Breathing Is No Joke

There are things in life you take completely for granted until you can no longer take them for granted. Breathing was one of them for me.

For most of my life, breathing required no thought, no effort, and certainly no strategic planning. It just happened. Inhale. Exhale. Repeat. I assumed that if I was alive, I was probably doing it correctly. Seemed a reasonable position.

So when someone first suggested I was not breathing properly, my response was immediate:

“Well obviously I am. I’m alive.”

Technically true. But also deeply incomplete.

What I eventually learned, rather reluctantly, is that there is a difference between breathing enough to remain upright and breathing in a way that actually helps you manage stress, anxiety, and pain.

And this is not just about PSP.

Yes, living with PSP forced me to pay attention to breathing in a way I never had before. But the benefits of proper breathing extend far beyond neurological disease. This is about general stress. General anxiety. General pain. The kinds of things millions of people deal with every single day, whether they are ill or not.

Breath will not cure PSP. It will not magically remove pain or anxiety. But it can meaningfully reduce the intensity of them, and I say that as someone who would once have rolled his eyes so hard at this conversation that he risked a retinal injury.

When I was first diagnosed with Parkinson’s at 45, before the later PSP diagnosis, my priorities changed dramatically. Up until then I had been a chartered accountant and consultant. My world consisted of numbers, transactions, integration plans, and deadlines. Nobody in corporate consulting has ever interrupted a meeting to ask whether the room is engaging in enough diaphragmatic breathing.

Then I started yoga.

And yoga delivered an uncomfortable revelation: my breathing was dreadful. Shallow, tense, inconsistent. Apparently you can survive for decades while being surprisingly bad at breathing. Who knew?

Even now, after years of practice, my physiotherapist, massage therapist, and personal trainer still regularly remind me to breathe. That feels like a fairly humbling review of my progress.

My trainer, in particular, introduced me to something called box breathing. The idea is wonderfully simple: breathe in for four seconds, hold for four seconds, breathe out for four seconds, hold again for four seconds, and repeat. That is it. No incense. No chanting. No spiritual awakening. Just structured breathing designed to calm the nervous system and bring the body down a gear or two.

And surprisingly, it works.

What finally struck me recently was how long humanity has actually known this stuff works.

Women, in particular, have been ahead of the rest of us for quite some time. Breathing through pain during childbirth is hardly revolutionary knowledge. Entire generations of birth partners have stood in delivery rooms shouting variations of “breathe!” with increasing panic.

Popular culture covered this years ago. Friends gave us Ross enthusiastically coaching “hee hee hoo” through labour classes. Meanwhile I somehow reached middle age without absorbing the lesson at all. My wife had caesareans, so my contribution to breathing techniques was essentially zero.

Instead, I arrived at breathing exercises through the scenic route: chronic illness.

Yesterday, a thoughtful reader sent me a simple message in response to one of my articles:

“Focus on your breathing.”

A small sentence. But it landed.

And to be clear, I am not talking about spiritual enlightenment here. I am not heading to an ashram. I do not own healing crystals. Nobody has started calling me “Guru Ben.” I am talking about breathing as a practical tool, supported by evidence, for helping reduce stress, anxiety, and pain in real time.

The science is actually fairly convincing.

A 2023 systematic review published in Brain Sciences examined 58 clinical trials involving breathing-based interventions for stress and anxiety. Most found meaningful reductions in symptoms, particularly when the breathing was slow, structured, guided, and practised consistently over time.

Research into chronic pain has also shown encouraging results. Controlled diaphragmatic breathing has been associated with reduced pain perception and lower anxiety levels, partly because focused breathing changes where attention is directed and may alter how pain is experienced.

Other studies suggest slow breathing, particularly with a longer exhale, may help activate the parasympathetic nervous system: the body’s braking system. Heart rate slows. Stress hormones reduce. Muscles relax slightly. None of this is mystical. It is physiology.

None of this replaces proper medical care, medication, physiotherapy, or pain management. But it may offer another useful tool alongside them.

And honestly, in a disease that has no cure, you start looking for wins that come from other places. Small advantages. Small reliefs. Small things that help you cope better than you did the day before.

So I am taking this more seriously now.

Not obsessively. Not performatively. I am not about to become the sort of person who begins every conversation by discussing “breathwork journeys.” But I am trying to use breathing deliberately rather than accidentally, as a practical tool alongside physiotherapy, yoga, medication, and the other small adjustments that collectively make difficult days more manageable.

Because this is what living with a terminal illness often becomes: not dramatic breakthroughs, but the gradual construction of a toolkit. Small things. Practical things. Manageable things. Ways to reduce the cumulative weight of pain, stress, and anxiety when all three arrive together. Which they often do.

And if one of those tools turns out to be something as basic as breathing properly, that is both mildly embarrassing and genuinely remarkable.

For anyone wanting a simple starting point, the Berkshire Healthcare NHS Foundation Trust page on breathing exercises is excellent. It includes a straightforward technique called rectangular breathing: inhale for five seconds, exhale for seven, and repeat.

Simple. Free. No crystals required.

And to the reader who reminded me of this: thank you. You were right. That message arrived at exactly the right moment.

Sources and Further Reading

• Bentley et al. (2023), Breathing Practices for Stress and Anxiety Reduction, Brain Sciences:
  PMC Article
• Controlled diaphragmatic breathing and chronic pain reduction, Current Psychology:
  Springer Article
• Respiration, pain perception and neural mechanisms, Frontiers in Neuroscience:
  Frontiers Article
• Berkshire Healthcare NHS Foundation Trust, How Breathing Can Reduce Stress and Anxiety:
  Breathing Exercises Guide