Behavioral and Psychological Approaches to Breathing Disorders

Front Cover
R. Ley, B.H. Timmons, Ronald Ley
Springer Science & Business Media, Feb 28, 1994 - Medical - 321 pages
We start life with a breath, and the process continues automatically for the rest of our lives. Because breathing continues on its own, without our awareness, it does not necessarily mean that it is always functioning for optimum mental and physical health. The opposite is true often. The problem with breathing is that it seems so easy and natural that we rarely give it a second thought. We breathe: we inhale, we exhale. What could be simpler? But behind that simple act lies a process that affects us profoundly. It affects the way we think and feel, the quality of what we create, and how we function in our daily life. Breathing affects our psychological and physiological states, while our psychological states affect the pattern of our breathing. For example, when anxious, we tend to hold our breath and speak at the end of inspiration in a high-pitched voice. Depressed people tend to sigh and speak at the end of expiration in a low-toned voice. A child having a temper tantrum holds his or her breath until blue in the face. Hyperven tilation causes not only anxiety but also such a variety of symptoms that patients can go from one specialty department to another until a wise clinician spots the abnormal breathing pattern and the patient is successfully trained to shift from maladaptive to normal breathing behavior.
 

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Contents

Beverly H Timmons
1
Basic Anatomy and Physiology of the Respiratory System and the Autonomic Nervous System Karen H Naifeh
17
11 Basic Anatomy
18
12 Mechanics of Breathing
22
13 Gas Exchange
26
14 Regulation of Respiration
31
15 Influence of Respiration on Cardiac Function
35
2 The Autonomic Nervous System
36
The Role of the Physiotherapist in the Treatment of Hyperventilation Elizabeth A Holloway
157
11 Normal Breathing
158
2 Initial Assessment
159
23 History
160
25 Identification of Trigger Factors
161
27 Other Types of Breathing Training
162
3 Reeducation of Breathing Patterns
163
32 Preparation
164

