Ed Harrold and Sat Bir Khalsa, Ph.D. explore the psychophysiology of slow yogic breathing and the growing field of yoga research.
Ed Harrold with Sat Bir Khalsa, Ph.D.. Originally published on YouTube September 23, 2021. Watch the original conversation on YouTube.
Ed Harrold and Sat Bir Khalsa, Ph.D. explore the psychophysiology of slow yogic breathing and the growing field of yoga research.
00:05.1 Hello again, friends. Ed Harold here. Welcome to our Life with Breath Expert series. Today, we have one of the most amazing human beings on earth, one of the top yogic researchers in the world, and I'm really excited to connect with Sat Bir today. I'm glad you're with us. Welcome back, friends. What a great hour we have for you today. It's always great to have someone on the program who knows what he's talking about. So we're really excited to have Sat Bir on today. But before we dive in to our experience with Sat Bir, let's just take a couple minutes and get ourselves grounded and connect with our breath.
01:02.7 So if you can, and if it's safe for you, let your eyes close. Become aware of your breath and just gently plant your feet down onto this beautiful planet. See if you can release any tension around the trunk of the neck or the shoulders. Kind of settling into your heart space, this beautiful thoracic cage. Release and relax any tension that might be... Begin to turn off the thinking mind and open up the feeling mind. Let's do a little technique to work on the process of exhale, this amazing half of the breathing technique that sometimes gets a short shift in the world. For those of you that wanna move your arms, that's fine.
02:09.9 For everyone else, just keep your arms on the legs. If you wanna choose to count, you can count. If not, just use intuition. We'll start with palms up. Inhale your arms overhead. Hold the breath in for a two-count. And then exhale your hands for a four-count, slowly back to your thighs. Take a resting breath. And then inhale. Sweep the arms overhead. Hold the breath in for a three-count. Release your hands for a six-count, slowly back to your thighs. Release your shoulder girdle, the upper back and chest. Take a slow-motion resting breath. Sweep the arms overhead again, holding in for a four-count. The exhale will be for an eight-count with an ocean sound when you're ready.
03:21.4 Begin to create more space in your life, releasing any old stress, affliction, pain. Resting breath. Two more, sweeping the arms overhead, holding in for a five-count. The exhale will be for a 10-count. If you're familiar with the yogi- yogic locks, draw up on them. Releasing slowly, really riding that exhale and all the benefits of carbon dioxide slowly out through the nasal channels. Resting breath. Reset the heart rate. Last round. Sweeping those arms out wide. Open your heart and lungs. Holding the breath in for a six-count, drawing up on the locks if you're familiar with them. The exhale will be super slow. Move the arms in rhythm with the exhale for the 12-count.
04:27.4 Take a resting breath. And I invite you to breathe as slowly as you possibly can without straining for the next spaces of time of your life, and really absorb this information that you're going to hear through your sense organs, through the belly, through the heart and lungs, and through the ears and eyes. Take a deep breath in through your nose and just exhale out with a soft sigh. Ah. Welcome back, everyone. Today we have the amazing Sat Bir Khalsa with us. And Sat Bir is a director of yoga research for the Yoga Alliance and Kundalini Research Institute, a research associate at the Benson Henry Institute for Body-Mind Medicine, a research affiliate with the Osher Center for Integrative Medicine, an assistant professor of medicine at Harvard Medical
05:47.9 School at the Brigham and Women's Hospital. He has conducted research on yoga and yoga therapy since 2001, and has been a practitioner instructor of Kundalini yoga since 1973. His research has evaluated yoga for insomnia, chronic stress, anxiety-related disorders, and in the workplace and in the public school setting. He works with the International Association of Yoga Therapists promoting yoga research as a scientific director for the Annual Symposium on Yoga Research as the editor-in-chief of the International Journal for Yoga Therapy. He is a medical editor at Harvard Medical School, special report instruction to yoga, and the chief editor at the medical textbook Principles and Practice of Yoga in Healthcare.
06:41.8 And without any further ado, ladies and gentlemen, Mr. Sat Bir Khalsa. Welcome, Sat Bir. Thanks very much, Ed. It's a pleasure to be here. You've got a very dynamic resume, sir. You've been in the game a long time. Obviously, your own personal practice beginning back in 1973, and now this has led to the amazing research that you do for humanity so that we have the foundational framework that we can show the value in yogic therapeutic therapies. What... Where was the point along the line where you began to see that, "I, I wanted to do scientific research and turn this into something more than just my personal practice"?
07:27.7 Well, I was always, uh, fascinated with science and research and, you know, I got my bachelor's degree in, in sort of math and physics in that direction. Um, and around that time in the early '70s, I, you know, I found yoga, uh, and began, began a sort of lifestyle practice. I moved into an ashram and did the whole, you know, the whole practice. You know, lived in a ashram community in Toronto in Canada and, you know, the whole community would get up in the morning at 3:30, and we'd do two and a half hours of our morning practice, which included an hour of yoga and then mantra chanting and meditations.
08:06.9 And, you know, I was immersed in that, that lifestyle and sort of left that whole academic thing. But then a few years later, uh, my passion for science sort of reemerged. Um, but this time I was really interested in, you know, the experiences that we were all having with these yoga practices. And so I set a goal at that time, this was around 1975, 1976, of wanting to do research on, on yoga and its practices and its benefits. And, um, so then I went back, uh, picked up some coursework, got into graduate school, got my PhD in neuroscience. Um, but it, it took a while because there was really no opportunities to do research on yoga at that time, so I was really doing sort of conventional research, and it wasn't
08:53.6 until 2001 when the National Center for Complementary and Integrative Health of our National Institutes of Health was actually funding research grants in this area, and I happened to be in a... working in sleep and biological rhythms. And so I, uh, sent in a proposal, a grant proposal, to do research on yoga for chronic insomnia, and that was funded, uh, for... with a five-year research career award, and that really started me off. So that was 2001. So the good news is that, that, y- you know, I was off and running and doing what I had planned to do, but the, the interesting part of the story is that from the time
09:33.5 that I set the intention till the time I started doing the research was 25 years. So, uh- Yeah ... the lesson there is that patience pays in science and research. Well, you know, there's always, there always seems to be resistance to change. Uh, and we see it especially in the scientific community. You were way out of the, way out ahead of everybody i- in regard to how you could see the benefit for the modern ailments of, of the human being, and just the way your heart just opened to wanting to give folks a solid scientific background in regard to the benefits of what a yoga therapeutic practice might look like.
