Physiological Mechanisms Involved in Holotropic Breathwork

CHAPTER NINE
Physiological Mechanisms Involved
in Holotropic Breathwork
In view of the powerful effect Holotropic Breathwork has on the psyche,
it is interesting to consider the physiological and biochemical mechanisms
that might be involved in this process. Another relevant topic related to the
physiology of Holotropic Breathwork is the concept of the "hyperventila
tion syndrome" and "carpopedal spasms" described in medical handbooks as
mandatory reactions to faster breathing. This myth of respiratory physiology
has been disproved by daily observations from Holotropic Breathwork ses
sions and other methods using accelerated breathing. Self-exploration using
holotropic states has also brought some new insights into the nature and
psychodynamics of psychosomatic disorders, a subject of many conflicting
theories in academic circles.
1. Biochemical and physiological changes
Many people assume that when we breathe faster, we simply bring more oxygen
into the body and into the brain; they believe that this is the mechanism
responsible for the experiences in Holotropic Breathwork sessions. But--due
to intricate homeostatic mechanisms operating in the human body--the
situation is actually much more complicated. It is true that faster breathing
brings more air and thus oxygen into the lungs, but it also eliminates carbon
dioxide (CO2). Since CO2 is acidic, reducing its content in blood increases
the alkalinity of the blood, more specifically the alkalinity/acidity index
called pH. The blood pigment hemoglobin binds more oxygen in an acidic
milieu and less in an alkaline milieu. This is a compensatory homeostatic
mechanism that guarantees effective oxygen supply during physical exertion,

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which is typically associated with increased production of acidic metabolic
products. The alkalosis during rapid breathing thus leads to reduced oxygen
transfer to the tissues. This in turn triggers a homeostatic mechanism that
works in the opposite direction: the kidneys excrete urine that is more
alkaline to compensate for this change.
The situation is further complicated by the fact that certain areas in the
body, including he brain, can respond to faster breathing by vasoconstriction,
which naturally causes a reduction of the oxygen supply. Observations in
Holotropic Breathwork sessions have shown that this is not a mandatory
built-in response of these organs to faster breathing. Where this vasocon
striction occurs and how intense it will be reflects the involvement of these
organs in traumatic situations in the individual's past. It tends to disappear
when a person relives and works through the memory of these events. The
physiological changes also depend on the type of breathing involved. Deep
breathing leads to a more complete exchange of gasses in the lungs, while
shallow breathing leaves a significant part of the gases in the "dead space,"
so that less oxygen reaches the pulmonary capillaries and less carbon dioxide
(CO2) is expelled from the lungs.
As we have seen, the physiological mechanisms activated by faster
breathing are quite complex and it is not easy to evaluate the overall bio
chemical situation in an individual case without a battery of specific labora
tory examinations. However, if we take all the aforementioned physiological
mechanisms into consideration, the situation of people during Holotropic
Breathwork very likely resembles that of being in high mountains, where
there is less oxygen and the CO level is decreased by compensatory faster
2
breathing. The cerebral cortex, being the youngest part of the brain from
an evolutionary point of view, is generally more sensitive to a variety of
influences (such as alcohol and anoxia) than the older parts of the brain.
This situation would thus cause inhibition of the cortical functions and
intensified activity in the archaic parts of the brain, making the unconscious
processes more available.
Many individuals, as well as entire cultures, that live in extreme alti
tudes are known for their advanced spirituality. Examples are the yogis
in the Himalayas, the Tibetan Buddhists, and the Peruvian Incas. It is
therefore tempting to attribute their advanced spirituality to the fact that,
in an atmosphere with lower content of oxygen, they have easier access to
holotropic experiences. However, we again have to take into consideration
the intricate homeostatic mechanisms operating in the human body. While
short-term exposure to high altitude might be comparable to Holotropic
Breathwork, an extended stay in high elevations triggers physiological adap
tations, such as increased production of red blood cells. The acute situation

