Breathing/Breath Anxiety (Episode 101)

SPEAKER_02 0:01

Welcome to Disordered. This is episode 101 of the podcast. Today we're talking about breathing anxiety or breath-focused anxiety, anxiety driven by a focus, a laser focus, or an obsession on the breath or the process of breathing. It's a really common problem and a common struggle in the community surrounding the disordered podcast. People are struggling with anxiety disorders and chronic anxiety. Josh and I have a very special guest on today to help us talk about breathing anxiety and how we might best approach it. Some of it's going to sound familiar. She also has some really great things to add, so we will get to that in a minute. Yes, the episode looks a little different today because I'm the only one recording the intro and the outro, but that's okay. It's really about the interview we did with uh Dr. Amy Jans and Claude, who's going to bring on in a second. If you're not sure about the host of Distordered, that's me, Drew Linzalata, and my co-host Joshua Fletcher. Just go to Distordered.fm and you can learn about us. I'm not going to do intros on my own here because that would be weird. Let's talk about breathing anxiety. Let's get Dr. Amy Jansen Claude on, and then I'll pop back at the end to wrap it up. All right, all the way from the prairies of Canada, we do have Dr. Amy Jans and Claude with us. Uh, Amy, tell us about yourself. What do we need to know about you before we get into this?

SPEAKER_00 1:12

Sounds good. Thank you. Uh yeah, so I am a clinical psychologist in Saskatchewan, Canada. Um, and I do a lot of work within the world of anxiety disorders and OCDN-related disorders. So I guess that's why I'm here.

SPEAKER_02 1:27

That is why you're here, as a matter of fact. Uh, how did we find Dr. Jensen Claude? I don't even remember.

SPEAKER_01 1:33

I found Amy a while back, uh, one of those profiles on um on Instagram where you just like you're annoyed that not as many people are seeing it because it's actual advice. You know, like really good ERP-related advice, anxiety disorder informed. And I really enjoy uh it there, and there's like a nice comic spin on it as well, which I also enjoy. Uh so I've been following Amy for a while, and we'll give her the details of stuff later later on. Um, but yeah, I I saw a post about breathing and people misusing breathing, and I was and it was a really refreshing take on stuff because it's always like, oh, breathe, stop, grind style. And people kind of use tech we call it techniqueifying breathing on here. And yeah, so I just thought we'd invite Amy on to talk about the topic of breathing, which is something that we all do, weirdly enough. I'm not breathing now, though. That's odd.

SPEAKER_02 2:34

No. Thought you were going a bit blue. Breathing is something that could be really it's it's interesting. One of my old Facebook group admins, Holly, she was great. She uh she used to say all the time, I turned my breathing into a total mess, which was one of the greatest statements I've ever heard from an formerly anxious person who talked about her struggle with breathing. So what do you what do you think, game?

SPEAKER_00 2:56

Yeah, it's one of those techniques uh where I think most I'd be really surprised if someone came to see me and hadn't been taught that technique in some sort of previous counseling or therapy or even through their own efforts looking up techniques or things to do to manage anxiety. Um it seems like it's really overused and perhaps not um used with enough intention behind the the why and and some of the reasons behind where it could become problematic that maybe gets missed alongside in in the mix. So I do find that that is something that I end up talking to people quite a bit about is sort of the the reason behind coping techniques and when to use and when not to use and and things to watch out for.

SPEAKER_01 3:56

I don't know about you, Drew, but back when I was in the midst of an anxiety disorder, you know, you go on, you look for help, uh, and people say, you know, just take a deep breath. You know, uh I didn't know I was in the middle of an anxiety disorder at the time. And so when you tell someone who's perhaps been over breathing for a long time to take a deep breath, and then they can't take a deep breath, that increases anxiety. It's like actually, no, I can't get it. I get I struggle with air hunger, or when a lot of when people misapply or try to use a relaxing technique, you know, a lot of that is breath-centered. So if anyone's listening now, you know, it's just like, oh you know, focus on the breath. But if you're me back then, I'm like, yeah, I'm focusing on the breath, and my breathing is totally messed up, and that is not helping me. And because I can't manage it because of the adrenaline and the cortisol, focusing on my breath is actually increasing my anxiety, but not in an informed way. So I had no idea. I was lost, I was anxious, trying to get rid of anxiety. I thought, well, if I just focus on my breathing, like I see in the movies and on TV and stuff like this, you know, you always see that, don't you? Like on a movie, like take a deep breath before you make the big pitch. Uh yeah, uh, but for an anxiety disorder, it's it's quite different. Uh, and um, yeah, it's it's quite it's can become quite conventional in cliche, isn't it? Just breathe, just breathe. And actually, for some people, particularly with somatic OCD, don't matter if you breathe or not, you can't stop breathing if you tried.

