Episode 170 How To Start Teaching Clients Breathwork: Solo Episode By Chris McDonald

Feb 28, 2024

What is breathwork and how can you begin utilizing this modality with clients? How can incorporating breathwork into sessions benefit physical health, mental well-being, and emotional resilience?


  • In today’s episode, I will discuss how you can integrate breathwork into your practice. I will share with you the benefits of breathwork and techniques for teaching your clients breathwork.

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The Art of Breath: How to Integrate Breathwork Techniques for Effective Therapy Sessions with Chris McDonald, LCMHCS


Chris McDonald: Join me today for a special solo episode as I dive into the therapeutic practice of breathwork and how you can teach it to clients. I will explore what it is, the positive impacts, and hands on strategies you can use right away. Stay tuned and embark on a breathwork adventure. that can truly help you up level your therapy practice and create better outcomes for your clients on today's episode of the Holistic Counseling Podcast.

This is Holistic Counseling, the podcast for mental health therapists who want to deepen their knowledge of holistic modalities and build their practice with. Confidence. I'm your host, Chris McDonald, licensed therapist. I am so glad you're here for the journey.

Hey, and welcome to today's episode of the Holistic Counseling Podcast. There is no guest today because this is a solo episode. As I mentioned to some of you, I know if you're in my Facebook group, I did a live today, this is February 19th as I'm recording this. This should be coming out on the 28th, I believe.

So one thing that I'm doing to change the podcast this year is to offer three guest interviews a month and then one solo episode. Cause I know it seems like my downloads are higher and I've heard from many of you listeners that you really do like the solo episodes. So I don't want to let go of those.

I know I had done up to six episodes a month. But unfortunately that is not sustainable unless I was just podcasting, but yeah, that, that is not sustainable right now for me. So I really am just coming back just a tiny bit from five to four a month, but I hope the value you will find in each episode with the amazing guests I have coming up.

And with each solo one. So I'm trying to figure out the best episodes to bring to you. So I have put a poll in my Facebook group. If you haven't joined that Facebook group, by the way, please join us. It's the Holistic Counseling and Self Care Group. It is a free group. We'll have that in the show notes.

Welcome to join us. And it's really a fun group. We have very kind people. So far, drama free, it has been. I've had that since 2018, and it's been pretty mellow. Great group of people to ask holistic questions, and we can talk holistic modalities as much as we want in a safe place. So, but to bring you to today's episode.

So how to start teaching breathwork to your clients. That's exciting. So I'm happy to bring this to you. My journey with breathwork started many years ago in the school system. I remember. using a lot of the brief solutions, because of course we don't see people long term in for quote unquote therapy in the school system.

But I, uh, would bring breathwork in because I noticed CBT wasn't enough. And that's why I think holistic therapy comes in because CBT is not enough for most people. We need a little bit more, especially my anxious students. So I started teaching breathwork and with amazing results. I remember this one teacher, fourth grade girl was like, I don't know what you're doing.

But it's made such a difference and that this girl was unfocused, had such a difficult time getting her work done. And of course it wasn't perfect. It's not a panacea to solve all problems, but it did really help her to do better in school and to get her grades up. Cause she could focus cause she was able to control her anxiety more.

And that's one of the benefits is that agency gives clients a sense of control because it's something that they can do and they can put this into place. daily. Today I'm going to go over ways to get started, talk more about the benefits, help you understand a few techniques to get started. And again, this is just a brief brief.

This is not a full training, so just be aware of that. This is not a full training. But just an overview to get you started. As always, you need to build your scope of competence with any holistic modalities, so make sure you always get the most training you can afford. And I'll talk more about my Art of Breathwork course too, and give you a little bit more details on that.

So let's start from the very beginning. A very good place to start. I feel like Sound of Music. What is breathwork? So we all have breath. Now, again, part of our autonomic nervous system, this is done automatically for us. Thank goodness, imagine if we had to concentrate every day to inhale, exhale, we would be exhausted and couldn't focus on much else.

But this is something that's one of the automatic things of our nervous system, just like our heartbeat. We can make some changes to it, right, with some things that we do, but overall, underneath, it's doing its, its duty and doing its job, hopefully, and keeping us alive. The cool thing with breathwork is we can make some changes so that we can learn how to control our nervous system.

We can't always control the response that our nervous system does, but we can build resiliency. That is the beautiful thing. So you've probably heard of the sympathetic nervous system, which is that a fight or flight. And a lot of times we'll drop down into that whenever there's perceived, again, perceived danger may not be true danger.

