Health Bite

Harnessing the Power of Breath with Respiratory Therapist, Caroline Gamble

June 20, 2022 Dr. Adrienne Youdim
Health Bite
Harnessing the Power of Breath with Respiratory Therapist, Caroline Gamble
Show Notes Transcript

A lot of times, people fail to notice how important it is for us to have an optimized breathing practice in order to live the life we’ve always wanted to live. We’ve had this thought for so long that breathing is something we’ve been doing so easily all these years that it already appears to be something we don’t need help with.

Did you know that by actually paying attention to the way you breathe and doing it in a way that is aligned with your dreams, you can actually change your relationship with the stressors present in your life?

We all deserve to live life in abundance and bliss – the life of our dreams! No one wants to be in the exhausting circle of stress and end up losing against unhealthy habits.

Join us as we interview Caroline Gamble, the Founder of The Breath Method who’s passionate about helping people reach awareness towards both the beauty and power of breathing.

Caroline Gamble is a trained and certified Respiratory Therapist. She is the Founder of The Breath Method, a clinic and an app that is created for breath education and optimization. Caroline also is the head of breathing for Thrive Global. She interacts in that space with many people from many walks of life including major CEOs and executives, informing them of the world of breathing and how we can harness that towards health and well-being.

In this episode, Caroline discusses the importance of optimizing our breath and shares practices we should try in order to properly align the way we breathe into the life we’ve always wanted to live.

What you will learn from this episode:

  • Understand how giving attention to the way you breathe can change your relationship with your life’s stressors;
  • Discover the reason behind the necessity of understanding the mechanics of why belly breathing is important;
  • Find out tips on how you can optimize your breathing through four simple steps that are proven to help you live life in better health.

Free Consultation: Have a 15-minute Breath Consultation: 

Go to and connect with me at

Key Takeaways:

“Yoga is so much more about the yoga that we do in modern studios around the world. Yoga is all about breath.” – Caroline Gamble

“If you want to evoke a sense, an aura, a feeling in your system, make your breath really represent that feeling that you want.” – Caroline Gamble

“You can become your own healer. You can correct the tension and the course that you are on by just becoming aware.” – Caroline Gamble

Ways to Connect with Caroline Gamble:

Ways to Connect with Adrienne Youdim:

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Adrienne Youdim 0:00

Hi there, podcasters! Welcome back to Health Bite, our podcast that is dedicated to providing small, actionable bites towards better mental, emotional, and physical well-being.

This week, we are going to take a little bit of a diversion from our usual format to bring before you a very special guest. So, I have with me today Caroline Gamble. She is trained, certified as a Respiratory Therapist. She is also the Founder of The Breath Method which is a clinic and an app that is created for breath education and optimization. She is the head of breathing for Thrive Global which is Arianna Huffington’s baby, and she interacts in that space with many people from many walks of life including major CEOs and executives, informing them of the world of breathing and how we can harness that towards health and well-being.

So, yay! I'm so excited to have you.


Caroline Gamble 1:15

I'm so thrilled to be here. And I love your book. I want to start with this. I keep reading chapters after chapters. Every night, I pick up your book and I'm reading it. I just read hungry for belonging and I really resonated with that story. It's just beautiful. I've told you this before. Anyone who is listening to this who hasn't read it, this book is so beautifully written, so insightful. You buy it for all your friends for Christmas or New Year. Anytime. It's just a beautiful accomplishment. Congratulations.


Adrienne Youdim 1:50

Well, thank you. That's so kind of you. I'm so glad that is resonating and it has an impact. That's what we want to do, right? To bring our life's work and what we love, so that it nourishes us, but then also hopefully to impact the world around us. So, much appreciated.

As I was thinking about doing this podcast with you and as I speak with you, I think you are lovely to listen to because number one, you have an abundance of vast knowledge base and information. I just love listening to you. Your accent is just delicious. So you can talk and talk and talk forever. I’m so happy!


Caroline Gamble 2:35

I could say anything and I would mesmerize you with my Mary Poppins voice.


Adrienne Youdim 2:42

I am mesmerized.


The Reason: Introduction to Breathing and Coaching

So, I really want to get into this. The reason why I brought this on, because this is a little bit of a diversion from our usual, is because – I was sharing this with you, Caroline, before we started recording – that I think holiday season always brings about a lot of energy, positive and negative energy, right? There's a lot of excitement about the holidays, and even excitement is a source of stress. It's also the end of the year, so a lot of us, work-wise or life-wise, have to get things done before the end of the year. Kids are coming out of school. We may be thinking about vacations or hosting parties. And so, it's just a lot. And so, a lot of times when I'm with the patients – my patients in the office, we start talking but I can feel this energy is getting in the way. So even though I'm not a breathing specialist, I have just been like, timeout. Let's just take a breathing break.

So, I would love to get your thoughts on that. And of course, maybe we should just back up first and talk about like, why do we need coaching in breathing? It's like something we all do automatically, right? And so, maybe it's funny to some people to think that you have to be coached in such a normal bodily function. What would you say to that?


