Why I thought “Breath” was disappointing (and even a little worrying)

If you have any connection with the health and wellness industry, you have probably heard of “Breath: the new science of a lost art” by James Nestor. I first came across it when I attended Breathing School last year, and since then it seems to have become a sort of bible for yogis. Don’t ask me why, but for some reason I resisted reading it until now. Maybe I had a premonition that I would find it a very frustrating and disappointing read.

The positives

There is no question that the breath is hugely important. Apart from the obvious benefit of keeping us alive, slow breathing has a number of documented benefits, including lowering blood pressure, calming the mind and having broader mental health benefits. I’ve written about this before. It is likely to also affect a number of chronic diseases, including metabolic diseases, as Nestor discusses.

It is also true that not enough research is being carried out on how various breathing practices affect our body and especially how they may influence our health and any diseases we may be living with. Nestor highlights that any research that is being carried out right now is not on the whole instigated by lung specialists (pulmonologists), which is why he justifies going to alternatives (what he calls ‘pulmonauts’) to learn more about the effects of breathing.

So this is a really interesting and important topic that is absolutely worth writing about.

However…

Finishing the book left me with a sense of frustration and, to be honest, anger – how the hell is everyone raving about a book that is meant to be about the science of breathing but in reality is more about Nestor’s experiments in breath and a complete misrepresentation and exaggeration of what research actually exists? Why is this popular science and not labelled as something else?

It’s an example of why science communication should be done by people who understand how science works

I don’t believe that science communication is the domain of scientists alone. In fact, scientists frequently suck at science communication because we know too much about the topic and can’t always grasp the level of communication and what is actually interesting to the general public.

However, if you are going to write about science, or present your work as science communication, you do need to be able to discern what makes a good research study and what doesn’t, what is tentative and what isn’t, and frankly what is bullshit and what isn’t. You also need to try and catch and challenge yourself when you develop a theory and know to flag it as a theory and personal opinion vs fact.

How on earth it is a NY Times bestseller and a GoodReads nominee for Science and Technology book of the year, is beyond my understanding, since it was written by a journalist (not a scientist) with very little understanding of how to conduct a proper scientific research.

Goodreads review

N=1 vs a well-designed, controlled research study

There is no question that Nestor is a good storyteller. So much so that the narrative of the book is mainly about his experience of being forced to breath solely from the mouth and the impact this had on his body and mood.

It’s an interesting story. It’s also anecdotal, ie a personal account, which means it’s not exactly reliable. It’s the experience of one person (or rather, two people), which means that you can’t draw broad conclusions about populations, and therefore must be taken with a pinch of salt.

Plus, let’s face it, he had pretty much decided what the outcome was going to be and was using the experience to back it up (having said that, I should highlight that scientists do exactly the same, which is why we have checks and balances like controls, large studies, statistics and experiment repetition to confirm that what we observed actually happened).

But let’s forgive this because it makes for good reading; this isn’t a textbook after all. And hopefully most people can discern the difference between the experience of one person and proper research.

Amplification of poor research as fact

Pretty much everyone with a scientific training of some description always, always writes in a tentative way – this may imply this, it may suggest that, more research is needed to be sure etc (notice how often I do it, even in this book review).

The book has a lot of footnotes and appears well-researched. In a way, this may be worse than having no references at all as I think most people know to look for references to trust a source. The issue is in many cases the studies are over-interpreted or misrepresented, or the evidence is poor and not enough to warrant the certainty of language he uses.

There’s one example that stuck to my mind because I read those studies myself when I wrote my blog post and my little ‘Science of pranayama’ booklet – on alternate nostril breathing. I described the studies as ‘dodgy-looking’ because of reasons I’ve explained before. They are worth discussing, because the idea that breathing from one nostril can activate a different part of the brain is definitely interesting. But there are no “clear links”, as he says. They are just interesting observations that merit further exploration.

Confirmation bias and far-fetched claims

Which brings us to the next problem – starting to verge into fiction due to confirmation bias, the tendency to search for, interpret, favour and recall information in a way that confirms or supports one’s prior beliefs or values. Again, to be fair to Nestor, we all do it. As you can see, I’ve cherry-picked the reviews that confirm my own views of the book. I would have just thought that an editor or someone else along the way would have picked this up and challenged some of these frankly far-fetched ideas.

Let’s take the example of Katharina Schroth, who apparently cured herself of scoliosis by breathing. It sounded dubious, but I was open to the possibility. Unfortunately, it’s not entirely true. She did use breathing, and undoubtedly that could have played a part in her recovery. She also used corrective exercises as part of her treatment, but that’s not mentioned in the book. Or that the Schroth method to treat scoliosis combines postural correction, postural perception and breathing exercises (see here and here for example).

Unfortunately full of pseudoscience and overblown claims. For example he talks about Katharine Schroth in Chapter 4 describing her case of scoliosis as extreme and her being left to whither in bed. Minor research shows that her case was considered mild to moderate and she didn’t cure it with just breathing but also physical therapy. His descriptions of her clinic skip over anything that disturbs the magic of breathing storyline he’s pursuing.

Goodreads review

There are many examples like this throughout the book. I’m not even going to talk about the whole evolutionary theory he puts forward. Perhaps he would have preferred that we didn’t develop our big brains and just kept breathing better.

It’s sadly a perfect example of science-washing

There is a lot of really interesting food for thought in this book. I was prepared to go along with a lot of what was being covered. I probably would have forgiven a lot had the language used been different (ie more tentative).

But when I started spotting all the dubious claims and over-interpretations of research, I honestly couldn’t believe anything anymore.

Can breathing help calm us down? Probably. Do people have actual breathing problems? Of course. Are we all breathing wrong and nearly all our ailments can be cured by just following this author’s breathing exercises? Doubtful.

If all this is true, put in the effort and run some scientific studies, Mr. Nestor. Prove your claims, get them peer-reviewed, and show the world. It’s too easy to write a misleading book these days.

How is this a NYTimes bestseller? Perhaps it should be in the fiction category…

Goodreads review

Nestor has definitely spent a great deal of time researching this topic, I’m not going to take this away from him. Some of it is even scientifically sound. He also does highlight that not enough research exists, which I completely agree with. Unfortunately, he either lacks an understanding of science and scientific research or chose to pursue a non-evidence-based book peppered with solid science to appear more scientific (aka science-washing).

The glowing reviews and bible-like status of this book means that the pseudoscience gets perpetuated (especially in the yoga community) – after all, it’s helpful for us yoga teachers to use this as evidence that the practices we offer can have such transformative effects. (overgeneralising here, my apologies)

A missed opportunity

We have a saying in Greek: the green leaves get burnt along with the dry leaves.

This definitely applies to this book. There are good points to it, but to me it’s frankly worthless because I feel like I have to fact-check every single thing he writes. That should really have been the job of someone else before this so-called popular science book was published.

More than anything I’m disappointed because it’s a missed opportunity to write something that’s actually scientifically sound. To actually put forward good research and all the reasons why we should be investigating the breath as a call to arms for researchers around the world to spend more time on elevating the breath from wellbeing fad to key part of holistic treatments.

Or maybe, it just shouldn’t be labelled as popular science.

Love it or leave it? What did you think of Breath?