Therapeutic Breathing Video Series

Learn more about various therapeutic breathing techniques by the Integrative Health Program at Children's Hospital of Philadelphia (CHOP).

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3 Part Breathing

Tonia Kulp: Three-part breathing is the introduction of diaphragmatic breathing, which is also very calming. It is shown to be one of the best types of therapeutic breathwork for a child or an adult, when they are experiencing pain. And I always encourage, you can do three-part breathing, sitting, or standing, but I encourage lying down because it allows you some, some greater movement.

So it looks like this. Three-part breathing is you breathe in through the nose, you fill the belly, you let the ribs expand with the breath and then you bring the breath high into the collarbone. And then the breath exits the same way, from the collarbone down the ribs, relax and then down to the belly. I can exaggerate that. It looks like this. Breath in. And out. Breathing in. And out.

So show me first: belly. And show me: ribs. Where are your ribs? And show me: collarbone. Can you point to your belly? And your ribs? And your collarbone? So for this breathing, we start with the belly and we let it go through the mouth. Belly, ribs, collarbone. We're going to start with just the belly first. Your breath is soft and slow, right? So now fill your belly again. Are you smelling your foot?

Patient: Smell my stinky foot.

Tonia Kulp: No can do. All right. Ready? And now we're going down the ribs. So our ribs get big and wide, right?

Patient: That was my belly.

Tonia Kulp: That's was your belly. Can you get it into your belly and your ribs? I know you can. Ready? Let's do it together.

Patient: That was me.

Tonia Kulp: You're silly. Okay. So now we have to do three parts: belly, ribs, collarbone. Do you want to feel on your way up? Okay. Ready? Big breath in belly, ribs. All the way up and out. Belly, ribs, all the way up and out. One more time. Belly, ribs, all the way up, all the way out. Good work. Give me five. You're the best.

Balloon Belly Breathing

Tonia Kulp: So belly breathing is a technique to teach children how to begin to use full capacity of their breath. It's very calming and sometimes we use a Hoberman Sphere which is like a giant expandable ball to show the rhythm of the inhale and the exhale. But we explain to let your belly be very soft and relaxed.

And then as you breathe in through your nose, you send your belly deep down, you send your breath deep down into your belly and allow your belly to expand like a balloon. And then as you exhale, gently that balloon deflates. The belly goes soft. Inhale, belly rises, fills with breath. And then exhale, softly, the belly releases.

You can breathe in through the nose and out through the mouth or for older children, you can also start to teach in through nose, out through the nose.

Do you think we should do our belly breathing next with the bumblebee? Yeah. Are you ready? Do you want to shake it out first?

Shake it out, shake it out, shake it out.

Patient: My head.

Tonia Kulp: Oh your head. How about, would you like to lie down on your back and we'll take the bumblebee for a ride?

Patient: Ah that would sting me.

Tonia Kulp: We remember we, he doesn't sting. We name, what did you name him?

Patient: Beatles.

Tonia Kulp: Beatles. Head here. Belly down. You ready? Flip over on ...

Patient: Face flat?

Tonia Kulp: Face flat. Can you flip onto your back for belly breathing? Thank you, my friend. Okay. So remember when we do our belly breathing, we breathe in and our belly gets big, like a balloon and we softly let it go.

Patient: Collarbones and then ....

Tonia Kulp: That's next. You're so good.

Patient: No, that's last.

Tonia Kulp: That is last. You're right. Can you show me big breath in balloon? And out through your mouth. Should we take the bee for a ride?

Patient: Uh huh.

Tonia Kulp: Ok, hold on tight. Ready? Fill that belly up real big. Nice and easy, one more time. How did it feel?

Patient: Good.

Tonia Kulp: You feel calm? That was good stuff.

Dragon's/Lion's Breath

Tonia Kulp: So Dragon's breath is, helps to release excess energy and tension in the body. And we often use it prior to a procedure or something where you may have to sit still for a longer period of time. And it's a deep breath in through the nose and then a very forced exhalation out through the mouth.

