How to Use Breathwork to Lower Stress and Anxiety in Kids

Episode Transcript

Dr. Nicole Beurkens:  

Hi, everyone, welcome to the show. I’m Dr. Nicole, and on today’s episode, we are talking about breathing. Now you might be thinking, “Dr. Nicole, I know how to breathe. My kids know how to breathe. Surely we don’t need to cover a skill this basic.” Well, yes, breathing is something that we do every moment of every day, but how much do we really understand about the role breathing plays in our physical and our mental health? Do we understand how to use our breath to manage internal states and our outward behavior? Do we know how we can teach our kids to do this? The amount of research on breathing, the use of breathing as a tool for regulation is massive. There is so much research about that and a lot of practical applications that we can use, but what I typically find when people come into the clinic is if they have been to therapy before or their child has been to therapy, they say, “Oh, yeah, we learned some breathing techniques, but I don’t really ever do them.” And what I find is that when kids and adults understand why these tools are helpful, and really, how they work, it makes all the difference. So trust me, when I say you are going to want to take some notes today and put the strategies that we are going to be talking about into practice immediately.

Now who is going to share with us all about this? My guest today is Campbell Will. He is a physical therapist and breathwork specialist from Australia, who works around the world, introducing people to the power of the breath. He’s worked in a variety of clinical settings, from the ICU to the sporting field, from young to old and everyone in between. His passion is for teaching the principles of breathwork, and how it can be used in all situations to better regulate the body, the mind and emotions.

Campbell, welcome to the show. I’m so glad that you are here today.

Campbell Will:  

Thank you so much, Dr. Nicole. I’m very, very excited to open up this little box of goodies, and there is lots of really wonderful stuff about the breath we can touch on.

Dr. Nicole Beurkens:

Absolutely. I love how practical these tools are. And what I say to parents and to kids is the amazing thing about understanding how to use our breath is it’s always with us. You don’t need to be worried about “Do I have the resources? Or if I’m out of the house, do I have the tools that I need?”, we always have our breath, which makes it so practical.

Campbell Will:  

Exactly right. Like it’s free. It’s nearly instantaneous, and we don’t need any equipment, we don’t need any special know-how. It’s just a little bit of understanding, and excuse the pun, but it’s just under our nose, right? It’s this thing that’s with us all the time. And I think you touched on it beautifully in the introduction, it’s something we are doing all the time, but not something many people are taught how to use, and it’s a skill. And it’s a skill that we can develop and refine. I really like to think of it kind of like the user manual for the body. We are not really taught how this thing works, and breath is really the remote control of what’s going on in our autonomic nervous system. So having a little bit of an understanding of this kind of master switch, I think is really important for everyone.

Dr. Nicole Beurkens:  

Oh, I love that, the remote control. I love that, I can’t wait to get into it. But first, we need to know how your life journey led you to the point of being focused on breathing and teaching other people to breathe. Share with us a little bit how you came to do the work you are doing today.

Campbell Will:  

Yeah, I can actually tie it back to one single moment. I always wanted to be a physical therapist, I’ve always been interested kind of in the body and how it works. So I went through physical therapy school and I was working in ICU’s at the time as a respiratory therapist, where I would go in, and kind of for the very ill patients be helping them breathe. Patients on ventilators and that sort of thing. But I had one patient who I came in to mobilize, take for a walk, and he looked at me with just such conviction in his eyes and he said, “Look, when you can’t breathe, nothing else matters.” And for him, the simple act of getting out of bed was a mountainous task because his breath wasn’t there. And that really just stuck with me and I saw the potential of this thing that when I started going into yoga practice and looking at pranayama, and the potential of the breath, versus what my role essentially was in the clinical setting, and I saw this huge gap of what the breath could do and what we are currently kind of using it for. So that really pushed me down this kind of never-ending rabbit hole of all things kind of respiratory physiology and nervous system regulation and emotional regulation. And I just, kind of through all of the settings that I’ve worked in, noticed that the application of breath doesn’t go away, right? It doesn’t have to be the only thing we are thinking about, but it definitely contributes and if you are breathing dysfunctionally, everything else you do is going to be disrupted and if you are breathing optimally, everything else you do is going to be a little bit easier. And I continued to kind of follow that because I really haven’t encountered anyone that if they don’t optimize their breathing, they don’t see benefits, whether it’s from sleep or stress or emotional regulation or mood or energy, it really is this kind of like ever giving gift that once you know how to use it, it really is endless in its benefits.

Dr. Nicole Beurkens:  

So true. You talked about it being this master switch or sort of remote control. I think when most people think about breathing, they’re like, “Yup, it’s this thing I do in the background all the time, that just keeps me alive”, right? So let’s expand on that. Help us get from that way that we just think about or really don’t think about breathing “Yep, it’s something I do to stay alive”, to understanding even the physiology of how and why it’s such an important thing for us, for really all parts of our functioning.

