The method of combined holotropic breathing in the psychotherapy of addictions.

Psychotherapeutic technique of holotropic breathing was first generalized and theoretically formulated by Stanislav Grof. It is now widely used in the treatment of borderline personality disorder in the psychiatric practice. Easy in technical performance, it produces a profound psychological impact, makes a patient to think over the existing problems. According to authors methodology it leads to “death and rebirth”.

The breathing sessions are usually long – about an hour. During the sessions the patient undergoes four perinatal “matrix”, each of them is closely connected with successive periods of biological birth. During each of this states the patients experience specific emotions and physical sensations, each state is associated with distinctive symbolic images. In our clinic classical holotropic breathing was firstly used during the abuse treatment due to the preparation for superstress hypnosis.

In the course of a 3-year observation of patients’ sensations and behavior during holotropic breathing sessions it is now possible to specify general features of perception of each "matrix" that are specific for medical manifestations of  drug addiction.

During the first sessions patients experience the feeling of peace, serenity, joy, bliss, sometimes even ecstasy. Physically this state is accompanied by slightly trembling sensations, running waves all over the body, chills, changes in taste in the mouth, light nausea, muscle twitching. The patients who are enduring withdrawal perceive this “matrix” manifestations as an opportunity to, at least, partially alleviate their physical condition. They are willing to attend sessions. Usually they take this state of emotional comfort as first manifestation of effectiveness of the treatment. In some cases they experience the same “high” effect as when using drugs, and usually are very surprised that it is possible to achieve without substances. In rare cases similar emotions and sensations form some kind of psychological addiction and patients tend to repeat only this state ignoring the subsequent dynamics.

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In the course of subsequent sessions of holotropic breathing the second “matrix” experience appears. It is radically different from the previous one. Mostly it develops in fear of death, fear of going insane, fear of never returning to normal state. All the time patients experience the fear of constant life danger. Physically this state is accompanied by body exertion, tightness in the chest, head and limbs pressure. Also discomfort and heaviness in different parts of body that are associated with pleasure zones is significant: severe thirst, urge to urinate or defecate can disrupt the session.

During the sessions almost all patients describe episodes associated with “freaky past” of extremely negative content or potential fatal outcome, overdoses, looting and violence to get money for drugs, senseless cruelty to family and close people. Such reminiscences are the first steps to understand the meaninglessness of the previous way of life. Hereafter all negative memories are fixed emotionally with the help of therapists. Some patients, when faced with negative experiences, try to defend against them. In these cases the subliminal protective mechanisms are included and former stereotype of avoiding difficulties dominates. Patients start mentioning the intensification of psychological addiction and strong craving for a drug. Later sessions of holotropic breathing are perceived by them with the fear of “return to the initial level” during the treatment.

Experiences associated with the third "matrix" are more concentrated than before. Especially it concerns physical sensations: patients experience severe pain and aches, choking, increased exertion. In terms of psychological effects – anxiety is enhanced, so as the feeling of aggression and excitement. Dr. S. Grof compared these sensations to the ones of a child being born through the birth channel.

Patients experienced suffering and constant pain or anxiety and aggression. However, unlike previous experiences, this one goes from victim to torturer. Memories of betrayal and deceiving behavior because of a drug dominate, sometimes with physical violence. Sexual experience memories are frequent but accompanied by immorality, risk and narcotic intoxication. Religious scenes reflect negative satanic ritual elements, where the patient is an active participant: one drinks blood and gets pleasure from it, uses drugs and makes others to do it. Multidirectional feeling of aggression is clearly manifested in the external monitoring. Some patients actively oppose some invisible objects; they wave their hands, legs, shout out words, and change their postures. Others, on the contrary, cry. Despite the predominance of negative experiences, they always present elements of struggle and there is always a feeling of hope and belief that this struggle will eventually end.

After breathing sessions patients were rethinking their way of life and it is an important factor in the preparation process for super-stress hypnosis. Preciously missing guilt appears with tears of repentance and begging for forgiveness. The awareness of mandatory fight for overcoming drug dependence smoothes negative emotional memories.

