By Philip Pawley
Asthma is essentially a breathing problem. No, I lie: asthma is not a breathing problem. Asthma is one’s own inappropriate reaction to feeling unable to breathe. This somewhat revolutionary statement (revolutionary to people who don’t know about the Alexander Technique) has important consequences for the treatment of asthma. Before I can consider those, however, I need to demonstrate the truth of what I say: the symptoms of asthma result from a very usual, but inappropriate, reaction to feeling that one is unable to breathe.
Let’s look at two major symptoms that are always present in an asthma attack:-
- The airways are constricted, making it difficult for the air to flow through them.
- The victim of the asthma attack is constantly straining to breathe in, even though it is readily apparent to the outside observer that what they need to do is to let out the air they have already breathed in. Only then will they have room for a fresh lungful!
Looking at the second symptom first, you can see what I mean straight away. The sufferer, feeling short of air, reacts by straining to take in more air even though the lungs are already at full stretch. This totally inappropriate reaction to feeling short of air then insures that there truly is a shortage.
Let’s return to the first symptom: the airways are constricted and feel blocked. How does the asthmatic react? By trying to force air past the blockages by forcibly sucking air in and blowing it out again. The heavy, chesty breathing we see whenever someone is out of breath. This triggers a reflex tightening of the muscles in the air-passage walls, constricting them further. (An attempt to flush out the blockage with a jet of very fast-moving air, this reflex is seen in normal operation whenever one coughs, sneezes or blows one’s nose – often with very effective results!).
In other words, the asthma sufferer’s real problem is not the physical fact of constricted bronchioles – or even inflammation. These are secondary problems, mere symptoms of the fact that it is their reaction to feeling unable to breathe that makes them less able to breathe than ever. Their reaction to feeling constricted is what makes them constrict their airways even further.
We see that the usual, habitual reaction is just about the worst possible. If, instead they had reacted to the feeling of breathlessness by refraining from making any effort to breathe, the problem would have automatically sorted itself out: both because their air passages would have relaxed and dilated and because they would have allowed their respiratory muscles to release and let the stale air out, leaving room for a new supply of fresh air. Without the Alexander Technique, this isn’t easily done, though.
To really understand the problem, we need to make it personal. If I am suffering an asthma attack, the thing I feel I have to do to breathe is the very thing that is interfering with my breathing. To stop interfering with my breathing I have to stop trying to breathe even though when I stop trying to breathe it feels as though my breathing has come to a standstill and that, if I don’t do something quickly, I won’t be around much longer. Allowing for a difference in degree of severity, this is the same problem we all have whenever we experience any difficulty at all in breathing. It doesn’t matter whether the problem is asthma brought on by hay fever or a stuffed-up nose due to a cold.
So next time you have a cold you too can breathe freely through your nose as normal. All you have to do is to stop sniffing and uselessly blowing your nose to get rid of the blockage! Don’t open your mouth either. Just ignore the feeling that you’re in dire danger of asphyxiation! Can you do that? I doubt it, but if you do, you will find that you are breathing freely through what was a completely blocked nose. Even if you do succeed for a time, I guarantee that the blockage will be back again shortly after. You see, it is no easy matter to disregard that feeling of asphyxiation. The fact that that feeling is utterly mistaken makes no odds.
Here, then, is a serious problem you didn’t know you had: an utterly unreliable sense of your own breathing. Actually, it’s more than that: it’s an utterly unreliable sense of movement, technically known as a debauched kinaesthesia. Recognising and then sorting out this problem is what the Alexander Technique is all about.
There is also a current of opinion, following the Russian Dr Buteyko, that the constriction of the airways is due to a shortage of carbon dioxide in the blood as a result of hyperventilation. It is certainly true that all this effort to breathe can and often does result in hyperventilation. Whether the carbon dioxide shortage is also a contributory factor to the tightening of the airways, I cannot say. Either way, the remedy I am advocating, by calming the breathing, eliminates the tendency to hyperventilation and so allows the carbon dioxide levels to return to normal.