Wilfried Ehrmann

Coherent Breathing

Aligning Breath and Heart

How to Improve Our Heart Rate Variability With Our Breathing

© in J. Kamphausen Mediengruppe GmbH, Bielefeld

First edition 2017

Author: Wilfried Ehrmann

Cover design, illustration: @graphlight, fotolia

Translation: Wilfried Ehrmann

Proofreading: Annouchka Bayley

Publisher: in J. Kamphausen Mediengruppe GmbH, Bielefeld,,


978-3-96051-538-8 (Paperback)

978-3-96051-539-5 (Hardcover)

978-3-96051-540-1 (e-Book)

First published in German 2016 by Tao-Verlag, Bielefeld,

titled: “Kohärentes Atmen. Atmung und Herz im Gleichklang“.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means without the prior written permission of the publisher, nor be otherwise circulated in any form of binding or cover other than that which it is published and without a similar condition being imposed on the subsequent purchaser.


Fig. 1-4: ©Wilfried Ehrmann

Fig. 5:Wilfried Ehrmann using ©Bill2499, dreamstime

Fig. 6: ©Wilfried Ehrmann

Fig. 7-8: ©Steven Elliott, with kind permission

Fig. 9-12: ©Wilfried Ehrmann

Wilfried synthesizes complex research from many schools of breathwork in understandable and compelling ways that translate directly to practices critical to controlling our own well-being. He is thorough in his research and documentation while being conversational and accessible in his presentation. In short, he delivers relevant life enhancing information on how we can use our breath to directly change our physical, emotional and mental states for the better. Coherent Breathing puts together theory and scientific data into an easily digestible format for immediate use in our daily lives.

Jim Morningstar, PhD, founder of the School of Integrative Psychology in 1980 and the Transformations Breathworker Training, pioneer in the integration of psychotherapy with such mind/body techniques as breathwork and bio-spiritual energetics, author of four books.

Table of Contents


Author’s Note

On Reading this Book

Chapter 1 – Taking Care of Our Health

1. The Salutogenetic Concept of Health

2. Tow Pillars of Health

3. Coherent Breathing as Method for Self-Provision

4. The Autonomic (Vegetative) Nervous System

5. Strengthening Para-Power and Total-Power

6. Practice Creates Health Competence

Chapter 2 – The Polyvagal Theory

1. The Autonomous Nervous System

2. The Polyvagal Theory

3. The Developmental History of the Nervous System

4. The Vagal Brake

5. Vagus and Breathing

6. Traumatization and the Polyvagal System

7. The Sensual Organs and Vagal Regulation

8. Summary

9. An Extended Model of the Vegetative Nervous System

Chapter 3 – What is Coherence?

