Is Conscious Connected Breathwork safe? (And why you keep hearing it’s “dangerous”)
If you’ve spent more than five minutes in the breathwork world lately, you’ve probably heard some version of: “Conscious Connected Breathwork isn’t safe… it can cause seizures… it can destabilise people… it’s basically dodgy hyperventilation.”
And honestly? I get why people say it. Conscious Connected Breathwork (often shortened to CCB / CCBW) can be intense. It can create big physiological shifts, strong emotional release, and (for some people) altered states. That combination deserves respect, not hype.
But “unsafe” is not the full story either.
Like most powerful therapeutic tools, safety depends on:
who is doing it,
how it’s being facilitated,
what the person’s physical/mental health context is,
and whether proper screening and contraindications are taken seriously.
Let’s unpack this clinically.
What is Conscious Connected Breathwork?
Conscious Connected Breathwork typically involves a continuous breathing pattern with no pause between inhale and exhale (often for 30+ minutes), usually with music and facilitation. The aim can range from nervous system regulation and emotional processing to insight, grief release, and trauma work.
A key point, clinically: many forms of connected breathing are “high ventilation breathwork” - meaning ventilation can exceed metabolic needs and shift blood gases (especially CO₂). This isn’t “just relaxation breathing.” It can move the body into a different physiological state. breathwork.org.uk+1
Why do people call it “dangerous”?
1) Because physiology changes quickly (and sometimes dramatically)
In high-ventilation styles, people can develop respiratory alkalosis (blood becomes more alkaline due to lower CO₂), which can lead to:
dizziness / light-headedness
tingling around mouth/hands
cramping or “claw hands” (carpopedal spasm/tetany)
feeling hot/cold, shaky, nauseous
This is a known pattern in hyperventilation physiology and is one reason breathwork organisations emphasise screening and contraindications. Medscape Emedicine+3breathwork.org.uk+3Cleveland Clinic+3
For most healthy people, these effects can be unpleasant but not dangerous-if the session is appropriately held and the breather can downshift. For some medical conditions, however, the risk profile changes (more on that below).
2) Because it can trigger panic (especially in panic-prone nervous systems)
Rapid breathing and body sensations can mimic panic sensations, and for some people it can tip into panic. The link between hyperventilation physiology and panic is well described in clinical literature. American Journal of Medicine+2ScienceDirect+2
3) Because it can bring up trauma content faster than someone can integrate it
This is the bit I care about most as a clinician: CCBW can open the emotional floodgates. People can experience:
overwhelm
dissociation or “floating away”
re-experiencing sensations/memories
destabilisation afterwards (sleep disruption, heightened arousal, emotional volatility)
This doesn’t mean breathwork is “bad.” It means the same intensity that makes it powerful also makes it clinically inappropriate for some people in some contexts-especially without trauma-informed facilitation and good integration support.
4) Because the industry is unregulated in many places
A hard truth: some breathwork is delivered with a retreat/high-performance vibe rather than a clinical safety vibe. When screening is skipped, contraindications are glossed over, or facilitators promise cures, risk goes up.
That’s exactly why professional standards have been emerging (for example, UK Breathwork Association professional standards emphasise intake, consent, contraindications, and advising clients with suspected contraindications to consult healthcare professionals). breathwork.org.uk
So… is it safe?
The clinically honest answer:
It can be safe for many people when it’s properly screened, well-facilitated, and appropriately titrated.
And it can be unsafe for some people, especially when contraindications are present or when it’s delivered in a “one-size-fits-all” way.
Research on breathwork is growing, with meta-analytic evidence suggesting breathwork can improve stress and mental health outcomes-but authors repeatedly urge caution and nuance (partly because protocols vary widely, and adverse event reporting is inconsistent). PMC+1
There are also studies/clinical reports in intensive breathwork traditions (e.g., Holotropic Breathwork) describing acceptable tolerability in specific settings-again, with the huge caveat: setting, screening, and support matter. MAPS+1
Contraindications: who needs extra caution (or should avoid CCBW)?
Different schools list slightly different contraindications, but common themes appear across professional guidance. The UK professional standards document explicitly references physiological changes (including respiratory alkalosis) and the need for contraindication education and screening. breathwork.org.uk
Common medical contraindications/precautions often include:
pregnancy (varies by trimester/school)
epilepsy / seizure history
uncontrolled high blood pressure
significant cardiovascular disease (e.g., prior heart attack/stroke, serious arrhythmias)
aneurysm history (personal; sometimes strong family history is flagged)
detached retina / glaucoma
some serious respiratory conditions (context-dependent; asthma can be a “proceed with caution” category)
(You’ll see very similar lists across professional breathwork guidance and major breathwork lineages.) breathworkalliance.com+3breathwork.org.uk+3IBF International Breathwork Foundation+3
Psychiatric/clinical red flags often include (again, context-dependent):
history of psychosis or current psychotic symptoms
current mania / unstable bipolar presentation
recent psychiatric hospitalisation or acute crisis
high dissociation without strong stabilisation skills/support
current high-risk substance withdrawal / severe instability
This doesn’t mean someone is “excluded forever.” It means CCBW may not be the right tool right now, or it may need medical oversight, modifications, shorter sessions, or a different approach (e.g., slow coherent breathing).
What “safe breathwork” looks like (the clinical version)
If you want a simple checklist, here’s what I look for clinically-whether I’m referring a client out or considering breathwork alongside therapy:
1) Proper screening + informed consent
written health questionnaire
clear contraindication discussion
“what to expect” explained (including strong sensations and emotional release)
no inflated claims (“this will heal your trauma in one session” is a red flag)
This is explicitly emphasised in UK Breathwork professional standards. breathwork.org.uk
2) Choice, pacing, and titration
CCBW should never feel like “hold on and survive it.” Safe facilitation includes:
options to slow down, pause, switch to nose breathing
encouragement to stay within a workable window (not white-knuckling)
shorter rounds for newer breathers or trauma histories
3) Trauma-informed holding and safeguarding
This includes:
grounding and orientation skills before intensity
consent-based support (including around touch)
clear plan for what happens if someone panics/dissociates
aftercare and integration support (not “thanks, bye!”)
4) The right modality for the right person
Sometimes the safest breathwork isn’t CCBW at all. Many clients do far better with:
slow paced/coherent breathing
gentle pranayama
somatic, pendulation-based breath cues
resourcing + micro-doses of activation
The goal is not intensity. The goal is restoration and integration.
A note on online breathwork
Online CCBW can be done well, but risk increases if:
people are off-camera,
the facilitator can’t observe distress cues,
there’s no clear safety plan,
there’s no pre-screening.
If someone has a complex trauma history or any medical complexity, I’m cautious about starting with online high-ventilation work unless there’s robust screening and strong containment.
My bottom line (and what I tell clients)
Conscious Connected Breathwork isn’t inherently “dangerous.”
But it is not neutral, and it’s not a casual wellbeing trend either.
Think of it like deep therapeutic work: it can be profoundly helpful when done responsibly- and unhelpful or risky when done carelessly, or with the wrong person at the wrong time.
If you’re a facilitator: professional standards, screening, and a trauma-informed lens aren’t optional extras. They’re the work. breathwork.org.uk+1
If you’re a client: choose practitioners who welcome questions, screen properly, and don’t sell intensity as a virtue.
References (starter set)
Fincham, G.W. et al. (2023). Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. (PMCID). PMC
Fincham, G.W. et al. (2023). High ventilation breathwork practices: An overview of their neurophysiological effects and safety profile. Neuroscience & Biobehavioural Reviews. ScienceDirect
UK Breathwork Association (2024). UK Breathwork Association Professional Standards (Proposal), updated 24 May 2024. breathwork.org.uk
American Psychological Association (2018). Stress effects on the body (notes hyperventilation can bring on panic attacks in panic-prone individuals). American Psychological Association
Cleveland Clinic (n.d.). Respiratory alkalosis: causes, symptoms & treatment. Cleveland Clinic
Medscape (2024). Hyperventilation syndrome: clinical presentation (carpopedal spasm with hypocarbia-related changes). Medscape Emedicine
Eyerman, J. (2013). A Clinical Report of Holotropic Breathwork in a Community Hospital Setting. MAPS Newsletter (PDF). MAPS