#26: How Breath Can Heal Trauma and Restore Meaning - Dr. Patricia Gerbarg

Note: This conversation with Dr. Patricia Gerbarg was recorded in August 2025.

In this episode, we explore how breathing patterns reshape the emotional brain, restore a sense of safety, and allow meaning to return to daily life with Dr. Patricia Gerbarg, co-creator of the Breath-Body-Mind program.

From her personal development as a healer to co-creating a global healing community active in trauma hotspots like Ukraine and Rwanda, we explore the science, stories, and practical tools that help people regulate their nervous systems and reconnect with meaning.

In this episode

• Meaning as state-dependent and grounded in safety
• What Breath Body Mind is and why safety comes first
• How vagus nerve signaling links breathing to emotion
• Why talk therapy alone often cannot reach stored trauma
• The sequence: focus → movement → muscle softening → coherent breathing
• Evidence from 9/11 survivors, veterans, schools, and IBD patients
• Programs in Ukraine supporting clinicians, children, and communities
• Rwanda’s community model blending breath, ritual, and narrative
• Restoring connection, agency, and love through breath practices
• How to start with short, safe practices and build consistency

Timestamps

0:14 – Opening Teaser: Breath and Meaning
 1:42 – Host’s Mission and Series Kickoff
 2:39 – Introducing Dr. Patricia Gerbarg
 3:48 – Why Breath Body Mind Exists
 7:31 – Global Growth and Going Online
 12:18 – Scope, Impact, and Ukraine Programs
 16:24 – From Psychoanalysis to Mass Healing
 20:31 – A Child’s Panic to Schoolwide Resilience
 24:20 – Gerbarg’s Public Speaking Breakthrough
 28:18 – Early Life and Path to Psychiatry
 36:58 – Discovering Breath After Illness
 41:04 – How Breathing Shapes Emotion
 47:14 – Publishing the Vagal Theory
 52:59 – Using Breath Clinically for Trauma
 59:22 – Building a Safe, Effective Sequence
 1:03:24 – Focus, Agency, and the Ha Breath
 1:06:07 – Coherent Breathing as the Foundation
 1:11:47 – Evidence From 9/11 to Schools
 1:16:47 – Inflammatory Bowel Disease Trial
 1:22:00 – Why Breakthroughs Lack Headlines
 1:27:04 – Real-World Results in Irish Schools
 1:30:48 – Rwanda’s Community Healing Model
 1:37:18 – Perpetrators, Forgiveness, Reintegration
 1:42:49 – Meaning as Connectedness
 1:47:44 – Rapid-Fire: Love, Art, and Advice

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Theme music by The Thrashing Skumz.
Developing Meaning is produced by Consilient Mind LLC.

Transcript

Opening Teaser: Breath And Meaning

Dirk 0:14

Hello, meaning seekers. In today's episode, I ask whether there's a connection between our breath and the meaning we create. Before we start the interview, here's a short teaser from today's guest.

Dr. Gerbarg 0:35

One of the most important effects that we've observed with the breathing is that it enables people to experience what I call a meaningful connection. Doesn't matter what it is, it could be a person, it could be a concept, it could be the universe, but the sense that you're connected in a meaningful way that seems to be activated by the practices and creating the conditions for that to happen.

Host’s Mission And Series Kickoff

Introducing Dr. Patricia Gerbarg

Why Breath Body Mind Exists

Dirk 1:05

That is so interesting to me. You just heard the voice of today's guest, Dr. Patricia Gerbarg. I am so excited to share this interview with you. In this podcast, I explore how people heal, how we sometimes suffer, and how we all can find our way back to connection. Meaning has a lot to do with connection for me. Often I do this by entering new healing communities, learning new models of the mind and healing approaches, and then talking with clinicians and teachers who are quietly changing the field. Today's episode opens our 2026 series with a really remarkable guest, Dr. Patricia Gerbarg. She is a Harvard-trained psychiatrist, psychoanalyst, researcher, and co-creator of the Breath Body Mind Organization, along with her husband, Dr. Richard Brown, who has been a previous guest and who also has a brief breathing demo that you can listen to on this podcast. Those are episodes 12 and 13, and I recommend checking those out. You may not yet have heard about Breath Body Mind, but I'm sure you've felt some of the problems that this healing approach addresses. Trauma, anxiety, and chronic stress do not just live in our thoughts, they live in our bodies. They shape how safe we feel, how connected we feel, and ultimately how much meaning we're able to experience in our lives. One of the central ideas that emerges in this conversation is that meaning is state dependent. And when we are chronically threatened or disconnected, meaning collapses. When we feel safe and well regulated, we can feel connected and meaning can return. Sometimes remarkably, and you are going to hear some remarkable stories of healing today. Dr. Gerbark has spent more than 25 years studying how something that's both ancient and ordinary, the breath, can help restore this healing state. Her work has been used with survivors of genocide in Rwanda, with people living through war in Ukraine, with people surviving 9-11 in New York City, and with kids in challenging school situations. Also, even in patients suffering from inflammatory bowel disease, there's now a study with really exciting results that you will hear about in a little bit. So in this wide-ranging long-form conversation, you will get to know Dr. Gerbarg and you will hear how breath patterns directly influence the emotional brain, why trauma can't be healed through words alone, how safety, connection, and agency are restored through connection with the body, and how breath can help with this. And we're also going to hear what all of this has taught Dr. Gerbarg about love, healing, and creating meaning in our lives. I really enjoyed this conversation. I am sure you will too. So without further ado, let me present to you my interview with Dr. Patricia Gerbarg. What is Breath Body Mind? How big is it? How where is it? How long has it existed? What is the picture? What is Breath Body Mind right now, 2025?

Dr. Gerbarg 5:25

Yeah. Breath Body Mind right now is a program that has uh numerous components, but most of them have to do with breathing, coordinating breathing practices with movement, mental focus, awareness of internal changes, and different kinds of visualizations and meditative states. So it's a really a program, it's a rich program that has many parts, and it's easily adapted for the individual as well as for groups of people who may have had some life-changing experience together, such as surviving a mass disaster, being in the middle of a war. These kinds of overwhelming experiences change people forever, and unfortunately, often in ways that distort their experience of life. We want to restore as best we can people back to whatever it is for them that would be the course of their life, their way of experiencing themselves and the world. And so we need something that reaches deep inside that can untangle all the twists and knots created by trauma. And then when the person is in their best state, enable them to then move forward in life.

Dirk 6:57

Nice. And I'm a level two, I've done your intro and level one, level two training. I'm a big fan, and you're describing the tools that you guys you have put together and you have refined. And I want to get into that. I just also want to hear a bit about how big and how broad you are, because there's so much out there in terms of breathing. And how many countries are you in? How many practitioners do you have right now?

Speaker 3 7:31

Okay. So what happened with Breath Body Mind, we had people that we had trained in a number of countries over the years, since we've been doing this for over 25 years now. And basically through word of mouth and whatever was put out on the internet, people found us, or they brought their friends and people who knew us and so on. So it's been growing. When COVID hit, I knew that we had to change all of our in-person breath body-mind sessions to online. So we did that. It took a lot of work to make it as impactful online, but we were able to fortunately achieve that. Since we've been online, of course, people from all over the world have been able to easily access the experiences that we offer. So we're in many countries now. I don't even know how many there are because we don't necessarily keep track of every single country that where somebody's tuned in and learned from us. But I do know that we have large programs in certain places because what we had to do up until that point, we mainly were just we were volunteering, our teachers were volunteering. We had some small programs that were paid, and then we'd have scholarships, but it got so big that we had to be able to pay our teachers for their time because there were so many programs happening. So we created a nonprofit foundation. And since then, we're going into our fifth-year celebration this December, and maybe you and your friends can join us.

Dirk 9:13

I'd love to, yeah.

Dr. Gerbarg 9:14

Yeah, our fifth year celebration, we have we have teachers from around the world who talk about what they've been doing. I would say our most gr active and growing programs are in Ukraine, where we've trained over 300 mental health professionals, as well as thousands of other just people who need help there. And they are now out there teaching it to their patients, to people in their communities. They've gone into schools to give it to children because we have a children's program. They've gone into some of the military psychologists are training with us right now because, of course, the war trauma is tremendous and they their people have to keep fighting.

