Holotropic Breathwork Benefits and Risks

Benefits of holotropic breathwork

Verywell / Catherine Song

Holotropic breathwork (HB) has become increasingly popular among those seeking to explore a unique process of self-healing to attain a state of wholeness. This unconventional New Age practice was developed by psychiatrists Stanislav and Christina Grof in the 1970s to achieve altered states of consciousness (without using drugs) as a potential therapeutic tool.

Holotropic breathwork involves controlling and quickening breathing patterns to influence your mental, emotional, and physical states. It is a practice that is derived from a spiritual framework, but is also a trademarked activity.

Holotropic Breathwork Practitioners

Official holotropic breathwork can only be lead by certified instructors that obtain a certification from the Grof Foundation after completion of a 600-hour training course.

In many countries, practitioners utilize this technique as a spiritual practice rather than a therapeutic one. In this way, some people participate to expand their awareness rather than to overcome or manage a mental health condition. Many proponents of HB propose that this technique moves you forward to a higher consciousness.

In other words, it may shift you into another state, which can be appealing to people who feel stuck and unable to advance using other means. Often times, this feeling of awakening can happen through some form of catharsis.

However, the belief is that trauma will only come forward during a session if it is necessary for healing; and that this won't be known at the outset of the session. Rather, each person's experience with HB is unique, self-directed, and unfolds on its own as the practice progresses.


After LSD became illegal in the late 1960s, the Grofs, who had been proponents of the therapeutic effects of LSD, developed holotropic breathwork. The technique was created to achieve psychedelic-like states without using psychedelic drugs. The Grofs were trained in Freudian psychoanalytic therapy and believed the process of deep, self-exploration brought on by these altered states can bring healing.

Stanislav Grof is known as the co-founder of transpersonal psychology (along with Abraham Maslow). Grof began his work at the Psychiatric Research Institute in Prague and eventually moved to Johns Hopkins University in Baltimore. His work was conducted with patients experiencing psychiatric illness, cancer, and drug addiction.

Window Into the Self

The practice of holotropic breathwork involves using a controlled breathing process to access altered states of consciousness. The purpose is to obtain enlightenment of some kind. From the Greek words, "holos" (whole) and "trepein" (to move toward), the word "holotropic" translates to "moving toward wholeness." 

The primary principle of this technique is that healing comes from within the person practicing the breathwork. This premise is also intended to help the participant come away feeling personally empowered.

During holotropic breathwork, participants breathe rapidly and evenly to induce an altered state from which it is believed that a deeper understanding of oneself can be derived. Some describe this experience as a more intense form of meditation.

The Basic Premise

The underlying tenet of HB is that each person has an inner radar that can determine the most important experience at a given moment, but that we cannot be aware of this experience until it happens.

From this perspective, the facilitator does not need to tell those who are practicing what to focus on. Instead, participants are instructed to figure out what emerges for them as they do the work.

People often experience an intense, "therapeutic" crisis that helps flush away negative energies and leads them to a healing place of greater understanding. This will always be specific to the person at that particular time in their life.

The intended breathing pattern is designed to be even so that the participant avoids hyperventilating. However, some attribute the physical feelings of the experience to a person's carbon dioxide (CO2)-oxygen (O2) balance getting out of whack, which is what happens with hyperventilation.

The act of hyperventilation (breathing out too much CO2, which causes respiratory alkalosis or alkalinizing of the blood) may lead to an altered state of consciousness as well as the physical sensations of tingling of the fingers and mouth, lightheadedness, and dizziness.

How It's Practiced

Below is a description of what a session of holotropic breathwork might look like.

  1. Holotropic breathwork is most often practiced in a group setting lead by a trained facilitator. It may also be offered in individual sessions or as part of a retreat. 
  2. People are paired off in a group setting. There is one "breather" and one "sitter." 
  3. The sitter only helps the breather if needed. The breather is the person actively practicing and experiencing HB. The sitter ensures that the breather is safe and supported during the session.
  4. A facilitator guides the session. Direction is given to increase the speed and rhythm of the breather's breathing. The breather is told to breathe faster and deeper while keeping their eyes closed. While the speed of breathing increases, attention is paid to keep breathing even, which helps practitioners avoid complications from hyperventilating.
  5. A session might last from 2 to 3 hours in total.
  6. The breather will lie on a mat for the duration of a session. Laying down grounds the breather and gives them the ability to move freely, in whatever pose their breath takes them.
  7. Repetitive music is played. The rhythmic music encourages the breather to enter an altered state of consciousness (similar to having a vivid dream). The music starts off with drumming, and eventually reaches a peak and switches to "heart music." From there it eventually changes to meditative music.
  8. The session is open-ended. This means that each person is able to derive their own meaning and attain self-discovery in whatever form that means for them. In addition to moving in any way that they want, breathers are encouraged to make any sounds that feel right to them.
  9. Afterward, participants draw mandalas about their experience and discuss what happened. This could be the re-experiencing of past trauma, feelings of joy, or the development of spiritual awareness. Essentially, the goal is for HB to be a catalyst for bringing to the surface the most important issues a person needs to address.
  10. Breathers and sitters swap roles for future sessions.
  11. There is not a specific guideline or expectation of what must occur or what issues are explored during a session. Participants are free to work on whatever comes up for them as they enter the altered state.

