Taking Hold Of One's Own Destiny: A Breathing Method To Help Manage PTSD

This essay is dedicated to all too many of my friends

Post Traumatic Stress

Post-traumatic stress is not defined by how horrible the event sounds in description; rather, it is determined by the victim’s response to the event. Furthermore, as Matt Larson so masterfully describes, there are many different sub-types of PTSD, caused by different experiences and eliciting different responses.

PTSD is often imagined as a problem of ‘bad memories,’ but this is not exactly true. It is a problem because the event has not fully become a memory. When an event is fully a memory, it is experienced as something in the past, over and done with. Think of it as a scar: it may not be pretty, it may get stiff in cold weather, and every time you look in the mirror, you remember that something bad happened to you a long time ago. But a scar no longer hurts. A trauma, on the other hand, is an open wound. It is an experience. It may affect every moment of a person’s life, or it may emerge intermittently when evoked by something that elicits a sense that the event is happening again.

In PTSD, the person’s nervous system is set to react as if there is an emergency whenever the trauma is recalled or otherwise evoked. This can be anything from an explicit memory to a small reminder: for example, although he does not consciously know why, a soldier gets anxious every time someone coughs, because one of his squad coughed right before a bomb went off. A victim of sexual abuse becomes nauseous when they hear the chink of bottle on glass—or spoon stirring a tea cup—because their abuser used to have a couple of drinks in a glass tumbler before initiating his rapes. Because trauma affects the brain at the deepest levels, those associated with survival, logical interventions (anything from reassurance to cognitive therapy) offer only equivocal success in helping people fully recover.

There are several methods of therapy that can help some people suffering from PTSD. Those that sound most encouraging to me are:

• MDMA assisted therapy, with a lot of the research done in Israel, to assist warfighters and others victims of war.

• Various forms of therapeutically oriented self-defense and martial arts: among other things, this can create group solidarity (the lack of which can be a terrible loss for those whose PTSD has caused them to leave the military or law enforcement, or otherwise estranged them from their social circle). In addition, combative training is powerful—the person who experiences PTSD has experienced something they couldn’t stop: a rape, an assault, the helpless witnessing of violence, a catastrophic event—but now they train to become powerful, within a context where, if they have a flashback or are otherwise overwhelmed, there is informed support for them.

• Animal interactions: Equine Facilitated Therapy: I have seen presentations on kids learning to ride horses (think how powerful a small child, victimized, feels when they can cause a thousand pound plus animal to move at their command, yet they are also responsible for that creature’s well-being); wolves interacting with veterans in a controlled setting ; prisoners caring for and training rescue dogs, some of whom are quite traumatized themselves.

• EMDR – Eye movement desensitization and reintegration therapy. I sometimes find the claims for EMDR a little grandiose, and one of its most prominent proponents, Besel Van der Kolk has come under fire for rather appalling ‘victim blaming’ of abuse victims, but it does help some people quite a lot. The message can be far greater than some of the messengers.

There are surely other therapeutic techniques that I am not aware of, but such a survey is not my purpose in writing this piece. There are times and situations where no therapy is accessible or possible. Consider a police officer who is involved in a shooting, with a possible lawsuit pending—medical records can be subpoenaed in such cases, and furthermore, if they avail themself of counseling in any way linked to their agency, the latter may regard the counseling records as owned by the agency, and demand access for fitness for duty evaluations.

Frankly, there are also a lot of bad therapists out there. I have seen all too many therapists who approach their clients with ideology rather than phenomenology, imposing their expectations on what the client’s experience must mean. In another example, I tried to find help for two friends of mine, law enforcement officers, and every therapist I spoke to said that they couldn’t work with police, that it was a moral issue to them not to help police officers. At which point, I lost a few colleagues/friends, when I stated that they had thereby defined themselves as not therapists at all.

For all these reasons, I would like to present a method of self-care, even self-therapy, for those who cannot, for whatever reason, access therapeutic help. I am not claiming that this technique, Image-Associated Breathing, is a cure-all. I am claiming that it is a very helpful tool to train your mind to be less reactive to traumatic memories.

Circular Breathing

The first stage of training in this method is to use it to develop the skill to better manage, in ascending order: minor irritations & inconveniences, troublesome situations and finally, emergencies.