Dirk 10:00

So Do you have numbers on how many level one, two, and three people you've trained at this point?

Speaker 3 10:08

We don't have exact numbers. If I had known you wouldn't have asked me for that, I would have gotten them collected for you. So I'm remiss.

Dirk 10:18

If you were to guess off the top of your head.

Speaker 3 10:29

So there's Ukraine. We have a lot of teachers in Turkey since the earthquake. When there's a disaster, we immediately offer open free crisis sessions online, and people come to that and then they want to be trained. We have quite a few in Turkey. We have a lot of people in the UK and Ireland, especially. We have programs in Brazil now, both for health professionals, but also small programs starting that this year for indigenous folks. We have programs in teachers in most countries in Europe. We have programs now in the Middle East that are growing. We also have started in Cambodia. We have teachers in different places. We have maybe we'd have a teacher in Pakistan. We've got a child teacher in Japan. It's Africa. We have a lot of programs there, especially in Rwanda, where we're connected with the Ubuntu Peace Center. They are responsible for thousands of genocide survivors. And what of the, and that center has used our program as a pillar of their community outreach efforts. And they are also collecting data and so on. So we know we've trained thousands of given it to thousands of people there with very good effect. And in other African countries, South Sudan, Uganda, Nigeria, some teachers in South America, that hopefully gives you a picture. Of course, we have a lot of Canada.

Dirk 12:03

It's hard to take in the scope of what you're just saying. What does it feel like to describe this and to know that you've built something that is now moving through so many people?

Speaker 3 12:18

The first thing to realize is that before I did this, I was a conventional psychiatrist in psychoanalysis. I saw one person at a time, usually for an hour at a time, uh, over many years. And with my analytic patients, I might see them four hours a week, maybe for five to seven years. So the number of people that I could treat in my lifetime career was limited. Being able to know now that this work is reaching tens of thousands of people, it just still gives me chills when I think about that. But the other thing to tell you is that what impacts me the most is the individual person that I can be in contact with. And so in working, for example, with Ukrainians, in getting to know them, in hearing their stories, in seeing them recover from the damage that the trauma has done to them and their families, to see them rise and go out and teach hundreds of people, that to me is so inspiring because of their spirit that can now come out again. Their spirit that was almost crushed, and then it was like you you just blew gently on the flame, and now they're out there in a powerful way helping other people in the middle of a war when they hear bombs falling all night every night. That kind of courage, that's what fuels me when I'm tired. That I just think of that and I I want to keep going.

Dirk 14:00

Is there a story that you can share of an individual that you worked with, you taught these techniques? I know we want to be private and not share other people's personal information unless people are okay, are really okay with that, but just to give a sense of somebody who's in the middle of this horrible war situation and dealing with bombs, and then you're doing this training, giving them this tools. And it's probably hard to pick one example. There's probably a lot of examples, but is there one example that might come to mind?

From Psychoanalysis To Mass Healing

Speaker 3 14:39

I I'll give you this one example. This is a woman who was a psychologist, and like most of the psychologists that we met there, they're trained to work one-on-one with adults. And yet their biggest worry is the effects of the war on the children of their country. So they wanted us to teach them how to work with children. And we do fortunately, we have developed with help from many people a wonderful program for children that's very simple. It's very effective, and it can work like literally within minutes. Whether a child is traumatized by war or just they have other issues, these techniques are fantastic. Anyway, she was suffering because of the cumulative trauma of the war. She had become depressed and developed a lot of physical symptoms, which is very common in this situation. Everything from backache to headache to inability to sleep, she was always exhausted. And she took our program and she became a level two teacher, just like you. Oh, she had a son. Again, I'm not going to give specific details of his age, but he would panic when the bombs would be the alarms would go off and they had to go to a shelter quickly, he would just be in a panic and have panic attacks. And the alarms were going off all the time. So it was terrible. But she once she learned the techniques and how to do them for kids, she used them with her son and cured his panic attacks. So when the alarms went off, he no longer panicked. And then she got the idea that about all the children i i in the school nearby. So she just went to the school and approached the teachers and offered to trade them and the kids, which she did, and in two weeks' time, she did this very quickly. She worked, she gave all the teachers two half-hour sessions, and then she spent about seven minutes in each classroom. There were 500 children in this school, ranging from age seven to 17. Okay, so all these kids. And she did this all in two weeks. And in the course of that time, as she taught the teachers how to work the program with the children, and she sent us pictures, which I absolutely love, the kids stopped panicking or getting upset when the air raids happened. And they were able to, on their way, they do their breathing practice, and on their way to the shelter, they would be doing breathing practices in movement while walking. And when they got to the shelter, they had other practices because they're all like games. And she sent me pictures of these kids. They used to get depressed, upset, withdrawn when they'd go to the shelter. Now they're like fine. They do their classwork, they pay attention, they play games, they do creative activities. And she told me that the school produced for the school and the parents a musical. And they actually produced cats, a school version of it in the middle of this war.

Speaker 1 18:05

Wow.

Speaker 3 18:06

Because the creativity was out there, and everyone had just the sense and the spirit to do something like that. So that's one of the stories I love.

Dirk 18:19

Amazing. So from here, I'm curious about so many things. I'm curious about the sequence of steps and how you developed the sequence of steps. I'm curious about why these are effective. And then I'm also curious about your personal story. And maybe to start there, I'm curious about you in your book, you talk about not being so comfortable with public speaking and then learning these breathing techniques and that really change things for you. Can you share that story?

A Child’s Panic To Schoolwide Resilience

Speaker 3 18:59

Okay. I had a very good education. I was blessed. And I want to also thank my parents, especially my dad, who believed that women could do whatever they wanted, and I especially could become whatever I wanted, and supported me to become a doctor. So that that was a fortunate thing. Anyway, I have always had a fear of public speaking, getting very nervous with the butterflies in the stomach, the jelly knees. But the worst part of it was that I would, my jaw would actually lock like this. So you can imagine trying to speak publicly with a locked jaw, it doesn't work very well. And when I was an adult, I managed to avoid public speaking my entire training. And of course, I was very comfortable basically working with one person in my office. I could talk to a very small group. I was fine with that seminar or whatever, but don't give me an audience. I had I had agreed to give a talk at a local group, a community group, about the breathing practices many years ago. And in the middle of it, my jaw locked. And I had to deliver the rest of it with clenched teeth. And after that, I absolutely refused to speak. That was the end publicly. But my husband and I, I think you've had Dr. Brown on here. Yes. He's a very good, polished, eloquent public speaker. We were giving lectures together at the American Psychiatric Association Annual Meetings, which is the largest gathering of psychiatrists internationally once a year. And every year, together we would prepare these lectures on complementary and integrative treatments. And I had my favorite two lectures, which I was supposed to give. And every time we'd get there and it was time for me to give my talk, he'd look at me and I'd go, give my talks as well as his. And understand we were giving eight-hour all-day courses in integrative medicine. So it meant he had to talk the whole eight hours, which I felt badly about. Anyway, we I was doing the breathing practices, it was two years, and we went to the meeting as usual, and we sat at the front as usual, and it came time for my talk. And I just stood up, went to the microphone, looked at everybody, and started talking. I didn't panic. I wasn't anxious. It was it was really totally unexpected. And since then I have loved public speaking. So I can't explain to you how breathing did this because nobody really could explain it, but it was a consequence of that. And I'm very grateful for that.

Dirk 21:55

Wow, that's uh that's a dramatic change. You're saying this is two years into. Doing your daily breathing practices, and then suddenly here's this huge shift in you, and it's been transformative ever since.

Speaker 1 22:12

Absolutely.

Dirk 22:13

Amazing. So I also want to back way up and get your personal story. I you're really an amazing teacher, and and you are a psychoanalyst. And for me, one thing that I found frustrating is that there are so many great psychoanalyst teachers, but I never really knew much about them personally. And so this the culture of the sort of the blank slate anonymity, I found, I don't know, it's probably something about me, but I found it frustrating because I like to know something about the person in order to see how to value their advice or their perspective. So for me, it's always interesting. And I'm also a child psychiatrist, so I'm interested in how people develop and professionally how we land where we land. Just to start at the very beginning, I would like to hear where were you born and what was in the ether at the time, either genetically or environmentally, that sort of set you up to become a healer.