Caroline Gamble 4:17

Yoga, Breathing, and our Nervous System: What Caroline has Learned from the Yogis

Well, indeed, it is a funny old one. I've been doing this for over 15 years, but more recently it's become quite a health trend. And so, I’m sure some people are rolling their eyes now. People are making money over breathing? Come on. So I get that. I really do.

My lineage is studying classical yoga with yoga doctors in the Himalayas of India. So I went off there in my early 20s. I started working in advertising and I was pretty good at it but I didn't love it and I burnt myself out. I got doing unhealthy things to get through the stress and the monotony of working in a career that was not really making my soul sing. So, I was savvy enough and connected enough that I knew I needed to find other things, even as a young 20 year old, to help me find my health. And so I would go off and take yoga classes. I would leave before the shavasana at the end, because I was so irritable with this anxiety that I knew I wasn't in alignment. But I persevered because something about it connected me with a stiller experience of my existence.

I kept going to these yoga classes and then it roll forward a couple of years, I ended up leaving advertising and going for long stints six months at a time to study with Yogis in India. What I learned from them, I mean, so many, this could be a podcast in and of itself, the stories I could tell you. Yoga is so much more about the yoga that we do in the modern studios around the world. Yoga is all about breath. There are many different parts to yoga – physical movement, stretching the body of imbalances is one. Another is meditation. Another is concentrating the mind. Another is withdrawing the senses. The Yogis millions of years ago knew that we were too sensory, outward, stimulated. And this was a fact. They didn't even have phone app notifications.


Adrienne Youdim 6:53



Caroline Gamble 6:53

There were no bing bing bings and artificial light back then, but they still recognize that stimulation overload was distracting and disturbing for our nervous system. So they have a whole discipline about withdrawing the senses and many different parts of yoga making up the full pie, but across all of them is breath regulation. The Yogis knew – and this is what I learned – that every health goal that we have, whether it is as you said to begin at the beginning, physical, mental, emotional, I would also add energetic, whatever health goal we have, it needs to start with your breath. Because your breath is the single lever that we have that we can control our nervous system with.

So our nervous system is like an arc. On one side, we have stress, and on the other side, we have relaxation. And we're always somewhere along that continuum.


Adrienne Youdim 7:57

And this is scientific, right? So like, you have a sympathetic nervous system that as you mentioned is one side of the arc which is stress and people recognize it as fight or flight is a common thing that is a term that is thrown around, then the parasympathetic which is the rest and relaxation. And so we are physically going between these two states on a regular basis.


Caroline Gamble 8:28

Stress Isn’t Necessarily a Bad Thing: The Parasympathetic and Sympathetic Sides of Man

Yes, our health really is determined by how easily we move on that pendulum. So stress is not necessarily a bad thing. We need to be able to pop into stress, and then we need to be able to shift into relaxation. We don't want to be more dominant in stress. We want to be somewhere between the two – in that relaxed, calm state where we can engage with a book, we’d be able to concentrate our mind, we're not so relaxed that we're falling asleep but we're not so stressed that we have that monkey mind – that agitation.


Adrienne Youdim 9:09

And I just wanted to point out also that stress is good. When I build on what you said, it's necessary for certain situations and circumstances to compel us to act, right? Sometimes you need to act. But the state that we are in right now, and I think perhaps you would agree, is this chronic stress, right? I think it has been happening before the pandemic, but really the circumstances of the pandemic, the ongoing uncertainty, the constant, every week there's a new variant or there's a new circumstance, is putting people in this constant state of stress, right?

And so you're saying that there are techniques in which we can – with breathing – regulate that. Bring us out of that chronic fight or flight.


Caroline Gamble 10:04

Indeed. Most of us are stuck in this chronic fight or flight. And it was pre-pandemic, there's a statistic that I share with all of my clients. If we see one device in our peripheral vision and the device is not even on and it's not even ours, our cortisol – which is our stress hormone – spikes. So this is in our peripheral vision, a dead device that is not even us. And we get a spike of cortisol. So imagine how much cortisol – that stress hormone spikes – we get throughout our day with all this interaction we get from devices.

Now add to that there are environmental stresses and the paint we put on our walls, the water we drink, the air we breathe, the food we eat. There's emotional stress in our interactions, the pressures we put on ourselves, mental stresses in social media, looking through social media, or just the news and thinking, “Am I living the life I want to live? They seem to be doing it better.” So stress is swirling around us, and there is this chronic stress.

So coming back to that nervous system swing between sympathetic and parasympathetic, both those sides of the stress, sympathetic has a distinct way of breathing. It is in high up into the chest. It is short. It is ragged, with spontaneous breath holds. And the other side, the parasympathetic, the relaxation has a very distinct way of breathing as well. It is low in the belly. It is full using the back of the lungs as well. It is slow and it is smooth.


Adrienne Youdim 11:58

And we don’t think about this. Often, we're not thinking about our breathing, but as you say this, it resonates with me and I'm sure it resonates with the listeners; that they can recognize, Yeah. Of course, when I'm stressed, it's short. It's shallow. It's fast paced as you said, and you're utilizing the upper areas of the lungs. Whereas the parasympathetic or relaxation is a much deeper breath, and so, we can recognize that.


Caroline Gamble 12:36

The Switch: Breathing Up into the Chest and Why We’re Stressed about It

Indeed. And it's so fascinating for me to understand on a really biological, physical level, the reason why we get stressed by breathing up into the chest, or if you're breathing up into the chest, you create stress, is because in the top lobes of our lungs, you have your sympathetic – your stress receptors. They're like little switches, and when air moves through them, it flips the switch, so it flips the stress.

So if you're only breathing up into the chest, which so many of us are, that alignment of our muscular skeletal system in times of stress and certainly after the two years we've all had is lifting up shoulders up by our ears, because we're bracing ourselves from this sense of threat in the world. And when you lift your shoulders up by the ears, you pull your breath only into the upper front lungs where you have all of those sympathetic stress receptors. So you're flipping those switches all the time, all the time, all the time, and it compounds this habit we have for upper chest frontal lobe breathing.


Adrienne Youdim 13:49

I want to reiterate this because this is very important. Not only does stress cause a certain type of breathing, but by breathing a certain way, you are perpetuating the stress by activating those switches, activating the sympathetic nervous system in the body.

I'm a very kind of science-y person. I don't like crystals and voodoo. And so I like to understand if you're telling me, I should pay attention to my breathing. I want to know why. I want like the concrete why. And this for me is a really profound why because it is cause and effect, but it is also cause in perpetuating that stress.

The other thing I want to point out is the shoulders. You know, I think if everyone just listening right now like lifts their shoulders and drops them, they may notice like wow, to some degree I was holding on my shoulders. I think we do it chronically.


Caroline Gamble 14:56

Indeed. In a minute, I'm going to give you a practice all about how to optimize your breathing and we're all going to drop the shoulders, but yes, exactly as you say, Adrienne. Everybody, lifting the shoulders up and then sink the shoulders down. And you know what? You can sink them further than you do. I want you to imagine you have sandbags resting on your shoulders or really heavy warm hands pushing your shoulders down, and you keep them down. You'll notice that you can't send so much breath into your upper lungs. Your breath has got to move low. It's finding a path lower as the shoulders stay low. Because lifting and lowering the shoulders, which is the habit of most of us, is just pumping the upper chest.


Adrienne Youdim 15:46

Yes. But before you get to that, I interrupted you. So you gave us the content in terms of simply the output chest. So give us the corollary to that.


Caroline Gamble 15:57

I was taking myself there as well because I want you to know. I want you to know when you go lower down into the lower part of the lungs, and I'm going to tilt my screen if you can see me, and if you can't, a couple of inches above your navel, if you imagine a line that runs across your core, just at your lower ribs is where you have your lower lungs. And the lower lungs, the lower half of the lungs, are imbued with all your parasympathetic, your relaxation receptors. So the switches that turn on your relaxation that shift your autonomic nervous system out of stress into relaxation, balance, that beautiful state where the circumstances of your life don't change. You still have the bills. You still have the issues. You still have the annoying kids who are coming back. We love them but sometimes you feel like we need more space. You still have those compromises. But when you have activated those parasympathetic, those relaxation receptors, you're okay about everything. You're not anxious about it. You're okay with it all. You see everything in its right order because your nervous system is in balance.


Adrienne Youdim 17:17

And I think this is also another important point I want to reiterate because it is important. This should not be misunderstood. This concept should not be misunderstood as Pollyanna, everything's okay, be grateful and happy. Because there's a lot of that right now, right? There's a lot of gratitude practices. And there's a lot of, we should be thankful for what we have, and we're just coming off of Thanksgiving, and all of that is true. But I think people also want to be validated in their experiences because people are under duress. Many people are dealing with a lot of stresses. And so, what we're saying now is, yes, that stress is there and we can't change that, right? If somebody has lost their job because of COVID, that stress is there. Or their plans are cancelled and they can't be with family during the holidays, that stress is there. What we're saying is how can you change your relationship to that stressor? And one way is in the way in which you breathe, giving attention to the way that you breathe.


Caroline Gamble 18:36

Caroline is Human as well: A Personal Story of Caroline and Her Experience 

Indeed. Let me give you a personal example. This time last year on the 10th of December, I moved from Singapore to Los Angeles on my own with two little kids. I'm happily married, but my husband was staying in Asia, setting up his next business, which makes us sound like wow, he's got another business. No, we are in constant startup mode. There's a lot of stress that comes with that and there's a lot of stress with moving countries. And then there was a lot of stress for me entering the Los Angeles School District with two kids on Zoom and seeing the impact of that. So even though I have been doing this for 15 years, my breath started being high up into my chest and I would bring it down every day, but every day, I was sparked by another stressor and my body reacted as yours does by the breath going high up into the chest. It became something I was doing more than the belly breathing. I was doing more chest breathing because I was under more duress than I was barely breathing, and so everything became more stressful for me.

I had a stressful few months. Then I really recognized it and dove deeper into okay, my morning practice of breath regulation is not cutting it. I need to be having my hands on my belly multiple times every hour to reconnect with my low belly breaths. So I really feel my breath move down into that lower part of my lungs and I know what is happening on a physiological level is that those parasympathetic switches are being flipped, and I would feel the shift.


Adrienne Youdim 20:29

Thank you for sharing that, because I think sometimes, people think that if you talk about breathing and you're a “breathing expert” or “head of breathing”, in my situation, if you are trained in obesity, medicine, or even clinical nutrition that you're immune from the normal human condition. Nobody is immune, right? Everyone is faced with the same and everyone needs reminders, even the head of head of breathing.


Caroline Gamble 21:05

We absolutely do. But for me, it was so insightful. I have so much knowledge. I've been doing this for 15 years. And I too, as you say, am not immune to it. Imagine my clients who have panic attacks. They are so conditioned to upper chest breathing that we really need to spend a lot of time connecting them, making them understand the biology, the mechanics of why belly breathing is so important. There's also this mechanical reworking. Our bodies form habits, and sometimes, it's just a habit of breathing into the upper chest. Even I developed that habit in January and February. And we need to put in the time to change that habit to rewire the mechanical movements of our body. Should we do that now?


Adrienne Youdim 22:03

Yes! I'm so impatient. Can we do it?


Caroline Gamble 22:07

The First of Four: Breathe through Your Nose with Your Tongue Up Wide

I'm impatient too for everyone to feel this good breathing. So, I'm going to take you through the steps of optimizing your breathing.

Now, I have worked with people who have a 20% lung capacity because they have COPD or emphysema or COVID. So these are people who really need long rehabilitation. Even with them, these four steps work. I've also worked with the average who is just having issues with stress management. This also works for them, these four steps. Young children, old people, these four steps are essential. Concentrate, that easy, that straightforward, and you can recall them and use them with the whole of your family.

Okay, so first of all, make sure you are sitting up tall. Have your knees lower than your hips if you can; I'm getting into my Yogi alignment. Sit tall. Be comfortable. Close your eyes. As I alluded to spoke about at the beginning, one of the yogi precepts is withdrawing your senses. So when you close your eyes, you are better able to feel your breathing and feel your body breathing, where in your body your breath moves. So the first step of optimizing your breathing is to breathe through your nose. I know it sounds really obvious. Maybe not to all, mouth breathing is a breath dysfunction.

So the reason why mouth breathing is a breath dysfunction is that the mouth was not created to breathe. The nose was created to breathe. We have a nasal cavity which is the size of a billiard ball behind your nose in your head. It is terminated so it has these these tunnels through it which are essential for cleaning the air you breathe, warming the air, humidifying the air, and pressurising the air that you breathe. So by the time your breath gets to your sensitive membrane of your lungs, it is absolutely the perfect heat, humidity, condition and pressure so that it doesn't disturb your lung tissues. If you bypass that and breathe through your mouth, it disturbs the lung tissues and creates inflammation.

Mouth breathing also loads your breath into your upper lungs. When you breathe through your mouth – and you can try that now if you're curious – try to take a mouth breath in and try to take it low. It's hard to get it lower than the chest versus close your mouth and breathe through your nose slowly, it's easier to get your breath lower into your lungs. So number one, breathing through your nose. There's a second part to number one. With your tongue up, resting against the roof of your mouth between the upper row of teeth. Your tongue shouldn't be pointed forward like an arrow. Let it be soft and wide like a circle. So the first step to optimizing your breath is breathing through your nose with your tongue up and wide, okay?

The Second Step: Letting the Force in Your Belly Go

The second step of optimizing your breath. We're going to go down through the body with your inner awareness if your eyes are closed, imagine your awareness going down to your belly to your navel. As you breathe in, I want you to push your belly forward to stretch the skin of your belly and pull your belly backwards as you breathe out. Again, push your belly as far forward as it can go, it should feel extreme as you breathe in, and pull your belly back as far as it can go as you breathe out. Twice more like that. Pushing your belly as far forward as it can go, stretching the skin of your belly as you breathe in, and pull your belly back into your body as you breathe out. And a final time, push your belly forward as you breathe in and pull your belly backwards as you breathe out. Good. Now let go of all of that effort. Let go of all of that force. Just allow the belly to gently move forward as you breathe in and gently return backwards as you breathe out. Effortless and organic. Natural and easy. No pushing, no pulling. Your belly just easily expands forward as you breathe in and easily returns backwards as you breathe out.

So as you are feeling that come into your body, the reason I told you to take a few push and pulls of that movement is that we hold so much tightness in our bellies through body shame, through pulling in our sphincter muscles and our abdominal muscles to avoid an emotion that we're confronting. We have these tight bellies, so we need to release our belly with that force so that then we can come into easy diaphragmatic breathing. Easy diaphragmatic breathing as your belly expands gently forwards as you breathe in, your belly gently, effortlessly relaxes back into yourself as you breathe out.


Adrienne Youdim 27:30

And our breath is also through the nose or through the mouth?


Caroline Gamble 27:33

Everything through the nose. Optimal breathing is through the nose in and out.


Adrienne Youdim 27:40

A Breathing Practice Each Morning: Its Importance and Power in Shifting You 

So let me ask you because I think people must be thinking and I'm thinking, this kind of intention as towards the breath is not feasible all the time, right? Sometimes, you're in the middle of a conversation or a presentation at work.


