From Altered States to Well-Being: A Mechanistic Model about Acceptance and Experiential Avoidance in High Ventilation Breathwork
Lena Erdmann, Josephine Jörke, Martha N. Havenith, Isabel Dziobek, Michael A. Rapp
Study at a glance
AI-extracted from the abstract| Characteristics | Clinical protocol Longitudinal |
|---|---|
| Population | Participants reporting on a recent high ventilation breathwork session (within nine days), including demographic and risk-related variables such as prior or current psychological diagnoses and symptom levels |
| Intervention | High ventilation breathwork (HVB) |
| Duration | Session reported within nine days; follow-up two to three weeks later |
| Topics | Breathwork |
| Citations | 1 |
| Key points | The authors propose that high ventilation breathwork may improve mental health by inducing altered states of consciousness that foster acceptance and reduce experiential avoidance, mechanisms they link to Acceptance and Commitment Therapy. They expect stronger altered states to predict greater improvements in well-being and reductions in depression and anxiety, mediated by these processes, and plan to test this in a longitudinal online survey with structural equation modeling. |
Abstract
This project investigates whether high ventilation breathwork (HVB) may support mental health through psychological mechanisms that have been proposed in the psychedelic-assisted therapy literature. HVB can reliably induce altered states of consciousness (ASCs) and has been discussed as a potentially low-threshold, non-pharmacological alternative to psychedelic interventions for conditions such as depression and anxiety, as well as a tool for improving mental well-being. Building on theoretical accounts suggesting that the therapeutic value of ASCs may partly arise from processes also targeted in cognitive-behavioural approaches, we focus on acceptance and experiential avoidance as candidate mechanisms conceptually aligned with Acceptance and Commitment Therapy. We assume that ASC-related experiences may facilitate relief when they promote enhanced acceptance of challenging experiences (e.g., aversive emotions, thoughts, or physical experiences), whereas experiential avoidance may amplify distress. To investigate these mechanisms and outcomes, we will conduct a naturalistic longitudinal online-survey in which participants report on a recent HVB session (max. nine days ago), including their subjective breathwork experiences, contextual factors of the session, and demographic and risk-related variables (including prior or current psychological diagnoses and symptom levels). Participants will rate perceived changes in mental well-being and symptoms of depression and anxiety up to nine days after the session and again two to three weeks later to examine whether any perceived benefits persist beyond the immediate aftermath. We expect that stronger ASCs will be associated with greater improvements in subsequent mental well-being and stronger post-session decreases of depression and anxiety, and that these associations will be statistically mediated by increased acceptance and reduced experiential avoidance during the session. We will test these associations in a structural equation model (SEM). In addition, the follow-up will exploratively assess whether HVB-related experiences are associated with subsequent levels of psychological flexibility, sense of coherence, and gratitude, thereby extending the mechanistic focus beyond immediate post-session effects. By identifying mental health-relevant mechanisms in HVB, this project may explain individual differences in mental health-related outcomes and inform facilitator guidance and participant preparation, helping to foster constructive coping with challenging experiences and, in turn, optimize breathwork’s potential to enhance mental well-being and reduce symptoms of anxiety and depression.