May 08 2012
Coherent Breathing
Last week I wrote about earthing – the claim that being in contact with the earth (especially using products you can buy for this purpose) helps to balance your electrons and improve health. Earthing fits into a category of pseudoscientific nonsense I called “just make shit up.” This seems to be a deep and constantly growing category, limited only by human imagination, ego, and greed. The existence of claims such as this is an excellent example for why we need the rigors and methods of science – without them to ground us to reality, there is no limit to the nonsense humans will believe.
Recently I was asked about another member of this category – coherent breathing. I bet you didn’t realize that you could use training in how to breath optimally. You probably naively assumed that the elaborate autonomic, respiratory, and circulatory systems that evolved over millions of years would have already optimized something as basic to life and physiology as breathing. You lazily just let your brainstem drive your respiration based on things like blood CO2 and oxygen levels, and let your autonomic nervous system regulate your heart rate and blood pressure. Why bother making a conscious effort to control your breathing when it will happen all by itself without any effort on your part.
Well, if you are willing to spend hundreds of dollars on a seminar you can learn how to synchronize your breathing with your heart rate. What will this accomplish, you may ask? Absolutely nothing – but it will make money for the guys running the seminar.
Here’s the idea – you can synchronize your breathing with your heart rate. This makes pretty pictures of pressure waves that people can graph and they will look really impressive to the scientifically illiterate. This will allow the blood that flows out from your heart through the arteries to match the blood that returns to the heart through the veins – because otherwise… Wait, there must be something more to this. I’m sure the Coherence website will have a coherent explanation for what is happening. They write:
When we don’t breathe productively over a long period of time, the parasympathetic nervous system becomes dysfunctional.
So if I don’t breathe correctly my autonomic nervous system will become messed up. I wonder why we evolved that way? You would think that if breathing properly was so critical to health and performance we would just naturally breath that way.
Seriously, I cannot find an understandable explanation on any of the available articles or websites on this issue for what is supposed to be happening. They talk endlessly about synchronization, and they talk about the real relationship between breathing and pressure in the cardiovascular system (as if they discovered it). This is all basic physiology, but then they add a layer of nonsense without ever making a real explanation for it. It’s wonderful pseudoscientific technobabble – lots of sciencey sounding words, but no real content.
Apparently a martial artist named Stephen Elliott invented this particular health pseudoscience. I could not find any publications by him or regarding coherent breathing. This is always a good indicator of the status of such claims. Having a trail of published research is no guarantee that a claim is true – most new ideas in science are wrong, and most preliminary studies will be false positives. But when a paper trail of research seems to be completely lacking, that probably indicates you are dealing with a “just make shit up” pseudoscience.
There are vague references to “our research” on the websites, but no actual research.
Typically, when I write about such obscure health products or notions some distributor or devotee will show up in the comments. They will commonly make two claims. First they will claim there is research, and sometimes they can even provide a link. This is usually to research that has nothing directly to do with the claims but is just being used to make it seem like the claims are evidence-based. I’m sure, for example, that coherent breathing proponents can link to physiology research demonstrating the relationship between breathing and blood pressure. This is just basic science that deals with the same topic. They can’t, however, link to peer reviewed independent research that actually demonstrates their claims. Sometimes they link to in-house studies that are completely worthless and are not published in a peer-reviewed journal, or are published in the obscure journal of alternative nonsense. This is often accompanied by the claim that we just don’t know the research.
Many people falsely believe that if you can link to even a single study, or a single researcher, that is making a claim then it is evidence-based. This is completely wrong, however. In order for a new phenomenon to be established you need to see a pattern of research, with replication and verification of basic concepts, and exploration of alternative interpretations, with a consensus building toward the new conclusion. We don’t see that with these fringe claims (that’s why they are fringe). Rather we typically see either nothing, or bad research by an isolated group or proponents.
The second type of claim that proponents often make when they stumble upon my blog deconstructing their favorite pseudoscience is their own anecdotal experience. They tell us how it has changed their life or their health, and apparently have no idea about placebo effects or the misleading nature of anecdotal experience. They then quickly become frustrated when their naive claims are met with skepticism.
We’ll see if that happens here (or perhaps my preemptive strike will prevent it). I hope it does anyway, as true believers do a better job of showing how vacuous and pseudoscientific their beliefs are than I can.