Campbell Will:  

Yeah, so the way I love to describe it is breathing is this unique thing in our body that is both automatic, and under conscious control. So right now, most of your listeners are just probably listening and their breathing is happening automatically, it’s being controlled by the brainstem, this kind of automatic process of just breathing about 22000 times a day. But if I asked everyone listening now just to take a deep breath, and hold that breath for a moment, and then let it go, what we did was we brought conscious control to the breath. We call this kind of breathing above the brainstem. So we brought breath up into the cerebral cortex, which is kind of my conscious control of things. So here is this opportunity for us to grab a hold of something that is happening automatically in the background, every moment of every day. But when I grab ahold of it, and I do something to it, I’m influencing the message that is being sent to my nervous system. And some really simple things, for example — and I like to tie this back kind of evolutionarily, what happens when we breathe quickly? Well, that’s tied to “Am I running away from a tiger? Am I being attacked by something?” This very scary, stressful situation. And when I’m breathing really slowly, my nervous system understands that, well, I’m probably not being attacked by a tiger right now because no one takes a long drawn out exhale when they are under threat. And people think, “Well, I’m not being attacked by tigers anymore.” And that’s true, but our autonomic nervous system, our stress response, is a really generic response that hasn’t changed a lot in a very long time. Whereas our environment has changed immensely in the last 100 to 200 years, where I might open up my laptop and read an email, or there’s a deadline, or there’s traffic. or there’s poor sleep, or there’s a stressful situation at home, and they’re all little tigers. So my breathing can be this thing where I can grab ahold of that autonomic process and direct my nervous system in the direction that I want to go. Do I want to be calm and relaxed or do I want to be elevated? It’s not to say that the sympathetic nervous system is bad, per se. Context is really important. We don’t want to be kind of stuck in that state for prolonged times because it’s really changing a lot of the processes in my body. If my body thinks I’m trying to survive, it is not going to prioritize things of longevity: Inflammation, digestion, cellular repair, because it thinks I need to deal with this threat that’s happening right now because my breathing is telling me I’m under threat.

Dr. Nicole Beurkens:  

And that’s really what’s at the heart of what we are talking about when we talk about chronic stress, right? Which has become an epidemic, not just for adults, but for children also. This constant sort of being stuck in your sympathetic nervous system, constantly having your body and your brain feel like there’s these pressures and these threats, and as you said, it has huge consequences for our physical health and our mental health, especially when we think about kids. It’s one thing to have a chronically stressed out adult, it’s another thing when we are seeing some of the inflammation and the digestive issues and the mental health issues and all of the things that come from even young kids being stuck in that sort of threat mode or that sympathetic mode.

Campbell Will:  

Yeah. I think you have hit the nail on the head. Especially in this last couple of years, I really don’t come across many patients that I work with that are not in that relative sympathetic state. And they can address that, and they can say — when it’s very interesting to me that symptoms might arise, and different symptoms, like you touched on. It might be poor digestion, it might be I can’t sleep, it might be I feel emotionally labile, and I don’t have this ability to self regulate. To me, they’re all symptoms coming from the same source, which is that my nervous system is a little bit out of whack. And that, for me, the fastest and most accessible way for people to start influencing their nervous system is through their breath. There are obviously other methods. Visual field is a really interesting one that’s coming out at the moment, but breath is something that we can all do. It doesn’t require a lot of know-how, there’s not kind of a high point of technical entry. We are all breathing, as you touched on at the start, we just need to know a little bit more about how to breathe for certain situations.

Dr. Nicole Beurkens:  

Yeah, and what I think for all of you listening who have kids with pretty significant challenges, whether they have been diagnosed with, something like autism or ADHD, or anxiety disorder, whatever it might be, or they’re just struggling with symptoms, it’s important to understand that kids with these challenges are inherently in more of their sympathetic nervous system, in more of a constant stress state than even the average child. And then you add on top of that all of the extra challenges that we have had in the last two years now, it’s no wonder that kids who were struggling even before everything with COVID are really struggling now. So if you are noticing that “My child has always tended towards being maybe anxious or stressed, or dysregulated, or kind of melting down easily, or whatever, but wow, that has really ramped up.” This is really why. What I love about this topic, and why I was so excited to do this interview is you are going to help us get into some things right now that we can do for ourselves and our kids to really help with that, because I think so often people think, “Oh, my gosh, this is going to take years and thousands of dollars of therapy and all of these advanced techniques”, and it’s like, actually, we can do some simple things with our breathing to help with that, which I think is an incredibly empowering thing.

Campbell Will:  

