Group Breathwork Sessions and Retreats: Safety Questions to Ask

Urgent first

In an emergency such as fainting that does not pass, a seizure, chest pain or severe trouble breathing, call your local emergency number (911 in the US). [1] Do not wait for the group to finish. If a session or retreat leaves you in emotional crisis, the 988 Lifeline (US) offers free, confidential support by call, text or chat. [2]

What this page does

It gives questions to ask, not names. We do not list, rank or recommend sessions, studios, retreats or teachers, and "near me" results are not provided. Group breathwork covers a wide range, from a gentle slow-breathing class to intensive sessions built on deliberate overbreathing. Which one you are joining changes the risk a great deal, so the first question is always: what exactly will we be doing?

Group settings change the risks

• A facilitator watching many people may miss one who is unwell. A professional code says facilitators should monitor participants and respond to difficult physical experiences. [3]
• Peer pressure to continue can be stronger in a group. The same code says participants should be told they can withdraw consent at any time, without judgment or pressure. [3]
• Retreats can be far from medical care and may combine breathwork with other activities such as cold exposure or water, which is a different risk. See the retreats and immersions page.

Questions to ask before you join

What is the technique?

• Is it slow, comfortable breathing, or does it involve fast, hard or repeated breathing or breath-holding? The second kind is covered critically on our intensive breathwork page. We give no instructions for it.
• Will any of it happen in or near water, a bath, shower, pool or sauna? Do not do breath-holding or overbreathing in or near water. Shallow water blackout can occur in any body of water at any depth, and it is often due to prolonged breath-holding. [4]

Who is screened out?

• Is there a health form, and does the leader read it? One professional code lists cardiovascular and respiratory conditions, epilepsy, psychosis, schizophrenia, bipolar disorder, complex trauma and recent surgery as conditions that may need adjustments. [3]


• Are pregnancy and medicines asked about? The code says to ask about pregnancy, and about medicines such as asthma inhalers and angina medication. [3]


• Are you asked about thoughts of self-harm? The code says to create opportunities to disclose these at registration. [3]

What is the emergency plan?

• Who is trained for seizures, fainting or panic? The code says breathworkers should be prepared to manage these, and mentions CPR training and knowing how to contact emergency services where the session is held. [3]


• Is there a clear way to leave the room, and a quiet space?


• For a retreat: how far is the nearest hospital, and is a trained medical person on site?

What about consent and touch?
See consent, touch and boundaries.

What are the terms?

• Total cost, cancellation and refund terms in writing. The code asks for clear information about fees and policies. [3]


• Whether sessions are recorded. The code asks for consent to photograph or film. [3]

What published studies tell us about groups

A descriptive report of a hospital program, covering 11,000 psychiatric inpatients who joined holotropic breathwork groups over 12 years, recorded no complaints of adverse reactions. [5] The program screened each patient first against four exclusions: severe cardiac disease, severe musculoskeletal disorders, pregnancy and paranoid ideation. [5] The report was not a controlled trial, and it does not show what happens in unscreened public groups. The practice it describes includes enhanced breathing (hyperventilation), which we do not teach. [5]

Who should check with a clinician first

Anyone with asthma or COPD, heart disease, blood pressure problems, epilepsy, glaucoma, pregnancy, psychosis, bipolar disorder, panic disorder, an eating disorder or trauma history should speak to a clinician before any group breathwork, especially intensive formats. NCCIH notes rare reports of worsened symptoms with relaxation techniques in people with epilepsy or certain psychiatric conditions. [6] See also warning signs and when to stop.