Different from everyday breathing, breathwork refers to controlling your breathing patterns to improve your physical, mental and emotional health. There is also Holotropic Breathwork (HB), which helps participants enter a nonordinary state of consciousness to activate inner healing. It does so with a tailored setting and process, fast, deep breathing and stimulating music.

From inside your mind, the healing activated by HB can potentially assist in alleviating past mental or physical trauma or mental illnesses such as depression, anxiety disorder and substance use disorder, for example.

To learn more about this form of breathwork, we emailed Cary Sparks, director of the Institute for Holotropics and Grof Transpersonal Training. Grof Transpersonal Training through the Institute for Holotropics is the only organization in the world that can certify Holotropic Breathwork facilitators.

Holotropic Breathwork was created in 1974 by Stanislav Grof, an American psychiatrist, LSD researcher and one of the principal developers of transpersonal psychology; and his wife at the time, Christina, a psychotherapist, teacher, artist and student of mythologist Joseph Campbell.

Founded in 1989 by Stanislav and Christina Grof, and owned since 1998 by Cary Sparks and her late husband Tav, Grof Transpersonal Training (GTT) describes Holotropic Breathwork as "a powerful approach to self-exploration and personal empowerment that relies on our innate inner wisdom and its capacity to move us toward positive transformation and wholeness." It adds that the framework for this practice combines psychedelic research, anthropology, various depth psychologies (which explore the unconscious mind), transpersonal psychology (also known as spiritual psychology), Eastern spiritual practices and worldwide mystical traditions.

More simply, a December 2023 overview of high-ventilation breathwork practices defines HB (referred to as GBW or Grof Breathwork) as a "non-drug alternative for inducing non-ordinary states of consciousness for psychotherapeutic applications."

Holotropic Breathwork experiences not only incorporate our "biographical dimension," or our life from birth to the present. They can encompass the transpersonal and perinatal dimensions of our psyche. GTT describes the perinatal as "the reliving of our birth from conception, in the uterus, through the canal and into the birth itself." In this state, one can undergo healing through the "psychospiritual birth-death-and-rebirth" cycle. As for the transpersonal, this dimension can feature realms involving Carl Jung's archetypes, experiences detailed by global spiritual traditions and even phenomena not tied to any specific tradition.

The word "holotropic" literally means "moving toward wholeness," from the Greek word "holos" for "whole" and "trepein" for "moving in the direction of something."

"What is experienced in each session for each person can be very different," Sparks wrote. "In general, once you start doing the deep breathing and listening to the music, at some point you will feel that an experience starts to take over and you go with it." She adds that there can be various types of experiences, such as physical sensations or movements, a spectrum of emotions, visualizations and more.

In the book Holotropic Breathwork: A New Approach to Self-Exploration and Healing, Stanislav and Christina Grof wrote that the Holotropic Breathwork session can also be "without specific content" in which the breather "enters a mystical state without having to face any emotionally or physically challenging material." On the other hand, breathers may "relive various highly emotionally charged events from their infancy, childhood or later life that involved a psychological or physical trauma, or conversely, moments of great happiness and satisfaction."

Just as one's inner experiences can vary significantly during Holotropic Breathwork, so can their outer manifestations. The Grof's book says that some people remain quiet, as though sleeping, while others "flail around, move back and forth, get on their knees, shake violently or move their pelvis forcefully up and down." Some may cry, scream, make animal sounds, talk in foreign languages they don't know or speak in gibberish.

While individual sessions are possible, Holotropic Breathwork tends to be performed in groups. People will pair off, with one person being the "breather" and the other "the sitter." Facilitators will monitor the room and may offer special assistance to either the breather or sitter if necessary.

Here's how it looks for the breather: With their eyes closed, a person will lie on a mat. Using the music playing, along with typically fast, deep breaths (for which no specific pace or goal is given), they will enter a different state of consciousness that will bring forth certain internal experiences. At the same time, the healing process built into the individual's psyche will also start working. Though similar themes may appear, each person's internal experiences will be unique to them in that specific time and place.

If the breather begins to move into another breather's space during the process or behaves dangerously, the facilitators and sitters will work together to make the situation safe again. For breathers who refuse to continue the process because of unpleasant emotions or physical reactions, facilitators can offer reassurance and provide calming bodywork to help them complete the session.

Following the process, additional practices such as mandala drawing may be included, and the facilitators can conduct energy release work if needed. Grof Transpersonal Training does not describe what the energy release work is on their website, but links to the "Principles of Holotropic Breathwork," which details the energy release as a specific form of bodywork. In writing about this practice, founder Stanislav Grof describes pressing on a painful area of the body at the end of the session to help facilitate release.

In Holotropic Breathwork: A New Approach to Self-Exploration and Healing, it adds that the releasing bodywork is for the breathers who did not find closure during their session or those experiencing residual symptoms. This bodywork may be followed by a soothing massage and can continue in a breakout room.

The sitter: They will be present and monitor the breather, assisting them if necessary with tasks such as bathroom breaks and bringing them tissues or a glass of water. However, they are not to interrupt the process.

Next, breathers and sitters will switch roles.

When asked about Holotropic Breathwork's benefits, Sparks pointed me to the research section of this webpage on the GTT site. The first study listed, published in September 2023, concluded, "The present findings indicate that 'connected breathing,' a type of breathwork that is characterized by faster diaphragmatic breathing than breathwork interventions usually apply, affects those parameters of brain activity and mood status that are associated with a better mental condition."

