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Breathing calmly in hospital yoga practice

Life of Breath researcher Krzysztof Bierski writes…

We are sitting together on a hospital bed. You have your legs crossed in front of your body. You try to keep your spine erect even though the weight you carry at work has made you slump your shoulders. You are simply too tired to be sitting upright. Despite feeling dizzy, you listen to teacher’s instructions and you bring your fingers to touch your sense organs. Thumbs gently press on your ears on both sides, index fingers cover the eyes. As you block your vision, you are momentarily confused as to what to do next. The teacher gently grabs your middle fingers and brings them to the sides of your nose, he guides your ring fingers to the space just above your lips and your small fingers just under. He calls this gesture the yoni mudra and the practice of attentive breathing – bhramari.

You are tense and exhausted but follow his guidance. Each morning he, or his colleague, offers you a reassuring smile. He doesn’t check your body but shows you how to use it in new ways: how to activate it and relax it. Now, after a period of more vigorous tasks, it is the time for us to work in unison. You are going to focus on me as you allow the air to enter your nostrils and fill your lungs. In this moment we are one. I am your movement in the world. I am your breath. On your exhalation, you keep your mouth closed and allow the air to leave through your nostrils as you hum. It is a bee-like sound: MMMMMMMMMMMMMMMMMM It carries until you feel there’s no more air in your lungs. Let’s start another round. We are one on the inhalation, allowing the air to flow gently into the body. MMMMMMMMMMMMMMMMMMMMM We are one on the exhalation as you experience the humming sound travel through your body, from the inside of your neck up towards your head and down towards your chest. Let’s try it again. Inhale, the air gently brushes your nostrils, the chest rises. Exhale, release the humming sound and the air out of your body.  MMMMMMMMMMMMMMMMMMMMM

I keep you company wherever you go and respond to your activity. I remain concealed as you drive a goods lorry between a depot near Chennai airport and building sites around Tamil Nadu but laboured when you manually unload the heavy loads. Just to keep your family fed and children equipped for school, you work overtime and over your physical and mental limits. Even though you thought waged labour would support all of you, there never seems to be enough to make ends meet. Your wife took over the work in the field, though for the duration of your stay at the hospital she will remain present near your bedside, day and night. And so will I. I was short when you picked up those tablets from the pharmacists that were supposed to make you feel more relaxed but gave you a stomach ache and accompanied you when your family brought you to the admission ward. At that time, your mind was racing, your body shivering and sweating; unable to speak and gasping for air. The tiredness, the tension, the pressure made me irregular and exasperated.

Now, we learn to work as one – to carry along in tandem. Attention brings us together. As you softly press your fingers on your sense organs, external impulses dissipate. Senses no longer urge you to act, but simply to be. Your eyes, just for now, are not searching for another task, the ears are not there to listen to demands and orders but only to hear the sound of your voice spreading through your body. By breathing with awareness you learn to appreciate yourself as a living being. As you focus on me, as we dance with the air, your awareness fills with experience of here, of now. So nothing to do but to breathe to breathe and be still. As you breathe calmly, you become calm.

Patients at the psychiatry clinic at Sri Balaji Vidyapeeth (SBV) medical college in Pondicherry, South India often mention bhramari (The Goddess of Bees) pranayama as one of their favourite yogic practices. As part of the recovery programme, they learn yoga together with teachers from the hospital’s Centre for Yoga Therapy and Research (CYTER). Each morning, at 10 a.m. the ward turns into a practice room with hospital beds used as yoga mats. Family members who accompany patients throughout their stay and hospital staff are invited to join but tend to be reluctant and require some persuasion. Yoga practice at the SBV’s psychiatry ward has been devised by CYTER’s director Dr. Ananda Balayogi Bhavanani and drawn from the Gitananada yoga tradition; it entails a wonderfully broad range of practices including asana (postural training), pranayama (breathing awareness), kriya (actions) and mantra chanting. Patients find bhramari particularly relaxing and, in this blog, I shall like to ask how we might account for this experience of calmness.

Biomedical research shows that bhramari can reduce heart rate and blood pressure, improve cognition and reduce stress and the authors see the practice as having a positive impact on bodily systems. My suggestion is that relaxation emerges as patients learn to breathe and to move without judgment. With yoni mudra, the senses are withdrawn but not blocked while the humming fills the body and the sensory field so that the breath can literally be touched and heard. Thinking follows the senses: one patient noted that when breathing out silently he could still hear his thoughts. With the hum, he ‘became the sound’ and thinking momentarily stopped. When moving with attention, that is without expecting an outcome and focusing on the immediate sensation of being, the breath is neither a source of nor a reaction to sensation. Rather, it becomes a way of sensing, feeling, thinking. In attentive breathing, to borrow from phenomenologist Maurice Merleau-Ponty (see his book Phenomenology of Perception, 2013 [1945]), action (movement) and perception (sensation) unite. They do not, however, impact upon one another as two separate entities. Rather, in attentive practice, patterns of experience begin to move as one. In bhramari the body remains still, the speech and senses detach and as a practitioner relaxes his breathing, his mind becomes calm too.   

Tim Ingold (in his article “Footprints through the weather‐world: walking, breathing, knowing”, 2010) follows Gibson to suggest that air is a medium, which affords experience so that living beings do not interact with but, rather, perceive and feel in the air. Pointing to their common etymological root, the author notes that, “by the way of our immersion in the medium (of air)” the weather (tempest) and the mood (temperament) are, in effect, identical. Indeed, atmosphere and attentive practice are quite alike: they always carry on and neither has a definable beginning nor end. Furthermore, the two can come together in silence, which is an expression of the former and condition for the latter. It is in silence, and with eyes closed, that practitioners explore the richness of being and attend to the subtle transformations of their experience. By remaining in silence, they do not enforce their will upon the world but allow it to take its own course. The atmosphere of calmness is facilitated by the teacher who, in his training, also learns how to move with curiosity, care and without judgement. Calmness then is not an individually experienced effect of a particular practice but an attitude, a way of being in the world, a property of ecological relations that include people, their movements and their medium, the air, neither acting nor controlling but corresponding with one another.

Taking this into consideration, yoga’s transformative potential seems to be educational rather than only therapeutic. For the patients admitted to the psychiatry ward, yoga and its practices of attentive breathing might, indeed, offer a temporary reprieve from stress. For calmness to become a durable condition, however, sustained practice is required and, in the next blog piece, I shall compare yogic breathing with the practice of weaving to suggest that wellbeing is not an effect of particular practices but a never-finished adaptive practice or a skill.

Acknowledgements: The research from which the material presented here is drawn has been generously supported by the DRS POINT Fellowship at the Institute of Social and Cultural Anthropology, Freie Universitaet Berlin. I would like to express my heartfelt thank you to staff at CYTER and SBV as well as colleagues at FU Berlin their for their support, advice and time.

Patient at SBV psychiatry clinic learning to arrange fingers in yoni mudra (Photo: Krzysztof Bierski)


  1. Krzysztof, what a brilliant way to expand our awareness beyond our "skin and skull" as Dan Siegel calls it. As a never did become a weatherman, your etymologic share re atmosphere, temperament,/mood etc is exquisite. Wishing you much success and hope some day we might meet. I'm a friend of Dr Ananda B's.
  2. A beautiful account of the empowering potential of Yoga Therapy.

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