In the realm of conscious, connected breathwork, a mantra echoes: ‘It is safe to breathe, it is safe to feel.’ This gentle reminder, often shared by facilitators during a breathwork session, guides participants towards a deep and transformative experience. What you won’t hear many of us saying, is ‘hold your breath’.
Unfortunately, there have been a couple instances in Unity breathwork sessions, where individuals intentionally engaged in breath-holding at the session’s conclusion, and what happened was shocking! I couldn’t find any direct information or explanation for it online at the time. So I did some digging and what I unearthed is pivotal information that should be on the radar of every breather and facilitator. Join me as we explore the depths of this revelation!
Breath Holding Dangers: My Personal Experience as a Breathwork Facilitator
First a bit of background info. I am a Breathwork facilitator, Breathwork teacher , and wellness writer. A few years ago during a group Breathwork session, a breather had what looked like a seizure at the end of the 60-minute class when I cued everyone to come back to a normal breath. His complexion turned a shade of blue, his entire body tensed, eyes glazed over, spittle gathered around his mouth, and he experienced temporary amnesia. Upon regaining consciousness, he confessed to regularly practicing Wim Hof breathing and deliberately holding his breath at the session’s conclusion—this being the last memory before the episode. I spent about 90 additional minutes sitting with him, and upon departure, he felt well, albeit slightly fatigued and disconnected.
A parallel incident unfolded weeks later with another participant. Despite my advice to resume breathing through his mouth at the sessions end, he chose to hold his breath, thinking it would be a pleasant experience. As I was overseeing a group of ten, I did not notice this happening immediately, and when I did, I rushed to his side, only to witness a similar seizure-like episode lasting about a minute.
As a dedicated researcher, I meticulously combed through online resources in search of answers, only to be genuinely surprised by the scarcity of information on the subject. While the rarity of such occurrences is reassuring, the fact that it transpired in my Breathwork classes twice, meant that surely it’s happened to other breathers and other facilitators have witnessed it. Recognizing the importance of unraveling the mystery, I felt compelled to investigate the root causes and, equally importantly, to elevate awareness regarding the potential risks associated with intentionally holding one’s breath during conscious, connected Breathwork sessions.
Conscious Connected Breathwork is Safe, Unmonitored Breath Holding in Breathwork is Playing with Fire
Before apprehensions about conscious, connected breathwork arise or concerns about its safety take root, please pay attention! The conscious, connected breathwork facilitated by programs such as Unity Breathwork, Breathing Space, AoB, Holotropic, and various other reputable Breathwork schools is not inherently associated with seizures. Rather, the incidents in question were directly linked to participants consciously choosing to hold their breath. It’s important to note here that I am not a medical professional, and I cannot definitively classify these episodes as seizures. However, my research unveiled a plausible connection: the participants’ intentional breath-holding likely resulted in significant hypoxia (oxygen deficiency in the tissue), potentially triggering a seizure.[1]
The Physiological Explanation for Breath Holding Dangers
Conscious, connected breathwork (CCB) involves mild hyperventilation, elevating pH levels and reducing carbon dioxide (CO2) levels. While this is generally not problematic or harmful, it’s crucial to understand that CO2 serves as a vital trigger signaling the need to breathe.[2] When individuals intentionally hold their breath after CCB, they can hold their breath significantly longer then they normally could. However, the absence of the CO2 alarm bell means they may not be alerted to diminishing oxygen levels. This can lead to severe hypoxia, a condition where the body is deprived of sufficient oxygen at the tissue level.[3] The consequences may range from a temporary hypoxic blackout to loss of motor control (LMC) and, in severe cases, a seizure, catching the individual off guard as the alarm system is effectively disarmed.[4],[5]
Important Aside: Seizures Rarely Cause Lasting Harm
It’s crucial to highlight that, despite their alarming appearance, seizures, as per information from the Center for Disease Control (CDC), typically do not necessitate immediate medical intervention or cause lasting harm—especially when they occur while the individual is already lying down in a secure environment. Surprisingly, almost 1 in 10 people will experience a seizure at some point in their lives.[11] Seeking medical attention becomes essential only under specific circumstances: if a seizure persists for more than 5 minutes, if the person encounters difficulty breathing or waking after the episode, if a second seizure occurs shortly after the first, or if the individual has underlying health conditions such as heart disease, diabetes, or is pregnant.[12]
With Connected Breathwork, We Are Lowering Our Oxygen Levels, Even Without Breath Holds
There is a common misbelief that we are raising oxygen levels during conscious, connected breathing, because we are breathing more. However, the opposite is true. Although you are breathing more during CCB, you are actually reducing the available oxygen levels in the tissues and organs because of something called the Bohr effect. This effect pertains to the fact that the haemoglobin in the blood holds onto oxygen more tightly when CO2 levels drop.
