EPPP Anxiety Part 2: The Power of Positive Breathing

 

In our previous post, ‘EPPP Anxiety Part 1: Anxiety and Your Brain,’ we looked at how to use focused meditative breathing to relieve anxiety, including the type of anxiety experienced by those preparing to take the EPPP. I promised to share research on how this type of meditation can actually increase the size of the brain, improve social skills, make it easier to achieve mental clarity and focus, in addition to increasing emotional intelligence, self-regulation and resilience.

Before jumping into this research, let’s review three reasons why slow breathing is so powerful for maintaining a positive orientation in the mind and body.

1. Slow Breathing Means “I’m Safe”

Perhaps you’ve notice that the rate of your breathing automatically speeds up whenever you’re confronted by danger. This even happens when you’re watching a scary movie. Faster breathing is the body’s way of getting ready to either flee or fight.

The really cool thing is that this phenomenon also works the other way round: when you slow down the pattern of your breath, you send a message to the body that you’re safe. If you are able to slow your breathing down to four breaths a minute, this tells your body that you are really safe.

Try it right now if you feel inclined: breathe in for four seconds, hold it for four seconds, and then let your breath out for four seconds. At the end of a minute you’ll have only taken five breaths, yet surprisingly you won’t feel short of air; rather you’ll be amazed at how safe and secure you’ll feel. Through this type of controlled and deliberate breathing, you’re sending your body the message that you’re safe, that you are so safe that you don’t need to breathe quickly.

2.  Slow Breathing is an Exercise in Focus

A second reason why slow breathing is important for wellbeing is that it helps to develop the same mental muscles needed for resisting constant shifts in focus. Deep breathing itself doesn’t do this, but deep breathing combined with mindfully observing the pattern of your breath helps to strengthen the brain’s capacity for attentiveness. By choosing to focus on your breath, or a simple prayer that you can synchronize with your breathing, you are giving a powerful message to your body that your wellbeing doesn’t depend on following every distraction that enters your brain.

When you choose to focus on your breathing for just five minutes, you’ll probably experience hundreds of distracting thoughts. Each time you say no to these distractions and calmly bring your focus back to your breathing, you’ll be a little more experienced in resisting distractions and preserving focus. As you do this, you will literally be creating new neuropathways in your brain.


3.  Slow Breathing Tethers You to the Present

By engaging in the discipline of deliberate, focused breathing, you are committing to live in the present.

Consider that when we’re controlled by our survival instincts we tend to be preoccupied by the past. For example, we obsess over past mistakes, we relive painful memories or we worry about what might have been if our past had been different.

Our survival instincts also lead to preoccupation with the future: worrying about what tomorrow will bring or obsessing over future scenarios that might never come to pass. Our survival instincts rob us of being able to enjoy right now.

The one thing that is always present to us is our breath. Insofar as our breath is always happening in the present, it has the potential to serve as a powerful antidote to survival-based obsessions with the future and the past. When we choose to focus all our attention on our breathing we are committing to enjoy the present. We are increasing our brain’s capacity for conscious moment to moment awareness through paying attention. At first this can be excruciatingly hard. Even experienced meditators find they can’t focus on their breathing for very long without the brain being bombarded with thoughts about the past or future. When that happens, it’s the brain’s survival instincts kicking in and feeling unsafe living in the present. To bring your mind back to the present, approach these thoughts as being separate from yourself; observe them but do not judge. Just gently and mindfully bring your focus back to your consciousness of the present moment via your meditative breathing.

Rewiring the Brain

Okay, now for the research I promised you.

The literature dealing with the cognitive benefits of mindfulness meditation is huge.1  Research on these types of meditative practices have shown that even four brief sessions reduces fatigue and anxiety and while enhancing the ability to sustain attention.2 Indeed, just five minutes a day of mindful, meditative breathing can literally make a difference to whether a person’s brain exists in a place of peace or chaos. This type of meditation is also associated with greater levels of attentiveness,3 self-regulation,4  emotional resilience,5 self-compassion,6  empathy and compassion towards others,7  improved social skills,8 increased cortical thickness,9 enhancement of spiritual values,10  improved immune function,11  reduction of pain,12 and “changes in gray matter concentration in brain regions involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking.” 13

Good News for Psychology Students!

It gets even better. In December 1998, when research on mindfulness meditation was still in its infancy, the Journal of Behavioral Medicine reported on the effects of mindfulness meditation in premedical and medical students preparing for exams. In terms of stress levels, this group is very similar to the population of people studying to pass the psychology licensure exam (EPPP). These students were facing “a cascade of consequences at both a personal and professional level” because of “inability to cope successfully with the enormous stress of medical education.” They were then given an 8-week meditation-based stress reduction intervention, which included activities such as a “Sitting Meditation” whereby participants exercised “awareness of body sensations, thoughts, emotions while continually returning the focus of attention to the breath.” Results were rigorously documented and compared to a control group. The abstract in the journal summarized the findings:

Findings indicate that participation in the intervention can effectively (1) reduce self-reported state and trait anxiety, (2) reduce reports of overall psychological distress including depression, (3) increase scores on overall empathy levels, and (4) increase scores on a measure of spiritual experiences assessed at termination of intervention. These results (5) replicated in the wait-list control group, (6) held across different experiments, and (7) were observed during the exam period.14

If you’re preparing for the EPPP exam, you may think you don’t have enough time to meditate. With the stakes so high, you can’t afford not to.


