Overview
This page covers Holotropic Breathwork, a group breathwork practice that Stanislav and Christina Grof developed in the mid-1970s. It sets out the origin accounts given by the developers and by reviewers, the names used for the method and related breathwork styles, the session elements described by developers and observers, and what studies have reported. Much of the material comes from practitioners, developer organizations or authors who studied sessions, so this page keeps those accounts separate from tested findings. Adverse events and contraindications are covered in full.
Where does Holotropic Breathwork come from?
Origins in psychedelic research
Stanislav Grof is a psychiatrist who trained in Prague and later worked in the United States. A biography published by Grof Transpersonal Training describes him as Principal Investigator of a program at the Psychiatric Research Institute in Prague that explored the therapeutic potential of LSD and other psychedelic substances, and as Scholar-in-Residence at the Esalen Institute in Big Sur from 1973. The method was developed with his wife, Christina Grof, in the years that followed that research, as the Grof Transpersonal Training biography also states.
Jacob's 2020 literature review describes Holotropic Breathwork as a psychotherapy developed by Stanislav and Christina Grof in the mid-1970s. The review states that the method is designed to produce an altered state of consciousness similar to experiences induced by psychedelics such as LSD and psilocybin. It also describes the method as a non-pharmacological route to those states.
Dating the method
The sources give different dates for development. Miller and Nielsen state that the Grofs developed the method in 1975. The Grof Legacy Project states that it was developed in 1974 during Stan Grof's tenure as scholar-in-residence at Esalen. Jacob gives the mid-1970s. A Grof Transpersonal Training biography of Christina Grof records her residence at Esalen from 1976 until 1988, so the dates should be read as approximate and as coming from developer-affiliated accounts.
The sources reviewed do not describe a continuous transmission from earlier breathing traditions to Holotropic Breathwork. Havenith and colleagues trace circular breathwork to traditional practices such as tummo and pranayama yoga, and they list Holotropic Breathwork among modern adaptations of that approach. That is a general statement about the family of practices and does not document a lineage from those traditions to this method.
Theoretical framework in developer accounts
Jacob describes the theory behind the method as somewhat based on psychoanalysis. He reports that Grof related the approach to Wilhelm Reich's observation that psychological defenses are associated with restricted breathing, and that Grof held that an increase in the pace of breathing loosens defenses and brings unconscious material to the surface. These are the developers' theoretical claims as reported by a reviewer.
Eyerman describes a map of experience with four themes of perinatal birth experience in four realms: somatosensory, perinatal, biographical and transpersonal. The perinatal framework is a developer model. The sources reviewed do not test it, and the studies described below measure self-reported experience and physiology rather than the model itself.
What do the names and terms mean?
Names used for the method
Jacob uses the terms Holotropic Breathwork and holotropic breathing for the same practice. The Grof Legacy Project uses the name GROF Breathwork and describes the experiential method as combining accelerated breathing, evocative music and focused bodywork that helps release residual emotional blocks. The sources reviewed do not explain when or why the name changed, and the name does not change what the sources describe.
The sources reviewed do not explain the origin of the word holotropic, so this page does not offer an etymology. Readers who encounter the method under a different name should check whether the description matches the session elements listed in this article.
Breathwork as an umbrella term
Breathwork is an umbrella term. A 2023 systematic review and meta-analysis by Fincham and colleagues defines breathwork as the deliberate control of the breath, and it includes trials of slow-paced and fast-paced breathing. Holotropic Breathwork is one of several named styles. Havenith and colleagues list it alongside Rebirthing, Conscious-Connected and Transformational Breathwork as related circular breathwork forms.
A 2023 review by Fincham and colleagues describes high ventilation breathwork as practices that involve volitional manipulation of breathing, and notes a long history of use to relieve psychological distress. The abstract frames these practices as having extraordinary effects on subjective experience and on autonomic nervous system function. This page relies on the abstract only, because the full text was not accessible for this record.
Related forms named in sources
Havenith and colleagues describe Conscious-Connected breathwork as a second circular form compared with Holotropic Breathwork in their 2025 study, and they report that the two styles produced highly similar outcomes. The comparison was made within one study and does not establish equivalence across all breathwork styles.
Pranayama is a yoga term that sources link to the regulation of breath. Havenith and colleagues name pranayama yoga as a traditional antecedent of circular breathwork. The page does not treat pranayama as equivalent to Holotropic Breathwork, because the sources reviewed do not describe them as the same practice.
What does Holotropic Breathwork involve?