Exactly. And I think that’s the point that everyone should understand, that it doesn’t have a really high barrier of entry. It is just this kind of quite simple understanding of what do I need to do? And what direction do I want to take my nervous system? And I think that’s something that’s accessible by everyone, and it doesn’t, as I said, require a lot of the kind of understanding of the underlying physiology or biochemistry. We just want to understand: What do I want to be prioritizing? To keep it super simple, I really like to break it down: We have our sympathetic nervous system, as we touched on, and most people understand that as our fight or flight response. And we also have the parasympathetic, which is kind of the opposite end of the spectrum. This is more about rest, repair, recover, digest. Those two systems kind of work in opposition. We are never both at the same time, and we are rarely all or one, right? Let’s think of it more in terms of a spectrum. I’m kind of towards that sympathetic state, or maybe I’m towards the parasympathetic state. And we can always kind of check in with ourselves. The state chart that I like to encourage people to think about is right at the top, we can think of a panic attack or a meltdown. This is a really high sympathetic state. And all the way down at the bottom is sleep. We are somewhere between those two points on the spectrum at any moment of any given day. I can kind of give myself a reference point. Maybe I’m alert, maybe I’m agitated, maybe I’m calm, maybe I’m sleepy, maybe I’m drowsy. I’m somewhere between those two points. And I want to think well, do I want to go up? Or do I want to go down? Because again, maybe I’m feeling really flat and down, and I need to go and do a presentation or I need to go to school. Then I would like to bring myself up, alright? Versus if it’s bedtime, and it’s time to wind down and I’m in that very agitated state, I need to come down. So there are certain simple triggers I think everyone should understand about the sympathetic and the parasympathetic. As soon as we breathe with our mouth, we are more in the sympathetic. As soon as we breathe high into our chest or shoulders, it’s going to be more of a sympathetic trigger. When we breathe quickly, and kind of the lowest hanging fruit, and most important is when I emphasize the inhale. And let’s take that example for a moment of a panic attack. It’s very inhale-dominant, it’s in and out of the mouth, it’s high in the chest, and it’s fast, right? That is my breath reflecting my nervous system. The other end of the spectrum is when I breathe with my nose, when I breathe down into the lower part, my chest, the diaphragm, the belly, when I breathe slowly, and when I emphasize the exhale, I’m going to push myself more towards the parasympathetic state. That, I think, is a piece of information that everybody should have, right? It’s very actionable, and it gives us a little bit more about grabbing a hold of the steering wheel and directing myself in what direction I would like to go. We can obviously combine all of those things. So if I’m going to breathe really slowly with my nose, concentrating on expanding down into my belly, and making my exhale longer than my inhale, it’s going to have a near immediate effect on my nervous system. And the thing I would like everyone to understand is your nervous system doesn’t have conscious thought, right? It only understands chemistry and electricity. So the length of my breath and the concentration of oxygen and carbon dioxide is what’s really sending the message. So even if my mind is very stressed, or overwhelmed, or worked up, if I can grab a hold of that pattern of breath, that’s the message my nervous system takes, it says, I’m breathing out slowly, I’m breathing in with my nose, it’s soft, and it’s long, I must be calm. And then I can start to have this bottom up regulation: Controlling the body to influence the mind, rather than trying to control the mind, which we all know is quite difficult at times.

Dr. Nicole Beurkens:  

That’s such a great point, because so many adults, even, will say, “I know strategies for trying to shift my thoughts or control my thought, but it’s hard”, and especially for kids, that’s really hard. And so I love these bottom up ways of doing that, where we don’t have to worry about trying to manage and rein in and redirect our thoughts. Just by focusing on our physiology, our breathing, we can impact that, because I know for myself that when I become aware that I’m really getting anxious or worked up, or my brain is spinning or telling stories, if I can grab a hold of my breath, do those techniques that I know, suddenly, I notice that not only physically do I feel calmer, but all of that cycling and chatter and like anxiety brain settles down, without me consciously having to try to control it. And I just think there’s such power in that, and for kids too.

Campbell Will:  

It’s such a good point. And I think a lot of people have that recognition: It’s really hard to control our mind, unless we are kind of long term practitioners in meditation and we have kind of done those really long hours. It’s almost a foreign concept. And I like to think that when we are trying to control the mind, we are going into the realm of the mind and that’s hard for a lot of people. Most people understand the body a little bit more. And the thing I think most people miss is this difference between stress physiology and psychology. If your physiology is stressed out, if you have got high cortisol, and epinephrine is up and your breathing is off, then you are going to have a response. Maybe one of those responses is psychological. Maybe like you said, the story begins to scatter around. But if I’m trying to manage that with a psychological tool, and not addressing the fact that I’m experiencing stress physiology, it’s only going to have a limited effect. And there’s a difference, right? Using a psychological tool for a more psychological problem is very much inclined. But if it is stress physiology, and if someone’s breathing is dysregulated, then that’s often what’s happening. Then we want to use a stress physiological tool, which is kind of managing the physiology, and letting that influence the psychology.

Dr. Nicole Beurkens:  

It’s so true, and I think particularly where kids are concerned, what often happens is a child is getting worked up, they’re distressed, they’re anxious, they’re starting to melt down, whatever it might be, they’re feeling overwhelmed. And we as adults come in, from a top down approach and try to talk to them, ask them what’s going on, talk to them about what’s happening, approach it from a cognitive or more of a psychological level, when really, we would be better off being more attuned to what we notice, perhaps, is going on with their breathing? What do we notice about their physiology and working with them at that level to calm that physiology? And then perhaps tap into more of the cognitive realm, right?

Campbell Will:  

Yeah, exactly. And we can even think about this in our own experience: The decisions we make, the information we take on when we are feeling really overwhelmed are pretty poor, right? Think of the last time you made a decision really under duress and stress, right? It’s usually not the best decision. And in hindsight, we can kind of think back and like, “Oh, that wasn’t a great decision.” But when you are experiencing stress physiology, and we can kind of go into the neural states that when you breathe quickly, we have much more activity in the amygdala, which is that very reactive thinking, it’s kind of us versus them, it’s survival. So you are right in terms of in terms of kind of managing the body or the physiology first, you are going to change the receptiveness of yourself or your child or whoever you are working with because they’re in a little bit more of a balanced state, physiologically, they have got less of that amygdala activation, a little bit more of the insula where it’s a bit more relational. It’s body awareness, it’s me, it’s space. So that really changes the information that we are going to give, like you beautifully touched on: Can I calm down the body first and then I can talk to the mind? Rather than trying to calm the stressed out, overwhelmed mind.