Gerbarg’s Public Speaking Breakthrough

Speaker 3 23:20

Oh boy. Okay, I'll try to I'll try to condense that as best I can. I was born in Baltimore, the second of four children, Baltimore, Maryland. At the time, my father was serving in the military as a physician, and he was in charge of a wing of a hospital. He was fairly fresh out of his medical training. Because of the Korean War, they had accelerated his program and condensed four years of medical school into three. And so he was serving a military facility. We were living in a place called Perry Point, Maryland, which was part of an army fist base. And my mother described it as a mud hole where there was a little corner grocery store, and I don't think there was much else there. So she was very isolated, away from her family for the first time, with no supports, with my father constantly working at the hospital, because of course there was as short as your doctors, and he had a big responsibility. But on top of that, he was an avid reader and learner. And so during his precious free time, he had a book club that he did reading the great books with all the other people he knew that he could bring to the house to do that. So there wasn't much support, I think, for her. And she had my sister, and 18 months later she had me. So this was quite quite a load on her. So that's the circumstance that I was born into.

Dirk 25:07

And then how did that lead you to medical school? And we can jump forward a lot and move quickly.

Speaker 3 25:15

So I would say probably obviously the greatest influence was my relationship with my dad. And although he was very busy, he would create ways to spend time with each of his children individually as well as a group. For example, I would sometimes get to ride with him when he went on rounds at the hospital very early in the morning, and we'd have time in the car to talk. And then we get to the hospital, and I'd sit in the waiting room with the switchboard operator who had one of those old switchboards where you pulled in and pulled out the cables. And I would listen to the speaker as they paged him constantly, Dr. Gerbart to the IC, Dr. Gerbart to the whatever. And so I get the sense of how important his role was at the hospital. I saw how everyone spoke to him there, how they turned to him, how they trusted him, how he always seemed to know what to do and how to help people. And all of that, of course, I absorbed. He also was able sometimes to ride with him, because we lived, they had originated in Philadelphia, but they wanted to get out of the city. And so they moved up to the Hudson Valley into literally what had been an old stone farmhouse in the middle of Wernfields. And he had his rural practice, also with a small town nearby at the time. So during the winter, and the winters there were very different. And you might not see the ground again until spring. So there was a lot of snow and ice, and people living in the mountains around there, the Catskills. So I would get to ride with him in the car when he made house pools. When the older folks could not get out to his office, he was still making house pools. And so riding in the car, we had a lot of time. And then seeing how he treated people, because I would I would be sitting there in their living room and he would be talking to them and listening to their heart. And just seeing how gentle and caring and respectful he was and how he treated them as though they were part of his family. That all was part of what I was fortunate to experience.

Dirk 27:40

Yeah, wow. What a different time. And here you really get to experience going into somebody's home and being with a real person and this just a very different kind of human connection than we ha have now a lot of the time.

Early Life And Path To Psychiatry

Speaker 3 28:04

Once I got older, when I was pre-med student and a med student, he would take me with him on rounds, and I'd see him reading his cardiograms and talking to the patients and all of that kind of thing. It's not easy to take your kid to work, but he managed to do it. And so I was in that atmosphere. I saw how the nurses interacted with him. I saw how he treated the staff. I got a job as a ward clerk in a hospital one summer. And that's that was an eye-opener because you get to see how the different personalities of the doctors affect what goes on the ward with all this. There's certain doctors who, and unfortunately not many, but they would come and they would literally have a temper tantrum if anything was wrong or not. They thought even if they didn't give the order, it was supposed whatever it was. So the word would come that certain doctor was coming to the unit and the staff would disappear. Nobody wanted to take the brunt of it. But most of the doctors were fine. But I so I had a different perspective on being a doctor and what it should mean and what it shouldn't mean.

Dirk 29:16

So you had this inside window into this really special kind of physician-patient relationship. And it sounds like you early on recognized the appeal of that and knew that you wanted to go in that direction. What about psychiatry? How did and were there any sliding glass, like you could have gone this way, could have gone that way moments?

Speaker 3 29:39

My father used to talk about his work. He wouldn't say a specific person, but he'd talk about it. And it became very clear that he spent a lot of time just talking with his patients, and he told me that a lot of what he did was practice psychiatry, even though he was an internist. It turned out that remember I told you that when we were on the that Army base, he was in charge of a wing of a hospital. Fresh out of trading. So he learned a lot about psychiatry. And he really admired what psychiatrists do and had friends who were psychiatrists and always wanted to learn more. He was fascinated, interested in people. And he would tell me that from his point of view, even though he was practicing internal medicine, 60% of his work was really psychological. So I was also primarily interested in people as people, not necessarily as bodies or interesting illnesses. When I went to medical school, I had the idea maybe I would do the same. But what I found when I was doing rotations, rotations in medicine, rotations in psychiatry, all different neurology, which I was also very interested in, the place where I was most at home always was in psychiatry. And the place where I got the most positive feedback was from my teachers when I did rounds in psychiatry. And little by little I said, you do you need to use and know medicine to practice psychiatry? What I really want to do is talk to people.

Dirk 31:25

So that all makes sense. And where were you in medical school and residency?

Speaker 3 31:31

I was at Harvard Medical School, and then I stayed in the Harvard system, did an internship at Cambridge Hospital, a rotating internship, and then my psych residency at Beth Israel Hospital in Boston, and then I trained at the Boston Psychoanalytic Institute.

Dirk 31:48

Nice. And so then how did you encounter breathing? Like how did that enter your life?

Speaker 3 31:56

Much later. I practiced conventional, what I would call conventional psychiatry and psychoanalysis for the first half of my career. And it was actually my husband, Dr. Brown, that introduced me to breathing practices at a time in my life when I was recovering from a very severe prolonged illness. And I had gotten Lyme disease, gotten into my brain. I had neurolime, severe neurolime for many years, was an invalid for a period of time. I don't want to go into details about that. But as I was recovering from that, he was becoming more and more interested in breathing practices. And he said to me, you should do this breathing because you know it would be helpful, it would help you. And my first reaction was, honey, thank you for the suggestion. But remember, I have three little children, I have a dog, I have two papers I'm writing, and my patients to take care of. I don't have time to do nothing but sit and breathe.

Dirk 33:03

And to pause with that, yeah, I feel like this is really important because I breathing is so powerful. It's so ancient. It can do so much. And yet, there's often this reaction of, oh, this is weak sauce, like what you're telling me to breathe. I breathe all the time. I roll.

Speaker 3 33:24

Yeah, I was typical of most physicians. I had never heard about and or learned anything in all my years about breath training. I knew nothing. I had no clue. I was not trained in meditation. I just was ignorant speaking, really. And but he's a very persuasive person and very patient. And he kept telling me different ways it would help my health and my recovery and this and that. So I said, okay, okay, already. I will do it. And so I took a program with him, and I was totally amazed.

Dirk 34:03

Which program was this?

Speaker 3 34:05

At that time, we the first course I took was through the Art of Living Foundation. It was a Suddarshan Priya program, and it had a lot of different kinds of breathing, intense breathing, gentle breathing, many things. But it was a small group of about 10 people that I knew, most people I knew. And I was shocked at the effect it had on me and on the other people in the room. We all talked about what we were experiencing. And at that time, if you asked people or you asked scientists or doctors, how does this work from India who use this, they would say it increases the oxygenation of that brain. But I knew that couldn't be it, that the changes that I observed were far beyond what could be happening just by increasing oxygenation. And so I became curious.

Dirk 35:06

What were the changes that you observed? And I also, when I took your course, the intro course for the first, the two-day course, there was a huge shift that I noticed. I was immediately sleeping better, more relaxed, more energetic, more focused. It was a dramatic change that I noticed at the time. What did you notice?

Speaker 3 35:30

I noticed all those kinds of things. And beyond that, it seemed to create a kind of mental clarity so that things that, for example, unresolved problems or issues or things that you didn't fully understand, suddenly you would see it more clearly. And it's like the pieces, you could put the pieces of puzzles together better. And the other thing was that it changed the way people were relating to each other, how they were interacting, and how they felt in those interactions with each other. So I gathered that it was changing the way people think, how they perceive, how they feel, how they connect to other people, and a whole host of things that it was quite powerful. And there was a lot there that we didn't understand and that I wanted to understand because I'm that type. If something's happening, I want to understand how and why, and if possible, how it can be used in therapeutic efforts to help people. Because something that powerful could certainly be used therapeutically.