I and other science bloggers can only scratch the surface of the many made up claims that are out there, proliferating on the internet. That is why it is important to develop the skills to evaluate such claims for yourself. It is good to at least develop some “red flags” that will make you skeptical of the claims. Coherent breathing has many such red flags: the lone guru who has apparently discovered something missed by the rest of the relevant scientific community, the lack of a history of published peer-reviewed research, the use of jargon that you cannot make sense out of (in other words, the inability to explain the phenomenon in plain language so that it makes sense), and extraordinary claims for wide ranging benefits.
36 Responses to “Coherent Breathing”
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Raise your hand if you were conscious of your breathing while reading the entire article! LOL (My hand is raised)
Dr. Novella,
completely off the topic:
“I bet you didn’t realize that you could use training in how to breath optimally. You probably naively assumed that the elaborate autonomic, respiratory, and circulatory systems that evolved over millions of years would have already optimized something as basic to life and physiology as breathing. ”
I get a sense (sense as in I am not good at reasoning yet) that you are using a rhetorical attack by speculating about evolution…. Selective pressures might have favored autonomic, respiratory, and circulatory systems that are unrelated, or even detrimental to today’s definitions of “optimal” health: (lack of disease, feeling happy and longevity?). A million years ago, I’d bet on the male reproducing champions having systems “optimized” for fighting.
For these Cognitive breathing quacks the above paragraph is a nice “missing the point” fallacy and could be used to set up a straw man too.
This reminded me of: “Do you masticate, Mr. Lightbody?”
Breathing frequency is normally chaotic. Chaotic frequency is what results from the summation of a number of non-linear and coupled processes. All of physiology is non-linear and there are a number of pathways that trigger breathing (low O2, high CO2, high R-SNO’s and others). When all of those non-linear trigger pathways are working correctly, what you get is chaotic behavior.
Coherent behavior is a sign of dysfunction. Coherence in breathing is a sign of dysfunction. That is what Cheyne-Stokes breathing is. My hypothesis is that as the number of pathways regulating breathing get out of range and begin to fail, then with fewer pathways involved, the behavior becomes more periodic and less chaotic.
The cells in your body don’t need coherent blood delivery, they need blood delivery all the time. You don’t want to set up coherent and synchronous behavior in something like blood delivery. Physiology is not set up to deal with synchronous behavior. If there are pathways that happen by chance to occur at the same frequency as the synchronous behavior you artificially induce, those pathways will get screwed up.
Physiology uses the principle of stochastic resonance. Stochastic resonance is a signal processing technique where you add noise to a signal, amplify the signal plus noise, then remove the noise from the amplified noise plus signal. This technique gives better performance than a noise-free system because the threshold for amplification is reduced by the noise. Essentially all of physiology uses this technique, so trying to impose synchronous behavior is likely to have only adverse effects.
“That is why it is important to develop the skills to evaluate such claims for yourself. It is good to at least develop some “red flags” that will make you skeptical of the claims.”
I find that the two easiest red flags for the average person to recognize are 1. Do the claims seem ‘too good to be true’ 2. Are they selling anything? (or linking you to place to purchase something) These 2 are a good screening process that anyone should recognize before delving into more details regarding evidence, and can save the person the trouble.
Also, since most people do not have the technical knowledge to evaluate certain claims, it is good to know people who are knowledgeable on various topics for advice when there is uncertainty. Of course they would need to seek out this advice. I’m often surprised that people are so willing to shell out a bunch of money before adequately investigating what they are purchasing. “Health! The ‘open sesame’ to the sucker’s purse!” (Yes, 2 Road to Wellville quotes, sorry)
As a speech and confidence coach, I train breathing – and while this ‘coherent’ breathing and syncing with the heartbeat does sound like baloney, there are some points I’d love you to address:
Your argument from evolution smacks of a logical fallacy: Argument from antiquity or the natural fallacy (I can’t tell which – if either).
I would suggest we did evolve to have strong breathing habits, but that sitting is an evolutionarily recent phenomenon, we were erect much more, and when we sat we just as often squatted as we sat. The effect of sitting (so much) is that the hunched spine blocks air getting to the lower lobes of the lungs, causing a breather to naturally adopt a habit of using their ‘accessory muscles of inspiration’ – the chest (intercostal) neck and shoulder muscles, instead of the diaphragm.