Like giving a presentation at work may not be an actual lying eating us, but our nervous system doesn't always know the difference, especially if we perceive that as a danger, if we have social anxiety and have difficulty presenting in front of people. So we have a lot of physiological responses to fight or flight.

I'm not going to get into all that here. But breathwork can help turn on what's called the parasympathetic nervous system, which brings us to that rest and digest. That calming response is where we want to be. Now we can't stay in that, nor should we. Our bodies aren't meant for that. So we want to have more flexibility.

So let's say that things are going great. And then all of a sudden you get an email that says you're being audited like I did this week. You might. Drop down, right? Reactionary at times. We all can be and just start to panic. Your heart's racing. You're sweating. You're starting to panic with those thoughts like, oh, my God, what am I going to do?

Am I going to have to pay back thousands of dollars? Um, of course, catastrophizing. That's all in that fight, right? That fight response or flight. We might want. I don't want to look at it. I'm just gonna I'm gonna go outside for now. So avoiding might try to avoid it in our mind or ruminate can be a form of flight.

And if you have clients that ruminate, So if we come back to breath, breath helps slow us down and slows clients down. That's the beautiful thing is once we can slow down, we can slow that heart rate. We can slow our breathing pattern. We can slow our blood pressure. It's a beautiful thing. And before I go further, I just want to let you know, if you struggle or clients struggle to get breath work going, they may need to do some movement before it doesn't have to be yoga, but yoga is a great way to integrate.

breath and movement, and it sets the body up. That's what yoga was created for, to actually help with meditation. Pranayama, my yoga teacher, Christine Weber, always would do breathwork at the end, which I know is unusual for a lot of people. Don't expect that, but it actually helps you to have a breathwork.

But what are the physiological effects of breathwork? It can lower our cortisol. It is research based. So just remember there's so much research on yoga and breathwork is part of yoga and, and there's so much on this about lowering cortisol, turning on that parasympathetic, reducing anxiety. It can also reduce Depression.

So we can also do some breath works to bring energy into the body, different ways to do it. We won't get into that today, but just know if you have clients who are more in the freeze state, if they're really struggling with depression, there are ways to work with the body. to help get them out of that. So to give them a little more energy, but let me start with the first step.

What do we do? So let's say that in your head, you're like, Oh, I want to try breath work with clients, but I'm a little anxious. It just seems like a little scary to do. I've never done this before. And of course, anytime we do something new, it can be a little scary. So I'm going to start very simply for you.

So the first step is knowing when to do it with clients. I don't know about you, but I was not taught how to do any modalities other than CBT and some of the basics. Maybe we did a little bit of art, but there wasn't anything like, Oh, here's a good way. Here's a gateway to do this modality. So you can start with breath in the beginning of a session.

Introducing it, ask the question, How would you feel about trying some breath work? I know I've done it myself and it's been helpful. That simple. We don't have to make this super duper complicated. But we want to get informed consent, so that is the key. To any holistic modality, we get informed consent. If they say no, we have to go with it.

And I've had clients say, I don't want to do any of that breath work. Cool. Let's do some movement then with breath. And a lot of times they're open to that. So some of them just don't, they might've had bad experiences and we don't have to push it. So let's do something else. Or maybe they just want to work on traditional therapy and do some CBT or DBT, something like that.

That's great. Then let's go to the other client that's looking to try something else. In my opinion, I find it very difficult to treat anxiety without using breath work. I'm going to take a step further. I find it very difficult to treat anxiety. Without movement and breath, which is why I'm a huge yoga advocate and Qi Gong, which is spelled Q I G O N G, and Gong means work with energy.

Qi is energy, and I'm taking a mindful movement course right now. Which is integrating that yoga qigong and what's called somatics and I'm going to be able to teach classes and be certified with this. So it's really cool, but I have seen the positive impact on myself. I teach all of these to clients and the impact is just, you can't even put into words how phenomenal it is, but let's back up the truck a minute.

So first thing you do once you Want to in session to start it 1st, identifying which clients you think would benefit. Maybe there's 1 that would be more open to trying it and. Let's say they agree, you ask them a question. So ask them first to start noticing their breath. I like to usually start with some grounding exercise as part of this before we even notice breath.

So figure out what is a good grounding to do with them. Just noticing their feet on the floor can be enough for some people. Noticing the chair beneath them. You can even go do a body scan with them. Noticing from head to toe or toes to head. Going through each and every body part, noticing sensation, noticing pain, or just noticing, period.