Discovering Breath After Illness

Dirk 36:50

Yes. Here I would like to hear more about how you understand that this makes sense, that breathing changes our emotional state. This also connects to meaning. And I'm thinking of Deb Dana, who I've had on the podcast, and she talks about the vagus nerve, which innervates all of our muscles of human connection, but also our internal organs and our lungs. And she says that meaning sort of emerges from our internal states, and breathing connects and can shift our internal states. Can you explain the connection between breathing and emotion?

Speaker 3 37:33

So can I tell you a little story of where her ideas might have come from?

Dirk 37:39

Yes.

How Breathing Shapes Emotion

Speaker 3 37:40

So now we're going back to the year 2000. We're going 25 years back. Okay. What happened next was as we continued breathing, and we be I began to and Dr. Brown together began to try to find some answers to all the questions that we had in our minds about how this was working. Because if we wanted to use it therapeutically, we needed to know how it was working. We needed to know what we were doing. We weren't just going to mess around. This required that I spend a couple of years digging through all kinds of scientific studies, including studies of the respiratory system, neurological studies, all kinds of areas that I wouldn't have touched on in my training. And when I would find something, because what we were trying to do, we were trying to connect the dots between breathing, through what pathways can that affect emotions, through what pathways can it affect cognition, through what, and so on. We were trying to fill in the dots to get it that way. And which kind of breathing, because there were many different kinds we were looking at and how to separate them anyway. So we had this big chalkboard, and we were when I'd find a piece of information in an article, we figured out where that went, and we started filling in these pathways. But we still had one gap. We couldn't so there were two things I found that completed the pathways. One was reading about the cano receptors and other types of receptors inside the lungs, and how breathing in and breathing out sets off millions of receptors all throughout the lungs and the thoracic area and so on. Okay. So every time we breathe in or breathe out, and there are millions of air sacs in the lungs, in the walls of these little air sacs, there are three different kinds of stretch receptors. So every time they open and close, you're setting off these little blips and patterns. And all these little blips come together, the roots of a tree, and they go up the vagus nerve to the brain. The second thing that gave us a connection was when I read back in 2001 some of the papers written by Steve Porgis, uh, because he was one of the few scientists that for years studied the vagal system. When I was in medical school, we were only taught that the vagal system helps to regulate all the glands and organs of the body. It does so much more than that. As he discovered through tracking the actual neural pathways inside the vagus nerve to see where they went and what they were doing. And based on the papers of his that I read, we were able then to extend the connections that we were making, that these receptors were feeding into the vagal system. Through that, what we realized was that when you change your pattern of breathing, you're changing the pattern of millions of messages that are going to the brain. And through the work of Butt Craig, who did some of the early work on the insular or interoceptive cortex, the place where that information goes and is laid down in a kind of map of everything that's happening inside the body. And then what happens to that map? How the information in that map is transmitted then to so many other critical areas of the brain. And that's just one of many of the pathways that we discovered and learned about. And as we were doing that, more were being found over the years.

Dirk 42:00

And so that's huge, right? Because here we have all this information about our internal states. And our am I relaxed? Do I feel good? Am I nervous? And and that sort of sets our baseline meaning-making system. How do we interpret what's coming in? And if I'm anxious and keyed up, I'm going to put a very different meaning to what's happening. And here's a tool, a lever is maybe too simple to think of it, the way to describe it. But you have these millions of connections, all these alveoli, and it wires right into our fear center and emotional centers. And so there's this connection, this relationship that we can now use.

Speaker 3 42:54

So to continue the story, in 2002, there was a conference on the science of breath in India, in New Delhi. And we were invited to present our science. That's where we first presented our scientific theory in 2002. And we wrote our first papers, actually was a two-part paper describing it in 2002, and submitted that paper for publication in a journal. It took the journal editors two years to decide because they were so conflicted about whether or not to publish it. Because remember, at that time, nobody had a clue, nobody heard of this, but they didn't know what to make of it. So finally, after two years of waiting, I said, that's it, either publish it or give it back. So they published it. It came out in 2005. So for you to understand how that got that information or that it was really a theory, but it had a lot of science to back it up. And from that time, I think that we had a big influence on how people brought about the effects of breathing. Yeah. It's been fascinating to see over the years how the Indian researchers have developed with this. And then the Western researchers took it on and more and more this has become the prevailing way that people approach understanding this part these parts of the system.

Dirk 44:41

And the main message of the paper is that breathing and emotional systems are connected. What's the main message of the paper?

Speaker 3 44:48

The first part of the paper describes the neurophysiological theory and the pathways and the science that's based on. And it covers several different types of breathing practices and their effects. The second part which was subsequently published is the more clinical part that describes symptoms and what we see some of the work we've done at that time. When people talk about breathing in the vagal system I get a little kick out of it because I feel like I'm the mother of that.

Dirk 45:24

Yeah that's a great story. And what an important discovery and that's a long time 2002 to 2005 that really speaks to this being a big paradigm shift.

Speaker 3 45:39

We found we we actually this has been studied on average it takes eight years for a scientific idea to be accepted in the medical community. It's a very slow process and it's taken many years and many lectures and we've published many papers and other people have done a tremendous amount of research for this to eventually be viewed as illegitimate. And of course the theories are further changing and evolving and refining as we get more information. But the amount of research now on the vagal system that and these other systems is tremendous.

Dirk 46:19

It's really great to combine the science and the physiology with the ancient breathing practices.

Publishing The Vagal Theory

Speaker 3 46:27

That's the sort of the concilience and coming together of the ancient and the modern the clinical and the clinical clinical because we can use it and also remember all this time I began once I realized and understood which practices would have different effects, I began offering these to my patients. And so I was able to see in real time with people who I knew quite well how we could use the practices therapeutically to address the various issues that were people were struggling with in their real lives. And I was able to see over sometimes a year's perspective talk about follow-up how it would then progress and one of the things that really struck me I had a number of cases where people had severe childhood trauma sexual abuse physical trauma all kinds of traumas and the breathing practices were so helpful. When people would do these practices in some cases there would be an almost instantaneous change in the trauma as it was being held in their minds and their bodies and certain symptoms would just suddenly dissolve and once that happened they were gone and they didn't come back for the most part. What kind of symptoms are you thinking of for example there's rather specific symptoms of sexual trauma for example where the person would have either sensations or let's say distorted perceptions even to the point of illusions that they had a defect in their body in the place where the trauma occurred and therefore they had to hide that part of their body. And a person who had for example been in therapy with me for many years made a great deal of progress in their lives and in their issues but where there would be some core piece of that trauma that just wouldn't respond to the treatment. And when they learned the breathing practices and did them over time there would be a moment with the breathing when it would suddenly be gone. They wouldn't be reliving it or traumatized or anything.

Dirk 49:07

It would simply be gone as like your your speech jaw clenching.

Speaker 3 49:12

Right. As though there had been a knot that was suddenly unwound and then the circuits could function in the way they were intended to function and the way they would have functioned if there hadn't been that trauma. And I saw a number of these which really fascinated and really wanted to understand how you could resolve trauma and what might be involved in that which was huge because that's so easy to do that in therapy. And one of the things that I realized is that when people are going through trauma that is so overwhelming and even life-threatening to them, the language part of the brain shuts down. So they're not processing experience with any kind of language and it's not encoded in the brain in the form of words. So when you're doing talk therapy and all you're doing is using words, you're not able to get to that place because it doesn't it's not made of language and it doesn't understand words really. However, when they go through the trauma it's a physical experience and if you can in a sense reach and speak to that part of the trauma through the body.

Dirk 50:35

Yeah this is also huge then and I didn't read the body keeps the score until three four years ago but this whole idea of trauma is held in not the language parts of the brain and so needing to use other approaches that that get more into sort of the feeling centers and don't enter through the frontal cortex and the verbal that's a big shift. I've Columbia I feel like a lot of it was CBT and dynamic therapy and talking and thinking and so I've become very interested in these other approaches that go more through feeling centers or breathing, somatic approaches.

Speaker 3 51:24

The information from inside the body is laid down probably in that insular cortex and it's preserved in other words all of the information is organized just as the anatomy is organized and it retains that organization right up into the map. It's completely organized. So if there's a trauma formation obviously it must be retained in however we remember the millions of maps that we lay down about what's happening inside our bodies every day. So if you want to reach that you need to take that route.

Using Breath Clinically For Trauma

Dirk 52:06

And so now I'm very curious to hear about you have this neurocoming together of ancient tools modern science clinical how do you assemble that into this sequence of tools that you teach in breath body mind there's so many different breathing approaches and it can be overwhelming and confusing and I I think especially in the level two teach uh training that I took it it started to click for me that okay there's a sequence that you teach and it makes sense and each part of the sequence there's various versions that you could use. So how did you pick from all the different practices that you could do and how did you come up with this sequence that you teach and that also makes me think of the impact on these Ukrainian children that you said here's this sequence that you teach and it's a few minutes, 10, 20 minutes, but learning that has such a big impact. So how did you come up with this sequence? How did you choose your tools and put them in order?

Speaker 3 53:21

With the children the sequences are much shorter with adults as we recommend at least 20 minutes of coherent breathing. With the children each practice might last a minute or two or three so it very they go through it much faster. But the original question you asked me had to do with how did we come up with it. So again it was first of all we decided whatever we don't want to use any practices that are going to have bad effects on people or make people decompensate or make people have panic attacks because we had studied many different breathing practices and we saw that certain kinds of intense or rapid breathing can trigger panic attacks, trigger flashbacks in people with post-traumatic stress and other dissociative episodes and so on.

Dirk 54:15

This is like the Wim Hof deep fast breathing or the Stan Groff using fast deep breathing to create psychedelic states. So you don't use those we don't use any of that.

Speaker 3 54:29

If a person is basically healthy and doesn't have those kinds of issues and they want to enjoy doing more challenging practices or they want to optimize their athletic performance, there's a place for that. However, if a person has vulnerabilities and a history of trauma then those and or certain disorders like bipolar disorder for instance you can trigger people to have manic episodes and we observed that we saw teachers doing practices that cause people to go into manic episodes and even with our hospitalization and other states. So that was the first thing very easy we eliminated any practices that we knew could trigger anybody to have a bad reaction because when we give our programs which we especially were concerned about being able to deliver programs that were simple, easy to learn could be done in a short time by people in the who were recovering or in the middle of a disaster large groups of people had to be helped. So we wouldn't even necessarily know their past history or any diagnoses they might have we had to make it really safe. So that was the first cut we got rid of anything that might cause a problem to someone who had a physical condition maybe they're recovering from COVID maybe they have a smoking history maybe they have asthma. These kinds of breath holding and rapid practices can trigger asthma attacks. We were very careful about that and that honed it down quite a bit then we looked at what are most people struggling with and the most common problem people are having is due to stress and anxiety. Trauma is an extreme form of stress and we know that when that happens there's an overact activation of the defensive part of our nervous system which is mainly run by the sympathetic nervous system because that's what helps us deal with danger so that this was a dis defensive state and we needed to be able to teach people how to get themselves out of that defensive state where they're overreactive where they're tense they're anxious they're worried they're wasting a huge amount of energy they're not thinking clearly they're not able to make the best decisions we wanted to get them out of that state into what Steve Porges called the green zone which is a state in which you're calm and relaxed you're thinking clearly you're relating to people appropriately you're able to perceive people and conditions as safe you feel safe you're best able to relate and connect with people when you're in a defensive state you're not connecting with people you're either running away from them or you're fighting with them but you're certainly not connecting in a related relatable way certainly not a loving way you're connecting maybe in battle but that's a whole different thing. That was one of the criteria so calming people down and getting them moving them towards that state was very important. The other thing was that many people in a trauma state are so distracted that they can't focus on what you're trying to teach them and they can't learn anything. They can barely understand what you're saying because they're upset. We needed a practice that would quickly focus their attention. The other thing is that they could be very exhausted they could be sleep deprived they could be totally exhausted and if they're totally exhausted again they're not going to be able to do much. So we needed something to bring their energy up quickly without overactivating their defense system. So these are some of the considerations and the practices we chose so that would be those would be the first things that we would need to do.

Building A Safe, Effective Sequence

Dirk 58:49

So you need to connect you need to get people's attention people are dissociated they're distracted and so you generally start with something like tapping to music or or shaking or ha breath say the or the ha breath and the ha breath and the ha breath yes for everyone not it depends on their drama but for many people that's especially kids within a minute they're focused if they do ha breath that's very handy.

Speaker 3 59:23

Okay so now you've got them they're focused they've got enough energy to pay attention and do something and learn something and then you want to begin to balance their system.

Dirk 59:34

And just to pause the the ha breath is a it's a a quick tense breath tense stomach and you flick your hands forward like you're shaking off water or you're you do a power stance and drop your arms so it's this energizing and that gets everybody awake and on the same page and a little more alert.

Speaker 3 1:00:01

And also remember when you're being when you're experiencing trauma you're usually helpless. You're feeling completely helpless. And so if you go that's empowering now you're not feeling so helpless you got a little juice there. That also helps them but then just if you were to just take a person say who's in the state that they're in and you try to teach them and you have them there sitting there and you have try to teach them to breathe it's very difficult for them to learn that in teaching groups of people especially if they were stressed or traumatized it was easier for them to learn the breath practice if you did it with movement, moving at the same time. They could learn it much faster. So we had then we then used a couple of different practices where you move your arms while you're in time to your breathing and that helps time the breathing and that helps them learn the breathing.

Dirk 1:01:02

And so then that's the next sequence is usually breathing in for four, holding for four beats.

Speaker 3 1:01:11

No holds there. Okay so you don't do the holds to begin with we yeah we would do something really simple like just breathing in for four counts and breathing out for four counts. And these are some newer things that we found we're using is especially in the conditions like in Ukraine where people are in the middle of a war. We have them hum as they're breathing out because the people are so disregulated and disrupted they can't coordinate their breathing with tones or instructions or anything else. But if you make if they have them hum when they breathe out they're certainly breathing out. So that gets them breathing out at the right time and breathing in at the right time very basic way.

Dirk 1:02:04

So it's just very basic in two three four and then hum two three four now they're starting to get it and their system is learning how to synchronize their breath with the instructions or the tones that you're giving them.

Focus, Agency, And The Ha Breath

Speaker 3 1:02:20

Then you can go on and get a little more complicated from there. So we have several practices like that that are very calming and very easy and help people get them into coordinating their breathing. So then they're ready to do the sequence that we use to lead into what we call coherent breathing, which is really the foundation of the practice. And leading into coherent breathing we do a muscle softening first because we found that people who had been undergoing so much chronic stress and trauma their whole body and all their muscles were so tense they couldn't relax them enough to breathe deeply or slowly so we relax the muscles and then we go into what we call coherent breathing which is slow breathing for most people around five breaths per minute some need more some need less the breathing in the time for breathing in equals the time for breathing out. So it's equal on the inhale and exhale then our job is to teach people how to do that as gently as possible. So they're not pulling the air in and they're not pushing the air out but really gently and naturally that's the art of the refinement of how they do the practice.

Dirk 1:03:49

So you're shifting people into this very relaxed state with this nice muscle relaxation where you start with the eyes and the mouth and face and then go all the way down all the muscle groups and then you're you have people more relaxed and then you have this coherent breathing which is the slow, even in and out breathing through the nose smooth, even preferably with their eyes closed or if they can't close them just looking downward very soft breathing often we'll use tones to time the breath in and the breath out and we chose coherent breathing because we see it as the sweet spot where you have created a state in which the person is both calm but at the same time they are alert.

Speaker 3 1:04:42

They're not like that drowsy calm that you get and their mind is functioning really well and clearly because the breathing also enhances the higher level cognitive functions which we want to include. So we have calmness relaxation with alertness and clear thinking and that's the sweet spot.

Coherent Breathing As The Foundation

Dirk 1:05:07

So you teach people how to shift into this calm alert state and you have this really nice practice and then you have all these evidence-based examples I was watching your one of your lectures and you were talking about different studies you had a study of 9-11 post-9-11 New Yorkers you had a study of veterans in Australia who had severe refractory PTSD you had a study of school children in Ireland who had been through a lot of trauma and all of these are really with really very impressive results so trying to think of a question in there what studies do you find most convincing that these tools are helpful at this point? Are those the three studies that that you Still talk most about, or where is the current state of evidence? So you have these tools, the mechanism makes sense, there's a lot of clinical examples where people really benefit. If you wanted to convince people that this is really powerful and helpful, like what are the main studies that you point people to at this point?

Speaker 3 1:06:23

We've actually published 12 studies, and we have two more in the process being written up for publication. So we're growing the evidence base as we speak. The studies that other people find convincing, other doctors or scientists or psychologists or whatever, certainly for a study to be convincing, people want it to be a large study, they want it to be, if possible, have a control group, not just be a study of one group. And they want to see that you've used certain test measures and so forth. Each of our studies is different. We've collaborated with many different groups of scientists and researchers on these, depending on the population. I'm going to tell you a little bit about some of my the studies that I think are really important. We did a study of the people in an agency in Ireland that serves 100,000 children with special needs who are mainstreamed to the public school system there. And the staff of this agency provide all of the services for these children and for their families, educational services, therapy, physical therapy, because they have all kinds of special needs, just as children here do. Height of COVID, their staff was extremely stressed. They were suffering all of the things that we were suffering at the height of COVID. And as caregivers, it was even worse because while their own families were getting COVID, being ill, hospitalized, they were caring for their families, they had to keep working and taking care of other people. The children were in worse and worse condition because many of the services they received were no longer happening because so many healthcare workers could no longer work. Either they were sick or they had other family to take care of and so on. So all the agencies were depleted, and this one agency got hit. They themselves were like at half-staff and still had this huge load of children to provide for. And other agencies were dumping their work on them because at least they were still standing, but not much longer. We did our three-day 12-hour programs, four hours a day for three days for them. And in the by the end of those three days, there was significant improvement in their levels of stress. Their energy went back up, their attitude improved, their hopefulness, their ability to relate to each other, their sense of connection with their families, with their work, all of these measures, their sense of calmness, everything improved, and their sense of work and stress overload went down. And then when we had them continue the practices on their own and with a once a week group session, the improvement was doubled.

Dirk 1:09:46

How many people did you look at and did you do a control at that time?

Speaker 3 1:09:50

I know sometimes you do No, we weren't able to do a control because that was the type of study where you're just there helping everybody in the agency.

Dirk 1:10:01

Of course, yeah, that makes sense.

Evidence From 9/11 To Schools

Speaker 3 1:10:03

There were 39 people who started that study. So it was reasonable. Another one that I think is important was this was a randomized control study that we did for people who had inflammatory bowel disease, ultra colitis, Crohn's disease. These are extremely severe conditions in which there's erosion that occurs inside the digestive tract. The medications used to treat it have lots of bad side effects, and many people end up having sections of their intestinal tract have to literally be removed surgically. It progresses over the years, it has a bad prognosis, and there's a lot of pain and disability associated with it, as well as a lot of symptoms. The specialty clinic for this inflammatory bowel disease clinic at Cornell received a grant to study the effect of Breath Body Mind, our program, on the treatment of these very ill patients. And again, Dr. Brown gave the patients our 12-hour, three-day introductory program, and then once a week for six weeks, and then once a month for the remainder of the study, which ran for six months. They practiced on their own. They came to once-a-month sessions, and we looked at where they were at that time. The control group had an educational intervention that is a standard part of treatment that's believed to be helpful in the treatment of this condition. What we found at the end of the six months was that everything that could be measured in the study in the group that did our program significantly improved. They had significantly less pain, less disability, fewer symptoms. Their anxiety went down, their depression went down, everything literally that could be measured, and one of their inflammatory markers, because this is an inflammatory disease that is driven by stress, one of their inflammatory markers went down. The group that had, and again, they had both continued their standard treatment. The group that had standard treatment plus this educational intervention had no improvement on any measures in the course of six months. So I think that seeing that this little, really minimal and very inexpensive intervention had such an enormous impact. Two of the patients, unfortunately, we didn't have a large enough grant to include having studies, colonoscopies, and things like that to actually look at what was going on inside. But many of them had colonoscopies as part of their routine care. And two of the patients just volunteered to us that when they went for their colonoscopies, their doctors told them that they had no more lesions. All their lesions were gone.

Dirk 1:13:17

That's amazing. And it is have you published this study?

Speaker 3 1:13:22

Yes. We have published it.

Dirk 1:13:24

Yeah.

Speaker 3 1:13:26

Why didn't it make front page news? The doctors that did the study with us, the gastroenterologists, thought this would revolutionize the treatment of inflammatory bowel disease. But obviously it has not. And very few people are even aware of it. It didn't receive the kind of publicity that many other supposed breakthroughs of much less importance receive in the press.

Dirk 1:13:52

Yeah. I'm very curious about that. And I would love to hear your thoughts about this. This is really, and I want to be mindful of your time. And but I think this is important. And especially, yeah, this these tools from breathing, which have been used for thousands of years, and there's a mechanism that makes sense, and there's clinical outcomes that make sense, and there's these studies that you're talking about. It seems so powerful and so compelling, and yet it it's hard to get it on the front page. What are your thoughts about that? Like how what are the barriers or the resistances that we have to really recognize and embrace these tools?

Speaker 3 1:14:43

This is just my personal opinion. Okay. So I'm gonna just tell it like I see it. This is how I see it. Treating an illness like inflammatory bowel disease with breathing will not make money for anybody. Having people pay tens of thousands of dollars for medication or for surgical procedures makes millions of dollars for drug companies and other interested parties. So who is gonna go out of their way or pay to put out PR and information about a practice for which they will not receive any kind of profit or remuneration? It would have to be a philanthropist or an altruist. And unfortunately, there aren't enough of those around.

Dirk 1:15:43

I think that makes sense. Or maybe an insurance company or maybe a socialized medicine country.

Inflammatory Bowel Disease Trial

Speaker 3 1:15:52

We have that hope. We have that hope. And we have been doing programs in the UK, for example. We've had nibbles from the National Health Service. In fact, the study I told you about was for an agency of the National Health Service. We have another study with the children for an agency for the National Health Service. But again, when we applied for a grant there, we didn't get the grant. So the other thing is that, and I will give this credence, it's very difficult for people who are experts in these fields, medically trained researchers who have learned a certain set of information their whole career, and they don't know anything about this field. So they don't have a basis to understand and respect and value what we're showing them. It doesn't make sense. They don't know the science of it, they have no personal experience of it, and they just don't get it. They don't get it yet. Some do. There are always a few who do.

Dirk 1:17:06

It's growing. It's growing. But yes, it you'd like to see it happen faster and in order to people say, if it's so great, why haven't I heard of it?

Speaker 3 1:17:16

My husband and I, we are not billionaires. We don't have the PR firm. We don't have armies of drug representatives to go to doctors' offices and give dinners and presentations and publicize, and we don't have those resources. We're just we're just doctors doing our work, and we're researchers who don't have access to those kinds of resources.

Dirk 1:17:43

And yet the Breath Body Mind organization is five years old, and you've trained probably more than a thousand people.

Speaker 3 1:17:50

Oh, more than that. I'm sure we've trained several thousand teachers.

Dirk 1:17:56

So that's a pretty good growth rate.

Speaker 3 1:17:57

We're used to to doing a lot with very little. And can I plug our work and I say if there's anyone else who wants to support our work, support a really fantastic research project, or support our work in disaster areas around the world. The foundation is a 501c3, Rathbody Mind Foundation, Inc., you can just Google it. And donations are welcome.

Dirk 1:18:23

So we'll link to that and definitely encourage people to connect and contribute.

