Blog Postpost

Posted Monday September, 14th 2020

*FEATURED BLOG POST* Linda Thai shares "Mask-wearing: A Moment to Calm the Nervous System Through Intentional Breathing"

Written by: Linda Thai

I am a yoga and meditation instructor, somatic therapist (Sensorimotor Psychotherapy), and trauma therapist (Brainspotting, Internal Family Systems, Havening Touch, Flash Technique).

I am NOT a technical breathing instructor (such as Buteyko) or medically-trained in the neuro-muscular technicalities of breathing.

Both yoga and meditation emphasize breath awareness, and in observing the breath and the body for the last 10+ years, I have come to notice that individuals who experience mental health issues/trauma histories struggle with nose breathing. Current health and safety requirements of wearing face masks has made life more challenging for these individuals, as well as those who experience structural, neuromuscular challenges with nose-breathing, including individuals who experience developmental disabilities (autism spectrum), or other medical issues.

Mouth-breathing as a stress response:
When we perceive danger, some of us rapidly mouth-breathe in, in order to quickly oxygenate the body and to mobilize the active defenses of fight and flight (sympathetic arousal). Putting on a face mask can elicit the beginnings of sympathetic arousal in many individuals who experience anxiety and/or who have a history of suffocation trauma, causing a rapid mouth-breath in. The resulting rapid suctioning of fabric against the mouth may elicit a heightened anxiety/panic/terror response in many individuals.

Nose-breathing combined with a long exhale (whether out the nose or the mouth) restores the body back into the parasympathetic branch of the autonomic nervous system (rest and digest, safety and connection), and keeps the prefrontal cortex online and therefore able to discern the difference between uncomfortable and unsafe. Discomfort is tolerable, knowing that the discomfort will not last forever.

Individuals whose nervous systems are conditioned to correlate mouth-breathing (sympathetic arousal) with danger responses will ab-react to mask-wearing.

And yes, the rapid mouth-breath inhale can be associated with sympathetic arousal in a good way - surprise, excitement, joy, awe and wonder. The ventral vagal branch of the parasympathetic nervous system mitigates this arousal (when developmentally co-regulated) creating a robust nervous system capable of tolerating the full range of positive emotions.

How I breathe when wearing a face mask:
We get advised to wear masks, but no one has taken the time to explain to us how to breathe when wearing a mask.

I have been using the face mask as an intentional activation cue to breath in-and-out through my nose and my nose only, and to breathe into the diaphragm.

I do box breathing exercises when I'm feeling a little anxious. Inhale for a count of four. Hold the breath for a count of four. Breath out for a count of four. Hold the breath out for a count of four. Repeat four times. You may wish to adjust the length of the inhale breath hold to something that is natural and comfortable for yourself. Some individuals prefer to elongate the exhale, rather than hold the breath after the exhale.

Once again, the invitation is to experiment with what works for you.


Mostly, I just focus on the long exhale, which activates the parasympathetic nervous system. I make sure that I’m breathing into the area below my navel, a result of my diaphragm being relaxed and fluid. (The diaphragm tightens up during sympathetic fight-flight activation.) I also make a point of relaxing my jaw, ears and eyes, as tension in these areas of the body indicates sympathetic arousal and can cause for a public outing to become unpleasant rather quickly.

If I catch myself sharply mouth-breathing-in, I close my mouth and breath in the rest of the way into my low belly, and then sigh or hum as I focus on a long exhale. Making audible sounds is not what an animal in danger does. It is what an animal in safety does. And so, this restores me back into the ventral vagal branch of the parasympathetic nervous system.

Our perceptions, experiences and narratives of ourselves and the world arise from the state of our nervous systems. By learning to recognize my own body’s sympathetic activation cues, I have learned to shift my nervous system’s experiencing of life. If you like, you can check out the video for breathing tips, techniques to turn fright into delight, and ways to release tension in the jaw and ears.

A curious invitation: what are your body’s cues that your nervous system is moving into sympathetic activation? And how can you intervene in order to restore clarity and calm?


Practicing distress tolerance:
Experiment with different types of face coverings. Face shields. Face masks - which fabrics feel better on your skin? Which styles of ear loops feel better for you? Perhaps an internal frame that goes under the fabric but over your mouth, so that they cloth is held off of your face/mouth? A nose piece, to keep your glasses from fogging up?

Practice wearing your face covering somewhere where you feel safe. Be curious about your body’s response to putting on a face covering. Notice how long you can tolerate wearing a face covering for, and experiment engaging in activities with it on (light housework, yard work) to see what levels of physical exertion are tolerable for your body. Give yourself permission to take “breathing breaks” - and notice how often these breaks need to be for you for now, and how long those breaks need to be.

Remember: practice makes progress, and it’s about progress, not perfection. And, the prize is in the process: in the process of all of this, we get to practice self-kindness, self-gentleness, interoception, distress tolerance, and self-regulation skills…..and perhaps for some of us, we get to recognize and address underlying issues of trauma and/or structural breathing challenges.

In conclusion:
Some individuals cannot nose-breathe and/or cannot tolerate wearing a face mask, for various reasons ranging from suffocation trauma to autism spectrum disorder to medical issues that inhibit nose-breathing. Some individuals have very tight diaphragms, which can make deep belly-breathing challenging. Some of these conditions can be treated more quickly than others; some folks have access to treatment, some do not.

The invitation is to be curious. Intentional breathing is a gift, for it anchors each of us back into the grace of this moment where kindness is possible. My encouragement is to be curious about what works and what does not work for you as you forge ahead to create safety in connection.

Linda Thai, MSW, ERYT-200, CLYL, is an adjunct faculty member in the Social Work Department at the University of Alaska Fairbanks and specializes in trauma-informed care and compassion fatigue resilience skills. She is also a mental health clinician at ND Systems, specializing in somatic therapies and trauma therapy. For more information, please visit www.linda-thai.com

If you'd like to learn more about Linda Thai's work, please visit her website.

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