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during Holotropic Breathwork might, therefore, not he directly comparable
to an extended stay in high mountains.
In any case, there is a long way from the description of the physiological
changes in the brain to the extremely rich array of phenomena that Holo
tropic Breathwork induces, such as authentic experiential identification with
animals, archetypal visions, or past life memories. This situation is similar
to the problem of explaining the psychological effects of LSD and other
psychedelics. The fact that both of these methods can induce transpersonal
experiences in which there is access to accurate new information about the
universe through extrasensory channels shows that the matrices for these
experiences are not contained in the brain.
Aldous Huxley, after having experienced psychedelic states with mes
caline and LSD-25, came to the conclusion that our brain cannot possibly
be the source of these experiences. He suggested that it functions more
like a reducing valve that shields us from an infinitely larger cosmic input.
The concepts, such as "memory without a material substrate" (von Foerster
1965), Sheldrake's "morphogenetic fields" (Sheldrake 1981), and Laszlo's "psi
or Akashic field" (Lasilo 1993, 2004) bring important support for Huxley's
idea and make it increasingly plausible.
2. Holotropic Breathwork and the "hyperventilation syndrome"
As we have shown earlier, therapeutic approaches and spiritual practices
using various breathing techniques for inducing holotropic states of con
sciousness represent effective methods of treating psychosomatic disorders.
However, they also bring important new insights regarding the response
of the human body to an increased rate of breathing. They have amassed
impressive empirical evidence correcting the deeply ingrained misconcep
tion concerning faster breathing found in traditional medical handbooks on
respiratory physiology.
More specifically, they have dispelled the persistent myth passed among cli
nicians from generation to generation asserting that the mandatory physiological
reaction to rapid breathing is the "hyperventilation syndrome." This syndrome
is described as a stereotypical pattern of physiological responses, involving
tetany of the hands and feet (carpopedal spasms), coldness of the extremities,
and sweating. This is accompanied by certain neuromuscular changes that can
be objectively detected. Here belong Chvostek's reflex (hyperexciability of
facial muscles) and Trousseau's reflex (spasm of muscles in the forearm and
hand after compression of the upper arm artery with a tourniquet). Typical
emotional reaction allegedly involves anxiety and agitation.

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The relationship between hyperventilation and various medical conditions
Robert Fried, one of the most dedicated researchers of the relationship
between breathing and various medical conditions, wrote a book called The
Hyperventilation Syndrome (Fried 1982). According to him, physicians should
pay much more attention to breathing. Stressed and distressed human beings
hyperventilate; hyperventilation can be found in 50 to 70 percent of people
with medical complaints, and in 90 percent of cases the development of
hypertension is preceded by disruptions of breathing. Faulty breathing can be
seen as a common etiological pathway for many problems. It is well known
in academic circles that hyperventilation is closely related to anxiety, but
there is no agreement as to whether hyperventilation causes anxiety or vice
versa; it is clearly a "chicken-or-egg" problem.
Anxiety-prone people hyperventilate when they ate exposed to stress;
panic sufferers often have a respiratory alkalosis. According to G. J. Goldberg,
"hyperventilation is one aspect of the anxiety reaction and it causes psycho
somatic symptoms" (Goldberg 1958). Hyperventilation plays an important
role in all anxiety disorders and possibly emotional disorders in general. In
the first half of the twentieth century, spontaneous hyperventilation was often
observed in hysterical patients. R. V. Christie called hysteria and anxiety
neurosis "respiratory neuroses" (Christie 1935). Spontaneous episodes of
hyperventilation occur in about 10 to 15 percent of the general population
and with much greater frequency in psychiatric patients, particularly those
who suffer from hysteria. The usual approach to episodes of spontaneous
hyperventilation is to administer intravenous calcium to increase the level
of ionized calcium in blood, give patients an injection of Librium or Valium
to calm them down, and place a paper bag over their faces to keep CO, in
their system and to reduce alkalosis.
These observations disprove the original idea expressed in W. B. Cannon's
book, The Wisdom of the Body. Cannon believed that breathing, being so
fundamental to life, is so strongly protected by homeostatic mechanisms
that it can take care of itself (Cannon 1932), It has since become clear
that, in spite of its apparent automaticity, breathing is not excluded from
the influence of many pathophysiological and psychopathological processes
that can interfere with it. In turn, abnormalities of the breathing patterns
can cause physiological and psychological problems,
Medical literature on the hyperventilation syndrome lacks clarity and is
full of contusion and controversy. Fried, who conducted systematic research
of the effects of rapid breathing, pointed out that the stereotypical reaction
described in the handbooks of respiratory physiology is in sharp contrast
with clinical reports about the unusually broad range of phenomena that
can occur in hyperventilating persons. These vary widely from person to

