Integrative Breathing Therapy

Originally developed by Dr. Rosalba Courtney DO, PhD, Integrative Breathing Therapy (IBT) is comprehensive and an individualised approach to breathing retraining and breathing therapy.

It is an evolving therapy and its development is built on the integration of scientific evidence, critical thinking and the accumulated and shared experience of IBT practitioners.

Many of the theoretical concepts, clinical tools and protocols developed during Dr. Courtney’s PhD titled “Dysfunctional Breathing; Its Parameters, Measurement and Clinical Relevance” have been tested and further developed in the clinical setting and in subsequent research.

A comprehensive Approach

IBT works with and aims to optimise the functions of the three key dimensions of breathing, ie the biochemical, biomechanical and psychophysiological dimensions, and the function of the unified breathing system. IBT recognises that breathing is a system made up of anatomically and functionally linked parts such as the nose, upper airway, thorax and diaphragm that are controlled by many shared neural pathways. It recognises that breathing has many primary and secondary functions with the potential to heal via a range of mechanisms.

Assessment and treatment of all dimensions of breathing and the various parts of the breathing system may be necessary for ideal treatment outcomes when using breathing in a therapeutic setting.

It addresses:

Dysfunctional mouth breathing
Empty nose syndrome and functional nasal disorders
Upper airway and laryngeal dysfunction
Breathing pattern disorders
Stress related breathing issues
Abnormal breathing perception
Hyperventilation
Sleep disordered breathing

The Three Dimensions of Breathing

The three dimensional model of dysfunctional breathing was developed during Dr. Courtney’s PhD research. This model shows that dysfunctional breathing correlates with biochemical, biomechanical and psychophysiological dimensions of breathing. This highlights the need for breathing therapy to assess and treat all 3 dimensions.

BIOCHEMICAL

The biochemical dimension of breathing relates to the maintenance and regulation of correct arterial Oxygen (O2) and Carbon Dioxide (CO2) levels and the regulation of the body’s pH. Hypoventilation and hyperventilation disorders and respiratory acidosis and alkalosis are evidence of the disturbance of the biochemical dimension of breathing.

BIOMECHANICAL

Breathing involves the action of a muscular-skeletal respiratory pump. This moves air into and out of the lungs and creates pressure changes in body cavities. Breathing pattern disorders of the upper airway/larynx and of the rib cage or thorax are evidence of the disturbance of the biomechanical dimension.

PSYCHOPHYSIOLOGICAL

There is a two way bi-directional relationship between breathing and the mind/emotions. Feelings and mental states affect breathing and also the experience of breathing discomfort or dyspnea. On the other hand attention to and modification of breathing has the ability to influences the mind and emotional states.

IBT is person centred rather than therapy centred. Breathing techniques are chosen and adapted
to suit a person’s condition and circumstances on the basis of history, assessments and goals.

ASSESSMENT

An IBT practitioner will assess the three dimensions of breathing before, during and after treatment to determine the extent and nature of a person’s dysfunctional breathing as well as its possible causes. Assessment helps the practitioner to determine the most suitable treatment and to adjust breathing instructions and other advice for maximum benefit to the patient.

TREATMENT

In people with functional breathing issues treatment is focused on correcting abnormal breathing behaviors and dysfunctional breathing. In individuals without dysfunctional breathing, breathing techniques are used in conjunction with other strategies to improve physical and psychological health or to achieve specific goals such as improved sports performance.

Breathing retraining is the primary therapy for dysfunctional breathing and has been shown to be effective. Consciously altering and modulating breathing in specific ways can also improve health and assist in the management of a number conditions because of the way breathing influences the mind and emotions and other body systems. While this does not mean that breathing training is the answer to all health problems it does show that it can play an important role as an adjunctive therapy.

Here are some of the physiological and psychophysiological effects of breathing:

Influences the function of the autonomic nervous system
Affects efficiency of circulation of blood, lymph and csf
normaliseS homeostatic reflexes such as REgULATION OF blood pressure
Trains the mind, focus and attention
Affects function of the digestive systeM
Calms the stress response and improves stress resilience
Influences the immune system and inflammatory response
Improves airway and lung function

Respiratory Complaints

Dysfunctional breathing
Asthma
Chronic obstructive pulmonary disease
Laryngeal breathing disorders and PVFD
Sleep disordered breathing
Empty nose syndrome

Stress Related Conditions

Anxiety
Panic disorder
Burnout
Chronic Stress
PTSD

Musculoskeletal Conditions

Recurring back, neck and pelvic pain
Craniofacial and TMJ pain
Breathing related postural disturbances
Chronic pain with central sensitization

Chronic conditions

Somatic syndromes
Long COVID
ME/CFS

WHAT IS INTEGRATIVE BREATHING THERAPY?