High ventilation breathwork as a non-pharmacological model for inducing psychedelic-like states: expert evaluations of therapeutic potential and risk

High ventilation breathwork (HVB) can induce altered states of consciousness with phenomenological similarities to those reported following administration of serotonergic psychedelics such as lysergic acid diethylamide (LSD), psilocybin or ayahuasca. Non-pharmacological methods capable of reliably eliciting such states may provide scalable models for investigating therapeutic mechanisms associated with psychedelic experiences while avoiding pharmacological and regulatory constraints. However, the therapeutic relevance and risk-benefit profile of HVB remain insufficiently characterized. In this exploratory study, 48 mental health professionals participated in an HVB workshop and evaluated perceived therapeutic potential, risks, and potential clinical indications. Participants reported altered states reaching intensity ranges comparable to those described in studies using moderate doses of serotonergic psychedelics. Internalizing disorders were suggested as indications, whereas psychotic, dissociative, and bipolar disorders were identified as contraindications. T-tests showed that perceived clinical potential of HVB significantly outweighed anticipated risks. Exploratory regression analyses indicated that trait openness and emotional breakthrough predicted perceived potential of HVB. HVB may represent a feasible non-pharmacological psychedelic induction paradigm warranting evaluation in controlled clinical trials.