10:22.6 Gosh, I just tip my hat to you, sir, because there hadn't- There had to be a lot of nos along the way. No, no, no Well, the nos- You know, there were some nos that were really sort of pronounced. I remember, um, when I was, uh, contemplating graduate school, I was interviewing a number of the faculty in the department, um, and, and looking for an appropriate faculty to, to, to mentor with, and I happened to be with the chair of the department, and he sort of asked me what my ultimate goals were, and I kinda let it out. I said, "You know, well, I'm interested in studying altered states of consciousness and yoga and meditation practices." And he basically said, "Well, if that's your plan, I suggest that you not go into science at all."
11:09.2 So he had really no value for, for, for, you know, what I was thinking of doing whatsoever. Um, so that was a clear no, but you know, when you're in your early 20s, you're pretty much indestructible, so, uh, you know- Yeah ... that, that, that didn't really slow me down in any way. But it, it is a cha- it has been a challenge. It's, it's a field that you don't go into if, if you want to, you know... It's, it, uh, you know, as I tell young trainees and young people who wanna start in this field of yoga research, I mean, it's a, it's a form of s- career suicide in a s- in a sense.
11:40.6 Right. Um, because you're, you're doing something that's very novel, um, that a lot of people don't understand, and, and a lot of people are the ones that, uh, are the ones that sign off on the grants, whether you get money. They're also the ones that review your papers when you try and publish them. So it is, I think, a little bit more of a difficult field to, to survive in, um, than conventional research and conventional medical approaches. Well, I think with you having that yoga mindset, I think it, it, it, not that it's ever okay, but it's, you know, the patience that you have and your ability to
12:15.0 keep moving forward and, you know, just letting things slide that aren't part of what you're trying to do, I think that's a big part of, of, of your make- makeup as a person. You know, I remember when I first was introduced to you by Stephen Cope, and Stephen had this idea of, of measuring athletics, uh, through, uh, yogic principles, and I reme- I'll never forget the first phone call that I had with you, and I, you know, I was, I was this young kid and I, you know, I thought I knew it all, and I was so nervous. I was getting a, on a phone call with, with Sat Bir, and I, I was telling you what I w- what I was doing and, and the benefits I was getting a- and you said, "Well,
12:57.4 well, Ed, how do you know?" I said, "Well, I do this, I do that, and this happens," and, a- and he, and Sat Bir said, "Ed, well, how do you know?" And then I, I said it again. Like, "This is what we're doing. We're doing this pranayama, we're doing these therapeutic postures, and we're doing this meditation, and these are the results." "Well, how do you know?" And it was just like, "Well, maybe I don't know." It, it was just so beautiful, and that was my first entry into what research requires, and it ha- doesn't have anything to do with the facilitator's personality. Uh, it, it has to do with hard science and repeating the same techniques over again at a certain time of day, and hopefully
13:44.5 having a control group who's not getting the work. I mean, it is, it is challenging, to say the least, and the way you held me accountable, it opened me up to a whole nother way of trying to get data, hard data, to provide to you for research. So thank you. Oh, no, you're welcome. I think. Yeah. Well, no, it's, it's, it's critical. I mean, uh, you know, if we really want to move yoga forward in society, we have to use society's language and society's mechanisms for bringing that into society, and that language and those mechanisms are research. It's the language of research, it's, it's the, it's the research design, it's the documentation, it's the measurement that is what is the real currency
14:39.0 in modern society. This is the way we can justify bringing yoga into the healthcare system, into the public schools, and into the workplace even, um, by this kind of, uh, research. You know, on a grassroots level, it doesn't matter. I mean, people, you know, most of the people that practice yoga didn't come to yoga because they read a research paper. They came to yoga- Right ... 'cause their neighbor solved his headache, or the person across the street- Mm-hmm ... fixed his knee, or, you know, someone else said it fixed their stress. And so it's, it's a grassroots movement that's going by, uh, who you know and, and, and by word of mouth.
15:12.5 But if you really wanna get it, um, deeper into society, you need the, you need the scientific basis, and, and that's where you're gonna convince policymakers, uh, people who are district supervisors of school districts, people who are directors of clinics, um, people who are CEOs of major corporations. It's tho- those are the people that are gonna wanna see the, the facts. They wanna see the, the, the measurements and the, uh, before they, you know, make the investment and the decision to, to incorporate yoga. So, you know, in, in today's world, 2021, we see various different, uh, illnesses that seem to be stress-related, uh, disruption to the nervous system, disruption to the natural rhythm of the human organism,
16:03.0 and you've been able to create psycho-physiological platforms to bring people back into balance. What does that look like today? What's the normal client that, that you see today? Uh, what- what's the prescription that you generally are prescribing right off the bat to folks? Well, you know, I'm not a, I'm actually not a clinician, so I don't do prescription, but- You know, if, if, if people ask me the general question, so, you know, so, you know, "How does yoga work and what's it good for?" Um, I really have to say that the most important and immediate benefit that people experience from yoga practice is management of their stress, their stress tolerance, their stress, uh, coping ability,
16:53.6 their resilience to stress, their ability to bounce back. And that really is, is, is of most value. And that's because, you know, we are, in modern society, undergoing a real epidemic of chronic stress. And chronic stress n- goes really deep. I mean, it is the basis and a strong contributor to many, many disorders and diseases, especially mental health conditions. And so our modern society really doesn't have much of a solution to that except for, you know, pharmaceuticals. And, uh, yoga is a behavioral practice that allows people to prevent that stress and prevent the onset of these types of disorders. So that is really a, a critical thing, is that, th- that when you practice these techniques, it's prevention.