You don't even have to give that cue that notice any pain or sensation. Just be present with what is, whatever is there. But notice without judgment. The minute we bring judgment into the equation with any of these holistic modalities, That is putting them more into that fight or flight mode, sympathetic arousal.

So we, that's not what we're trying to do, to do with this. Now, some clients, especially those that are anxious, maybe anxious about doing breath work. This is, might be new for them. So asking them, what is your experience with breath work? That's where I start and figuring out, okay, what have you tried before?

I'd be curious to know and have them show you. Cause sometimes people have heard the generic, Oh, take some deep breaths. You have anxiety. What the hell does that mean, right? And I have a lot of clients who will just go, inhale, exhale. And they do that maybe three times. Which is a start, at least they were trying, but it's not going to do much.

And that, those are usually the same people that say to me, breathwork doesn't work. Well, no kidding, right? So there are some ways that can make breathwork more helpful. And I don't want to say right or wrong because if it works for somebody to just do a quick sigh good for them, but I'm highly, I find it highly unlikely.

So let's find some best practices, right? So if we're starting to notice breath. And you can do, I can do this with you right now. So if you're in a good spot, if you're driving, pull over, of course, or pause it until you get home and sit in a comfortable chair, feet on the floor, and just notice your breath for a moment.

Just see if you can tune in first to your belly, feel the belly rise on the inhale, fall on the exhale, and then moving to the chest. See if you can notice the rise of the chest with the breath. In the fall, and check in with yourself to see what you notice. Is there sensations anywhere else? Just be present with what is, accepting what is, not judging yourself.

If this is hard for you, just notice this is hard. But without judgment. So being present with the breath is the first step. Noticing it. And you may want to check in with clients with that exercise to say, how is this for you? Cause maybe they are so far in freeze response that they're dissociating and they can't feel their belly.

They can't feel their chest, but that's okay. We don't want them to get upset at themselves. I'm not doing this right. And start beating themselves up. Cause again, that's not going to be helpful to the process. So let's just notice. Okay, so you don't notice in your chest. That's okay. Where do you notice?

Maybe they notice. Can they notice in the back of the body, the ribs expanding if they sit forward? Can they notice the ribs expanding on the sides? Or we can choose an anchor. And I've learned this through mindfulness meditation. We choose an anchor and focus on that to meditate. Same thing for breathwork to start.

Can you notice the air coming in through your nose? And out through your nose. It may also help just to notice the tip of your nose, keeping your awareness there. You can imagine cool air coming in through your nose, and warm air coming out as it's warmed from your body. You can also imagine the air coming in through the nose, traveling down the throat into the lungs, and then coming back out through the mouth through the nose, depending where you're breathing from.

Imagine following the breath all the way to your lungs. And then reversing it from your lungs all the way out through your nose. If that's too much, just go to your nose and just notice how it feels just to feel the breath. And just be present. And if thoughts come out through this process, just notice them.

Get yourself into that observer role. Notice with curiosity. I see that. That's planning, we can note it, or that's organizing a task that's got to get done. I see that, and let it go, and come back to your breath. And you may have to do that over, and over, and over, it's okay. But noticing, and again, allowing thoughts to come up, that's part of mindfulness meditation.

But this doesn't even have to be meditation, this can be just noticing. Doing this just for a few minutes to start. Is enough. That is all. If they're having trouble, if they're dissociated, having them place their hand on their chest. Can you feel the rise of your hand on the inhale? And the fall? And if not, that's okay.

Or on their belly, if they're comfortable touching themselves. Because we want to keep this trauma informed. And just see if they notice. Sometimes those cues of touching can be helpful. You can also have them lay down if you're comfortable having them do that on the floor, on a yoga mat, put an object on their belly or chest, just to notice the rise and fall.

With kids, you can put a stuffed animal or something cute and fun. I don't still mind that stuff either really. Depends on your client. So step one, noticing breath is a great start. Integrating it with groundedness I feel is so helpful. You can also do The grounded of arriving, just noticing, arriving, looking around the room slowly from left to right, seeing objects, shapes.

So if you're on telehealth, they can look around their room and then they can look at what's behind you on telehealth and you can ask for permission to do the same in their space to ground. Great way to arrive. So once we start the noticing, let's say you meet with a client again. I just want to say a cautionary tale about 478 that was popularized by Dr.

