Screen for contraindications before any session

Know and respect the medical and psychological contraindications — holotropic breathwork is not for everyone.

Why it works

Sustained hyperventilation causes real physiological changes: hypocapnia, alkalosis, and significant cardiovascular demand. For people with cardiovascular disease, seizure disorders, severe psychiatric diagnoses, or active psychosis, these changes are not safe. Screening protects participants and maintains the legitimacy of the practice.

How to do it

1. Complete the standard medical and psychiatric questionnaire provided by any certified Grof Transpersonal Training facilitator.
2. Disclose: cardiovascular or respiratory conditions, seizure history, severe psychiatric history (schizophrenia, bipolar disorder with psychosis), pregnancy, glaucoma, recent surgery.
3. If uncertain, consult your physician before attending.
4. For psychological contraindications, seek a licensed therapist for assessment rather than self-qualifying.

Evidence

Contraindications are based on the known physiology of hyperventilation and established clinical caution in intensive somatic and altered-state work. They represent clinical consensus rather than RCT-derived exclusion criteria. (clinical)

Adverse event rates in trained holotropic breathwork settings are not well documented in the literature; caution is warranted given the intensity of the practice.

Common mistake

Attending an uncertified or poorly facilitated workshop that skips the screening questionnaire — the protective value of the practice depends entirely on trained facilitation and proper vetting.