Caroline Gamble 28:01

Yeah, that's absolutely fine. It's not feasible all the time. We breathe over 20,000 times a day. We cannot concentrate on all of them. That's far too stressful.


Adrienne Youdim 28:11

So do you recommend breathing breaks? And if so, like how frequently? How do we circumvent that?


Caroline Gamble 28:19

I recommend a breathing practice each morning. It's as if you are just trying, as if you wake up and brush your teeth to clean your teeth and make sure your teeth are really great for you for the rest of the day. You set your breathing in the morning. You recognize that we all have a tendency, especially if there's world stress and personal stress going on, we all have a tendency to breathe in the upper chest. So you set your breathing, you connect with your breathing in the morning, and you start to reform your breathing habits by just five to 10 minutes of breathing with these four steps. And then throughout the day, if there are times when you feel stressed out, you need to remember, I am stressed. There is a way of breathing that will compound this feeling of stress. Elongate. Stretch it out. I can keep breathing that way. Or if I want to arrest this stress, if I want to shift out of this stress, if I want some reprieve, I can move through these four steps. And it will change in just a few short breaths. Once this becomes familiar, you just need a minute of this to shift you.


Adrienne Youdim 29:35

And you brought up the book Hungry For More and I talk about this in the book of course and also my clinical practice, which is that fact that we use food for so many different functions. One is of course soothing. And oftentimes, people will find themselves getting up to go to the pantry or grabbing something they know they're not hungry and they don't quite know why, and often it is triggered by stress. You're feeling the stress, you may or may not be naming it or noting it, but it is causing a reaction, and that impulse often is to go grab something, right? You know, smokers may go grab a cigarette. If you're not a smoker, the easy thing is to grab something to eat. And so there's an itch, but the food or the cigarette is actually not itching the itch, right? It's not what you're hungry for. What you're hungry for is to come out of that agitated state. And so I like to connect that because I think it's practical for people. When you're feeling that agitation, that itch, and you're like what do I need right now, what you need is a method of soothing that actually scratches the itch, which is to dial down the angst, dial down the sympathetic nervous system.


Caroline Gamble 31:09

Absolutely. Bring you into relaxation. Now, it's easy to say and harder to do because so much of this is habitual. You want to go and get that sweet treat. You want to fulfill that habit that you have. Well, if you just give yourself a few moments to breathe, maybe the urge will be lesser. You deserve to give yourself that because we should all be able to float through life and live that life of our dreams. What is your dream? Is your dream to eat compulsively when you're feeling stressed and still have those habits that you've been plagued with for decades in another couple of decades? Or is the dream that you have for yourself to actually be measured, be in the moment, make choices that are aligned with your greatest version of yourself? We all deserve that.

So certainly, I use the breath. With all of my clients, using the breath as this pause button, for us to just pause and give ourselves the opportunity to make a decision that is more aligned with our greatest self.


Adrienne Youdim 32:25

And it doesn't have to be all the time, right? You don't have to be perfect in order to be effective. And I think if people are skeptical of this working, what you said is a great strategy, which is do this first, try it, and if you still feel compelled to do whatever it was that you wanted to do, fine. But at least try this first. And what happens over time is when you interject a new habit into that habit loop – I don't think it's true; there’s science and it's called neuroplasticity, because your brain cells actually rewire themselves. So by intercepting that habit loop and introducing this breathing technique, with time, you can break that cycle, that habitual cycle of whatever getting up and grabbing something to eat or whatever that is.

So I love that tip. I love that. I think it's interesting for people to know that there's also different kinds of breathing for different circumstances and for different health outcomes. And I know this is a vast topic that we won't be able to get to the bottom of in this segment, but can you just introduce people to that idea, and what is that all about? Different types of reading for health.


Caroline Gamble 33:58

Well, before we do, I need to finish the two steps, the final two steps.


Adrienne Youdim 34:04

So good. I'm like, let's move on sister, but we still have two steps.


Caroline Gamble 34:08

Okay, good. You know what? I hope you've all actually felt the shift just through breathing through your nose with your tongue up and wide and belly breathing, but there is more. And I’ll zip


Adrienne Youdim 34:21

No. By all means, take us through it.


Caroline Gamble 34:23

So number one breathing through your nose with your tongue up and wide. Number two is belly breathing which means your belly expands bored as you breathe in, returns backwards as you breathe out. I guided you through using a little bit of force just for the first few breaths so that you free up your tight belly habit that many of us have.

The Third Step: Feeling the Back of Your Lungs

The third thing to do. I want you to take your hands to your lower ribs now, fingers pointing forward and the thumbs on your back. So that third step of optimizing your breathing, underneath your hands, your fingertips, you should feel your belly moving as you breathe. So your belly, that diaphragmatic breathing of step two, expanding forward as you breathe in, and then returning backwards as you breathe out. But step three is also feeling the back of your lungs breathing, so feel that in your thumbs. As your belly expands forward into your fingertips as you breathe in, your back expands into your back. It's as if you are holding a balloon inside your body and the full 360 degrees inflation of the balloon happens within you. You feel it in your finger tips, you feel it in your thumbs. So that is the third step of optimal breathing.

