Breathing through challenges - resilience in stressful situations

Celeste: Welcome back to the final week of the Nursing and Midwifery Health Program Victoria's podcast series ‘Wellness Reimagined, How to Thrive in Stressful Times”. I'm Celeste Pinney, a Registered Midwife and Senior Clinician at the Nursing and Midwifery Health Program Victoria and host of the podcast. And I'm joined today by wellness speaker Mark Bunn. Welcome back, Mark. 

Mark: Hi Celeste. Great to be with you again. 

Celeste: Great to have you here. So this week, the topic that we're going to be discussing is ‘Breathing through challenges: resilience in stressful situations. Today's podcast will be focused on the breath, and how we might be able to use breathing exercises to improve our stress response or help calm us down in situations of stress or crisis. We do often get questions from nurses and midwives who use our service about ways, or strategies that they can use to help reduce anxiety and overwhelm at work, or when stress or difficult situations arise. And today, Mark is going to take us through a few breathing techniques that can be used easily and effectively at any time. But Mark, first off, would you mind telling us a little bit about what you know regarding breathing exercises for stress and why they're effective? 

Mark: Yeah, love to, it’s been one of my pet subjects for decades. Actually, I think I was probably the first athlete in Australia to use nasal breathing in, sort of, elite competition. So I was doing it in pre-season training back at 1994 when I was playing for Hawthorn and getting a lot of strange looks from my teammates, who are gasping with rare through their mouth and panting, and the reason I had done it because I had read a book by a triathlete in America who had looked and done some research on alpha brain waves and lower heart rate, better focus when you breathe through your nose versus the mouth, and he got that off an Ayurvedic Physician he was seeing in India. And so it was really just fascinating, and the whole understanding is that as little babies and full of midwives out there it's a perfect example of little children when they're first born, they're what's called obligate nose breathers. That means they're obligated to breathe through the nose. That's how we're designed. The mouth for respiration is really just an emergency backup situation if there's a really stressful response, you know, mum smashed our head into the lamp, or dad's dropped us on the floor, we scream. We get in through the mouth of that emergency situation, and then we go back to nasal breathing. So little babies, they're in mom or dad's arms, and their mouths closed, their belly rises and falls, very relaxed, very peaceful, very calm. Of course, as we go throughout our lives, particularly in our busy world today, we get to sort of adolescence and adulthood, and there's stresses everywhere, and there's traffic and there's demands at work, and over time, many of us become conditioned to just mouth breathe at the first sign of stress, and we don't even know about it, and, but over time, this sort of stimulates, of course, our fight or flight response, that sympathetic nervous system, and being able to switch that around to start to train ourselves to nasal breathe right throughout the day, even in exercise and doing specific breathing techniques that train us to tolerate more carbon dioxide in our system over time can really, really powerfully enable us to have a stress free physiology, or at least a more stress free, more resilient physiology. The air comes in through the nose, it gets filtered from all the impurities, it gets warmed, it gets humidified, gets in the perfect state for oxygen exchange. The ancients call it the prana, the life force, the Chi energy, goes right through the nasal septum, straight to the brain, integrates mind and body. So the exact opposite of that sort of stressed, sort of hyperactive, sort of on edge feeling, which gets exacerbated when we mouth breathe. As we said, mouth breathing great for emergencies, but we want to switch back to our normal state of breathing as much as we can throughout the day. And the beauty is, we can train that, and there's some beautiful techniques that allow us to align that breathing together and integrate the hemispheres of the brain, etc, etc. 

Celeste: Yeah, I've heard more about mouth breathing in recent times. I think it's becoming more well known that you know well, the benefits of nose breathing versus mouth breathing, and I've even heard of people taping their mouth during sleep to try to avoid mouth breathing, because there's so many benefits for, like you said, making sure that the toxins are coming through the nose, are purified and that sort of thing. So, yeah, really, I think maybe breathing and breathing techniques are underutilized, or we may not know as much about it as we could, but I think it's becoming a little bit more well known, which is really good. Mark: Yeah, just on that Celeste, there's just to really graphically illustrate the power, and this is really the first technique. The first technique today is just having some conscious awareness of breathing through one's nose. And so one of the studies that has been done recently was not a formal study as such, only two people, but they're now expanding that out to 500 people at Stanford University through Dr Anne Kearney's research, but they had two men who plugged their nose. So they plugged their nose, this is at Stanford, for 10 days, and they had all their vitals monitored, CO2, blood pressure, heart rate variability, snoring, sleep apnea, exercise performance, etc, etc. And then after the 10 days, they had the plugs taken out of their nose and they had their mouths taped up. So basically, 10 days only mouth breathing, 10 days only nose breathing. The difference-blood pressure, systolic, 142 down to 124 with nose breathing. All the nurses and midwives will know how amazing that is. Heart rate variability-150% increase with nose breathing. Heart Rate Variability, of course, a great representation of the robustness of the nervous system, resilience to stress. Carbon dioxide, increased 30% which is massive. Snoring- a 30 fold reduction in snoring during the night. And sleep apnea, we all know the devastating effects of sleep apnea. In one case, went from 24 episodes a night with mouth breathing to zero, and in the other man, 53 episodes through the night on average, mouth breathing to zero-nose breathing . Really, really amazing results. So we're designed to breathe through our nose. That's how nature designed it. Ayurvedic medicine is all about living in tune with how our bodies designed and this is one of the most fundamental things, just training ourselves consciously, putting our attention on breathing, how we're designed through the nose, deep into the belly. Really, really profound results. 