Endurance sportspeople, trained singers and other interested folks often do train themselves to breathe into their diaphragm to great effect.
The story I’ve heard (and re-told with minimal research to confirm or disconfirm) is that by mouth/chest breathing we’re huffing out too much CO2, the blood’s pH goes out of whack, and the body dumps bicarbonate into the blood to balance it. The gluggy bicarbonate laden blood struggles to permeate the bood-brain barrier and causes the brain to feel it’s lacking Oxygen (from actually getting too much) and this causes a runaway effect of further chest breathing and adrenaline.
There is also some promising sounding science about Buteyko (which seems like pseudoscience that happened upon some actual science by accident) reducing the reliance upon asthma meds, particularly inhalers, with proper breathing nose/gut techniques to train people out of panic breathing.
Given that I’m trained in NLP and call myself a ‘speech and confidence coach’ while at the same time claiming to be a skeptic, I’m often torn on these kind of topics. I am always worried about becoming a snake-oil peddler, while also keenly aware that the placebo effect is one of the greatest tools I can utilize.
So, guru and talker on my favourite podcast: What say you?
I believe the evolution argument is valid and not fallacious. We are not talking about singing or optimal physical performance – the coherent breathing is about regulating blood pressure and blood flow based upon breathing. This is all a highly regulated system in the body that has been tweaked by millions of years of evolution – going back to before we were anything like humans. Cardiovascular, respiratory, and autonomic functions are basic and critical to survival – so, very strong evolutionary pressures to optimize.
The notion that we can improve this system by consciously altering our breathing is nonsense. It’s a complex self-regulating system, you’re better off just letting it do it’s job.
Of course – I am talking about healthy individuals. Age, disease, obesity, etc. can affect the system. But even then, there is simply no rationale to coherent breathing.
Even though breathing is partially under autonomic control, it’s still as prone to repetitive stress injuries as any other skeletal muscles, even in people who are otherwise healthy. All you need is a bit too much tension in your scalenes for a few years and you’ll find yourself ready to pass out at random moments during the day (as I found).
This isn’t an argument for “coherent breathing,” just to note that correct breathing doesn’t necessarily come naturally even in healthy people.
#HarryKey – “Given that I’m trained in NLP and call myself a ‘speech and confidence coach…”.
Trained in NLP? How do you get ‘trained’ in a fake science?
Steve, one of the points that you may have left out of your response to HarryKey is that the theory of evolution is backed by mountains of evidence and more than a hundred years of research. Saying that it is an argument from antiquity might be like saying that the germ theory of disease is an argument from antiquity. Yes, it has been around a long time, but we have the evidence to support the theory, unlike TCM or homeopathy or, in this case, coherent breathing.
While breathing is a highly regulated system, it can go wrong at times – i.e. anxiety attacks during which people hyperventilate and pass out. Deep, controlled breathing can help to relax a person enough to calm themselves, although it has nothing to do with synchronizing with the heart. I would imagine that the coherent breathing seminar would help people feel more relaxed and they would then say that their parasympathetic nervous system is back on track, but it is probably just a simple relaxation technique.
In the martial arts, a student has to learn to fight rapidly using all his limbs and muscle strength to knock out his opponent. Sometimes, there is breathing problems in fighting. A student has to take a breath, initiate another blow, withstand another attack. An instruction for coherent breathing would ask a student to breath properly so that he doesn’t pass out or allow his heart rate and blood pressure to elevate extremely high. Anything else explaining this basic need would be science-y.
“You lazily just let your brainstem drive your respiration based on things like blood CO2 and oxygen levels, and let your autonomic nervous system regulate your heart rate and blood pressure.”
You’re right, Doc, I have been lazy…I feel so ashamed.
My favourite make-it-up-on-the-spot loon is Ignaz von Peczely
http://en.wikipedia.org/wiki/Ignaz_von_Peczely
SteveA, Thank you! I have been following a link path through wikipedia from you Peczely link. I haven’t had so much entertainment in weeks.
So far:
Iridology >Moleosophy > Phrenology > Characterology > Physiognomy
Its a like a nonsense salad on Wikepedia.
Breathing appropriately is part of most sports and of things involving physical performance (dancing, singing, and speech/debate, and acting). I did speech/debate in high school and one of the most important things to remember was to breath appropriately and to also try to time your breathing. This is to control the rate at which you speak, the tone of your voice, the volume of your voice — posture helps these things too. I highly, highly doubt that this in any way affects one’s health.
