When people ask this, they’re usually asking about predatory practitioners. That’s a reasonable worry and I’ve written about it separately.
This post is about the other risks — the ones that come from the practice itself rather than from bad actors, and which get discussed far less because they’re inconvenient for anyone selling intensive experiences.
The short answer: gentle work is low-risk for almost everyone. Intensive work carries real risk, and is routinely marketed as though it doesn’t.
Risk one: going faster than you can integrate
This is the main one.
Somatic and breath-based practice can surface material quickly — old grief, fear, body memory, states a person has been successfully not feeling for years. Surfacing it is sometimes exactly the point. But there’s a difference between material arriving at a rate you can process and material arriving all at once.
When it’s too fast, people flood. They dissociate, or panic, or leave the room functioning but go home and spend three days unable to do very much. For a small number of people with particular vulnerabilities, the destabilisation can be more serious than that.
The responsible approach here is titration — small doses, deliberately, with pauses to let things settle. The irresponsible approach is maximum intensity, because intensity produces dramatic sessions and dramatic sessions sell well.
Risk two: the physiology of intensive breathwork
Worth separating out, because people conflate all breathwork and the risk profiles are entirely different.
Slow, gentle breathing — lengthening the exhale, breathing low into the belly — is about as safe as anything gets.
Fast or prolonged intensive breathing is a different matter. It alters blood chemistry significantly and can produce dizziness, fainting, and tetany — involuntary cramping, typically in the hands and around the mouth. Unpleasant and usually harmless in itself, but genuinely alarming, and fainting carries its own risks depending on where you are.
More importantly, intensive breathwork has real contraindications. Standard ones include pregnancy, cardiovascular conditions, uncontrolled high blood pressure, epilepsy or seizure history, recent surgery, certain eye conditions including glaucoma and retinal problems, and a personal or family history of psychosis or bipolar disorder.
That list isn’t exhaustive and I’m not in a position to assess your individual situation. If any of it is relevant to you, that’s a conversation with your doctor before a conversation with a practitioner — and any practitioner who waves that away is one to avoid.
Two rules apply regardless of health, and they’re not negotiable: never do intensive breathwork in or near water, and don’t do it alone the first several times. People lose consciousness doing this. Both rules exist because of actual deaths, and no amount of experience exempts anyone from them.
Risk three: touch, trauma, and training
Body-based work with someone who has a trauma history requires specific training. Without it, touch intended to be therapeutic can reproduce the original experience rather than resolve it.
The particular failure mode is a practitioner who recognises that something significant is happening but doesn’t know how to stabilise it, so the session opens something it can’t close.
Risk four: scope
Some of what brings people to this work is outside what this work treats. Clinical depression, PTSD, eating disorders, active substance dependence — these need clinical care, and somatic practice at best sits alongside it.
A practitioner who takes on everything that walks through the door is a risk in themselves, regardless of intention.
What a responsible practitioner actually does
The checkable version:
Screens before, not during. A proper intake covering medical history, medication, mental health history and what you’re hoping for — in advance, in writing or in conversation, not improvised once you’re lying down.
Declines work. Has conditions they won’t work with, says so, and refers out. A practitioner who has never turned anyone away hasn’t been paying attention.
Paces deliberately. Works below your maximum, builds tolerance over sessions, and treats a big release as something to be integrated rather than a result to be repeated.
Checks in during, in plain language. Not “how’s your energy” — do you want to continue, do you want to slow down, what’s happening right now.
Can stabilise. Knows grounding and orienting techniques and uses them rather than letting a session run long because something dramatic is occurring.
Has supervision and referral relationships. Someone they take cases to. Named professionals they send people to.
Gives aftercare guidance. Tells you what the next 24 to 48 hours might be like, and what to do if it’s difficult.
Is insured.
None of this is exotic. It’s the baseline in every body-based profession, and its absence is a decision rather than an oversight.
What you can do
Disclose fully, including the embarrassing parts. Medication, diagnoses, history. The screening only works if it’s accurate, and a practitioner cannot keep you safe from information they don’t have.
Ask one question before booking: what happens if I become distressed during a session? A competent answer is specific and procedural. A vague one — that it’s part of the process, that they’d hold space for it — tells you they haven’t thought about it.
Know that pacing is yours. You can slow anything down, at any point, without explanation. If that’s met with reluctance, that’s your answer about the practitioner.
The proportionate summary
Most of what I teach is slow breathing and attention, and the risk attached to it is close to zero. You can begin today with no screening and no supervision and come to no harm.
The risk concentrates in a specific place: intensive experiences, delivered fast, by people with no screening process, to groups where nobody is watching individuals closely. That’s also where most of the money in this industry is.
Knowing which of those you’re buying is most of staying safe.
If you have a medical or mental health condition, speak to your doctor before starting intensive breathwork — and tell any practitioner you work with. I’d rather turn someone away than take on work I shouldn’t.
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