Celeste: That's so good to hear that. And I imagine you can train yourself, if you aren't already a nose breather, or you're breathing more through your mouth than your nose. You can probably practice starting to just bring some awareness as a starting point to breathe through your nose. 

Mark: Absolutely. Yeah, I get people even right now, on their on their breaks, or, you know, days off when they're doing their exercise, even just going for a walk as an example, and just making sure mouths closed, breathing through the nose. Some might have a little bit of difficulty initially, because they haven't used their nose properly for so long. It's a bit like the garden hose sitting out in your backyard and you haven't turned the tap on for a few years. It gets blocked up with dirt and stones, and you need to turn the tap on and get everything flushed out initially. So the more we use the nose, the more we flush out those toxins, we clear the blockages, sinuses improve. A whole lot of things improve, and then as nasal breathing is comfortable, even, you know, in the car, driving home from a shift or walking to the bus, just increasing the pace of getting a little bit more intense with the exercise and trying to maintain that comfortable nasal breathing, and just doing that will have a really, really profound effect. Late at night, can't get to sleep just lying on one's back, two or three minutes, slow, deep, relaxed breathing through the nose deep into the belly, really great way to calm the nervous system and often help promote falling asleep when needed. So it's a good way to start. 

Celeste: Yeah, great tips. Alright, well, maybe you could let us know about some breathing exercises that you found to be really good for stress, promoting calm, relaxation, that sort of thing. 

Mark: Yeah, absolutely. So first one we, we've already, already covered, really, and it's just at every opportunity we can, just to have some conscious awareness on how am I breathing, and making sure the mouths closed and breathing nice and deep relaxed through the nose. The more we do that, as we said, more we start to clear the sinuses, make the whole respiratory system functioning more optimally. We're getting more that oxygen, that life force to the brain, and it's a bit like going to the gym. When we go to the gym and we exercise our muscles, over time, they become stronger, and we can do more with less effort. And so the same with nasal breathing. So. Just every chance we can do it, walking exercise bike, even sitting in the car at the red lights, watching TV, etc, etc, etc. And then number two is what we call balanced breathing, or in anyone who does yoga will often have done this in a yoga class. It's called Nadi Shodhana, and what we now know particularly from the science, but again, all the traditional ancient cultures knew about this is that our nostrils both work in an integrated function, but also have a separate function. The right nostril stimulates left hemisphere of the brain function. It's considered the male nostril, heating, it stimulates sympathetic nervous system, bringing through the left nostril is calling it has that lunar energy, stimulates the right side of the brain and is considered the female side. And so Nadi Shodhana; what we do is we alternate breathing, and it helps to integrate both of these sides together, integrates two sides of the brain hemisphere, and is just a beautiful introduction to any yoga practice, or if people meditate or just at any time throughout the day, for one or two minutes a break on shift when things are getting a little bit hectic or overwhelming, and we're not sort of feeling like we're thinking clearly, it's a really good way to get that integrated sort of mental state back. So basically just sitting up straight and we're not sure where everyone is at the moment listening to this podcast, but preferably not driving a car or heavy machinery or somewhere safe, yep, yeah. But generally, so we just sit up nice and straight and take the right thumb, and with the right thumb just block off the right nostril, so you're closing the right nostril and simply breathing out through the left nostril and then in through the left nostril. Once that's done with the index and middle finger, or whatever finger you prefer, again on the right hand, you close off the left nostril, and this time, breathe out through the right nostril, and then in through the right nostril, close the right nostril with the thumb. Breathe out through the left nostril, in through the left nostril. Close the left nostril off with the middle index fingers, out through the right, in through the right, and just repeat. So exhaling out one nostril, inhaling in the same nostril, closing that nostril off, out the other nostril, in, and repeating. So just very simple, we're not trying to over breathe. We're trying to force the breathing. The breathing just goes at its own pace. And over a minute, two minutes, three should feel a nice settling, really nice integrated, sort of feeling of mind and body. 