1. What does Coherence Mean?

2. Quantum Coherence According to Mae-Wan Ho

3. The Sense of Coherence in Salutogenesis

4. Complete Coherence According to Alan Watkins

5. Heart Coherence

6. Heart Rate Variability

7. Measuring Heart Rate Variability

8. Methods of Calculation

9. Heart Coherence and Heart Intelligence

Chapter 4 – The Breath-Heart Coherence

1. Lungs and Heart in Cooperation

2. The Respiratory Sinusarrhythmia (RSA)

3. The Valsalva Wave

4. Diaphragm and Blood Pressure

5. Valsalva Wave and Brain

Chapter 5 – Coherent Breathing

1. The History

2. The Method of Coherent Breathing

3. The Elements of Coherent Breathing

Chapter 6 – Practicing Coherent Breathing

1. Regaining the Original Mode

2. Practice and Resistance

3. External Support

4. Practice as Meditation

5. The Six Bridges

6. Variations of Coherent Breathing

7. Questions Concerning the Practice

8. Biofeedback and Coherent Breathing

Chapter 7 – Other Schools of Breathwork - a Survey

1. Schools of Strong and Intense Breathing

2. Dynamic Breathing Meditations

3. Internal Breathing Meditations

4. Pedagogical Schools of Breathwork

5. Pranayama

6. Summary

Chapter 8 – Breathing Less: The Findings of Buteyko-Breathing

1. Breathing and the pH-Value of Blood

2. Vicious Circles of Over-Breathing

4. Buteyko Breathing and Coherent Breathing

Chapter 9 –Adrenalin-Breathing of Wim Hof

1. Adrenalin-Breathing

2. Breathing and Stress Reaction

3. Hormesis and Stress Experiences

4. Inner Breathing

5. Eustress and Distress

6. Dynamic and Coherent Breathing

Chapter 10 – Integrative Breathing and Integrative Breath Therapy

1. What does “Integrative” Mean?

2. The Setting of Integrative Breathwork

3. Coherent and Integrative Breathing

4. Integrative Breathing and Mindfulness

Chapter 11 – Breath Coherence and Psychotherapy

1. Mental Problems and Stress

2. The Importance of HRV for Psychotherapy

3. Types of Attachment

4. Example Trauma Therapy

5. Example Depression

6. Psychotherapy: Guidance and Self-Competence

7. A New Paradigm for Mental Health

8. Interplay of Therapy and Breathing Exercises

9. Coherent Breathing during Therapy

10. Coherent Breathing for the Therapist

Chapter 12 – Areas of Application

1. Coaching

2. Coherent Breathing in Sports

3. Coherent Breathing with Children

At the End and at the Start




This book deals with the subject of breathing “coherently”, a system of breathing that is celebrating its 13th birthday as of this year, 2017. Fundamentally, Coherent Breathing leads the breather to inhale and exhale in a synchronous manner at their resonant rate, in combination with conscious relaxation, so as to facilitate wave action in the body. Resonant coherent wave action depends on both breathing and relaxation.

If we’re familiar with resonance as it relates to the human body, we may be used to thinking of it as “cardio-pulmonary resonance”, this because for the last few decades we have been able to observe resonance in the action of the heartbeat easily and non-invasively via plethysmography, where plotting the heart rate in time yields the heart rate variability (HRV) cycle. With the advent of Coherence instruments (2009), we are able to see blood action associated with both breathing and heartbeat, the former being impetus for variability of the latter, the state of the art definition of resonance being the near 180 degree phase correlation of the two phenomena.

A more complete understanding of how one elicits this resonant physical state reminds us that the central nervous system is also intimately involved, both autonomic and somatic functions thereof. So a more complete way to think of resonance is as a state wherein the body and mind are united in purpose, this purpose being realization and maintenance of a state of mind/body coherence. Perhaps Mae-Wan Ho’s definition of coherence is most complete, this being that coherence is an expression of wholeness of a living system, where it’s opposite, incoherence, is a measure of its entropy. Life requires organization and integration; disease and death accrue from its opposite, disorganization and disintegration.

Our present state of understanding is that “healthful” breathing promotes wholistic health and well-being and that poor breathing promotes its opposite. A primary mechanism by which breathing affects our health is by facilitating healthful circulation and its outcome, autonomic nervous system balance, where this balance can be observed via multiple biometrics including EEG, EMG, heart rate, blood pressure, skin conductivity, and hand temperature, where we tend to see these measures shift rapidly toward balance and away from sympathetic dominance once Coherent Breathing begins, autonomic balance swinging like a pendulum from sympathetic to parasympathetic emphasis with each cycle of inhalation and exhalation, respectively. Whether autonomic balance is an outcome of the wave or the wave is an outcome of autonomic balance is a question. What we do know is that the wave is an outcome of synchronous coherent diaphragm movement combined with conscious relaxation.

The current theory is that Coherent Breathing influences central nervous system function by bathing the body and brain with wavelike circulation, this “Valsalva Wave” issuing from the chest during exhalation via the left heart and arterial tree, and returning to the chest via the venous tree and right heart during inhalation. This wave action can be observed almost anywhere a plethysmograph can be attached including arteries, veins, and capillary circulation. The presence of the wave can also be observed in the brain non-invasively via EEG and HEG.

Breathing induced heart rate variability, wherein the heart rate rises coincident with inhalation and falls coincident with exhalation, is an autonomic response to the presence of the respiratory wave via baroreception. I make this distinction because myriad autonomic factors affect heart rate. However, when breathing is synchronous and coherent, breathing tends to dominate and the HRV cycle phase locks with breathing.

The volume and power of heart contractions are also synchronized with breathing so as to accommodate alternating circulatory emphasis, i.e. blood volume rising in the arterial tree during exhalation and rising in the venous tree during inhalation, their overall equality being of critical concern to the autonomic nervous system.

