When Brendan Leier lay down for his first guided breathwork session over Zoom, he settled into a breathing rhythm, keeping a fast pace with the music the instructor was playing. As the session progressed over the next hour, he felt energy building up in his body, which the instructor invited him to release through a series of “om” chants.
Still, the pressure kept rising until one moment Leier jolted up to holler at the top of his lungs — exerting so much force that he burst the blood vessels in his nose, staining his white beard red with blood.
“Then, I just flopped back down on my back and experienced this overwhelming feeling of absolute bliss,” Leier, an ethicist at the University of Alberta in Canada, told Salon in a phone interview. “That experience was quite interesting because I had never had a physiological feeling like that before.”
During the session, Leier was practicing a form of high-intensity breathing called holotropic breathwork, he said. This technique was created in the 1970s by Stansislav and Christina Grof, former psychedelic researchers who specialized in the drug LSD. After the U.S. government banned the substance, with many other countries following their lead, the Grofs pivoted to studying breathwork. Although it’s been around for decades, holotropic breathing is one of dozens of forms of high-ventilation breathwork recently surging in popularity.
“On average what happens is that you basically go into an altered state of consciousness,” explained Dr. Martha Havenith, a breathwork practitioner and neuroscientist at the Ernst Strüngmann Institute for Neuroscience in Germany. She emphasized that the experience doesn’t manifest for everyone the same way and each session is very different. Nonetheless, “a lot of the aspects are quite similar to psychedelics,” Havenith said.
"For me, the foundation of the psychedelic experience is a gestalt experience, so you leave seeing things a different way than you went in."
Interest in psychedelic drugs like LSD and psilocybin “magic” mushrooms has exploded in recent years thanks to a wealth of research pointing to their potential treatment for depression, post-traumatic stress disorder, addiction and chronic pain. But these drugs remain highly illegal in most places, despite research showing relatively low risks compared to drugs like fentanyl or methamphetamine. Many cities have decriminalized psychedelics while Oregon, Colorado and, as of this month, New Mexico are beginning to roll out the country’s first pathways for patients to access them. But in Oregon, where these clinics are already operational, psychedelic therapy typically costs thousands of dollars per session.
High-ventilation breathwork techniques may produce transcendent experiences similar to those experienced with psychedelics in a way that is more accessible. However, research on this technique is limited, and sources say it puts stress on the body that may not be suitable for everyone.
“Holotropic breathwork provides access to biographical, perinatal and transpersonal domains of the unconscious and thus to deep psychospiritual roots of emotional and psychosomatic disorder,” the Grofs wrote in their 2010 book on the technique. “It also makes it possible to utilize the powerful mechanisms of healing and personality transformation that operate on these levels of the psyche."
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Holotropic breathwork, which combines high-ventilation breathing with music and movement, is partially built upon ancient Eastern traditions including certain forms of yoga and meditation. Another technique called “rebirthing” is similar but specifically focuses on uncovering suppressed memories that are serving as emotional blocks. Conscious connected breathing focuses on maintaining a constant in and outflow of breath to achieve similar results.
It’s recommended to have at least one trained facilitator present during the session who can also be available for the integration process afterward. Many of these techniques have formal training programs for facilitators, but it’s largely up to the individual to ensure the breathwork they are participating in is safe and legit, said Dr. Guy W. Fincham, a neuroscientist at the University of Sussex who studies breathwork.
“Checking credentials is key for all breathwork practice,” Fincham told Salon in an email. “It's kind of the Wild West out there.”
During a session, which can last up to a few hours depending on the practice, people may experience lightheadedness, dizziness or an elevated heart rate. Sometimes the muscles of the body tense, leading the hands to clamp up into “lobster claws.” Some also report experiencing altered states of consciousness, in which they see visions or resurface forgotten memories. Others may scream, cry or move their body in unexpected ways, Havenith said.
"If you’re doing the combination of hyperventilation and breath holds, you’re shifting these blood gas levels up and down to the point that those shifts alone can have effects."
“One of the things that seems to be a theme more strongly [for breathwork] than for psychedelics is that people feel it in their body,” Havenith told Salon in a video call. “Your body may be doing stuff that you don’t feel like you planned … We’ve seen people dance or go into crazy yoga poses and that kind of stuff.”
Leier said his prior experience with psychedelics was much more cognitive in nature, whereas his experience with breathwork was more focused on his body. However, both did make him experience some sort of altered state of consciousness.
“For me, the foundation of the psychedelic experience is a gestalt experience, so you leave seeing things a different way than you went in,” he said. “I think guided breathwork maybe has a similar insight, although I think psychedelics are far more efficient at that.”