Andrew Wheel. I think I'm not sure how to say his name is W E I L. Years and years ago, I remember I heard about it, I have clients that come to me that say they feel like they have quote unquote failed at breathing because they can't do four, seven, eight, or I have clients with PTSD that say that their minds are racing too much and they can't hold their breath for seven or exhale for eight.

And they're gasping for air. This is not helpful. Here's why. So if we're holding our breath for that long, and this is what I just learned actually today, I was doing some reading with my teacher, Christine Weber, um, who I went to training with. She said that can actually be cause strain on the heart. to do that.

It's not accessible to everyone. And then eight, breathing out for eight, I have trouble with that. Can you imagine people that struggle with PTSD and high, high anxiety and have never tried this practice before to try to get to eight? They will be gasping at the end. And do you know what happens when you gasp at the end of breath?

It turns you into sympathetic response in your body, your nervous system, and you're in fight or flight. So that defeats again, the whole purpose of breath work. So how do we shift that? So we don't always have to use numbers. I think that's the key to a lot of times you hear about four or four, whatever that is box breathing.

I don't use that either. But you don't have to use numbers. Numbers can be triggering for people. It's not always trauma informed. If we think about, you know, it can bring people back to school with, I have to count and I'm not good at counting or I lose track of counting. And if somebody's anxious, they may not feel like they're counting the quote unquote correct way or right way.

So it can be a struggle. So you can just take counting out of it and just have them lengthen their exhale. I'm going to teach you in a minute how to do straw breath to start. Or if they want to count, if they're okay with it. Um, have a gentle way to get into it and don't make a goal. There is no goal for breathwork.

It does not have to be four, seven, eight that they have to strive for. Think of breathwork that where it is, wherever they are meeting them where they're at. And just if they want to try longer exhales, great. But if they don't get there, it's okay too. So it is not the Olympics. It's not a competition.

We're not trying to be like anyone else. Everybody's body is different. Everybody's tolerances are different. So just know that that is different for everyone. So a more realistic 4 7 8 could be a 4 2 5 or 6. So that means inhale for a count of 4, hold for a count of 2, exhale for a count of 5 or 6. And when I do this, I'm very careful and cautious with clients.

I forewarn them about some people get dizzy, lightheaded. And if that happens to you, stop immediately, that means you're breathing too hard or something is going on in your nervous system or body that is just causing danger signals. So it's better to stop. So letting them know there can be some side effects and of course, informing clients about the benefits and risk is part of our ethical obligation as well.

Any kind of holistic modalities that we do. So if you don't want to do numbers, And again, not for everyone, what we can do is called straw breathing. So it's taking a slow breath in and then exhale through the mouth, pretending you're blowing out through a straw, nice and long and slow. So the whole goal of this is to have a longer exhale than an inhale.

So the longer exhale is what calms the nervous system and turns on that relaxation response. And I usually always keep the in breath to four. Sometimes I might switch up the numbers, but. With strawbath, we don't have to worry about it, no numbers. That might be a relief to some clients and to you, right?

Because it is a little harder to teach them with numbers. I will give you that. It takes a little more practice. But with straw breath, it's pretty simple. And to do these practices with your client, that is how you teach breath work and yoga. Do it with them. Don't just say, here, do this, but I'm not going to do it.

Because that also, I think, can help with co regulation with both of your nervous systems. And I think doing it with them can ease their mind a little bit that they're not on display, especially with teenagers. You know, they feel like you're staring at them too much in the spotlight, shall we say. So let's try straw breath.

So take a breath in through your nose, breathing in, and then exhale through your mouth like you're blowing out a straw. So your mouth's making a small circle and just keep exhaling. You don't want to get to the point of gasping. And then when you're ready to take another breath, breathing in through the nose and then exhale through the mouth like you're blowing out a straw, blowing bubbles in water.

And one more time, inhaling through the nose and exhale through the mouth.

Good. And do that up four or five times and then have your client notice how they feel. You can also have them rate how they feel before the breath work and then after. That's a little brief solution. So on a scale of one to five, five being highly anxious. How do you feel at the start of this? And then after the breath work, how do you feel on a scale of one to five is one is totally relaxed.

Five is highly stressed and let them see for themselves and rate themselves to see any positive impacts. How cool is that? So you can also, if they have a Fitbit or Apple watch, let them look at their heart rate. I always like to do that, especially with meditation. What is my heart rate after? What is your heart rate after breath work?

