Breathwork - induced holotropic states of consciousness for self-exploration and psychotherapy (Grof® Breathwork)
by Stanislav Grof, January 2020

Holotropic breathwork is an experiential method of self-exploration and psychotherapy that my late wife Christina and I developed at the Esalen Institute in Big Sur, California, in the mid-1970s. This approach induces deep holotropic states of consciousness by a combination of very simple means - accelerated breathing, evocative music, and a special bodywork that helps to release residual bioenergetic and emotional blocks. For legal trademark reasons, we are using  the brand name Grof® Breathwork in the Grof® Legacy Training for our work with holotropic breathwork.

The sessions are usually conducted in groups; participants work in pairs and alternate in the roles of “breathers” and “sitters.” The process is supervised by trained facilitators, who assist participants whenever special intervention is necessary. Following the breathing sessions, participants express their experiences by painting mandalas and sharing accounts of their inner journeys in small groups. Follow-up interviews and various complementary methods are used, if necessary, to facilitate the completion and integration of the breathwork experience.

In its theory and practice, Grof ® Breathwork combines and integrates various elements from modern consciousness research, depth psychology, transpersonal psychology, Eastern spiritual philosophies,  shamanism and other native healing practices. It differs significantly from traditional forms of psychotherapy, which use primarily verbal means, such as psychoanalysis and various other schools of depth psychology derived from it. It shares certain common characteristics with the experiential therapies of humanistic psychology, such as Gestalt practice and the neo-Reichian approaches, which emphasize direct emotional expression and work with the body.
However, the unique feature of this approach is that it utilizes the therapeutic potential of holotropic states of consciousness. The extraordinary healing power of holotropic states - which ancient and native cultures used for centuries or even millennia in their ritual, spiritual, and healing practices - was confirmed by modern consciousness research conducted in the second half of the twentieth century.

This method provides access to biographical, perinatal, and transpersonal domains of the unconscious and thus to deep psychospiritual roots of emotional and psychosomatic disorders. It also makes it possible to utilize the mechanisms of healing and personality transformation that operate on these levels of the psyche. The process of self-exploration and therapy in holotropic states of consciousness are spontaneous and autonomous. They are governed by the inner healing intelligence of the psyche and body, rather than following the instructions and guidelines of a particular school of psychotherapy.

These revolutionary discoveries concerning the spontaneous healing potential of holotropic states consciousness are new only for modern psychiatry and psychology. They have a long history as integral parts of the ritual and spiritual life of many ancient and native cultures and their healing practices. They represent rediscovery, validation, and modern reformulation of ancient wisdom and procedures, some of which can be traced to the dawn of human history.

In ancient and pre-industrial societies, breath and breathing have played a very important role in cosmology, mythology, and philosophy, as well as being an important tool in ritual and spiritual practice. Various breathing techniques have been used since time immemorial for religious and healing purposes. Since earliest times, virtually every major psychospiritual system seeking to comprehend human nature has viewed breath as a crucial link between nature, the human body, the psyche, and the spirit. In modern medicine, breath and breathing has lost its numinous quality and has been reduced to an important physiological function.

Similar to a requirement for psychedelic sessions, a good medical examination is a prerequisite for working with faster breathing. Above all, we need to know if the person is in good cardiovascular condition. It is difficult to predict how intense emotions and body work can impact the body and particularly the cardiovascular system. High uncontrolled blood pressure, cardiac arrhythmia, history of strokes or heart attacks, or presence of an aneurysm could mean a serious risk.

A good completion of the session often requires bodywork. There are conditions that might need limitation or modification of physical interventions – conditions after fractures or operations, vertebral disk prolapse, whiplash, osteoporosis, diaphragmatic or umbilical hernia, colostomy, etc.

Another important consideration is the emotional condition and past and present psychiatric history. If the person has a history of psychiatric hospitalization, particularly a longer one, it is necessary to find out what was the nature of the disorder, what form it took, and the circumstances that led to it. This evaluation has to be done by a person who is familiar with traditional psychiatry and also with transpersonal psychology. In many instances a condition that was diagnosed as a psychotic episode was a misdiagnosed spiritual emergency. In that case, we have not hesitated to accept such a person into a holotropic breathwork workshop or into psychedelic therapy and they usually did not experience any special problems.

