Challenging Traditional Science: Breathwork Meditation for Self-Transcendence

Current research on complementary and alternative medicine (CAM) mind-body therapies, such as breathwork techniques and meditation practices, has shown that these modalities positively affect both physiological and psychological aspects of health and well-being (Busch et al., 2012; Reddy & Roy, 2019; Zaccaro et al., 2018). One facet of well-being that is making its debut in scientific communities as a powerful indicator of overall health and wellness is self-transcendence, a phenomenon elicited through convoluted and interconnected cognitive and psychological experiences that can arise with breathwork and meditation (Kitson et al., 2020; Reed, 1991, 2013). To understand the depths of this relationship, and to support valid research efforts for exploring self-transcendence and overall well-being through breathwork and meditation, this article discusses the state of the traditional science on these modalities compared to a Complex Systems Science (CSS) view and Whole Systems Research (WSR) approach when building and conducting investigations on this phenomenon.

Defining Terminology

It is important to recognize and define potentially unfamiliar terminology that will be presented in this article. CSS is a scientific discipline and theoretical framework that views the world and its environments and inhabitants as interacting elements in a reciprocal relationship where one element can influence the entire system, and the entire system can help organize and shape one element (Arnold & Wade, 2015; Koithan et al., 2012; Notarnicola et al., 2017). The entire system is considered when analyzing phenomena, planning interventions, and making decisions on how to improve outcomes, as all separate elements of the system extensively influence one another (Koithan et al., 2012; Notarnicola et al., 2017). WSR, a scientific examination process and approach that considers the whole individual and its surrounding environments and communities during investigations, supports this holistic perspective when guiding research efforts, as its foci and methodologies follow CSS principles, opposing the potentially tunnel-visioned view of traditional reductionistic research strategies (Ijaz et al., 2019; Ritenbaugh et al., 2003; Verhoef et al., 2005).

Figure 1: Characteristics of Complex Systems (Systems Innovation, 2020)

Self-transcendence is described as an extension of one’s internal, external, temporal, and transpersonal boundaries to create a greater connection with the environment and encourage an overall sense of wholeness and purpose (Kitson et al., 2020; Reed, 1991, 2013). In other words, the more an individual can look within and evolve beyond any limitations that may have been internally or externally set, the more this sense of self can promote an understanding and acceptance of one’s essential place in the universe. Self-consciousness, a construct that is heavily involved in the self-transcendence process, is defined as the activation of self-reflection through the acute, nonjudgmental self-awareness of thoughts, beliefs, and emotions, providing a space for self-transcendence to occur through unrestricted introspection (Cobos Garcia, 2022; Garcia et al., 2012; Kang, 2019; Steinhorn et al, 2017; Vago & Silbersweig, 2012). Breathwork meditation appears to provide its practitioner with the mental space to explore cognitive and psychological phenomena that are both motivated and cultivated by self-transcendence, in turn promoting positive and lasting effects on health and well-being (Goleman & Davidson, 2018; Joshi & Telles, 2009; Kitson et al., 2020; Reed, 1991, 2013; Zaccaro et al., 2018).

It is also imperative to acknowledge that though each meditative practice and breathwork technique influences the body in its own way (Busch et al., 2012; Goleman & Davidson, 2018; Joshi & