I cannot do without thinking what should be innate. (Image: The Spinoff)
I cannot do without thinking what should be innate. (Image: The Spinoff)

SocietyAugust 24, 2024

The Spinoff Essay: Forcing the exhale

I cannot do without thinking what should be innate. (Image: The Spinoff)
I cannot do without thinking what should be innate. (Image: The Spinoff)

In breath therapy, I’m confronted by the difficulty I have in carrying out the bare minimum needed to live.

The Spinoff Essay showcases the best essayists in Aotearoa, on topics big and small. Made possible by the generous support of our members.


If the body has forgotten how to do so, I am told, it will become anxious when forced to breathe properly. I am told this by Naomi, the respiratory physiotherapist I’ve been seeing for about a year
in a drab, windowless room at Wellington hospital. There, lying on a bed covered in a deep green vinyl and looked down upon by a poster of two giraffes, Naomi watches my torso. 

It’s a peculiar experience reflective of a peculiar (although not uncommon) situation, one that makes me believe, when I let it, that despite any external signs of success – my job and qualifications and remarkably accurate Donald Trump impersonations – I am, like the man himself, a fraud. Fundamentally ill-designed for living. 

Because, there, exposed under the opaque glow of fluorescent lights, what becomes blindingly clear is this: I cannot do without thinking what should be innate. I cannot do what “lesser organisms” like sharks do through their gills, and worms do through their skin, and the increasingly unwieldy monstera on my dining table does through thousands of tiny stomata on the leaves I have let gather dust.

My problem, Naomi tells me, is not one of scarcity, but of abundance. My breathing is too rapid, too forced, and – caught somewhere in the blooms of alveoli behind my breastbone – too shallow. I collect breaths with the same determination as a squirrel collecting acorns, as though I plan on stashing them in the folds of my body and pulling them out in times of famine. I am, according first to the internet and later to the medical professional before me, an over-breather. 

This diagnosis does not come as a surprise. “You’re hyperventilating,” my mum has spent 15 years exclaiming, usually after we’ve hugged or I’ve told her I have a headache, the cause of which I sometimes attribute to her personally. This issue, this pattern I fall into of sharp, gasping intakes, developed when I was a teenager and contracted swine flu. 

The premise, I can appreciate, is almost funny. An inner-city girl in an inner-city Wellington apartment fighting a strain of the virus first detected in La Gloria, Veracruz, a town with a population as low as its altitude in metres is high, both in the 2000s, like the decade. 

The seven days I spent homebound with the flu stand out not because I remember them, but because I don’t. I slouched, barely conscious, back and forth from my bed to the couch where I tried to rest and struggled to breathe. At first I couldn’t eat, and then I didn’t eat because it was too hard, and eventually – a turning point – I threw back a handful of plain popcorn. 

By the second week, I started to regain energy, and my rash-crusted face began to look more human and less, as Mum put it, “like raw hamburger.” My ability to breathe, though, never quite returned. I continued to approach the activity as if a capsized sailor experiencing cold water shock, instead of a normal if sentimental teenager updating my Facebook status with Bob Dylan lyrics.


At my mum’s urging, I developed a limited understanding of the physiological phenomena occurring. I learned that over-breathing disrupts the balance of oxygen and carbon dioxide in the body, reducing the latter, which then constricts blood vessels supplying blood to the brain. I learned, too, that the symptoms of a blood-starved brain are numerous, like the laundry list of side-effects attached to the end of US ads for Viagra or Ozempic, finished, always, with Death.

Still, it wasn’t until, sitting in that drab, windowless room for my first appointment, I worked through a check-box form and realised the extent to which my inability to catch a breath impacted my life. Did I experience muscle aches? Yes, regularly, as though I was an Olympic gymnast with neither the medals nor physique to show for it. And fatigue? Constantly, although – tick – I was also a terrible sleeper.

The over-breathing helped explain a host of mild symptoms: my dry mouth and bloated stomach and arms that tingled with the sensation of popping Ricies cereal. It also helped explain some of the more significant ones, like vertigo, preceded, usually, by standing up, and shrouded, come the afternoon, in the brain fog that rolled in on cue at 3pm.