Session elements
Eyerman lists six elements of the method: an introductory presentation of a map of experiences, enhanced breathing, evocative music, body work focused on amplifying physical blocks, mandala drawing and supportive group sharing without analysis or interpretation. The account describes the structure of one community hospital program.
Jacob describes the music as moving through five phases: opening music, trance-inducing music, breakthrough music, heart music and meditative music. He reports that the music is intended to help emotions surface and to mask the sounds of participants in a group. Jacob's review does not report studies that tested these elements separately.
Facilitation and group context
Jacob reports that Grof discouraged facilitators from interpreting participants' experiences and asked them to ask questions that help the participant reach their own understanding. Grof also described nourishing physical contact, such as holding a hand or touching the forehead, which he said should be used with the participant's consent and with attention to boundaries.
Miller and Nielsen recruited participants who had been referred by Holotropic Breathwork facilitators in Denmark. The Grof Transpersonal Training organization, which Christina Grof was past president of, is the developers' training body. No statutory regulation or training standard for facilitators was found in the sources reviewed, and no independent professional body's register was identified for this method.
Physical and experiential variation
Jacob reports that the physical response varies from one person to another and that faster breathing commonly brings intense physical sensations at first. He summarizes Grof's account of two mechanisms: discharge of pent-up energy through tremors, twitches and coughing, and what Grof called tetany, a set of repeated muscular contractions that Grof described as tending to be self-limited. These are the developer's interpretations, and they have not been independently tested.
Havenith and colleagues recorded physiology during sessions. They found that a reduction in end-tidal carbon dioxide during deliberate hyperventilation was correlated with the onset of altered states of consciousness, with a correlation of r = -0.46. The measurements were taken during the same sessions as the questionnaires, so the findings describe the physiology of the sessions studied and do not show that a given experience will occur for any individual.
What is Holotropic Breathwork used for?
Reported purposes in developer and practitioner accounts
Developer and practitioner accounts describe Holotropic Breathwork as a route to self-exploration, emotional release and transpersonal experience. Eyerman's report describes the method as offering experiences of non-ordinary states of consciousness, a direct experience of a higher power, and physical and emotional catharsis associated with stress and prior trauma. These are the author's descriptions of the method's aims, not measured outcomes.
Miller and Nielsen framed their study as an inquiry into whether the method has significance for the development of self-awareness. Rhinewine and Williams proposed in 2007 that the method might be useful for common psychiatric conditions such as anxiety and depressive disorders. They described their paper as hypothesis-posing and suggested that hyperventilation might facilitate extinction of avoidance behavior. That mechanism is a hypothesis, not an established finding.
Outcomes that have been studied
The outcomes measured in the available studies are mainly self-reported. Miller and Nielsen measured temperament, character and interpersonal problems in 20 participants after four sessions. Havenith and colleagues reported that the depth of altered states predicted later improvements in well-being and reductions in depressive symptoms in their sample. Those are associations within a single observational study and do not establish a treatment effect.
Eyerman reports that 82% of 482 documented inpatients described transpersonal experiences. The report treats this as the main outcome, and it does not compare symptoms against a comparison group. Eyerman describes a weekly group offered in a community hospital in Missouri from 1989 to 2001, so the outcome reflects an experience reported at the end of a session.
Clinical use and its limits
Rhinewine and Williams framed Holotropic Breathwork as a possible adjunct to ongoing psychotherapy rather than as a stand-alone treatment. Jacob describes the method in similar terms. Neither source documents a clinical protocol for a specific condition, and neither source assigns a target population for the method as a treatment.
Jacob states that research on Holotropic Breathwork specifically is sparse. He notes that much of the supporting literature concerns meditation, which shares some breathing features, and that findings for meditation should not be taken as findings for this method.
What does the research show?
Randomized trials of breathwork in general
A 2023 systematic review and meta-analysis of randomized controlled trials by Fincham and colleagues searched several databases up to February 2022. The primary outcome, self-reported stress, included 12 trials with 785 adult participants. The pooled effect favored breathwork over control conditions, with an effect size of g = -0.35 (95% CI -0.55 to -0.14). Most included studies were judged to be at moderate risk of bias, and heterogeneity was intermediate.
The same review reported similar small-to-medium effects for anxiety and depressive symptoms, and it found moderate and significant heterogeneity for both. Most of the included stress trials tested slow-paced breathing, and two tested fast-paced breathing. The authors urge caution to avoid a miscalibration between hype and evidence. The abstract does not name Holotropic Breathwork as an included intervention, and this page does not assume that it was.
