Supported against a wall, with shoulders braced back, the patient is instructed to take slow and deep inspirations, raising his arms the while, and letting them fall with expiration. This performance is repeated three times a day, for ten minutes at a time.
The method has been elaborated by Tissié, and Cruchet also has thereby obtained excellent results, which he has put on record in his thesis.
The patient is placed upright against some support, his heels together and his arms by his side. For the first three minutes he recites aloud, drawing a slow deep breath at frequent and regular intervals. Then he proceeds to make similar long inspirations and expirations, elevating his arms synchronously with the former, and depressing them with the latter. The exercises may advantageously be repeated every three hours to begin with, then their duration may be increased and the intervals lengthened, until the séances are extended to fifteen minutes three times a day. Their continuance will vary with the individual, but the ultimate aim is to reduce the period and to spin out the interval still more, until eventually their object has been attained and they may cease.
A concrete example may be given:
A young man had suffered for eleven years from generalised tics of peculiar intensity. Every few seconds violent twitches of an electric-like rapidity seized the muscles of his head, trunk, and limbs, to the accompaniment of abrupt cries and inarticulate growls. A sojourn of a few weeks in hospital, and the acquisition of the most elementary technique in athmotherapy, resulted in a complete cure ere many months had passed.
Tissié explains the action of this method on tics by a special action of regular respiration on psychomotor centres. Raymond and Janet incline to the opinion that attention depends on respiratory activity, but Tissié[227] argues there is antagonism between deep respiration and maintenance of attention, and Cruchet supports this hypothesis.
If we prescribe respiratory exercises, we are temporarily suppressing the attention, and reducing psychical activity to a minimum. Thus tic, which is a reflex of thought, does not occur, and if the exercises are renewed often enough, the habit will gradually be lost.
In our opinion, it is precisely the bestowal of the attention on the allotted task that has such a salutary effect. Whatever be the movements, they demand of the patient a momentary halt, a momentary interruption of those ill-timed motor reactions that make concerted action impossible. Observation shows that the degree of successful control is in proportion to the degree of concentration of the attention. The novelty of the exercise in itself acts as a stimulus, but when this novelty wears off, faults are prone to reappear. Hence the necessity of varying the procedures, and of rendering them always interesting; in the end the habit of supervision is contracted, and the patient feels increasing satisfaction in watching his physical infirmities daily diminish and the resources of his will daily widen.