The intricate connection between emotions and breathing finds expression in everyday phrases like a “gasp of surprise” or a “sigh of sadness.” This linkage is further evident in laughter and crying, where breathing patterns are noticeably altered. Within this framework, Chronic Hyperventilation Syndrome (HVS) emerges, characterized by abnormal breathing at rest and during activity without an organic cause. While studies point to psychological factors like anxiety as potential triggers for HVS, the syndrome’s etiology and clinical presentation remain elusive, with multiple contributing systems.

Offering a unique perspective, victims of torture provide a lens into HVS development. A group of individuals subjected to organized violence experienced clinical signs of HVS following their release. Their stories suggest that enduring extreme pain and deprivation can lead to sustained breathing abnormalities, where hyperventilation could serve as an adaptive mechanism, reducing pain perception. Yet, over time, such abnormalities might persist and become maladaptive, especially if trauma finds relief through intrusive thoughts, as seen in PTSD.

Clinical diagnosis of HVS entails a symptom history and a provocation test involving breath-holding and over-breathing exercises. Remediation approaches include breathing retraining, which helps clients manage air hunger without panic or the urge to over-breathe. The process involves guided awareness of breath, practicing different breathing maneuvers, and shifting from thoracic to abdominal breathing. A successful outcome entails reducing the breathing rate to six to eight breaths per minute.

Ultimately, the intricate dance between emotions, trauma, and breathing showcases the complexity of HVS. While emotions influence breathing, breathing can also impact our psychological state. By understanding these interconnections, we unveil avenues for effective treatment approaches, offering hope for those navigating the challenges of HVS and related conditions.


Turner, Stuart & Hough, Alex. (1993). Hyperventilation as a Reaction to Torture. International Handbook of Traumatic Stress Syndromes :725-732. Doi: 10.1007/978-1-4615-2820-3_60.



One of the victims started hyperventilation after only a breath-hold time of 1 to 2 seconds and 10 seconds of over- breathing. Typically breathing into a brown paper bag loosely covering the nose and mouth helps improve the symptoms by increasing blood levels of carbon dioxide (i.e., hyperventilation results in reduced levels of carbon dioxide in the blood PC02– hypocapnia).

Breathing retraining:

A typical program would start with the client’s being asked to lie in a comfortable position on a couch, perhaps with a pillow under the knees for support. Awareness of breathing is encouraged by asking the client to imagine the air going into his or her lungs, as if the air is passing down a tube and filling a balloon every time a breath is taken. Different breathing maneuvers, such as breathing in, breathing out, and breath-holding (for a short time) can be rehearsed, asking the client to concentrate on each of these automatic experiences. Asking the client to put one hand on the upper chest and another on the abdomen is useful in learning awareness of thoracic and abdominal breathing. One of the aims of treatment is to encourage people to use abdominal rather than thoracic breathing.”. 


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