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An Interview With Stephen Elliott On Coherent Breathing

A few weeks ago, I had an opportunity to interview friend and colleague Stephen Elliott, Founder and President of COHERENCE L.L.C and life scientist. Stephen is the principal author of The New Science of Breath, Coherent Breathing – The Definitive Method, and his latest book Wuji Qi Gong And The Secret of Immortality (also about breathing). Steve is the contemporary discoverer of the Valsalva Wave and principal inventor of Valsalva Wave Pro. He also writes fantastic and always popular monthly articles for The Behavioral Medicine Report.

I asked some candid questions about coherent breathing and Stephen’s perspective on the psychophysiology of respiration, past, present, and future…

Stephen, can you define a coherent breathing style?
Coherent Breathing involves conscious breathing a the nominal frequency of 5 breaths per minute with comfortable depth AND conscious relaxation of certain anatomical zones that we refer to as “bridges.”

What are the advantages of breathing in this way?
The bottom line is increased blood flow throughout the body and all that accrues from increased blood flow. This includes psychological changes, everything that is mediated by the central nervous system which joins in to facilitate increased blood flow.

You have written a great deal on the advantage of breathing for increased blood flow. Please explain to our readers your views on how and why breathing affects blood flow.
This is the really central question and one that has been largely overlooked by medical sciences. Research in the early part of the 20th century was very focused here, but interest in it was somehow lost during the latter half of the 20th century. So, I think of my work as picking up where the researchers of that time left off.

It starts with the very premise of respiration, why do we need to do it? Of course, the immediate answer that comes to mind is that we must have oxygen in order to survive – everyone “gets this” because all of us know what it feels like not to get oxygen. We relate to this very personally based on a lifetime of direct experience.

In health sciences this “oxygen paradigm” translates directly into the science of gas exchange, which is largely limited to the understanding of importing and exporting gasses into and out of the blood.  But the larger role of diaphragm action is all but lost. In fact, I challenge you to find a single book on pulmonary physiology that even mentions the role that respiration plays in circulation.

What do you believe that role to be?
There is no question that the larger role of the diaphragm along with thoracic and abdominal cavities, is to literally function as multiple simultaneous pumps, one comprising the diaphragm and thoracic cavity and the other the diaphragm and abdominal cavity. These  pumps literally pump blood through the heart and lungs, and food and blood (via the mesenteric) circulation through the gut. This is the reason that we see both autonomic and enteric nervous systems begin to synchronize with breathing as it becomes slower, deeper, and more rhythmic, circulatory and digestive systems take advantage of this work being performed by the diaphragm, which is a large very strong muscle.

The diaphragm mediates pressure in the the chest and abdomen

What evidence supports your views?
For decades we have studied heart rate variability, which we know is heavily influenced by respiration – this being called respiratory sinus arrhythmia (RSA) and translated as “the heart rate changing in a sinusoidal fashion as a function of respiration.” Also for decades, HRV has been accepted as occurring in response to changes in blood flow and pressure, i.e. “baroreceptor response,” the underlying assumption being that blood flow and pressure change as a function of respiration. This understanding  has been  accepted for decades, yet without looking much deeper. Personally, I needed to see the changes in blood flow and pressure.

And can you see them?
Yes, this is the primary breakthrough of the “Valsalva Wave” and Valsalva Wave Pro, the instrument that allows us to observe, measure, and train this blood wave.

Does the blood wave appear as you anticipated?
Yes, it looks very much as I theorized that it would look in Coherent Breathing – The Definitive Method which was largely focused on the phenomenon of the respiratory arterial pressure wave and its relationship to heart rate.

Did you coin the name “Valsalva Wave”?
Yes. The only nomenclature we have to discussing a blood wave in the circulation is “respiratory arterial pressure wave” which describes the rising and falling of blood volume in the arterial system with exhalation and inhalation, respectively.  However, there is an equal and opposite component of the wave that occurs in the venous circulation.  And while I am not the first to recognize a venous wave phenomenon, to my knowledge I am the first to clearly attribute it to respiration.   So, we needed a new name for this wholistic phenomenon. As the wave is both arterial and venous, Antonio Valsalva’s initials worked nicely as he is one of the earliest Westerners to observe the blood wave as a function of respiration. Bob Grove of J&J Engineering and I settled on it while Bob was helping me develop the instrument.  I have since trademarked it.

