Holotropic Breathwork: The Potential Role of a Prolonged, Voluntary Hyperventilation Procedure as an Adjunct to Psychotherapy

Objectives: To pose the question of whether Holotropic Breathwork (HB), a prolonged, voluntary hyperventilation procedure, might be useful in treatment of common psychiatric conditions such as anxiety and depressive disorders.

Design: This is a hypothesis-posing paper pertaining to a potential novel treatment. SUMMARY: The neurophysiology and psychology of hyperventilation are reviewed, including findings demonstrating that hyperventilation leads to significant changes in central nervous system activity as measured by various technological means. Preliminary evidence suggesting efficacy for HB is reviewed. A tentative biopsychologic hypothesis is offered, suggesting a potential mechanism that may underlie putative therapeutic effects of HB. Specifically, when HB is used in the context of ongoing psychotherapy, hyperventilation may facilitate generalized extinction of avoidance behaviors, resulting in therapeutic progress. Individuals high in trait absorption and social desirability who have failed to respond adequately to psychotherapy might be those most likely to respond to HB. Recommendations for future research directions examining the therapeutic potential of HB are offered.

Conclusions: Further research using more sophisticated methodologies than have been used to date will be necessary in order to confirm or refute the hypothesis that HB may be useful in treatment of psychiatric disorders.