What Is Holotropic Breathwork?

Holotropic breathwork is fast, deep, continuous breathing done lying down for two and a half to three hours with loud music playing, until you drop into a trance-like state. We run a weekly holotropic breathwork class in Medellín next to our ayahuasca work, and that class is the shorter facilitated ninety-minute format rather than the full two and a half to three hour Grof structure described below. Stanislav and Christina Grof built the method in the 1970s at the Esalen Institute in California. They wanted the states they had been studying with lysergic acid diethylamide (LSD) without the LSD.

The mechanism is plain physiology. Breathing that hard for that long strips carbon dioxide out of your blood. The blood turns alkaline, the vessels in your brain narrow, and your hands and face start to tingle. That shift is the trance people describe. Whether it changes anything for you after the music stops depends on what you carry in and what you do in the weeks after.

Where Holotropic Breathwork Came From

Holotropic breathwork was developed by the psychiatrists Stanislav and Christina Grof in the 1970s, after legal LSD research in the United States had closed down. Stanislav Grof had spent years running clinical LSD sessions. Then LSD went into Schedule I of the Controlled Substances Act. As David Nichols sets out in his 2016 review of psychedelics in Pharmacological Reviews, human research with these compounds effectively stopped for a generation. Grof moved to Esalen as scholar in residence and started looking for another door into the same room.

What he and Christina Grof landed on was breathing. Grof Transpersonal Training, which still holds the trademark, describes the method as accelerated breathing combined with evocative music in a set and setting built for it. The name is Greek. Holos means whole and trepein means moving toward, so holotropic reads as moving toward wholeness.

If you have heard it called Grof breathwork, holotropic breathing or holotropic breath work, it is the same practice under a different spelling.

What the Breathing Does to Your Body

Sustained fast breathing pushes out more carbon dioxide than your body is making, and that single change drives everything else you feel. The medical name for low blood carbon dioxide is hypocarbia. The StatPearls chapter on hypocarbia lays out the first half of it, and lists painful tingling in the hands and feet among the effects. Lower carbon dioxide raises blood pH into respiratory alkalosis. The arteries feeding the brain constrict, and blood flow to the brain drops.

That is why the standard list of effects is so consistent across every room this is done in.

• Tingling and numbness in the fingers, the lips and around the mouth, usually within the first ten minutes.
• Lightheadedness that can tip into feeling like the floor moved.
• Carpopedal spasm, which is the hands and feet cramping into a claw. It looks alarming and it is not damage.
• A drop in ordinary self-monitoring, which is the part people call the trance.

The cramping is the one that frightens first-timers. It eases within a few minutes of breathing normally again. A facilitator who knows the practice will talk you down to a slower rhythm until it lets go.

Joseph Rhinewine and Oliver Williams described holotropic breathwork in these terms in the Journal of Alternative and Complementary Medicine in 2007, calling it a prolonged voluntary hyperventilation procedure. They reviewed what hyperventilation does to central nervous system activity. Their paper poses a hypothesis rather than reporting a trial result, and they say so themselves.

What a Holotropic Breathwork Session Looks Like

In the classic Grof format people work in pairs, and each person takes a turn as breather and a turn as sitter. The breather lies on a mat with eyes closed and breathes. The sitter stays next to them for the whole session. Grof Transpersonal Training is specific that the sitter is there to be present and to help with practical things, and is not there to interfere, interrupt or guide the process.

The breathing part runs two and a half to three hours with music the whole way through. Grof Transpersonal Training says a session shorter than that is not Holotropic Breathwork. The music is not background. The arc is deliberate: driving and rhythmic at the start, heavier through the middle, then slow and open at the end while people come back.

Two things usually follow the breathing. The first is focused release work, which is hands-on pressure applied where a breather asks for it, so that whatever got stuck in the body has somewhere to go. The second is mandala drawing, where you sit with paper and pastels and draw the session out before you try to say anything about it. Then the group talks.

