After reading a blog titled Tai Chi and COPD, we were inspired to share an approach we’ve been using to teach tai chi to people who have difficulty breathing.
We have been teaching the Eight Ways online for two years with vulnerable students who have lung disorders including interstitial lung disease, fibrosis, and COPD. We usually have small classes of about 10 students, with a preferred maximum of 15.
In this work, we purposely do not focus on patterns of breathing in and out. Instead, we focus on softening, relaxing, and breathing gently to reduce anxiety about becoming breathless. Many students with lung disorders have noted that pressure to follow breathing patterns causes them anxiety, making it harder than ever to breathe.
While our school’s style of teaching qigong includes some emphasis on breathing patterns, neither the Eight Ways nor the beginning form include breathing patterns except for the opening move’s yin-yang breath and our encouragement to allow the breath to become longer and slower over time.
Our Eight Ways’ students report their oxygen levels often increase during class, and they report relief at not getting breathless from the pressure to breathe a certain way.
Clear focus on the principles in each of the Eight Ways is key to our approach. We focus on being grounded, upright, and centered. We work to build strength since people experiencing illness often become weak. We also work to improve balance. Awareness of one’s feet on the ground and how the weight is distributed support better balance. Uprightness envisioned as an upward lift of the head towards the heavens helps counteract postural issues like hunching and leaning forward.
We alternate standing with seated work, usually including three standing segments of 10 minutes each, two seated segments of the first five, and then 10 minutes.
Other seated times include: welcomes with Q & A, reviewing the related images for the Eight Ways on slides, a short discussion, and our closing meditation.
The students have been very clear that they like the rhythm and are relieved that they do not become breathless or fatigued, while at the same time recognizing they are benefiting from exercise.
The seated focusing work and meditation mostly involves finding and getting comfortable with one’s center of balance and center of vital energy–the tantien–and being in principle. We reinforce the major principles of being grounded, upright, and centered as we prepare to sit together.
We also include softening one’s thoughts and emotions. Sitting or standing, we often we suggest they do a scan of anything they may be holding tight, whether it be muscles, thoughts, or emotions. We suggest they ask themselves to allow tightness to soften, and let tightness and discomfort settle down and rest in the tantien. We ask them to simply breathe gently without holding their breath.
Frequently we remind them how to find their tantien, and then focus on how the tantien gathers vital energy or chi. Since vital energy accumulates in one’s sea of chi, we envision and feel it as energy spreading throughout the body, especially to places where one may feel discomfort. We often suggest envisioning the chi as warmth or as soft white light gathering and spreading throughout their body.
In the quiet focusing segments and meditations, one strategy we use is to tell them to focus in the tantien and be gentle when other thoughts come in, and then gently let go of those thoughts and return to focus in the tantien.
Recently a student shared that she treats unwanted thoughts as a puppy and gently guides the puppy back. We enjoyed that!
We take care to build a community for our participants. We schedule ample time at the beginning to hear updates or concerns from whoever wishes to share. We ask them to use their video views and first names and suggest using gallery view often so that Q & A discussion and sharing sessions include everyone. We also take turns looking into the gallery during teaching to stay aware of how things are going.
We record the sessions, carefully edit them, and make them available only to participants. When people inevitably miss classes due to medical appointments or illness, they express gratitude for the recordings, and some say they use them to practice outside of class.
Starting with the registration form, we emphasize that since they know their own bodies best, we ask them to agree to sit and rest when they feel tired or out of breath, and only return to movement when they feel ready.
At the outset of learning and practicing every one of the Eight Ways, we remind them it is perfectly okay to hold onto something like the back of their chair, a walker, a cane, or whatever else they may need, and we frequently model that for them.
Here are a few heartfelt quotes collected from participants:
I find that the sessions with Tai Chi are gentle … they get me up so I’m not sitting on my rear end. They don’t exhaust me. I can get up, I can use my leg muscles, I can use my muscles, and I’m not a wet rag at the end of the session. And the way that the sessions are conducted with meditation and resting interspersed with doing the physical motions works out perfectly for me. So, on a hard day, I can recover a little bit and then get up and move again.
I had no sense of balance. So, I said, well, I’m going to try this, but I doubt that I’m going to be able to do it. But in working with the shifting of weight from one leg to another, I saw that I could do things that I haven’t been able to do before. With this practice of this weight shifting, consciously doing that weight shift, that if I put all my weight on one leg, that frees the other leg to come up, and then I just slowly switch to the other side. And so, for the first time in my older life I’ve been able to feel more balanced. And I think that’s huge.
My posture had improved—the attraction to the heavens kind of thing. I really feel that I’ve had a workout and lengthened.
I don’t get good feelings from exercise. I get short of breath. And everybody knows what being short of breath is like, it’s painful and scary, and it doesn’t make you want to exercise.
I’m finding with this disease, I not only need the physical conditioning, but also this kind of stress reduction. … To get my body moving and breathing and mindfulness and all that it encompasses is good for all of us.
I’m interested not only for the physical conditioning, but also for the spiritual aspect, too, the grounding in the present, the meditative aspects.
Recognizing that the medical profession is increasingly recommending tai chi for a variety of patients, we share this approach for teachers who are finding the need to adapt their classes for people who can be referred to as “medically fragile,” with the confidence that the benefits of tai chi will enrich the lives of people at various stages of vulnerability and health.
Jesse Leinfelder has been with the School of Tai Chi Chuan/Tai Chi Foundation since 1978. She began studying and teaching tai chi with the Gainesville Tai Chi Center, and continues learning, practicing and teaching through summer and winter trainings and online classes. She has also taught with the Portland School, and now lives in Santa Fe, New Mexico. In her other professional work, Jesse enhances early childhood education and care. Currently Jesse serves on the Board of the Tai Chi Foundation.
Joan Campbell, EdS, is a retired Professor of Education and has been practicing tai chi since studying at Professor Cheng Man-ch’ing’s Hall of Happiness in New York in 1973. Joan began teaching tai chi with permission from Patrick Watson in 1986. In addition to her own classes, Joan teaches ongoing tai chi classes with her husband, Paul Campbell, in Gainesville, Florida.
Photo by Annie Spratt, Upsplash
© Tai Chi Foundation, Inc. 2022