Celeste: Very relaxing. 

Mark: Yeah, beautiful. 

Celeste: It's really nice, and it gives you something to focus on as well, which I think could be helpful if the mind is very busy or, you know, lots of, lots of thoughts you just give that really concentrate on that breathing. 

Mark: Yeah, yeah. So the next one is based on some beautiful science that's come out over the last five or six years about the whole importance of being able to tolerate more carbon dioxide in our body. When we think of breathing over the last few decades, most of us think of, you know, when we're stressed, we've got to have this big inhalation, you know, we've got to get more fresh oxygen in and oxygenate the brain, which is really, really important. But what they're finding that even more important than oxygen, which is, of course, we know is fairly stable in the blood, regardless of how we, we, breathe, what we want to do is to build up our resistance or our tolerance to carbon dioxide. So instead of breathing that out, you know, we think of being stressed. You know, the little child that's waiting to go under the stage before a school performance, and they got this sort of upper chest rapid breathing, and they're breathing out all this carbon dioxide, and they're sort of feeling anxious. We now know through the science that even anxiety, which we traditionally thought of as a mental sort of issue, is now very much physiological, if we can change the chemistry, the balance between oxygen and CO2, we can actually ameliorate anxiety to a really, really significant extent. And so what we want to do, to do this is extend the time that we exhale, so we're not focused as much on the inhalation. We're focusing on the exhalation and then also incorporating some breath holds. And what holding the breath in a comfortable manner does, is it, of course, builds up CO2 in the body, and over time, we get more tolerant of that, and CO2 in the blood, of course, does a lot of good things, it relaxes the blood vessels, vasodilation, we get an increase in nitric oxide throughout the system, and basically, you know, heart, cardiovascular system, reproductive system, much more blood flow, more relaxed, more open and really, really important. So something called box breathing, and I'm sure some listeners will have already done this technique, but it's really powerful. They used to have SAS soldiers who used to have to stake out the criminals for, you know, 10 or 12 hours overnight up in the roof of a house. And they had to be really quiet and completely calm. They would often do this breathing technique to help them stay in that state. Lot of elite Olympic athletes now do it because it's a great way to train ourselves, to have this extended exhalation and a little breath hold so. Way to do it again, just sitting up nice and straight, is we're going to do a cycle of four breaths. One's going to be an inhalation for four counts, then we're going to hold the breath for four counts, before we then exhale for four counts, and then hold the breath again for four counts, and then back to inhalation. So it's an inhalation, breath hold, exhalation breath hold, count of four, and I'm just going to time it through. So a lot of good apps out there on people's phones today that you can just download a little apps that will take you through the box breathing, and then you can vary the timing too. So as you get more proficient with the breathing, you can extend the breath holds or the time that you exhale, and get even better benefits. 

Celeste: So can people do that for any type, you know, four counts, five counts, what is for sort of the best count to do for most people do you think? 

Mark: Yeah, it's a good place to start. So as we do it now, everyone will get a really good idea of where their breathing is at as we go through a four count box, breathing if, if you're struggling with that, and you're really finding after two or three counts, you really need the next breath, or you're struggling to hold the breath, then you might even bring it back to, you know, three counts to begin with. And then some people will get to the four count, and could easily go to five or six on the exhalation or the breath hold so, yeah, everyone's different. Play around with anything. We just go with what's comfortable. We're not trying to, it's not like hold the breath so your face goes red, you look like a beetroot, and you're gonna, you're gonna burst or particularly, that's the beauty of all the ancient wisdom around breathing, whereas the West, we try and sort of push ourselves to achieve things, the Eastern approach is very much on comfort. You know, we want to cultivate the body to do all this very naturally, so it becomes part of our life, and we're not straining to do it. So the four counts, should be quite comfortable. There's that little bit of discomfort just at the end. So we're getting that feeling like the body's needing to do something to improve its functioning, but not enough that we feel discomfort or strain. 

Celeste: Okay, good to know. 

Mark: All right, so sitting up again, nice and straight, and I'll count us down, and we'll start with an inhalation. So coming down from 4,3,2,1, inhale through the nose. 2,3,4, hold the breath. 2,3,4 ,exhale through the nose 2,3,4, hold the breath 2,3,4, inhale 2,3,4, hold the breath 2,3,4, exhale 2,3,4 hold the breath 2,3,4, and just repeat in your own time, another couple of cycles in, hold, exhale, hold. Nice, okay. 