Drawing first sounds like a soft add-on and it is not. Language arrives fastest and flattens the thing it describes, so the drawing catches what you would otherwise have lost by the time your turn to speak came around. You do not need to be able to draw.

Why People Cry, Shake and Shout

A holotropic breathwork room is loud, and the noise is coming from the participants as much as from the speakers. People cry. People shake, sometimes hard. People curl up, push against the floor, laugh, or lie completely still for two hours and then sit up wrecked.

It can be that the body has been holding a posture for years and the breathing finally loosens it. It can also be that a memory surfaces with the feeling still attached to it, which is not the same as remembering it. It can also be that the alkalosis is simply making the nervous system loud and the person is meeting their own anxiety with no story to hang it on. The same session produces all three in the same room.

There are roughly two types of people who walk in. One type is braced and wants to keep a hand on the wheel, and for them the work is letting the breathing win. The other type wants a big experience and pushes for it. For them the work is the opposite, because chasing an outcome in a session this long is like chasing a butterfly. Both leave with something. Neither gets what they came for by forcing it.

A hard cry on a mat is not the same as a change in how you live. What you do in the following weeks fills that gap. That part is your responsibility, and no facilitator can do it for you.

Can You Do Holotropic Breathwork by Yourself?

You can breathe this way alone, and the full holotropic breathwork format is built so that you do not have to. The sitter is not a nicety. Somebody has to fetch water, put a blanket on you, and stay calm while your hands cramp shut. None of that works if the person it is happening to is also the person in charge.

There is a harder reason too. Hyperventilation is a standard way to provoke a seizure on purpose. In neurology it is a routine electroencephalogram (EEG) activation procedure. Chethan Rao and Rachel Kuperman reported in the Journal of Child Neurology in 2024 that it brings on generalised spike and wave discharges in more than nine out of ten children with childhood absence epilepsy, with the seizure itself usually arriving inside ninety seconds. Their review covers diagnosis rather than breathwork, and the physiology does not care why you are overbreathing. Somebody who has never had a seizure and does not know they are susceptible should not find that out on a bedroom floor with nobody in the house.

So if you want to work with breath on your own, keep it short and gentle, sitting or lying down, and stop the moment it stops feeling manageable. Save the full-length version for a facilitated room. Ours runs weekly and the times and details are on the breathwork in Medellín page.

Holotropic Breathwork vs Wim Hof vs Conscious Connected Breathing

These three get lumped together as "breathwork" and they are three different practices with three different goals. Getting them confused is how someone ends up doing breath holds in a hot tub because a holotropic breathwork article told them breathing changes your state.

Three breathwork methods at a glance

The Wim Hof Method is the one people most often mistake for holotropic breathwork, and the difference is the breath hold. The official instructions are thirty deep breaths, then hold on the exhale until you need to breathe, then one big breath held for fifteen seconds, repeated three or four times. That is minutes rather than hours, and it is normally paired with cold. Kox and colleagues published the result that made it famous in the Proceedings of the National Academy of Sciences in 2014. Trained subjects could raise their own adrenaline and blunt the inflammatory response to injected bacterial endotoxin. That study ran on 24 participants and it measured immune response, so it says nothing about emotional processing. The official instructions themselves warn that the breathing can make people pass out, and that it must never be done in or near water or while driving. If the cold half is the part that draws you, our ice bath sessions in Medellín are the closer fit.

Conscious connected breathing sits between the two. The International Breathwork Foundation defines it as connecting the inhale straight to the exhale with no pauses. You breathe in and out through the same channel, with an active inhale and a relaxed exhale. Rebirthing, which Leonard Orr taught from the 1970s, is the best known lineage of it. In practice the pace is gentler than holotropic breathwork, the session is shorter, and a facilitator is talking to you the whole way rather than sitting quietly beside you.