Most significant for me, the reason that my GP had referred me to the clinic in the first instance, was my anxiety. This anxiety both hovers around me like a mosquito, and lives within me, a beneficiary of my generous interpretation of squatters’ rights. As with its manifestations, its causes, I know, cannot be boiled down to a single noun or verb. Still, the evidence that over-breathing contributes to anxiety which contributes to over-breathing is abundant. 

“So we’re going to try to deepen your breathing and slow it down,” Naomi tells me. I am lying on the green vinyl bed, and my breasts have fallen into my armpits, making it clear that under the cotton of my shirt, my upper chest is working overtime. “We’re going to draw the breath into your stomach for four seconds, and then breathe out for six.”

This part, this time with Naomi, I enjoy. She is knowledgeable, empathetic, and generous. She is the sort of person who, I imagine, spends her weekends engaged in wholesome activities like hiking, gardening and improving the world by simply existing. When I am with her, I want nothing more than to impress her, to give her reason to murmur, “nice diaphragmatic movement.” 

It’s when I leave her office that the whole endeavour fills me with despair. As anyone who has ever been to physiotherapy knows, the treatment is only effective if you do your exercises, and like everyone who has ever been to physiotherapy, I do not want to do my exercises. I do not want to carve out space, morning and evening, to breathe my back into the floor. I do not want to nip into meeting rooms throughout the day to reset my rhythm. I do not want to do these things because they leave me – huffing, sweaty, and exhausted – more anxious than I was to begin with.

“That’s quite common,” Naomi said when I raised this with her. “Your body is used to over-breathing, so it’s going to feel like it’s not getting enough air when you breathe properly.” This is comforting, in a sense: to know that while I can’t yet breathe properly, I can at least breathe improperly normally. Still, it’s a cruel fact that the solution is to keep going. To extend the length of my inhales and exhales, and the time between them. To move the breath through my trachea and further into the reaches of my interior lobes. 


This is, of course, what all therapy demands of us. That we wade through and feel that which we are working to heal. I wouldn’t say that it’s easier to ventilate feelings than lungs, but it is, I find, more gratifying. In talk therapy, I get to complain extensively about other people and how they are ruining my life. In breath therapy, I’m confronted by the difficulty I have in carrying out the bare minimum needed to live. 

“But you’re still doing your breathing exercises?” my psychotherapist asked recently, in a convergence of worlds, of body and mind. I confirmed that yes, I was. I am. I sit around and breathe, and lie around and breathe, and walk around breathing, pretending that it comes naturally. 

Often, when I’m concentrating on this, I am reminded of a teacher I had in intermediate school who explained to my class that some yogis believe everyone is born with a certain number of breaths. “And so if you’re breathing really fast,” she said, “we’ll say ‘slow down – you’re wasting your life.’”

For a woman so attuned to breath, it’s a bitter irony that hers ran out in her 50s. It also serves as a lesson, if you’re looking for it, that all we can control is our breath. Or, as I am inclined to interpret it, that even our breath is largely beyond our control. 

Nevertheless, the task of breathing well is getting incrementally easier. I spend longer on my inhalations and exhalations, longer letting the air circulate around my body. And where this used to leave me fatigued and panic-stricken, now it makes me only tired and a little tense. 

“It does seem like you’re forcing the exhale,” Naomi observed when I saw her a couple of weeks ago. After routinely tripping myself up on the inhale, this, too, is an indication of progress. It’s also funny, as if I’m unconsciously reticent to let go of the fruits of my labour. As if the only way I can bring myself to part with them is to deny them, to spit them out like vitriol. 

There are techniques to help smooth this action, to quiet the release. “Try exhaling through pursed lips,” Naomi encourages me, demonstrating just how gently, how effortlessly it can be done. I’m not jealous of her, I don’t think, yet my appreciation of her is complicated. Naomi inspires within me change, but she also inspires the ultimate anxiety: the fear that by the time I’ve realised the former, I’ll be out of breath completely. 

Keep going!