The method comprises five elements: group process, intensified breathing (hyperventilation), evocative music, focused body work, and expressive drawing. The method's general effect is advocated as a non-specific amplification of a person's psychic process, which facilitates the psyche's natural capacity for healing.
Holotropic Breathwork is usually done in groups, although individual sessions are done. Within the groups, people work in pairs and alternate in the roles of experiencer ("breather") and "sitter". The sitter's primary responsibility is to focus compassionate attention on the breather. Secondarily, the sitter is available to assist the breather, but not to interfere or interrupt the process. The same is true for trained facilitators, who are available as helpers if necessary.
Originally developed as an adjunct to psychedelic psychotherapy, Holotropic Breathwork is an autonomous psychotherapeutic practice which, nevertheless, retains many of the clinical precautionary measures that were implemented in the medical use of LSD.
"Holotropic Breathwork" is a trademark.
Typical experiencesParticipants in Holotropic Breathwork sessions report a wide variety of experiences (Taylor, 1994). From observing many people in nonordinary and expanded states of consciousness, Grof developed what he considers to be a “cartography” of the psyche, which describes four main categories of experience.
Sensory and Somatic: This realm of experience includes various hallucination|hallucinatory phenomena, such as visualizing images or geometrical patterns. More commonly, participants report a greater awareness of and ability to act out somatic processes and bodily impulses, such as assuming postures, dancing or moving in specific ways, and making sounds. They may also claim to feel where energy is blocked or streaming, consistent with the belief in vitalism.
Biographical and Individual Unconscious: As in more traditional therapies, participants may revisit unresolved conflicts, repressed memories, and unintegrated traumas. Compared to talk therapies, the unconscious mind|unconscious material is more likely to be re-experienced than merely remembered. Participants report that this deeper processing can be more effective at clearing Psychological trauma|trauma, especially as it relates to subtle ways that trauma is held in the body.
Perinatal: Along with most other Breathwork practitioners, and in disagreement with John Locke's claim that the infant after birth is a tabula rasa, Grof believes that the birth process is a traumatic event (psychological)|traumatic event that leaves powerful residue in the psyche (see "Importance of the birth process" below). Participants in Holotropic Breathwork sessions report having images, emotions, physical sensations, and cognitions that convince them that they are remembering aspects of their own birth. Sometimes details can be verified with medical records. Some claim that these experiences help them release the birth trauma, including deeply held negative beliefs about themselves or the world.
Transpersonal: Referring to the possibility of accessing information outside the normal boundaries of the ego and body, transpersonal experiences reported in Holotropic Breathwork sessions include reincarnation|past life memories, experiential identification with other life forms, out-of-body experiences, Henosis|oneness, encounters with spiritual archetypes, and connection with the collective unconscious.
Importance of the birth processOne aspect of Grof's extensive theory is the belief that there is a connection between a person's life experiences and experiences in the birth process. In his book The Holotropic Mind, Grof (1992) separated this process into four stages known as the Perinatal Matrices:
# Amniotic Universe — The womb. The only world that life knows at this point. Blissful feelings of peace and joy, in a healthy womb. # Cosmic Engulfment; No Exit — Equilibrium disturbed; contractions begin. Unbearable feeling of being stuck in hell with no way of escaping. # Death versus Rebirth Struggle — Second clinical stage of childbirth; intense struggle for survival. # Death versus Rebirth Experience — The child is born. Intense ecstatic feelings of liberation and love. New world begins.
Professional practiceThere is an Association for Holotropic Breathwork International which promotes professional and ethical practices governing Holotropic Breathwork.
There is an extensive training and certification program for facilitators through Grof Transpersonal Training. For those who wish to become certified, there are two tracks, Educational and Practitioner. Both have the requirements of attendance at seven modules and a two-week closing intensive, covering training in transpersonal psychology (including psychopathology, spiritual emergency, and addictions), as well as the theory and practice of Holotropic Breathwork. The training also includes ten hours of consultation with a certified practitioner and 150 total hours of participation in HB workshops led by Stanislav Grof or a certified practitioner (Baum and Pounds, 1993). In addition, those wishing to become independent workshop leaders (Practitioners), must apprentice at least four times at workshops with previously certified practitioners before leading groups of their own. There are currently more than 1000 trained facilitators located throughout the world, including clinicians, businessmen, public, psychotherapists, etc.
