Story by Kelsey Thalhofer
Photos by Brendon Burton
Morning sun streams through the large windows of the second-story yoga and Pilates studio. Turning to face the four women in this day’s class, Quincy O’Toole calmly breathes out as an energetic smile slides easily onto her face. With the touch of a button, the stereo fills the open room with sounds of drums, wind instruments, and soft, rhythmic voices. O’Toole, black pants flaring around her thin frame, begins dancing her way across the smooth floor.

Her wiry red hair flies freely as she leads students through NIA, a Neuromuscular Integrative Action low-impact aerobics routine. O’Toole reminds her students to exhale with each step. “When you’re seeking balance, it’s a great metaphor for life,” she says, moving through the routine. “You need to keep breathing in order to keep everything organized.”
O’Toole experienced her own revelation about the power of focusing on slow, deep breaths eight years ago while dancing NIA. “I was holding my breath and then gasping for air, and I thought, ‘If I can’t give my body what it needs to sustain movement, how can I expect my body to perform?’” she says. “When I could focus on breath patterns in ways that were in line with the rhythm of the music, all of the sudden my body had a deep reservoir of energy that it could give me.”
She began researching the science behind breathing and breath techniques online, and now O’Toole incorporates conscious breathing into every class she teaches. While breathing is a common focus of yoga exercises, O’Toole believes it’s also central to NIA, which she says is all about finding joy. “People focus so much on eating organic food and spending money on vitamins and supplements and getting enough sleep,” she says. “Not a lot of people think about the breathing part.”
O’Toole emphasizes exhaling as a way to help her students think about breathing in a new way. Some of her students don’t feel they can inhale deeply enough, but O’Toole teaches them to firmly expel air from their lungs, which allows the body to naturally take in the air it needs. She also says prolonging the exhale twice as long as the inhale can increase her students’ oxygen intake significantly and help them improve cardiovascular and emotional health.
Conscious breathing, also known as “abdominal breathing,” “biofeedback breathing,” or “breath awareness,” involves taking slow, deep breaths that expand the belly, rather than the chest. Belly breathing is natural for newborn babies, says Alfred Lee, a breath researcher and practitioner based in Portland, Oregon. But as the body matures, poor posture, laziness, and a culture that discourages round bellies leads adults to lose their original breathing habits and begin breathing through the chest, causing what Lee describes as a “cascade of negative effects.”
“Your breath is the most important tool you have to manage and eliminate stress,” says Lee, who co-authored Perfect Breathing: Transform Your Life One Breath at a Time, with fellow practitioner Don Campbell. Both men believe conscious breathing can help boost a body’s immune system, reduce stress, and increase heart health. Lee also says he has rarely
come down with a cold or flu since he began practicing conscious breathing, and the techniques help him better cope with anger. “For me, it’s been absolutely life-changing,” he says.
As part of the body’s fight-or-flight response, chest breathing triggers an adrenaline release and causes feelings of fear, anxiety, and panic. It also causes blood vessels to constrict, making the body’s pH more acidic, a condition that has been linked to a variety of health problems, Lee says.
In contrast, practicing slow, deep breathing allows the human body to relax and take in more oxygen, which helps restore pH levels by increasing the body’s alkalinity, and can help manage emotions. “Deep breathing allows you to navigate all those big emotional sinkholes,” Lee says. “Focusing on your breath reduces your emotions and activates the logical, problem-solving, rational side of the brain.”
Lee also says simply breathing into the diaphragm for three seconds and out for six can help people achieve better emotional and physical health. When he feels his breath quicken, Lee knows he needs to take a step back and think about his emotions, a concept similar to the Buddhist philosophy of mindfulness. “Every spiritual tradition uses these [breathing] techniques,” says Lee, because they allow people to clear their mind and focus.
Lee recommends everyone practice deep breathing techniques, even if it’s only for five minutes a day. One exercise involves sitting in a chair and placing one hand on the chest and the other just beneath the ribs, allowing the hands to guide breaths flowing in through the nose and out through pursed lips, exhaling twice as long inhaling.
Sandra Richey-Wallace, a respiratory therapist at Oregon Health and Science University in Portland agrees that breathing influences the rest of the body’s functions. “Your lungs and your heart work very tightly together,” she says. “If one of those organs isn’t working, then the other isn’t working very well.”
Richey-Wallace works with patients whose breathing is compromised by emphysema, asthma, or surgery. One technique she recommends to patients is “pursed lip breathing,” in which patients shape their lips into a tight circle—as if drinking from a straw—while breathing out deeply. The shape of the lips helps add resistance as they exhale, slowing down each breath to calm breathing patterns. For some, conscious breathing practiced over months and years can improve long-term wellness. But Tom McCarthy, a postmaster in Hilo, Hawaii, says the techniques literally healed him overnight.
Before McCarthy discovered conscious breathing, he greeted every day with coffee and a dry, hacking cough. The coughing sometimes became so violent McCarthy worried he would lose control of his bike while cycling to work. McCarthy’s doctors believed he suffered from allergies and for 12 years prescribed mixtures of breathing inhalers and steroids, but nothing seemed alleviate his coughing fits. It wasn’t until he picked up Lee’s book, Perfect Breathing, at the library one afternoon that McCarthy found the answer. Scanning over the book’s exercises, he decided to give one of them a try. That night, he lay in bed inhaling slowly and exhaling twice as long.
When McCarthy awoke the next morning he began his normal routine, initially unaware of any physical difference. “I’m sitting there drinking my coffee and I go, ‘Holy shit! I’m not coughing!’” he says.
McCarthy experimented with the same deep breathing techniques throughout the day and his cough didn’t return. Later, when he gave the exercises up for a few days, the cough came back, proving to him the techniques really did treat his condition.
Now he uses conscious breathing not only to control his cough, but also to calm himself before dentist appointments and surgeries. McCarthy still marvels at the thought that his chronic condition was solved so simply.
“I’m living proof that it works,” McCarthy says. “My cough, which had such a big impact on my daily life and health, could be solved so simply and naturally without any drugs or foreign substance; just air. There’s no co-pay on that!”