Coherent Breathing, the system, offers a method for breathing and a method for relaxing, so as to elicit mind/body resonance, the method of relaxation being “The Six Bridges”. The six bridges are anatomical zones that possess both conscious and unconscious governance. They also all exhibit an “open” and “closed” state. The bridges are associated with the parts of the body with which we interact with the world around us, transmitting or receiving, affecting or sensing, input or output. Two clearest examples are the eyes and the diaphragm. We have clear conscious control of each, but when we are not controlling them consciously, the autonomic nervous system controls them for us – automatically.

So Coherent Breathing, the system, proposes that we learn or relearn to breathe and to relax consciously so as to generate the wave in the mind/body. Having trained both properly, it becomes automatic – not unlike riding a bicycle. It becomes a choice that we may make mindfully.

My many thanks to Dr Wilfried Ehrmann for bringing the theory and practice of Coherent Breathing to German speaking people around the world.

Stephen Elliott, Life Scientist, Author

Author’s Note

For a long time, I have been intrigued by conscious breathing. For the first time in my life, I explored the power of breath by learning to play the clarinet at the age of 11. Suddenly, my breath could produce sounds with the help of the instrument, and the quality of these sounds depended on the length and strength of the breath, whether they sounded strong and clear or weak and dwarfed. Also the beauty of the tone was the result of the flow of breath.

Many years later I started to develop an interest in my inner world. I took therapy for years and visited groups for self-development. I felt drawn to body therapy when I realized that therapeutic talking alone could not bring me deep enough into myself. During this time, I had my first experience with conscious connected breathing in a longer session, which connected me to deeper layers of my psyche. Since then the passion for breath consciousness has not left me. I started to work as psychotherapist and connected the awareness and mindfulness of breathing with other approaches I had been trained in. I noticed the important role of breathing in bringing up and resolving inner issues with myself and with many clients throughout close to thirty years of practice.

Together with colleagues I founded an association in Vienna dedicated to fostering and spreading breathwork in different forms. Since the early nineties, it has grown to a considerable organization with various activities. I am the editor in chief of a journal on breath therapy and breathwork and have been facilitating a training program for breathworkers since 1993. In 1995, I came into contact with the international scene of conscious breathing and have been working for the International Breathwork Foundation since then.

After having written several dozens of articles about the breath and about breathing, I started to write a basic manual of breathwork, which was published as “Handbuch der Atemtherapie” in 2005 (parts of the book have been translated into English and can be obtained from the author). Since then, a decade has passed, and new developments arose in the world of the breath, with new insights and methods.

In 2011, I completed my second book, which is also available in English: “Consciousness in Evolution”. It describes the history of mankind and its traces in the souls of humans from an integral perspective. By this I came into contact with integral forums, where people are occupied with evaluating, interpreting and improving the vast work of the US philosopher Ken Wilber. There I met Günter Enzi, who one day talked about Coherent Breathing, in which he was interested in its connection to heart rate variability.

With his selfless support I started to explore intensely the relationships between the rhythm of the heartbeat and breathing. Soon I noticed in my own investigations how easily and quickly Coherent Breathing could calm me down and help me to relax profoundly. I could prove the physiological efficiency of the method by measuring the improvements in the figures of my heart rate variability.

Out of the cooperation with Günter, the idea to this book was born. He supported me with a lot of precious hints during the process of writing. I am very grateful for his contribution to the book. I contacted Stephen Elliott, the founder of Coherent Breathing, who welcomed my project spontaneously and gave me a lot of professional help with several questions, which came up in the process of writing. I also thank him warmly for the preface to this book.

My own experiences and those of many clients and students have strengthened my conviction that Coherent Breathing can be an invaluable help for relieving and healing many if not all the problems and sufferings of our bodies and souls. This is why I hope that this book will help many people who are interested in the breath on their way and that it will inspire many to become interested in the breath. Being interested in one’s breathing always implies being interested in one self, one’s body and spirit, health and inner balance.

On Reading this Book

The method of Coherent Breathing, which is presented and explained in this book, is easy to understand and to practice. You might ask yourself why so much theory is necessary and opt instead to turn directly to the relevant chapter on the method itself and begin practice.

There is nothing wrong with this as not all need to be pleased and enthusiastic about theoretical insights. I tried to keep the excursions to physics, biology and chemistry as simple and easy to grasp as possible. There is a glossary of special terms at the end of the book. And those who want to get more information about certain aspects of the manifold connections, which are important for Coherent Breathing, can use the references for deepening the knowledge about the subject.

