Helping neurodivergent kids think about 'breathing'

Jessica Narowlansky

Mar 30, 20244 min read

Updated: Apr 2, 2024

There is no question that breathing strategies can be an incredibly important and powerful tool for many neurodivergent young people to have in their 'life toolkit', especially those struggling with anxiety. However, I cannot count the number of clients who have said to me, 'If one more person at school tells me to breathe, I will scream!'. When I ask them why this is, they often say they do not understand what breathing is meant to achieve and they just wind up feeling dismissed.

For many this plays into a familiar self-doubting narrative of not understanding what they are being asked to do or why.

Given the frequency of these conversations it really gave me pause for thought. In taking a step back and considering this, I found myself thinking this way…

As so many of us working therapeutically with this population know, the need for adaptation in approach is key. There is something we need to be hearing here.

It may seem like semantics but, as the saying goes, the devil is in the detail.

In thinking about this I have found the work of people like pedagogue Peter Vermeulen to be extremely helpful. Vermeulen suggests (and the DSM 5 agrees) that autism is in part a struggle with the capacity for accurate social prediction. Put in simpler terms, individuals with autism may encounter challenges in consistently and accurately contextualising the social world around them.

To make what Vermeulen calls a ‘smart guess’ about what one is seeing or is experiencing right now, one needs the information stored in the brain from past experience to be able to instantly build a working context. This ‘contextual blindness’ can make it very difficult to manage in a fast moving, inferential world. I see this with clients all the time, often leading us to build a catalogue of ‘scripts’ they can draw on when they find themselves in situations where the context of something is unclear.

Staying with autism, another useful concept to think about is monotropism. As Fergus Murray states in his article Me and Monotropism: A unified theory of autism

“In a nutshell, monotropism is the tendency for our interests to pull us in more strongly than most people…making it harder to deal with things outside of our current attention tunnel.”

This combination of difficulty in formulating accurate context and in shifting attention can lead to challenges in social interaction, communication, and understanding social mores - especially under pressure.

I thought this was poignantly summed up in an article written by a mother reflecting on her journey to learn how to support her autistic son when she discovered that, “.. making the implicit explicit when it comes to social expectations or interpreting people's mental states is a key parenting theme in my family.”

All of this makes it clear how navigating a statement like ‘just breathe’ is actually akin to asking someone to navigate a black hole.

I often see this lack of awareness present itself in interventions such as school based mindfulness programmes where, unfortunately, neuro-biased assumptions about how young people will make sense of things is a constant and invisible presence. I found that this was often at the heart of why these kids are so sceptical about the idea of how breathing could possibly help them.

SO…

What emerged through many conversations with clients around this whole mindfulness area is that simply demonstrating a technique with the promise of its effectiveness was not enough.

We need to move out of the abstract and remember to build a simple but clear context around WHY breathing can be helpful.

Together with my clients we arrived at the realisation that understanding how the body works helped them significantly in understanding the ‘WHY’.

The following is the kind of information clients found very helpful. Some kids want to know more, others less, but the principle of knowledge as a an empowering force was consist for most everyone.

When we become stressed, breathing patterns generally become rapid and shallow. When breathing becomes rapid and shallow, this reduces oxygen flow to brain and, as a result, heart rate increases and numerous brain functions are impacted.

More specifically, along with increased heart rate, shallow, rapid breathing triggers changes in the brain including:

Amygdala activation: This part of the brain, responsible for emotional processing, becomes more active and releases stress hormones
Hippocampus effected: a region of the brain crucial for memory formation and emotional regulation experiences reduced activity
Prefrontal cortex impaired: a part of the brain, responsible for decision-making, impulse control, and emotional regulation becomes impaired. This leads to decreased cognitive flexibility and difficulty in regulating emotions and behaviour.
Cerebellum impaired: this part of the brain which plays a role in cognitive and emotional processing as well as coordination, does not function effectively

… along with a myriad of other brain responses. All of this will leave anyone feeling out of control!

Critically, all of this also means your language centre essentially goes ‘offline’ so it is virtually impossible to listen to anyone at that moment.

We then discussed how the one thing you can aim to control in such a moment is your inefficient breathing. Through doing so, you begin to give your body the oxygen it needs to regain control over heart rate and allows more oxygen to travel to the brain. This brings the thinking brain (the prefrontal cortex) back 'online' and, in turn, allows other brain and body functions to begin to stabilise.

Bottom line

Breathing is not just something to do because someone tells you to, you do it because it literally:

begins to stabilise your heartbeat
oxygenates your blood and brain
slows the release of stress hormones

Circling back to Vermeulen's points; together, the client and I are building a clear context.

Time and time again, this is often a light bulb moment.

Another really important outcome here is it is incredibly reassuring that this is all not just another missed social rule or that there is some mysterious, inaccessible attribute to be understood. This is all irrefutable and concretely rooted in our biology.

Of course building this frame can take time, but most often this unpacking process is time well spent.

Resources:

Helping neurodivergent kids think about 'breathing'

Together with my clients we arrived at the realisation that understanding how the body works helped them significantly in understanding the ‘WHY’.

Circling back to Vermeulen's points; together, the client and I are building a clear context.

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