Proponents of this technique contend that this altered state allows people to access parts of the mind that are not usually accessible; this might include re-emerging memories of past events.

What It Feels Like

A common question is what does it feel like to participate in holotropic breathwork? It might seem scary to breathe in this way, and you might worry about the effects that you will experience.

Rapid breathing can feel overwhelming or unsettling but practitioners are always welcome to back off if the sensations feel like too much. However, breathers are encouraged to (safely) push through if they are able as it is thought that this is the pathway to the enlightenment the practice seeks to reveal.

Rather than calling it an altered state of consciousness, some prefer to refer to this as a "non-ordinary state of consciousness" to reflect that it does not necessarily have the negative connotations of altered states. In general, the concept of having a dream might be a more useful metaphor.

Holotropic breathwork is an experience that is supposed to bring the person into a deeper dimension of the present moment and to see things in a more colorful, insightful way than reality might appear otherwise. 


Research to support the therapeutic benefits of holotropic breathwork for psychiatric conditions such as depression and anxiety is lacking. However, there is some evidence to suggest that it might be helpful for relaxation, stress relief, personal growth, or self-awareness.

Spending time in a trusting environment, focusing on deeper life concerns, learning how to support other people, trusting in your ability to heal yourself, and developing compassion are all potential benefits.

It is recommended that holotropic breathwork is undertaken alongside traditional therapy, rather than be used as a replacement for it.

Potential Risks

There are some potential risks of participating in holotropic breathwork. There is some concern that this technique causes distress in vulnerable individuals, such as those at risk for psychosis.

In addition, there are significant medical risks of hyperventilation. Plus, few studies have been done on either the efficacy of achieving mental health "enlightenment," healing through HB, or the general safety of the practice.

Since the process of holotropic breathwork is aimed at a "deep experience," it is possible that uncomfortable feelings will arise, also known as a "healing crisis." Indeed, this technique is controversial because it involves the possible amplification of symptoms in potentially problematic ways.

HB can cause reduced carbon dioxide and other alterations in blood chemistry that can lead to dizziness, fainting, weakness, spasms of the hands and feet, and even seizures.

Who Should Not Practice

This technique can evoke intense physical and emotional changes. Therefore, there is a list of specific criteria that exists to advise against participation. For anyone considering trying HB, it is a good idea to discuss possible risks with your healthcare provider before embarking on this alternative practice, especially if you have any of the following conditions:

  • Cardiovascular disease
  • Heart attacks, high blood pressure, and angina
  • Glaucoma or retinal detachment
  • Recent injury or surgery
  • Any condition that requires you to take medication
  • Panic attacks or psychosis
  • Seizures
  • Severe mental illness
  • Aneurysms (or family history)
  • You are pregnant or are breastfeeding

A Word From Verywell

Given the associated risks and limited research evidence, there is little to suggest that holotropic breathwork should be used as a viable alternative to traditional mental health treatments. However, if used as part of a larger treatment program, it is possible that it may offer benefits or clarity for certain people. If you choose to participate in this technique, ensure that you are aware of the risks.

You can practice this technique as part of group sessions, workshops, or retreats. Individual sessions are also available. The best course of action is to talk with a trained facilitator to determine which type of session is best for you. The facilitator should guide and support you through the process.

4 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Holmes S, Morris R, Clance P, Putney R. Holotropic breathwork: An experiential approach to psychotherapyPsychotherapy: Theory, Research, Practice, Training. 1996;33(1):114-120. doi:10.1037/0033-3204.33.1.114

  2. Grof S. Holotropic Breathwork: New Perspectives in Psychotherapy and Self-Exploration. Semantic Scholar. Albany, NY: State University of New York, 2010.

  3. Miller T, Nielsen L. Measure of significance of holotropic breathwork in the development of self-awareness. J Altern Complement Med. 2015;21(12):796-803.

  4. Victoria H, Caldwell C. Breathwork in body psychotherapy: Clinical applicationsBody, Movement and Dance in Psychotherapy. 2013;8(4):216-228. doi:10.1080/17432979.2013.828657

By Arlin Cuncic
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety."