Exhaling the past: A comprehensive neuropsychological test of breathwork as a tool for trauma processing
Creators: name: Dziobek, Isabel
name: Havenith, Martha N.
name: Bayer, Mareike
Publisher: name: Open Science Framework
Year: 2024
Subjects: subject: Physiology
subject: FOS: Biological sciences
subject: Psychiatry and Psychology
subject: Neuroscience and Neurobiology
subject: Medicine and Health Sciences
subject: Life Sciences
subject: Breathwork
subject: RCT
subject: Trauma

description: Abstract: At a prevalence of 50-70%, childhood trauma is one of the most pervasive factors that can lastingly contract the perception box of individuals - and communities. Shedding rigid patterns of cognitive-emotional processing imprinted by trauma can be difficult. Altered states of consciousness (ASCs) triggered by psychedelics have recently emerged as a promising avenue to re-expand the perception box, but legal and financial obstacles put this approach out of reach for most. Here, we propose to rigorously test circular breathwork as an alternative therapeutic tool to support trauma processing via ASCs. To do so, we will 1) track socio-emotional and mental health effects of breathwork at the behavioral and the neuronal level and 2) directly compare its acute neuronal signatures to those of psychedelic states. By for the first time unravelling the psychological and neuronal underpinnings of breathwork, we aim to 1) outline the neuronal prerequisites for deep psychological change without pharmacological interventions and 2) evolve breathwork into a scientifically sound treatment with clear guidance on requirements and outcomes. If successful, this will establish circular breathwork as a low-cost and low-risk, highly accessible method to effectively expand the perception box of individuals beyond the confines of trauma. Executive Summary: Childhood trauma can violently shrink our perception of the world - and our ability to freely choose our actions in it. This often entails deeply entrenched dysfunctional beliefs and processing strategies that permanently impair well-being. Given that childhood trauma affects 50-70% of individuals 1–5, effective trauma processing is one of the most powerful levers to unlock joy and vitality across communities. Talk-based therapy cannot meet this challenge alone, because trauma frequently manifests as a set of embodied imprints beyond cognitive access. In other words, understanding trauma is often not the same as healing it. The search for alternatives increasingly highlights altered states of consciousness (ASCs) as an effective and age-old answer: For centuries, humans have entered ASCs to ‘change their minds’ for the better – whether by fasting, physical exertion, extreme temperatures, or psychedelic substances. Circular breathwork* is one of the most accessible practices to induce ASCs. However, rigorous research into its potential clinical benefits and underlying mechanisms is almost entirely lacking. In the proposed project, we tackle this lack of evidence with a multidisciplinary team combining 20 years of experience in clinical-psychological and fundamental brain research, and 10 years of experience in psychedelic research and breathwork coaching. We will use these skills to test the following hypotheses: (1) Breathwork facilitates trauma processing in individuals with a history of childhood trauma. (2) It does so by altering socio-emotional processing on the neuronal and the behavioral level. (3) The neuronal dynamics triggered by breathwork are comparable to those evoked by psychedelics. In Experiment 1 (EX_WELL), we will recruit a total of 90 individuals with adverse childhood experiences (ACEs) but no acute post-traumatic stress disorder. Participants will undergo a set of four breathwork sessions, accompanied by guided integration, over the course of six weeks. The effects of this treatment on mental health will be compared to a control group that experiences four sessions of immersive storytelling. Neuropsychological treatment effects will be assessed via self-reports, neuronal markers, and behavioural tests of socio-emotional functioning (experiential avoidance, social trust), psychopathological burden (anxiety, depression, physiological stress), and overall well-being. Neuronal markers will be assessed with task-based EEG. In Experiment 2 (EX_ASC), we will explore whether the acute neuronal dynamics and subjective experiences evoked by breathwork resemble those triggered by psychedelic substances. To this end, we will obtain EEG recordings of 36 individuals throughout a breathwork or storytelling session (specifically during short intermittent resting-state recordings to eliminate artefacts), and compare their neuronal dynamics to the most robust EEG signatures of psychedelic experiences induced e.g. by DMT. Together, these measurements will elucidate whether - and by which neuronal and psychological mechanisms - breathwork can act as a non-pharmacological, low-cost, and thereby widely accessible, counterpart to psychedelic-assisted trauma therapy. * Used here as an umbrella term for techniques that involve intense breathing, increasing O2 and decreasing CO2 saturation to alter consciousness. This includes e.g. Consciously Connected, Transformational and Holotropic Breathwork, Rebirthing and Tummo.