In Short – Issue 4 (Winter 2026)

January 31, 2026

Image credit: John Repp

The Physiology of Breath

By Helena Rho

Whenever I feel anxious or afraid, I hold my breath. I don’t realize I’m doing it until I’m almost lightheaded. As a pediatrician, I saw children with asthma and cystic fibrosis in respiratory distress, their mouths wide open, gasping for air. I prescribed medications and administered nebulizer treatments. But really, I was helpless. When I remember their terror, the widening of their pupils, the frantic searching of their eyes, I instinctively hold my breath. As if I can stop time, stop their suffering.

While I was going through an ugly divorce from an even uglier husband, I started running around the reservoir in Central Park. I wasn’t very good at it, and this was compounded by my inability to breathe properly. I kept holding my breath. Which is crazy, given that my heart and lungs needed oxygen delivered at an increased pace, given what I was doing. As a doctor, I knew this, and yet I kept pushing myself into oxygen deprivation. But I never passed out. Breathing is an involuntary action—it goes on regardless of whether you want it to or not.

My ex-husband is a pulmonologist. In an ironic twist of fate, the man who caused me to hold my exhale an insufferable number of times actually treats people with breathing problems. He told everyone that the reason he became a lung doctor was because his father smoked. He was terrified his father would die of lung cancer, he said, and “had to do everything” in his power to stop it. Everyone who heard this story was touched, and many were moved to tears. Only I knew the truth: During his residency, he admired an attending who was a pulmonologist. But the story about his father “played better to an audience.” Ironic that he was better at crafting a narrative than I was, a writer.

Breath has an intricate physiologic relationship with stress and anxiety. The neural circuits that regulate our emotions are entwined with breath signals. If we slow our breath, we can decrease our level of stress hormones. We can make pain bearable. I’m really good at inhaling air and holding it, not so good at the letting go. No grace in my exhale, like I’m flailing, running away from someone. An expert at a center for emotional intelligence recommends the RULER framework when you feel assaulted by feelings: recognize, understand, label, express, and regulate. One of the best ways to combat intense negative emotions is in the “regulate” section (the one most intriguing to me, a survivor of childhood sexual abuse and domestic violence): Take deep breaths in and out. Being implemented in thousands of schools, RULER seems to work for children. I swear, I’m trying to learn it.

These days, I walk around the lake in Minnewaska State Park whenever a plot point is twisting unexpectedly or a character isn’t behaving the way I want them to. To be honest, the woods have never done much for my peace of mind but staring at water has always been my salvation. On a cold November afternoon, I stand on a precarious granite plateau, blazing blue below me. The sun slants across my face, and I close my eyes. I take a long inhale, remind myself not to hold it, and exhale slowly. Then I do it again and again.

Helena Rho is a four-time Pushcart Prize nominated writer and the author of Stone Angels, a novel, and American Seoul, a memoir-in-essays. She is a devoted fan of K-dramas, Korean green tea, and the haenyeo of Jeju Island.