Dr. Nicole Beurkens:  

Yeah. And what I think is so lovely about this, too, we have a term that we use a lot in when we are talking about Child Development or talking about effective parenting strategies, and that is co-regulation: That in order to help a child be able to better regulate their emotions and behaviors, we have to regulate ourselves and sort of pass our own regulation on to them, especially in challenging moments. And it strikes me that focusing on our own breath in those moments is such an effective co-regulatory tool because our breathing, when we are with someone who is managing their breath, who is taking more of those slower, deeper breaths, that presence and even the pace of their breathing rubs off on us, right? And we are able to regulate around that. 

Campbell Will:  

I love that you touched on that. I think it’s such a powerful tool, and I call this — and I think in some realms, they call it entrainment, right? The way that one system is moving is going to sync up the other systems, and that happens between people. And we kind of know that as well. We have all experienced that where you maybe sit down next to someone that’s in a really euphoric state, and you feel a little bit lifted by it, or that’s in a very, very down state, and you kind of get drawn down a little bit. So sometimes the only thing we can do is control ourselves. But knowing that that’s going to then help influence those around us, is a very kind of selfless act. If all you can do is get yourself into a nice coherent state of body and mind knowing that that’s then influencing the people around you, I think is the first step. And then you can kind of take stock of the situation, and what other tools I can apply.

Dr. Nicole Beurkens:  

I think that’s so powerful, especially for all of you listening, who maybe deal with kids who lots of times during the day they are going from zero to 100 with very little warning, and maybe melting down, and you are feeling out of control for how to manage that. We talk a lot about “You can’t control anything your child is doing, you can control your side of it.” And I think this breathing and having these tools for regulating ourselves with breath and managing our side of things, it’s such a powerful way to have a positive or supportive influence in those moments with kids of any age, whether it’s a little toddler having an issue or it’s a teenager or a young adult child. Such an empowering thing for us as parents. I want to ask a question about oxygen and carbon dioxide before we get into some techniques that we are going to give people. You talked about the breathing through the nose versus the mouth, you sort of touched on some things about oxygen. Talk a little bit about why that’s so critical, how the way that we breathe influences things like oxygenation, how carbon dioxide levels perhaps influence states like anxiety, or dysregulation, because I think that’s helpful for people to understand.

Campbell Will:  

Yeah, I completely agree. It’s really where I spend most of my time educating people, because I think it’s the most misunderstood piece. We understand the importance of oxygen. Oxygen is kind of the fuel for our cells. But what a lot of people don’t understand is the role that carbon dioxide plays in making the oxygen available to the cells of the body. So I love to use this analogy, and most people understand it: We can think about the hemoglobin or the red blood cells, kind of like taxis, and they carry the passengers of oxygen around the bloodstream. We have got hundreds of millions of them. The only person that’s able to open the door to the taxi is carbon dioxide. So we have to have the presence of carbon dioxide that allows the oxygen to move from the red blood cell into the cell of the body, where it then goes to the mitochondria and produces energy. What we tend to see, and we are shining a light on this in, especially the generalized anxiety population, that panic disorder, is that these patients have a really high sensitivity to carbon dioxide. We have all experienced this. In fact, we can do it now, perhaps not if you are driving but if we just take one breath in, we breathe out, and we hold our breath — we can pinch the nose, and we are just going to hold and we are going to wait until we feel “I need to breathe”, okay? We don’t have to let it become really, really intense, but there’s a sense or an urge where it becomes a little bit perhaps frightening or a little bit anxiety-provoking, right? What’s happening is we are not — and most people will feel like “Well, I ran out of oxygen, okay, and that’s what made me need to breathe”. Your oxygen level didn’t drop. What happened was the level of carbon dioxide went up because I wasn’t breathing out anymore. So that slight increase in carbon dioxide is what triggered your brain to say “Something stressful is happening.” And our amygdala is a big chemo sensor, but mainly our carotid arteries, our Iota and our brainstem are filled with these little chemoreceptors, and their job is to monitor the levels of carbon dioxide. When carbon dioxide goes up, they ring an alarm bell that says, “We need to do something.” The reason that we don’t have that kind of sensor for oxygen is if we were sensing oxygen going down, it’s a little bit too late. We are probably going to pass out. So evolutionarily, we have kind of developed this safety net of being more sensitive to carbon dioxide going up, because typically the next thing that happens is oxygen will begin to go down. So we kind of catch it one step earlier. But the patients that are anxious — think about how most people breathe when they’re anxious: We breathe quickly, we breathe shallow, we might breathe in out of the mouth. All of these things are reducing the concentration of carbon dioxide. If we are doing that day in and day out, we have a very, very small window of tolerance or buffer zone, and as soon as my carbon dioxide goes beyond that point, I’m going to feel the symptoms of anxiety or stress or panic or overwhelm or whatever it might be for that individual. So working with someone to increase their tolerance, or build that buffer zone gives them a little bit more physiological flexibility so that the alarm system in my brain — and it’s actually called the suffocation alarm, we can understand how panic-inducing that might be isn’t triggered so easily. Okay. And there’s some very, very interesting research around panic attacks and these out of the blue panic attacks, where they put a lot of people in this patient population on monitors, and when they had a panic attack, what they saw is an hour before their physiology started changing, but they didn’t notice. They started breathing a little bit higher and their chest, they started breathing out more carbon dioxide. Their physiology was beginning to change, but they have very little awareness of that physiological state, until it gets to the point where we cross the threshold, the alarm system goes off, and I have a panic attack. 

So what I think is really important is people having that awareness of how they’re breathing throughout the day. How is that different from how I’m breathing when I’m feeling stressed or overwhelmed? Can I do some simple practices and simple understandings and build my tolerance to carbon dioxide? The easiest way we do that is we do not open our mouths. There’s about 50% more resistance to the air when I’m breathing in and out through my nose, so that holds a little bit of the carbon dioxide back. When I’m doing physical exercise, if I’m going for a walk, or even a light jog, maybe some yoga, again, trying to maintain my mouth closed. Let your body become accustomed to that slight discomfort that is carbon dioxide. The thing that people need to understand is your brain kind of has an association with co2. So when you first begin any of these practices, it’s going to feel a little bit anxious. It’s not going to feel very nice. But the more we do that, we kind of desensitize that response from the brain and we start to separate the emotional response to the physiological state. I heard this beautiful quote once that a lot of psychology is misinterpreted physiology. My mind is responding to the state that my body is in, and in the past, that might have been a difficult situation or a situation that I was anxious or panicing at, and my mind being the kind of automation and prediction machine that it is, kind of jumps back to the last time this physiological state was occurring, I was really anxious, so I’m going to create anxiety. So people always want to understand when they are doing this exercise, it will feel a little bit challenging, but that’s the point. We kind of want to lean into that discomfort and dissociate those two states and so that the next time it comes up, instead of my mind jumping to anxiety, my mind’s jumping to “This is physiology, what’s happening right now is the carbon dioxide level and my blood is changing.” I can then do something about that, I can change the way I’m breathing to change my physiology, to stop myself kind of going up that up the steps to that point where I crossed the threshold.

Dr. Nicole Beurkens:  

That’s a beautiful explanation of that. The best, simplest, most practical explanation of that I’ve heard, so thank you for that. Very, very powerful, and it’s making me think about two trends that we are seeing, particularly in kids, but I know in adults as well: The trend of increased anxiety across the board, but also we are seeing an increase in kids coming in, and I believe this is true for adults too, of mouth breathing. We are seeing more and more kids, who the norm for them, is sort of this low tone kind of mouth hanging open doing a lot of breathing through the mouth. Sometimes that’s because of chronic congestion or allergies or sinus issues or whatever, but a lot of times especially kids maybe who have developmental disability, kids have certain types of sensory motor or low tone issues tend to have that mouth hanging open more, they’re breathing through their mouth a lot more during the day, they’re breathing through their mouth when they’re sleeping, which is not good, and as you are talking about this, it’s really making it so clear that connection then, between that type of more open mouth breathing throughout the day and the night, and kids nervous systems being hyped up and then being more anxious.

Campbell Will:  

Right. I couldn’t agree more. And I think it’s something that we really have to address sooner rather than later, and with kids is probably the most opportune time to do it because once you develop habits and patterns, it’s harder to change them down the line. But more than that, the two points that I think are really important are: As soon as we open the mouth, we breathe off a lot more carbon dioxide. But the second thing that happens is now because I don’t have the resistance from the nose, I’m less likely to use my diaphragm. And everyone can feel this. If we take a big — wide open and we take a breath in, what happens? It goes straight into the top of the chest, path of least resistance, right? Now, if I take a deep breath through my nose, you are going to feel the belly or the lower part of the rib cage, because my diaphragm is having to pull the air in because there’s a little bit of resistance from the nostrils. Now, a lot of the sympathetic nerves live in the upper chest. A lot of the parasympathetic nerves, the vagus nerve is stimulated by the diaphragm. So one, now we have got this physiological trigger, and two, we are again pushing into that simple, static nervous system at rest. If I am breathing 20,000-25,000 times a day, if each of those breaths is telling my nervous system, “There’s a tiger, there’s a tiger, there’s a tiger, there’s a tiger,” you can see how people get into this really elevated state, where it just takes something small to cross that threshold, and then I kind of have that emotional disruption, or mood disruption or nervous system dysregulation, or those things that we have kind of crossed the threshold.

Dr. Nicole Beurkens:  

So powerful. So let’s get into some tools or some specific things. I mean, one of the things I’m thinking about right out of the gate is exactly what you are talking about with helping kids and ourselves to learn to breathe more consistently through our nose, right?

Campbell Will:  

Yes, I like to, again, especially when we are talking about kids is we need to make it a little bit playful, we need to make it a game. You cannot breathe through your mouth if you have got a mouthful of water. So something I often like is for people to just play a game of take a sip of water, and then see if you can walk around the house or do some laps around the yard, just to get into the habit of “Hey, I can breathe with this thing.” And do I have to immediately swallow the water? Alright, well, that shows us that there’s a little bit of a sensitivity there. The other thing is just tongue placement, I think it’s really important. Getting people to just pop the tip of the tongue behind the top teeth, okay is going to, again, encourage us to seal the lips, but not the jaw. We don’t want to be clenching the jaw, but we do want the lips to be sealed. People should remember that this is a gradual process, right? The first when you begin kind of pushing into nasal breathing, it might feel like you are not getting enough air. The most common response is “I just feel like I can’t get enough air.” If we remember what we are actually feeling is an increase in carbon dioxide, that kind of helps us go “Alright, well, it might feel a little bit uncomfortable.” But if I think I’m suffocating, or I think I’m running out of oxygen, I’m not going to persist with that. So I think it’s important we understand that your oxygen level is actually going up and you are making more oxygen available. It’s just that your chemo senses are a little bit sensitive right now, and they’re giving you that response of “I need to breathe more”. That will pass relatively quickly. I think getting into play, making it a little bit playful, how long can you hold a sip of water in your mouth? Because then we don’t even have to tell someone you need to breathe through your nose, it becomes automatic. It’s the only option, and I think that’s really helpful. 

The second thing, which is what you touched on: Mouth breathing during the night. Unfortunately, we can’t control what we are doing when we are asleep. But if you, as a parent, notice that your child breathes through the mouth during the night, there are some things we can do. Number one, during the day, is building that physiological tolerance. The reason my mouth opens often at night is because the carbon dioxide level goes up. Our breath rate reduces when we sleep so the co2 level goes up and there’s that discomfort in the brain that says “I need to get rid of this carbon dioxide.” It sounds a little bit scary and I often encourage people just to take this with a grain of salt. I do this myself every single night because I was a mouth breather through the night and I would wake up very tired in the morning with a dry mouth split lip, and I just thought it was normal until I discovered it wasn’t. So I use a very thin strip of micropore tape that you can just get from the pharmacist and I put a little vertical strip across my lips. I’m not taping my mouth closed, we never do that. It feels very claustrophobic. It’s just a little seatbelt. It’s to stop the low tone of the jaw opening at night because your body is not self-optimizing, right? It is efficient. If your mouth is open, you are breathing through your mouth, full stop. End of story. Because there’s less resistance to the air. So we just need to prevent the mouth from opening and then the only option is my nose. Most people will find that the first three to five nights, that tape is on the ground when they wake up in the morning. And that’s normal. It’s an adaptation process. What I would recommend, whether people are doing it for themselves or their children, is to do it before we go to bed. Rather than turning the lights off and popping on this taping going, “Oh, this feels a little bit strange”, maybe I’m reading a book at night, or maybe there’s a wind down practice that we have. Let’s put the tape on then and get used to it. I can still talk from the sides of my lips if I needed to. If I was to yawn, it’s probably going to come off. It shouldn’t be restrictive. It’s just a gentle reminder. But I honestly feel that if you can get someone breathing nasally through the night, you fundamentally change how that person works throughout the day.

Dr. Nicole Beurkens:  

Absolutely, and I can attest to that. The research shows that’s true, and I have seen it in many kids at the clinic,  the difference that it makes not only in the quality of their sleep, but just in every part of their functioning when we can use taping or — I mean really, mouth taping is the main way to do it to help them learn how to breathe and keep breathing through their nose at night. Sometimes it also involves, I should say, if you notice that your child is mouth breathing at night, you should have their primary health care provider look at: Is there something else going on there? Do we have chronic congestion? Are the tonsils and adenoids enlarged? There can be other things to look at there, but I think the point here is to be aware that mouth breathing through the night isn’t ideal. It’s not normal, and it creates a lot of issues, and so to look into that. But the taping can just make such a profound difference for kids in terms of their regulation and their function the next day.

Campbell Will:  

Yeah, and I think it’s really important as well, for us to touch on — this is kind of chicken or the egg, right? If someone’s breathing through their mouth, is that creating the adenoids inflammation? Because my nose has these little hundreds of millions of cilia and the mucosal lining that’s trapping that pathogen. If I’m breathing through my mouth, my lungs and respiratory system then have to work to push that back out and we get chronic inflammation through the throat in the airways for habitual mouth breathers. So perhaps that mouth breathing has preceded these other presentations. But as you said, it’s most important to get that checked out with a physician, but it should be something that we are really kind of pushing. Even things like facial development, jaw structure, there’s some really interesting research coming out now that those habitually mouth breathing through developmental stages have a different shaped-face when they grow up, which means they’re more likely to mouth breathe for the rest of their life. So it’s kind of like we have this window of opportunity to really affect change in that really crucial period of time. I think we should all be trying to address that as best as we can.

Dr. Nicole Beurkens:  

I think that’s so true. And just now all of you listening to just be aware of this. This is new information, I know, for many, if not most of you. So just be aware. Even a starting point is just noticing how your child breathes, noticing your own breathing. Just being aware of what you are doing with that, and then this first set of tools around just getting more acclimated and comfortable and aware of breathing through our nose, I think is great. What else? What else can we be thinking about and starting with?

Campbell Will:  

So the other things, I think — let’s maybe jump to: I like to think of offline tools as what I’m practicing in the background, online tools is what I do in the moment.

