Case Studies

Sandra's new year resolution was to seek help with her COPD. She had suffered from asthma, had smoked despite all advice not to and had been diagnosed with ACO (asthma-COPD overlap). 

I had been recommended by her daughter, a nurse, who I had worked with on anxiety and stress.

Our first focus in winter, was to make sure she was protecting her airway by wearing a snood when out in the cold. She also began the transition towards breathing nasally as much as possible. She noticed an improvement almost immediately. Cold/dry air was no longer irritating her airway (which had been triggering coughing fits) as the nose warms and humidifies inhaled air on its way to the lungs. 

We then worked on introducing some lifestyle changes. Previously quite sedentary due to worrying about making her condition worse, Sandra started taking short walks, stopping as soon as she felt out of breath, but trying to continue to nose-breathe throughout. She eventually progressed to longer walks with her daughter, stopping less and less over time. 

I also encouraged Sandra to hum and sing periodically throughout the day, initially a few lines at a time, to develop more capacity. She enjoyed singing and this was something she welcomed. She soon progressed to verses then whole songs and on a later follow-up call she told me she had joined a COPD singing support group and continues to attend today. She is an example of it never being too late to turn things around when it comes to breathing.

William's wife, an NHS nurse, came to me after a recent traumatic car crash. She spoke of always sleeping poorly due to William's snoring but that since the accident, things had got a lot worse as she felt anxious all the time. William agreed that reducing his snoring would be a huge help to both of them. Like all snorer's he was not only waking up in the morning feeling tired, he felt constantly tired every single day. First and foremost, however, he was keen to help his wife. 

It took only a few sessions to turn things around. William's willingness to follow my suggestions made the difference. It also helped his being a keen golfer- the opportunity to combine certain breathing techniques with his favourite pastime. It was a surprise to him, but not to me, that improving his habitual breathing pattern, helped his golf as well as his sleep. As I often do with breathing, I reduced sessions to a half hour and spread them out over several weeks.

Like for everyone, a huge change for William was having so much more energy during the day (and on the golf course). Improving his breathing during sleep meant getting more Oxygen to his body, to help him recover and recharge his batteries for the day ahead. More Oxygen, more energy. He had never thought about the fact that snoring is breathing.

Needless to say, for Sandra it was also life-changing. Sleeping well meant we could work on her anxiety. She learned how to quickly control her anxiety and panic attacks, with breathing alone.

John had suffered asthma all his life, but changes at work were causing him stress and anxiety, which he found was making his asthma symptoms worse. His sleep was bad and he felt increasingly tired. He was worried about his work performance and ability to stay awake in meetings or control bouts of coughing at the office (which he suspected bothered his colleagues).

On assessment, I highlighted several ways he could breathe more efficiently, both during the day, at home or at the office, and during sleep. As always, I took time to explain why this would reduce his symptoms, make him less anxious etc. and then gave him some basic exercises that he could use in the moment to calm himself down. Over the block of five sessions we worked on other techniques to help him manage his anxiety at work and breathing changes that would give him a long-term strategy for reducing his asthma symptoms and improve his sleep.

John came off his inhalers by Session 3 and his bouts of coughing became a thing of the past. We postponed the fifth session a month and by that time his sleep had improved markedly. He had managed to make the transition from mouth breathing to nose breathing and what struck him most was how much more energy he had. Basically, he realised he'd been "short-changing" his body of Oxygen. "I feel a different person" he said. I contacted him recently to ask his permission  to use his case study and he told me he had joined the local gym and been attending regularly. 

Post-pandemic, I received a number of referrals from the NHS to help people suffering from long-Covid. Hospitals (that I continue to work with) were aware that as well as counselling and psychotherapy, I worked with breathing, so they saw it as a possible way to help staff get back to work. Breathwork did not typically get rid of long-Covid altogether, but it did help to reduce symptoms considerably.

Janet had been a runner and had finished several marathons. Not being able to train (combined with her COPD-like symptoms) was badly affecting her mental health. She was back at work on a phased return but found herself exhausted early in the day. 

After assessment, I decided on what techniques and exercises from the Buteyko method and my own repertoire would benefit her most. Simply introducing a new treatment modality into her life  made her feel more positive. Nothing she had been offered so far had made any difference. Like most runners I have worked with, particularly years ago, Janet had never paid any attention to her own breathing. She had learned about the respiratory system in her nursing training- about what can go wrong, but not about 'functional' breathing and what can make a difference before illness sets in.

From gentle exercises at home, we progressed to graded-exercise at her local gym. Janet took on a routine of gentle chest-opening yoga postures to help open up her ribcage and give her more capacity. After months breathing so shallowly he body was stiff and her capacity very limited. The postures combined with deep diaphragmatic breathing helped open things up. We also worked on her transition to nasal breathing- as always, no one had ever suggested she try breathing through her nose.

Using the treadmill at the gym with a heart rate monitor allowed us to monitor exactly how quickly she could progress, slowly increasing speed and/or incline. Her condition proved unforgiving- too much, too soon, and her symptoms would partly return, which would set her back mentally. Even today she has to be careful not to 'overtrain'. Janet remembers her first run- a gentle jog but without stopping to walk at all, as being huge, a milestone equal to her first marathon. Her case was a valuable learning experience for me as well. 

Despite having never had asthma previously, Ben developed asthma-like symptoms following a chest infection. He was diagnosed with exercise-induced broncho-constriction as his symptoms only bothered him either during, but more often than not, after his runs. He took an interest in breathing after discovering the Patrick McKeown's Oxygen Advantage® programme, and came across my profile as an advanced instructor.

In my experience people who are fit cardio-wise usually make rapid progress with optimising their breathing. For me, and people I work with usually agree- the key is knowledge. Knowing the basic science of how breathing really works and the importance of Carbon Dioxide as the catalyst in Oxygen-release is usually a game-changer. Breathwork then has both purpose and meaning.

Ben's condition was not the worst case I have worked with but it was complicated by his tendency to worry about his symptoms coming on and/or getting worse. We therefore had to address this 'psychological element' in parallel with the breathwork itself. As Ben was particularly keen on trying it out, I used hypnotherapy in his case and made a few recordings for him to listen to periodically and before sleep. As do most people, including myself, Ben found them both enjoyable and effective. I am trained in a particularly effective but little known self-hypnotic technique called Open-Focus™ which was developed by Dr Les Fehmi 50 years ago. In all the years I have worked with stress, my own and others', Open-Focus is one of the best methods I have found for treating anxiety.

Ben's EIB symptoms were eradicated totally- leading him to wonder if he had been correctly diagnosed! He maintained a routine of using a saline rinse every other day and of course, taping his mouth every night became a habit he says he will never stop. Soon, Ben began to enjoy his running more than ever before. Once over the EIB, he noticed he was far more relaxed both during and after a run. His breathing, even around a steady 'Zone 2' type pace, seemed closer to effortless. His breathing had always been 'laboured' with much huffing and puffing going up hills. Having learned to breathe more efficiently, such things became a thing of the past.