide that we don’t need is expelled by the lungs to provide nourishment to trees and plants. And those very plants provide oxygen back to the bronchial trees within us.

As Pocahontas said,

“…we are all connected to each other
In a circle, in a hoop that never ends”

(Sorry, couldn’t resist the Disney reference!)

Do You Find Yourself Holding Your Breath?

When we don’t breathe, we don’t shift. When we don’t let go, we become rigid. Letting air out is an excellent way to start bringing flow back into your body via the breath.

Most people think of the inhale as the main part of the breath. But an inhale is only as good as the exhale before it.

Think of it this way. If you didn’t get all your air out, your next inhale will not bring in much fresh oxygen! There’s just not enough room with the lungs partially full of old air.

Furthermore, if you don’t exhale all the way, your lungs and ribcage don’t get to move through their full range of motion. Now you are working towards rigidity in a pattern of half full lungs, and you are reducing the amount of flow in your body.

The less your ribs move, the less your diaphragm moves, the less massaged your gut organs get by the movement of your diaphragm, and you become more rigid in your digestion.

The less air you get out, the more your body shifts into a state of fear and tension.

Think of your lungs as a balloon. If you never exhale completely, that balloon keeps getting more and more filled with air, and you feel like you’re floating away from the ground. We need a sense of the ground to feel stable, supported, and, well, grounded!

One way to start creating more flow and learning to let go is by letting air out.

Notice that I didn’t say FORCING air out (which is what most of us tend to do). It’s about allowing the lower front ribs to soften down instead of cramming them down.

Here is a short video on how to find an exhale breath that will get your ribs and lungs moving again.

Think of this breath as a sigh. Like you’re getting into a hot bath, or arriving home after a long day and sinking into a nice soft couch. “ahhhhhhh.” After that first delicious sip of an ice cold drink on a hot summer day, “ahhhhhh.”

If you like, take note of how you feel before and after doing this breath for about 5 rounds of 5 breaths. Has the quality of your breath changed? How about the quality of your mind? Your mood? You may be surprised by the results.

To take this a step further and work on sensing your body in addition to sensing your breath, practice also feeling the places where your body touches the chair, and/or where your feet touch the floor. Notice if you’re tensing your shoulders or your face, and see if you can soften there.

More and more throughout your day, be aware of what’s happening in your breath and your body.

Just noticing your breath, and not even trying to change it at all, is an incredibly powerful technique. You can watch your body find it’s rhythm again.

*Again, If doing this makes you feel anxious or uncomfortable, consult with a provider who can help you work through the process of getting back in touch with your body.

So if you’re like me, and you’ve been trying really hard to get better but things still don’t feel right, breathing and sensing might be the missing link.

Don’t underestimate the power of finding the flow in your lungs, your mind, your spirit. Trust me, I’ve been there, and I’ve made it to the other side. And I know that if I can do it, so can you!

If you want to work with me on this or just have questions on next steps, feel free to send me an email or leave a comment below. Derya@MyEssentalPT.com.

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