How Alternate-Nostril Breathing Works

For the anxiety of letting the world down, a grounding technique

A shirtless man with his lungs highlighted in neon colors
Matthias Tunger / Getty

When I came to the part in Hillary Clinton’s new book where she describes how she treated her anxiety with a practice called alternate-nostril breathing, I thought, that sounds impossible. I tried breathing through only one nostril at a time. I couldn’t do it.

Then I read a little further and saw that she recommends using her fingers to cover one nostril. Got it. Okay, that makes it much easier.

Clinton demonstrated the technique last Wednesday in an interview with Anderson Cooper on CNN. She doubled down on her enthusiasm, suggesting that it’s best done sitting cross-legged on a yoga mat with eyes closed. “I would highly recommend it,” she said. She also endorsed it to viewers of CBS Sunday Morning: “Off I went into a frenzy of closet-cleaning, and long walks in the woods, and playing with my dogs, and ... yoga—alternate-nostril breathing, which I highly recommend—trying to calm myself down.”

So why would this be calming? Inducing partial suffocation isn’t the most intuitive anti-anxiety ritual. Breathing through one nostril reminds me of having a cold. I also don’t like touching my face. That’s how we spread cold and flu viruses. Every hour, people touch their faces 15 times, and the less you touch your face, the less you risk contracting a respiratory infection.

I’m always open to the possibility that I’m overthinking things. This isn’t really about a clinical explanation; it’s just a traditional ritual that some people like. The book goes a little further, presenting the breathing as a sort of alternative to antidepressants:

Friends advised me on the power of Xanax and raved about their amazing therapists. Doctors told me they’d never prescribed so many antidepressants in their lives. But that wasn’t for me, never has been. Instead I did yoga with my instructor, especially breath work. If you’ve never done alternate-nostril breathing, it’s worth a try.

Okay, this book was written quickly and in a state of serious stress. Breathing exercises can be helpful in depression and anxiety, and I don’t think she means to suggest anyone replace or forego medication in medically necessary states.

Still this is not a simple, passing reference. The book gives detailed instructions for the reader:

Sit cross-legged with your left hand on your thigh and your right hand on your nose. Breathing deeply from your diaphragm, place your right thumb on your right nostril and your ring and little fingers on your left. Shut your eyes, and close off your right nostril, breathing slowly and deeply through your left. Now close both sides and hold your breath. Exhale through the right nostril. Then reverse it: Inhale through the right, close it ...

There are literary contracts to fulfill, and those contracts usually demand a certain number of words. It’s conceivable an editor said, “You should really expand on that alternate-nostril breathing thing, because that’s useful tip for anxious readers.”

And Clinton said, “I don’t know if that’s really why people would be buying and reading this book.”

“No, the people want to be calmed, and the rest of the text is really not pulling that off,” the editor insisted. “Plus it shows that you have hobbies you’re passionate about, obsessed with, as the kids say.”

“I’m really not.”

“But we want it to seem that way. Then you can go on the news shows and talk about that and it will be very human.”

“I really would prefer to talk about substantive issues, like how we should abolish the electoral college.”

“Well if that’s how you feel ... then the book is cancelled!”

“Okay, fine. I will do this in order to get the bigger messages across.”

It’s also possible that the yogic technique really was that important in coping with, as Clinton describes it in the book, letting the whole world down. Normally when a patient says something like this, a psychiatrist could say that person is exaggerating.

In keeping with the obsession theme, Clinton even gets into why alternate-nostril breathing works:

The way it’s been explained to me, this allows oxygen to activate both the right side of the brain—which is the source of your creativity and imagination—and the left side—which controls reason and logic.

Again, this book was written quickly and in a state of stress. She has more pressing concerns than considering how inhaled air goes down into the lungs, where oxygen is transferred to capillaries filled with blood that then go to the heart. The heart has a single left ventricle, and it shoots blood up to the head, oxygenating the brain’s hemispheres with the same blood.

I don’t believe that antianxiety rituals need sound physiologic rationale. CNN later dove into the “studies” that have been done on alternate-nostril breathing, which mostly involve 20-some subjects and are published in places like International Journal of Yoga, which conceivably has some degree of pro-yoga bias.

These sorts of rituals work because we believe they work. Alternate-nostril breathing affects the circulatory system by way of the nervous system—by calming a person down through distraction and a sense of control. In the case of Clinton, the control is over a body that was falsely said to suffer from illnesses by conspiracy-minded “doctors” who swore that she had Parkinson’s disease, and judged by a nation for her clothing and appearance and smile or lack thereof, while her male opponent was allowed to never smile and to brag about using his status to coerce women to “let” him assault them, and the news dismissed it as “explicit sex talk,” and even evangelical Christian leadership said it “ranks pretty low on their hierarchy of concerns.”

And so it helps to breathe in through one nostril, and then exhale, and then breathe out through the other. And then repeat. It helps if your eyes are closed.