I’m lying on a massage bed in a dimly lit treatment room in Mayfair, breathing so hard I think I might pass out. Rob Rea, one of London’s most sought-after breathwork practitioners, is guiding me through holotropic breathwork – a technique developed in the 1970s at Esalen, in California, by Christina and Stanislav Grof, pioneers in LSD research, as a drug-free way to access altered states of consciousness.
“Just keep going,” Rea encourages, as I start to wonder what exactly the point of all this minor discomfort is. After about 20 intense minutes – with batches of roughly 15 long inhalations, each followed by a short, sharp exhalation – something extraordinary happens. My body shakes from the inside out and I experience what researchers call “oceanic boundlessness” – a dissolving of physical boundaries.
For the next 10 minutes Rea tells me to imagine myself in two years’ time, walking through a meadow. I’ve never taken LSD, but I imagine this slightly strange, freeing feeling is the goal. As quickly as it started, it’s over. My body has done something remarkable, and all I did was breathe.
What just happened? When you breathe rapidly like this, you blow out CO2, which causes the blood vessels to become narrower, thereby cutting off blood flow to the brain. This creates an altered state of consciousness: “60 to 70 per cent of people doing holotropic breathwork will cry at some stage,” Rea tells me afterwards, “because it’s a big emotional release.” I don’t cry, but I leave with a new respect for what our bodies can achieve through breath alone.
Even if you’re not seeking oceanic boundlessness, most of us are breathing incorrectly. We’re shallow breathers, using only a small fraction of our lung capacity, according to Dr Immanuel Fruhmann, a psychotherapist and breathwork therapist at the Mayrlife Medical Health Resort in Austria. “We typically operate at 15 cycles per minute of this shallow breathing,” he explains, “and we need to lower it to four to eight.” This is when we get into deep breathing and “full-body oxygen saturation”. Chronic shallow breathing is connected to many complaints of modern life: poor sleep, difficulty focusing, heightened anxiety.
Once considered a fringe wellness practice, breathwork is now used in boardrooms, sports stadiums and even warfare (the US Navy Seals have used “box breathing” to maintain focus under pressure since the mid-2000s). A 2022 analysis in Neuroscience and Biobehavioral Reviews found that controlling your breath at around six breaths per minute consistently increases heart rate variability, a key marker of stress resilience and adaptability. And, more than meditation, a 2023 Stanford study found that just five minutes of cyclic sighing – emphasising prolonged exhalations – significantly reduced anxiety and improved mood.
For Dr Guy Fincham, discovering proper breathing was life-changing. Halfway through his psychology master’s degree, he developed chronic fatigue syndrome so severe he had to take a two-year leave of absence. “I came across breathwork, particularly the Wim Hof method,” he recalls. The method, which is reportedly practised by Gwyneth Paltrow, Oprah Winfrey and surfer Laird Hamilton, involves 30 to 40 big inhales and exhales, followed by breath holds lasting from half a minute to several minutes. “I found that it helped me regain some control over my physical symptoms, preventing relapsing,” says Fincham.
True healing only began, however, when he discovered slower-paced breathing practices through discussions with New York psychiatrists Dr Richard Brown and Dr Patricia Gerbarg, creators of the Breath-Body-Mind programme. It was about “accessing these states of deep relaxation, activating my parasympathetic nervous system – just taking off layers of stress”, says Fincham.
He went on to complete a PhD in breathwork, founded the Breathwork Lab at Brighton & Sussex Medical School and is now a decentralised research fellow in partnership with ResearchHub and DMT Quest. His research revealed something surprising: even placebo groups, simply breathing at 12 breaths a minute (a neutral rate), reported profound experiences. “Some participants were saying, ‘I had this amazing experience. I had tears of joy,’” he says.
Not everyone agrees that breathwork alone is a sufficient means of improving stress and mental health. Dr David Spiegel, a professor of psychiatry and behavioural sciences at Stanford University, emphasises that breathwork should complement, rather than replace, treatments such as cognitive behavioural therapy or medication for diagnosed anxiety disorders. Breathing techniques show promise, but more studies with larger sample sizes need to be carried out. Conditions such as severe panic disorder or PTSD still require proper treatment, with breathwork as part of a comprehensive plan.
The good news is that daily breathing requires no equipment or guidance, costs nothing and can be done anywhere. “Whatever you repeat, you become a master in,” says Dr Fruhmann, who has maintained a daily breathwork practice for more than 10 years. “It needs to be as natural as brushing your teeth.”
For long-term health, Fruhmann advises practising the coherent breathing technique to slow down the heartbeat. Try “breathing in and out at around five and a half seconds in, five and a half seconds out. That’s about five and a half breaths per minute,” he explains. Fincham practises an even slower version: three breaths per minute, breathing in for 10 seconds and out for 10 seconds. “It’s so simple. You can tell someone to breathe in for five seconds and then out for five seconds, no pauses, just trying to get into the most relaxed state possible.”
Box breathing – the technique used by Navy Seals – is Dr Fruhmann’s recommendation for managing overwhelming moments. “It’s about following the lines of a square,” he explains. “Breathe in for four, hold for four, breathe out for four and hold for four.” Repeat this for three or four rounds during the day when needed. For night-time waking, Fincham suggests a modified version: breathe in for four, hold for four, out for six, hold for two. The extended exhale activates the parasympathetic nervous system, helping you return to sleep.
One month on from my treatment with Rea, I wake at 4am and find that box breathing helps relieve my anxious thoughts. More generally, the practice means I’m not feeling the tightness across the chest that was present for much of the past year. Taking a few minutes to place myself in an imaginary meadow isn’t quite as good as being in the real thing, but it is a wonderful mental escape.
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