For understanding, why Coherent Breathing should be practiced in one way and not in another, as described in this book, it is crucial to comprehend the background. Otherwise, someone might have the idea to make the exercises “intuitively” in a different way, which is not fundamentally wrong but misses the deeper effects of Coherent Breathing.

Apart from that, understanding what is going on in the body when breathing is aligned to a coherent rhythm can enhance the inner effects because we have an intimate connection between cognition and organic processes. We need an insight about the usefulness of new exercises; otherwise the motivation can fade away soon.

Many people have a visual access to the inside of their bodies. Knowing about the internal processes and connections can help to connect the breathing exercises with imagination and visualization, which can help to easier dive into the desired rhythm.

Finally, it helps spreading the method when we gain an understanding about its impact on our physiology and our well-being. Many people in our culture need a theoretical background as assurance to enter into new ways of perception and experience or unfamiliar practices. Far too quick, we tend to remove methods, which do not stand up to the rigid demands of science, to the corner of speculation or esoterics. Yet, this book gives nourishment for both: Those who want to give a try to a new method, and those who first have to soothe their inner critic before going into practice.

In the initial chapter, I describe a new paradigm, which is probably necessary for the whole area of health services and will become more urgent in near future as it is about viewing ourselves not only as consumers of public health care, but as primary responsible for our own health. The method presented in this book claims to offer an important contribution to this new orientation, which everyone can utilize as long as one is able to breathe consciously. But it needs a widely socially accepted basis in form of a scientifically verified and at the same time sufficiently comprehensible theory.

The general remarks of the first chapter are presented in more detail in the second. The model of the polyvagal theory helps to understand the central role of our autonomic nervous system for our well-being and our social competence and how we can influence it beneficially.

The third chapter offers an explanation of coherence, a phenomenon already existing in inanimate objects striving for interactive harmony. Even more, we can take advantage of the notion of coherence in regard to processes in our bodies, because health and coherence seem closely interlinked. In this context, we will deal with heart rate variability, which offers a yardstick for this connection.

The fourth chapter leads us to the connection of heartbeat and breathing rhythm and thus to the immediate preparation for Coherent Breathing. Here we find the new discovery by Stephen Elliott and his team: We can shape our breathing in a way that it optimally supports and unburdens the activity of heart and blood circulation. By this, a wave of coherence is activated, which in turn harmonizes many other physiological systems.

Equipped with these provisions, we get to know Coherent Breathing in its practical form to encounter and understand its fundaments in the fifth chapter. Now there is nothing to prevent starting to practice right away, and the next section offers extensive practical hints, recommendations and support. In the seventh chapter, we find further Coherent Breathing exercises, among them the “six bridges”, which is an enlargement of Coherent Breathing.

The seventh chapter gives an overview over many breathing methods and schools, which have developed over time, so that we can see the value of Coherent Breathing in a broader context, and we can judge, which breathing exercises are useful for which purposes. Many people use breathing exercises and are familiar with certain methods. It is important for them to understand how their exercises relate to Coherent Breathing.

The eighth section will go into more detail about the chemistry of breathing. It is of great importance for this subject how the physical compression ratios we use in Coherent Breathing are related to the chemical process of the oxygen and carbon dioxide metabolism during breathing.

In the ninth chapter, the connection between breathing and hormone regulation in the body will be explored in respect of the question whether and how rapid and deep breathing can be beneficial for our health.

The tenth chapter presents integrative breathing as comprehensive method of breath therapy and prepares the ground for the next section dealing with the question how especially Coherent Breathing can be used in psychotherapy. Finally, the application of Coherent Breathing in coaching, sports and with children will be highlighted.

The terms “Coherent Breathing” and “Valsalva wave” used in this book are protected by copyright by COHERENCE LLC.

In this book, all male attributions include females and vice versa. Quotations from German sources are translated by the author.

Chapter 1 – Taking Care of Our Health

We are on the edge of a basic shift of our health care system. Many prognoses indicate that we are about to hit the borders of financial viability. The undeniable successes of medical research and practice have brought a lot of alleviation to sick people and prolonged their lives. On the other side, we notice a growing number of illnesses and new forms of diseases, which cause us worries. There is also an increasing dissatisfaction with medical care by many, even in countries with enormous expenses for the health care system. Academic medicine based on classical science can help a lot of people but by far not all. It best works with “normal patients” with average sensitivities and resilience. Others react allergically to medication or cannot tolerate the standard doses. Many suffer from disorders without diagnosis. They run from examination to examination without result. They have “pains without findings”. Others suffer from the side effects of treatments more than from the original symptoms.

