Dressed in a hospital gown with a neck brace holding her chin stiffly up, looking like she had indeed been through the wringer, and speaking in a hoarse whisper, the first words my mother said when I arrived at the hospital were: “That breathing saved my life.”
         Mom had just endured her second neck surgery in four weeks. Months earlier, at Christmas, I had practiced long, slow, deep breathing exercises with her. Mom’s eyes now spoke silent chapters and books of pain, as she told me that “that breathing” gave her something she could hang onto, something to pull her through.

         In my physical therapy work, I’m constantly telling people: “Breathe.” Perhaps a bit exasperated with me, a humorous and delightful client (who was, unfortunately, stiff as a thick oak board) told me: “I am breathing--if I wasn’t, I’d be dead.” (This was the same fellow who, when asked how he’d slept, said “on my back.”) As tactfully as possible, I explained to this gentleman that the minimum amount of breathing required for life functions isn’t necessarily the optimum amount.

         We can live weeks without food, days without water, but only minutes without air. Breathing is so close to life itself that the medical-chart notation for death is “patient expired.” In many languages, the very same word means both “breath” and “spirit”: In Hebrew, it’s ruach; in Sanskrit, prana; in Latin, spiritus; and in Greek, pneuma.
         Years ago, I studied New Testament Greek, and remember being intrigued that pneuma could be translated as wind, breeze, air, breath, soul, or spirit--depending on the context. Some wheelchair users today like pneumatic tires--the kind you fill with air. And most people don’t want pneumonia, although that disease has sometimes been called the “old man’s friend.”
         Yoga practitioners advanced in pranayama are masters of the breath. For speakers of English, spiritus is especially worth pondering: inspire means to breathe in, but it can mean much else besides. An inspirational person or poem can kindle the life within you. So--when you breathe, you inspire, you bring in the spirit.

         It’s helpful to know the basic mechanics of breathing. The diaphragm is a dome-shaped muscle extending horizontally within the human trunk, dividing the chest above (with heart and lungs) from the abdomen below (with the other internal organs). When the diaphragm contracts, its shape flattens, creating a vacuum in the lungs above. Air moves in to equalize the air pressure with the outside world. When the diaphragm relaxes, it reverts to a dome shape and the air is expelled. The body’s blood is cycled through the lungs with each beat of the heart. In the lungs, the blood releases carbon dioxide waste and takes up life-giving oxygen. Along with the kidneys, the bowels, and the skin, the lungs are a major route for the removal of wastes and poisons from the body. When you breathe well, you literally purify and energize the blood.
         When the diaphragm moves through its full “excursion,” the belly actually moves up and down--not because the lungs descend that far, but because the diaphragm pushes down on the internal organs, displacing them somewhat. This constant “massaging” action improves digestion and assists the return of blood from the lower body to the heart.
         Unfortunately, many of us are shallow breathers. Thus, we don’t get this automatic internal massage, we don’t fully ventilate the lungs to help keep them cleared out, we don’t fully purify and energize the blood, and we don’t bring in as much spiritus as we could.
         Many health teachers--including many in mainstream medicine--instruct their clients in “diaphragmatic breathing” or “belly breathing.” We’re looking for the belly to gently rise and fall with each breath, and for the rib cage also to expand and contract rhythmically--signs of a good “air exchange.” With inspiration, it’s helpful to think of sending the air first to the belly, to the bottom of the lungs, and then out to expand the chest. With exhalation, the chest and belly fall. The entire body tends to relax during exhalation, so this is the time in which to gently push the limits of motion during slow stretching exercises.
         Tight pants binding the waist constrict breathing. It hasn’t always been trendy during my lifetime, but I like baggy clothes. I hate belts, and all my pants have elastic in the waistbands. Posture is also important: See how much air you can move out, and in, and out again sitting hunched over or slouched, then sit up tall and try again.
         In addition to shallow breathing, many of us often simply stop breathing altogether for brief periods. Our health will improve dramatically when we replace shallow and irregular breathing with a habit of relaxed, full, rhythmic breathing. Practicing good breathing directly improves our health, but especially so if better breathing habits carry over into the rest of our lives.
         It’s good to breathe in through the nose if you’re not “stuffed up”--the nose filters the air and prepares it for the lungs. Breathing out through both nose and mouth, or through either, is fine. Some people may worry that if they breathe “too much” they will hyperventilate, but hyperventilation is actually caused by very rapid breathing. This sometimes happens with extreme anxiety or panic. Long and slow breathing can calm such a person. Breathing helps maintain the proper pH of the blood, which is thrown off in hyperventilation. Because breathing is so involved in delicate physiological balances, medical patients who are on supplemental oxygen should treat it as any other prescription drug, and follow the prescribed dosage exactly. Under these circumstances, “more” may not be better. Some people who have breathing-related medical problems benefit from “pursed lip” breathing: by gently blowing out through pursed lips, a small backpressure is created--which helps keep lung passageways open.