During a breathwork we are blowing off more C02 than usual, so even though there is oxygen in the blood, when you breathe more, less of the oxygen is being released into the tissues and organs. The slightly lower oxygen levels is hypothesized to lead to the release of the psychedelic spirit molecule DMT during breathwork, and account for many of breathworks beneficial effects. And it is completely, safe so long as you keep breathing. However, if you purposefully hold your breath, it may put your at risk for hypoxia.
Listen up Wim Hof Followers
Both of my breathers that experienced those incidents were physically healthy men, who also practiced Wim Hof, and admitted to holding their breath purposefully immediately prior. I find it hard to dismiss this as mere coincidence. While I hold immense respect for Wim Hof’s contributions to making Breathwork mainstream and appreciate his research and teachings, it’s crucial to acknowledge that his approach is achievement-oriented. Unfortunately, this emphasis on accomplishment can sometimes encourage an ego-driven or forceful approach to Breathwork, where individuals may push themselves beyond their limits and neglect the body’s signals. And in my research for this article, the only instances of seizures reported during Breathwork were linked to Wim Hof sessions. For reference, there are videos documenting these occurrences: Video 1 and Video 2.
During these sessions, the breathers were engaging in deep and forceful breathing. When striving to give 200% effort instead of attuning to the body’s messages, there’s a risk of unnecessarily lowering CO2 levels. As mentioned earlier, CO2 serves as the body’s alarm bell to breathe. Additionally, the Wim Hof method teaches practitioners to resist the urge to breathe and embrace discomfort, potentially leading one to overlook or dismiss crucial signals prompting the need to breathe. So if the thought arises during a conscious, connected breathwork (CCB) practice to hold your breath, I strongly advise against succumbing to that urge!
Intermittent Breath Holding With Supervision Is Likely Safe
There are some Breathwork schools that purposefully cue breath holds throughout their sessions. Again, I am not a doctor, however, the trigger for seizures appears to be the notably low CO2 levels and consequently, lower oxygen levels due to the Bohr effect that occurs from a full-length Breathwork session. Given this fact, it stands to reason that intermittent breath holds are likely safe. This is because every time you hold your breath you rebalance the body’s chemistry and as a result, you raise the CO2 and oxygen. If the breath holding is also being led by a practitioner who counts the breath hold, does not extend it for too long, and the students follow the instructions and begin to breathe on cue, then this should minimize the risk of hypoxia. Holding the inhale may also help to lower the risk versus holding the exhale because when you hold the inhale you are introducing more oxygen into the body.
Conscious Connected Breathwork is Not About Forcing, It’s About Allowing
In Breathwork we are not forcing the breath or pushing our bodies beyond their capabilities. Our approach involves taking full-body breaths, ensuring a seamless connection between inhales and exhales, allowing space for whatever needs to surface—be it sensations, emotions, or sounds. This breathing technique is generally safe, provided you do not have any underlying medical conditions. If you have preexisting health concerns, it is advisable to consult with your healthcare provider before participating in a Breathwork session.
It’s worth emphasizing that seasoned conscious, connected Breathwork facilitators often advocate for a passive and non-forceful exhale. This recommendation serves two key purposes: first, it aligns with our intention to allow rather than force any experiences to emerge; and second, it helps prevent excessive drops in CO2 levels. Breathing out more than you breathe in can lead to a significant reduction in CO2, and maintaining a balance is crucial for a safe and effective Breathwork practice.
Safety Guidelines for Breathwork Facilitators:
- Pre-session Inquiry:
- Begin by asking participants if they engage in practices like Wim Hof or free diving.
- If affirmative, stress the importance of continuous breathing during the session to prevent missing emergency signals, given their enhanced breath-holding tolerance.
- Active Monitoring:
- Vigilantly observe participants to ensure consistent breathing throughout the session.
- At times, participants may unintentionally cease breathing during the session, often encountering a moment of serenity and interconnectedness. However, this natural occurrence markedly contrasts with the deliberate choice to withhold breath. Trust your intuitive perception, and if you sense any constriction or apprehension, gently guide them to reconnect with their breath. Employ grounding touch if needed.
- Notably, both instances of breath cessation transpired towards the session’s conclusion, precisely when I prompted participants to resume regular breathing. It’s crucial to exercise heightened vigilance during this phase, ensuring every individual in the group is actively breathing and has seamlessly returned to normal nasal respiration.
