The CHEK Approach to Health - The Breath Reigns Supreme PDF Print E-mail

The CHEK Approach to Health - The Breath Reigns Supreme

Column #137, 4th February 2012

I have previously written about my experience of the CHEK approach to health for the North East Journal and The Journal of The Bowen Therapy Professional Association. Aimed at therapists this briefly presented the Totem Pole of Survival method as taught by Paul Chek of the CHEK Institute (although all opinions in this article are my own). In this article we will take a deeper look at this method of assessment and application. The challenge here is that when tackling a topic of holistic nature, it probably requires something of a thesis of all different theories and research to really do it justice. So, in the essence of keeping it simple let’s have a look at one specific area. The body’s “Top Priority” in fact: The Breath.

First; A Quick Recap of The Totem Pole of Survival

Developed by Paul Chek, this is a holistic model that enables the identification of the root cause in order to apply effective therapy. The essence of the model is that the body’s main concern is for survival. Without the stress and demand of surviving we would never develop and evolve and simply wouldn’t be here.

In general the body will compensate and make changes to enhance the chances of survival. When something is not quite right, the body will adapt and make a change. For example if we have an infection, the body will create a high temperature and fever, or if we sprain an ankle the body will shift weight and change gait. All in the name of preservation and survival. The totem pole simply applies a layer of theory to this survival instinct. All things are not equal and the bodymind has an innate hierarchy of control systems that it prioritises.

Here’s a look at the Totem Pole, in descending order of priority:






Visceral Organs

Emotions (floating position)


Slave Joints

Respiration and The Breath

There is a wealth of experience and knowledge that different therapists can share about the importance and function of respiration. From biochemical balance and energetics to structure and movement and beyond. Movement therapists Bonnie Bainbridge-Cohen and Emilie Conrad give this insight:

“Breath…is internal music, and the body is a resonating chamber for it. To breathe with an aesthetic appreciation for the power of the breath is to be born again each moment to the seeds of possibility within us."

During dissection studies, Gil Hedley shared similar inspiring descriptions about the heart and the diaphragm beating in rhythm creating vibrations and energy throughout the body. But when I refer to the dictionary definition I get a rather deflating “to take in air into the lungs and expel it (inhale and exhale)”. I personally feel there is more to it and given that we do it around 20,000 to 40,000 times a day, I enjoy giving a little more attention and appreciation to this innate and natural ability.

I am acutely aware of the wide ranging expertise and experience of readers to write on the topic of the breath. Read on for my growing and evolving experiences around the subject and how I relate it to this notion of the Totem Pole.

The Breath in terms of Survival

The focus of this article is to establish why, in CHEK Philosophy, might respiration reign supreme at the top of the totem pole of survival? You may have heard the phrase “3 weeks without food, 3 days without water, 3 minutes without oxygen”, which goes a long way to emphasising its importance. If we stop breathing for 3minutes, we die. Granted, if we stop eating due to a mastication (bite) obstruction/dysfunction we die too, but we get a lot longer than three minutes. Therefore, if anything is disrupting respiration it will need to be acted upon quickly to facilitate breathing. The obstruction to optimal breathing and the resulting change that the body makes will be dependant on the situation and cause, but other functions are further down the list of priorities. For example, as poor posture and joint pain is considered a lesser threat to survival than getting oxygen into the body there may be postural alterations to facilitate the breath.

When bodyreading and measuring posture in the clinic I observe a lot of Forward Head Posture. Paul Chek states that this is a common response to a respiratory obstruction and indeed the body will make this compensation within minutes of an impeded airway. The change in head position is merely a way for us to be able to breath more freely. The question is – what is the cause of the obstruction that leads to the Forward Head Posture, as there are mapotential factors including;

Food Allergy

Growth and Development Disorders

Structural issues due to impact and injury

Emotional and Behavioural factors

The body has compensated for our own benefit in order to improve our ability to breathe and increase our chances of survival. This may seem matter-of-fact, but whilst the forward head posture may be causing neck and shoulder pain (for example), this is a necessary trade-off. As a Bowen and Corrective Exercise Therapist at work, the forward head posture may be evident and we may also see structural changes as we view posture and observe movement. With such a change in head position (weighing approximately 14lbs) and the relationship with the centre of gravity and balance, have there been further changes to thoracic curvature and rotation, pelvic shifts and lower limb alignment?