In endurance running, I focus on regular and deep breathing, and have tested some breathing techniques. I don’t think it matters for my leg muscles, but certainly I feel more relaxed if I take longer & deeper breaths while running. I have done various things like practice breathing through the nose versus mouth. Because the nasal passage is narrower, it requires a slower breath, with more force to get the same amount of air in & out of the nose compared to the mouth. Maybe this technique strengthens my diaphragm, not sure. Again — I highly doubt these things actually affect the O2 levels & CO2 clearance in my muscles — that probably is more strongly affected by cardiovascular health (muscle vascularity and iron & hemoglobin levels, heart rate, etc. ). I also play tennis and I have to say that I don’t think about breathing one bit while playing — except that vocalizing during a hit does, in fact, make me hit the ball harder. Not sure why, probably has to do with core/abdominal-muscle contraction. I’m not a good tennis player, though.
All these anecdotes don’t lead to the conclusion that there’s any sort of optimal breathing techniques in general — especially not that “coherent breathing” is a real thing. Just that breathing is part of these activities, in addition to stance, gait, body positioning, limb motions, and muscle control and a strategy for breathing is probably on the list. Your track coach, speech coach, singing coach, swimming coach … etc etc will probably coach on breathing (a little bit) in addition to all the other aspects of the activity — we don’t need a lone guru with a grand theory on breathing in order for empirical knowledge to still be true. I just wanted to put this out there for all the enthusiasts who understand that breathing techniques may be a part of their physical activities, but these truths don’t at all support the coherent breathing-babble.
@Steven Novella
‘ Earthing fits into a category of pseudoscientific nonsense I called “just make shit up.” The existence of claims such as this is an excellent example for why we need the rigors and methods of science – without them to ground us to reality, there is no limit to the nonsense humans will believe.’
Like this?
http://blogs.scientificamerican.com/streams-of-consciousness/2012/05/08/science-remains-a-stranger-to-psychiatrys-new-bible/
http://whyevolutionistrue.wordpress.com/2011/06/25/is-medical-psychatry-a-scam/
A nice ‘kappa’ coffee anyone?
http://1boringoldman.com/
Is Szasz still a crank?
“Of course they would need to seek out this advice. I’m often surprised that people are so willing to shell out a bunch of money before adequately investigating what they are purchasing. ”
I get to on my occasional evening floating shift at a retail pharmacy part time job, field questions about all sorts of stuff they sell…I will I think start counting the outcomes of these conversations with patients and keep track of how they go….
Anyway, it is quite often that I explain to a patient what homeopathy actually is. Usually they find it crazy…sometimes they do not buy it…other times they go with the “well, it wont hurt to try it will it?”…I told a patient the other night that they would be better off giving the 12 dollars to a charity for children starving somewhere in the world and not lining the pockets of cranks getting rich off of selling sugar pills….yeah, I was in a bit of a mood
My point is, regarding the quote, is that it is even more frustrating and weird, that even after they seek and receive the advice, it seems to not penetrate…but at least some of the times it does.
Is it possible that one day we will have a DSM entry to describe those who compulsively seek refuge in the term ‘logical fallacy’? Or perhaps there is one already?
Something just occurred to me: I have this booklet written by a PT that’s supposed to be about how to breathe correctly. And it’s got all these weird motions you’re supposed to coordinate with your breathing, it’s got all these weird visualizations to make it smoother, all this information about what supposedly can happen in your body if you chest-breathe, but what it doesn’t do is explain where the muscles you’re using are located: here are the muscles used in in quiet breathing, in deep breathing, which ones contract or relax when you inhale and exhale… and this seems to be true generally, I’ve never had a PT thing to show me this stuff about any of the exercises I’ve done. They spend years studying this stuff and never think to explain it to patients, even when I explicitly ask, “How should I do this?”
HarryKey,
The Coherent Breathing is definitely in the “make up shit” category as their “theory” takes to philosophy for explanation.
If you are “trained” in NLP then you might want to check the older claims/products/services made by the more famous practitioners. Let’s take Tony Robbins from the 1980s as an example.
A) the acid/base labeling of foods for an alkaline diet ,
B) eating nothing but fruit in the morning,
C) candida and detoxification,
D) stimulation of the lymphatic system through deep breathing cleaning toxins.