The holotropic state of consciousness opens access to a wide range of experiences from the individual and collective unconscious, as well as superconscious – perinatal and prenatal, ancestral, racial, past life, and phylogenetic memories, archetypal realms and mythical figures. Any of these contents can be associated with traumatic experiences. Holotropic states of consciousness can free them and open the way to positive, peaceful and even ecstatic feelings. The inner self-healing intelligence has a natural inclination to remove obstructions, pain and chaos and restore order.

It is remarkable how such a natural procedure – breathing, music, and a body work guided by inner self-healing intelligence – can bring positive results in a wide range of disorders - deep depression, panic anxiety, claustrophobia and other phobias, aggression states, psychogenic asthma, migraine, nausea, psychosomatic pains, pre-menstrual pain, and Raynaud’s disease. On the other side of suffering, we frequently find significant improvement of self-image, self-realization and self-actualization, quality of life, joie de vivre, and zest.

The nature and course of holotropic sessions varies considerably from person to person and also for the same person from session to session. Some individuals remain entirely quiet and almost motionless. They may be having very profound experiences but give the impression to an external observer that nothing is happening or that they are asleep. Others are activated and show rich motor activity, sometimes to the point that they are agitated and frantic. They may experience intense tremors and have complex twisting movements, roll and flail around, assume fetal positions, behave like infants struggling in the birth canal, or look and act like newborns. Also crawling, slithering, swimming, digging, or climbing movements are quite common.

Occasionally, the movements and gestures can be extremely refined, complex, quite specific, and differentiated. They can take the form of strange animal movements emulating snakes, birds, or feline predators and be associated with corresponding sounds. Sometimes breathers spontaneously assume various yogic postures and ritual gestures (asanas and mudras) with which they are not intellectually familiar. The emotional qualities observed in holotropic sessions cover a very wide range. On one end of the spectrum participants can encounter feelings of extraordinary wellbeing, profound peace, tranquility, serenity, bliss, cosmic unity, or ecstatic rapture. On the other end of the spectrum are episodes of terror, all-consuming guilt, murderous aggression, or eternal doom. The intensity of these emotions can transcend anything that can be experienced or even imagined in the everyday state of consciousness. These extreme emotional states are usually associated with experiences that are perinatal or transpersonal in nature.



In the middle band of the experiential spectrum observed in holotropic breathwork sessions are less extreme emotional qualities that are closer to what we know from our daily existence - episodes of anger, anxiety, sadness, hopelessness, and feelings of failure, inferiority, shame, guilt or disgust. These are typically linked to biographical memories; their sources are traumatic experiences from infancy, childhood, and later periods of life. Their positive counterparts are feelings of happiness, emotional fulfillment, joy, sexual satisfaction, and general increase in zest.

Sometimes faster breathing does not induce any physical tensions or difficult emotions, but leads directly to increasing relaxation, sense of expansion and well-being, and visions of light. The breather can feel flooded with feelings of love and experiences of mystical connection to other people, nature, the entire cosmos, and God. When that is the case, it is very important to assure the breathers that positive experiences are extremely healing and encourage them to accept them without reservation as unexpected grace. Properly integrated Grof® Breathwork sessions result in profound emotional release, physical relaxation, and a sense of wellbeing. Serial breathwork sessions represent an extremely powerful and effective method of stress reduction and can bring remarkable emotional and psychosomatic healing. Another frequent result of this work is connection with the numinous dimensions of one’s own psyche and of existence in general.

To prepare the holotropic session, the room needs to be equally distributed with mattresses for each breather; the breathers will begin in reclining positions with the sitters at their sides. We usually lead the breathers through a relaxation exercise of the entire body and then start music and suggest that the breathers increase the rhythm of the breath. They then continue breathing faster throughout the session at their own speed. Many of the participants do not need any help and intervention, except a bathroom break. They follow the flow of the breath and the music and express what the inner intelligence guides them. Their experience reaches the climax and breakthrough, quiets down, and ends up in a meditating mood.

When the session does not resolve successfully, the breather needs a skillful facilitator to help him or her to complete the session by body work. It is important to find the areas of the body of the breather and accentuate them. When this is happening, the breather is encouraged to express what spontaneously emerges - by voice, grimaces, coughing, shaking, kicking – without any inhibition of any kind. After this body work resolves the emotional and physical blocks, the participant goes to the breakout room and paints the mandala. This body work is equally essential for the termination of psychedelic sessions.

In Grof® Breathwork we also use a different form of physical intervention that is designed to provide support on a deep preverbal level. This is based on the observation that there exist two fundamentally different forms of trauma that require diametrically different approaches. Borrowing the terminology from British law, the first of these can be referred to as trauma by commission. This form of trauma results from external intrusions that damaged the future development of the individual, such as physical, emotional, or sexual abuse, frightening situations, destructive criticism, or ridicule. These traumas represent foreign elements in the unconscious that can be brought into consciousness, energetically discharged, and resolved.

Although this distinction is not recognized in conventional psychotherapy, the second form of trauma, trauma by omission, is radically different and requires different approach. It actually involves the opposite problem - lack of positive experiences that are essential for a healthy emotional development. An infant, as well as an older child, has strong primitive needs for instinctual satisfaction and security that pediatricians and child psychiatrists call anaclitic (from the Greek anaklinein meaning to lean upon). These involve the need to be held and experience skin contact, be caressed, comforted, played with, and be the center of human attention.

When these needs are not met it has serious negative consequences for the future of the individual. Many people have a history of emotional deprivation, abandonment, and neglect in infancy and childhood that resulted in serious frustration of the anaclitic needs. Others were born premature and spent their first months of life in an incubator without intimate human contact. The only way to heal this type of trauma is to offer a corrective experience in the form of supportive physical contact in a holotropic state of consciousness. For this approach to be effective, the individual has to be deeply regressed to the infantile stage of development, otherwise the corrective measure would not reach the developmental level on which the trauma occurred. Depending on circumstances and on previous agreement, this physical support can range from simple holding of the hand or touching the forehead to full body contact. Use of nourishing physical contact is a very effective way of healing early emotional trauma.

Carefully selected music is extremely important in holotropic states of consciousness; it has several functions: it mobilizes emotions with repressed memories, brings them to the surface, and facilitates their expression. It helps to open the door into the unconscious, intensifies and deepens the therapeutic process, and provides a meaningful context for the experience. The continuous flow of music creates a carrier wave that helps the breathers move through difficult experiences and impasses, overcome psychological defenses, surrender and let go.

Breathwork music has to be of good quality, with a significant proportion of spiritual, ritual, and aboriginal music – that responds deeply to what anthropologists refer to the “primal mind:” it responds to any race, gender, history and culture. At the beginning the music is opening and comforting and becomes activating and engaging. In the middle of the session follows powerful and dramatic “breakthrough music.” Later in the session, the music changes into heart opening, feminine, and finally quiet and meditative. At the beginning, the music should be opening and comforting,  becoming more active and engaging in the middle of the session, and later on more powerful and dramatic "breakthrough music". Ideally, the music should continue as long as the breathers are still in process. The beautiful meditative music at the end is an important part of the healing process and should not be abruptly cut off. No synthetic or techno music, these genres should be avoided should not be used in holotropic states of consciousness.

Sharing groups are an important part of the experience; there should be enough time for each breather to share. It is essential that the breathers remain the authority concerning their own experience; there should not be interpreting of the experience, but respectful asking of additional questions about the experience can help to amplify the experience. It is recommended to have a good Jungian dictionary of symbols.

Follow-up and complementary techniques can enrich the sessions - therapy with a good facilitator, writing the content of the experience, additional painting of mandalas, analyzing dreams, expressive dancing or painting, meditation and movement meditation, acupuncture, physical exercise, jogging, swimming, and the like. We can also utilize other modalities which can deepen the experience, such as Sandplay (Dora Kalff), Gestalt therapy (Fritz Perls), Psychodrama (Jacob Moreno), MDMR (Francine Shapiro), and Family constellation (Bert Hellinger).

Stanislav Grof, January 2020