Holotropic-specific studies
The Holotropic-specific research identified is small and uncontrolled. Eyerman's 2013 report documents 482 consecutive inpatients during group sharing, with no comparison group and no symptom outcomes. Miller and Nielsen's 2015 quasi-experimental study followed 20 Danish participants through four sessions using pre-during-post measures, with no control group. The authors reported reductions in persistence temperament, interpersonal problems and hostility. Their participants were referred by facilitators who offered free sessions for the study.
Havenith and colleagues (2025) compared Holotropic and Conscious-Connected sessions in 61 participants, with 30 in the Holotropic group and 31 in the Conscious-Connected group. The design was observational, the participants had previously experienced at least five immersive breathwork sessions, and the authors state that the sample was experienced. The study reports questionnaire-based similarities to psychedelic experiences, such as ego dissolution, and the authors note that its findings describe session-level physiology and self-report.
What the evidence does not show
No randomized trial of Holotropic Breathwork was identified in the searches run for this page. Rhinewine and Williams noted that further research with more sophisticated methods would be needed to confirm or refute a therapeutic role for the method, and that statement still applies to the published record.
The Holotropic literature identified therefore rests on uncontrolled reports, a quasi-experimental study and one observational physiological study. Findings from the broader breathwork literature, including the meta-analysis of breathwork trials, should not be transferred to Holotropic Breathwork without a study of the method itself.
What are the safety considerations?
Reported adverse events
Documented adverse events for Holotropic Breathwork are limited. Eyerman reports that staff recorded no complaints of adverse reactions during or after sessions over 12 years. Jacob's review lists suggested risks, including a possible worsening of an underlying seizure disorder or arrhythmias, and states that these have not been extensively documented.
In the study by Havenith and colleagues, most participants reported improved well-being, and some reported a decrease. The authors did not ask about adverse effects directly. Fincham and colleagues found no adverse events directly attributed to breathwork in the included trials, but one fast-paced trial reported hot flushes, shortness of breath or sweating.
Hyperventilation-related risks
Hyperventilation has documented effects. A National Health Service trust leaflet describes hyperventilation syndrome as over-breathing that can cause tingling or numbness in the limbs or around the mouth, dizziness, palpitations, sweating and a feeling of being unable to breathe. The leaflet describes a clinical syndrome, not breathwork sessions.
Kane and colleagues reported on hyperventilation during diagnostic electroencephalography in 3,475 largely outpatient participants. Adverse events were rare, and no significant cerebrovascular, cardiovascular or respiratory events were reported. Seizures were provoked in 69 of 3,170 patients investigated for possible epilepsy (2.2%), with one generalized tonic-clonic seizure. This was a supervised clinical setting, and only the abstract was read.
Contraindications and care boundaries
Miller and Nielsen report the facilitators' contraindications in their study: glaucoma, retinal detachment, osteoporosis, cardiovascular disease, aneurysm, infectious disease, seizure disorders, strong medication, severe mental illness, recent significant surgery or injuries, and pregnancy. Eyerman's program excluded severe cardiac disease, severe musculoskeletal disorders, pregnancy and paranoid ideation.
Havenith and colleagues excluded people with a history of psychosis and people with chronic central nervous system disease, especially epilepsy,. These exclusions are precautions named by specific studies and facilitators, not a settled rule. Breathwork does not replace assessment or treatment, and a clinician can advise whether attending is appropriate.
Psychological distress and professional support
Eyerman includes two case reports of inpatients with severe depression whose sessions included experiences of death and of deceased relatives. The sources reviewed do not follow participants after sessions systematically, so post-session distress is reported only in general terms.
Rhinewine and Williams framed the method as a possible adjunct to psychotherapy. People with a history of trauma, severe mental illness or a current crisis should involve a qualified mental health professional before taking part. Chest pain, fainting, a seizure, a sustained fast heartbeat or distress that does not settle need urgent medical help rather than continued practice.
Connected Entries
Showing 8 of 11 related records.
Classification and context
- Entry type
- Modality
- Practice type
- Breathwork: accelerated breathing with music and bodywork in group sessions
- Traditions
- Transpersonal psychology, Pranayama and yoga breathing traditions (antecedent named by Havenith et al.)
- Concepts
- Breathwork (umbrella family), Volitional hyperventilation, Non-ordinary states of consciousness, Perinatal matrices model, Evocative music in five phases, Mandala drawing, Group sharing without interpretation, Circular breathwork, Conscious-Connected breathwork
- Categories
- Alternative
Sources and discovery context
Research and public-health sources support evidence and safety context. Directory and discovery sources describe navigation, relationships, practitioners, and access—not clinical efficacy.
A narrative review that summarizes developer accounts and a small number of studies, with no systematic search reported.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports the developers' account of origin, the session components as the developer describes them, and the reviewer's statement that Holotropic-specific research is sparse. Does not establish that the described risks occur at any rate, and does not establish efficacy.
- Supports sections
- History and Origins, Terminology, Practice Description, Claimed Uses, Research and Evidence, Safety and Suitability
An uncontrolled report by one author on group sessions offered in a single hospital program, with staff-recorded outcomes.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports descriptions of one program's structure, the self-reported experiences of documented patients, and the absence of complaints recorded by staff. Must not be read as a safety study, as evidence of effectiveness, or as evidence that the method is low-risk in general.
- Supports sections
- History and Origins, Practice Description, Claimed Uses, Research and Evidence, Safety and Suitability
A small single-arm study with pre, during and post measures and no control group.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports the self-reported and questionnaire changes in this sample, the facilitator contraindication list, and the 1975 date given by the authors. Does not establish a comparative effect, control-group benefit, or safety. Participants were referred by facilitators who gave free sessions.
- Supports sections
- History and Origins, Practice Description, Claimed Uses, Research and Evidence, Safety and Suitability
An observational study comparing two circular breathwork styles within sessions, with questionnaire outcomes.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports session-level physiology, correlations with altered-state onset in this sample, and the authors' statements on exclusions and on adverse effects not being asked about. Does not establish treatment effects, a causal mechanism, or the frequency of adverse events. Participants were experienced practitioners.
- Supports sections
- History and Origins, Terminology, Practice Description, Research and Evidence, Safety and Suitability, Claimed Uses
A review of randomized trials of breathwork that reports small-to-medium effects on self-reported stress and secondary outcomes.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports the general breathwork evidence summary, the reported effect sizes and risk-of-bias judgments, and the statement that no adverse events were directly attributed in included trials, apart from the side effects noted in one fast-paced trial. Must not be applied to Holotropic Breathwork specifically or to safety in general.
- Supports sections
- Terminology, Research and Evidence, Safety and Suitability
A review of high ventilation breathwork effects and mechanisms, cited from its abstract only.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports the definition of high ventilation breathwork as volitional manipulation of breathing and the abstract's description of its effects as reported. Does not support any specific adverse-event rate, and does not establish that Holotropic Breathwork is classed in this category.
- Supports sections
- Terminology
A hypothesis-posing paper with a suggested mechanism that the authors say requires testing.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports the statement that the paper proposed a hypothesis and that further research was needed. Must not be read as evidence of efficacy or as a summary of the preliminary studies it reviewed.
- Supports sections
- Claimed Uses, Research and Evidence, Safety and Suitability
A multicenter service evaluation of hyperventilation during EEG in a clinical setting, reporting adverse events and provoked seizures.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports the adverse-event and seizure rates reported for supervised hyperventilation in a clinical EEG setting. Must not be transferred to group breathwork sessions, which differ in length, setting and population.
- Supports sections
- Safety and Suitability
A National Health Service trust leaflet describing symptoms and self-help advice for hyperventilation syndrome.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports the list of hyperventilation symptoms and the advice to seek GP help for recurrent attacks. Describes hyperventilation syndrome, not breathwork sessions, and must not be used to state how often breathwork produces these symptoms.
- Supports sections
- Safety and Suitability
A biography published by the developers' training organization describing Grof's research and residence.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports the biographical details, the Prague LSD program and the Esalen residence dates as the organization states them. Must not be used as independent evidence of origin dates or of the method's effects.
- Supports sections
- History and Origins
A biography of Christina Grof published by the developers' training organization.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports Christina Grof's co-creation of the method, her Esalen dates, and her role in the training organization, as the organization states them. Not independent evidence of origin dates.
- Supports sections
- History and Origins, Practice Description
A developer-affiliated program page that describes the method under the name GROF Breathwork.
How this source relates
- Source link
- Exact source page
- Relationship
- Supports the 1974 date as this organization states it, and the GROF Breathwork name and description. Not independent evidence for dates or effects.
- Supports sections
- History and Origins, Terminology
Links to Gyfts Holotropic Breathwork page for this practice, for discovery only. The platform's descriptions and claims are not independent claims. Machipedia does not rely on them for evidence.
How this source relates
- Source link
- Exact source page
- Relationship
- Links to Gyfts' page for this practice, for discovery only. The platform's descriptions and claims are not independent evidence, and nothing on this Machipedia page relies on them.
- Supports sections
- Practice Description