Connected breathing

Holotropic breathwork: three hours of breathing to music

By GyroscopeUpdated November 15, 202612 sources

Family

Connected breathing

Breaths

Faster and deeper than usual, no set rate

Carbon dioxide

Falls, for a long time

How well tested

Weak

Risk

High, read the safety part

Timer

None, on purpose

Holotropic breathwork is two to three hours of faster, deeper breathing to loud, evocative music, lying on a mat with a partner sitting beside you. Stanislav and Christina Grof built it in the 1970s as a legal way into the kind of states his psychedelic research had studied. It does that well, and a 2025 study tied the effect to how far carbon dioxide falls. The evidence that it treats anything is small and uncontrolled, so we’d only do it with a certified facilitator, after a health screening.

People hear about holotropic breathwork in two ways. Fans describe reliving their birth, scenes from early childhood, or feeling at one with everything, and the stories are so vivid that the practice seems to prove itself. Critics call it a fancy name for hyperventilating until you get dizzy. Both have a point. Two researchers described it in 2007 as “a prolonged, voluntary hyperventilation procedure.” And the experiences are real enough to score like psychedelic ones on the questionnaires scientists use for psilocybin. What nobody has shown yet is that having them makes people better in a lasting way.

What it is and where it comes from

Stanislav Grof was a psychiatrist who ran psychedelic sessions at a research institute in Prague and then, for six years, at the Maryland Psychiatric Research Center in Baltimore. In his own history of the method, he writes that money for new projects had become hard to get, so he took a sabbatical and moved to the Esalen Institute in Big Sur, California.

At Esalen, workshop participants kept asking him for a psychedelic experience. Psychedelics were illegal, and he writes that Esalen’s staff would have been very upset if he’d broken that rule. He remembered that, near the end of LSD sessions that hadn’t resolved well, some patients had started breathing fast on their own, and told him it took them back into the middle of the experience. In 1974, he and his wife Christina developed a breathing method around that observation (Grof dates it to 1974, and most papers say 1975), and called it holotropic, which means “moving toward wholeness.”

There are two schools now. Only facilitators certified by Grof Transpersonal Training, the program the Grofs founded, can use the name Holotropic Breathwork. Grof’s later program, Grof Legacy Training, teaches the same method as Grof Breathwork “for legal trademark reasons.”

How to do it

Holotropic breathwork is taught only in workshops. A session goes in this order, with no count or pace to follow, and it shouldn’t be tried alone.

1. Screening first. The Grofs’ principles call for a talk through the physical and emotional reasons not to take part, with an expert opinion if there’s any doubt. Grof’s later program calls a good medical exam “a prerequisite for working with faster breathing.”
2. Pairs. People work in pairs and swap roles. The breather lies on a mat with eyes closed. The sitter stays close, brings water or tissues, helps with bathroom breaks and doesn’t interfere.
3. Faster and deeper. After a relaxation exercise the music starts and the breathers speed up. The Grofs give no rate or pattern. Their principles say only that the breathing is “faster and deeper than usual.”
4. The music. It starts evocative and stimulating, builds to dramatic “breakthrough” music, then shifts to quiet, meditative pieces near the end.
5. Two to three hours. A session usually runs two to three hours, and longer if someone is still in the middle of their experience. The breather stays lying down the whole time.
6. Bodywork. If tension is left at the end, a facilitator may work with it through what the Grofs call energy release work, taking cues from the breather.
7. A mandala. Afterward the breather draws or paints a mandala, a circle filled with whatever came up.
8. Sharing. Later the same day, after a long break, the group talks it through. Facilitators don’t interpret what people saw.

In the German study below, the workshop day had two sessions of about three hours each, so everyone breathed once and sat once.

A simple way to picture it

It’s a bit like the light, floaty moment when you stand up too fast, stretched out over three hours, with loud music in a dark room doing the steering.