- Hypoxia Awareness:
- Be alert for signs of hypoxia (low tissue oxygen levels), such as a bluish tint in the skin, fingernails, or lips.
- Promptly intervene if hypoxia is detected, encouraging immediate breathing. Ask your participant to open their eyes and establishing eye contact to guide participants in syncing with your breath. You can also keep a spray bottle with a essential oil mixed in with water, and if a participant does not respond to your cues to resume breathing or top open their eyes, you can spritz them with it.
- Seizure Recognition:
- Familiarize yourself with potential seizure indicators, including jerking movements, body stiffness, glazed eyes, spit in the mouth corners, staring spells, or rapid blinking.
- Promptly identify and respond to signs like confusion, loss of consciousness, drooling, foaming, or unusual breathing.
- Seizure Management:
- If a seizure occurs, maintain a calm presence by the participant’s side.
- Clear the surroundings, remove glasses if worn, and gently roll the person onto their side.
- Reassure them verbally, emphasizing safety and the importance of breathing until the seizure concludes.
- After the seizure, ensure the person is seated in a secure location, withholding water or food until full alertness is regained.
- Emergency Response Criteria:
- Understand that seizures typically resolve on their own but be prepared to call 911 if the seizure exceeds 5 minutes, breathing difficulties persist, or a second seizure quickly follows.
- Immediate medical assistance is also warranted if the person has underlying health conditions.
- Post-Seizure Care:
- Allocate extra time post-seizure to guarantee full grounding before allowing the participant to leave.
- Avoid offering water or food until the participant is fully alert.
- Engage in a discussion to explore the incident, emphasizing the risks of breath-holding and fostering understanding to prevent recurrence.
- Rejoining the Session After a Seizure:
- If someone has a seizure in you class and wants to join again, this is a decision you should not make lightly. Both of my participants wanted to come back, however, I did not feel it was safe for them or the other members of the group. I recommend you listen to your intuition and exercise caution when deciding whether a participant can rejoin the session after a seizure.
- Suggest a medical consultation, especially if the individual expresses a desire to continue Breathwork.
- If deemed safe, recommend private sessions (as opposed to groups), with clear guidelines against breath-holding.
Closing Thoughts On Breath Holding Dangers During Breathwork
In both instances, I found myself remarkably composed, maintaining a deep inner assurance that all would be well. I attribute this composure to the profound emphasis on the inner journey and the cultivation of a connection to one’s felt sense (body intuition) fostered by Make Some Breathing Space and AOB in their training programs. This focus allowed me to rely on my intuition to guide me in providing optimal support during and after these experiences. Both individuals emerged from the sessions not only healthy but also feeling secure and well-supported. The training from both programs has equipped me to navigate various situations with ease and grace, for which I am profoundly grateful!
This underscores the significance of caution when considering schools that offer a brief, intensive breathwork training over a week or weekend. While one can quickly grasp the technique, the ability to safely and authentically support others in their deep inner journeys requires a lot of time, as well as a personal exploration of these realms. Breathwork delves into profound work, addressing trauma, grief, and pain, where a myriad of emotional and physical experiences can surface. Adequate training is paramount to effectively handle the complexities that may arise during these deep and transformative processes and to keep the participants safe.
If you are considering training to become a facilitator and would like to train with me and graduate with an international facilitator certificate through Make Some Breathing Space, please reach out to me.
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Breath Holding Dangers in Breathwork Citations:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374628/
[2] https://journals.physiology.org/doi/full/10.1152/advan.00030.2015
[3] https://link.springer.com/chapter/10.1007/978-94-017-1828-8_1
[4] https://www.researchgate.net/publication/302442886_Hypoxic_Blackout_Diagnosis_Risks_and_Prevention
[5] https://wexnermedical.osu.edu/blog/what-happens-when-you-hold-your-breath
[6] https://pubmed.ncbi.nlm.nih.gov/11313215/
[7] https://pubmed.ncbi.nlm.nih.gov/11313215/
[8] https://clinicalgate.com/breath-holding-spells-and-reflex-anoxic-seizures/
[9] https://pubmed.ncbi.nlm.nih.gov/17024640/
[10] https://www.researchgate.net/publication/302442886_Hypoxic_Blackout_Diagnosis_Risks_and_Prevention
[11] https://www.cdc.gov/epilepsy/about/first-aid.htm
[12] https://www.cdc.gov/epilepsy/about/first-aid.htm
[13] https://www.cdc.gov/epilepsy/about/first-aid.htm