Speaker 3 1:18:29

Some years ago, we had done a program, the same fundamentals training for a charitable organization called Bernardo's, that's the largest children's charity in Ireland. And again, their staff were very stressed. And they also wanted level one teacher training. So we trained level one teachers among their staff. And there were one or two, there were a couple that went to, I think level three actually training. We didn't hear from them for a few years again. And then we found out that unbeknownst to us, they had conducted an evaluation comparative study through a branch of the health service in which they compared three different programs for school children who were several hundred were included in the study. And they were in schools in areas where there was poverty, marginalization, disadvantaged, many immigrants, because Ireland has been especially generous at taking in people from other countries and other cultures. It was a 10-week program, which they compared Breath Body Mind, a mindfulness program, and something called Growing Seeds that teaches children about compassion and inclusion and those sorts of things. At the end of the study, they found, and they were specifically looking at a focus on emotion regulation. The Breath Body Mind program had by far the greatest benefit improving emotion regulation, negative emotions, and negative behaviors compared to the others. In the 10-week period, the mindfulness program didn't show a significant effect on anything they were measuring. The Growing Seeds program had a small effect, positive effect on emotion regulation. But the star outstanding part of that was the Breath Body Mind program. And we were very glad to see that because it provided some concrete evidence that this is the program that works the fastest.

Dirk 1:20:47

Yeah, that sounds like a compelling example. This is a study, it's a real-world population, and it's controlled, and it's not you doing the study. You didn't even know about it. So that seems pretty convincing to me.

Speaker 3 1:21:03

I think mindfulness is a very good program and is very helpful, but it's slower. Maybe if they had extended this over a period of months, we might have started to see a greater impact from the mindfulness program. And but that's something mindfulness is already established in many schools and in systems. One of the beauties of our program is that you can integrate it into any already existing program very easily. And breathing is also a form of mindfulness of breath and is the basic, most fundamental form of mindfulness to begin with.

Dirk 1:21:42

Yeah, I think a lot of people find mindfulness compelling and helpful. And I think there's research that shows that the breathing combined with mindfulness is more helpful than the mindfulness alone.

Why Breakthroughs Lack Headlines

Speaker 3 1:21:56

Exactly. Now, in terms of current, more current work, this is with the Ubuntu Center for Peace in Kigale, Rwanda. We're working with Dr. Jean Bosco Nyanzima, who is uh founder and the director, executive director of the center there. He and a number of his staff have trained, our trainers and love up to level three teachers. They've been working with us for quite a few years now and using our practices to help people there, many of whom are first and second generation survivors of the terrible 1994 genocide, in which a million people were killed in the course of three days there. So the whole country is still trying to recover from that genocide.

Dirk 1:22:50

Yeah, that's hard. So impossible to wrap my head around how big that.

Speaker 3 1:22:54

And what they found, and they've been tracking because they test people before their program, they have a comprehensive, it's like a they train community, people from the community as community-based healers, and they go out and form groups of 16 to 20 people who need assistance, psychological support in the community, and they meet for a period of 10 weeks. And during that time, they learn breath, body, mind. They also do local customary rituals, and they do a group narrative therapy that they call the Tree of Life, where they look at the different stages of their lives and fit come to understand different meanings of what's happened to them, share their experiences, and use the power of the group for healing, because in that culture, they especially stress the relationship of the group, not just the individual. And so it's a perfect blending of those three approaches. And they've had really heroic, I have to say, heroic benefits. And I've seen many videos of individuals when they've gone through that program, the stories of what happened to them during the genocide, many were children, watched their families being slaughtered, barely escaped with their lives, and all the years that have gone by, they have been plagued with consequences, severe PTSD, inability to get on with their lives, inability to relate to people. Well, you get just every possible from addictions to violence, horrible stories. And then by the end of that program, and I want to mention physical symptoms too, they are singing, they're dancing, they're thanking everyone, they're describing profound transformations of their lives, how they relate to people, how they relate to their perpetrators. And by the way, he's also been working with perpetrators. Tens of thousands of people have been incarcerated for 30 years now because they were identified as perpetrators. And now on the 30th anniversary, many of them are being released back to the communities where they were abusers and the murderers, and they have to go back to those communities now by working with the people who are the survivors and working with the perpetrators who are about to come home. This work is critical because what happens is when the survivors are healed, they come to a place where they say they're finally ready to forgive the perpetrators and welcome them back to their communities. The perpetrators have been feeling like they are the worst people on the planet for what they did. They have such enormous guilt and regret, they feel like they're no longer human beings and they don't even deserve to be forgiven. And remember, this was a mass hysteria that was perpetrated by outsiders who brought in methods to turn people against each other, and they fomented this massacre for their own purposes. So the perpetrators uh were as much, in a sense, victims of literal, it was propaganda, convinced they were persuaded to attack their friends and neighbors whom they had known their whole lives.

Dirk 1:26:46

This is where yeah, where can people learn more about this story? This is this is a massive event and story, and it's amazing that you're part of this.

Real-World Results In Irish Schools

Speaker 3 1:26:58

Yes, people should be more of especially now, because this is the kind of thing that is starting to happen in our country. When you can turn one group of people against their neighbors and manipulate their emotions and their minds through propaganda, and they didn't even have the internet to do it, you end up with, in a sense, in essence, a civil war where everybody loses, everybody suffers. And then is even our civil war, we are still suffering echoes of our American Civil War long ago. So that's the last thing you ever want a country to have to go through. Anyway, so there are lessons here for us, certainly. But their government and their people are committed to trying to heal themselves from these deep wounds. And when when when the perpetrators are given the community based healing program. And allowed an opportunity to heal. When they finally finish that, they're able to say things like, I feel like a human being again. I want to go home and ask these people to please forgive me. They're ready to ask for forgiveness and to be reintegrated and try to be whole again as a people. So it's the stories that Dr. Rush, and I wish he could tell you himself. Actually, maybe the interview him. When he tells the stories about his own people and what he himself survived.

Dirk 1:28:39

Yeah, put me in touch with him, and that would be amazing to learn more about. Yeah.

Speaker 3 1:28:45

So he has completed a randomized control study of his program for several hundred of these people. And by the way, what he found was that their scores, when they finished his program, their scores on depression, anxiety, and post-traumatic stress went down about 60% just by the end of his program. And they have ongoing now, then they have ongoing groups to continue with one another. He's also brought it to high schools for very troubled youth, again, with fantastic results. So these studies are going to be coming out over the next couple of years.

Dirk 1:29:28

Amazing. So turning towards meaning, to me, it makes sense that there's a lot of connections between meaning and breathing. There's a writer, George Saunders, who talks about meaning and stories as coming from connection and impact. And trauma dissociates us. Breathing can turn on these biological systems of connection. How do you, yeah? How do you think about meaning? And that's a big open-ended question. But you've had a huge impact on all these people, all these studies, thousands of teachers trained. So anywhere you want to take it, as a healer, what have you learned from your clinical work about meaning? How do you apply that to your own life? Any way you want to sort of riff on meaning?

Rwanda’s Community Healing Model

Speaker 3 1:30:24

This is a new question for me. This is my first attempt to answer what is really a very deep issue. Because I think that there are many things that we do in life, and what is it that's important to us has to do with meaning. What does it mean to us? Is it significantly important in some way? And also it involves connection because when we're isolated, we have no connection, nothing means anything. So I like to think about it as a meaningful connectedness. So what we see is, and I've heard this from a number of people who did our program, I put in mind particularly a woman named Cholene, who was one of the first two women approved to fly the US U-2 plane, spy plane, she was serving in the Air Force. And she's given me permission to share her name and identity and her story. What happened with Cholene was that after she served in the military, she was a pilot for United Airlines and she was scheduled to be on the flight on September 11th that was headed for the Pentagon and that eventually crashed. She was scheduled to be on that flight, but at the last minute, her connecting flight was changed, so she wasn't on the plane. But one of her friends from the Air Force Academy died. One of the pilots on that plane died. And when she heard about this, when she saw it on the news, she was suddenly overcome with enormous survivor guilt because she had a lot of combat training. She believed that had she been on the plane, she could have changed the course of events and saved all those lives. And she suddenly felt disconnected. And this is actually a common symptom of post-traumatic stress disorder. It's a quiet symptom, so we don't hear as much like flashbacks and things like that. But it's there. People feel disconnected from everything and everyone that had any importance in her life. And she had family, she had she was regularly practicing her religion, she was very patriotic. None of it meant anything. It was though she was floating in a gray void. She couldn't bear that feeling. She wanted to be connected again. So she did two years of intense volunteer work after Hurricane Katrina. That didn't work. Then she went for several years as an embedded journalist back to the Middle East during the wars. That didn't help. Finally, she got the idea, maybe if I become a doctor, I'll find meaning in life. So at the age of 40, she enrolled in a pre-med post back program to get her pre-med studies at Columbia. She's a very bright lady. Within two weeks, she realized that she couldn't focus on her studies and she knew she'd flunk out. So at that time, we were doing a lot of programs for people affected by the World Trade Center attacks. And one of her friends said, There's this Dr. Brown who's giving this program in breathing. Maybe if you do that, you'll be able to focus on your studies. So she came with that. We were doing our program at that time over weekends. So it was a Saturday, Sunday, five or six hours each day. I will never forget at three o'clock in the afternoon, on the first day of the program, during one of the breaks, she took me aside and said, Dr. Gerbart, I have to tell you what just happened to me. And she described to me how when she was doing the breathing, the rhythm of the bells and the breathing reminded her of the tide in the Arabian Gulf where she used to swim. And swimming was the only thing that gave her some sense of connection. And when she finished the breathing, she suddenly felt connected again to everyone and everything that had meaning to her. And that connection once made remained. She was able to concentrate, she was able to think clearly. She long since graduated, she became an ostrich oncologist, and she lives a full life, a very full life.

