Breath Practices From Qigong: Calming Your Nervous System, 1 Breath at a Time

Put 1 hand on your chest and 1 hand on your belly, right now, and breathe the way you were breathing before you read this sentence. Do not fix anything yet. Just notice which hand moves more.

For most of us, in the middle of a busy day, it is the hand on the chest. That high, quick chest breath is the breath of fight or flight, and many Women in Midlife live in it from morning to night.

We cannot tell our heart to slow down. We cannot tell our gut to start digesting. What we can do is slow our exhale, and the exhale is a door into the whole Nervous System that is always within reach.

This chapter gathers the breath practices my husband, Christopher, and I teach in Great Energy Qigong and in my Autoimmune Recovery Method classes, with the steps written out so you can follow them at your kitchen table. Next to each 1, you will find the physiology underneath it and what the research does and does not show.

'Stress: The Load Women Stop Noticing' lays the foundation in its sections 'Inhale Deep, Exhale Long' and 'More Ways to Tone the Vagus Nerve'. Read this chapter as the practice room that goes with them.

Emotional regulation is knowing how to come back to our breathing, and to consciously choose to welcome a neutral space. Neutrality is your greatest immunity.

What the Breath Can Do, and What It Cannot

I love these practices, and I want you to have an honest picture of where they fit.

We cannot meditate our way to higher ferritin. We can't breathwork our way into replenished hormones, and we can't somatic our way into a functioning thyroid.

When ferritin sits in the teens, progesterone has gone quiet, or cortisol is pouring glucose into your blood from the inside, the breath helps in the moment, and the anxiousness returns once the practice ends. That is what I call a treading-water practice, and 'The Spiritual Layer: Why You Cannot Pour From an Empty Vessel' tells the story of my own years of it.

When the body is resourced, the same breath lands in a body that can finally hold the calm it gives you. So keep breathing, and get your labs. 'Your Lab Wish List for Midlife' shows you which ones.

Why Your Breath Reaches Your Nervous System

Your autonomic Nervous System runs without your permission, and it has 2 main modes. In the sympathetic mode, fight or flight, your heart speeds up, your breath rises high and fast into your chest, your digestion pauses, and your muscles get ready to move.

In the parasympathetic mode, rest and digest, your heart slows, your breath drops down into your belly, your digestion switches back on, and your body does its repair work. Both modes are good designs, and trouble begins when the switch stays on and your body can no longer tell a real threat from an ordinary Tuesday.

It can feel like a jaw that stays tight, thoughts that race at 2 AM, or an exhale that never quite finishes.

The main nerve of rest and digest is the vagus nerve. Vagus comes from the Latin word for wandering, and it is the longest of your cranial nerves.

I teach it as a nerve with 3 centers:

• The head. It begins at the brainstem, at the base of your skull.
• The heart. It travels down both sides of your neck and branches to your heart and lungs.
• The Hara. It passes through your diaphragm, the dome-shaped breathing muscle under your ribs, and continues to your stomach and intestines. Qigong calls this belly center the lower dantian.

Head, heart, and Hara, all wired together by 1 nerve. About 80 percent of the vagus nerve's fibers carry messages up from your body to your brain, as the Stress chapter explains. When you slow your breath and soften your belly, you send a message up that chain of command: the danger has passed.

The vagus nerve also carries a calming signal to the immune system, a pathway researchers call the inflammatory reflex. In an early study, an implanted device that stimulated the vagus nerve in people with rheumatoid arthritis brought inflammation down. I will not claim that any particular breath flips that same switch, because that link has not been established.

What is well established is simpler. When you breathe in, your heart rate rises a little, and when you breathe out, your heart rate slows a little, and the vagus nerve drives that slowing. A long, slow exhale gives the nerve more time to work.

