Just breathe: Dynamic breathwork as interoceptive exposure for veterans and police

Abstract

Military veterans and police officers experience high rates of trauma-related symptoms alongside autonomic dysregulation, yet many do not engage with or complete conventional therapies. Breathing-based interventions may provide a low-cost, acceptable alternative. I used a single-subject, multiple-baseline-across-participants design with eight veterans and police officers to evaluate a 10-session online dynamic breathwork protocol. I hypothesised that this intervention would (H1) increase resting heart rate variability (HRV) and reduce resting heart rate, (H2) improve self-reported psychological symptoms commonly associated with PTSD, and (H3) be rated as acceptable and feasible for home-based use. Participants practised cyclic hyperventilation, extended breath-holds, and a Valsalva-type manoeuvre in 10 sessions across a 20-day period. Resting heart rate variability (RMSSD) and heart rate were recorded daily with Polar® H10 sensors. Self-reported psychological measures of depression, anxiety, affect, mindfulness, and psychological flexibility were completed at baseline, post-intervention, and follow-up. Physiological outcomes did not show meaningful change. However, large effect sizes were observed across all psychological measures, with reductions in self-reported scores of depression, anxiety, and negative affect, and increases in mindful awareness and psychological flexibility. Social validity ratings indicated that the protocol was highly acceptable and feasible for home use. In contrast to traditional exposure therapies that target external trauma cues, this intervention employed breath-based interoceptive exposure to engage conditioned internal responses, offering a novel pathway for inhibitory learning. My results suggest that while short-term autonomic adaptation was not evident, structured online breathwork may offer a promising and scalable means of reducing psychological distress for trauma-exposed operational personnel.