So offline, I think the most important is to try and build that co2 tolerance, that tolerance to carbon dioxide. Two easy ways we can do this, right? The simple sense is we need to breathe less. When I breathe less, I’m breathing out less carbon dioxide, and it’s going to build up in my blood. A lot of people have perhaps heard of box breathing. This is really nice — again, make it a little bit playful. Okay, where for example, we would breathe in for a count of three, we would hold the breath for a count of three, we would breathe out for a count of three, and we would hold the breath for a count of three. All of a sudden, I’ve just increased the length of my respiratory cycle. And the beautiful part about this is we can meet people where they’re at. Three seconds might be impossible, so maybe I do two seconds: I breathe in two, hold two, out two, hold two. And what that allows us to do is progress. When two seconds become easy or comfortable, let’s try and stretch the box a little bit bigger. And we can draw it as we are doing it. We can give the visual reference, but starting to increase the sides of the box is building that capacity to tolerate carbon dioxide. That’s probably the easier one that I would work with children because we can make it a shape, we can make it a game.

The other thing we can try and do is just breathe softly. Okay? Right now we can all probably feel the movement of air that’s coming in and out of our nose, hopefully our nose and not our mouth. We might also notice just the subtle movement of the chest and the belly. I love to use this example of let’s turn the volume down, right? Could you make the air coming through your nose a little bit softer and stiller? Is the movement of your body a little bit more subtle? We are going to breathe a little bit less, and if we are working with children, we can call this “secret breathing”. How softly and quietly can we breathe? And explaining that what’s going to happen very quickly is you are going to feel like, “I need to breathe a little bit faster.” And there’s the challenge: Can I kind of stay in that zone of my body saying “breathe more”, but my mind is in top down regulation controlling the breath: Soft, slow and still. And maybe I can hang out there for 30 seconds, or 60 seconds or a few minutes, if that’s possible. But it should be this kind of singular point of focus. Can I focus on just turning down? How quietly can you breathe? How soft and still and silent? And make it a game. Can you make it look like you are holding your breath because the breath is so small and still and soft? Because again, all that’s happening, and our kind of primary goal there is that the carbon dioxide level builds up. And if I can do that repeatedly, my brain starts to see: Oh, this, this level of carbon dioxide is not associated with something stressful happening. I’m in a playful mood, or I’m sitting down or I’m relaxing in bed. I’m doing that in an environment that is conducive to my brain interpreting “Emergency”. Okay, so those two build on a kind of carbon dioxide tolerance, which I think is the most important aspect physiologically. Now, is there anything you want to touch on there before I jump into…

Dr. Nicole Beurkens:  

No, I think it’s great. We can think about building some practice for ourselves and our kids with that. This is outside of moments of stressors or whatever. This is just us prioritizing for ourselves and for our kids, and even together, something we can do as a family, just having some periods of practice with this to kind of build that stamina or that tolerance. I think that’s great.

Campbell Will:  

Yeah. We know the power of an extended exhale for vagal tone and for kind of that parasympathetic state. So little simple things like if you have got a hanging mobile, or you have got maybe a balloon, can we try and blow and keep that up as long as we can? Or how long can we move that kind of hanging thing where we have got a little bit of a target? Again, I’m not telling someone “You need to exhale for twice the length of your inhale”. We need to make it playful. Let’s take a slow breath in through the nose, and how long can we breathe out and make that breeze or play it over my fingers? But again, what we are doing there is teaching the nervous system how to access parasympathetic state. And the idea of that, that then when I need it, it becomes easier. It’s kind of like I’m giving myself a little bit of a roadmap of how to get from sympathetic to parasympathetic.

Dr. Nicole Beurkens:  

That’s so key, because the big objection that I hear from people is like “Oh, yeah, I learned breathing techniques, but they don’t work for me.” Well, the issue is that people are trying to just apply them when they’re in the midst of some kind of panic or anxious kind of thing. It’s like no, you have to do your practice and your training for it so that it’s there and useful when you need it.

Campbell Will:  

I love that you touched on that. I always have to remind people: This is a skill. Think back to when you learned to ride your bike. You wouldn’t just go straight onto a mountain bike track. That’s akin to what we are doing. I’m in this heightened state, and I’m trying to use a skill that I haven’t developed. So we have to think of, and that’s why I love the term — these offline tools, right? You need to practice them when you are feeling calm when you have got a balanced emotional state. So that when we flip the switch, it’s like, I’m not trying to do something that I don’t know how to do. I’ve practiced it, I’ve put a little bit of time into it. I know the steps and what it should feel like, then it’s going to be a lot more effective in the moment when I need it.

Dr. Nicole Beurkens:  

Yeah, I love it. So how about, before we wrap up here, a tool that we can use in the moment or that we can help our kids use in the moment?