A) Lacked scientific merit when sold to followers, merely a hypothesis. This was a staple of “living health” seminars, shown to now be harmful.
B) Lacked scientific merit when sold to followers, merely a hypothesis. This was a staple of “living health” seminars, shown to now be harmful. (basically an extension of the low fat fad of the 80s)
C) Lacked scientific merit when sold to followers, merely a hypothesis.
D) Lacked scientific merit when sold to followers, merely a hypothesis. This was a staple of “living health” seminars, shown to now be harmful.
Scientific merit requires searching for volunteers, doing controlled studies, replicating the data, then waiting for independent verification. I find it quite odd that with all of Robbin’s money from selling speculation, tens of millions of dollars, none of it is or was ever used to scientifically test the claims he made/makes. A,B,C, D could have all been done easily, especially with all the compliant customers he has, for under $1 million. Testing the claims of NLP requires volunteer subjects and time on fMRI machines, again, easily done with $1 million.
Buteyko is the same thing: speculation and selling a hypothesis for money. You use good words: “science sounding”. Exactly. “sounding”. The science does not support claims made by the quacks. These gurus have access to compliant, paying subjects, millions of dollars at their disposal, (an experiment scientists dream: scores of people who pay to be tested on) yet no experiments are done. That’s funny.
Your other good writing: “The story I’ve heard”. Exactly. The story told to get money from the credulous.
As always I’m impressed by your laser-like precision at dissecting these criminal(!) organizations, Steven. I’ve recently self diagnosed myself as a life-long Skeptic (thanks to the SGU) and every episode and blog I add to my Bullshit Detector Kit. Thanks mate!
(hope this post wasn’t too sycophantic)
@emanresu
I don’t think you have quite got the gist of what NLP actually is have you?
HarryKey: “that by mouth/chest breathing we’re huffing out too much CO2.”
Do you know what the rationale for this? I would’ve thought it more likely that the opposite would be true. If the air in our lower lungs isn’t being turned over as often as it should be, would it not carry more CO2 than ‘chest’ (upper lung) air?
SARA: “SteveA, Thank you! I have been following a link path through wikipedia from you Peczely link. I haven’t had so much entertainment in weeks.”
My pleasure. Glad to hear it’s doing someone some good.
@ Dirk Steele
It wouls appear that emanresu was simply discussing the other junk science promoted by Tony Roberts.
Which is reasonable enough since discussing the failures of NLP is about as necessary as discussing the failure of flat earth arguments.
“My point is, regarding the quote, is that it is even more frustrating and weird, that even after they seek and receive the advice, it seems to not penetrate…but at least some of the times it does.”
Yeah. As frustrating as it is sometimes, the message isn’t always lost. Sometimes, even if at that moment the person expresses doubt about the information you are giving, some of that information will stick with them. Slowly over time they may come around to that position (or closer to it), much like how attitudes change over time in general. This is especially true if they get the same information from multiple sources over time.
“Is it possible that one day we will have a DSM entry to describe those who compulsively seek refuge in the term ‘logical fallacy’? Or perhaps there is one already?”
Hmm. I wonder how that relates to people who take refuge in thinking fallaciously. That seems to be a more common problem
@bgoudie
Do you mean Tony Roberts, the welsh football player or the American stand-up comedian?
I totally agree with your second sentence. NLP is pseudoscientific ‘entertainment’ that has spawned a new age cult. It is scientology minus the thetans. Unfortunately, the organisation still has to pay tax! Richard Bandler and John Grinder were not quite as smart as L Ron. eh?
@ccbowers
‘I wonder how that relates to people who take refuge in thinking fallaciously.’
This has happened in all societies. The myths that underpin the cohesiveness of that society that allows for co-operative behaviour. The unwritten laws of culture that we are unconscious of until we experience a different culture and make the mistakes. Like the rules of grammar that we instinctively use but cannot fully understand or explain until we learn a foreign language. Try this bloke’s ideas. Skip the administration bits and take a little time to digest. Metaphorically speaking…
You will not be disap pointed with the points made.
http://faculty.buffalostate.edu/rabinrl/103/podcasts/index.html
“The unwritten laws of culture that we are unconscious of until we experience a different culture and make the mistakes. Like the rules of grammar that we instinctively use but cannot fully understand or explain until we learn a foreign language”
Dirk, you take my statement too literally, it was really a rhetorical question. Your link appears to be a series of lectures for what seems to be an anthropology class of some kind pretty close to where I currently live in upstate NY. I do find the topic interesting to some degree, and although it certainly helps to compare/contrast to other cultures you can certainly examine from within.