We use a particular technique called Circular Breathing. It is derived from East Asian martial traditions and, among other things, was used to keep warriors calm on the battlefield. [NOTE: I have found that this history to be helpful. Many people, men in particular, are hesitant to engage in anything that seems associated with ‘New Age,’ ‘blissed out,’ type of activities. I certainly found this to be true when working with gang-affiliated youth. When they are informed that this is derived from martial arts, many people who would otherwise reject the activity are willing to give it a try. Others resonate with the ‘exoticism’ of an East Asian practice, something that takes them away from the world in which they grew up—and were traumatized within.]

There are two variations of circular breathing. Try both, alternating between them, until you know which one works best for you. From that point on, exclusively practice the one you prefer. At the initial stages, practice circular breathing sitting in a comfortable position in a peaceful environment. Once you master this breathing method, it can be used in any environment, in any posture. If you train regularly, it will kick in automatically, rather than being something you must think about. In essence, your breath itself becomes your center: not your body posture, not the situation or the location in which you find yourself.

Lest there be any confusion: This is NOT a ‘time-out’ where you take a few deep breaths and then return to your life, refreshed. Instead, you are striving to develop a ‘pseudo-instinct’—a trained response so bone-deep that you do not even have to think about it; it becomes something close to a reflex, just as an expert with firearms may be referred to as an ‘instinctive shooter.’

Circular Breathing Method #1

• Sit relaxed, but upright, feet on the floor, hands in your lap.

• Do not slump or twist your posture.

• Keep your eyes open. (As you practice, so you will do. If you practice with your eyes closed, your newly trained nervous system will send an impulse to close your eyes in emergency situations. If you want to use a breathing method for closed-eye guided imagery or relaxation—to get away from your problems, so to speak—use another method altogether.) The point is that the person who is living with PTSD almost always is hyper-vigilant. We should never practice an allegedly helpful activity that would compromise the person’s need to scan their surroundings.

• Breathe in through the nose.

• Imagine the air traveling in a line down the front of your body to a point two inches below the navel.

• Momentarily pause, letting the breath remain in a dynamic equilibrium.

• As you exhale, imagine the air looping around your lower body, between your legs and up through the base of your spine.

• As you continue to exhale, imagine the air going up your spine and around your head and then out of your nose.

Circular Breathing Method #2

This is exactly the same as Method #1. You simply reverse the imaginary direction of the breath.

• Imagine the air around the head, looping down the back, falling down each vertebrae, continuing down past the base of the spine to the perineum, and looping again, this time up the front of the body to a point 2 inches below the navel.

• Momentarily pause, letting the breath remain in a dynamic equilibrium.

• As you exhale, imagine the air ascending up the centerline of your body and out your nose.

How to Practice Circular Breathing

It is not yet time to attempt to work with traumatic memories. First you must become skilled with this breathing method.

• Try both methods: you will soon find that it is somehow easier to breathe in one (imaginary) direction than the other. It will feel easier to imagine your breath going down your back or down your front.

• Some people find it helpful to imagine that their breath has light or color. Others take a finger or object to trace a line down and around the centerline of the body to help focus their attention. Choose which of the variations works better for you.

• When you first practice, do so while seated and balanced. Once you develop some skill, try circular breathing while standing, leaning, or even driving. You will soon be able to use this breathing in any posture and under any circumstance. Most people find that after a short time they do not need to visualize the circulation of the breath. You will actually feel it, a ring of energy running around your body. You begin to feel balanced and ready for anything.

• Once you are comfortable with your chosen pattern of breathing, experiment with it in slightly stressful circumstances, like being caught in traffic or stuck in the supermarket checkout line, with the person in front of you painstakingly counting out change and coupons. Try it also when afflicted with minor issues: stage fright, a meeting with your supervisor, or a client, customer or neighbor who always seems to put you off balance. Once you can reliably use it in this manner, with a clear experience of being better able to manage your stress before, during and after the interaction, use it in more intense situations: you are caught in traffic with no off-ramp or exit available, late for a job interview; you have been falsely accused of inappropriate behavior on the worksite; your child has been caught stealing from a local store; you need to end a date in the middle of dinner, or break up with someone. The ‘opportunities’ for practice are endless.

• Once you have successfully used it in numerous stressful situations, you will naturally shift into this mode of breathing when you find yourself in such events. Eventually, you will no longer be a need to tell yourself to start circular breathing. It will become reflexive, automatic, replacing old patterns of breathing that actually increased anxiety, fear or anger within you. At this point, when you find yourself in an emergent situation, you very likely will ‘boot up’ automatically. Even if this is not fully reflexive, you will have enough internal calm to deliberately shift into the circular breathing pattern as you attend to the emergency.

When Should You Use Circular Breathing?

The way you organize physically affects your thinking. For example, if you assume the posture and breathing of a depressed person (slumped body, shallow breathing, sighing), and maintain it for a while, you’ll very likely start to feel a little depressed. Similarly, if you clench your fists and start glaring around you with a lot of tension in your body, you may start to feel angry; old issues and grievances may arise in your thoughts, simply because you have begun to hold your body as if there is someone nearby towards whom you feel angry. (You have probably observed people working themselves up from anger through rage into an attack in just this way.) Circular breathing is used to create a mind-set, that is adaptable and ready for anything, equally prepared for an easy conversation, an intense dialogue with an adversary, even a fight, yet fixed on none of these. You are trying to develop an ‘omni-directional potential energy.’ Think of a cat walking along the edge of a fence: it is perfectly balanced, yet ready to jump off at the slight danger, leap towards a bird on a nearby branch, fight with a cat coming the other way, or simply stop dead and contemplate its surroundings.

This method of breathing is very helpful when you are anticipating a crisis situation, perhaps when you are expecting a meeting with a troublesome individual or preparing to deliver someone very bad news. This breathing activates the entire nervous system in a way that enhances both creativity and the ability to survive.

Even in the middle of a confrontation, particularly a verbal one, there are many times when this breathing will have a very powerful effect. Not only do we get more stressed or upset in the presence of an upset person, but we also become more peaceful in the presence of a calm one. People tend to template their mood to the most powerful individual close by. Think of someone who, when they walk onto a scene, often calms things down before they’ve said a word. You’ve probably seen the opposite as well; someone with no malevolent intent who just seems to irritate or agitate people as soon as they appear. Using this breathing method is a vital tool in making you the former type, a person of quiet power.

It is helpful to use this method of breathing after the crisis is resolved as well. A crisis does not usually occur at the end of the day, and you will need to regroup in order to go on with your job. Circular breathing will bring you back to a calm and relaxed state, prepared to handle the next crisis, should one occur.

Circular breathing will also prevent you from carrying the crisis back home with you at the end of the day. Before entering your home, sit quietly in your car or yard (or in a quiet room in your house if your neighborhood isn’t safe) and practice circular breathing for a moment or two before you engage with your family, or, if you live by yourself, settle back in to your life apart from work. The only thing that should come home is you, not the crises you weathered.

Image-Associated Breathing to Heal from Trauma or Ward off Traumatic Reactions

Circular breathing, along with a particular method of imagery work, is an effective method of warding off the effects of potentially traumatic events.

• Let us imagine that something very upsetting has happened to you. Perhaps you even recall an old trauma that still plagues your mind.

• Whenever you think about it (or it forcibly intrudes into your consciousness), your body tenses or reacts in various ways. Your breathing pattern often changes.

• If this is your situation, go someplace where you will not be disturbed for a while. Make the mental image of that trauma as vivid as you can tolerate. This takes some courage, because most of us simultaneously ‘avoid-as-we-remember.’ Rather, if only for a moment or two, meet it head on and re-experience it. If you physically organize as if something is happening, the brain believes that it truly is. Notice, in fine detail, how you physically and emotionally react. As difficult as this may be, it is important to establish for yourself your baseline response to the trauma. We must clearly experience what it does to us.

• Now take a couple of deep sighs. Sighing breaks up patterns of muscular tension and respiration. This is like rebooting your computer when the program is corrupt.

• Mentally say to the ugly experience, “Hush. You move right over there to my right (or left). I’ll get to you in a minute.” For some people, it is even helpful to make a physical gesture, ‘guiding’ or ‘pushing’ the experience off to the side. We cannot force ourselves to stop thinking about an experience if it has psychological power. Instead, we move it aside, as if we are guiding a wounded person to a waiting room while we organize ourselves to properly deal with it.

• Now initiate your preferred method of circular breathing.

• As the memory creeps back in (it will), just breathe and center yourself, placing the memory off to the side. Once again say, “Hush, I’ll get to you in a minute.” You can’t fight it, so don’t try. Just ease it aside until you are ready.

• When your breathing is smooth and your body is centered, you will be relaxed like an athlete, ready to move but with no wasted effort.

• Now, deliberately bring that ugly memory or trauma into your thoughts and imagination. As you find yourself reacting, continue circular breathing, trying to bring yourself back to physical balance as you focus on the traumatic memory.

• Bit by bit, in either one session or a few, you will notice that you are increasingly able to hold the image with a relaxed body and a balanced posture. You are now able to re-experience the memory without the same painful, tense, or distorted response you used in the past. You are, metaphorically speaking, turning the open wound into scar tissue. The reason is that when you were traumatized, you were in a particular physical state, with your body engaged in fight, flight, freeze or flinch reactions. Now, you are recalling the event without any of those reactions at all. Your brain realizes that it’s not happening NOW.

Think of how you hold babies so that they are safe: you do not drop them nor do you squeeze them so tightly that they are frightened or uncomfortable. To be strong in the face of trauma is very similar in that you internally hold the memory with the same gentle strength with which you hold babies, whether asleep or struggling to see over your shoulder. You are not wiping the slate of memory clean. Rather, you are placing it in a proper context: it is something that happened to you, but it does not define you.

If, on a daily basis, you can ‘inoculate’ yourself against stressful, even potentially traumatic experiences, life will continue to be enjoyable or will become enjoyable once again. The goal is not to restore some kind of mythic ‘innocence’ that you had ‘pre-trauma.’ The goal is to relegate the experience to its proper place—something ugly that happened sometime in the past but in no way controls the present.

Interlude: For Therapists

• Until you master the breathing as a pure act, you cannot use it as a tool to deal with trauma. Furthermore, until you can do this for yourself, you cannot teach it to clients. This is a skill that you can only lead the way by experience.

• Do not do trauma work of this kind with clients unless you have both general training and experience in this area. Things can go wrong in so many ways for victims of trauma, particularly within the therapeutic milieu and you must be both adaptable and knowledgeable.

• If you are working with someone who is seriously traumatized, it will be better to have the person do the breath work in your presence. However, face-to-face is often not the best way to do this work (I will explain ‘why’ below). I have found that sitting at an angle or even side-by-side is often more helpful. You should already have been ‘tracking’ your client; you should know if they wish to look you directly in the eyes when they speak of difficult things, or if they turn away. It is your responsibility to be aware of what you client prefers and respect that.

• Ensure that the client has mastered circular breathing and can use it to manage day-to-day stressors, and beyond that, has handled some kind of intense situation, even a personal present-day crisis. Do not ask your client to do something beyond his or her capabilities.

• If ‘facing’ the trauma is overwhelming, the client can focus on one sense at a time: what they heard, smelled, saw, or felt.

• Have the client focus on the trauma very briefly, and then breathe through the momentary flash of emotion and re-experiencing of the trauma. Do this several times, as if dipping one’s toe in very cold water, gradually getting acclimated to it, rather than plunging in headfirst.

Doing For Oneself—With Someone Else

Notwithstanding the ‘interlude,’ regarding the possible involvement of a therapist or counselor, the focus of this essay is the acquisition of a tool that one can use for oneself. It is wonderful to have someone in one’s life that one can truly depend: to show up, to be present, to offer advice when asked, and to be silent when you have not. It is wonderful in a different way to be able to depend on oneself. Sometimes, however, we cannot achieve the latter without the help of someone else.

Let us imagine that you have experienced some kind of trauma. You are intrigued by the method I have described here and follow the steps in order. Unfortunately, when you attempt to initiate this breathing method to face your fears, your rage, or your wounds, you are overwhelmed the moment you recall it to mind. You are unable to breathe smoothly and deeply, and you are, therefore, unable bring your body to the state of dynamic relaxation necessary to do this work.

So, you have someone whom you trust in your life: a spouse, a lover, a friend, a ‘battle buddy’ or ‘training brother’ (terms from the military and martial arts, respectively), and you ask them to be with you as you embark on this attempt at self-healing. In many cases, you tell them that you do not want to talk about the event (or life situation). They may already know, they may know in part, or they may not know at all. You inform them that you intend to work something out inside, but that you cannot do it alone. Why is it often necessary to keep the traumatic event unvoiced?

• Those who care for us may try to ‘help’ us by offering ideas and encouragement—some people, inadvertently or consciously, try to involve themselves in our lives therapeutically. We didn’t ask for that, and it very often is NOT what we need. Also, at this time, at least, we definitely don’t need someone to comfort us, or to make the pain go away.

• Some believe that it is their job to bear witness, to hear the whole story, but then, they are horrified, disturbed or even make judgements upon what we should have done. In other situations, they press us to tell more, as if through ‘venting,’ we will spew it out of our system and then it will be gone. However, unlike bad meat, we cannot simply vomit it up and be relieved. Yet we find ourselves pressed by our well-meaning (or sometimes voyeuristic) friend to give-them-details, and suddenly, it is about ‘them’ or about ‘us:’ not ourselves. Perhaps, someday, you will want or need to tell them the ‘story,’ but that will be when you can state from the core of your being, “I am no longer that person anymore.” In some cases, however, it may be a story that should never be told, not to that person, maybe to no one at all. Sunlight does not always heal—sometimes trauma, like vampires, must be buried with a stake through its heart, never to see the light of day.

• Others are pained for us at what we have gone through and show their pain in their bodies, facial expression or just their eyes. Now, if we care for them, we feel like we must ‘take care of them.’ We feel responsible for their pain. They were here to help us. But now, we end up abandoning ourselves, in order to be attentive to their emotional state

One of the most terrible aspects of trauma is the isolation it imposes; this is beyond the loss of community, or the sense of being an outcast. Sometimes, we isolate ourselves out of love. We do not wish to burden a loved one with the horror we experienced, yet they see the pain we are in, or they may experience the pain that spills over into your shared lives. You do not wish to destroy a relationship by telling them something about the ‘you’ that you are, that you are striving no longer to be.

Perhaps most devastatingly, accompanying the experience of trauma is shame. This is true whether we have done something horrible, or if something horrible was done to us. The reader may find this hard to understand, but this is because we confuse guilt and shame. Guilt is an internal sense that we have done something wrong—it is a kind of self-punishment. Despite the psychological problems we sometimes incur when feeling guilt we do not merit, guilt is a necessary aspect of being human so that we learn to self-regulate our behavior when there is no authority present to force us to behave.

Shame is the sense of being helpless, exposed, unable to stop what is happening to us. Although they may sound quite different, being forced to strip off one’s clothes in front of others, being caught stealing or cheating on a test, being sexually assaulted or huddled in a cellar with bombs falling overhead, all share one thing: we are helpless to make it stop. This sense of helplessness—shame—is perhaps at the core of all trauma. Now, consider this: you are sitting in front of another person, someone you love or at least deeply trust, and you are contemplating what maybe unforgivable sins of your own or horrifying things that you experienced, and they gaze at you. It truly doesn’t matter what their emotion may be—their eyes are as inescapable as the eyes of God that watched, but did nothing, when you were ground into the rocks, torn by explosions or witnessing your friends die. When we are in a state of shame, being ‘seen’ can be agony. You cannot do this alone, yet you must be left alone to breathe freely.

Back to Back

What I recommend—and this is, perhaps, the most important part of this essay—is that you sit on the floor, with your legs outstretched, and your friend, your lover, your partner . . . sits back-to-back with you, with their legs outstretched as well. They support you as you support them. Because you are not making eye-contract, you are not burdened with their reactions, their being-in-relation-with-you, their eyes.

But they are there. As you breathe, they breathe. Often, you find yourself breathing in unison. As your breath circles around your body, as you invite the traumatic experience back with the intention of transforming it into a memory, as your body tenses or twists, they feel it. They breathe—that is their only task. To sit with the same peaceful, calm gravity that one assumes when holding a sleeping child.

Your body centers itself within your breath, and you experience something new, that your body is free from the memory, despite its existence in the past. You hold the image, yet you, too, sit with the same peaceful, calm gravity that one assumes when holding a sleeping child. When you falter, when your breath catches, they keep breathing. Despite your distress, they do not leave. If you reach your hand back, they take your hand. They do not turn to you, do not hold you. They simply have your back. They breathe. You breathe. And you do the work that needs to be done.

This substack is currently free. I do hope to have my work supported, so for those who want to do so, here’s a far less expensive way than a paid substack subscription, one that will truly be welcome - to me at least. Please buy one of my books. My newest release is The Good Stranger: Managing Intense Interactions Within Social Services Environments.