I want to admit to something I got wrong for a long time. For years I did not value the importance and benefit of breathwork. My training had taught me to be sceptical of it, that the use of breathing exercises could actually operate as a safety-seeking behaviour which would slow down the treatment rather than aide it. Looking back, I think I left a genuinely powerful tool sitting in the drawer while I reached focused on other areas. I would like to explain how that happened and what changed my mind, because the distinction I missed turns out to matter a great deal.
Why I was taught to be wary
There is a real and reasonable point buried in the caution I inherited. In classic cognitive behavioural work on panic, controlled breathing was sometimes taught as a way of managing frightening bodily sensations, and researchers noticed a problem. When comparing studies in which the breathing exercises were added to those without it, there was no benefit shown and it potentially had negative affects. When people used breathing exercises specifically to try to reduce the anxiety and panic, the technique quietly became a safety behaviour. It joined the long list of things anxious people do to escape discomfort, and like all of those things it sometimes worked in the short term and cost them in the long term. If you only feel able to cope because you are breathing in a particular way, then the underlying message to your brain is that the sensations really were dangerous and needed managing. The breathing had become another way of fighting the feeling, and fighting the feeling, as I have written before, tends to make it louder rather than quieter.
So the caution was not baseless but what I regret was my more general view that breathwork was not important. One of the things I'm frequently focusing on in therapy is that it is not what you are doing that is good or bad, but more the purpose or function of the behaviour. I had equated breathwork as bad rather than seeing that breathing exercises to directly try to control or get rid of anxious feelings and sensations can be problematic and backfire, but breathwork can also be very powerful when used in more helpful ways.
What I had actually overlooked
The thing I had failed to appreciate is that the breath is one of the very few direct dials we have on the automatic nervous system. You cannot simply decide to lower your heart rate or talk your gut into unclenching, but you can change how you breathe, and the way you breathe feeds straight back into the systems that govern how safe or threatened your body believes it is. A slow, extended out-breath in particular nudges the body towards its calmer, more settled state. I go into how that machinery works in more detail in the recent piece on why your nervous system is not broken, but the short version is that the breath is a real, physical lever, and I had been treating it like a placebo.
In compassion-focused therapy, breathing is understood as a bridge into the soothing system, the part of us that lets us feel safe, steady and connected, and which tends to be the least developed of the three systems in the driven, capable people I work with. Their threat system is loud and their drive system is relentless, and the settling system has barely been exercised. Breathwork, done in the right spirit, is one of the most reliable ways to begin building that missing capacity.
The distinction that changes everything
Here is the difference that took I did not pay attention to earlier in my work. It is not the breathing that helps or harms, it is the intention behind it. The same slow breath can be an escape or a form of care, and those two are worlds apart.
Escape breathing is breathing you do in order to get rid of the anxiety. You start the exercise, and then some part of you is watching the dial, checking whether it is working yet, willing the feeling to leave. The moment the breath becomes a tool for making the discomfort disappear, you are back in the old trap, because your attention is fixed on the very thing you are trying to move away from, and your brain reads all that monitoring as confirmation that something is genuinely wrong.
Regulation breathing is different in aim rather than technique. You are not breathing to banish the feeling, you are breathing to steady yourself so that you can stay with the feeling and still do what matters to you. You are not saying to your body, make this go away. You are saying, I have got you, we can handle this, there is no emergency here. The anxiety is allowed to be present. You are simply choosing not to treat it as a five-alarm fire, and the breath is how you communicate that stance to a nervous system that only understands signals, not arguments.
· · ·
Breathwork as a foundation, not a rescue
Once the intention is right, breathwork stops being an emergency measure and becomes something closer to groundwork. This is the part I most wish I had understood sooner. When the body is chronically braced, everything else we might do in therapy has to fight uphill. It is very hard to step back from a harsh thought, or to move towards something you value, when your system is convinced you are moments from disaster. Settle the body first, even a little, and all of that other work becomes possible in a way it simply was not before. Regulation is not the whole of the work, but it is very often what makes the rest of the work land.
That is why I now think of breathwork less as a technique to deploy when panic strikes and more as a daily practice that lowers the baseline, a way of regularly reminding the body what safe feels like so that it is not starting every day already halfway up the threat curve. Used like that, it is not a plaster. It is part of the foundation the whole house stands on.
How to try it, and how to know it is working
If you want to experiment, keep it simple. Let the out-breath be a little longer than the in-breath, perhaps breathing in for a slow count of four and out for six, and let the pace settle somewhere unhurried, around five or six breaths a minute if that feels comfortable, without straining after the numbers. The counting matters far less than the spirit. You are not performing a manoeuvre on yourself, you are keeping yourself steady company.
And here is how to tell whether you are doing it as care rather than escape. Notice the question in your mind while you breathe. If it is "has it gone yet?", you have slipped back into control, and it is worth gently resetting the intention. If it is closer to "I am looking after myself while this passes through", you are in the right place, whether or not the anxiety has actually eased. This is where I would ask you to trust your experience rather than my say-so. Try it for a couple of weeks, pay attention to what you notice, and let your own body be the evidence. The same racing heart can feel like threat or like aliveness depending entirely on your relationship to it, something I explored in why anxiety and excitement feel almost identical, and the breath is one of the clearest places to feel that truth for yourself.
Common questions
Is breathwork just a distraction technique? It can be, and that is exactly the version I would steer you away from. If you are breathing in order to make anxiety disappear, the breath becomes a way of avoiding the feeling, and avoidance tends to keep the problem alive. Used as regulation, to steady yourself while you stay with the discomfort rather than to banish it, breathwork does something quite different and much more useful.
Why did some therapists treat breathing exercises with suspicion? Because early work on panic showed that controlled breathing, when used specifically to control or escape frightening sensations, could function as a safety behaviour and maintain the fear. The caution was about how the tool was used, not about the tool itself, a distinction I did not fully appreciate for a long time.
How is breathwork meant to work on the body? The breath is one of the few direct influences we have on the automatic nervous system. A slower, longer out-breath in particular encourages the body towards its calmer, more settled state, which is why it can be such a practical way of signalling safety rather than threat.
How often should I practise? A little and often tends to work better than waiting for a crisis. Treating it as a short daily practice gradually lowers your baseline level of tension, so your system is not starting each day already primed for danger. That steady, everyday use is where most of the benefit lives.
· · ·
Get in touch
If you would like some help building this into something that actually holds up when life gets difficult, you are welcome to book a free 15-minute phone consultation. It is a relaxed, no-pressure conversation about what is going on for you and whether working together might be a good fit.