This brings us right back to day 1 of my initial Bowen Therapy and CHEK training, where we discussed how a pain in the ankle may be caused by something further up the line/chain/train. In respect to this article the take-home message is that if there is an obstruction to optimal breathing there will likely be a compensation or change in the control systems below on the Totem Pole. The breath reigns supreme.

Identifying Breathing/Respiratory Dysfunction

Some etiology may appear unrelated to breathing, however continued awareness and perspective of the role it may play is important. Experience across health practitioners will vary so in some cases they may be able to assess and work with the client and other times they may need the skills to identify key factors and then refer out. A simple test that I do with every single patient/client is to observe their breathing pattern.

What is Good Breathing?

To see a natural breathing pattern just watch a baby or infant breathe. Instantly at birth, the baby takes its first breath and you will see the belly naturally rise and fall. We see this because the diaphragm is the primary breathing muscle and it is pulling the air down deep into the body causing an expansion. When we breathe it should feel smooth and relaxed, without undue tension through the chest, neck or abdominals.

Assess for Success

Try This: Lying or sitting comfortably lay one hand on your chest and one hand on your belly. Take a deep breath in and out. Repeat as you take notice of:

Whether it feels deep or shallow?

Which hand moved first and most?

Which muscles and tissues are contributing to the movement?

Where is the tension or restriction?

Did you breathe in through your mouth or nose?

What causes the breath to be compromised?

Consider that a correct breathing pattern leads to around 20,000 breaths per day, whilst shallow breathing leads to 40,000 breaths per day. Inverted Breathing Patterns appear common, but you might be reading this thinking why would I need to be taught how to breathe? Think back to the infant’s natural, effortless breathing pattern. Whilst this is automatic and was not required to be taught to the baby, it seems that as we reach adulthood, there have been several potential factors that may have altered this pattern:



Muscular Imbalances

Spinal Health

Visceral Organ Health


Poor Sleep







Nutrition / Allergy



Exercise Technique



Infant Development

The point is that if you are repeating something, anything detrimental to your health 40,000 times a day, you need to find the cause, make changes and enhance it. Briefly, here are some signs and symptoms that can inform your next clinical decision:

Forward head posture

Breathing Pattern

Mouth breathing at night. Saliva on pillow in the morning.


Bad Breath

TMJ disorders

Neck and Low back pain

Tendency for pronation injuries in ankle


Of course, in theory, if there is no dysfunction then the respiratory control system may not be causing the compensatory changes in the control systems below it. This is all part of the assessment pathway. What is next on the totem pole of survival (Mastication)? As previously mentioned I’m not suggesting we all switch to using it, just to be intrigued and interested as to how it relates to your current assessment practice. Another piece of the puzzle!

If you have any questions on how I implement the CHEK Approach or the Totem Pole model please contact me. You thoughts and feedback would be welcome too. Please see my website for references of this article:

Bradley, B. (-). Correct Breathing Patterns.

Chek, P, (2004). How to Eat, Move and Be Healthy. Chek Institute.

Chek, P. (2004). Posture: The CHEK Approach. The CHEK Report. Issue 3.

Conrad, E.

ECBS (2009). The Bowen Technique Training Manual Volume One. ECBS.

Hedley, G. (2008). Human Dissection Studies Course. Integral Anatomy

Kendall FP, McCreary EK, Provance PG, Rodgers MM, Romani WA. (2005) Muscles Testing and Funcion: With Posture and Pain, 5th Edition. Lippincott, Williams and Wilkins.

O’Reilly, S. (2008). A Matter of Life and Breath. The CHEK Report. Issue 21.

Rolf, I. (1990). Rolfing and Physical Reality. Healing Arts Press.

Sears, J.P. (-). Breathing for Optimal Health in a Modernized World. Part 1 and 2. CHEK Institute.

Jack Walton
Written on Saturday, 04 February 2012 00:00 by Jack Walton

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