Woman lying on mat with eyes closedHolotropic breathwork, a therapeutic method designed to stimulate an altered state of consciousness, is based on the theory that the effects of hyperventilation represent unique and specific levels of consciousness. Oxygen deprivation occurs through hyperventilation—prolonged, deliberate breathing at an accelerated pace—and the reduced level of oxygen is believed to induce a stage of altered consciousness.

Trained practitioners, known as facilitators, pair this state with evocative music and expression through art to help the person in therapy achieve greater self-discovery. 

Development of Holotropic Breathwork

“Holotropic,” which comes from the Greek “holos” (whole) and “trepein” (to move toward), means “moving toward wholeness.” The method was developed by Stanislav and Christina Grof, a husband and wife team trained in classical psychoanalytic therapy. The Grofs became interested in altered states of consciousness and their application to psychological therapy in the 1970s. Through their extensive experimentation with ways of helping individuals in therapy achieve an altered state of consciousness (including the use of psychedelic drugs such as LSD before they were banned in the 80s), they discovered that hyperventilation can greatly impact brain states. 

This approach toward exploration and healing of the self combines elements of anthropology, consciousness research, depth and transpersonal psychology, and mystical traditions from around the world.

Holotropic Breathwork Theory

According to holotropic breathwork theory, the altered state produced by hyperventilation can allow an individual to access parts of the consciousness that are not usually accessible. Stanislav Grof, psychiatrist and co-founder of transpersonal psychology, supports a comprehensive theory of human psychology that suggests levels of consciousness include memories of past events, one’s own birth experience, and “past life” experiences. Proponents of this method theorize individuals may be able to access these different levels of consciousness through work with this technique.

Altered states of consciousness (ASCs) is a method not frequently used in contemporary therapy, though throughout history ASCs have been incorporated into various methods of healing . 

What Happens in a Holotropic Breathwork Session?

Sessions may take place in a one-on-one format between a facilitator and the individual seeking treatment, but this technique is most often offered in group sessions. Participants in a session are paired off, with one person as the “breather.” The other person, the “sitter,” is available to assist the breather if necessary but only offers support and does not interrupt the process, unless it is necessary to do so. Facilitators, the trained providers who guide the session, lead participants in a relaxation exercise, encouraging them to increase both the speed and depth of their breathing but allowing them to determine the most comfortable rhythm. 

A session may last between two and three hours, during which the breather lies on a mat and utilizes breathing and the evocative music to enter a different state of consciousness. The content is flexible, and the sessions are left open-ended in order to help individuals stimulate their inner healing mechanism and draw forth a unique internal experience with fewer constraints than a typical therapy session might have. Music with repetitive rhythms is incorporated into the session as an additional way to promote a trance-like brain state.  

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Some individuals find themselves moving to the music or crying out, while others remain still. Individuals may re-experience past trauma; find themselves in a joyful, serene, or meditative state; or experience a spiritual awakening. Others report mythical or religious experiences, while some simply achieve a higher level of trust in the self, release stress, and find greater clarity and the ability to address and overcome issues troubling them. 

The breathing process is followed by a period of creative expression—the drawing of mandalas—and a period of sharing and discussion. Facilitators do not attempt to interpret an experience, but they may encourage the participant to elaborate and clarify on their own or refer to past experiences in order to help participants better understand their own experiences. 

Holotropic breathwork is considered by some to be a more intense form of meditative/contemplative practices. Many who have experienced a session find it to be an intense emotional process, and some people may initially be frightened by the changes, emotions, and memories they experience. Thus, the creators of the technique recommend it only be practiced under the supervision of a trained facilitator, as facilitators undergo lengthy and intensive training in order to be able to oversee individuals as they experience atypical and sometimes dramatic changes in their state of consciousness. These facilitators are capable of recognizing when unintended effects of the treatment might necessitate medical attention. 

Issues Treated with Holotropic Breathwork

Research has shown this technique to be helpful in the treatment of a number of conditions. Individuals experiencing concerns that show little or no improvement with traditional therapy may find this method to be a helpful approach, for example. Avoidance behaviors in particular have reportedly been reduced after this therapy. The method has also been shown to be of significant benefit in achieving long-term abstinence from alcohol and other substances.

Participants report a number of positive outcomes from the holotropic breathwork technique, such as: 

  • Released stress
  • Reduced chronic pain
  • Improved symptoms from conditions such as depression
  • Improved self-awareness
  • Increased positive outlook
  • Decreased negative side effects of past trauma

Training for Holotropic Breathwork 

The Grof Transpersonal Training program offers official certification for those who wish to become facilitators of holotropic breathwork. Their courses are comprised of 600 hours of training, and the training typically takes place over a two-year period. Training in the technique is designed to be flexible. 

According to the Grof Foundation, helping professionals as well as others from a variety of disciplines (business, art, and education, among others) attend training to become certified as facilitators. Those who simply wish to experience the technique in greater depth often pursue training, as well.

The Grof Foundation maintains a web-based registry of facilitators who are certified, and only those individuals who have obtained certification from the Grof Foundation are able to offer sessions and events. 

Concerns and Limitations of Holotropic Breathwork

Controlled, voluntary hyperventilation is the goal of holotropic breathwork. Because hyperventilation produces low levels of carbon dioxide in the blood, the process can bring about behavioral and physiological changes, and these changes may be intense. Therefore, holotropic breathwork is not indicated for those with any of the following medical conditions:

  • History of cardiovascular disease (including angina or heart attack)
  • High blood pressure
  • Glaucoma
  • Retinal detachment 
  • Osteoporosis
  • Significant recent injury or surgery
  • Pregnancy 
  • Conditions requiring the use of medication

The experience of holotropic breathwork has also been shown to make some people uncomfortable, and the technique may even cause some individuals to panic. Thus, holotropic breathwork is not recommended for individuals who are prone to panic attacks. People who have a history of psychosis or experience disturbances in personality or mood may be overwhelmed by the intense emotional experience of holotropic breathwork, and this overwhelm may lead to a worsening of symptoms. 

Finally, some clinicians have raised concerns that holotropic breathwork causes people to experience powerful emotions and painful memories but does not allow significant time and attention to work through and overcome these issues. Given this concern, many experts have recommended holotropic breathwork be used a component of ongoing therapy rather than a stand-alone treatment. 

Cost may be a barrier to some, as the cost of receiving holotropic breathwork can vary depending on factors such as the background training of the facilitator, the location of the services, and whether health insurance provides coverage for the issue bringing the individual to therapy.


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