It’s unclear exactly what is happening in the brain and body when these forms of high-ventilation breathing are performed, and relatively little research has been conducted on them. However, a study Havenith published last week in Communications Psychology found these altered states of consciousness achieved through high-ventilation breathwork were directly associated with reduced levels of carbon dioxide, presumably as a result of hyperventilation.
When the body hyperventilates, as it does during high-ventilation breathing, carbon dioxide levels drop, said Dr. Jack Feldman, a neuroscientist at the University of California, Los Angeles. This causes the pH levels of the blood to change, which can impact the way the brain works. (This can also cause the muscles in the body to tense up.)
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“When the pH levels rise, you could get changes in all aspects of brain function, including some that have been reported to be a consequence of holotropic breathing,” Feldman told Salon in a phone interview. “[That includes] this sense that it is a psychedelic-like experience.”
Some forms of high-ventilation breathing like the Wim Hof method also include moments of holding the breath, which restricts the flow of oxygen in the body and produces different effects in the nervous system, Feldman said.
“If you’re doing the combination of hyperventilation and breath holds, you’re shifting these blood gas levels up and down to the point that those shifts alone can have effects,” he said.
However, hyperventilation in the breathwork setting is a bit different from what might occur if one is having a panic attack, Havenith said. When the body hyperventilates, the sympathetic nervous system is activated, triggering the body’s “fight or flight” response. But during certain forms of high-ventilation breathwork, the body is breathing deeply which also activates the parasympathetic nervous system responsible for rest and relaxation, she explained.
That may in part be why people report similar experiences to psychedelics, because these substances have also been shown to activate both systems. However, this is one of several unproven theories on why this might be the case. One suggests this form of breathing activates parts of the brain that release serotonin, and another posits that dimethyltryptamine (DMT), which is naturally produced in the body to protect neurons when oxygen is not available, is produced in the process.
Like psychedelics, breathwork has also been shown to increase the degree of chaos in the brain, meaning neural activity gets less predictable and more complex. With psychedelics, this “desynchronization” in the brain that increases randomness may be related to the distorted sense of time and space and changes in perspective that are experienced during a trip. People who do this breathwork also report those two effects.
“There seem to be some first indications that the general neuronal signatures of breathwork are similar to those psychedelics,” Havenith said. “But how we get there is really the part that's not been studied properly at all.”
While the mechanism remains unclear, users do report similar experiences with breathwork as they do with psychedelics. In a 1996 study comparing holotropic breathing and therapy, participants who did both breathwork and therapy said breathing increased their self-esteem and reduced their anxieties about death compared to those who received therapy only. A 2015 study found this technique also improved participant’s temperament and reduced their interpersonal problems. And in a 2013 study, 82% of participants reported entering an altered state of consciousness that transcended the self, with some saying the process helped heal their trauma and depression.
More recently, a 2020 meta-analysis reported that certain forms of high-ventilation breathwork improved anxiety and depression, reduced stress, decreased PTSD symptoms and increased people’s ability to connect with others.
However, many people report negative experiences in which the breathing triggered panic attacks or unveiled psychological wounds they weren’t ready or able to process. High-ventilation breathing is not recommended for people with epilepsy, lung diseases or asthma that limit breathing, high blood pressure or cardiovascular problems, and schizophrenia or a history of psychosis. It should also be avoided in pregnancy as well as by people with brain injuries or cerebral aneurysm or a history of panic attacks.
In Havenith’s study, participants who had also tried psychedelics reported that high-ventilation breathwork was about 80% as intense as their experience taking psychedelics like psilocybin, MDMA or LSD. Feldman said the difference between slower forms of breathwork like box-breathing that do not stress the body and high-ventilation techniques is comparable to the difference between “jogging and wind sprints.” For people who are not accustomed to this type of activity, sources say it’s probably best to start with something less intense.
“You have to be really focused on it and to me it has been sort of stressful, like you have to push yourself to do it in the same sense that running wind sprints would be stressful,” Feldman said. “For most individuals who are not in that space, it’s hard to jump directly into the more intense forms of breathing.”
On the other hand, Havenith said in her personal life breathwork was able to kickstart the process of healing from her own trauma after meditation, therapy and self-help practices left her feeling a little stuck.
Leier, in Canada, wasn’t going into his first breathwork session with the intention of healing anything in particular. It was only after the session that he realized how much work stress had been accumulating in his body over the past several months.
“The breathwork was completely somatic, like no thoughts going in,” he said. “There was this incredible energy that I didn’t realize even existed.”
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