Hyperventilation – Good, Bad or Insignificant

by Gunnel Minett

Hyperventilation is one of the most misunderstood, under-diagnosed, and frequently overlooked illnesses in medicine and psychiatry.
Prof. H.E. Walker

Hyperventilation has always been an important part of both Rebirthing and Holotropic Breathwork. Still it is not clear what role it plays. Is it good or is it bad? Is it essential for the healing process or is it to be avoided? There are arguments both for and against.

What is hyperventilation?

Part of the confusion around the role of hyperventilation in breathwork is that it lacks a clear definition. According to medical experts, Hyperventilation, or the Hyperventilation Syndrome (HVS), is usually defined as a form of ‘overbreathing’ i.e. breathing more than is necessary to meet the body’s requirements. HVS can be triggered by rapid and/or shallow breathing (high in the chest), but paradoxically, it often leads to shortness of breath, panic attacks and/or cramps in the body. Most medical definitions point to the cause being that the inhale exceeds metabolic demands. But the truth of the matter is that HVS has defied precise definition and explanation of the underlying factor/s for the past 100 years.

It is also important to distinguish between two types of hyperventilation; Acute and chronic hyperventilation. There is no medical evidence that either form of hyperventilation has any positive effects on body and/or psyche. Both forms are known to cause short and long term damage. Acute hyperventilation only constitutes around 1 percent of all hyperventilation cases and is the easiest to detect and treat. It is usually triggered by a sudden increase in stress or anxiety and/or intensified breathing. A common cure is believed to be to breathe into a paper bag or other type of confined space to help reset the carbon dioxide imbalance in the blood as quickly as possible (by breathing carbon dioxide rich air). This is however not to be recommended since it may lead to insufficient oxygen intake. Medication and/or relaxation methods are preferred methods since they offer less risk of side effects. Chronic hyperventilation is difficult to detect and is commonly misdiagnosed. It means that a person is constantly breathing too little to keep the body healthy. The underlying mechanisms are usually unknown, with a number of suggested causes including stress, diet and lifestyle. Over time chronic HVS may lead to a number of physical symptoms such as high blood pressure, hypertension, infections, digestive problems, depression, sexual disorders, sleep disorders, tiredness and overall low performance, that often are regarded simply as age related illnesses.

Hyperventilation in breathwork

Acute hyperventilation is a common feature in breathwork sessions. The effect is often tetany or cramps and muscular spasms with intense pain in both muscles and joints. Because it can cause a substantial amount of pain and be a very negative experience for the client many breathworkers question if it actually is beneficial and to be encouraged, or whether it is negative and is to be avoided. Not just because of the physical pain involved but considering any negative psychological effects it may have. As yet there is no real answer to this question. Although there is clear medical evidence that tetany can be very harmful to the body and no evidence of any positive effects of hyperventilation, the debate for or against is mainly focused on the psychological effects.

Because Rebirthing clearly focuses on guiding the breathing, the discussion around HVS among Rebirthers is somewhat different than in Holotropic Breathwork. During the earlier years of Rebirthing, hyperventilation played a central role and was seen as an essential part of the healing process. Today opinions cover the whole spectrum from good to bad. Many supporters of hyperventilation follow Orr/Ray’s theoretical framework, whereas the opponents tend to come from schools that have developed their own theoretical framework (in particular in Europe).

Hyperventilation is bad

According to Swiss-based breathworker Joy Manné hyperventilation is bad for the client. She argues that: “Hyperventilation rapes the unconscious. It forces
into consciousness painful experiences or altered states of consciousness that the client may not be ready to integrate.” According to her tetany also plays a positive role. “The psychological function of tetany is to prevent material that cannot be integrated from coming up from the unconscious and overwhelming the client: the pain that tetany produces takes all the attention available. Manné even goes as far as to link tetany to the breathwork practitioner: “Tetany also prevents clients from having experiences their Rebirther cannot cope with: some clients stop having tetany when they change their Rebirther.” Her conclusion is: “When there is a good foundation which allows for the integration of painful events, tetany does not happen, even during the strongest connected breathing rhythms.” (Soul Therapy, pp167-168, North Atlantic Books, 1997)

Hyperventilation can be useful

According to Austrian breathworker Wilfried Ehrmann hyperventilation can be useful and lead to an important opening or insight for the client. In his view it has a central role in breathwork and all breathwork practitioners should therefore learn to handle tetany symptoms. (Handbuch der Atem Therapie, Param 2004)

Hyperventilation is good

Within Holotropic Breathwork the attitude to hyperventilation is mainly favourable. According to Grof: “The psychosomatic response to faster breathing, the hyperventilation syndrome, is considered a pathological condition, rather than what it really is, a process that has an enormous healing potential.” (Psychology of the Future, lessons from modern consciousness research, p 185. Albany, USA: State University of New York Press, 2000.