Campbell Will:  

So the best tool in my opinion, and this is just — relatively recently, out of Stanford, there’s a wonderful neuroscientist called Andrew Huberman who works — the Huberman Lab is very much the fear networks in the brain and breathing, and they have developed this or found this tool of the physiological sigh. Okay, and what this does — and a little bit of background is we have a little cluster of neurons in our brain stem called sigh neurons, and they unconsciously trigger us to sigh, for most people about 10 to 12 times an hour. And all a sight is it’s a little bit of a bigger inhale, a little bit of a longer exhale. So those sigh neurons, when they monitor carbon dioxide levels getting a little bit high, let’s balance the body. We breathe some of that co2 out. But again, we can take conscious control over that mechanism. So this they have found is the kind of fastest way to calm your physiology down, and then what we touched on before is that physiology will then influence psychology. So the physiological side, it’s a double inhale, and it’s a prolonged exhale. So I like to think of breathing comfortably full in through the nose, we pause for a moment, and then we sneak another breath in, and then a long easy exhale. So we take two inhales. Pause, inhale, let go. Let’s do one more. So inhale, a little pause, second, inhale, soft, long, easy exhale. Feel the shoulders dropping below, chest dropping below, perhaps the face softening. 

Now, if we are in a very heightened state, we might need to match how we are feeling. So it might be more of an in, in out. Okay, maybe I need to pick up the tempo a little bit because if I’m in a really heightened state, and I’m trying to get down here, that gap can be really big, right? So sometimes I think it’s important — and the people that often say, well, the breath work doesn’t work, perhaps I’m trying to do a really calming pattern of breath, and I’m really elevated. I need to bring myself up so that I can come down. So there’s lots of flexibility within that technique but the general rule of thumb is two inhales, long exhale. And why it works is that when we inhale, we create a certain amount of pressure in the lungs. The second inhale prompts open all the alveoli. And we have got about 600 million of these tiny little balloons in the lungs, and they all prop open, and that draws a lot of the carbon dioxide out of the blood. I then have that long exhale, which allows us to restore the natural level of carbon dioxide and to stimulate the vagus nerve. So it’s a really simple, backed by science, kind of mechanistic way to calm your physiology down, and then you can start to grab a hold of your mind.

Dr. Nicole Beurkens:  

Hmm, I learned something, this is great, the double inhale with that, that’s fantastic. And here for all of you who are thinking “Every time I try to tell my kid when they’re stressed or whatever, ‘You need to breathe’ or whatever, and they say no,”, here’s the key to that: You just start doing it yourself, and then they will model after that. Don’t make it some sort of demand or “You need to breathe,” or “We need to” — you just start doing it like this, double inhale just like we did here. We could experience it together. Just start doing that, and they will start to match our breathing and physiology.

Campbell Will:  

Yes, I couldn’t agree more, because it’s going to have a limited effect if you go in and your child is in a certain emotional state, and you are saying, “Hey, do this breathing,” we know that’s probably not going to work. But if I could sit down and just self regulate, and then perhaps co-regulate, make it a bit of a rhythm, make it something that’s audible, it’s obvious, it’s drawing their attention. They’re thinking, “what are you doing?” It adds a little bit of curiosity. “Oh, can you join in?” And again, we are not trying to tell someone, “This is going to calm you down.” We know mechanistically that’s what it’s going to do, and sometimes I think we need to be a little bit sneaky and take the backdoor in to get that kind of self regulation to happen. And then it can be that I can introduce words and cognition and emotional balance.

Dr. Nicole Beurkens:  

This is so good. I have about a hundred more questions and things to talk about, so we are going to have to have you back at some point in the future for a part two of this, but this was just fantastic. And you gave everybody such amazing information, practical things that all of us can put into place right now. I want to make sure that all of our listeners know where they can find out more about you, your work, and the kinds of tools and things that you have available.

Campbell Will:  

Yes, I will. Firstly, I would love to come back for part two. I think we can have a lengthy conversation on all these tools. I’m at breathbodytherapy.com. I work primarily with people in the US. We spend half a year in the US. Currently, we are over in Australia. For people on social media, I’m at Breath Body Therapy, and I really encourage people just to reach out. It might just be a question or a query or a concern, but I’m very passionate about this work and what it can do. So I always encourage people to just ask the question. It doesn’t need to go down the rabbit hole of all these things. It might just be like, “Hey, what can I do in this situation?” Or “Where can I start?” And I think on that point, the most important thing for everyone, whether it’s themselves or with their children, is breath awareness. Just notice: How do you breathe when you feel good? How do you breathe when you feel stressed? Can you notice the difference? If you don’t know the difference between your stressed and overwhelmed breathing, and your calm and content breathing, then that’s where we need to begin. Because then you can start to recreate that calm and relaxed breathing, to get yourself out of stress and overwhelm. So I think breath awareness is a very simple, but very powerful tool in helping people cultivate that sense of self awareness. And that, I think, is a tool that really goes far for lots of different situations.

Dr. Nicole Beurkens:  

I absolutely agree, and you have got so many wonderful things, not only on your social media, but also on YouTube. You make lots of free videos and things, but you have got so many resources. So I really do want to encourage all of you to — we’ll have all the links and things with the show notes. But really do check out what’s there. Some of these things would be great, even some of the shorter videos you can watch with your kids, depending on their age and developmental level. So really, I just want to encourage all of you to take advantage of the things that Campbell’s made available, some really great stuff. And I’m so grateful that you were able to take the time to be with us today, and we look forward to having you back.

Campbell Will:  

I really appreciate you taking the time to have me on and to shine a light on such an important tool. So I’m grateful. Thank you, Dr. Nicole.

Dr. Nicole Beurkens:  

And thanks, as always, to all of you for listening. We will catch you back here next time for our next episode of The Better Behavior show