Mr. Absenger

Human Resources, Recruitment & Training

Stress Management 101: Teach Employees How to Breathe

By Werner Absenger, Chef de Cuisine, Cygnus 27 at Amway Grand Plaza

Controlled Breathing: The Most Basic of Mind-body Techniques

Noticing your breathing pattern and being able to change breathing from tension producing to one of relaxation is a simple and crucial mind-body technique. 
Meditation and deep-breathing form the foundation for many other mind-body techniques (1).

When we are stressed, many of us tend to breathe shallowly. This shallow breathing elevates blood pressure, heart rate and raises anxiety. Deep breathing, either gently in meditation or rapidly during chaotic breathing increase the body's capacity to draw in oxygen and free carbon dioxide. 
Deep breathing calms the mind and engages the body's natural relaxation response. 
Deep breathing also decreases blood pressure, reduces heart rate and promotes cardiac function. It is also beneficial for other stress-related conditions such as diabetes, intestinal problems, asthma, chronic pain, depression and anxiety(1).

The appreciation of the significance of breath is detected in the word "inspiration." The name for taking in breath also suggests that one is "inspired," "excited," "ennobled," or "turned on" by life. Respiration is the only system of the body that is both automatic and voluntary. Breathing goes on without us having to think about it. Breathing also can be controlled(1).

Breathing has this excellent adaptability about it. It is always there, always accessible for use, and we can shape breathing. As we form our breath, as we regulate its depth or shallowness or its rate, we can also modify many other functions in the body(1).

Breathing is responsive to emotional states and can also shape emotional states. When you are stressed, breathing is shallow and hurried, and the sympathetic nervous system is stimulated. The body wants more oxygen to go to the large muscles, so it can either run away or fight. If you are ready for a fight or you are trying to run, you need a rush of energy and adrenalin. If this state persists, it can cause a variety of physical problems(1).

Slow deep breathing calms the sympathetic nervous system stimulation. The vagus nerve, which passes through the diaphragm, is part of the parasympathetic nervous system, the part of the autonomic nervous system that brings relaxation. When we breathe slowly and deeply, we stimulate the vagus nerve and bring about relaxation (1).

What Does the Science Say About Controlled Breathing?

During controlled breathing, we minimize the use of muscles in the shoulder, the neck, and the upper chest. As mentioned above, activation of the sympathetic nervous system is decreased. Controlled breathing impacts the brain directly by minimizing the cerebral cortex's excitability. This in turn contributes to a cognitive diversion, essentially restructuring pain stimuli. Interestingly enough, controlled breathing enhances brain function, airflow through the nose and movement of the diaphragm, lightly stimulates the vagus nerve and increases oxygen exchange(2).

Controlled breathing reduces pain, anxiety, emotional distress and aversion to chemotherapy in cancer patients undergoing invasive procedures such as stem cell transplantation. Patient's subjected to orthopedic surgeries, as well as preterm labor seem to benefit from controlled breathing, as well.

Most readers reading this are probably all too familiar with burns. Even a so-called "minor" burn can impact productivity in our fast paced environment. Imagine now the impact we could have on employees to intervene immediately. I am not saying that the burn will be less severe, so proper medical attention is still required. I am merely saying that the perception of pain can be dramatically altered by employing relaxation breathing before and after proper medical attention. I am deliberately citing research from a hospital burn unit to illustrate the positive effects controlled breathing can have on pain perception in patients undergoing a very painful procedure, burn-dressing changes.

Park et al. (2013) recruited 60 patients for their study and divided them into two groups. The intervention group would receive instructions for "relaxation breathing" and the control group would not. Each group consisted of 30 patients. The researchers conclude their study by writing that burn patients who received the breathing training fared significantly better decreasing pain and anxiety. They write "Relaxation breathing is a simple and inexpensive technique nurses can use to help burn patients manage pain and anxiety…"(2).

Imagine the possibilities for intervening on the front lines, administering first aid to burns victims in your kitchens utilizing controlled breathing.

Chiang, Ma, Huang, Tseng, and Hsueh investigated the effects of controlled breathing on anxiety and asthma in children. The researchers found that controlled breathing significantly lowered anxiety in children with moderate-to-severe asthma, positively affecting physiological and psychological health(3).

I reviewed a study by Oh et al. (2010) illustrating the positive effects of medical qigong on quality of life for cancer patients, who are plagued with substantial physical, psychological and emotional distress, side effects and toxicity. Medical qigong is a traditional Chinese mind-body practice that has been practiced for more than 5000 years. Medical qigong is a meditative movement practice that involves focus on movement and breathing. Major findings of the study were that quality of life of cancer patients improved in assessed physical, social, emotional, and functional well-being. C-reactive protein, a marker for inflammation, improved significantly for cancer patients participating in medical qigong(4).

This transitions us into a couple studies involving Eastern modalities of controlling breathing. One very popular and widely practiced practice is yoga. Yogic breathing exercises affected global gene expression(5), and affected circulating immune cells, supporting the hypothesis that controlled breathing has measurable effects at the molecular level(6). Controlled breathing as employed by Sudarshan Kriya Yoga practice has been shown to reduce stress, anxiety, post-traumatic stress disorder (PTSD), depression, stress-related medical illnesses, substance abuse and improved rehabilitation of criminal offenders(7).

Sharma (2013) did an extensive review of 17 studies about yoga as a possibly stress management technique. Out of the 17 studies, 12 demonstrated positive changes in psychological or physiological stress related outcomes. Granted yoga is a controlled breathing practice that involves movement as well, thus could be termed a moving meditation. However, yoga practice involves a lot of controlled breathing, which could be applied in the everyday life. This brings me to a modern definition of yoga, which I believe is very applicable to what we are talking about here as we look to carry over controlled breathing lessons from yoga into everyday life. Yoga has been defined as "a systematic practice and implementation of mind and body in the living process of human beings to keep harmony within self, within society, and with nature"(8).

How To Practice Controlled Breathing

There are two huge challenges in teaching employees how to breathe. The first challenge is to teaching employees the benefits of paying attention and controlling breathing. The best way in my opinion is to show them how to do that if they are not already engaged in a mind-body practice such as yoga, meditation, tai chi, or qigong. I showed employees from the Amway Grand Plaza Hotel, and Cygnus 27 who participated in Mind-Body Skills Groups two controlled breathing methods I picked up during my training with Jim Gordon at the Center for Mind-Body Medicine and Saybrook University. I detailed both of the practices below.

The second challenge I believe is even bigger than the first. A roadblock no one is immune to, not even a person with graduate education in mind-body medicine. That challenge is to remember to implement controlled breathing in the first place. To overcome these challenges, it is not enough to practice just once.

Controlled Breathing Method I: Soft Belly

"We are going to take a few moments to give ourselves a chance to experience breathing deeply and noticing how it feels. Just sit comfortably. Your eyes can be open, slightly opened and unfocused, "soft eyes," or they can be closed. Notice the breath, going in through the nostrils and out through the nostrils, and notice the thoughts and feelings, the emotional feelings and the sensations, the bodily sensations that arise. You may be thinking about lunch, feeling your stomach rumble. Or you may be feeling pleased just to be sitting here. Noticing the thoughts, feelings and sensations. Name them and bring your attention back to the breath going in and out through the nose. Continue this process of breathing and noticing for few minutes. When you are ready, open your eyes and come back to the room."(9)

A free audio version of Jim Gordon guiding you through a 4-minute "Soft Belly Meditation" is also available (J. S. Gordon, n.d.)

Controlled Breathing Method II: Chaotic Breathing

The chaotic breathing exercise I sometimes do when I am too wound up from life's daily little stressors.

Stand with feet hip-width apart, knees slightly bent.
 Bend your arms at the elbows, keeping your hands in fists at armpit level. 
Then pump our arms up and down while breathing rapidly in and out through the nose, concentrating particularly on the exhalation. 
Using your arms as bellows, move the breath deeply into the lungs and feel the chest expand with each inhalation. Breathe as fast as you can making sure your breathing stays deep. 
Do this as totally as you possibly can, without tensing your body and making sure your neck and shoulders stay relaxed. 
Continue until you literally "become the breathing" allowing the breath to be chaotic - meaning, not in a steady predictable way. 
I encourage you to keep your eyes closed during this exercise. If you feel like you may lose your balance, you certainly open your eyes. Try to do this for 3 minutes, and once you stop simply become aware of how you feel. Breathe deeply. Notice your breath. Notice how your body feels... Breathing deeply, relaxing(1).

