By Dr. Adam Abodeely, MD, FACS, FASCRS, MBA

Coral Cove Wellness Resort www.coralcovewellness.com

Breath is life. Every moment, our breathing not only sustains oxygen exchange but also influences our nervous system, emotions, and mental state. Across traditions—from yoga and Buddhism to modern psychotherapy—controlled breathing has been used as a pathway toward healing and transformation. Today, this intentional use of breathing, broadly called breathwork, is gaining widespread attention in wellness and medical communities alike.

Breathwork encompasses a wide variety of practices that deliberately regulate how we breathe in order to affect mental, emotional, and physical health. Whether practiced slowly to activate the parasympathetic nervous system, or more intensely to induce altered states of consciousness, these methods hold promise as safe, accessible tools for enhancing well-being.

What Is Breathwork?

Breathwork refers to a family of techniques that involve conscious control over the rhythm, depth, or pace of breathing. Unlike ordinary, automatic breathing, breathwork is intentional and structured. It can be practiced in clinical settings, wellness retreats, or even at home, often with guidance from trained facilitators.

Some of the most recognized forms include:

• Diaphragmatic Breathing (Belly Breathing): Slow, deep breaths engaging the diaphragm to reduce stress and promote relaxation.
• Coherent or Resonant Breathing: Breathing at a rhythm of about 5–6 breaths per minute, linked to improved heart rate variability (HRV) and resilience.
• Sudarshan Kriya Yoga: A structured series of cyclical breathing patterns shown to reduce symptoms of depression and anxiety.
• Wim Hof Method: Combines rapid breathing cycles with cold exposure and meditation to boost stress tolerance and immune response.
• Holotropic Breathwork (HB): A therapeutic technique using prolonged voluntary hyperventilation, often accompanied by music and bodywork, to evoke altered states of consciousness.

Each protocol differs in intensity, purpose, and application, but all share a core principle: that the way we breathe profoundly shapes how we feel.

Physiological Pathways of Breathwork

Breathwork influences the body through multiple, interconnected mechanisms:

1. Autonomic Nervous System Regulation
   Breath acts as a bridge between voluntary and involuntary functions. Slow, paced breathing enhances vagal tone, increases HRV, and strengthens parasympathetic dominance—the “rest and digest” state associated with relaxation and resilience. Conversely, fast breathing can temporarily stimulate sympathetic arousal, building stress tolerance when practiced safely.
2. Brain and Neurochemistry
   Changes in CO₂ and oxygen balance affect brain metabolism, serotonin synthesis, and oscillatory brain wave activity. Slow breathing synchronizes neural activity across regions, while hyperventilation in Holotropic Breathwork induces transient hypofrontality, a state linked to visionary experiences and emotional release.
3. Emotional and Cognitive Processing
   By heightening interoceptive awareness (the perception of internal bodily states), breathwork fosters mindfulness, emotional regulation, and a shift away from ruminative thought patterns. This aligns with findings that mindfulness-based breathing reduces anxiety, depression, and maladaptive rumination.
4. Stress Hormone Modulation
   Breathwork has been shown to influence cortisol dynamics. Slow breathing lowers baseline cortisol, while fast-paced breathing temporarily raises it but accelerates recovery, similar to exercise-induced stress resilience.
5. Immune and Inflammatory Pathways
   Though still under investigation, some studies suggest that specific breath practices (e.g., Wim Hof Method) can modulate inflammatory cytokines and immune responses, underscoring the breath’s systemic effects.

Evidence Supporting Breathwork

Recent clinical research has begun to validate the therapeutic potential of breathwork:

• A meta-analysis of randomized controlled trials found that breathwork significantly reduced stress, anxiety, and depressive symptoms, with small-to-moderate effect sizes.
• A scoping review confirmed that multiple breathwork interventions show benefit for clinically diagnosed anxiety disorders, supporting their use alongside psychotherapy.
• Holotropic Breathwork, specifically, has demonstrated improvements in self-esteem, death anxiety, and psychiatric symptom reduction in early controlled studies, suggesting its utility as an adjunct to therapy.
• Complementary findings show that yogic and mindfulness-based breathing share similar mechanisms, offering alternative non-pharmacologic approaches to stress and mood regulation.
  

Closing Remarks

Breathwork is more than a wellness trend—it is a scientifically supported practice with deep historical roots and growing clinical validation. From simple diaphragmatic breathing to profound experiences in Holotropic Breathwork, these techniques allow us to access the nervous system, quiet the mind, and restore balance to body and spirit.

As evidence accumulates, breathwork may increasingly serve as a scalable, low-cost adjunct to traditional therapies, empowering individuals to play an active role in their mental and physical health. Ultimately, in rediscovering the power of breath, we reclaim one of the most accessible tools for healing and transformation.

References

• Banushi, Blerida, et al. “Breathwork Interventions for Adults with Clinically Diagnosed Anxiety Disorders: A Scoping Review.” Brain Sciences, vol. 13, no. 2, 2023, p. 256. MDPI, https://doi.org/10.3390/brainsci13020256.
• Fincham, Guy William, et al. “Effect of Breathwork on Stress and Mental Health: A Meta-Analysis of Randomised-Controlled Trials.” Scientific Reports, vol. 13, no. 432, 2023, https://doi.org/10.1038/s41598-022-27247-y.
• Lalande, Lloyd, et al. “Breathwork: An Additional Treatment Option for Depression and Anxiety?” Journal of Contemporary Psychotherapy, vol. 41, no. 3, 2011, pp. 193–200. Springer, https://doi.org/10.1007/s10879-011-9180-6.
• Rhinewine, Joseph P., and Oliver J. Williams. “Holotropic Breathwork: The Potential Role of a Prolonged, Voluntary Hyperventilation Procedure as an Adjunct to Psychotherapy.” The Journal of Alternative and Complementary Medicine, vol. 13, no. 7, 2007, pp. 771–776. Mary Ann Liebert, Inc., https://doi.org/10.1089/acm.2006.6203.