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Mindful : October 2019
when you exhale. In my case, the difference was t wo inches (40-inch inhale/38-inch exhale). That translated into 52% capacity, or a letter grade of D. I was crestfallen, but Alyson reas- sured me, saying most of her students “fail miserably on their first try, so you must be doing something right.” Then she said, “Do you want to see what your diaphragm looks like?” and pulled out a vegetable steamer bas- ket—the kind with flaps that expand and contract. I was flabbergasted. When you look at anatomy charts in a doctor’s office, the diaphragm is usually portrayed as a thin red line, but it’s the biggest breathing muscle in your body, about the size of a small pizza, and it will expand four or five inches when you inhale (if you let it) and shrink back into place when you exhale. “The digestive organs are right below the diaphragm and they get really happy when you’re breathing the way you’re supposed to breathe,” Alyson said. “And so does your heart. Everything gets really happy, and if you do it long enough, your body will remember and want to breathe that way all the time.” To bring my sorry diaphragm back to life, Alyson put me through an exhausting series of exercises, including Rock ‘n’ Roll (shifting back and forth between powerful belly breaths and crunching exhales while seated), Diaphragm Extensions (lying with my back on the floor and lifting a 20-lb. weight up and down with my belly muscles), and Exhale Pulsations (exhaling rapidly as if blowing out a candle 40 or 50 times). By the end, I felt bone weary, but strangely exhilarated. My lips, fin- gers, and toes were tingling, and the buzz lasted for hours. I don’t think my cells had ever been bathed in that much oxygen before. Just before I left, Alyson had me do another BIQ reading. This time the gap was 2.75 inches, which translated into 72%, or a strong C+. Maybe there was still hope. My Breathing Regimen The next day Dr. Vranich and I met on a video call. She was in her apartment in New York City, where she spends most of her time when she isn’t travel- ing the world teaching firefighters, pregnant women, extreme athletes, and other folks how to get more intimate with their diaphragms. She told me I was a rare specimen: a hori- zontal inhaler (good) and a vertical exhaler (not so good). She speculated that I’d conditioned myself after the tracheotomy to brace on the exhale and, as result, had a lot of stale CO2 stored in my body. “ You’ve never had the muscle memory of a good exhale,” she said, “so we have to teach you a new way of moving your muscles.” Her solution was to train me to relax my front abdominal muscles on the exhale and squeeze out the air with my diaphragm, lower abs, intercostals, obliques, and the muscles of my pelvic floor. Essentially, she figured that if I learned to breathe correctly with those muscles, my front abs would start mimicking the movement by associa- tion. “ Your belly muscles are going to do it because your side muscles are doing it,” she explained. So, over the next several weeks, Belisa put me through a grueling regi- men aimed at strengthening my inter- costals (the small muscles attached to the ribs) and my obliques (my side abdominals) and getting them to work in harmony with my other breathing muscles. She also taught me how to tilt my hips forward on the inhale and backward on the exhale to engage my glutes and pelvic floor muscles. “I want you to feel as if you’re being scooped out in the middle and your belly button is getting closer and closer to your spine,” she said. It was hard mastering this motion, at first. But eventually, after several weeks of daily practice, it started to feel virtually automatic. My breath suddenly became fuller and more relaxed, and, every now and then, I could feel myself slipping into a natu- ral breathing rhythm without even thinking about it. In the beginning, Belisa said my goal should be an 100% BIQ score, and by the end of week four, the readings began to climb into the high 80s. Breathing for Better Health A hot topic for breathing researchers lately has been slowness. Recent stud- ies by cardiologist David O’Hare and others have shown that slow-paced breathing can have a positive impact on heart rate variability, a measure of the heart’s ability to adapt to stress. Increasing HRV makes the system more flexible and resilient. That’s why it’s often cited as a predictor of longevity and overall well-being. None of these studies surprised Richard Brown, an associate clini- cal psychiatry professor at Columbia University—and an adept in aikido, qigong, Zen meditation, and other practices—who has spent most of his career studying the benefits of slow breathing. He and his wife, Patricia Gerbarg, an assistant clinical profes- When you look at anatomy charts in a doctor’s office, the diaphragm is usually portrayed as a thin red line, but it’s the biggest breathing muscle in your body. 68 mindful October 2019 well-being