Can Breathwork Help in Treating Trauma?

Breathwork is a powerful therapeutic modality that works on the physical, emotional, psychological and spiritual level (Zimberoff and Hartman 1999). It is a “self-regulated process that connects conscious with unconscious, allowing the individual to work through physiological resistance to emotional processing typically not accessible in traditional talk therapy” (Young et al, 2010; Aideyan et al 2020). Breathwork is considered an ancient practice that has been used widely across cultures for religious and healing purposes (Grof & Grof, 2010). In breathwork, the person deliberately breathes in an altered way. Depending on the type of breathwork, the breathing may be faster-than-normal and/or deeper-than-normal. The breath is done in  a cyclical fashion, otherwise known as a breath pattern, so that there is no pause between exhales and inhales. Many studies refer to the breathing pattern as “conscious connected breathing” (Zimberoff and Hartman 1999).

“Trauma is a psychophysical experience, even when the traumatic event causes no direct bodily harm (Rothschild 2000).” Trauma happens in the body, mind, and from the transpersonal lens, it also occurs in the spirit. When triggered, it interferes with the individual’s ability to distinguish between the past and present. It can also interrupt the brain’s typical processing and functioning (Rothschild 2000). Trauma can manifest in many different symptoms and experiences, but a core feature of trauma is the disintegration of experience whereby the explicit and implicit experiences and memories of an event become disconnected from one another (Rothschild 2000). Many approaches can and should be utilized to treat the symptoms and possibly the underlying causes of trauma. 

One way that breathwork can be supportive in the treatment of trauma is by increasing the nervous system’s parasympathetic response. Some types of breathwork are known to balance the sympathetic and parasympathetic response (Zimberoff and Hartman 1999). While the parasympathetic nervous system response is activated in states of rest, relaxation, and pleasure, the sympathetic nervous system is activated during states of stress, both positive and negative (Rothschild). For individuals with trauma, the autonomic nervous system can trigger the fight or flight mode of hyperarousal. Alternatively, traumatic stress can also trigger the freeze response. Part of trauma therapy requires resourcing clients so that they are able to stay in the optimal arousal state. “Breathwork offers a practical tool for normalizing the dysregulation one endures in mind and body when chronically stressed…[It] strengthens emotion regulation via management of physiological states” (Aideyan et al 2020). A regular breathwork practice can help re-regulate the nervous system which can allow clients to build up their window of tolerance and potentially process and integrate traumatic experiences.

The different types of breathwork can be understood as being on spectrum. On one end, there is “breathing to relieve stress and induce calm” and on the other end is “breathing to prompt a therapeutic catharsis and emotional release” (Zimberoff and Hartman 1999). It is up to the therapist to use discretion to provide the best care, taking into consideration the clients’ level of stability, safety, and readiness. Deep Relation Breathing (DRB), as defined by Aideyan in A Practitioner’s Guide to Breathwork in Clinical Mental Health Counseling involves inhaling deeply and expanding the diaphragm, while steadily breathing in a fair amount of air, followed by a slow exhale (Aideyan et al 2020). The studies show that “parasympathetic activity increases while sympathetic activity decreases during DRB, evidenced by decreased respiratory rate and oxygen consumption, decreased heart rate (Chang et al., 2013; Kaushik, Kaushik, Mahajan, & Rajesh, 2006), and lowered blood pressure” (Howorka et al., 2013; Kaushik et al., 2006; Mourya, Mahajan, Singh, & Jain, Journal of Mental Health Counseling 81 2009; Aideyan et al 2020). The culmination of these physiological activations is called the “relaxation response” and its therapeutic effects are attributed to its ability to regulate the autonomic nervous system (Aideyan et al 2020). 

Yogic breathing induces the relaxation response and is associated with increased parasympathetic activity. It is generally theorized that the positive effects of YB are also linked to vagal nerve stimulation (Jerath et al., 2006; Zope & Zope, 2013; Aideyan et al 2020). Yogic Breathing (YB) has been shown to be useful in working with depression. YB has also shown great success across a diverse population of clients. It can be used in conjunction with other therapeutic modalities or as a stand-alone intervention. This study concluded that “consistent positive outcomes across several different studies and participant samples confirm a substantial evidence-basis for YB in clinical mental health counseling” (Aideyan et al 2020). As the study points out, “traditionally, the aims in yoga are to connect breath to movement, which can be a highly effective healing process that supports the body-brain connection (Brown & Gerbarg, 2009; Aideyan et al 2020). This can also aid in sensorymotor function.

Due to the lack of diversity in the field of Psychotherapy, breathwork has been removed from its various cultural contexts and analyzed through Western lens which has led to mostly limited, outdated, and highly generalized research on its uses. More research is needed on the applications and uses of breathwork within proper cultural contexts. However, existing research does indicate its efficacy in treating anxiety, depression, and trauma. Different types of breathwork can be utilized in various stages of Trauma Treatment to support Phase I resourcing, Phase II memory, processing and Phase III integration. Breathwork can support positive outcomes in each stage of trauma treatment as long as appropriate and ethical discernment is utilized. In addition to or alongside trauma treatment, Holotropic Breathwork is correlated with having transpersonal and spiritual experiences which can aid in self-exploration, spiritual, and personal development and healing (Eyerman 2013). 

Aideyan, B., Martin, G. C., & Beeson, E. T. (2020). A practitioner’s guide to breathwork in clinical mental health counseling. Journal of Mental Health Counseling, 42(1), 78-94.

Eyerman, J. A. M. E. S. (2013). A clinical report of Holotropic Breathwork in 11,000 psychiatric inpatients in a community hospital setting. Multidisciplinary Association for Psychedelic Studies Bulletin Special Edition, 23(1), 24-27.

Grof, S., & Grof, C. (2010). Holotropic breathwork. Albany, NY: State University of New York.

Ogden, P., Minton, K., & Pain, C. (2005) Trauma and The Body: A Sensorimotor Approach to Psychotherapy. New York: W.W. Norton and company, Inc.

Rothschild, Babette. (2000). The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment. New York: W.W. Norton & company, Inc.

Zimberoff, D., & Hartman, D. (1999). Breathwork: Exploring the frontier of ‘being’and ‘doing’. Journal of Heart-Centered Therapies, 2(2), 3-52.