In the spring of 2013, a clinical report was published that featured results from 11,000 psychiatric inpatients at Saint Anthony's Medical Center in St. Louis, Missouri, who participated in Holotropic Breathwork for 12 years, from 1989 through 2001. "82% of the 482 psychiatric inpatients reported having transpersonal (mythopoetic) experiences," reads the report. "16% reported experiencing prior life experiences, including what was reported as perinatal experiences in two patients. 2% reported 'no experiences.' There were no adverse reactions or unresolved negative outcomes."

A November 2020 correlational study featuring 119 HB practitioners found that "practitioners' degree of engagement, given by the period and number of HB practices, was significantly positively correlated with practitioners' psychological orientation, self-actualization, life purpose and quality of life." Similarly, a 1996 study found that those who participated in Holotropic Breathwork experienced an increase in self-esteem and a decrease in death anxiety when compared with participants who took part in experientially oriented psychotherapy.

In summary, Holotropic Breathwork may improve mood, self-esteem and quality of life while decreasing certain anxieties.

You can practice Holotropic Breathwork as often as you'd like, according to Sparks. However, remember that it requires 2.5 to 3 hours of your time and a facilitator, so Sparks added, "It wouldn't normally be done every day like some other breathwork practices."

"We tell people to use their own judgment and trust their inner healing intelligence about when and how often to 'breathe,'" she said. "It is usually good to allow some time between sessions for integration of the material that has emerged."

"For most people, HB is very safe," Sparks explained. "We use a medical form for screening and if there are any relative contraindications [conditions that make a treatment risky], we discuss them with the participant and often ask them to check with their doctor for an okay to participate. There are also certain psychiatric diagnoses that are contraindicated for HB."

When asked about psychiatric contraindications, Sparks explained, "The main issue with psychiatric diagnoses is not that we think HB wouldn't be helpful, but that the person would need more support than can be offered in an HB workshop or retreat. If there was a residential center with a large enough staff, so that the person could be given full support to experience what is coming up from the psyche, we believe that HB could often be appropriate and helpful." However, Sparks is not aware of any centers currently offering this type of Holotropic Breathwork support.

Physical contraindications include certain cardiovascular conditions, such as heart attacks or surgery, and glaucoma. Pregnancy is a "relative contraindication" for HB, according to Sparks, who added, "Many people have done HB while pregnant (including me). However, the HB facilitator would want to have a discussion with the pregnant person to discuss certain issues that they'd want to be aware of to make the decision for themselves."

Cleveland Clinic states that you should consider avoiding Holotropic Breathwork if you have a history of any of the following: cardiovascular issues, high blood pressure, recent injury or surgery, any condition requiring regular medication, panic attacks, psychosis and seizure disorders.

According to a December 2023 overview of high ventilation breathwork practices, potential acute effects of Holotropic breathwork may include:

"If the person doesn't have any of the medical or psychiatric contraindications described, then there is no reason they can't try the practice if they are drawn to it," stated Sparks. "It's really just a matter of whether the person is interested and wants to try it."

If you're interested, the GTT website lists Holotropic Breathwork facilitators by region. It also has a schedule of upcoming events organized by the Institute for Holotropics and Grof Transpersonal Training.

The seeds for Holotropic Breathwork were planted when the Grofs were working at the Esalen Institute, a not-for-profit holistic educational center in Big Sur, California. After describing his psychedelic work at both the Psychiatric Research Institute in Prague (his birth city) and Baltimore's Maryland Psychiatric Research Center, Stanislav writes that people at Esalen wanted to have their own experiences but couldn't because of psychedelics' illegality. This was in 1974, and the Controlled Substances Act passed four years earlier in 1970.

To come up with a solution, Stanislav referred back to memories of his patients' LSD sessions. Toward the end of these sessions, pressing on certain painful areas on the patients' bodies would "release the emotions and blocked energies behind them." While doing this bodywork, Stanislav recalled that the patients would begin to breathe fast and later explained that this type of breathing helped intensify their experiences, bringing them back to how they felt in the middle of their LSD sessions. "This observation showed me that faster breathing can bring the unconscious material to the surface of consciousness," Stanislav wrote.

At Esalen, the Grofs began experimenting with these memories as a framework by having participants lie on their backs, breathe and listen to music (also part of Stanislav's psychedelic experiments in Prague and Baltimore). Some people would begin to go into what they called "the process," and the Grofs would use bodywork to help them find release. Stanislav writes that this process would regress some people back to reliving their birth.

After injuring his back and being unable to conduct a large Esalen workshop, Stanislav and Christina decided to pair up participants, teach them the process and allow them to work together. Those participating in Holotropic Breathwork were called "breathers," while the others monitoring them were known as "sitters." Many participants found this to be a powerful, intimate experience, and this framework for Holotropic Breathwork has continued to this day.

If you're looking for a more intense form of breathwork that will help you reach a nonordinary state of consciousness for inner healing without drugs, then Holotropic Breathwork may be for you. However, if you deal with certain cardiovascular or psychiatric conditions or glaucoma, you may want to avoid the practice.

To pursue Holotropic Breathwork, you can find a trained facilitator through Grof Transpersonal Training.