         In our habitually acquisitive culture, I notice that many people who are new to breathing exercises focus on inhaling as much as possible. But it’s actually more helpful to focus on a complete exhalation--“letting go” creates space for the next breath. Without a good exhalation, retained stale air occupies space that should be available for fresh air.
         I also notice that some people bring a strong work ethic to breathing exercises, straining to suck in roomfuls of air. These people also tend to hold the breath for several seconds before releasing into the exhalation, almost like a pothead straining to get his money’s worth out of each bong hit. We probably shouldn’t think in terms of breathing “exercises” at all--“exercise” implies too much work. Instead, it’s breathing practice. I tell the hard workers to relax: Don’t try for 100% maximal air exchange, just shoot for 80% in a relaxed and rhythmical way. And don’t hold the breath, which should be like the waves of the ocean--going out, coming in. The water at the beach may pause ever so slightly at its highest point, but it doesn’t “wait”--it turns and moves back out to the sea. For the mathematically inclined, the image of a “sine wave” may help.
         At first glance, rapid breathing would seem to increase air exchange, but it doesn’t: rapid breathing is usually shallow breathing. Exercise does increase the respiration rate, but with exercise we also breathe more deeply. Regular aerobic exercise fosters health in a hundred ways. When not exercising, LSD is the rule: long, slow, and deep. Wholistic physician Andrew Weil says that people in some cultures believe God allots a certain number of breaths to each of us--a good reason to breathe more slowly.

         Breathing is a central focus in many types of meditation. I learned to meditate in the mid-1980s, at the (Buddhist) Zen Center in San Francisco. This meditation practice, called “zazen,” is simple, but not easy: You sit quietly for forty minutes, maintaining good posture. With the mind, you simply watch the breath--in . . . and out . . . in . . . out. . . . Of course, the mind wanders. When you catch it wandering, you gently bring your awareness back to the breath. If the mind wanders ten thousand times, you bring it back ten thousand times. You occasionally check in mentally with your posture, and make any adjustments needed. Then, back to the breath. . . .
         Such a meditation practice can focus and calm the mind. Better breathing and postural habits can also carry over into the rest of a meditator’s life. Including in physical therapy school--where the same postural principles were taught--I have never seen so many people with good posture as the regulars at the Zen Center. My own posture, poor since childhood, improved a lot when I meditated regularly--I jokingly tell people that it went from horrible to just bad. For a lucid introduction to meditation without any religious trappings, as well as a look at the highly effective Stress Reduction Clinic at the University of Massachusetts Medical Center, see the outstanding interview with meditation teacher Jon Kabat-Zinn in the book Healing and the Mind, by Bill Moyers.

         You don’t have to take up formal breathing exercises or adopt exotic meditation practices to enjoy the benefits of better breathing--they’re available right now, immediately. The first step is awareness: see if you ever catch yourself breathing shallowly or holding your breath. If so, then replace that problem with some long, slow, deep breaths.
         You can place reminders around your home or workplace, like three-by-five cards saying “Breathe.” I once made a colorful little sign centered on this word, and stuck it up on the wall--it reminded me, a thousand times or more. Perhaps some needlepoint: “Breathe” could fit nicely next to “Home Sweet Home.” If you ever get nervous or tense, that’s the very best time to practice.
         Another good time to practice is if you find yourself awake in bed, wishing you were asleep. That’s a golden opportunity! Counting breaths is better than counting sheep. See if you can get to ten before your mind wanders, or before you fall asleep. And I hope you have sweet dreams. There’s no reason not to; the spiritus is all around.