Did it go down? Hopefully it did. Or if it didn't, that could be curious. Wonder why. Are you in more sympathetic response, right? If the heart rate went up. And one more breath that you could do is called three part breath. This is a little bit more tricky as far as the skill involved. You do have to learn a little bit more about this, but it starts with the first part is breathing in through the belly.

You can have them place their hand on their belly if they want and inhale and just notice the belly rise. We just did that, right? We already did part one. And fall and do that a few times and then place your hands on your lower ribs. Part two is feeling the side ribs expand. So we're going to breathe from the belly to the ribs.

So you can try it with me if you'd like, and then exhale. So we're not counting. We're not holding, we're not retaining at the end of the inhale or exhale. And try that again. Breathing in from the belly to the ribs and then exhale. And this really helps with tuning into the body, that interoception, noticing what's going on in the body, building that connection.

And then the third part is breathing all the way into the chest. So you can have them place their hands underneath the collarbone. And this can be challenging for some people. So maybe breathing to the ribs is enough. Remember personalizing this. individualizing it. But if they want to try, so go ahead and breathe from the belly to the ribs to the chest.

So you should feel the chest rise a little bit and then exhale. So let's try it. Take a breath in through your belly, ribs all the way to the chest. Big old breath, and then exhale. And this time I want you to imagine as you breathe in, it's like you're breathing in a wave on the ocean. So the wave comes to shore on the inhale, and then on the exhale it goes back.

Inhale the wave on the shore, exhale the wave goes back. Inhale the wave on the shore, exhale the wave goes back,

and then just allow your breath to go back to its natural rhythm. So every time you teach a breath work and change breath, give them a break. You don't want to do this for too long. I usually do about four or five times. You can kind of feel your way through it. If they want to do a little longer, that's okay, but what we don't want to do is over Thank you.

breathe and do it too long. And then they may be lightheaded and dizzy. There can be some after effects and it's just bringing the parasympathetic in too much on the system. So just breathe normal, let, letting go of the breath and just check in with yourself. You can do the check in with the heart. What are you feeling emotionally?

The mind, where is your mind? Is it busy? Jumping from topic to topic, like monkey mind, like a monkey swinging on the trees, or is it a little calmer or are you just focused and then notice your energy? Are you feeling grounded, more energized or somewhere in the middle? So just tune in and notice. So having that time to.

Really listen and notice their, where they are is helpful because that interoception and with interoception comes awareness and with awareness comes emotional regulation. Imagine that, right? How cool. So this is all connected. This is all research based. So the more you can practice this, they're building those neural pathways.

So the last part I'm going to say before we go today is to give it for homework. But not just any homework. This is a preventative practice. So they need to practice daily. Help them figure out a time, put it in their calendar, whatever they need to do to remember, and to find a time to practice four or five times.

As a safety mechanism, making sure that they're not doing it a hundred times. Because we can over breathe. We can overdo this. And making sure to time it, right? Even if they want to just do five minutes, sometimes that can be a little more helpful to, to regulate it. I hope this was helpful for you. Um, I'd love to hear from you and how this goes for you.

You can always email me at chris. holisticcounselingpodcast. com. And like I mentioned, getting more training is important with breath work. I have a course I wanted to let you know about as well in case that you want to get more training. So this is a prerecorded course, but you can learn more about the science behind it.

Uh, how to assess client readiness, contraindications, how to integrate for, to maximize the therapeutic benefits, and the when and how. We did a tiny bit in this, but this goes a little bit deeper. What are some more specific breathwork practices? I go into more of those with practice for you. More of the ethical considerations, scope of practice, client autonomy, informed consents.

And then tips for assisting clients and yourself for consistent breathwork practices. And that brings us to the end of another episode. Be sure to tune in next Wednesday when another one drops. And if you are interested in my Art of Breathwork course, I applaud you because I find it to be the foundation of my holistic modalities that I use in session.

It is one of the most powerful ones you can use. And with this recording. You will get some handouts as well. So that's the bonus for you and you can earn 1. 5 CE hours for NBCC. And now this is available for 65. Go to hcpodcast. org forward slash breathwork course. That's hcpodcast. org forward slash breathwork course.

That'll be in the show notes too. And once again, this is Chris McDonald sending each one of you much light and love till next time. Take care. Thanks for listening. The information in this podcast is for general educational purposes only. And it is given with the understanding that neither the host, the publisher, or the guests are giving legal financial counseling or any other kind of professional advice.

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