Why is that the third step? Because our habit when we are under stress in the modern world is to breathe in the upper frontal lobes of your lungs. We've covered that. But most of your lung mass are in the back of your lungs, yet we under use and utilize breathing in this space. We don't breathe into the back of our lungs. The back of our lungs are imbued with vastly more blood vessels than the front of our lungs. More blood vessels mean greater oxygenation, more vitality in the air from the breaths that we breathe. Better functioning on all of our levels, physical, emotional, mental, and energetic. So we want to send the breath into the back of the lungs where the thumbs were both to benefit from that parasympathetic flips being switched and from all the blood vessels that will give you greater oxygenation.

One of the keys to best health is how much oxygen you have. It's a key marker. Doctors look at how much oxygen you have in your cellular level to see how long you're going to live and what health you're going to live. So we want that oxygenation.


Adrienne Youdim 37:10

Practice, really. When you pay attention, you notice that at first, my thumbs weren't really affected or moving. But by being really intentional about it, I can feel now the change in the width and breadth of my back.


Caroline Gamble 37:27

Indeed. The back of the lungs accessing that is so crucial for all of us and I really want you to have a takeaway that that isn't part of the lungs that we just are under utilizing. One of the remedial therapies for COVID is to lie patients with COVID on their fronts with their head turn to the side, so that they have to breathe into the back of their lungs, so that they have to activate those parasympathetic responses and all of those blood vessels for oxygenation so that they can fight the disease.


Adrienne Youdim 38:06

So great. Step three is on the back.


Caroline Gamble 38:09

The Fourth Step: Make the Expansion Slow, Smooth, and Steady 

Yes. We're into step four. So you can keep your hands on your body if you wish.

Recap. One, breathing through the nose with your tongue up and wide. Number two, belly breathing, belly expanding forward as you breathe in, returning backwards as you breathe out. Step number three, back breathing, feeling that same motion, back expanding backwards as you breathe in, returning in towards your centre as you breathe out.

Step four is the quality with which you do those first three steps. So you can push and pull your breath. You can do big, bold breathing whilst doing those first three steps, but that's not good breathing. Good breathing is slow. So I want you to hold your body again, just as your hands were before, and feel a slow expansion into your fingertips and your thumbs. And then make that expansion also smooth because we want to get away from ragged breathing, which unsettles your nervous system. Smooth and steady. Feel this in the motion of your abdomen expanding as you breathe in and returning in which as you breathe out. Slow, smooth, steady. And then, even. We want there to be an evenness between our inhale, the expansion through our abdomen, and the exhale, the returning in of our abdomen.


Adrienne Youdim 33:43

I mean, I'm so relaxed. I'm gonna fall asleep, Caroline.


Caroline Gamble 39:46

Well, you can use it for that. If you know those four steps, if you need to energize yourself, you focus on them. If you need to stimulate your mind and be able to write a killer speech, you focus on those four steps. If you need to come back home from work and be present with your family rather than be in work mode, you do those steps. And if you need to quiet the monkey mind to fall asleep at night, you focus on those four steps. So they are cure for everything.


Adrienne Youdim 40:26

So, I was pushing you towards this different types of reading for health but I want to ask you a question first. I had heard that we should have a prolonged exhale. You were suggesting or recommending that the inhale and the exhale is even, but I also know that I have heard that a prolonged exhales or longer exhalation activates the parasympathetic nervous system, the vagus nerve which connects the heart and the brain and the gut. So can you can you explain that discrepancy? Why might I have heard that? Or maybe I'm just wrong?


Caroline Gamble 41:08

Oh, no. You are absolutely right. So those four steps are all about optimizing your default breathing. The 20,000 breaths that you have each day, we want the majority of them to be following those four steps, but your breath can be shaped in endless countless ways and each way you shape your breath will give you a different outcome.

So the inhale is your activating part of your breath. When you inhale, your heart rate lifts which makes you more activated. Your blood pressure rises. So again, there's the sense of excitatory element to your inhale. Your exhale lowers your heart rate and lowers your blood pressure so there's this calming quality to it. And yes, absolutely, both the inhale and the exhale actually stimulate your vagus nerve, but elongating the exhale will give you more of that relaxation response. If you want to be activated and energized, you focus on the inhale because you want that heart rate lift and a little bit of a peak in that blood pressure to really allow you to charge forth. But we're charging too much in today's world so most of us want more of that relaxation. So you focus on the exhale which will lower the heart rate, lower the blood pressure.

A rule of thumb is if you want to – let's focus on the relaxation. If you want to imbue a sense of deep relaxation, deep calm, the rule of thumb is double your exhale to your inhale. So that might be a three second inhale, but again, you focus on quality. So slow, smooth, steady, low into the body and into the back. And then you have a six second exhale. Very slow, very smooth, very steady, and you are slowing your heart rate, you're slowing your blood pressure, and you're really activating the shift in yourself, swinging yourself more into that parasympathetic realm.


Adrienne Youdim 43:26

What I was gonna say is that, again, I love the physiology behind this. I'm such a geek. I geek out on the science. I love it.


Caroline Gamble 43:37

We could go so much deeper. I want to go into the cavity of the heart with you, Adrienne, but maybe not in this session.


Caroline Gamble 43:43

Well, maybe not, but it is noteworthy to point out that, again, that vagus nerve is connecting your gut with your heart with your brain. So again, this change in pressure in the belly and the prolonged exhalation as well as the inhalation to some degree is activating this nerve which then relays the information to the heart, tells the heart to chill out in essence, slows the heart rate, dilates blood vessels so blood pressure goes down, and then that information is relayed to the brain as well as a sense of ease, right? It's saying, “Oh, guess what? The heart over here is relaxing , and so, you should too.” It's such a beautiful relationship between the systems of the body, that they're really communicating this sense of calm and ease. They're informing each other of calmness.


Caroline Gamble 44:46

Indeed. The quality. If you want to evoke a sense, an aura, a feeling in your system, make your breath really represent that feeling that you want. So if you want calm, make your breath really your embodiment of calm. So slow, smooth, deep, expanding easily, returning easily. Your system is very complex yet also simple. If you want to evoke a mood, then allow your facial structure. How you hold your face? The gesture of our faces sent by feedback loops through every system of your body. It also determines how you breathe. So if I was going to go into it deeper with you, and we are going to have another practice, I would start by asking you to soften your eyes. Let your eyeballs sink back into the sockets, let the muscles around the eyes soften, and take on a calm, tranquil smile. So feeling like the corners of your mouth can smile into your head. It doesn't have to be some big goofy grin. That's not going to give you the mood you want. It's this serene face, serene breath, you're going to have a serene day.


Adrienne Youdim 46:10

Just like we were talking about the shoulders, we don't notice how much we are holding up or how often we're holding up our shoulders and just exaggerating that movement allows us to recognize that and drop the shoulders, I find the same is true particularly with our eyebrows and with our jaw. So oftentimes, we walk around in the world with our eyebrows lifted and with our jaws clenched. And so sometimes, even I do this with my kids before bedtime to try and get them to relax, I'll tell my kids can you really exaggerate the eyebrows up and then drop them? And then they notice, oh, wow. To some degree, they already were up. There was tension in the eyebrows, and same with the jaw. Really open the mouth wide, and then drop them and then you realize in that act, how much you were clenching before. But we don't notice it when we're just kind of walking through the world.


Caroline Gamble 47:12

Tight Bellies are a Fallacy: How Pulling Up Bellies Affect Our Breathing Practice

The jaw is such a biggie. With teeth grinding, that is absolutely showing us that we're clenching our jaw. And what we do to release the jaw before you go to bed at night, you take a big yawn like a lion, and that is a way for your body to say “let me let go of this jaw.” But you've been carrying that tightness throughout the day. And you might yawn yourself out of it for a few moments, but then in your subconscious as you're dreaming and asleep, your jaw will tighten again. I'm not saying this to overwhelm. I'm saying this to empower you. All these little ways, you can become your own healer. You can correct the tension and the course that you are on by just becoming aware of your jaw, aware of your eyes, aware of that tight belly. When you're pulling tightness in, it's actually a fallacy that we need to have pull up bellies in and keep them tight so we have a strong core. That's not making you have a strong core. That's giving you muscle atrophy. We don't want to hold any muscle in too tight because it actually loses its strength. What we want is this easy diaphragmatic breathing of the core expanding out as you breathe in, drawing inwards as you breathe out, 20,000 times a day. You have this little toning, expanding the belly out as you breathe in, drawing the belly inwards as you breathe out. That creates an adaptive, strong, long term muscle.


Adrienne Youdim 49:02

This is such a great primer. Just to bring a little bit more awareness to intentional breathing, and, yes, it shouldn't be overwhelming. It can be but it shouldn't be, because as I always say, again, it doesn't have to be perfect in order to be effective, right? Just micro shifts is better than what you were doing before. So small moments where you are more intentional. And I like the idea of waking up and doing a few moments just to kind of set the tone of the day, just as a reminder, but also bringing it in, particularly in those moments that you're feeling the itch as I call it, that those moments of angst. So this has been so very helpful.

I would love to just hear a few words on how it is that we can vary this and just the concept of varying it for health or for even particular health conditions, you can vary your breath as a tool as a healing tool, right? So just tell us a little bit about that, but that is a topic in and of itself.


Caroline Gamble 50:16

Box Method: More into Inhaling and Exhaling’s Connection with the Way Our Body Functions

Well, as I touched upon before, your inhale and your exhale have two distinct deliveries. So your inhale delivers you this spike in your heart rate, limiting your blood pressure, this excitatory element.

Some of you might have heard of Wim Hof. Have you heard of Wim Hof, Adrienne? Wim Hof is the ice man and he's made this very pumping inhale breath practice, very popular, because it sparks you up, it energizes you, and really makes you feel a lot. So if you are feeling depressed, that is a good practice to do, practices that focus on your inhale. So that might be doubling your inhale over your exhale. You might be a six second inhale, holding your inhale, and then a three second exhale. If you're feeling depressed, if you're feeling sluggish, lethargic, despondent, like you don't want to wake up and get out of bed, you don't feel the motivation to exercise, that could be helpful for you to give you that sense of sparkle. And then the exhale, as I said before, it's deliverable. It’s going to calm you. So if you are dealing with stress management, if you have monkey mind, if you have hormonal irregularities, those are connected with stress, connected with being too excitatory in your system, you would want to be focusing on that slower breath practice. Now if you feel like you're somewhere between the two or neither really is where you are, you can work with breathing practices that are going to have that balance.

There is box breathing which is a popular form of breath where you have an inhale of a certain land, and then you match your breath hold of that certain land, and then you match your exhale of that land, followed by another breath hold of that land. And it can be any duration that suits you. So inhaling for three seconds, holding your breath for three seconds, exhaling for three seconds, and holding your breath for two seconds. If you feel comfortable with going further, you can up that.

Usually, it's interesting, Adrienne, when anyone is doing that full-part breath practice of inhale, holding the inhale, exhale, holding the exhale. The most challenging part for everyone is to holding the exhale because you release your carbon dioxide. There’s carbon dioxide being a craving to breathe in and want more. And so what you need to do if you are doing a box breathing practice, to find the duration for that final breath hold that is easy and comfortable for you, and then match the other sides of your breath to be that.


Adrienne Youdim 53:41

So yes, just to reiterate, it's called box method because the four steps inhale, holding the breath, exhale, and holding the breath are all equal in time. So you can imagine like you're going around the perimeter of a box, and it's helpful to match the time to that hold at the exhale, because that's the most maybe uncomfortable or unnerving.


Caroline Gamble 54:07



Adrienne Youdim 54:10

So this has been so great. I'm sure people feel like I often do, that when you have all this great information, right afterwards, you're like, wow, I've got all this great information and I'm going to do it, and then the next morning, you're like, what happened? You may not even remember. But you have a lot of resources for people. So tell us about that and tell us how we can find you. How people can find you to get more information.


Caroline Gamble 54:40

Caroline’s Resources: The Breath Method 

Oh, yeah. So I have an app. You'll hear my voice, Mary Poppins. It’s all my guide and breathing practices. It’s called The Breath Method and you can download it from App Store and Google Play. You have daily guided breathing practices which will take you through those four steps and we will go deeper into some of those steps on some days, we will have a brief overview of them all with more of a meditative journey through them. On other days, we'll go into the biology and the anatomy on other days, but you have this daily breathing practices and it's for free.

And then you can also have breathing practices for specific to give you a relaxation to de-stress you, to help you fall asleep. I work with a lot of people who have similar issues and it's really quite simple to use your breath to fall asleep at night more easily, fall back to sleep when you wake up at midnight, and just have a deeper consistency night after night. For mental focus, I give you breath practices for that. And energizing breath work. So people who want to be consistent when their workouts that oftentimes or some days they're feeling low for it, we’ll then do an energizing breath practice and I'm telling you, after five minutes, you are ready to go for that. You’re gonna nail it.

And so yeah, there's free content and then there's also subscribe to content. It’s all science-based. Like Adrienne, I'm a bit geeky for the science.


Adrienne Youdim 56:27

I've downloaded it. It is a great app and it gives you the nicer notification which pops up in the morning and just says if you want to start your day with the a breathing practice, you can. So I love that.


Caroline Gamble 56:43

You can turn off the notifications. I don’t want my app to be giving anyone stress.


Adrienne Youdim 56:53

But it is a nice reminder if you wish to have that. And then if people want to know more about you, you do work with clients one on one. Is that information through the app? Is there a website that you can direct people to?


Caroline Gamble 57:05

Free Consultation: Have a 15-minute Breath Consultation with Caroline for Free

Yeah. You can go to and connect with me there or But what I wanted to do, Adrienne, I wanted to offer all of your listeners a free 15-minute breath consultation with me.


Adrienne Youdim 57:20

Wow. I love that.


Caroline Gamble 57:24

I think that would be really fun. I've worked with Thrive Global but I also do give that 15-minute consultations. You can get a lot out of 15 minutes.


Adrienne Youdim 57:38

Can I get one too? I want a 15-minute consultation.


Caroline Gamble 57:40

You can have one, of course.


Adrienne Youdim 57:43

How can they schedule that with you?


Caroline Gamble 57:47

First, email me. If you're interested, email me at the address

You know what? It has changed my life. I certainly don't do it perfectly. I too am human, but it’s given me the breath and I’ve so done many things and many things that I do are really helpful, but the breath is always in my pockets. It's always with me. I can be on a plane. I can be in a business meeting. I can be having a walk. I can be in traffic. You can harness the power of your breath to give yourself what you need moment by moment. So I want to give that to everyone else.


Adrienne Youdim 58:33

That's wonderful and it's such a great place to end. This has been so lovely. So much great information and just nice to be with you.


Caroline Gamble 58:43

Oh, likewise. Nice to be with you, as always.


Adrienne Youdim 58:47

And so we'll put all that information in the show notes too, on how you can contact Caroline and The Breath Method. And of course, you can find me at where you can get information on the book Hungry for More as well as the 30 day journaling guide that I have created. Lots of information and content. And if you love this podcast and you love this episode, please share. Share it with anyone who it would be of benefit. Thanks again, Caroline.


Caroline Gamble 59:22

Much love to you all.