By Puente, I, PhD Candidate, Barcelona 

INTRODUCTION 

In the middle 70 ́s, after two decades working with LSD and other psychedelic substances in psychotherapy (Grof, 1975; Grof, 1980), Stanislav Grof and his wife Christina developed the Holotropic Breathwork (Grof, 1988; Grof, 2000). This method was designed as a non-drug way of accessing non-ordinary states of consciousness or “holotropic states” (Grof, 2000) a neologism proposed by Grof. The word “holotropic” is derived from the Greek words “holos” and “trepein”, and means “moving toward wholeness” (Grof, 2000). Holotropic Breathwork is a novel experientially-oriented psychotherapeutic technique which involves a number of diverse elements, including music, elective bodywork and accelerated breathing (the instruction is to breathe “deeply and mindfully”). Holotropic Breathwork sessions 

usually last between 2 and 3 hours, and are terminated voluntarily by the client. Both individual and group therapies are possible, but the group therapy context is the most commonly used. The most characteristic and unique element of this procedure, compared with other psychotherapeutic methods, is the prolonged and voluntary hyperventilation or overbreathing (Rhinewine and Williams, 2007), but all the cited elements are considered mandatory in the HB procedure. To date, few studies have examined empirically the therapeutic potential of this hyperventilation procedure, giving some preliminary evidence of the clinical utility of Holotropic Breathwork (Binarova, 2003; Hanratty, 2002; Holmes, 1996; Pressman, 1993). 

The aim of the present study was to asses the short term and long term effects of Holotropic Breathwork in the context of a weeklong workshop via a battery of test, measuring levels of distress, meaning of life, death anxiety and personality traits. Specifically, it was hypothesized that after the workshop the volunteers would reduce their levels of distress and death anxiety, and would increase their meaning of live, self-directedness, cooperativeness and self-transcendence. 

METHOD 

Participants 

Fifty eight participants, aged between 22 and 65 years, were recruited among the participants in the “Insight and Opening” workshop. Participation in the study was completely volunteer. Both “first breathers” (participants who were exposed to Holotropic Breathwork for first time) and those who has previous experience where allowed to take part in the research. No control group was used in the present study. The workshop was held at a human development centre near New York City, during October 2009. Sixty one percent of the participants were female. Educational level was above average: 84,9 had graduated from college, 28,3% had a PhD or master degree, and 11,3% had a medical degree. 

Study design 

A repeated-measure, Pre-Post test design with a 4 month follow-up time point was used for the present study. Five different measures were taken, using five questionnaires. The instruments included measures of psychiatric symptoms, levels of distress, meaning of life, death anxiety, personality trait and the subjective experience during the HB sessions. The measures were distributed in the following way: 

1)Pre-test. The first measure was taken the first day(s) of the workshop, before the first Holotropic Breathwork session takes place. 

2-3) During the retreat: a measure of the participants experience during the HB sessions was taken using the Peak Experience Profile (PEP); the PEP was assessed two times, one after each HB session. 

4-5) Post-test: new measures were taken two weeks (Post1) and four months (Post2, follow-up) after the workshop. 

Materials: 

1) Brief Symptom Inventory (BSI) (Derogatis, 1993), a 53 item version of the Symptom Checklist-90-Revised (SCL-90-R). This test measure aspects of psychiatric and psychologic distress. The test provides a measure of 9 dimensions of symptoms (summarization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism) and 3 global index of distress. The Global Severity Index (GSI) reflect the total punctuation of the test, and provide a measure of the global level of distress (higher scores indicate a higher distress and symptomatology). 

2) Purpose In Life test (PIL) (Crumbaugh, 1968; Crumbaugh & Maholick, 1969). This test provides a measure of the extent to which an individual perceives life to be meaningful, based on the theory and concepts of V. Frankl. This 20 item questionnaire is rated in a seven point Likert scale. The scoring within the range of 20-140. 

3) Death Anxiety Scale (DAS) (Templer, 1970). The DAS is a self assessed True-False choice questionnaire consistent of 15 items, and it reflects beliefs, attitudes and concerns about death 

4) Temperament and Character Inventory-140 (TCI-140). Based on the psychobiological Personality model of Cloninger (Cloninger, 1999; Cloninger & Svrakic, 1997), the TCI-140 is a self-assessed 140-item questionnaire in a five-point Likert format. This test measure 7 dimensions of personality: 4 Temperament dimensions (Novelty-seeking, Harm-avoidance, Reward dependence and Persistence) and 3 dimensions of Character (Self-directedness, Cooperativeness and Self- transcendence). 

