Chapter 5: Interaction of Psychological and Emotional Effects with Breathing Dysfunction

This is a chapter 5 summary of “Multidisciplinary Approaches to Breathing Pattern Disorders” by Leon Chaitow. The second edition will be coming out this December, and you can preorder it by clicking on the link or the photo below.


This chapter is dedicated to showing the connection between the body and consciousness; how our psyche is influenced by breathing and vice versa. This chapter was easily my favorite out of the entire book.

Breathing Strategies

Optimal breathing involves moderate abdominal expansion, some intercostal involvement, and minimal involvement of accessory muscles. Conversely, chest breathing is dominated by accessory muscle use. These two breathing styles are merely end points on a continuum rather than discrete categories.

In terms of which strategy is used, chest breathing is often the preferred route for consciously mediated intentional breathing; whereas abdominal breathing is the main route for relaxed, automatic breathing.

One reason you would want to override automatic breathing is to prepare for sudden action. At the onset of exercise, ventilation immediately jumps.  This change occurs via three phases, with the first phase occurring independent of exercise load. This phase is a conscious exercise preparatory action. The other increases occur as exercise demands increase.

When we are in an emergency situation, these breathing phases change. Prior to the initial pre-action deep breath comes a breath holding phase, which helps increase sensory organ stability.

These preparatory breathing changes are great for imminent danger or action, but problematic when threats are non-physical and in the future.  While these situations do not require immediate breathing changes, the body still prepares for the threat when it is on the mind.

It is in these emergency situations we see the advantages of chest breathing, which include the following:

  • Prepare for action
  • Protect from physical confrontation; as abdominal muscle tension decreases abdominal breathing.
  • Increases in cardiac output and heart rate.
  • Can get more air via mouth breathing (voluntary), which is often associated with chest breathing.

Conditioned Breathing

Classical conditioning can play a huge role in how we breathe. Many different stimuli can lead to certain responses being elicited, and this effect occurs much more quickly when fear is involved.  This is why something such as fear associated with a panic attack can lead to such quick physiological changes.  We want these changes in fearful situations, as the last thing you want to be doing when a threat is imminent is thinking about how you should breathe.  The brain best prepares you unconsciously based on past experience.

Learned fear is much attributed to the limbic system. The hippocampus and amygdala have slightly different functions regarding memory. The hippocampus deals more with conscious memories, whereas the amygdala houses our protective unconscious ones.  The amygdala’s functionality allows us to respond quickly to threats without conscious deliberation.

The amygdala is a very useful brain structure when our lives are threatened. The problem is that its alarm system cannot tell the difference between actual and potential threats. So that thought about planning your wedding 4 months from now that stresses you out may lead to protective responses kicking in via the amygdala; just to ensure your survival.  It is for this reason that the breathing changes that occur when we are in danger may perpetuate and become one’s norm.

  1. Hey Zac, I’ve heard tons about you from a friend and past coworker Julie Blandin. I just entered my first year of PT school and know with out a doubt that this is how I want to treat once I graduate!!! The reason I read this article is because i know I’m stuck in the T4 syndrome pattern and can’t quite figure out what I need to do. What I got from this is my lower thoracic spine is oriented to the right while my upper thoracic is oriented to the left. One thing that I’m still wondering is, is my right humerus externally rotated as well? I have tons of PRI exercises available to me, I just don’t know which ones I should be focusing on. Any guidance would be greatly appreciated. (Julie evaled me while I was working with her, that’s how I know the pattern I’m in.) My symptoms include right shoulder pain, right neck pain, and left scap pain (T1-T4) area.

    1. Hey Chris,

      Congratulations on starting PT school; it’s a fun/frustrating experience, but once you get out and learn it is worth all the work.

      Regarding the superior T4 syndrome (if that is the big driver for you), you could still possibly have limited R HG IR, but more likely limited L HG IR and apical expansion (assuming no pathology). Your objective is to fill up your left chest wall so you “untwist” the superior T4 so to speak. The way you do this is via left lower trap and left serratus activities (think reaching with the left). You need to create a stable spine into trunk rotation via these muscles. From there, you would want to work on activities that involve right lower trap and right tricep.

      I just base that off of what you tell me, but I’d really have to look at everything before giving you anything firm. You may want to check out my postural respiration and Impingement and Instability posts to get some better ideas.

      Hope this helps,