(Brown & Gerbarg, 2012) consider breathing practices to be beneﬁcial not only in putting a parasympathetic down-regulation on sympathetic nervous system arousal but also in stimulating oxytocin-mediated feelings of attachment and safety. In CRM, heart breathing is used for attachment and would be expected to enhance any oxytocin-mediated feelings of calmness through being-with the other. Oxytocin can be used in putative corticolimbic relearning exposure therapies although the mechanism is not known (Acheson & Risbrough, 2015). It would be no surprise if intranasal oxytocin were found to enhance the attachment resources used in CRM for expanding the ability to countenance the basic affects generated in the hypothalamus and midbrain.
In common with CRM, (Brown & Gerbarg, 2012) consider that traumatic experience disconnects the sufferer from the world, the self and from close relationships. The impact on the emotional world of the person is such that survival rather than secure and rewarding attachment becomes the priority. Triggering of unresolved responses from the past impairs the free ﬂow of interrelatedness with the world and the people therein, complicating perceptions and interpretations. The use of breathing sequences and patterns when in the state associated with the trauma alters the physiology of it in such a way that healthy functioning can be restored.
The recent description of a molecular mechanism for state-dependent learning of fearful responses (Jovasevic et al., 2015) highlights the need for the breathing changes to be engaged when the person is revisiting the frightened, angry, shame-ﬁlled, abandoned state induced by the trauma. Practice of altered breathing patterns at other times will have no impact on the body memory left over from the time of adversity. So, ﬁre breathing may be required when a terriﬁed freeze is dominant, heart breathing to an abandoned, panic-stricken child part may unlock the frozen attachment drives, or earth breathing may restore contact with the body when numbness is threatening disconnection from processing.
Breathing practices may be a regular part of a mindfulness program and they confer their beneficial effects in a general way. However, the beneﬁts of changes in breathing sequences in CRM are more speciﬁc as they are used within the context of the trauma memory and the processing of it; they enable the nervous system to orient fully to the content of the trauma memory as they are regulating and resourcing in a way that allows full access. When the body sensations associated with the clinical complaint have taken the attentional focus into the trauma memory – the somatic-affective-motor-memory complex – the affect is fully stepped into. Because the ego state is resourced also through an attuned attachment anchored on an eye position, the emotion which was hitherto too overwhelmingly awful to contemplate can be experienced – with all the attendant physiological arousal. To prevent dissociation or disconnection, it is necessary to be able to maintain breathing in a way which regulates and releases. This can rapidly transform the activation so that the memory loses its power to distress. While sensorimotor residues of obstructed defence responses are being held in mindful awareness, their energy can be released not through voluntary action but through breathing – although sometimes identifying what the body wanted to do is helpful. If the arms wanted to push away, but were unable to move at the time of the index trauma, breathing from the tension in the arms can initially prevent overwhelm or ﬂooding by emotions but then can promote release of the obstruction and so be felt as completion of the defence response. The act of triumph can be entirely in imagination as the arousal in the body is modiﬁ ed through change in the breathing patterns. The shift from the nigro-striatal movement impulse to the mesolimbic system that is now freed for positive valence is hypothesised to occur here as the memory is fully oriented to. The body is then relaxed and the prevailing emotion is positive.
The traumatic impact upon breathing
When an event is experienced by a person as traumatic, there is an immediate body reaction. The ﬁ rst response may be an orienting to the event and preparation of an active or passive defence response to it. Thereafter the frontal cortex comes online sufﬁciently to assess and evaluate the range of possible responses, inhibit those that are inappropriate and release those that are most likely to ensure survival. The physiological reaction to the initial orienting towards the danger then settles to the level required by the new appraisal of the environment.
If, instead of quickly resolving, the defence response is obstructed, either by a top-down, cortical regulation or by a freeze through conﬂicting demands at a subcortical level, then the tension pattern in the body may not clear quickly and effortlessly. If there is also a high physiological activation and an intense emotion that ensures that the event is “burnt into memory” (Elbert & Schauer, 2002), the residues may be experienced in the body long after they are needed and perhaps for the rest of the person’s life. Pierre Janet considered that the multiple layers of traumatic memory could be usefully brought to the surface through re-experiencing and verbalizing, but he also saw the need for effective action to overcome any residual sense of helplessness (van der Hart et al., 1989). The restoration of acts of triumph is a key part of trauma processing in somatic therapies (e.g., Ogden & Fisher, 2015) when blocked defence responses are liberated and effective action becomes possible. Physical, social and interoceptive defences (van der Hart et al., 2006) can all involve orienting and defence movements organised primarily in the midbrain rather than at higher levels. As interoceptive defences arise in response to intrapsychic threats, such as intolerable emotions, the possible mechanism outlined in can be seen to apply also to perils perceived within the person’s internal mental space even when there have been no external correlates. A client whose relative was killed may be haunted by imagined details of the death and have a pronounced visceral response to these, even when there was no direct contact with the corpse.
CRM invites attention to all aspects of the body’s experience during the processing of a traumatic event. The aim is that there will be healing without overwhelm as dissociation or uncontrolled abreaction may interfere with the process in a way which leaves a further experience of failure rather than of triumph. Change in breathing pattern helps to ensure that there is no re-locking of the frozen state creating treatment resistance.
The orienting reﬂ ex arises in response to novelty (Sokolov, 1963) and requires a rapid and sophisticated appraisal through many brain areas. When the event is experienced as traumatic, there are autonomic nervous system changes and muscular system changes that involve areas of brainstem, thalamus, basal ganglia, limbic cortex and neocortex. The impact of the stimuli on the different structures leads to gaze shift, attention shift and adjustments in muscle tone that permit orienting and defence. The emotionally charged gaze direction may form the basis for the distress eye position which can be identiﬁ ed during subsequent treatment. It has also been proposed that the body residues of obstructed defence responses are stored in subcortical loops through the basal ganglia (Corrigan, 2014a). Before summarising those arguments we will consider the possibility of clinical consequences of a peritraumatic breathing “freeze” or involuntary cessation of respiration.
(Extracted from) The Comprehensive Resource Model: Effective Therapeutic Techniques for the Healing of Complex Trauma, written by Lisa Schwarz, Frank Corrigan, Alastair Hull and Rajiv Raju, published by Routledge, 2017