Dirk 1:35:25

Wow, what a story.

Perpetrators, Forgiveness, Reintegration

Speaker 3 1:35:27

Yes. So in thinking about how did all that happen and instantaneously, I think about it in a scientific way. I think about in a sense, not just the wiring, because we all think about wiring being unscrambled, but I think about the milieu. Where are the wires? What are they floating in? What kind of chemicals surround the synapses, the connections between all these neurons that affect what goes on at those points where they almost but don't quite touch, where chemicals travel between them. I think that what's happening is a really complex combination in a sense. And all of those are changing as we change the way we breathe. I think that the brain does know how to heal itself. The brain knows, in a sense, where things are supposed to go. If we give it a chance, if we set the conditions, thinking in more human terms, not right about just the biochemistry, the conditions have to be that we convince ourselves, our brains, that we really are safe, and we can activate our most loving, connected, caring feelings through these vagal and other hormonal pathways. And when we put it all together, we can reconnect in a meaningful way.

Dirk 1:37:27

Yeah, that that makes sense to me. And I can imagine that trauma or fear will shift us into this state of disconnection. We're not safe. And so now through breathing, so that there's this whatever disconnected thought loop neural network that's running, and now by breathing together as a group, we can reaccess that felt sense of safety and create that internal shift. And yeah, that makes sense to me. Just a couple more questions. These are rapid fire questions I ask people at the end, sentence completion. So according to me, Dr. Patricia Gerbarg, the meaning of life is I can only tell you the meaning of my life, or what means the most to me in life. Any way you want to go with it, yeah.

Speaker 3 1:38:32

I would just say loving others and being loved. That's the meaning of my life.

Dirk 1:38:39

And maybe elaborate a little bit on that.

Speaker 3 1:38:42

I have a feeling for people. I would call it meaningful. It seems to be what gives me the greatest joy and sometimes the greatest sorrow of people. I think it motivates most of what I do most of the time.

Speaker 1 1:39:01

Nice.

Speaker 3 1:39:01

And I've been blessed that there are people who love me dearly and people that I love deeply in my life. I wish that for everyone. And things like trauma that disrupt our ability to love and feel loved can be healed and should be.

Dirk 1:39:23

Beautiful. I love it. The most meaningful thing that I did yesterday was Oh, let me think about yesterday.

Speaker 3 1:39:29

It seems I'm so in the present moment. Remember what I did yesterday. Oh, there were two meaningful things that I did yesterday. One was hugging and kissing my husband. And the other was something I did at about 10 o'clock last night. My mother is now 99 years old. And I will attribute some of that longevity to my husband's knowledge of herbs and complementary treatments, as well as standard psychopharmacologic expertise. But she lives with us, and every night when I say goodnight to her, I tell her I love her and she tells me she loves me. And that's a mean meaningful, very meaningful moment because I never know if she's gonna wake up in the morning. And I want that to be the last thing she remembers.

Dirk 1:40:26

Beautiful. If I come to you and I say, Dr. Gerbarg, I feel like I'm just this speck of dust, I don't matter, uh uh don't have meaning, existential dread. What's your next step?

Speaker 3 1:40:41

My next step would be to sit down with you and listen to whatever it is that you need to tell me.

Dirk 1:40:51

Nice. So just listen, establish a connection, understand and uh as a starting point. Yeah, that makes sense.

Speaker 3 1:41:03

Really for two reasons. One is I don't know what you need uh until you tell me. I don't understand why you're in this state. And the second is that if I sit down and listen to you, that will tell you that you matter, at least to me.

Dirk 1:41:24

Nice. The most meaningful work of art that I've seen in the last week could be painting, music, TV show, anything come to mind?

Meaning As Connectedness

Speaker 3 1:41:37

Actually, last night I watched with my mother, I watched Awakenings with her. And I was a little worried because unfortunately, she's recently developed some dyskinetic movements that are very distressing. And if you remember the movie Awakenings, where Robert De Niro had all kinds of abnormal movements, I thought it was gonna upset her, but fortunately it didn't. And her comment about the movie indicated to me that she really appreciated the I don't remember exactly the word she used, I wish I could, but it had to do with it was a quiet but very deep movie. And she appreciated because she's completely mentally intact intellectually and understands everything at the age of 99. And she really appreciated and enjoyed that movie and the performance that Robin Williams and Robert De Niro did there. And my brother had suggested it, and I'm glad that we followed his suggestion.

Dirk 1:42:52

Nice. I'll have to.

Speaker 3 1:42:54

Good evening for her.

Dirk 1:42:55

Makes me want to go back and watch that again. If there's if you had a chance to get a big message out to the massive audience of this podcast, or I'm joking a bit, but but if you were given a billboard or some kind of a platform to get out some simple message, is there something that you that comes to mind that you would put on that bill? There are two.

Speaker 3 1:43:20

I have two billboards.

Dirk 1:43:21

Yes, two billboards.

Speaker 3 1:43:23

The first message, because it's so much on my mind all the time, is remember Ukraine and help them. I feel very strongly that these people are on the front line and that of protecting not just themselves but the rest of us from very bad things. And they deserve it. They are fighting with such courage and such sacrifice for themselves and for us, and with all that's going on and all the awful things that are happening in many places of the world, including here, they are a critical part of the world that we live in and the world that we want to live in. If you have any ability to help them, whether it be financially or donation-wise, or through our organization, please don't forget then in the flood of other names. The second billboard, I would say love all of your neighbors.

Dirk 1:44:31

Yeah, I'm taking that in. A lot to take in and very relevant for the present moment. And really appreciate you taking this time and talking with me. Is there anything else you want to mention before we finish? I will link to Breath Body Mind and definitely encourage people to take the intro course, learn, and experience it for yourself.

Speaker 3 1:45:01

That'd be great. And even if they can't get to take a course soon because it may not be convenient, we now have teachers who have just wiggly sessions, and beginners can just find a teacher on our website and join a class and learn some of the basics until they're able to take one of the fundamental courses. The other thing is that we're working very hard in New York State to provide training to frontline workers, and that's an option that people can explore those, many of those courses are for free. We also just to mention we have two websites now. The foundation has its own website, which is Breathbody Mind Foundation. So they're sure to go there, and that shows more of the current international work that's going on. I do want to thank your interview and some of the most original questions I've ever been to respond to. It was really fun.

Dirk 1:46:01

Really fun, yes. Appreciate you and all your work and you talking with me now.

Speaker 1 1:46:06

Okay.

Dirk 1:46:08

Thank you for listening. Are you doing your breathing yet? If you're curious to explore more, I suggest taking a breath, body, mind, fundamentals course. I recommend it. If you enjoyed this episode, please share it. Rate us, join our Substack newsletter to keep in touch. We have a lot more coming up, including an episode on IFS ketamine group therapy treatment for trauma in Asheville, North Carolina with Ted Riskin. Much more to come. Also, I've started a clinic using these combined integrative approaches that you're learning about in this podcast. So I'll tell you about that, how that's going. Until next time, I hope you have a meaningful and meaningful month. Keep in touch. And if you figure out the meaning of life, let me know.