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holds the nose and firmly closes the mouth while seated upright.
Then, he/she holds the breath in expiration (that is, with "empty"
lungs) until he/she feels uncomfortable.
The person then continues in expiration while utilising one or
more distractions:
1. Body gyrations. These involve moving the torso about
while holding the nose—flinging the body from side to side,
bringing the head towards the knees, rocking from side to side,
4. Maximum pause
5. Three minutes’ shallow breathing
6. Control pause
7. Three minutes’ shallow breathing
8. Control pause
9. Three minutes’ shallow breathing
10. Maximum pause
11. Three minutes’ shallow breathing
12. Control pause
13. Three minutes’ shallow breathing
and rocking forwards and backwards.
2. Mobile exercises. Finally, the sitting gyrations don't distract
the person enough and he/she stands up while holding the nose
and begins to walk around the room in circles. He/she may walk
outside the room, keeping on the move until he/she can really no
longer hold the breath. In our clinic, this is often called "the
Groucho Marx walk".
3. Nose-breathing. The person then tries to prevent over-
breathing by breathing strictly through the nose. He/she sits down
again and deliberately tries to achieve a shallow breathing equilib-
rium. After a rest of two to three minutes of shallow nose-breath-
ing, another control pause is carried out.
4. Fun & Games. Children usually make a game of the exer-
cises. When they start to have difficulty holding the breath, and
really want to breathe in while they are sitting down and holding
the nose, they pace out steps around the room and count up the
number of steps in their heads. Some do squats; some jump up
and down on the spot. Afterwards, they compare their results
with others. Both children and adults can be fiercely competitive
over their achievements!
Adult asthma sufferers are usually accustomed to using peak-
flow meters. But rather than using the meters (which can be used
if desired, however), Buteyko practitioners prefer to use a single
instrument: the stopwatch. Success is measured as each person's
increase in control pause is accurately timed.
Maximum pause can be stretched to surprising lengths, but it is
the control pause which is the final measure of success. If the feel-
ing of first difficulty does not arise until 40 to 60 seconds have
passed, a patient can feel confident that his/her respiratory prob-
lems are improving rapidly, that the hyperventilation is being cor-
rected and that the oxygen and carbon dioxide ratio has been nor-
malised. However, if the person feels an attack coming on, he/she
can do one maximum pause, then three minutes’ shallow breath-
40 - NEXUS
ing, then one more maximum pause. If no relief is felt, the patient
can take one puff of the bronchodilator and, if necessary, one puff
five minutes later.
A typical session of Buteyko breathing exercises is described
here in table 2.
soot Be
while holding the nose—flinging the body. from side to side, Practice Time for the Buteyko Exercises
ringing the head towards the knees, rocking from side to side, « Mild cases of asthma tend to be episodic, and may be trig-
gered by types of exercise or by viral infections. Once the
Table 2. A typical session of Buteyko breathing exercises Buteyko method has been learned and practised correctly, mild
1. Take the pulse cases tend to need only episodic treatment with bronchodilators
2C and episodic breathing exercises.
- Control pause * Moderate cases are those who suffer from frequent asthma
3. Three minutes’ shallow breathing or mild continuous asthma, and those who make regular use of
4. Maximum pause a bronchodilator with usually a steroid preventive inhaler. The
5. Three minutes’ shallow breathing exercise requirements for these people are 2 to 4 times per day
for 20 minutes.
6. Control pause + Severe cases are usually on medication of two different
7. Three minutes’ shallow breathing types of bronchodilator inhalers plus steroid inhaler, with or
8. Control pause without oral steroids and with or without other agents like
4 ' q methotrexate. They tend to need frequent hospital visits. The
9. Three minutes’ shallow breathing breathing exercise requirements for people who suffer serious
10. Maximum pause attacks, with protracted stays in hospital, are 3 to 5 times per
11. Three minutes’ shallow breathing day for 20 to 30 minutes initially, later easing to two sessions.
12. Control pause To achieve best results, these sufferers may need 3 to 12
. months of practice.
13. Three minutes’ shallow breathing
14. Take the pulse again A Final Note of Caution
The purpose of this article is to familiarise the reader with
the Buteyko theory and method, not to serve as an instruction
and rocking forwards and backwards. manual. The Buteyko method should not be learned without
2. Mobile exercises. Finally, the sitting gyrations don't distract expert supervision. Consult a Buteyko teacher and medical/health
the person enough and he/she stands up while holding the nose practitioner before proceeding with any exercises or treatments.
About the Author:
Paul J. Ameisen, MBBS, ND, DipAc, FACNEM, has been a Medical
Practitioner for 21 years. His first appointment was as Resident at
St Vincents Hospital, Sydney. He has since practised at Liverpool
Hospital, Sydney; Framingham Union Hospital in Boston, USA;
Baragwanath Hospital, South Africa; and Mudgee District Hospital,
NSW, Australia. He has a Diploma of Naturopathy, a Diploma of
Acupuncture from Medicina Alternativa, and is a Fellow of the
Australian College of Nutritional and Environmental Medicine. Dr
Ameisen is currently in private practice. He is the author of Every
Breath You Take (Lansdowne Publishing, Sydney, 1997, ISBN 1-
86302-567-7).
Editor's Notes:
+ Dr Paul Ameisen was a speaker at the 1999 NEXUS Conference
in Sydney. Videotapes of his talk, "Secrets of Correct Breathing"
are now available; see Video Reviews this issue for details.
This article is edited from Dr Ameisen's book, Every Breath You
Take (reviewed in NEXUS 5/02, Feb-Mar 1998). Copies of the
book are available from NEXUS offices.
Buteyko Information:
For more details about the Buteyko method and practitioners:
in Australia, contact Clare Benton at the Vita Centre, Sydney, tel
(02) 9328 1066, 1800 658 818 (free call), website