Covid-19 Part Three: Coronavirus and Breathing

Breathing

The coronavirus gives breathing new meaning. I have a theory about it.

A week ago my most anxious patients had their symptoms under control. They would come in (yes, that was dumb on my part, seeing patients face to face, but we were five feet apart) or we used an app to discuss life, stress, relationships, work, play. We discussed everything but the novel coronavirus. Which is remarkable.

Everyone else, normal people, totally freaking out.

I attribute the absence of panic, the practical superior attitude of my anxious patients to therapy. They breathe, they work their muscles, all of the CBT we teach in this gig. They work the program.

But that was then, back in the first week, and now no one is absolutely cool. In the past couple of days everyone has talked of nothing else-- only quarantine and contagion, whether or not it is too late, who is sick.

Me, too. I panic too. Whatever anxiety we held in abeyance, denial, for as long as we could, well, we have officially lost it, along with our money. And the fear of dying, our worry about loved ones. It has us, even the most Zen among us. More than an eyebrow is twitching.

Therapists wonder if there will be a suicide epidemic. Money matters to everyone.

I had this theory that if we got sick we could still ignore it, not judge it, could distract with all kinds of things, hobbies, etc., breathing (the way the yogis do). But no! That won't work if we can't breathe,  if we can't exercise, can't get out of bed, which is what happens when we have pneumonia.

So that theory, watch it disappear. Coping is going to be hard.  All we have left are our usual devices, if we get sick.

We should call our doctor, On the telephone a primary care physician can tell us if we need to be examined or should go to an emergency room. Telehealth is covered by most insurance. Check that out before leaving home.

But if sick, and our anxiety is getting in the way of a good time, there are the following exercises to consider, standards in your average therapydoc's toolbox. To me it really is all about breathing and distracting, being creative and thinking less. But here are 2 suggestions.

I.

Visualization techniques are nice. Focus on encouraging antibodies to make an appearance, come out to play, those little packmen in your bloodstream that eat up foreign cells. Order them to gobble up corona cells.  Mind games are free. You can play if you have the virus, or even if you don't.  

II.

Focus on your breath. The method I teach my patients is just that, focus on  your breath. We all breathe anyway, so we may as well be mindful about it. Some people, when they get anxious, literally stop or slow it down. And we need it.  

There are 2 nice ways to go about about this.

1. Just as we attend to a throbbing paper cut, or anything else that our body ego seems to notice, like that nasty feeling we get gastro-intestinally when things don't move, pay attention to the air coming into the mouth, the nose, flowing into the body.

• Put your hand on your heart, notice your chest rising and falling in sync with your inhaling and exhaling. That's the power of breathing.
• Find your breath, either in the nose or mouth. Mentally attend to it, just watch, feel it, that and nothing else. If it is easier you can watch something while focusing on your breath, a nice picture perhaps, or a video of the sea, but it is the flow of your breath you care about, the wave of air that refreshes the body and the mind.
• Once you have found your breath, watch it for as long as you can. One minute is great. Three minutes, fantastic. A few times a day? Amazing.
• If you've been breathing through your nose, switch to mouth breathing and notice as air glides onto the roof of the mouth and the tongue, the teeth. Then as it disappears, goes where it is supposed to go, your chest rises.
• If you're breathing through your nose, feel the mucous membranes respond. They may feel cold. Watch as air carries inward to do the work of life.
• You don't have to do anything other than watch the show. You don't have to count, don't have to breathe more deeply. Just watch what is going on without any effort on your part. That's the ticket. It forces us to get greedy, to want more air, just doing that, and we'll inhale more deeply to comply.

There. You have mastered this.  You can and should turn to this fabulous, accessible, G-d given technique that actually works whenever there's a need to reduce anxiety, even depression. Practice it when you aren't anxious or depressed. Do it driving, do it doing dishes, do it while listening to your mother rant at you on the telephone to STAY HOME DURING THE CORONA CRISIS.

Alternatively.

2.  The balloon technique. 

 Notice the breath, your inhalation. After a few unscripted breaths, try to intentionally bring the breath to your belly, to fill it up like a balloon. You can even push your stomach muscles out to do that. Fill it up. Once full, suck in a bit more air and hold your breath 3 seconds.

Exhale slowly, imagine that balloon deflating. Stretch out the exhalation for as long as you can, and when you're out of breath, hold that pose for a moment.

Repeat.

To your health,

therapydoc