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person and also from episode to episode (Fried 1982). The range of possible
reactions to faster breathing is so great that hyperventilating patients have
been called "clients with the fat folder syndrome" (Lum 1987), because they
make frequent fruitless visits to physicians, Traditionally, hyperventilation is
seen as a symptom of some other disorder, rather than a factor responsible
for generating symptoms. Clinicians usually do not believe that something
as simple as hyperventilation can cause such intense and variegated changes;
they tend to look for other causes.
According to S. R. Huey arid L. Sechrest, who studied 150 hyperven
tilating persons, hyperventilation was able to mimic in otherwise healthy
individuals a large array of medical conditions so successfully that these
people were misdiagnosed and received a long list of false diagnoses (Huey
and Sechrest 1981). These included diseases of the cardiovascular system,
respiratory system, gastrointestinal system, musculoskeletal system, nervous
system, endocrine system, immune system, and of the skin. Some of these
individuals also received psychiatric diagnoses. This brings medical under
standing closer to the observations from Holotropic Breathwork, but is still
far from the recognition that the "hyperventilation syndrome," rather than
being a pathological reaction requiring symptomatic suppression, represents
a great therapeutic opportunity.
Hyperventilation in psychiatric patients and observations from
Holotropic Breathwork
As we mentioned earlier, spontaneous episodes of hyperventilation often
occur in neurotics, particularly hysterical patients. Freud described in several
case histories the extreme feelings of suffocation and marked respiratory dis
tress occurring in panic attacks. That was the reason why he for some time
entertained the idea that the birth trauma, being associated with suffocation,
could be the source and prototype of all future anxieties (Freud 1953), Klein,
Zitrin, and Woerner called the feelings of suffocation that accompany panic
attacks "false suffocation alarm" (Klein, Zitrin, and Woerner 1978). This
panic cannot be alleviated by breathing oxygen with 5 percent of carbon
dioxide that should prevent any respiratory alkalosis.
It has been noted that in psychiatric patients the symptoms induced
by rapid breathing are more intense, colorful, and variegated. Patients
with abnormalities of the central nervous system show a greater diversity
of symptoms and persons suffering from pain have a lower threshold for
hyperventilation. In psychiatric patients, hyperventilation tends to produce
what has been described as an astonishing array of sensory, emotional, and
psychosomatic symptoms. According to Fried, this long list includes dizzi
ness, faintness, apprehension, depression, anxiety, panic, phobia, chest pain,

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muscle spasms, various physical sensations, headaches, tremors, twitches,
blurred vision, nausea, vomiting, "lump in the throat," and many others
(Fried 1982). These symptoms are not explainable in traditional medical
terms and can mimic a variety of organic diseases. Fried also found that the
mean breathing rate of control groups is lower (twelve breaths per minute)
than of psychiatric patients (seventeen breaths per minute) and seizure
patients (seventeen breaths per minute).
Hyperventilation tends to aggravate many symptoms and disorders, such
as Raynaud's disease, migraine headache, angina pectoris, and the panic anxi
ety syndrome. Fried therefore suggested an approach to these disorders that
teaches these clients slower breathing exercises as a "therapeutic measure."
This is exactly opposite to the practice of Holotropic Breathwork based
on the observation that the continuation of hyperventilation can resolve
emotional and psychosomatic problems by accentuating them temporarily,
exteriorizing them, and bringing them into consciousness for processing.
The practitioners of Holotropic Breathwork have a unique opportunity
to study the psychological and somatic effects of rapid breathing, since
they observe them regularly in statu nascendi as these emerge in the process
of their clients. In Holotropic Breathwork workshops and training, only a
small portion of the participants experience a response that the handbooks
of respiratory physiology describe as typical and in a sense mandatory (car
popedal spasms, coldness of the feet, etc.) The observations from this work
show that faster breathing produces an extraordinarily rich spectrum of
emotional and psychosomatic symptoms. They thus support Fried's critique
of a simplistic understanding of the hyperventilation syndrome.
For Fried, who views this amazing array of symptoms triggered by faster
breathing from the point of view of traditional medicine, "it remains a
mystery how such a simple physiological function as breathing can produce
such a broad spectrum of symptoms." The practice of Holotropic Breathwork
provides deep insights into the dynamics of the hyperventilation syndrome
and offers a simple solution for this "mystery." It shows that the richness of
the response to faster breathing cannot he understood in simple physiological
terms because it is a complex psychosomatic phenomenon that reflects the
entire psychobiological and even spiritual history of the individual.
The symptoms induced by rapid breathing can appear in all areas of the
body and in all possible combinations. The systematic study of these reactions
shows that they represent the intensification of preexisting psychosomatic
symptoms or exteriorization of various latent symptoms. The continuation
of accelerated breathing makes it possible to trace these symptoms to their
sources in the unconscious--to memories of traumatic biographical events,
biological birth, prenatal traumas, and even various transpersonal themes
(e.g., phylogenetic memories, past life experiences, and archetypal motifs).