Such ideas evoked fear of the future only among some patients. They tried to leave the session quickly. It is important to understand that to overcome this fear and continue treatment by all rules is essential in the whole process of subsequent individual work with a therapist. Some patients perceived physical sensations at this stage as the return to abstinence. In this case immediate rebuttal is necessary.

Signs of the fourth "matrix" were connected with the subjects of death and rebirth, with a feeling of victory and triumph. Many patients spoke about the changed senses: visual and auditory impressions, smells, tastes seemed more powerful, bright and pleasant. Patients have described the return of feelings that were taken by the drug, they claimed they saw a completely new way to understand and appreciate their loved ones, the beauty of nature, the ability to enjoy the sounds of music. The pursuit of justice, respect for others, the desire to create became important again.

Some patients recalled feelings of the first "matrix", but now they do not simply observe, but completely belong to this situation and take full responsibility for it. The prevailing is the sense of deep relaxation, serenity and inner peace. The patients claimed about the exemption from drug addiction or opportunity to get rid of it.

The milestone of the whole medical treatment of addiction is the understanding of the patient’s own active position. After the treatment termination usually the patients continue holotropic breathing at home, as a means of psychological discharge in stress situations. In rare cases it is accompanied by hyperactivity, euphoria, agitation for 2-3 hours after sessions. The patients demanded special attitude towards them and built grandiose plans. These transient states pass spontaneously and require certain clarifications.  

In the course of further classical version of holotropic breathing there emerges a hypothesis of potentiating effect of psychotherapy and smoothing of emerging adverse manifestations. Firstly it was carried out by means of inclusion of some Buddhist mantras into music, and other elements of meditative melodies and songs that create mystical atmosphere and accelerates the entry into an altered state of consciousness. This music is laminated by a single rhythm of breathing, and then sounds of child’s birth are added and then with the help of computer patients hear screams and key words of a therapist. All this forms negative emotional state against drugs.

Further combinations include varying degrees of intensity of the voice instructions, layered on melody.

The starting point in this innovation was the work of our scientist (I. Smirnov "Computer psycho semantic analysis and therapy at an unconscious level," 1995) about the effectiveness of the unconscious auditory input of information, especially when combined with the state of altered consciousness. The uncontrolled words and phrases of the patient create an opportunity to overcome the psychological defense mechanisms with real effect on their behavior in an emergency situation or in “choice” situation, when one has to choose anything from a few decisions (to buy or not to buy the drug, to use it or not). Practically this combination revealed in barely audible words repetition of the therapist on the background melody with sounded reaction of other patients in a state of trance at this suggestion. The sobbing, gagging and even uncertain hum and noise on the background were defined in the process of respiration.

The final principles of combined holotropic breathing are formed according to the way the patients pass all the classical periods described above. Particularly effective are inclusions of mantras and individual voice effects (the baby’s crying) while going through the first "Matrix" with the background of safety, security and emotional stability. It appeals to the experience of living and requires its subsequent interpretation. Mandatory is the overlay of verbal musical symbols at the 2d - 3d sessions of breathing. This combination helps the patients to be prepared for super stress hypnosis and full participation in it since the early days. Significant are clearly audible key installations of super stress hypnosis during the experiences of the 2d and the 3d “Matrix”. These phrases fix the relation between physical and emotionally unpleasant symptoms that reveal negative memories of former life, thereby forming its negation. The anchoring effect of the  aversion to psychoactive substances is achieved  by realization of liberation from the old stereotype of behavior during the experiences of the last "Matrix". It became possible by using the direct access of information to the memory in an altered state of consciousness (when the entire session of holotropic breathing is forgotten).

These kinds of combinations of the classical version of holotropic breathing with various musical and verbal comparisons allowed to increase the effectiveness of psychotherapy of various substance abuse as in the duration of treatment, so as in the depth of the desired effect. According to observations over the last year the aversion to psychoactive substances was formed among 88% of our patients.

The desire of patients to purchase CDs with audible support of breathing sessions before their discharge speaks about the effectiveness of selected combinations.