17:42.9 It's really, uh, allowing you to cope effectively. It's making you a better functioning human being. Um, and that's going to reduce your disease burden. It's also going to, on the other side, it's going to improve positive psychological states. It's gonna improve your state of wellbeing, your, your comfort, your, um, uh, your quality of life, uh, and e- even to some degree, your spirituality. Yes. Yes. Now, I understand that you had an amazing paper published last year. Can you let our viewers in on what you were able to discover, have, have put out there, and then how is it helping people today? So yeah, we, we started, uh, work in my lab on yoga for anxiety-related disorders, and that actually began, as you mentioned, with Steven Cope.
18:32.6 But we were, uh, looking at, uh, young adult musicians at the Tanglewood Music Center and, uh, looking for the benefits of yoga, and found that indeed yoga could really help with their music performance anxiety. You know, and we, we tried to get grants and continue that line of research, but, but were not able to. But then, you know, w- I was working with some, uh, clinicians who were applying yoga to their generalized anxiety disorder patients, and we published a couple of small trials. And then I d- um, you know, worked with a couple of v- very high level collaborators to get a grant from NCCIH, uh, which was a multi-site study of a yoga intervention
19:11.1 for generalized anxiety disorder. Um, and, you know, this was a six-year-long study, $4 million of, of federal funds for this, and we were fortunate enough to get really good results. We showed that the yoga intervention that we used, which was a Kundalini yoga practice, um, was almost as effective as the gold standard of treatment for generalized anxiety disorder, which is cognitive behavioral therapy. Um, so really nice strong results showing, uh, really good efficacy and, and we were able to get this published in one of the leading, um, medical journals, uh, Journal of the American Medical Association Psychiatry. Um, so the beauty of that, the beauty of getting these kinds of strong studies published in really top-notch journals is that that's what has the impact.
19:57.4 That's what leads the field. Other researchers will pick that up and do their own trial. You get stronger trials, you get more trials, you build up a, a, what we call a critical mass of evidence. And then suddenly there's reviews and, and meta-analysis or statistical analysis of those papers. And ultimately, when the body of evidence grows big enough, there are policy statements and so-called consensus statements by leaders in the field, and they will then publish those, and that's what makes it into the clinician's office. That's what gets published in the journals that, uh, everyday clinicians read. And if clinicians read it, then, you know, they're gonna recommend it to their patients.
20:36.2 You know, so someday, at some point when this, when this field of research grows a little bit more because of this kind of work, you know, the clinician will be able to say, "You know, I can offer you this, uh, this pharmaceutical for treating your anxiety disorder, but, you know, there's a, there's a growing bo- research on yoga. So, you know, if you want, you can maybe go and try that first, and if that doesn't work, we'll, we'll talk about a pharmaceutical. And that's beautiful because now we're, now we're looking at a behavioral strategy that not only, uh, cures the symptoms of the disease but also prevents, you know, further relapse.
21:10.5 And most importantly, it's addressing the underlying, uh, issues with the disease. 'Cause a pharmaceutical doesn't give you any new skills. It just basically- Mm-hmm ... you know, changes, you know, things in, going on in your, in your central nervous system artificially. Mm-hmm. And a lot of times when you stop taking the pharmaceutical, the, the disorder comes right back. But with a behavioral intervention like yoga, you're learning new skills, and those new skills stay with you forever. So suddenly you've got what is essentially a permanent fix, uh, for this issue. And that, that just must make people feel so amazing that they are able on their own to self-correct
21:52.2 on the fly or un- unplug from that uncomfortable, painful memory and bring themselves back present. When, when you're speaking of yoga, I, I would assume that there, there is a, there's a pranayama practice, there's a, there's an asana practice, and, and there's a meditation practice. So we've got three platforms that we're bringing together, and when you were putting, uh, the work together, w- was there something in, in, in the research, in what you were prescribing that, that even surprised you? Was it a breathing exercise or was it a particular way you taught a series of postures or was there a meditation technique that simply lit up everybody's brain?
22:35.7 Well, I mean, we designed the, the intervention to be a pretty much thorough application of, of yoga- I bet ... practices. And, and, you know, when I talk about yoga practices, most yoga researchers are really applying traditional yoga. We're not just doing asanas. Uh, we're doing- Mm ... traditional yoga. And I like to conceptualize that in terms of four components. Um, so we have the asanas, we have the deep relaxation practices, typically a shavasana, we have the breathing techniques, the pranayama, and then we have the meditative practices. So those are the four components that most researchers are really studying, and that really sort of reflects, uh, you know, traditional yoga practice.
23:15.4 Now, there is a good deal of evidence that, um, breathing techniques have an input, have a value for generalized anxiety disorder. There's trials that have shown that simple exercise can improve generalized anxiety disorder. Relaxation techniques have been used, uh, to treat generalized anxiety disorder. And recently we also have studies of meditation and mindfulness that, uh, have eff- have been shown to be efficacious for the treatment of generalized anxiety disorder. So if each one of those four components has been shown to have efficacy, it's no surprise the traditional yoga that puts them all together would have- Mm ... at least as much , if not more efficacy.
23:54.3 And the other beauty is that different people experience anxiety in different ways. So if you're coming at them with four different components, it's likely that one of them is really gonna, you know, work for them really well. Right. Um, because there are people who fail from, you know, the standard cognitive behavioral therapy for generalized anxiety disorder. There are treatment failures for that. And so it may well be that yoga may be able to pick up those individuals and, and, uh, solve their, uh, issue, um, you know, with, with these four components of traditional yoga. Well, obviously the human body is, is super intelligent. The brain, full capability.