SPEAKER_02 5:27

I always tell the story of uh, oh, don't even get me started with like the breathe through. I have people in my practice all the time, like, well, do you what do you think about the like you know, you have to hold one nostril and breathe only through one? Like, well, you could do that if you want. But I'll never forget when I first started dealing with panic attacks, and I was at, I was an undergrad at the time, I didn't know what to do, I was freaking out, of course. And I went to like the university health service on campus and I met with this psychiatrist who was about a million years old, and I'm sure he had the best of intentions, and he taught me how to hyperventilate. So the next time I was panicking, I'm like, oh, he told me to take deep breaths, and I absolutely wound up numb, tingling with my hands and feet locked, the carpoedal spasm thing, freaking out because I thought I was literally done, like put me in the ground. That was bad breathing. I did not know that. I did not know because he didn't take deep breaths and I saw and next thing you know, I was absolutely done. My face was numb, my hands were numb. I locked in spasm and I did not know what it was. And I ran into the infirmary on campus. My girlfriend was had we were in her car, and I'm like, oh my god, you're gonna give me help. I was absolutely beside myself. I walked in the door, the nurse in the infirmary saw this and dumped out her lunch and handed me, handed me her paper bag, and it was I was better in 30 seconds. So breathing and anxiety, you do the math, you know. So uh what kind of techniques do you people come to you with that that they've been taught or they think are good, or the you know, the wellness gurus tell us this is how this is just one simple tip to banish your anxiety with the sacredness of your breath.

SPEAKER_00 7:02

Oh my goodness, there's so many different things that people have been taught, and you know, even the ones that are you know potentially reasonable can become tricky and problematic. I think anytime we use a coping strategy or tool with that sense of urgency, it really just reinforces a message to our brains that whatever we were trying to fix or undo or combat, I guess, in a way that there's something important there, something dangerous, or something we need to be on the lookout for, which is really just gonna ramp up that attention hypervigilance cycle. So even if they we do have a reasonable breathing strategy where we are, you know, trying to reduce the hyperventilation and not just take a deep breath, it can really spiral itself with that whole attention spiral. So I think um even if we're trying to use a coping strategy and we do decide to use that, because of course everything's individualized, and we need to make sure that we are taking into account why someone's using a certain strategy or technique, we need to make sure that um we're not contributing to that attention hypervigilance cycle. And we also have tolerance and we can start to undo that brain association with how we're responding so urgently, and we need to develop a sense of tolerance for that particular thought or symptom or emotion as well, whatever we're trying to do with that breathing technique.

SPEAKER_02 8:43

There's the trick too, of like how it tricks you. For me, I remember thinking, like, no, walking around the house all day trying desperately to fill my lungs completely up to the bottom of my jaw was literally saving me from suffocating. I had to do that, right? But as it turns out, I didn't have to do that.

SPEAKER_00 8:58

Yeah, that's that whole misattributions of safety thing, right? So the only way you stayed safe was to do something. So try to fix it or pay attention to your breath or something, and and we really need to develop some sort of tolerance or confidence that we don't need to do all of these things when it comes to anxiety or a particular symptom.

SPEAKER_01 9:22

Yeah. And and on on and what are you inadvertently teaching the threat response when you've stopped what non-anxious you was doing and you then start to focus on your breathing for the sake of trying to get rid of anxiety? Not for people with conventional stress and anxiety, you know, I I said to Drew the other week, I do this, I'll take 20 breaths if I've got a stress response, you know, just not to get rid of how I feel, to help kind of how I feel. I know that me taking 20 breaths, it clears my mind a bit, you know. Uh, but that not in the midst of an anxiety disorder, that would not have helped. But what are we teaching the brain, particularly our friend that we have a button for? What are we teaching uh the bre the amygdala when we stop what we're doing? When we stop what we're doing, and then we try to almost biohack ourselves, you know. If I do this breathing, I get rid of an anxiety. What do we teach the brain there?

SPEAKER_02 10:23

You mean when we have to like I have to do this, one of these breathing techniques that I was taught? I have to. What do we teach the brain?

SPEAKER_01 10:28

Yeah, or even if you, yeah, or even if you feel like it, you you're scared, you have a fear of fear, you have a fear of anxiety, so you stop what you're doing to start focusing on your breath. What are you actually doing there? Like, yes, you think you're doing the the initial thing to calm anxiety, but what you're also teaching yourself is that if I start messing around with my breathing, I'm actually sending a signal to my brain that says anxiety is bad and dangerous, and I must get rid of it. Uh, which creates a behavior, thought-feeling, feedback loop where we're like, oh, yeah. And the thing is, like, back when I was really struggling with anxiety, sometimes I would take breaths and then I and then and it would work. And I know Drew can relate to this, where he'd actually factor in parts of his ritual going places where he would stop and he would do breathing exercise. Because actually, this ritual and this thing started to get the credit for anxiety passing and not our ability to tolerate it.

SPEAKER_02 11:36

How do you get a client out of that? Like if somebody comes to you and they're stuck in that, what where where are you taking them to get them, break them out of that ritualization of like specialized breathing to try to calm down?

SPEAKER_00 11:48

Yeah, I think um, because we want to break that that urgency type type of loop as well, if we can because it can be really hard to break a habit, kind of cold turkey like that, especially if you were really under the impression that that was a really helpful thing to do, and that was what was keeping you safe or away from danger in some sort of way. So I think that part of it might be trying to create a bit of a delay to take away that that urgency kind of sense of I need to respond to this right now, and I need to make sure that um I'm doing something to make it go away or undo whatever's happening. Um, so if we can start with maybe a delay before we work to maybe ceasing that that ritual that can start to undo those threat, danger type of cycles and and keep our attention maybe down on it as well. Yeah.

SPEAKER_02 12:45

That's that's a tough thing to introduce though, because it feels so urgent at the time, right? So you know, if you're listening to this and it's like, what is how does she possibly delay? Like I'm suffocating, I it's automatic. I have the I feel like I can't get a deep enough breath right now. So of course I'm gonna take a huge deep breath. Yeah, it's practice though, right? It's like, wait a minute, I you know, I know wait a minute, I notice that I I feel, I notice that I really want to take a deep breath right now. Like, can you notice that you want to do that in the worst way? That might give you a little bit of a wedge to say, well, what if I don't? What if I just let my hang on, what if I like let my body do what it wants to do here for a second? Scary experiment though.

SPEAKER_00 13:26

Yeah, I think that's a real nod to trying to get some experience with these particular symptoms or sensations when you're not in the midst of really intense anxiety that comes with, you know, a whole bunch of symptoms alongside the breathing. So if we're talking something like panic, that um that's why we might do something what we call interoceptive exposures. So when someone is with you in the office and they're not, you know, already sort of triggered into a panic scenario, whether it's expected or unexpected, et cetera, that we might, you know, experiment with our breathing a bit and try to induce hyperventilation or particular other symptoms. But for the purposes of this one, since we're talking about breathing, that we can obtain that experience so that we learn that, hey, look, we can tolerate that without taking that deep breath or whatever breathing technique we're used to using, that in that moment, then you have that experience. You know that you've been able to sit with it and see what's happened to it over time. Does it go away? Does it get worse? So we do need that kind of evidence in our minds so that we can take that step, like you're talking about. Because we certainly wouldn't be able to do that hand, you know, just right now I'm gonna decide not to do that without that experience. That'd be really tough.

SPEAKER_02 14:50

Yeah, when it's level 10. Like, tell me how to do it when I'm in a panic. Well, practice it when you're not in a panic. You know, I I think one of the things that's super interesting when you mentioned the interoceptives, and I don't know, Josh for your personal experience was you you build a belief when you're stuck in that disordered state that my body is betraying me. I can't trust my body anymore. How many times we've heard that? I can't trust my body anymore. It stopped working properly. Well, okay, well, if we do a little exercise and session for two minutes and you get your heart rate up and you're breathing really heavy, notice that you're can you watch that abate? Because your body has not betrayed you. Like it's following the instruction to be hyper-vigilant, but it has not stopped working. But I know that an anxious person will insist that, like, no, no, it feels like my body has betrayed me. I can't trust my breathing anymore. And the interoceptive is a great way to start to become familiar with breathing again. Like, no, no, no, you forgot how your body breathes, you just see it as an enemy now, but it knows what to do. So I don't know, just throwing that out there.

SPEAKER_01 15:57

No, absolutely. Yeah, yeah. And be wary of when focusing on your breathing becomes the compulsion. It did happen for me as well. I hated it. Uh, and particularly with other symptoms, you know, and I liked I mean, I love I love how you spoke about interoceptive exposure. We love interoceptive exposure. It's basically purposely inducing the thing we don't like. What better way to signal to the threat response? I I'm alright with you by literally doing it yourself, you know. But for me, it was um back when I was really like poorly and stuff, it was like uh with undiagnosed OCD, I would obsess about my breathing. I would say, and then it felt weird when I forgot about my breathing. And anyone with OCD knows this. When you forget about a theme or a compulsion, it feels weird and irresponsible. So I remember there were certain times where I'd be like, gone an hour without checking on my breathing. And then obviously, there's all these conventional wellness books about how to breathe correctly. You give that someone who's obsessive and compulsive, a bit like the sleep anxiety episode that we did, Drew, like you know, like why sleep is so important. Give that to an obsessive, compulsive person, they will lose their minds. Same here. The breathing was the same, and actually, what I like to do, I don't know what you do, Amy, but when someone's having a panic attack in the practice, I'm like, okay. They're like, what do I do? I'm like, nothing. Yeah, we need to learn, like Amy said, we need to learn that your body can tolerate it. If you start putting in magical things, then they start to get the credit, and then you'll panic more the next time those magic things didn't work. They don't work the next time. It was just coincidence, you know. And so, yeah, I mean, I know it sounds a bit cold and callous, but I'm like, I sit there calm because I'm trying to convey to the client, I don't think you're in danger. Yeah, it feels rubbish, but let's teach the brain and you know that we can tolerate this.

SPEAKER_02 17:59

So if I was a client, you want to do a little like I'll be your anxious client? What do you think? Yeah, I'm gonna sit back and enjoy this.

SPEAKER_00 18:07

All right, so I'm the therapist today.

SPEAKER_02 18:09

Yeah, you're you're the therapist. Imagine you're a therapist. I don't have to imagine I am, she says. So I think, oh, that's right. And I'll be like, you know, 2006 Drew comes to see you. And I I'll I'll raise some of the common, like, but yeah, but you know, people always they listen to the podcast, they're like, Yeah, that was great. Yeah, but that was great, but so it the one of the common things that we hear all that I hear all the time at least is but I can't stop thinking about my breathing. But how am I supposed to not focus on my breathing? I'm constantly checking in on my breathing. How do any tips for stopping that, Dr. Jansen Claude? Help me, please. You're my own.

SPEAKER_00 18:47

Yeah, so I think um your your brain is gonna want to keep thinking about it because you're in this cycle, right? Of paying attention to your breathing and then doing something about your breathing. So you're monitoring it as much as you possibly can. Uh, so we we really need to get experience with kind of allowing your your breath to to do whatever it does. And then the overthinking will will start to subside once we start to break that cycle and get some experience with learning what our body does by itself without doing anything with it. Because essentially it's all of our efforts and things that we're we're doing that are are keeping that overthinking going. Because we think it's protective. We think we need to be monitoring what's happening at all times. That's the only way that we think we're keeping ourselves safe, but our our body is already doing what it needs to be doing. Um, and it's not doing anything wrong that we need to fix.

SPEAKER_02 19:50

Yeah. I have such a hard time though, because I keep trying to, I can't convince myself. That sounds right now, but when I get really afraid, it goes right out the window. And I'm trying to convince myself. I'm trying to convince myself, then I try and think of like other things. And all my mind wants to do is check on my breathing, and I can't seem to stop it from doing that. Like, how do I stop my brain from from doing that?

SPEAKER_00 20:11

You gotcha. That is a hard cycle to change. So I think what we need to do is really get experience with seeing what happens, like real life experience, because your your brain is really, really good at trying to come up with the yeah, buts and what ifs and all these scenarios, like our brains are just real expert level when it comes to that type of thing. So if we get some real experience, some real evidence in that evidence bank about what happens if we maybe bring on this breathing in a way that we're trying to often you know fix with all these strategies and techniques and thoughts and things that we're trying to do. If we spend some time in session bringing that on, trying to increase our breathing rate, and then sit with that here without doing anything, that over time is what's gonna help that cycle, that real life experience.

SPEAKER_02 21:08

I'm gonna make a scrunchy face, like 2006 true would hate that. Like I have to be short of breath to stop my to teach my brain, like, oh okay, I'm fine.

SPEAKER_01 21:18

No, but we're practicing to get evidence. I love that. That's what all exposures are. You practice because your rational brain knows you're safe. But we're practicing to get evidence for the brain to code and file away. Uh, and we can only file and code away those memories when the threat response is activated, so there's no point trying to do it at home. And so, yeah, I'd be like, Yeah, yeah. We open up the cloister when we're scared, and that's when the brain learns, you know. And it doesn't matter when I do when I do interoceptive exposure here, it's like it doesn't matter. We the step one is to be uncomfortable, you're safe, you know, and we'll show you that, and then we'll You realize you can push yourself to the air quotes limit, you know, um, then it's a lot easier to do things, and we don't we now naturally less start monitoring less and less. But 2006 Drew was just a moody that wasn't any different than the 2025 Drew, though.

SPEAKER_02 22:20

Really, I mean, think about it. So I might have noticed that Josh said air quotes. So clever. And the breathing episode we're using. Oh, I didn't even notice that. I am a genius at all times. I didn't even notice that. It's a subtle genius. I think one of the most interesting things, Amy, that you you know gave to me as your client, an excellent job, by the way. Did you know you had to pass your board exams again today on disordered? We're testing you. So uh no, that was really great. Was I love the evidence bank? The evidence bank is so I'm stealing that. I'm totally stealing that. Yeah, the one for the evidence bank little footnote that it's I got stole from you, but it's really good because that becomes it's experiential. You can't people get so down on themselves because, like, I get so frustrated because I keep I don't want to be thinking about my breathing all day long, but I can't help it, and then I hate that, and then I think I'm doing something wrong and I get really frustrated. Like, it's okay to be it's okay to be frustrated. Your brain will frustrate you sometimes. That's allowed. So go ahead and express the frustration, just be careful about drawing conclusion from it, because in the end, you are never gonna think your way out of out of breathing anxiety, you're only gonna behave your way out of it and learn your way out of it. So, love evidence bank, totally using that.

SPEAKER_01 23:30

Okay.

SPEAKER_02 23:31

What else we got on breathing anxiety?

SPEAKER_01 23:36

Me, uh I uh someone like yes, when we can fixate on any symptom, we can s fixate on our breathing. Um, what do we do in the midst of when our breathing is off? So we're lying in bed. I used to get it where my stomach was bloated and it would press against my sternum, and then it felt like I couldn't breathe properly, but it is actually because of my bloating, which is something that we spoke about in a episode of a very early episode of disorder. Um what does it look like, Amy, practicing with breathing without without compulsing? What does it look like? So, okay, I've noticed I'm not breathing okay. I'm trying to, you know, practice breathing and that's not working for me. So what does it look like when we tolerate that? Or or or what does it not look like?

SPEAKER_00 24:30

I think anytime that we're trying to kind of undo a ritual and and cease a ritual, we have to be careful that we don't create another ritual. Um, so anytime that we can um kind of lean into uncertainty and and not knowing that that can be more helpful than trying to create another ritual like reassurance. So that reassurance would look something like, it's okay, it's okay, I'm safe. Um, nothing's gonna happen to me, you know, those types of things. And that can really create like a self-reassurance cycle and a new ritual. Um, so anytime that we can lean into the like, oh, my my breathing is is what it is, um, might be okay, might not be okay, it doesn't have to look perfect. Anytime we can kind of lean into the unknown or uncertainty, that can be more helpful than creating something entirely new. So that's probably where I would suggest if we're really stuck in some sort of thoughts about something else and trying to create something new is is really trying to create some sort of personalized, I guess, what works for you type of uncertainty script.

SPEAKER_01 25:44

So important. Uh and it's interesting. I also wanted to ask, I was excited to ask this, Drew. Uh, as a psych in Canada and stuff you specialize in anxiety disorders, what is your view and opinion about regulating? I can regulate my nervous system.

SPEAKER_00 26:03

Oh, that's that's quite the topic, hey.

SPEAKER_02 26:08

It is, eh?

SPEAKER_00 26:10

It's definitely gone overboard. I think sometimes, not sometimes, all the time, in the world of social media um things that sort of take flight, um, this has become really over-generalized. So regulating can be really helpful for some conditions and and some types of concerns. So we see it with like borderline personality disorder, let's say, where we do need to work on regulating our emotions so we're not being destructive and we can still be effective. Um, or even in PTSD, sometimes we need to work on regulating our nervous system. And I get that there because that's just making it a little bit less sensitive. Um, but when it comes to anxiety, I'm gonna say I don't love the term. Um, and I think it would be more helpful to talk about just anxiety sensitivity. Some people are more sensitive to the experience of anxiety. Um, and we don't necessarily need to regulate our nervous system. Um, we need to be able to experience it in a different way and develop a new relationship with anxiety, and that's going to have more of the longer-term benefits than constantly fighting against it with all these strategies and techniques that people who do endorse the regulating um types of strategies do tend to say. So I do think it's overgeneralized and maybe taken from some other types of disorders or concerns and really used a lot in the world of anxiety disorders, which makes sense. Um, but it's maybe unhelpful in the world.

SPEAKER_02 27:58

Especially in breathing, I think it's used to regulate my breathing. And I think the thing that I found, and by the way, we gotta do it. Regulator So you knew that was coming. I wrote one of the things I had somebody the other day said a brilliant thing to me. She said, as it turns out, regulating wasn't, I wasn't trying to regulate my actual nervous system, I was learning to regulate how I interact with it. And I thought, wow, that was really brilliant. Like, I didn't earn my money that day because she was way smarter than me, and which was great, but like, yes, correct. So regulating breathing. Like, do you think nature would be silly enough to give us control over that? Like, it doesn't. So, yeah, you don't have to regulate your breathing or your nervous system.

SPEAKER_01 28:43

How do you think you breathe during sleep? You're not consciously doing that, are you? Your brain is doing it for you. The more you try and mess around with it, you're kind of like trying to overclock something that's screaming out to be to be calmed down, you know. So if you you start, you I mean, I find this regulation whole narrative falls under the quick fix culture of mental health. You know, your nervous system is dysregulated, regulated. How's about why don't you learn that your body regulates itself when you leave it the hell alone? Now, don't get me wrong, there are exceptions. So, yeah, you know, if you are struggling with BPD or uh bipolar, um, on are this these kind of techniques are great, and they usually fall under uh DBT therapy, not CBT, DBT, where Drew and I always get on a high horse or ice packs. But actually, for some people, you know, if they're in a severe state of distress because they've got certain conditions, yes, those things are really helpful. But in terms of anxiety disorders, and the vast majority of people that listen to this podcast, it's about, like Amy says, it's learning that our body will regulate itself when we stop trying to quick fix it and get rid of feelings we don't like.

SPEAKER_02 30:03

Even in the the case of using like DBT skills, which are great, even then, you're still not turning off the biology underneath it. What you're really doing is like interacting with it in a different way. So if you have someone who's really, you know, struggling to deal with what they're feeling physically or emotionally, and have them hold those ice cubes in their hands. That's that's not there's no magic in the ice cube that's turning off adrenaline and cortisol and all of those chemistry, all that chemistry. It's just keeping you from amping it up even more. So regulation is something we use for people who get carried away in the response, and it becomes very maladaptive and very kind of reductive, sometimes destructive, like Amy said. But in the case of the breathing thing, one of the things that was interesting is that I learned over time accidentally, I don't know how I did this. Experiments, little experiments. I had to learn the difference between can I not breathe and do I feel like I can't breathe? That was probably the biggest thing. And that that was little experiments with like, well, what if I don't take a breath right now? What will happen? And ultimately your body takes a breath. So, as interesting as it was, it was little tiny experiments of like, no, no, I really want to take that deep breath right now, but what if I don't? First of all, what if I breathe into my belly instead of my rib cage? That was useful to me because I could not expand my rib cage, just it's not expandable. So I learned to breathe into my belly, and then it was just experiments with don't take a really deep breath right now and see what your body does. I mean, for what it's worth, I learned that to for me, the air hunger was a sensation at the base of my throat. But that only came through the little experiments and that like Dr. Jansen Claude is talking about. Like, oh, it's a it's a feeling of tightness at the base of my throat. It has nothing to do with my pulse ox, you know, saturation. It's fine. It just feels like I have a tightness here which makes me feel like I want to take a really deep breath. And over time you can learn that. It's for some people it's a band across your chest or it's tightness in your abdomen.

SPEAKER_01 31:56

Mine was a bloat but bloated stomach. There you go. Yeah, I remember that. Yeah. Uh Amy, when's the um when is it? I mean, it's always okay, but I mean, in particular in your work, when is it okay to use like focusing on the breath or breathing? And do you ever use it?

SPEAKER_00 32:16

I think I use it more selectively. Um so anytime that I would use a coping technique um at all, um, and breathing would be one of those, would be um have to be done in conjunction with that, but also that attention to tolerating. So if we would have to have a discussion about, you know, we can look at coping strategies if that's something that you want to do, but we will have to be mindful of that whole urgency loop that we talked about earlier, as well as the intention behind the use of a strategy. And we have to pair that with being able to tolerate it without doing anything. So, so after that discussion, then I might use it with some people, not everybody, but some people, if we really need to turn down the volume of anxiety to a level where someone could be affected, like if they had something kind of coming up that they really were not in a position, we had don't have enough evidence on that evidence bank, we haven't done enough interoceptive exposures, et cetera, et cetera, and worked on that tolerance aspect, then maybe we would use like a grounding or breathing strategy to just turn down the volume enough that someone can move ahead and be effective in that moment as they are also working on tolerance and building that evidence bank. So I guess that's maybe how I would individualize it, but it would be more rare and selective that that I would use a coping strategy like breathing.

SPEAKER_02 33:53

I I tend to find that the only time that a breathing-based coping strategy seems to be applicable if somebody wants to learn that sort of wellness skill, is the person who doesn't have breath-focused anxiety. If their focus is cardiac or muscle tension or dizziness, they can they can tolerate that focus on the breath and use that. Well, it's turn toward, you know, turn toward it, look at it, notice it, whatever you want to do. The person with that breath focus has an almost impossible time using breathing-based calming, you know, because they just want it to work and then it doesn't work, and then they feel even shorter of breath and they want to breathe even more. It's it it almost never works.

SPEAKER_01 34:30

That's why it's okay to do it as an exposure. I think I said on a previous episode. I went to a conventional think Vipassana breathing uh class near me, and everyone was you know in their zen, chilled out, whatever, doing whatever. I went in as an exposure. I'm like, I'm gonna breathe and doing all this stuff because I'm gonna get used to my breath doing weird things. Uh, I was also exposure to uh panicogenic relaxation, which is uh again really common with anxiety disorders, you know, where I feel so calm that immediately spikes my anxiety because I'm just not used to that. Um, and so meditation and breathing in in induced exercises for me, because it was framed, was an exposure for me. So I didn't start beating myself up because I'm the one panicking and freaking out, and everyone else is you know chilled and asleep and whatever. It's knowing and acknowledging, you know, I had an anxiety disorder, breathing is one of my triggers and kind of obsessions, and and so purposely going and breathing in weird ways to show that I could cope was was was a part of it. And then if this applies to you at home, you know, whenever your breathing is odd, that's a great time to play around with it.

SPEAKER_00 35:52

I think that the point about you know when to use something and it being really individualized too is is really important because, like Drew was saying, if that is your main focus, um, and that is the symptom that is the most concerning to you, and you have rituals around that, then using that strategy is going to be really unhelpful. So I think that's where you know maybe we don't spend enough time talking about individualized strategies. Like we can't, it's not all one size fit-all. We really do need to make sure that we're keeping into account the the person and and what their particular symptoms look like and the cycle and what drives it. Um, so that's where it gets real tricky when when people are following the advice of you know really popular people or whatnot that that they're strategies that might work for some people, but certainly not all. And we need to take into account the the person.

SPEAKER_02 36:47

Yeah. I like to do the you know, universal principles, individual application. Like that's so important. And it's crazy because even when you're following, you know, and and by the way, we will give you Amy's socials and stuff because she's tragically underfollowed. But even people like us, the three of us who are in a very niche, we're never going to be the size of some of these giant social media celebrities. It's really hard to get the answer in the scroll or from this podcast episode or a video or a book because it could be so individual. And your obstacles to applying these particular principles and ideas could be very individual. So if you've listened to 8,000 podcasts about breath anxiety and you still have it, that's not your fault. It's not you're not doing something wrong. Why can't I get it? Well, sometimes it's impossible to get just by listening to somebody. So, you know, always try and let people off the hook that way. Give yourself a break. This is a very experiential thing, and that like individual application can be really important.

SPEAKER_01 37:43

That's so important, Drew. Yeah, you're right. It's like uh for any inner correct the critics, it was uh actually you're doing the best you can and you you given and you're using the information that's presented with you, and it is informed information. If you're surrounded by people like, and I just took a breath, you know, or if you're the popular influencer who's like, just breathe and stuff. Yeah, some people resonate with that, they're calm with that, but you know, you know, it's not it's not universally applied, it's individually applied for you. You're not different if that doesn't work for you. It's just your anxiety is different, people's anxiety is different, people's threat responses are different. You know, someone someone who's anxious and a threat response is firing off non-stop because they're afraid of a colleague at work is still anxiety, but it's different from a I'm panicking about my own brain, I'm questioning my sanity, I'm I'm I'm worried about why I'm anxious all the time for no reason. That would be a different intervention. And so that's why it doesn't work for you. So just breathe doesn't work for everyone, and it probably doesn't work for the vast majority of people listening to this podcast.

SPEAKER_02 38:51

Yeah. One thing I might add, and then I think we'll let Amy sort of put a bow on this, is I know that if you're listening to this, because the breath focus is your biggest source of angst right now. For you, this seems specially important. And a lot of people will say, but it's your breath. If you don't breathe, you die. Just a quick reminder that listening alongside you are people who are absolutely gonna die on their hill and say, no, cardiophobia is clearly the special important one. No, fear of psychosis is clearly the special important one. No, you don't understand. My real event OCD actually happened. So remember that, like, while yeah, breath is certainly important if you're breathing, you're alive. If you're not, that's true. But be careful of that hanging on like hot death to that belief that, like, no, no, no, but this is this is very special. It's my breath because sitting next to you is an anxious person who will throw down with you because they're most afraid and think it's super impactful if they vomit, or if they make a scene in public in front of their kids and they're a horrible parent and they scar their children for life. So, like everybody's anxiety is gonna say it's the one that's the most important and special. Breathing is important, but it's still not special in this context. Just saying. You got anything you want to wrap up after that, Ian?

SPEAKER_00 40:07

Man, so much pressure. Um pressure, no pressure. Um, I think I like I like where where it it ended is that um anxiety looks looks different for for people. Um, it has that specialized focus for everybody. Um the principles are similar though, across. So even though anxiety is trying to tell you that that it's it's different, or or maybe you need a different strategy, or you should or should not use something. So that's the same principles really, really are there, and that over time we need to develop that ability to tolerate the experience without doing anything about it, trying to fix it, um, trying to make it go away, because those are the things that really ramp it up in the end. So, whatever that looks like for you and your individual anxiety ritual, safety behavior cycle, um, that's where where we need to really focus and spend that time and figure out what that cycle looks like is is the first start. Um, so that's I guess the main thing I'd like to say there. Very good.

SPEAKER_02 41:17

That was a great way to wrap it up. How can people where should people go to find you?

SPEAKER_00 41:23

So that's tricky. I work in public public health care. So I'm in the public healthcare system in Canada. So it can be, it's really hard to come come see me unless you are in my city and um need publicly funded healthcare.

SPEAKER_02 41:39

Well, if they want to just follow along with you on social media, where where would you want them to go?

SPEAKER_00 41:43

Yeah, so I'm um at Dr. Jansen Claude. Very good.

SPEAKER_01 41:48

At Dr. Jansen Claude. Yeah, Drew and I are both followers of your work. And um, yeah, it's nice to just uh hear more about what you do. And it's lovely that you uh I wish I had a uh a Dr. Jansen Claude as my therapist. When I saw public funded health, I I did not get that. I got something very different. Um, but so yeah, um thank you for coming on and talking about this subject. I know it's something that will resonate with a lot of our listeners. And um, yeah, thanks for the really uh helpful insights as well, which um me and Drew will steal and dress up as our own. 100%.

SPEAKER_02 42:24

Yeah, totally. Uh if you go to disorder.fm slash 101, I'll make sure I have a link to uh Amy's socials. And if you're just listening as a podcast episode or on YouTube, look in the description and I'll make sure there's a link there too. And yeah, you guys should check it out. She definitely knows what she's talking about, and we appreciate you. Thanks so much. All right, let's do a quick wrap-up, put a bow on this episode. Again, a strange episode of Disorder, because I'm recording bookends around the interview. But a special thanks to uh Dr. Amy, Jensen Claude for getting up early in the prairies of Canada to record with us today, share her experience about uh breathing and breath-focused anxiety, really appreciate it. We'll probably have Amy back on to talk about other topics because she's pretty awesome. If you want to find Amy on social media, the best bet would probably be on Instagram. She's at Dr. Jans and Claude. Again, if you're listening to this in a podcast app, look at the description. If you're on our website, disorder.fm slash 101. I'll have a link there. And if you're on YouTube, it will also be in the YouTube video description. So click on through and give Amy a follow. She's really awesome and she gives really, really great advice and excellent, well-informed, clinically validated content related to anxiety and anxiety disorders. Thanks for listening. We'll be back again next week with another episode about something, don't know what. Again, pop on over to disorder.fm if you want to send us a question or did it anyway, or you want to get in our mail list so you can participate possibly in disordered roundtable discussions. Thank you so much for all your support. If you kind of dig in the podcast, maybe leave us a review on Apple Podcasts or Spotify because it certainly helps us out. But uh yeah, thanks for hanging out. Hope you got something out of this one, and we will see you guys again next Friday. Take care.