With the children we like to ask them to pretend that they are a dragon or a cheetah or a lion, just to kind of make it more fun. So you can sit in a comfortable seat either on your heels or here, easy seat or even in a chair. And it looks like this. Take a deep breath in and let it go. And the point is to really take a very deep breath in and to exhale, forcefully all of the air through the body.

Are you going to be a dragon today or are you going to be a lion?

Patient: Hulk.

Tonia Kulp: You're going to be the Hulk. Okay. It's the same way either way. Isn't it? You remember what we do? We take a deep breath in and then we let it go and we open our eyes really big and we stick our tongue out and we let all the air out we possibly can, right? Ready?

Patient: Yes.

Tonia Kulp: Give us some fives. Let's do this. One, two. Big breath in. Let it go. Let's do it again. Roar as loud as you can mister.

Patient: Ok. That wasn't loud.

Tonia Kulp: That wasn't loud? I know you've got an even bigger one in there. You're going to stick your tongue out and open your mouth.

Patient: Ok - I'm going to smack my face.

Tonia Kulp: No smacking, no. We're calm yogis, remember? Ready? Let it go.

Can you show me one big one on your own? Go for it. Big breath in. Let it go. Yes, exactly. Good job. I like it.

Mantra Breath

Tonia Kulp: Mantra breath is a pattern of breathing with a word or a statement, which we call in yoga, a mantra. It works very well with older children, preteen, adolescent. We use it oftentimes to help settle and ground, or if you're feeling nervous before a procedure we suggest sometimes to the kids that they use a mantra that will help them through a procedure.

Maybe it is, I am strong or I am fierce. Maybe it's I am calm or I can get through this. And you can do mantra breathing a lot of different ways. We can add movement with it, with our breath, or you can simply invite the patient to breathe in to the internal sound of, I am. And exhale to their mantra. Calm. Breath in. I am. And breathing out. Calm. That's mantra.

Hop on your mat. Hop on your mat, Mr. Dragon and step your feet big and wide. So when we say, I am we breathe in. And when we say fire, we breathe out, right? And we'll add a little movement. So show me your warrior two. Nice and strong and fierce. You ready? Say it with me. Breathe in. I am.

Let me hear it. Ready?

I am. Fire.

I am. Fire.

I am. Fire.

One more time. I am. Fire.

Ok. That's good.

That was really good.

4-7-8 Breathing Technique

Tonia Kulp: So 4-7-8 is basically teaching the extended exhalation, which is very calming and grounding. It's useful to help promote a restful sleep prior to a procedure that might make you anxious. If you have a little too much tension and anxiety built up in the body. But the ratio isn't as important necessarily as beginning, holding and then extending the exhale.

So it looks like this. You breathe in for four. Hold for seven. And let it go for eight.

Breathe in through the nose, out through the nose, if it's comfortable for the child or in through the nose and out through the mouth is the more traditional way. So it looks like this.

Breathe in. Hold.

And out.

So remember 4, 7, 8. Sometimes it seems like a lot, so we'll have to make it a little bit quicker and if it's too much, we'll shorten it. Okay? We could go like 2, 4, 6 or something, but should we try the 4, 7, 8 first? And it's a, breathe in for four, hold for seven and a big whoosh for eight. Right? You got this? You got this. Ready? I'm going to count us. Let it all go.

Let's do this. Breathe in 1, 2, 3, 4. Hold 2, 3, 4, 5, 6, 7, whoosh.

Patient: Who lost their headband?

Tonia Kulp: I don't know.

Patient: Hold on. Broken.

Tonia Kulp: Don't worry about it.

Are you comfortable sitting like that? You good? You ready? You want to count for me? I'll do you. Okay. Breathe in.

1, 2, 3, 4, 5. Ok I can't get it in my head.

That's all right. I'll count for you this time. Ready? Breathe in 1, 2, 3, 4. Hold. 2, 3 4, 5, 6, 7. Let it go.

That was awesome. Biggest whoosh. Ready? Deep breath in. Go, hold it.

Patient: Mommy! Stop.

Tonia Kulp: Let it go. Good job!

Related Centers and Programs: Integrative Health, Integrative Oncology Program