@ccbowers
‘it was really a rhetorical question.’
Exactly. Just listen to the first 2 lectures… if you do not want to continue… then next time I am in Hell’s Kitchen I will ply you with drinks at a venue of your choice….
Dirk,
Annoying rhetoric on your part. NLP is garbage because the explanations given for “why” (theoretical foundations pulled out of their ass to explain an observation) have not stood up to scientific evidence for the last 30 years. Reading the wikipedia might be a good start. Perhaps you, like Grinder and Bandler, are more interested in sex with minors than testing the hypotheses of NLP psuedoscience — rhetoric is annoying, please refrain, thanks.
@emanresu
‘Perhaps you, like Grinder and Bandler, are more interested in sex with minors than testing the hypotheses of NLP psuedoscience — rhetoric is annoying, please refrain, thanks.’
If you said that to my face I think I would respond with something far more physical than rhetoric. I have already stated that NLP is psychobabble earlier in my comments. If you have trouble in understanding the English language I suggest you go finish your homework.
@ccbowers
After the first two Section 1 lectures you may want to jump to Section 3, lectures 1 and 2. Although you may miss much in the process of learning.
http://faculty.buffalostate.edu/rabinrl/103/podcasts/index.html
Even if you disagree with Ron Rabin, it will give you a better understanding of the position of Szasz than Steven Novella can ever express. So it is educational, in that, you may think differently afterwards. Which is my favourite kind of education. Thanks.
@ SteveA
It’s covered quite succinctly in the Wikipedia article on Hyperventilation – and I will admit that at first glance the idea seems a bit silly. The wiki article even mentions how counter-intuitive it seems.
But yes, the science seems quite valid: There should be a certain balance of CO2 to remain healthy. Mouth breathing seems to be a reasonable culprit for ‘carbon shedding’ – which upsets the blood pH and makes it alkaline (I think) and causes the system to dump bicarbonate to regulate the pH.
@ gr8googlymoogly
I get that your question is rhetorical, but I could have received training in homeopathy. The training is not what is in question, it’s the rationale behind it.
There are some elements to NLP which are clearly quite obvious and effective – particularly relating to rapport and our empathic responses. Mirror neurons would quite adequately describe how mirroring works. The work of Milton Ericksson in hypnosis is quite accepted scientifically, but that nutbag Bandler has done a lot to make the whole field to look like magick.
But yes, NLP is at its core a stinking great pile of pseudo-science with some gems of science hidden in there. To be honest, most of the work in psychology is still pretty pseudo-scientific.
I generally use the bits of NLP that work for me and avoid mention of it when in educated skeptical company.
@emanresu
Yes I am using these terms to openly admit I don’t ‘know’ well, anything, but let’s not get epistemological.
But that doesn’t mean I just made it up:
Hyperventilation: “Counterintuitively, such effects are not precipitated by the sufferer’s lack of oxygen or air. Rather, the hyperventilation itself reduces the carbon dioxide concentration of the blood to below its normal level because one is expiring more carbon dioxide than being produced in the body, thereby raising the blood’s pH value (making it more alkaline), initiating constriction of the blood vessels which supply the brain, and preventing the transport of oxygen and other molecules necessary for the function of the nervous system.[4]” – http://en.wikipedia.org/wiki/Hyperventilation
So the rationale behind what I teach (which is most definitely not Coherent Breathing) is that by breathing less, slower, through the nose (so the nostrils slow the flow and the mucous covered hairs filter and moisten the air), one will experience a calming sensation.
They will be comfortable and more capable of speaking to groups, asking out girls or just dealing with deadlines. Now the power of suggestion in my voice and choice of words is laid on thick when I run through these exercises (which is very intentional – to harness the power of suggestion). I am not clear on what is the difference between the placebo and the actual effect. I am also not sure if that’s important, because I’m not dealing with science, I’m dealing with people’s subjective experience. I can tell you this (from anecdotal experience): Panic breathers show far greater improvement from these exercises.
“Given that I’m trained in NLP”………………….zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz oh sorry did you say something else ?
You come to neurologica and admit that !