5) Peak Experience Profile (PEP). This questionnaire was designed to assess mystical experiences (Pahnke, 1969). This 100 item version of the original test is used to measure altered states of consciousness, and provides scores for seven domains of mystical or peak experiences: Internal Unity; External Unity; Transcendence of Time and Space; Ineffability and Paradoxicality; Sense of Sacredness; Noetic Quality; and Deeply-Felt Positive Mood. 

Objectives: 

The main purpose of the present study was to explore the effects of Holotropic Breathwork (HB) in the context of a weeklong workshop called “Insight and Opening”. The specific goals were: (1) explore the short term and long term effects of the HB in levels of distress, meaning of life, death anxiety and certain personality properties, measured with different psychometric test; (2) analyze the types of the experiences participants have during the HB sessions, using the Peak Experience Profile (PEP). 

RESULTS 

In the present paper we present (1) a comparison between the scores of the participants in the first two measures: before the breathwork sessions (Pre-test) and two week after the workshop (Post1-test). (2) the results of the Peak Experience Profile (PEP) for each Holotropic Breathwork session. 

(1) Comparison between the scores of the participants in the first two measures. 

In the Pre-test scores, compared with other studies (Eley et al. 2009), the workshop participants shown a higher novelty seeking (M= 61,69; SD= 8,01), a lower harm avoidance (M= 50,04; SD= 11,71) and a remarkable higher score in self- transcendence (M= 60,81; SD= 7,43) for the TCI-140. A similar profile was found by Puente in a previous research (Puente, 2007). Related to the self-transcendence high score, Hanratty (2002) also found a higher score in the Tellegen ́s Absorption scale, compared with the general population. The Absorption scale measures the capacity of one person to access non ordinary states of consciousness, and is similar to the self- transcendence scale. Grof (2002) also explains that the people who have had transpersonal experiences in their lives are more attracted towards non ordinary state of consciousness and techniques as Holotropic Breathwork. Being a novel psychotherapeutical approach, the high scores in novelty seeking were expected. 

In the Post1-test measure, the participants showed a reduction in the score of the Global Severity Index of the BSI (M= 25,0; SD= 32,91) and an increase in the Purpose In Life (PIL) total score (M=114,22; SD=13,17) compared with the Pre-test scores (GSIpre: M= 35,19; SD= 32,14; PLTpre: M=108,48; SD=14,86). These differences are statistically significant (Post1: GSI, p=0,01; PLT=0,008). The scores of the 9 dimensions of the BSI showed a reduction, and the differences in Interpersonal Sensitivity, Anxiety and Hostility were statistically significant (Post 1: Int-Sen, p=0,001; Anxiet, p=0,015; Hostil, p=0,05). The Death Anxiety Scale total score remains similar, and shows only a little reduction 

The TCI-140 shows an increase in the scores of self directedness and cooperativeness, and a reduction in the score of harm avoidance between the Pre-test and Post1-test measures. The difference in self directedness was statistically significant (Post1: SD=0,05). 

B) Results of the Peak Experience Profile (PEP) for each Holotropic Breathwork session. 

The criteria for designating a volunteer as having had a “complete” mystical experience is that the scores on each of the scales had to be at least 0.6 (considering unity a single scale, and choosing either internal or external, whichever was greater). We add “almost-complete” mystical experience criteria to the classical one. The criteria for an “almost-complete” mystical experience is that the scores of 5 of the 6 scales had to be at least 0.6. 

Following this criteria, during their first HB session (N=21) two volunteers had a “complete” mystical or peak experience (9,5%), and three volunteers (14,3%) had an “almost-complete” mystical experience. During their second HB session (N=19), another two volunteers had a “complete” mystical experience (10,5%) , and three more (15,8%) had an “almost-complete” peak experience. 

SUMMARY 

First, the volunteers showed some significant changes on dependent measures when the Pre workshop and the Post1 measures are compared. The volunteers showed, two weeks after the workshop: 1) a significantly greater reduction in the Global Severity Index of the BSI; 2) a significantly greater increase in the total score of the Purpose In Life Test (PIL); 3) a reduction in the harm avoidance and significantly greater elevations in the self directedness dimension of the TCI-140. 

Second, the results of the present study showed that Holotropic Breathwork can produce mystical type experiences in the context of the “Insight and Opening” workshop. According to the volunteer ratings on the Peak Experience Profile, two 

volunteers have a “complete” mystical or peak experience (9,5%) during their first HB session, and another two volunteers (10,5%) after their second HB session . 

KEY WORDS: holotropic breathwork,, hyperventilation, personality, meaning of life, symptomatology, self-transcendence, peak experience