By Joyu Lee, Hanne Mette Ridder, Charlotte Lindvang 

Abstract

This article presents an expanded application of the Music Breathing (MB) method, evolving from its clinical origins to support emotional well-being in broader populations. Building on Körlin’s foundational framework, this adaptation integrates principles from narrative therapy, mindful self-compassion, and trauma-informed expressive arts to offer a more inclusive and accessible approach. Through an in-depth case study of a university student, we explore how MB fosters embodied awareness, self-regulation, emotion regulation, and meaning making. Rather than focusing solely on broadening an individual’s Window of Tolerance, this model emphasizes broadening the “Circle of Capacity”—the ability to experience distress, joy, curiosity, playfulness, and emotional presence. Thematic analysis revealed four overarching themes: (1) breath as a pathway to embodied awareness and regulation, (2) music as a supportive medium for emotional exploration and regulation, (3) shifting inner narratives toward flexibility and mindful self-compassion, and (4) developing emotional capacity through repetition and intentional practice. Together, these findings highlight the potential of MB as a structured yet adaptable practice that supports emotional growth and the re-authoring of identity through creative and reflective engagement.

Introduction and background

The origins of Music Breathing (MB)

The psychiatrist and music psychotherapist Dr. Dag Körlin (2008) developed Music Breathing (MB), a trauma-informed method that combines meditative breathing with music listening. The MB method originated from the Bonny Method of Guided Imagery and Music (BMGIM) (Bonny, 2001, Goldberg, 2013) and was created to support psychological healing in clients with trauma-related conditions, such as complex PTSD, dissociative disorders, and prolonged stress (Körlin, 2019b). Based on clinical work with psychiatric trauma patients, Körlin aimed to alleviate symptoms like flashbacks and hypervigilance by addressing dysregulation within the autonomic nervous system (Körlin, 2008, Körlin, 2019b, Körlin, 2020, Körlin, 2023). MB has since been incorporated into various clinical settings, particularly as a preparatory and stabilizing intervention within BMGIM protocols (Maack, 2012, Lee, 2023). The multifaceted therapeutic impact of MB may include improvements in trauma-related symptoms, dissociative processes, interpersonal functioning, and narrative coherence—key domains in trauma recovery. These outcomes suggest that MB contributes to symptom relief and deeper relational and integrative healing (Körlin, 2019b, Körlin, 2023).

From arousal to emotion: vitality forms and the role of music

Vitality forms describe the dynamic patterns through which experience unfolds over time, such as rising, fading, pulsing, or lingering sensations. While these patterns shape the raw energy of affect, they are not emotions themselves. Instead, they serve as the temporal contours of bodily arousal, functioning as a bridge to emotion by becoming recognizable emotional episodes when combined with meaning and context (Stern, 2010). Music provides a key illustration of vitality forms, as elements like crescendos, rhythmic pulses, and sustained tones reflect the same dynamic qualities present in the body’s arousal systems. In this way, music externalizes vitality forms, allowing listeners to experience them not just as sound but also as lived affective contours, thereby connecting bodily affect to the emergence and communication of emotion. Higher cortical processes further modulate these dynamics, and practices like MB employ breath-music feedback loops to make vitality forms more conscious and support their regulation (Körlin, 2019b, Stern, 2010).

Music for MB

In Körlin’s original MB design (2019b, 2020, 2023), music was understood to impact listeners primarily through two dimensions: arousal and modulation. Arousal refers to the level of activation in the autonomic nervous system, ranging from calming parasympathetic responses to activating sympathetic ones. Modulation, on the other hand, reflects the extent of change in musical elements such as harmony, rhythm, and tempo over time. Based on these effects, music in MB can be classified according to (1) the level of arousal and intensity it evokes and (2) the degree of harmonic and structural transformation it undergoes (Körlin, 2019b, Körlin, 2020, Körlin, 2023). Music that features a high degree of repetition—whether in melody, harmony, or rhythm—tends to maintain a consistent level of arousal, whether that level is low or high. As a result, such music is classified as having low modulation. In the earlier stages of MB, the absence of variation in the music’s formal or dynamic elements can induce a sense of monotony and predictability. When music is intentionally combined with guided breathing, breath becomes a fundamental part of the engagement. In this context, breathing is not just a physiological process; it serves as a structured way for the listener to synchronize with the music’s flow. As a result, the experience transforms from a passive act of hearing into an active and intentional practice. This practice enables the integration of perceptual awareness and breath regulation, thereby enhancing meditative presence (Körlin, 2019b, Körlin, 2023).

In the later stages of MB, the MB facilitator1 introduces more complex music featuring shifts in tempo, rhythm, and emotional tone to enhance emotional engagement and improve emotion regulation, sensory integration, and sustained presence. Changes in musical harmony can evoke various emotions, memories, and imagery, which can be reflected and adjusted through the listener’s breathing. In this way, breathing responds to the music’s emotional intensity and adapts to the feelings and associations that the music evokes (Körlin, 2020, Körlin, 2023). Clients are encouraged to adjust their breathing in real time, modifying its volume and pace to manage the arousal triggered by the music. This dynamic interaction fosters physiological attunement, supporting adaptive modulation of arousal in response to the emotional contours of the music (Körlin, 2008, Körlin, 2019b, Körlin, 2023).

Client-finding music in MB

In the initial MB sessions, the facilitator explores the client’s musical interests and preferences. If the client demonstrates active engagement, they are encouraged to introduce their favorite music, which may be integrated into the process as appropriate. Körlin’ s (2020) guidelines for applying “client-finding music” (p. 11) highlight the importance of choosing pieces with predictable dynamics, smooth transitions, minimal lyrics, and a ritualistic or ceremonial quality. This phase ultimately aims to equip clients with cognitive tools—specifically, the ability to recognize how music affects their emotions, choose pieces that support emotion expressions, and create a personal music repertoire they can continue to utilize beyond structured sessions.

Overview of MB stages

MB combines elements of concentrative and facilitative meditation. The concentrative aspect emphasizes the body image of breathing, which includes the breath’s volume, form, tempo, and synchronization with music. In contrast, the facilitative aspect invites an open awareness of whatever arises—images, thoughts, emotions, or sensations—without judgment or resistance (Körlin, 2019b, Körlin, 2023). Participants are encouraged to flow with their experiences, allowing them to unfold naturally while maintaining a sense of presence and non-attachment.

In the first stage of MB, the parasympathetic nervous system (PSNS)—the part of the autonomic nervous system responsible for rest and recovery—is activated. This activation occurs by focusing on an imagined representation of a small breathing volume, identified as the Breathing Center (BC), which is typically felt at the end of an exhale (Körlin, 2008, Körlin, 2019b). Although this state emphasizes parasympathetic activation, breath-based and meditative practices are better understood as modulating the balance between parasympathetic and sympathetic activity, supporting states that range from calm alertness to deep relaxation depending on context and individual response (Porges, 2011, Reybrouck and Brattico, 2022, Tang et al., 2015). As the MB process progresses, from breathing in silence to adding music, individuals are gently guided to expand their Breathing Volume (BV), progressing from small, contained breaths to fuller, more spacious inhalations and exhalations (Fig. 1). This expansion ideally is grounded in the BC, where the body feels most settled and stable. As the breaths grows in depth and range, the calm, regulated quality of the BC remains central, providing a steady internal reference point (Körlin, 2019b, Körlin, 2023). By establishing a sense of internal stability, individuals can enhance their emotional and physiological capacity to remain present and self-regulated, even when sensations or emotions become more intense (Körlin, 2008, Körlin, 2019b, Körlin, 2020, Körlin, 2023). Throughout this process, they are supported in broadening their Window of Tolerance (WoT), which allows them to engage with more dynamic inner states from a position of embodied safety. Every person has a WoT, which is a zone of arousal where we feel regulated enough to think clearly, experience emotions, and process our experiences (Körlin, 2019a, Siegel, 1999). When we are within this window, we can stay present with what is happening both internally and externally. However, if we move outside this window—into hyper-arousal (characterized by excessive intensity, such as anxiety or panic) or hypo-arousal (manifested as numbness or disconnection)—it becomes more challenging to process thoughts, feelings, and memories in a meaningful way (Siegel, 1999).

  • The process of MB unfolds across a series of structured stages, outlined as follows (Körlin, 2020; Shum, 2021):1.
    Diagnostic Interview: A comprehensive intake interview to address the client’s personal history, psychiatric and psychological background, significant relationships, and current functioning in work and family. It is important to explore recent events that prompted treatment, focusing on any history trauma and the client’s coping strategies. While sensitive, these topics should be discussed early in therapy, as music may trigger trauma-related responses.

    2.
    Discovery Breathing (DB): This stage involves exploring spontaneous discovery and using imagination to visualize breathing through a thorough assessment.

    3.
    Silent Breathing (SB): During this stage, the MB facilitator introduce terms of BC and BV and guides the client through meditative breathing “induction” without music. The purpose of this stage is to learn and practice meditation skills prior to music integration.

    4.
    MB for Grounding (MB-G): This stage focuses on developing self-regulation skills through grounding practices. The client incorporates the mindful breathing techniques learned in the SB stage, emphasizing emotional stability and maintaining consistent breathing while intentional listening to music.

    5.
    MB for Modulation (MB-M): This stage aims to enhance the ability to regulate breath and fine-tune emotional and physiological responses while intentionally listening to music.

    6.
    MB for Working (MB-W): This stage aims to help the client channel and release stronger and more overwhelming emotions through impactful music with the specific focus on using one’s breath as a resource to return to safety and stability.
  • After each MB experiential, the client is encouraged to draw. The arts process is action-oriented and sensory-based, allowing the client to authentically explore their thoughts, emotions, and experiences through creative expression and verbal processing (Körlin, 2019b, Malchiodi, 2020, Malchiodi, 2023). Körlin envisioned expanding the MB practice to reach beyond clinical populations2 (personal correspondences, 2022, 2023). The first author was attracted to MB’s structured and integrative approach, which combines breath and music as co-regulating tools to support physiological stabilization and emotional processing. Drawing on the foundational work of Körlin, the first author expanded the approach with the aim of laying the groundwork for broader studies. The following section details the development of this adaptation, and the processes involved in making the practice more accessible and inclusive. The adaptation sequence includes: 1) facilitating relational assessment using the “Tree of Life for MB” model, 2) connecting the “Ball of Light” external image to the BC, and 3) integrating Russell’s circumplex model of affect (1980) into Körlin, 2019b, Körlin, 2020 two-dimensional music assessment framework.

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Keywords; Embodied awareness, Music breathing