Medical treatments have to become more individualized: Every patient needs a therapy adjusted to his condition and needs. At the same time, the cost pressure rises and the time doctors can dedicated to their patients decreases. The waiting times become longer, the dissatisfaction grows. Although more and more money is pumped into the system, it seems as if people are not becoming healthier and happier.

The basic shift we are probably facing presently means taking on self-responsibility. We are used to other people caring for our health: doctors, hospitals and the whole social and health care system. Now it is the point to reclaim this responsibility to ourselves without having to renounce the support of experts. We should become the primary experts for ourselves and see the specialists of the health care system as partners.

Medicine of the third person perspective (diagnosing and treating symptoms from outside) needs to be complemented by the first person perspective (investigating symptoms from the inside). So the challenge is to build up and improve our own health competence, and we notice the presentation of more and more promising approaches.

We discover ways to influence our bodies from the inside. For our organism is a gigantic self-controlling system. We know and experience thousands of subsystems regulating themselves all the time. As long as everything runs fine, we do not pay any attention to our blood pressure, lymph circulation or secretion of digestive enzymes. In every moment, our bodies autonomously achieve incredible results. Our brain is taking part in all these procedures. When we want to become the primary doctors inside of ourselves, we should learn to use those parts of our brain as highest authority of inner selfregulation, which are accessible for our consciousness. How can we program ourselves in a way that our bodies remain efficient on the one hand and regenerative on the other?

The method of Coherent Breathing presented in this book offers an important approach to this topic. For with the breathing process, nature has provided us with a metabolic function, which can operate with or without consciousness. With consciousness we can influence the breathing to modulate other physical systems by stimulating or moderating them. We just have to know how to breathe “correctly” for creating the desired results and how we can train our bodies to automatically breathe in a way that is most beneficial for them, which means for us and for our health.

1. The Salutogenetic Concept of Health

We often hear about the crisis of health care. For handling these problems, we presumably need a new paradigm, which includes viewpoints from Salutogenesis. This means:

„Man is on the way, which is to see as a continuum from health to sickness in many different dimensions and turns away from a dichotomous view of health vs. sickness. With this, we focus on the question, which factors, which coping resources help to manage life, and turn away from a view about stressors, which is loaded with negativity, as stressors can be seen as helpful signals in the life of a person as well. When dealing with stressors, it matters to explore their character and to find ways for the individual to handle them and succeed in resolving the tension.” (Lorenz, S. 26)

Crucial is the question, how an organism manages to grow and develop in a healthy way – that is to create a dynamic order, which is named coherence by the founder of Salutogenesis, Aaron Antonovsky. Life involves various challenges the human organism has to cope with. For this task, it needs the ability to regain balance, when imbalance happens due to the influence of different stressors. Thus, it will also improve its general coping abilities.

2. Tow Pillars of Health

Based on these reflections, I would like to present the model of health on two pillars. Human health rests on two mutually dependent perspectives:

Self-care (first person perspective)

Professional support (third person perspective)

Self-care and self-competence always should be in the first place: One’s own individual awareness of body and health, mindfulness of one’s own quality of life, and the ability to handle impairments to this quality, so that the right equilibrium can be restored quickly.

In case of need, when self-competence does not suffice, the public organizations of care with their experts: therapists, doctors, hospitals, pharmacies etc. come into play.

When we take both pillars seriously and appreciate them in their importance, one’s own health does not get delivered completely to the health care system as it is the case to a large extent today, which causes high expenditure and human burdens. Rather, the primary and ultimate responsibility stays with the persons concerned, and this should also be acknowledged by the professional health management and by the governmental health policy. This primary and ultimate responsibility can be adopted by the individuals by strengthening their own competence concerning their bodies and their health.

This implies:

Collecting and using information, i.e. health education,

Improving one’s own life style in areas in which one’s wellbeing is reduced or impaired,

Setup and cultivation of exercises and practices serving the maintenance of health,

and continuous attention on the inner perspective, i.e. inner health monitoring.

3. Coherent Breathing as Method for Self-Provision