24:33.3 The mind, it, it, it's unbelievable. When, when you work with the controlled breath a- and you move your soft tissue in, let's just call it non-traditional ways, ways you wouldn't normally move it, you know, going to work or in your 9:00 to 5:00 mind, how does that controlled breath with moving the fascia and soft tissue and the spine in all these different non-traditional directions, h- how does that help the brain help us with pain and anxiety? So the research on, on breathing practices as, as therapy and as, and, and effects, and effects on internal state, both psychological and physiological, this field of research is really exploding.
25:19.1 And perhaps the most, um, studied form of breathing, which is the most common form of breathing in yoga, is the long, slow, deep yogic breathing. You know, different yoga traditions call it different things. Some people call it two-part breathing, three-part breathing, abdominal breathing, belly breathing, uh, yogic breathing. The, the main, the main issue is that you're breathing with your entire torso. So the abdomen's coming out on the inhale and so on. So you're moving, you're breathing with the entire torso. But the most important component really is that you're going slow. You're slowing the breath down. And, um, research is really starting to show phenomenal changes to, um, you know, slow breathing.
26:00.7 And, and this is happening at many levels. It's happening on the physical level as you're talking about. You're moving the body. You're, you know, you're, you're, you're moving the body in very different ways than, than you're, if you're doing shallow chest breathing. Um, but you're also doing things with gas exchange. You're also affecting the central nervous system. You're affecting the autonomic nervous system. Uh, and you're making long-term changes as well, um, because, uh, you know, we as humans have the ability to change our breathing pattern. This is not something that animals have. So, um, this is allowing us to, to modulate our internal state. Um, and yoga also has, in addition to the slow breathing, of course, many different breathing practices.
26:42.6 The fast breathing techniques, Kapalabhati, breath of fire, um, uh, Bhastrika and so on, the alternate nostril breathing. Um, and so we have a whole, you know, sort of panoply of different techniques that, that we can use with different effects. And so it's, it's really, um, amazing what, what we're seeing with the science and, and, uh, it's starting to be used clinically Well, it, it's great that you have the ability to see scientifically that what you're doing is working. I mean, that really puts you at the front of the line any time you, you, you wanna get a grant or, you know, something like that, and you can show that you have this research in
27:25.6 your handy book from the past. I mean, I just think that's fantastic. You- why do you think that out of all the senses, what, what is it with the breath that seems to have the most profound effect on the mind and body? Well, that's a great question. Uh, it's a great question. Why, why is it that we can control the breath and then influence our internal state? Um, and this whole idea of influencing an internal state is, is, you know, a form of self-regulation. The ability to, through these yogic practices, to control our internal state. And, you know, pranayama is just one of those techniques.
28:06.9 We do the same thing when we meditate, do- we do the same thing when we do asanas. Um, but I suppose one thing about the, the breathing pattern is, is that we know even in mammals that there's obviously a very, very strong connection between internal psychological state and our breathing pattern. So we know when we get fearful, our breath rate increases, becomes more shallow. We know that when we're sleeping, our breath slows down. We know that when we, um, uh, become passionate about something, our breath takes on a different breathing pattern. Crying is associated with a whole, you know, very different breathing pattern. So is laughter.
28:49.7 Um, so we know that- Mm-hmm ... that the expression of, you know, the emotions and, and stress and other psychological states are very clearly manifested, uh, in, in breathing alterations. So what yoga's basically doing is j- just driving the system in reverse. You're doing breathing patterns to generate certain specific states. And, um- Mm-hmm ... and, you know, we can show, and some studies have shown, that sort of very shallow chest breathing can generate anxiety. Uh, and that's- Mm-hmm ... often the breathing pattern that people with anxiety have. It's a very shallow, so just, you know, chest breathing. And, um, when, when, when you breathe a lot slower, you're basically, you know, calming the system down.
29:33.0 So there's research studies that convincingly, you know, have convincin- convincingly shown that slow breathing, um, allows you to tolerate pain more effectively. Mm-hmm. Slow breathing allows you to have less stress reactivity. You're able to cope with stress more effectively. Um, you're able to cope with emotion more effectively when you do slow breathing. So there's a very strong impact on the central nervous system and on the autonomic nervous system. Um, when we do slow breathing, the autonomic nervous system is responsible for cardiovascular control. So when you engage in slow breathing, you immediately reduce blood pressure. Um, and so this is really, uh, a fundamental feature of this whole idea that w- we can, as humans, you know, self-regulate
30:23.8 our breathing to generate, um, these desired effects. And the neuroscience is starting to catch up with this as well. So, um, there are regions in the brain whose neural activity, uh, of all the neurons in that region of the brain, is highly synchronized with the breath rate. So you can see these graphs that they've done in these studies where, you know, you see the breathing cycle going up, in- inhaling, exhaling, inhaling, exhaling, and then they show the frequency of firing in these, these neurons in these different regions of the brain, and it's going up and it's going down in sync entirely- Mm-hmm ... with the breathing rate.
30:59.9 And when the breathing rate changes, so does the firing rate, suggesting that there's direct relationship between breathing pattern and central nervous system activity. So this is really wired into our system. Um, and it's not just humans that it's wired into. Um, there's a remark- study I have to tell you about. This, this is really a remarkable, uh, study and re- and really something that, that, that's going to lead to some fascinating research. Um, as I've mentioned, animals don't have this ability to willfully change their breathing rate. So what this team of researchers did was that they conditioned, um, uh, rats in the laboratory to breathe slower.
31:40.6 The way they did this was, um, uh, negative conditioning. Rats don't like flashing lights. So they monitored the rats' breathing, and whenever the rats were breathing above a certain frequency, the, the lights would flash. So pretty quickly the rats learned that if they were breathing fast, the LED lights would come on. And so to avoid that, their breathing got slower, and slower, and slower. They ended up with a population of rats whose breathing rate was essentially permanently slower. They had created slow-breathing rats. Um, and what's amazing is that this parallels yoga practices because when you do pranayama practices over several months, you slow your breathing down.