In this article, we briefly introduced controlled breathing, then we learned about some studies on the impact of controlled breathing in clinical populations. Finally, I have attempted to provide two examples of controlled breathing I have used with employees here at the Amway Grand Plaza Hotel and Cygnus 27.

It is incredible to think that a simple practice as merely focusing on one's breath can have such a tremendous impact on health and well-being. Having shown that the hospitality industry employees, as a group are more stressed than the general population, I think it would serve our mission to show them and teach them the most basic of all stress management techniques: Controlling your breath.

References:

(1) Gordon, J. S. (n.d.). Soft Belly Meditation. Washington, DC: Center for Mind Body Medicine.
(2) Park, E., Oh, H., & Kim, T. (2013). The effects of relaxation breathing on procedural pain and anxiety during burn care. Burns, 39(6), 1101-1106. doi:10.1016/j.burns.2013.01.006
(3) Chiang, L.-C., Ma, W.-F., Huang, J.-L., Tseng, L.-F., & Hsueh, K.-C. (2009). Effect of relaxation-breathing training on anxiety and asthma signs/symptoms of children with moderate-to-severe asthma: A randomized controlled trial. International Journal of Nursing Studies, 46(8), 1061-1070. doi:10.1016/j.ijnurstu.2009.01.013
(4) Absenger, W. (2013, February 26). Oh et al., 2010-Medical Qigong, quality of life and inflammation in cancer patients. The Alternative Medicine Blog.
(5) Qu, S., Olafsrud, S. M., Meza-Zepeda, L. A., & Saatcioglu, F. (2013). Rapid Gene Expression Changes in Peripheral Blood Lymphocytes upon Practice of a Comprehensive Yoga Program. PLoS ONE, 8(4), e61910. doi:10.1371/journal.pone.0061910
(6) Saatcioglu, F. (2013). Regulation of gene expression by yoga, meditation and related practices: A review of recent studies. Asian Journal of Psychiatry, 6(1), 74-77. doi:10.1016/j.ajp.2012.10.002
(7) Brown, R. P., & Gerbarg, P. L. (2005). Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression. Part II--clinical applications and guidelines. Journal of Alternative and Complementary Medicine (New York, N.Y.), 11(4), 711-717. doi:10.1089/acm.2005.11.711
(8) Sharma, M. (2013). Yoga as an Alternative and Complementary Approach for Stress Management: A Systematic Review. Journal of Evidence-Based Complementary & Alternative Medicine, 19(1), 59-67. doi:10.1177/2156587213503344
(9) Gordon, J. (2011). Mind-Body Medicine Professional Training Program. The Center For Mind-Body Medicine.

Chef Werner Absenger, chef de cuisine, has helped propel Cygnus 27, one of the highest-ranked restaurants in Michigan, into the forefront of the state’s premier culinary scene. Chef Absenger has been with the Amway Grand Plaza for 10 years. A 20-year culinary industry veteran, he has held posts at Alpenrose Restaurant & Café in Holland, MI as chef de cuisine and executive chef, and at the Grand Hotel in Mackinac Island, MI where he worked in various positions ranging from chef tournant to banquet chef. Chef Absenger also honed his skills at the Hyatt Regency Scottsdale Resort and Spa at Gainey Ranch in Scottsdale, AZ and at the Hotel Gasthof Gramshammer in Vail, CO. Before joining the culinary team at the Amway Grand Plaza, Chef Absenger was an entrepreneur and operated an organic smoothie bar, Juz C, in Grand Haven, MI. As the owner, he developed the menu, concept, and theme of this healthy establishment from 2001-2003. Mr. Absenger can be contacted at 616-774-2000 or WAbsenger@amwaygrand.com Extended Bio...

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