Is it really hyperventilation?

Grof, as well as many other breathworkers, also makes the very important observation that although hyperventilation in a breathwork session has many similarities with acute HVS, there are also important differences. By now it is well establish that it is possible to breathe faster and more intensively for hours without this leading to the classical symptoms for hyperventilation. Instead it may result in increased relaxation or mystical experiences. Even with signs of cramps in hands and feet, continued intensive breathing does not necessarily result in an intensification of the cramps. Instead there seems to be a self-regulatory system in function which ‘typically reaches a climactic culmination followed by profound relaxation.’ (Ibid) Over time the tensions can move between various parts of the body as their intensity diminishes. The pain caused by the cramps often coincides with a release of painful memories and can lead to powerful insights. The pattern of this sequence has a certain resemblance to a sexual orgasm.

The first western psychotherapist to study this phenomenon was Wilhelm Reich. He concluded that the body energy that could be intensified through breathwork was closely linked with the sexual drive and named it orgone energy (from the words organism and orgasm). Orgone energy, he argued, is present everywhere in the universe. He saw human beings as manifestations of this pulsating energy and the personality and muscle armour as defences against it and that disruptions in this energy can cause illness.

Let’s call it Super ventilation

Since HVS defies precise definition and explanation, it is quite possible that the reaction in breathwork may in effect be something completely different. To emphasise this very important difference, Californian Rebirther, Dr Eve Jones prefers to call it ‘Super ventilation’. Swedish breathworker Bo Wahlström
 describes it as a reaction to strong energy being activated through the increased breathing pattern. When the body’s circulation suddenly is flooded through intense breathing any muscular tension or restriction in the circulatory system may lead to cramp and tensions that also lead to tetany. An important
difference between HVS and tetany in breathwork is that it is possible to continue breathing and still come out of the tetany if the body and exhale becomes more relaxed and if the strong energy is accepted and integrated.

This may be linked with biodynamic psychotherapist Gerda Boyesen’s discovery of ‘psycho-peristalsis’, which she describes as increased activity (or bubbling) in the body (in particular in the gastro-intenstinal tract) when a client gets in touch with intense emotions or memories. (Gerda Boyesen Institute http://www.biodynamic.org)
Unlike hyperventilation, super ventilation does not seem to lead to carbon dioxide imbalance in the blood. According to Russian breathworker Sergei Gorsky, studies in Russia have shown that the intensified breathing pattern in a Rebirthing session does not always lead to a drop in the carbon dioxide level. (The Spirit of
Breathwork, International Breathwork Foundation, 2001). One indication of this difference is that the cramps from super ventilation can disappear instantaneously whereas the imbalance in the carbon dioxide level that causes alkalosis and tetany in hyperventilation needs time to be restored.

Spot the difference

Not all intensified breathing in a breathwork session is super ventilation. And just because the breathing pattern occurs spontaneously it is not automatically beneficiary (the same way as a “spontaneous” heart-attack or stroke is not good). Since ‘real’ hyperventilation is known to have clear negative effects on the body, it is important to learn to avoid this and concentrate on the positive super ventilation. It takes a well qualified breathwork teacher to teach the difference between hyper- and super ventilation and how to guide a client towards the latter ‘safe’ form of breathing.

It would therefore be helpful if Grof, as well as many other breathworkers made a clearer distinction between good super ventilation and bad hyperventilation. After all, there is no evidence that the Inner Healing is not triggered by super ventilation, .i.e. intense but open breathing and not by hyperventilation, i.e. breathing restricted by a body in fear.

But Grof even goes so far as to argue that there is a healing effect in ‘hyperventilation’ as a result of the intense muscular spasms that may occur as a result. He claims that we can free ourselves from long term or chronic pain in two ways. One is by catharsis in the form of wild, uncontrolled body movements, coughs, vomiting and so on (a view shared by conventional psychotherapy); the other way is through breathing, which he regards as a new, more efficient and exciting development of psychotherapy. Grof argues that through the breath: “… the deep tensions surface in the form of transient muscular contractions of various duration. By sustaining these muscular tensions for extended periods of time, the organism consumes enormous amounts of previously pent-up energy and simplifies its functions by disposing of them. The deep relaxation that typically follows the temporary intensification of old tensions or appearance of previously latent ones bears witness to the healing nature of this process.” (Psychology of the Future, lessons from modern consciousness research, p 192. Albany, USA: State University of New York Press, 2000.)

Is it really all in the breathing?

As with HVS in general, breathworkers need to remind themselves of how much they still need to learn about the various elements involved in a breathwork session, and what really contributes to the healing process. One of the major factors that will determine if the intensified breathing will lead to super- or hyperventilation is how safe the client feels. Hyperventilation is often a result of acute anxiety. In addition to the initial fear, the anxiety is often fuelled by panic caused by a sense of breathlessness and inability to breathe in enough oxygen. In a good breathwork session the client is made fully aware that it is safe to breathe, even though it may lead to a certain temporary discomfort in the body. Rather than being frightened by the fear that an old traumatic memory may trigger, the client is encouraged to ‘stay with it’ and that it is safe to re-live the experience. This may be enough for the body to switch from hyper- to super ventilation and lead to healing rather than damage.

Internal environment

With the help of modern research we have been able to build a fairly strong argument that it is the altered breathing pattern in a breathwork session that has the direct healing effect. Recent cellular research indicates that the ‘internal environment’ plays a crucial role for the behaviour and well being of the cells in our body (The Biology of Belief, Bruce Lipton, 2004.) To flood the body with oxygen rich blood may cause such an improvement in the environment for the cells. (Molecules of Emotion, Candace Pert 1997). But since mind and body are one, positive thoughts may also be enough to create a good inner environment.

But there is also evidence pointing in the opposite direction, in particular from studies of near death experiences (NDE), that are often triggered by situations where a person has stopped breathing altogether. Still the effects of NDE have many similarities with breathwork, in particular the triggering of memories. One explanation for the euphoric sensations in NDE is that although the brain is very sensitive to lack of oxygen, not all parts are equally sensitive; those parts that deal with emotions are particularly oxygen sensitive. Therefore oxygen deprivation may trigger euphoric or mystical experiences. At the same time this is contradicted by the fact that the memory function is no less oxygen sensitive, which means that a person experiencing a NDE should not be able to remember it, which is usually not the case.

The change in carbon dioxide may be another important factor. During the 1950s the American psychiatrist L.J. Meduna carried out experiments, giving his patients a mixture of oxygen and carbon dioxide as a form of psychiatric treatment, resulting in the patients getting a surplus of carbon dioxide in the blood. This caused a number of his patients to have dreamlike experiences that had many similarities with near-death and breathwork experiences. The patients described fantastic emotions, strong colours and geometrical patterns. Many also experienced a higher cosmic connection, whereas a small group has such horrible experiences that they woke up terrified. (Fenwick, Peter, & Fenwick, Elisabeth. The Truth in the Light. New York: Berkeley Books, 1995.)

The importance of intention

The fact that breathwork and NDE represent the absolute opposites as regards oxygen intake and still tend to result in very similar experiences indicate that there are other factors than the actual breathing that determines the outcome of a breathwork session. One such factor may be the increased relaxation and subsequent opening and increase of the body’s inner circulation, created by simply providing a ‘safe space’ for the client. Another important fact is the special intent by client and therapist to create a ‘healing opportunity’. Perhaps it is sufficient to simply relax and/or focus on healing for the body to initiate its natural healing ability.

Research has clearly shown how important the mind is for the well being of the body. A positive thought is good for the body whereas bad thoughts have equally bad effects. And the drugs industry has clearly shown through the placebo effect, that it is sufficient for a patient to be told by their doctor that they are taking a potent drug to actually initiate a natural healing process in the body and get cured (sometimes even displaying the same side-effects as the potent medicine they believe they are taking). Equally, studies into the effects of prayer on the healing process have shown that the intent plays a crucial role.

There are still many questions to be answered. Hopefully the breathwork community will realise the importance of working together with science to find these answers and accept that mind and body are in no way separate. After all, the unconscious mind is the main controller of our bodily functions. Consequently, physical as well as psychological reactions give us important clues. So although breathwork is usually described as psychotherapy, perhaps it needs to be re- defined as simply therapy i.e. healing of both body and mind.

Keywords; hyperventilation, superventilation, breathing, Pert, Lipton, Grof, Manne, Wahlström

© Gunnel Minett, June 2007

About the author:
Gunnel Minett is a psychologist, author and breathworker. Her books have been translated into several languages.