32:26.4 There was a study that actually showed that people that were engaged in a, in a pranayama practice over several months, they looked at their spontaneous breathing rate, it was slower. So there's plasticity in, in this whole breathing circuit. So that was, that was great, showing that, that, that- Wow ... you know, there's plasticities in animals as well. They took it one step further. They said, "Well, in yoga, and, and in slow-breathing practices, the idea is that this will help improve stress regulation and emotion regulation. So let's test this in the rats." So they took their regular breathing rats, their fast, regular breathing rats, they took their slow-breathing rats, and they gave them ...
33:02.5 They exposed them to a stressor in the laboratory. And they found that the stress response to the slow-breathing rats was less than the stress response in the fast-breathing rats. So this is actually a animal model of how- Mm-hmm ... slower breathing can actually self-regulate, um, nervous system, uh, activity. So this is really amazing 'cause now i- in, in an animal model, we can now start to determine exactly where this is happening in the central nervous system, and which nuclei in the brain are happening, and how these changes are taking place. So this is really gonna give us some solid foundation and understanding of, of, uh, the, the efficacy of pranayama.
33:41.1 And scientists are not just ha- scientists and pol- policymakers are not satisfied with just seeing that slow breathing, uh, does these things. If they can see the mechanism behind it, that just gives this an extra push that says this is not just a, a, an epi phenomenon, this is a real phenomenon and we know the mechanism. And when you get down to the mechanism level, that's when you really start to change heads a- and turn things around with respect to credibility. Where would folks find that research, Sat Bir? Well, I mean, most research is published, um, and available o- on PubMed, which is a government, um, website that, that, uh, lists all of the
34:24.4 publications that are done, um, in, in medicine for, for that matter, in all the major medical journals. Uh, so it's P-U-B-M-E-D. And, and you type in the word yoga or you type in slow breathing and, and, you know, you get all of the hits of the studies that have been done. Um, so that's, that's one way to find this. I mean, to do that you'd probably do a search of something like rats, slow breathing, uh, stress and, and, uh, and see what comes up. So when, when we're dealing with anxiety or more stress than the system can handle, pain, it seems to me that the pace of your breathing will be a reflection
35:10.8 of the pace of the film in your mind, and how you're interacting with that film. So if you've been triggered and you're breathing rapidly unconsciously, the film you're watching in your mind will have a tendency to move very, very quickly, and there's a lack of, say, coherence between the heart and the brain. If we're breathing slower, the pace of the film is slower, and we have the ability to be plastic with the film because the pictures are moving slower in the mind. Would that be a, a layman's explanation of what's happening? Well, it's an interesting way to put it. It's more of an artistic way to put it than a sort of a accurate, uh, way that the central nervous system works.
36:02.8 What we're really talking about is neural mechanisms. We're talking about that when you breathe slower, there are certain neurons in the brain that are affected by that. Uh, we don't understand yet how that takes place, which neurons, which inputs are happening to which nuclei in the brain to generate that change in, in, in, uh, in emotional reactivity or stress reactivity. But obviously the regions of the brain that are involved in stress and emotional reactivity, the so-called limbic system, is obviously being impacted. So there's some kind of connection between, uh, the res- respiratory regulation centers and, um, this center that's responsible for stress and emotional reactivity that's,
36:45.0 that's activated. Um, and so that n- needs to be worked out with respect to slow breathing. It's starting to be worked out with meditation practice. So we now know that when you meditate, you focus your attention, you're engaging the attention networks of the brain. And this is in the prefrontal cortex. This is in the frontal lobes where your executive regions of the brain, where the attention networks are. And we now know that when you do that, when you focus attention in the attention networks, there's inhibitory connections between the prefrontal cortex and the limbic system. So when you meditate and focus attention in that way, in that relaxed, non-analytical, um, a non-judgmental manner- You are then
37:28.1 sort of sending inhibitory signals to your emotional brain. You're quieting that down. So that's why this experience of meditation is associated with a sense of peace and calm, because you are quieting d- down the limbic system. And over time, there are actually plastic changes that take place, place in the brain. Uh, so for example, um, a study has been done to show that long-term meditators actually have a smaller limbic system. I mean, it's- Mm-hmm ... the, the brain is, is working on this principle of use it or lose it. So the more you're emotionally reactive, the more those regions of the brain are built up and, and ready for you to go.
38:05.4 But if you spend more time sort of quieting that down over months and, uh, years of practice, you're not using that part of the brain as much, it's going to get smaller, and you become less emotionally and less, uh, stress reactive. Amazing. Amazing how we can adapt on the fly heart rates, brainwave activity, spinal posture, hormone secretions, neurochemistry, and how the breath is communicating to all these various systems how to show up in the present moment and, and be conscious and be, and be present. I don't think there's anything on earth more effective that works for everyone across many platforms than meditation. Simply being able to be not externally stimulated a- and being okay in the inner world, and just, and just watch
39:08.3 the show. Right. Uh, there, there seems, there seems to be s- some resistance to this. Why do, why do you think we resist what we require the most? Well, I'm not sure if, uh, it's a resistance. Um, to me, it's basically a lack of knowledge of this practice. I mean- Mm-hmm ... you know, when we're born, you know, we don't come out with a yoga mat. We don't come out with instructions for yoga practice. That's not wired into us. We have to learn these techniques. We have to learn how to meditate. We have to learn how to breathe slow. Mm-hmm. And, um, so it's, it's basically along the lines of a hygiene.
39:47.5 Uh, that's the way I like to talk about it. Yeah. Uh, and, and the analogy is, like, dental hygiene, you know? Mm-hmm. Brushing your teeth, you have to learn that. Your parents te- you, teach you. You, you learn it in school. The doctor tells you about it. The dentist teaches you how to do it. And so you then brush your teeth and you do oral hygiene, and you maintain your, your oral health. You don't get cavities. You don't get gum disease. Um, and that's something that is culturally passed on. So for example, in the 1800s, I mean, this was a big problem in, in, in the schools in the United States, where the kids were having these oral health problems.