What happens in your body

Fast, deep breathing blows off carbon dioxide faster than your body makes it. In the 2025 study, people breathing as taught averaged about 20 mmHg of carbon dioxide in their breath across the session, while people lying in the same room breathing normally averaged 37. Falling carbon dioxide narrows the blood vessels in the brain, which cuts blood flow. It also brings the numbness and tingling around the mouth, the muscle spasms in the hands and feet, and the light, dizzy feeling that MedlinePlus lists as symptoms of hyperventilation.

Time is the big difference from Wim Hof rounds. The Wim Hof Method’s rounds last a few minutes and end in breath holds. A holotropic session keeps the breathing going for hours with no instruction to hold, so carbon dioxide stays low for most of an afternoon. What happens in a fast breathing session walks through each sensation, and carbon dioxide has the chemistry.

The surprising part came out of the same study. The lower someone’s carbon dioxide went, the deeper their altered state tended to be. The breathing itself made the difference, since the people who breathed normally through the same music in the same room had much weaker experiences.

What the evidence shows

In 2007, two researchers looked at everything published on holotropic breathwork and found three studies they’d count as reliable evidence, and only one of those had come out in a peer-reviewed journal. They wrote that better studies would be needed to confirm or refute whether it helps with conditions like anxiety and depression.

In Denmark, researchers followed 20 volunteers through four sessions at two weekend workshops, 12 weeks apart. Afterward, people reported fewer problems with others, such as hostility and being overly accommodating, and the experienced breathers scored higher on self-transcendence. Paranoid thinking went up a little, most in first-timers, which the authors called a “wary phase.” There was no control group, and the volunteers already liked holotropic breathwork.

In 2025, a German team recruited 61 experienced breathers, each with at least five sessions behind them, and randomly assigned about 70 percent to breathe as taught and the rest to breathe normally in the same session. On the mystical experience questionnaire, the active breathers’ scores couldn’t be told apart from a standard dose of psilocybin on all four parts, though they scored lower than psilocybin on six of 11 parts of a second questionnaire. The deeper the experience, the better people’s wellbeing and the lower their depression scores a week later. But this group was already keen on breathwork, and the researchers didn’t ask directly about bad effects, though a few people’s wellbeing dropped.

The biggest number comes from a US hospital. A psychiatrist reported that about 11,000 inpatients at a hospital in St. Louis did 90-minute breathing sessions between 1989 and 2001. Staff recorded no complaints of bad reactions, and 82 percent of the 482 patients whose reports were rated described transpersonal experiences. Nobody measured whether their symptoms improved, and there was no comparison group.

We couldn’t find a randomized trial of holotropic breathwork as a treatment for depression, anxiety or trauma. We’re confident it changes how people feel for hours. Nobody knows yet whether it helps them in a lasting way.

Who should skip it

The rules for every fast practice apply here too. Lie down for the whole session, never do it in or near water, and never drive afterward until you feel fully normal. Holotropic sessions add their own list. When Danish facilitators screened people for the 2015 study, they ruled out anyone with:

• glaucoma or a detached retina
• osteoporosis
• heart disease, including past heart attacks, angina and high blood pressure
• an aneurysm
• an infectious disease
• a seizure disorder
• strong medication
• severe mental illness
• recent major surgery or injuries
• pregnancy

Grof’s own program adds that uncontrolled high blood pressure, an irregular heartbeat, or a history of stroke or heart attack “could mean a serious risk.” It asks for an evaluation by someone who knows psychiatry if you’ve ever been in a psychiatric hospital, and adjusted bodywork after fractures, operations or a slipped disc. The St. Louis hospital screened out severe heart disease, severe bone and muscle problems, pregnancy and paranoid thinking.

Grof Transpersonal Training warns that events without proper screening, preparation and integration can lead to panic or worse. A certified facilitator is part of the safety, so skip events that leave it out. Who should skip which breathing exercises has the full list for every practice.