The Respiratory System
in Applied Psychophysiology
The respiratory system is unique among physiological systems in that it is both voluntary and involuntary. This fact probably explains the predominance of breathing in meditation and healing traditions. Practitioners very commonly use relaxed breathing therapies1 for reducing physiological tension and arousal, and for treating a wide variety of specific symptoms and disorders. Some researchers and practitioners consider many symptoms as breathing-related (Janis, Defares, & Grossman, 1983; Lichstein, 1988; Fried, 1987a, 1993a, 1993b; Ley, 1988a, 1988b, 1992, 1993; Timmons & Ley, 1994). This view asserts that breathing in anomalous ways frequently increases the risk for developing or triggering many symptoms. Therefore, breathing therapies are essential in the treatment of patients with many different symptoms and disorders.
Those symptoms directly implicated for breathing therapies include panic, functional chest pain, and asthma. Breathing therapy is also part of the treatment of many other symptoms and disorders, including migraine headaches, hypertension, and anxiety. Practitioners use breathing therapies alone or use them in combination with other relaxation therapies, behavioral therapies, and other forms of stress management. Some authors (e.g., Janis et al., 1983) speculate that altered breathing patterns may mediate some of the positive effects of relaxation therapies and biofeedback-assisted relaxation through autonomic nervous system (ANS) changes.
In this chapter, we attempt to provide an overview of respiratory physiology in both the normal case and in cases where some form of hyperventilation (HV) or anomalous breathing may occur. We then review the controversy concerning hyperventilation syndrome (HVS) and its role in many functional disorders. This is followed by a description of breathing therapies as they are often used in applied psychophysiological treatment. (Throughout the chapter, italics on first use of a term in text indicate that the term is included in the glossary at the chapter's end.)
The respiratory system is among the most complex organ systems in the body. Descriptions of the anatomy and especially the physiology of this system are provided in medical textbooks (e.g., Guyton & Hall, 1996) and in abbreviated forms in Fried (1993b) and Naifeh (1994). A