Before You Begin

• Breathe through your nose, if it is clear, unless a practice asks for the mouth.
• Choose your position. Every practice here works standing, seated, or lying down.
• Let it be easy. Christopher teaches it this way: whatever practice you take, breathe into it until you feel it soften, and if you feel tension building, change it so there is less strain, or come out of it entirely.
• If you feel dizzy, tingly, or more anxious, stop, let your breath return to its own rhythm, and try a gentler version another day.
• Ask first about breath holds if you are pregnant, or have a heart or lung condition, uncontrolled blood pressure, or a history of fainting or seizures. In our Qigong practice itself, the breath keeps moving and we do not hold it.

The Belly Check

This is the first practice I give every new student, and it takes no time at all.

Whenever you notice yourself listening to others, you're not talking, maybe you're on a phone call, or you're talking with someone, just kind of casually put a hand on your belly. Check if your hand expands when you breathe. Where am I? Where's my breath? My chest or my belly?

1. Several times a day, when you are listening rather than speaking, rest 1 hand on your belly.
2. Breathe normally, without changing anything.
3. Notice: does your hand move out as you inhale and back in as you exhale?
4. If the movement lives in your chest, let the next few breaths drop down under your hand.

You cannot change a breath you have never noticed. The belly check turns an automatic habit into information, the same way a symptom diary turns a vague feeling into a pattern.

Belly Breathing, the Way We Open Every Class

Diaphragmatic breathing, or belly breathing, moves your diaphragm fully, and your diaphragm is the very muscle your vagus nerve passes through. Christopher opens our live classes with this sequence.

1. Rub your hands together. Take a deep breath in, and let it out with a sigh.
2. Give your hands a little shake. Settle your feet so they feel comfortable on the floor.
3. Relax your shoulders away from your ears. Loop them up, back, and down.
4. Rest your hands on your navel or just below it.
5. As you inhale, let the breath move deep into your body, so your hands move away from you.
6. As you exhale, relax, and let your hands move back in toward your body.
7. Let your face relax, then your whole body.
8. Make each exhale a little longer than the inhale, so all of the breath goes out before you start again.
9. After a few rounds, let your hands rest at your sides and see if the breath keeps going on its own.

Throughout a Qigong practice, when you notice the breath has climbed back into your chest, you simply bring it back down. Each time you notice and return, you are doing the practice.

The Long Exhale: 4 Counts In, 8 Counts Out

When I want to relax, I make my exhale longer than my inhale and let my Nervous System settle a little before I go on. In class I teach it with numbers.

1. Sit or lie down with 1 hand on your belly.
2. Inhale through your nose for a count of about 4, or whatever count feels natural to you.
3. Exhale slowly for a count of about 8.
4. If 8 feels like a strain, exhale for 6, and let it lengthen over the coming weeks.
5. Continue for 2 to 5 minutes.

Read this chart as text

Illustration of the vagus nerve, 3 centers and 1 nerve, running from the brainstem in the head, to the heart and lungs, to the belly (the hara). About 80 percent of its fibers carry messages up. Beside it, a breath pattern of 4 counts in through your nose and 8 counts out slowly: heart rate rises a little on the inhale and slows a little on the exhale. If 8 is a strain, exhale for 6, for 2 to 5 minutes.

This is the breath the rest of this book calls 'inhale deep, exhale long.' You can use it in a waiting room, in the car before you walk into the house, or awake at 2 AM. The long exhale is the 1 practice in this chapter to carry everywhere.

Fogging the Mirror: The Victorious Breath

In the yoga world, a slow exhale with a soft sound at the back of the throat is called ujjayi, the victorious breath. I teach it with an imaginary mirror, so your body understands it right away.

1. Hold your hand up in front of your mouth, as if it were a mirror.
2. Breathe on it with your mouth open, the way you would fog a mirror. Do this 2 times.
3. Now fog the mirror again, very slowly, with your mouth closed.
4. Notice the gentle rumble at the back of your throat. The air is leaving through your nose.
5. Breathe in through your nose, and exhale with that same closed-mouth, mirror-fogging rumble, slowly.
6. Pair it with the long exhale: about 4 counts in, and about 8 counts out.