So choose on how much handling you want. Pick conscious connected breathing if you want someone tracking you closely and a session you can fit into an afternoon. Pick holotropic breathwork if you want the long version and you are willing to be left alone inside it. Pick the Wim Hof Method if you want a daily practice and cold water, because it will not give you the other thing.

What the Research on Holotropic Breathwork Shows

The research base under holotropic breathwork is thin, and anyone telling you otherwise has not read it. The good evidence that exists covers breathwork in general. Almost none of it tested the Grof protocol.

The strongest piece is a 2023 meta-analysis by Fincham and colleagues in Scientific Reports. They pooled twelve randomised controlled trials covering 785 adults and found a small to medium effect of breathwork on self-reported stress. Most of the included studies were rated at moderate risk of bias. It is worth reading before you decide what to expect. A small to medium effect on a self-report questionnaire is a real finding and it is a long way from the claims made in breathwork marketing.

On holotropic breathwork specifically the literature is a handful of small studies. Miller and Nielsen published a measure of self-awareness change after holotropic breathwork in the same journal in 2015, with no control group. That study and the Rhinewine hypothesis paper are roughly where the clinical literature stops.

A randomised trial of the full Grof protocol against an active control would change what we say here. It would have to measure something more than a questionnaire filled in on the same afternoon. If a trial like that lands and holds up, we will say so here.

And this is not the practice for everybody. If you want treatment for a diagnosed condition such as depression, post-traumatic stress disorder or an anxiety disorder, see a doctor. Ask about the treatments that have trial evidence behind them. Breathwork can sit alongside that. It is not a substitute for it, and a facilitator who tells you it is has made a decision about your health that is not theirs to make.

Who Should Not Do Holotropic Breathwork

Holotropic breathwork has a real contraindication list and it is short enough to read in thirty seconds. Brigitte Grof trained with Stanislav and Christina Grof at Esalen and has run holotropic breathwork seminars since 1989. She publishes the list directly: pregnancy, untreated high blood pressure, cardiovascular problems, glaucoma and epilepsy.

The reasoning behind each one follows from the physiology above, and the last few entries are standard Grof lineage screening rather than items from her published list.

• Cardiovascular disease or uncontrolled high blood pressure. Overbreathing for that long drives up heart rate and blood pressure, and a compromised heart should not be asked to do that.
• Pregnancy. The blood gas swings and the physical stress have not been shown to be safe, so it waits.
• Epilepsy or any seizure history. Hyperventilation is used in clinics to provoke seizures deliberately.
• Glaucoma or a detached retina. Pressure changes in the eye can make both worse.
• Recent surgery, a recent fracture, or an acute infection. The bodywork and the physical intensity are the problem here rather than the breathing.
• A history of psychosis or psychiatric hospitalisation. A group breathwork room has no clinical cover, and Grof lineage groups say so plainly.

Do not screen yourself off a web page. Take that list to a doctor who knows your history. Be specific about your heart, and about anything ever described to you as a blackout, an absence or a fit. A facilitator who does not ask you these questions before you lie down has already told you what kind of room you are in.

Breathwork Before and After an Ayahuasca Ceremony

Breathwork and ayahuasca do overlapping work and they are not interchangeable. Holotropic breathwork gets you to a non-ordinary state using nothing but your own lungs. That makes it a reasonable way to find out how you handle one before you drink anything.

Used before a retreat it does two things worth having. It gives you a rehearsal for lying down with your eyes closed while something moves through you. It also takes some pressure out of the expectation you have been building. Our ayahuasca ceremony preparation guide covers the rest of that ground.

Used afterwards it is an integration tool. When the comprehensions from a ceremony have not landed yet and the body still feels heavy weeks later, a breathwork session can move what talking about it has not. That is the same job we describe in our integration guide, approached through the body instead of through language.

One caution. If you are planning both, bring it up on the consultation call before you book either one.

If you are still working out whether holotropic breathwork is a fit for you, book a free 30-minute consultation call. We will go through your health history and what you are hoping for before you commit to anything. All the best on your path.

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