Slow-paced, resonance or coherent breathing

Domain X · Body, movement, breath & physical · Lehrer, Vaschillo, Gevirtz · 2013

What it is

Slow-paced breathing is a low-intensity, at-rest practice in which the client breathes smoothly, without breathing deeply and without holds, at a slow, steady rate. Three overlapping traditions use it:

Format

• Format: individual, in-person, with ECG or PPG heart-rate sensor and a respiration belt; Shaffer and Meehan add that live displays of heart rate and breathing are needed and that ECG is preferred during slow breathing. Home practice in the 2013 protocol is twice daily, about 20 minutes each time,…
• Where no sensors are available, the published fallback is to breathe with a pacer at about six breaths a minute rather than at an individually measured rate. A typical integration into psychotherapy:

Who practises it, and how they are trained or regulated

• Brown and Gerbarg teach Coherent Breathing alongside "Breath Moving", a "Ha" breath, body scan, tapping, qigong movements and Open Focus attention, usually in multi-day workshops (for example a Friday-evening to Sunday-morning residential format) with home practice review. A BBM handout describes practice lying with legs supported on a chair or sitting, progressive relaxation of the body, and breathing in time with…
• How change is thought to happen. In the developers' account, breathing at about 0.1 Hz drives large heart-rate oscillations (respiratory sinus arrhythmia) because breathing and the baroreflex then reinforce each other: heart rate rises and falls in phase with the breath and in opposite phase with blood pressure. Repeated practice is proposed to strengthen baroreflex function and autonomic regulation, which the…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• dropping practice entirely once well; returning symptoms (offer a refresher).
• performance anxiety about the screen; signal artefacts (a flat or low PPG signal suggests switching to ECG).
• fatigue across trials; overbreathing at the slower rates ("shallower and smoother breaths" is the published remedy).
• client attaching anxious significance to a changed number (normalise: it is an individual and slightly moveable characteristic).
• body areas that carry trauma or pain (let the client choose where the breath "goes"); imagery effort increasing breathing depth.

Problems the guide addresses

• Evidence status (brief)

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.