The slight narrowing at your throat slows the air on its way out, which lengthens the exhale almost by itself. You can also hear the breath, and hearing it gives a restless mind something gentle to follow. This is 1 of the quickest ways I know to bring calm to the Nervous System.

Research on ujjayi as a separate technique is small. What it reliably does is the part with the evidence behind it: it slows you down and stretches the exhale.

Relax on 3 Exhalations

Tension is sneaky. We can get so used to it that we stop noticing it, the same way we stop noticing the chronic stress we have adapted to. This is a small practice I use myself.

1. Take 3 slow breaths.
2. On the first exhale, soften the tiny muscles of your face: your forehead, the space between your eyebrows, your jaw, your tongue.
3. On the second exhale, soften your belly. Let it be a soft belly.
4. On the third exhale, feel how the soft belly softens the rest of you, your shoulders, your hands, your breath.
5. Notice that the next inhale comes in more fully on its own.

Relaxing the face gives the whole Nervous System the command to relax. When I relax, I can bring the breath in much more fully, and that fuller breath brings more space into the lungs and into the heart.

The Sigh

A sigh is the body's own reset button. You already sigh without trying, about every 5 minutes, roughly 12 times an hour, and in 2016 researchers at UCLA and Stanford mapped the brainstem circuit behind it in mice. Those spontaneous sighs reopen the tiny air sacs in your lungs that slowly collapse with ordinary shallow breathing.

In Great Energy classes, the sigh shows up again and again. We open with a deep breath in and let it out with a sigh, and the Emotional layer chapter suggests 3 big, audible sighs to let a feeling move.

There is also a well-studied general practice called the cyclic sigh. It comes from the research world, and I include it because the evidence behind it is good.

In a 2023 Stanford trial led by Melis Yilmaz Balban and published in Cell Reports Medicine, 108 adults practiced 5 minutes a day for 28 days. Cyclic sighing brought a larger lift in positive mood than mindfulness meditation, and the largest drop in breathing rate of the techniques tested.

1. Breathe in through your nose.
2. At the top, take a second, shorter sip of air through your nose to fill your lungs fully.
3. Exhale slowly and completely through your mouth, all the way out.
4. Repeat for up to 5 minutes, letting the exhale stay long and unhurried.

Hmm, Interesting: Humming and Sound

I teach 3 little mantras for the moments when your mind grabs a stressful story: 'So what?', 'Why not?', and 'Hmm, interesting.'

So what? Why not? Hmm, interesting. Each one buys you a breath between what happens and what happens next.

The third 1 has a vagus nerve stimulator built in. When you hum, you can feel the 'mmm' move down from your head into your chest and down into your belly, through all 3 of the vagus nerve's centers.

1. When a lab result, an email, or a comment sets you off, pause.
2. Take a breath in through your nose.
3. On the exhale, hum a long, low 'Hmmm,' and let your mind add the word 'interesting.'
4. Feel the vibration travel from your head to your chest to your belly.
5. Repeat 3 times. You are stepping into the Witness, curious about the moment instead of caught inside it.

Humming does something measurable in your nose, too. In a 2002 study of 10 healthy men, published in the American Journal of Respiratory and Critical Care Medicine, humming raised nasal nitric oxide about 15-fold compared with a quiet exhale, because the vibration ventilates the sinuses, where nitric oxide is made. Nitric oxide helps defend the airways and relax blood vessels.

Christopher adds sound to movement. During the shaking warm-up in our classes, he invites a sound from high to low on any vowel you like, 'Ahhh,' as the body shakes.

A long, sounded exhale is a long exhale you can hear, and the sound itself lets held energy move. The Kharrazian practices in the Stress chapter, singing loudly and humming until you feel it in your chest, belong in this same family.

Box Breathing, for the Moment You Walk in the Door

Box breathing, also called square breathing, gives a busy mind a shape to hold. Christopher teaches it as the short entry into meditation, right after throwing away the trash.

1. Breathe in through your nose for a count of 4.
2. Hold the breath in for 4.
3. Breathe out, through your nose or mouth, for 4.
4. Hold the breath out for 4.
5. Continue for 2 or 3 minutes, which is about 10 to 20 rounds.