1. [For a good entry-level book on the cognitive benefits of mindful breathing, see Chade-Meng Tan, Search Inside Yourself: The Unexpected Path to Achieving Success, Happiness (and World Peace) (New York: HarperOne, 2012). ]

2. [Fadel Zeidan et al., “Mindfulness Meditation Improves Cognition: Evidence of Brief Mental Training,” Consciousness and Cognition 19, no. 2 (June 2010): 597–605, doi:10.1016/j.concog.2010.03.014; Also see Fadel Zeidan et al., “Effects of Brief and Sham Mindfulness Meditation on Mood and Cardiovascular Variables,” The Journal of Alternative and Complementary Medicine 16, no. 8 (July 28, 2010): 867–73, doi:10.1089/acm.2009.0321; James Beauchemin, Tiffany L. Hutchins, and Fiona Patterson, “Mindfulness Meditation May Lessen Anxiety, Promote Social Skills, and Improve Academic Performance Among Adolescents With Learning Disabilities,” Complementary Health Practice Review 13, no. 1 (January 1, 2008): 34–45, doi:10.1177/1533210107311624; Shamini Jain et al., “A Randomized Controlled Trial of Mindfulness Meditation versus Relaxation Training: Effects on Distress, Positive States of Mind, Rumination, and Distraction,” Annals of Behavioral Medicine 33, no. 1 (February 1, 2007): 11–21, doi:10.1207/s15324796abm3301_2; “Effectiveness of a Meditation-Based Stress Reduction Program in the Treatment of Anxiety Disorders,” American Journal of Psychiatry 149, no. 7 (July 1, 1992): 936–43, doi:10.1176/ajp.149.7.936; Fadel Zeidan et al., “Neural Correlates of Mindfulness Meditation-Related Anxiety Relief,” Social Cognitive and Affective Neuroscience 9, no. 6 (June 1, 2014): 751–59, doi:10.1093/scan/nst041; Yune Sik Kang, So Young Choi, and Eunjung Ryu, “The Effectiveness of a Stress Coping Program Based on Mindfulness Meditation on the Stress, Anxiety, and Depression Experienced by Nursing Students in Korea,” Nurse Education Today 29, no. 5 (July 2009): 538–43, doi:10.1016/j.nedt.2008.12.003.]

3. [Yi-Yuan Tang et al., “Short-Term Meditation Training Improves Attention and Self-Regulation,” Proceedings of the National Academy of Sciences of the United States of America 104, no. 43 (2007): 17152–56.]

4. [Ibid.; Shauna L. Shapiro, Gary E. Schwartz, and Ginny Bonner, “Effects of Mindfulness-Based Stress Reduction on Medical and Premedical Students,” Journal of Behavioral Medicine 21, no. 6 (December 1, 1998): 581–99, doi:10.1023/A:1018700829825.]

5. [Shapiro, Schwartz, and Bonner, “Effects of Mindfulness-Based Stress Reduction on Medical and Premedical Students”; John Meiklejohn et al., “Integrating Mindfulness Training into K-12 Education: Fostering the Resilience of Teachers and Students,” Mindfulness 3, no. 4 (December 1, 2012): 291–307, doi:10.1007/s12671-012-0094-5.]

6. [Alberto Chiesa and Alessandro Serretti, “Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis,” The Journal of Alternative and Complementary Medicine 15, no. 5 (May 1, 2009): 593–600, doi:10.1089/acm.2008.0495.]

7. [David DeSteno, “The Kindness Cure,” The Atlantic, July 21, 2015, http://www.theatlantic.com/health/archive/2015/07/mindfulness-meditation-empathy-compassion/398867/; Paul Condon et al., “Meditation Increases Compassionate Responses to Suffering,” Psychological Science 24, no. 10 (October 1, 2013): 2125–27, doi:10.1177/0956797613485603; Shapiro, Schwartz, and Bonner, “Effects of Mindfulness-Based Stress Reduction on Medical and Premedical Students”; ibid.]

8. [ James Beauchemin, Tiffany L. Hutchins, and Fiona Patterson, “Mindfulness Meditation May Lessen Anxiety, Promote Social Skills, and Improve Academic Performance Among Adolescents With Learning Disabilities,” Complementary Health Practice Review 13, no. 1 (January 1, 2008): 34–45, doi:10.1177/1533210107311624.]

9. [Long-term meditation practices were found to lead to increased thickness in the cortical parts of the brain. “Brain regions associated with attention, interoception and sensory processing were thicker in meditation participants than matched controls, including the prefrontal cortex and right anterior insula.” Sara W. Lazar et al., “Meditation Experience Is Associated with Increased Cortical Thickness,” Neuroreport 16, no. 17 (November 28, 2005): 1893–97.]

10. [Alberto Chiesa and Alessandro Serretti, “Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis,” The Journal of Alternative and Complementary Medicine 15, no. 5 (May 1, 2009): 593–600, doi:10.1089/acm.2008.0495.]

11. [Richard J. Davidson et al., “Alterations in Brain and Immune Function Produced by Mindfulness Meditation,” Psychosomatic Medicine 65, no. 4 (August 2003): 564–70.]

12. [Fadel Zeidan et al., “The Effects of Brief Mindfulness Meditation Training on Experimentally Induced Pain,” The Journal of Pain 11, no. 3 (March 2010): 199–209, doi:10.1016/j.jpain.2009.07.015.]

13. [Britta K. Hölzel et al., “Mindfulness Practice Leads to Increases in Regional Brain Gray Matter Density,” Psychiatry Research 191, no. 1 (January 30, 2011): 36–43, doi:10.1016/j.pscychresns.2010.08.006.]

14. [Shauna L. Shapiro, Gary E. Schwartz, and Ginny Bonner, “Effects of Mindfulness-Based Stress Reduction on Medical and Premedical Students,” Journal of Behavioral Medicine 21, no. 6 (December 1, 1998): 581–99, doi:10.1023/A:1018700829825.]

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