Reactions and contraindicationsIn a section entitled "Focused Body Work", Grof (1988) writes: "The last component of holotropic therapy, the focused body work, is used only when it is indicated. There are many sessions with a smooth course where no interventions are required. In some of these sessions, the hyperventilation does not trigger any difficult emotions or unpleasant physical manifestations and leads to progressive relaxation and to feelings of an ecstatic nature. In others, emotional and psychosomatic distress develops, but continued breathing brings about quite automatically a good resolution and good integration of the session" (194). He goes on to say that there are "only a few situations when focused body work is necessary in the early phases of holotropic sessions" and that "the main indication for the use of focused body work is a situation during the termination period of the session (usually after about an hour and a half to two hours) in those individuals where the breathing and music did not bring a complete resolution" (194) He points out that the "work on such problems is desirable, since it brings the session to a cleaner resolution and better integration, but it is in no way mandatory" (194-5). It is in this context that Grof refers to the exteriorization of "the various forms of physical discomfort associated with the emotional distress" (195). At this stage, "it can be helpful to use certain interventions that cooperate with the process, deepen it, and intensify it ... massage or pressure in the areas that are tense or painful, or offers of specific resistances that increase existing tensions ... Among the reactions that might spontaneously occur under these circumstances are violent shaking, grimacing, coughing, gagging, vomiting, a variety of movements, and a wide range of sounds that include screaming, baby talk, animal voices, talking in tongues or a language foreign to the client, shamanic chanting, and many others" (196)
Contraindications to be considered include: serious cardiovascular problems, glaucoma, severe psychiatric illness, and pregnancy (202); while special precautions are recommended in the case of epileptics (203).
He points out that caution is required in the case of individuals with a history of psychiatric hospitalization. Such procedures are "not without certain risks" and "if the process gets to be too active and extends beyond the framework of the sessions, it can require special measures" (251). Elsewhere, he writes that "experiential work with severely disturbed individuals requires a special residential facility with trained staff where continuous support is available for twenty-four hours a day; it should not be conducted on an outpatient basis" (204).
ResearchGrof (1988) admits the experimental nature of the process in the context of an adventure of self-discovery. Referring to his partnership with his wife, he comments: "Our own experience with this technique has been limited to experiential workshops lasting up to four weeks. We have not had the opportunity to subject it to rigorous evaluation in controlled clinical studies, comparable to my research in psychedelic therapy" (xiv). Later, he adds: "It is important to realize that holotropic work is completely open-ended. It is best to think about it as an ongoing research project and psychological experiment ... The training of the facilitator should never be considered a fait accompli. Holotropic therapy is a process of continuous learning, rather than mechanical application of a closed system of concepts and rules" (207).
Research by Holmes et al. (1996) concluded that holotropic breathwork combined with traditional verbally oriented psychotherapy led to “significant reductions in death anxiety and increases in self-esteem” relative to just traditional psychotherapy.
In a theoretical review article, Rhinewine and Williams (2007) offer the hypothesis that holotropic breathwork operates via a biopsychological mechanism that results in experiential exposure to feared internal representations, and consequently in extinction of covert avoidance behaviors. The latter disinhibitory process, experienced by the breather as "catharsis," may correspondingly result in therapeutic progress among patients who had previously shown limited gains in verbal psychotherapy, as previously demonstrated in Holmes and colleagues' (1996) study.
Research by James Eyerman, MD (2013) * reported results of 11,000 clinical patient experiences and 482 individual patient reports, and showed the 'procedure was well received. No complaints of adverse reactions were recorded during the sessions nor afterwards on the clinical units.' Eyerman goes on to conclude that Holotropic Breathwork 'offers significant benefits in terms of emotional catharsis and internal spiritual exploration, according to the participants. The lack of even one single reported adverse sequelae in more than 11,000 Holotropic Breathing in-patients over more than 12 years, indicates that Holotropic Breathwork could be considered a low-risk therapy to assist patients with an extremely broad range of psychological problems and existential life issues.'
CriticismHolotropic Breathwork has been subject to criticism, on points of medical and spiritual concern.
Responses to criticismGrof disputes many of the medical criticisms of Holotropic Breathwork, arguing that they are based on misunderstandings of the physiological and psychological processes involved. In his paper reviewing the literature on the effects of faster breathing, he concludes that "The fact that during rapid breathing symptoms surface and become manifest is not a pathological phenomenon...With skillful support and guidance, the emergence of symptoms during hyperventilation can result in healing of emotional and psychosomatic problems...". (Grof 2003)
Rhinewine and Williams (2007), reviewing the medical literature on hyperventilation in the context of a theoretical article on Holotropic Breathwork, state that "The procedure of voluntary hyperventilation has proven to be safe after medical screening for contraindicating conditions, and has been demonstrated across numerous studies to be helpful in treatment of anxiety as a tool for diagnosis and desensitization."