22 Neurotransmitters
40
23 Functions of the Autonomic Nervous System
42
3 Stress
44
4 Further Reading
45
Nasopulmonary Physiology Pat A Barelli
47
11 Preparation of Air for the Lungs
49
15 Body Temperature
50
18 Sleep and Postural Adjustment
51
19 Nose versus Mouth Breathing
52
22 Nasal Pressure Tests Rhinomanometry
53
23 Sinus Nasoantral Pressure Tests
54
26 Middle Turbinate Syndrome
55
4 Conclusion
56
Behavioral Perspectives on Abnormalities of Breathing during Sleep Christian Guilleminault and Donald L Bliwise
59
2 Sleep Apnea Syndrome
61
3 Treatments for Sleep Apnea Syndrome
62
4 Guidelines for Therapists
64
5 References
65
6 Further Reading
66
Control of Breathing and Its Disorders Sheila Jennett
67
12 Motor Pathways from Brain to Respiratory Muscles
68
13 Inputs to the Brain Stem Complex
70
2 Components of Normal Behavioral Control
72
22 Deliberate Control of Breathing
73
32 Correction of AcidBase State
74
34 Correction following Reflex and Voluntary Interference
75
4 Disorders of Control
76
42 Breathing Too Little or Too Much 421 Underventilation
78
43 Inability to Exert Voluntary Control over Breathing
80
Breathing and the Psychology of Emotion Cognition and Behavior Ronald Ley
81
2 The Effects of Breathing on Emotions and Behavior
82
3 Breathing and Cognition
84
32 The Effects of the Expectation of Noxious Events on Breathing
85
Hyperventilation and Cognition
86
34 Hyperventilation and Cognitive Deficit
87
35 Test Anxiety and Hyperventilation
88
4 Hyperventilation Cognition and Conditioned Emotions
89
5 Concluding Remarks
90
51 Clinicians Research and the Progress of Science
91
Diagnosis and Organic Causes of Symptomatic Hyperventilation William N Gardner
99
22 Alveolar and DeadSpace Volumes
100
24 Control of Breathing and CO2
101
3 Short Historical Survey
102
4 Diagnosis
103
42 Signs Features Found on Examination
104
5 Etiology of Hyperventilation
105
52 Organic Causes of Hyperventilation
106
6 Investigative Sequence
108
62 Diagnosis of Hyperventilation
109
63 Search for Organic Causes of Hyperventilation
110
8 Conclusion
111
Hyperventilation Syndromes Physiological Considerations in Clinical Management L C Lum
113
2 Etiology
115
3 Factors Affecting Symptom Threshold
116
34 The Voice
117
5 Physiological Mechanisms
118
52 Respiratory Alkalosis
119
54 Loss of CO2 from Neurons
120
6 Pseudoallergy
121
83 Education
122
10 References
123
Psychiatric and Respiratory Aspects of Functional Cardiovascular Syndromes Christopher Bass William N Gardner and Graham Jackson
125
2 Psychiatric Aspects
126
3 Respiratory Aspects
128
32 Hyperventilation as an Etiological Factor in FCSs
129
33 The Etiology of Chest Pain in Functional Heart Disorders
130
34 Effects of Hyperventilation on Cardiovascular Function
131
4 Assessment
132
42 Assessment for Evidence of Hyperventilation
133
43 Psychiatric Assessment
134
54 Psychotropic Drugs
135
7 References
136
Hyperventilation and Psychopathology A Clinical Perspective Herbert Fensterheim
139
3 The Secondary Reactions
140
4 Problems in Formulation and Treatment
144
5 Summary
146
Management of Patients with HyperventilationRelated Disorders Christopher Bass
149
3 Treatments
150
32 Breathing Retraining Physiotherapy or Controlled Breathing
151
33 Psychological Treatments
152
4 Concluding Remarks
153
5 References
154
33 Retraining Method
165
34 Frequency of Sessions
166
35 Group Instruction
167
38 Progress
168
310 Posture
169
313 Clothing
170
316 Challenge
171
42 Mental Relaxation
172
43 TapeRecorded Instruction
173
6 Conclusion
174
8 Further Reading
175
Breathing and Vocal Dysfunction Daphine J Pearce
179
3 Resonators
181
5 Singing
182
7 Smoking
183
8 Posture
184
10 Observation
186
12 Therapy
187
121 Relaxation
188
13 Conclusion and Guidelines for Therapists
189
14 References
190
Respiratory System Involvement in Western Relaxation and SelfRegulation Paul M Lehrer and Robert L Woolfolk
191
3 Hypnosis
193
5 The Alexander Method
194
6 Meditation
195
7 Paced Slow Respiration
196
8 Abdominal Breathing
197
9 Biofeedback
198
10 Relaxation and Hyperventilation
199
11 Conclusion
200
Behavioral Management of Asthma Jonathan H Weiss
205
3 The Role of Psychological Factors in Asthma
207
31 Cognitive Variables
208
33 Behavioral Variables
210
41 Asthma Interview
211
42 Asthma Problems Checklist APCL
212
44 Asthma Diary
213
51 Knowing the Facts and Fallacies about Asthma and Its Management
215
52 Knowing Ones Symptom Precipitants and Aggravants
216
54 Relaxing and Doing Abdominal Breathing
217
55 Talking to the Doctor and Other Members of the Treatment Team
218
7 References
219
Respiratory Practices in Yoga Frank A Chandra
221
3 Prolonged Expiration
222
7 Nasal Passages and Nasal Cycles
223
9 Effects of Pranayama on Carbon Dioxide Levels
224
10 Underbreathing Normal and Overbreathing
225
11 Respiratory Muscles
226
13 Comparison of Pranayama and Mechanically Assisted Ventilation
227
15 Hormonal Effects
228
16 Meditation
229
18 Guidelines for Therapists
230
20 Further Reading
232
Styles of Breathing in Reichian Therapy David Boadella
233
2 Breathing Patterns
235
4 Intestinal Breathing
236
5 Breathing as Sucking
238
7 Words of Caution for Therapists
241
8 References
242
Breathing and Feeling Ashley V Conway
243
An Integrative Model
244
3 Implications for Therapy
248
4 References
250
Breathing Therapy Magda Proskauer
253
BreathingRelated Issues in Therapy Beverly H Timmons
261
2 Emotion and Breathing
263
3 Placebo Responses and Breathing
265
4 Panic Attacks and Breathing
266
42 Assessing Treatment Outcome Studies
267
Their Significance for Therapists
270
52 Physiological and Clinical Evidence
271
53 Performance and Breathing Patterns
273
6 Breathing Retraining
274
61 Problems in Retraining Breathing
276
7 Breathing Measurements in Therapy
281
72 Biofeedback of Respiratory Measurements
282
8 Future Directions
286
9 References
288
Publications of the Symposia on Respiratory Psychophysiology
293
Author Index
295
Subject Index
301
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