40:25.7 They couldn't study because of the pain involved. And so they started implementing dental hygiene into the public schools. Um, there's, there's a study that I saw that, you know, they hired some 270 dental hygienists to go through all the schools in New York State to teach dental hygiene. And then in the '50s, there's these randomized control trials in which i- in one school they sent in dental hygienists and had them do their, um, dental hygiene and a, and a control school that didn't, and they showed that the grades and the performance in the kids in the, in the school that got the dental hygiene was much superior, and their oral health was much superior.
40:59.7 So this is something that, that ... These are, these are practices that we learn. And I like to think of yoga as mind-body hygiene, the techniques for which, um, you know, the, the techniques that we can use to maintain the health of our minds and our bodies. So the postures allow us to keep our musculature, our fascia, our connective tissue, um, our lymphatic system, all the physical components of the body, the skeletal system, keep that functioning well. The breathing techniques to keep our, our breath regulation in track, uh, on track. And of course, the meditate, the med- the meditative practices to allow us to cope with stressors and, and life events
41:45.0 more effectively. And so that's what, that's how I conceptualize this. It's a mind-body hygiene. And just like dental hygiene, I think it needs to be pu- taught in the schools. So that's why my laboratory spent a lot of, um, years, uh, doing studies on yoga in the public school setting to try and demonstrate that, that kids need these kinds of behavioral practices in order to be able to, um, successfully become adults without getting sick, without getting stressed. Um, and interestingly, talking about the breath, one of the things that, that is really anecdotal about yoga practices that incorporate pranayama practices is breathing is one of the things that immediately clicks with people.
42:28.5 And we have students in, in the middle schools and the high schools when we were doing these studies, and they were... The next day after they first learn the slow breathing in yoga, they're, they're doing it before their soccer match, you know? They're doing it before a test to try and relieve their anxiety. They're doing it before bed to try and get to sleep better. It's one of the things that people immediately, uh, start to work with and, and find very efficacious right off the bat. So, so that's the way I conceptualize it. It's something you have to learn. It's something you have to be taught.
42:59.3 Mm-hmm. Well, when we're talking about yoga and, and breathing, it, it's hard not to talk about, I guess fundamentally the phrenic nerve, the motor nerve for the diaphragm, and having an efficient range of motion and strength, flexibility with the diaphragm muscle between the chest cage and the abdominal cavity. And then this amazing vagus nerve, this 10th cranial nerve that just is so wonderful for the gut, brain, and gut health, and insulating ourselves maybe from disruptive emotions or high levels of inflammatory markers in, in, in the body. In the, in the kundalini yoga tradition, obviously, you know, it's about energy, big time, and then managing that energy with the vagus nerve and neurochemistry secretions to support that.
43:55.2 I found that strengthening my diaphragm muscle, it's almost like a second heart. It is s- responsible for body posture, the enteric nervous system, the massage of the higher gastrointestinal organs, the stretching of lung tissue. And then when you add in the vagus nerve and all of its qualities, it, it almost is, would seem like a cure-all for the modern ailments of humans. It really has, it really has global impact a- across the body and across psychological functioning. I mean, it, if you look at, um, the physiology of respiration, it's extremely complicated. Yes. There are stretch receptors. There are chemoreceptors. Um, there are baroreceptors or, or so-called, um, you know, blood pressure receptors.
44:55.0 And all of these things, you know, participate in this symphony of breathing, and it just covers, you know, the entire body and the nervous system. It's, it's really a complicated system. So when you start to manipulate one thing, a lot of other things follow suit, 'cause in the body and the mind, everything is connected to everything else. So I mean, I think that's one of the reasons why you do something as simple as slow breathing and you have this re- these remarkable benefits. And slow breathing is so much more efficient than, than regular breathing. Uh, you know, aside from the, uh, psychological benefits, the physical benefits are, are enormous.
45:31.7 I mean, one of my favorites is this whole idea of the fact that slow breathing is so much more efficient, um, in terms of gas exchange than regular slow, um, rapid chest breathing, and that's because you're basically opening up more of the lungs. You're taking, you're giving more time for the lungs to open up and expand. And the way the lungs work is that the larger the surface area of the lungs when they're expanded, the more surface area you have for gas exchange. So it's essentially like when you breathe slow, you're breathing with like an extra lung. Um, and that, that makes your oxygen and carbon dioxide ex- exchange much more efficient.
46:13.5 Now, where that really comes into play is like at high altitudes. Mm-hmm. So for example, uh, if you go up to high altitude, there's much less oxygen in the air. So as a consequence, you know, you may have to take supplemental oxygen. But if you do slow breathing, you can avoid that because you're breathing more efficiently. You're able to use the existing oxygen that's out there more efficiently than if you're doing fast breathing. And this has actually been studied. Um, uh, a, a pranayama researcher of some note, um, followed the Italian team up Mount Everest. And, you know, he was studying, um, the results of their trip up to the top, and he examined those climbers who made it to the top.
46:58.4 Some of them were on oxygen because they couldn't manage without it, and other w- the other ones didn't need oxygen. And what they found is that those climbers that didn't need oxygen had a spontaneous breathing rate that was much slower. Right. In other words, breathing more efficiently. And so they didn't need oxygen at the top because they had the ventilatory capacity because of their slow breathing rate, whereas the other ones who were breathing faster were breathing less efficiently. Essentially, you can think about it as rapid breathing is like breathing with one lung, whereas slow breathing is like breathing with all of your lungs. Mm-hmm. Mm-hmm.