Celeste: That's great. I really like that. I've done the box breathing before, and I think it's really effective. And, you know, you can do it anywhere, just takes a couple of minutes, I think, to start noticing a shift, with a change in the emotional state. And very interesting to hear about, yeah, the science behind the carbon monoxide and how we can increase our tolerance to that, so that that helps with conditions like anxiety.

Mark: Absolutely, yeah. And just the very last one is, again, the science is just fascinating, or even just the investigation, it was a guy called James Nestor, and I'm sure many listeners 

Celeste: Ah, yes, yes. 

Mark: New York Times best seller that he brought out a few years ago. And he did some fascinating research, where he went into many of the sort of traditional cultures and their breathing practices. And what he found is that they had almost identical breathing practices, the breathing, what they now call resonant breathing, or coherent breathing, correlates very strongly with all the good aspects we know about breathing- are lowering the heart rate, feelings of relaxation, mind body integration, more robust nervous system, greater integration, coherent, brain functioning, etc and whether you looked at Buddhist monks that were doing their traditional chants, or in kundalini yoga, where you have like a SATA NA MA recitation, you have OMMM in Jainism and many other traditions, and even the Catholic Ava Maria Rosary, where, you know, the priest would chant something and then the congregation would repeat it back. All of them had this same breathing cycle of about five and a half seconds for inhalation, five and a half seconds exhalation. And really fascinating and then University of Pavia in Italy did studies where they actually got people to do this breathing technique, this timing, five and a half seconds in, five and a half seconds out, and yeah, correlated with all those benefits we spoke about earlier in terms of heart rate and nervous system and integration, coherent functioning of the brain, so, so simply, the last little tip is just again occasionally, when we've got a few minutes, we can just have this coherent breathing, just, and it's extended. Most of us breathe about half that rate. Most people breathe about three seconds in, three seconds out, and so it's almost doubling that cadence. So it's just slowing down the breath, and we just, I just go for about six seconds. It's easier when you're timing it six seconds inhalation. So it's a nice, slow, deep inhalation, always through the nose where we can and then a six second exhalation. And people will find that really, really slow to begin with, but within that, they'll also, after a few minutes, find that their brain functioning, and their thoughts are also hopefully slowing down and becoming more settled and relaxed. So again, another really simple practice we can do just a few minutes here and there to get some really profound benefits. 

Celeste: Fantastic. That's so great. And I like that they're free, simple, easy. You know, you can get an app if you if you're not sure about doing it on your own. I've used a couple of the apps for the box breathing, just because I find it's easier to concentrate if you've got a timer going in the background, rather than having to time it in your head. So that's fantastic. Cool. Thanks, Mark, thanks for sharing that. It's been a really good session today, and we've come to the end of our series. It's been amazing having you here for the last six weeks, and you've shared such incredible wisdom and knowledge, and I'm sure our listeners have gotten a lot out of it. So we really appreciate your time. 

Mark: Well, thanks for having me. I love working with nurses and midwives. I have right throughout my career. I often say in my talks, my three favourite groups ever are school teachers, aged care workers and nurses and midwives, because they're definitely just that whole caring aspect, so important for our community, and I know it's quite challenging for many out there today with not just shift work and everything, but, you know, just the whole work and life and more and more demands and sometimes less resources to do it. So I really hope something within the podcast can help them manage that stress and continue the amazing work that they all do and you do. So thank you. 

Celeste: Definitely. And if people are interested in finding out more about you, Mark, do you have a website, or is there a way people can find out more about you? 

Mark: Yeah, I have two websites. So the website that's more focused on, I guess what we've spoken about in the podcasts, sort of resources and books and ebooks, and just tips and articles, is dharmic living.com so dharmic is, D, H, A, R, M, I, C, so dharmic living.com and then more for my speaking, if, yeah, anyone knows any groups or associations or partners that work in a business or anything that ever want a health speaker or wellbeing speaker for conferences or events. It's just my name- Mark Bunn, b, u, double n, markbunn.com.au. 

Celeste: Lovely, well, we'll pop that in the show notes as well so people have got that handy if they need it.

Mark: Yeah, and Instagram is dharmic living 108 so often our little tips and things on Instagram, so yeah, dharmic living 108 is the Instagram handle. 

Celeste: Excellent. Well, thank you, Mark, all right. Well, that's it for today and for our well being series, for any nurse or midwife in need of support, you can find us on 9415 7551 to make an appointment with one of our nurse/midwife clinicians. Thanks for joining us for this series. Take care.