Anyway, so yes, now we can monitor the blood wave that rises and falls in the circulation directly. We are no longer constrained to observing its secondary autonomic effect, heart rate variability.

Are there any immediate advantages to monitoring the Valsalva Wave vs. heart rate?
The instrument has only been on the market for 6 months, but yes. Certainly the most important thing is that we can now begin to adjust our paradigm. Not really knowing that breathing produces this wave action in the circulation has kept us from understanding the  rightful significance of breathing. Its kept breathing in the realm of the mysterious. I am not saying that we understand everything there is to know about breathing. But I see this as a big breakthrough in our understanding which paves the way to a future understanding.

Then what is your take on heart rate variability (HRV) biofeedback?
I divide HRV into two types: breathing induced heart rate variability, and  heart rate variability for all other reasons. In much of the research, these two are often scrambled together, leading to some confusion. With  the recognition  of the Valsalva Wave, I think we are able to understand breathing induced HRV much better now. As far as heart rate variability for all other reasons, specifically subtle autonomic adjustments, we have a long way to go. At the same time, I am personally not convinced that the latter is all that important. Time will tell…

I noticed in your writing that you draw strong parallels between Coherent Breathing and exercise. Can you tell us more about what you are thinking?
First, I want to point out the 2008 Physical Activity Guidelines for Americans by the Department of Health and Human Services, issued in September, 2008. The recommendations are very strong – that everyone that is “able” exercise for an hour or so every day and do weight bearing exercise involving all muscle groups three times a week. The health gains they document are huge. But as you know, one of my frustrations is that no one even knows about the report, the last recommendation of its kind by the federal government since the Surgeon General’s report in 1996, an no one knows of it. I learned of it in BMED Report around the end of last year, and ended up writing a summary article.

Cutting to the chase, it is my belief that one of the key reasons that exercise is so beneficial to health is that it requires us to breathe with more than 10% of diaphragm range, the range of a typical adult. Generally, the more often we exercise the better off we are, within reason. If I can take some license, the more often we breathe with more than 10% of diaphragm range, the better off we are. Oh but wait, we can breathe with more than 10% all the time… In this regard, I argue that consciously employing the diaphragm to breath more slowly, deeply, and rhythmically, is ”exercise.” But this exercise, is unlike exercise the bicep for comparison. This exercise facilitates the pumping action.

What range do you think is appropriate?
40-60%, thereby eliciting the strong pumping action and increased blood flow described earlier.

But the diaphragm is inside the body, how do you know when you are using 40-60% of diaphragm range?
Well, once you know what it feels like, then you know what to do. Biofeedback is very useful to speed comprehension. When one breathes with 40-60% of diaphragm range, the Valsalva Wave, as measured in the capillary circulation varies by about 2%. Heart rate varies by 20-30 beats.

You recommend that one breathes “coherently” all the time. Are you saying that if you exercise there is no need to do that?
Exercising without breathing coherently throughout the day is far better than doing neither. But no, exercise does not circumvent the advantage or value of breathing slowly deeply and rhythmically during daily life. I recommend that one does both, breathe coherently during daily life and exercise according to the Department of Health and Human Services report, which by the way, never mentions respiration.

How do we derive psychological advantages if improved circulation is the central mechanism?
The bottom line is that when we do not breathe well, we do not feel well either physically or mentally. I know I don’t. I expect that we’ll find that many of these advantages ultimately accrue from increased blood flow and perfusion to the brain. I have offered before, and I will offer again here that I believe a key evolutionary function of thoracic pump, mediated by the diaphragm, to be that of helping pushing blood upward against gravity in erect vertebrates, thereby relieving the heart and vascular system from bearing this full burden.

Any thoughts on the future?
I often hear from people close to the field say that they think breathing is “the next big thing.” I happen to agree with this, especially in these challenging health times. In my view, there is nothing more important to health, well-being, and longevity. And it allows people to stay healthy without spending their entire incomes, retirement, or whatever, then this may be what gets people’s attention. As a scientist, I had a very gratifying moment a few weeks ago. An MD and researcher told me that he thought the discovery of the Valsalva Wave is the biggest medical breakthrough he has witnessed in his lifetime. We will see..

Steve – thank you for taking time to talk with me and our readers, for your excellent articles that you write here at BMED Report, and for the important, original contributions you make to the field of biofeedback.


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