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This is true even for some extreme physical phenomena that can occasion
ally be observed during Holotropic Breathwork, such as seizure-like activity,
apnea, cyanosis, asthmatic attacks, or various dramatic skin manifestations.
These phenomena represent exteriorization of historically determined imprints
that are associated with specific events, such as near drowning episodes, seri
ous accidents, operations, childhood diphtheria, whooping cough, biological
birth, prenatal crises, or past life experiences. As precarious as they might
appear, they are not dangerous if we are working with physically healthy
people, who can tolerate the emotional and physical stress involved in such
reliving. Naturally, it is important to respect the contraindications for deep
experiential work and screen out persons with serious problems, particularly
various cardiovascular disorders.
A surprising but consistent observation from Holotropic Breathwork is
that the symptoms induced by hyperventilation initially increase in inten
sity, but continued breathing brings about their resolution and permanent
disappearance. This fact is in direct conflict with the assumption that the
psychosomatic symptoms are a mandatory physiochemical response to hyper
ventilation. Permanent disappearance of these symptoms after full emergence
of the unconscious material with which they are connected shows that they
are psychodynamic in nature and not simple physiological manifestations.
In our work we see many people who do not develop any tensions during
several hours of intense breathing. This type of reaction increases with the
number of holotropic sessions and eventually becomes a rule rather than
an exception.
Even the vasoconstriction occurring in various parts of the body as
a result of faster breathing is not an invariable and mandatory effect of
hyperventilation. The observations from Holotropic Breathwork show that
bioenergetic blockage in a certain area typically causes vasoconstriction. The
origin of this blockage can be psychological or physical traumas from postnatal
history, the trauma of birth, prenatal crises, or various difficult transpersonal
experiences. Faster breathing tends to bring the unconscious material to the
surface and release this blockage after its temporary intensification. This is
typically followed by the opening of circulation in the afflicted area.
An extreme example is Raynaud's disease, a severe disturbance of
peripheral circulation in the hands associated with feelings of cold and even
trophic changes of the skin (damage to the skin due to lack of oxygen and
of nourishment). We have had the opportunity to work with a number of
persons suffering from this condition, who were able to heal this disorder
by doing Holotropic Breathwork. In their initial holotropic sessions, they
all showed extreme and painful tetany in their hands and forearms. With
continued hyperventilation, these cramps were suddenly released and were
replaced by powerful flow of warm energy through the hands and experience

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of force fields enveloping the hands like giant gloves. After these experiences,
the peripheral circulation remained permanently opened.
As we have already mentioned, the same mechanism can play a criti
cal role in many chronic infections, such as sinusitis, pharyngitis, tonsil
litis, bronchitis, or cystitis, which are traditionally considered to be purely
medical problems. If we succeed in releasing the bioenergetic blockage, the
circulation opens up and these "chronic infections" tend to clear, It is also
conceivable that the same mechanism plays an important role in the genesis
of peptic or duodenal ulcers and ulcerous colitis. The vitality of the gastric
or intestinal mucous membranes that do not have good circulation might be
compromised to such an extent that they cannot protect themselves against
the bacteria implied in this disorder (Helicobacter pylori) and the effects of
hydrochloric acid and digestive enzymes.
These observations show that in many instances diseases are related
to blocked emotional or physical energy and resulting fragmentation, while
healthy functioning is associated with a free flow of energy and wholeness.
This is related to one aspect of the term holotropic, which literally means
"moving toward wholeness" or "aiming for wholeness." These findings are
consistent with the basic principles of Chinese medicine and of homeopa
thy. They are also related to the modem concept of energy medicine. The
representatives of this orientation assert that medicine would become much
more effective if it complemented or in some instances even replaced its
organ-pathological strategy with an approach based on understanding and
use of the bioenergetic dynamics of the body.
"The hyperventilation syndrome": Fact or fiction?
In summary, the experiences and observations from Holotropic Breathwork
show that the traditional concept of the hyperventilation syndrome is obsolete
and has to be revised. The muscular tensions that develop as a result of rapid
breathing do not have to involve the hands and feet, but can occur anywhere in
the body. Their source is the pent-up emotional and physical energy generated
by traumatic events in the breather's history. Continued breathing typically
leads to intensification, culmination, and resolution of such tensions. They
can also be easily removed by emotional and physical abreaction. Repeated
sessions tend to eliminate the occurrence of these tensions. Some people can
breathe faster for several hours without showing any signs of tension; they
actually become progressively more relaxed and ecstatic.
What seems to happen is that faster breathing creates a biochemical
situation in the body that facilitates the emergence of old emotional and
physical tensions associated with unresolved psychological and physical
traumas. The fact that during rapid breathing symptoms surface and become

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manifest is not a pathological phenomenon, as it is traditionally understood.
This situation actually represents a unique opportunity for healing. What
emerges under these circumstances is unconscious material with strong
emotional charge that is most ready for processing, This understanding of
the symptoms of hyperventilation accounts for the enormous inter- and
intra-individual variability of the responses to hyperventilation. That seems
to be analogous to the situation concerning the extraordinary richness and
variability of the experiential content of psychedelic sessions.
In the light of the observations from Holotropic Breathwork, spontane
ous episodes of hyperventilation occurring in psychiatric patients and the
normal population are attempts of the organism to heal itself and should he
supported rather than suppressed. With correct understanding and skillful
guidance, the emergence of symptoms during hyperventilation can result in
the healing of emotional and psychosomatic problems, positive personality
transformation, and consciousness evolution. Conversely, the current practice
of suppressing the symptoms can be seen as interference with an important
spontaneous healing process involving the psyche and the body.

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