'Take a deep breath': Here's why, for some people, this is terrible advice.

The field of trauma treatment is rapidly growing, which means that, as a trauma-informed strength coach, I spend a lot of time studying different clinical approaches. And as I do, I witness countless yoga teachers, therapists, somatic therapists, massage therapists, and physical therapists telling the stressed out to take a nice deep breath to get grounded.

To this I say: STOP!  Please stop telling folks to "take a deep breath."

On the surface, it makes a lot of sense to tell people to take a deep breath. We commonly think of deep breathing as a way to slow down time, our breath, and ultimately our autonomic nervous system.


But guess what ? Lots of people with chronic stress, post-traumatic stress disorder, or complex post-traumatic stress disorder will find this act at best, damn near impossible, and at worst, triggering.

If you live with chronic stress or trauma, there is a good chance that you experience constriction in your primary breathing muscle  (the diaphragm).

The diaphragm is a muscle beneath your ribcage that contracts and flattens out to fill your lungs with air. As you exhale, it relaxes and expands upward. When we are breathing at rest, it should handle most of the work.

Working in conjunction with the diaphragm is a whole set of secondary breathing muscles  —  your intercostals, scalenes, sternocleidomastoids, pecs minor, and abs.

Muscles of respiration. Image via Physiopedia.

These muscles are of your neck, chest, and belly. And theoretically, when you are at rest, they are too. Even when you are working hard in a sympathetic state, they are only handling some of the load.

But if you live with chronic stress or trauma, these muscles are often overused, and your diaphragm does almost none of the work.

Imagine you are hiking and you see a bear or some other predator you find threatening. Sense into your body. What does it feel like? What are your muscles doing? It is likely your whole trunk is constricted. This is a life-or-death situation, and your limbic system has taken the reins and is going to do its damnedest to save you with some defensive mobilization or immobilization.

Now imagine that you are running late for a very important meeting, and you are stuck in traffic or on a stopped subway train without cell service. You are going to miss something very important and have no way to let the others know. Sense into your body. What is your breathing like, and where are you breathing from? Is any air making it into your belly? Probably not. Your whole trunk is constricted even though this is not a life-and-death situation  —  it is just very stressful.

In both cases  —  actual life or death and perceived life or death  —  you braced.

And even when the bear runs off and the train starts to move again, your diaphragm will probably still be constricted with the lingering stress. Many of us don’t realize that we have not relaxed our diaphragms and that we are always bracing our primary breathing muscle to some extent.

I work as a beginning strength coach with the general population in New York City, and I can tell you that for the most part, New Yorkers are a bunch of chest-breathers hustling and living in a very stimulating environment. It is common for people living with trauma, or simply with a lot of stress, to be stuck in a defensive state  —  fight or flight. Their trunks are always bracing just a little, and that diaphragm rarely gets the chance to move.

What happens to muscles that have not been moved? That’s right  —  they get stiff and eventually weak. It does not feel good when you become keenly aware that your muscles are stiff and weak.

Telling a constricted (stressed) person to take a deep breath invites them to realize just how tight everything is inside.

For some people that may be okay, but for others  (like me!)  it can feel terrifying. It can feel claustrophobic, suffocating, and absolutely triggering. Deep breaths are a goal for folks like us  —  not the starting place.

The good news is that there are countless alternatives to get grounded, present, and mindful of the body that don't involve the breath. Here are a few to get you started:

1. Focus on a part of the body that feels neutral.

Put your attention there. Neutrality is often found in places like the hands or the seat. People might feel funny about the fact that it's their butt that feels good, but it often does. Get grounded by feeling into a part of your body that feels supported and easy, rather than going straight for the center.

When I began to incorporate mindfulness meditation into my own treatment, I realized that the only place that felt safe to focus on was my hands. So that's where I started.

2. Name five things.

For some folks, turning inward at all is dysregulating. Suddenly becoming aware of your state can be quite jarring at times. For clients who cannot ground by looking inward, I ask them to become situated and present by looking around and naming five blue things, five red things, and five yellow things. It gets people to closely look at their environment and keeps their prefrontal cortex turned on as opposed to triggering an emotionally reactive limbic response.

3. Listen to sounds near and far.

If I am encouraging someone to turn inward, I will ask the person to first listen for sounds far away  —  people talking outside, wind, cars  —  and then closer sounds like water running through the pipes or cooking sounds in the kitchen, and then even sounds from inside of that person’s own body. If I am trying to bring someone’s awareness back outside of the body, I encourage the same process but in reverse  —  starting nearby and opening up to sounds far away.

4. Follow the breath rather than trying to control it.

If breath is the main driver of your practice, like in yoga or certain mindfulness meditation practices, you can follow the breath without manipulation. By being behind the breath (following it), the constriction can feel less stifling than being on top of it (focusing on it). But please keep in mind that for some people, following or focusing on the breath is a goal to be worked toward, not a tool to be employed right in that moment.

Yes, after years of diaphragmatic breathing, I can take a deep breath without panicking. But it took work.

On behalf of the constricted breathers who panic when they notice their constriction, I am going to ask you to not start with the breath when working with trauma. Get creative or use the tools I listed above, but start somewhere safer, possibly outside of the body completely.

This story is excerpted from an article that originally appeared on Medium and is reprinted here with permission.

Images courtesy of John Scully, Walden University, Ingrid Scully
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Photo courtesy of John Scully

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