47:34.6 That's, that's just amazing. It, it just verifies a lot of what I, what I believe, and it's great to have scientific evidence to, to back that up. When you think about- Breathing per se, i- it's a muscular contraction and strengthening muscles of inhale and exhale. Whenever I, whenever I work with athletes in traditional Western sports, it's always you warm up the neuromusculoskeletal system, the brain senses the higher levels of carbon dioxide and tells the heart to beat faster, and then lactic acid builds up, and then the brain tells us to breathe. But at that point, it's too late 'cause you've already made the system toxic.
48:22.7 What I have found is that if we warm up the breathing system first, the cardiovascular system second, and the neuromusculoskeletal system third, we become much more efficient in all levels of sport, whether it be endurance or whether it be a steady state run or whether it be a sprint. Has that, has that been something that you've been able to discover along the way? Well, you know, I've not been involved in doing this research myself. Um, you know- Mm ... my topics of research have been more along the lines of mental health and, and sort of global issues like, like chronic stress and, and emotion regulation.
49:06.8 Um, but I think that, that the science is really starting to catch up with this. I mean, um, what slow breathers have is a greater ventilatory reserve. Um, they're capable under challenge of breathing more, whereas people who don't have that ventilatory reserve, they're under challenge, their breathing capacity is already maxed out. They can't do any more to cope with anything else. Whereas slow breathers have that additional ventilatory capacity. One of the things that's, that's accounting for that, aside from the fact that it's more efficient exchange of oxygen and carbon dioxide, is a change in actually in the chemoreflex. People who breathe slowly, um, are less...
49:52.9 Their, their respiratory rate is less driven by hypoxia or hypercapnia, which is basically low oxygen or high carbon dioxide. Um, and that's because they are breathing more efficiently. And so when they are at, in under challenge, like at high altitude, um, they're not breathing as fast and as hard as those people who are spontaneously fast breathers. That means that if they were under challenge under that circumstance, they have a ventilatory reserve. They could breathe more, uh, if they needed to. So that's this whole idea of, of, you know, reserve capacity, which, uh, which probably has a lot to do with a- athletic performance. Um, because, you know- Mm ...
50:37.4 athletic performance, you're pushing the body to its extremes. You know, uh, you can see it in any kind of, you know, aerobic type sport. I mean, I'm a hockey fan. Um, and when- Mm ... you're watching, you know, the hockey game and, and they're starting to time how long the defenseman was in the zone because the other team was all over them, and he's been out there for two minutes, he can barely move kind of thing. Right. It's ventilatory reserve. That's right. That's where this comes into play. And so if you do these yogic practices, you're going to improve your ability to perform, um, uh, with respect to your respiratory system more effectively.
51:12.4 From a physiological standpoint, when we're talking about the slower breathing, what we're really training ourselves to do, I believe, is to stay with the, the product of exhale longer than someone who has an untrained nose or mouth breathing. It seems like the body inhales on its own. It's a natural response to bring life to the inner world. It seems like as a culture, we're, we're short-changing ourselves on the exhale and training ourselves to constantly, you know, have a longer exhale so that when we're not practicing, it happens by the subconscious brain. So the slow motion breathing, that would have to have something to do with a, a, a more disciplined exhale, Sat Bir, wouldn't it?
51:59.5 Well, I'm not sure if it's a discipline. I think it's just an automatic pattern because in that one study that I mentioned in which they took people and had them practice pranayama techniques for- 12 weeks. What they found was, yes, the breathing rate was slower, but in the analysis of where the changes were taking place, it was a little bit deeper, but most importantly the length of time of the breath was really on the exhale. Mm-hmm. So the inhale, yes, it lengthened a little bit, but the exhale lengthened a lot. So in slow breathing, people who are slow breathers, they're spending more time on the exhale, and this is an au- this, I think is an automatic change,
52:46.4 uh, that when you condition the, the respiratory system to become a slow breather, um, the difference is, is really reflected mostly in the exhale duration. Y- i- to simplify a lot of the breathing with, with clients, I do something I call length, depth and pace. So the length of the inhale, the length of the exhale, the depth of the inhale, the depth of the exhale. Right. The pace of the inhale, the pace of the exhale, and when we can focus on growing that, length, depth and pace, it seems to have a tremendous effect on the neurological systems of the brain. Yes, absolutely. How do you feel about that?
53:32.4 Well, I think it's true, but you know, the, the thing about length, pace and, and depth is that these, these things are connected. If you ask somebody to breathe slower, um, they're automatically gonna have to go deeper. Mm-hmm. So these things are, are intimately connected. You can't go slower unless you go deeper. Right. You can't do a- Right ... more shallow breath. You'll turn blue. Right. So, so if you're breathing slowly, you're automatically gonna breathe, breathing deeper. Um- Right ... now interestingly you're not gonna be changing, um, the actual ventilation itself, um, because in rapid breathing, um, you are going more fast, so you're exchanging more quickly.