You decide how long your 4 is. If holding the breath out for 4 feels like a strain, count a little faster, so the holds feel doable and even.

There is something to explore at that last corner of the box, where you really want to breathe in and, for a moment, you do not. That gentle urge is carbon dioxide rising, and resting with it calmly is how your body grows more at ease with it. In the 2023 Stanford trial, box breathing also lifted mood over the month, though cyclic sighing lifted it most.

Keep the holds gentle and short. Box breathing is the 1 practice in this chapter with breath holds, so it is the 1 to skip or shorten if your practitioner has asked you to avoid them.

Breathing Smile Energy

This is the breath Christopher uses inside Effortless Meditation, the method I describe in 'The Mental Layer'.

1. Settle comfortably, and relax your face until there is an easy smile.
2. Picture something that brings up a natural smile: a person, a place, a memory, a feeling.
3. Imagine that smile rippling out from your body to the far edges of the universe and coming back to you multiplied 100 times.
4. As you breathe in, receive the smile energy. As you breathe out, let it move through your body, into every cell.
5. Get curious about how energy moves with your breath. Does it rise and fall, expand and contract, or something else?
6. Let your attention surf lightly on that movement, welcoming every thought that comes.
7. To finish, rub your hands together until they are warm, cover your eyes, and then gently rub your face.

Your Breath Through a Midlife Day

Breathwork works like watering soil, as the Stress chapter says: a little every day changes where your whole system rests. Each practice has its place in the day.

• On waking. 5 slow belly breaths before you reach for your phone.
• At the table. 1 long exhale before the first bite. 'Your Stomach' explains why a meal eaten in rest-and-digest digests better.
• When a hot flash begins. Inhale deep, exhale long, and fog the mirror. In 2 randomized trials, paced breathing did not reduce how often hot flashes came, and The Menopause Society's 2023 nonhormone statement does not recommend it as a treatment for them. The breath helps you meet the wave with less panic, and 'Hot Flashes and Night Sweats' gives you the treatments that change the wave itself.
• Before a hard conversation. Box breathing, or 3 rounds of 'Hmm, interesting.'
• Coming home. Throw away the trash, then 2 or 3 minutes of box breathing.
• At the desk. The belly check, every time you are on a call and listening.
• Lifting, carrying, rising from a chair. Exhale on the effort, the way the Pelvic Floor chapter teaches.
• At 2 AM. Lying down, 4 counts in and 8 counts out, with your hands on your belly. 'Sleep: Why It Breaks in Midlife, and How to Get It Back' sorts out what is waking you.
• When grief or anger is stuck. Shake, sound high to low, and sigh it out. 'The Emotional Layer' explains why feeling has to move.

When Your Breathing Is a Symptom: When to Get Seen

Sometimes the breath is telling you something about your Physical layer, and the practices above are not the answer. Breathlessness on the stairs can be a sign of low ferritin, and a struggling thyroid, low B12, or your heart can do the same.

Get emergency care now for sudden shortness of breath, chest pain or pressure, or pain and swelling in 1 leg with breathlessness, which can be a blood clot.

Make an appointment soon if you notice:

• New breathlessness with ordinary activity, or a racing heart that will not settle.
• Snoring, gasping, or a partner who has heard you stop breathing in your sleep. 'Sleep' walks through the STOP-BANG screen for sleep apnea, which becomes more common after Menopause.
• Episodes of tingling, lightheadedness, and air hunger that keep returning, which deserve a look at overbreathing, anxiety, and the physiology that drives anxiety.
• A cough, wheeze, or tightness that has lasted for weeks.

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'The Mimics: What Else These Midlife Symptoms Could Actually Be' and 'Anxiety and Mood: When You No Longer Feel Like Yourself' go deeper.

Practicing With Us

These practices grow stronger in company. Great Energy Qigong is taught live online, and practicing alongside other people is part of what makes it steadying. We are not designed to heal in isolation, and that includes learning to breathe again.