54:12.7 But the amount of air you're exchanging is much less. In slow breathing, you're breathing a lot slower. You don't have as much opportunity to exchange breath, but you're breathing deeper, so you're allowing more exchange to take place. So really it, it's a similar, uh, pattern. But in terms of efficiency, it's, it's a much more efficient way to breathe. One of the things that I've been able to, to help folks with is m- move them away from mouth breathing, and keeping the mouth closed and re-inspiring the brain and the body through the nasal channel, the sinuses, et cetera. And, and one of the things that I've been able to do is, when we're out of breath and we're making that progression where there's a buildup of toxicity in the brain and
54:55.3 the body, is to use Kapalabhati for just two or three rounds. And it's almost like a cooling breath. It's almost like a reset breath that takes the higher levels of carbon dioxide, it gets it out, it has enough quick oxygen coming in to stabilize the brain, and then after two or three rounds of quick Kapalabhati, we can go back to that slower, deep, rhythmic diaphragmatic breath rather than hyperventilate out into the field and let all that energy out through the mouth. So it's interesting. Y- you can take these breaths of fire, these heating techniques, and just do it for a round or two, and it's, it's almost like it has a cooling effect or a reset or a reboot
55:41.1 effect to the autonomic cardiovascular and neurological system. Amazing. And you're straying into territory that, that, that we really haven't, y- you know, studied yet. There's, there's no studies on this area. You know, the w- the studies, uh, th- there's a really good study that looked at fast breathing patterns, and what they found was that there's really no difference in oxygen and carbon dioxide levels. And you might think, whoa, you're breathing faster. You must be getting rid of carbon dioxide and accumulating oxygen more rapidly. Well, no, because you're using up the oxygen more because it's a very, um, active breathing pattern, and that active breathing pattern
56:19.8 is generating more carbon dioxide because you're putting more energy into the diaphragm muscle. The other thing with the fast breathing is that if you're breathing very fast, you're breathing very shallow as well. And when you breath- Right ... when you breathe very shallow, what you're doing is really exchanging the dead space, which is the space between the back of your, uh, back of your mouth and, and the top of the lungs. That is- Fascinating ... that, that dead space is, is, is a lot of what's being exchanged, so you're not really getting that change in the lungs. However, it's, it's quite possible that Kapalabhati is doing something with the coordination of the, of the diaphragm and the way the diaphragm works
56:59.1 that is having a positive benefit. It's a very aggressive and very active form of breathing, and so when you stop that breathing pattern, it's kind of like a tension release phenomenon, um, that you do something very active and then suddenly you relax deeper than when you were before you started the breathing pattern. This is, uh, you know, this tension release phenomenon is, is typical in muscles. So if you just measure the tension of a, a specific muscle, say your forearm, um, and then you tense it really, really tight and hold it, then you'll measure the tension and you see the tension is a lot. Then you release it and let it relax.
57:34.9 It will go down to a relaxation level below the baseline. So although Kapalabhati and these fast breathing techniques are very, um, sort of very active and very effortful, the phenomenon may well be that after you're done, you go down to a deeper relaxation state. So there's a lot- Amazing ... to be learned here. There's a lot of complexity, as I say, in, in this, in, in the respiratory system. And so, uh, I think this is a very exciting area of, of research that, that we have to look forward to in pranayama. But y- there, there must be going, g- more going on than O2 and CO2 being exchanged.
58:15.8 We, we ... You know, in other words, it, it appears we're inhaling and exhaling the same amount of oxygen. In other words, we have CO2- Right ... two oxygen molecules with the carbon- Right. Right ... and then we're inhaling ox- Right. Right. So- Now, the carbon's- Right. We see this misconception. Right. A lot of people think, and, and it, this is, this is a fault of many yoga instructors. They'll say, "Oh, slow breathing gives you more oxygen. You know, the world is walking around oxygen deprived, and when you do slow breathing, you bring in more oxygen." You know, it's not true. Um, this is a major misconception.
58:50.1 Um, the oxygen level, our, our, our bodies are really geared towards keeping oxygen at 100%. It's only people with COPD, emphysema who have a challenge, or if you're at high altitude, that's when your oxygen saturation drops. Mm. That's a sign of very ill health. For most people, their oxygen saturation's 100%. So this whole effect on the central nervous system and the auton- autonomic nervous system is happening in a different way, and we don't know exactly how this is being conveyed to the central nervous system. It could well be from the vagal afferents. The vagus has efferents, which go out to the periphery, but 90% of the vagus nerve is afferent.
59:29.8 So it may well be that when you breathe in that way, you're stimulating vagal afferents that convey this information to regions of the brain that are involved in stress and emotion regulation. This is all to be determined. This is really, uh, you know, an, an area that needs to be, uh, fleshed out more, more fully. Yeah. You know, it's always a pleasure to be with you because, you know, you have no real huge ego around the work. I remember meeting you 15, 20 years ago, and I'd say, "Sapir, you know, you know, why does this happen?" And you'd say, "Well, Ed, nobody really knows." Or I'd say, "Well, why is this happening?" He goes, "Ed, nobody really knows." And it seems as, as much as we're moving this ball forward, and there is all
60:16.2 these great scientific papers that you've had something to do with getting published and putting the word out there, it seems like we're going down a rabbit hole here that where we, where we know so much more, but there's also so much to be uncovered. It's, it's really exciting as a scientist to, to, to really see that because you see how much depth there is and how much more there is to learn. Um, but by the same token, I mean, we're, we're finding so much. Uh, and over the past 20 years, it's just been amazing the amount of yoga research that's been done and how far we've come in just the past 20 years.
60:50.0 It's just exploding. So it's a very, very exciting time, uh, for yoga on the planet. Well, you opened a lot of doors for a lot of researchers. You're one of the founding fathers of the research of yoga therapy and bringing that into a scientific model, and may I be one of the first to wish you a happy 70th birthday. Y- Man, you look great. Well, I feel good. I play street hockey twice a week and racquetball three times a week, and so I'm still very active and, and I, I attribute, you know, yoga t- to my ability to, to, to keep that going. Well, I learned so much from you today as always, and I can't thank you enough for taking an hour out of your life to share, uh, your wisdom with our audience, Sapir.
61:35.2 So thank you so much, my friend. It's been my pleasure, and for anyone who's really interested in the science, we have a, an upcoming symposium on yoga research on November 15th and 16th. It's online. You can find it by going to the International Association of Yoga Therapists, uh, which has a website, and you click on conferences, and you'll find our symposium on yoga research. If you're interested at all in some of the science, we have some of the leading yoga researchers presenting their work, and it's, it's really a great opportunity to see how this field is progressing. Yeah. Everybody that's in that conference is the real deal, and I think anyone, everyone should try to tune into that and, and just get a piece of it to really add another layer
62:18.5 of experience and wisdom to therapeutic yoga applications. Thank you so much, Sapir. My pleasure as always. Have a beaut- have a beautiful afternoon, sir. Same to you. Namaste. Namaste, brother. So long. Take care. Take care.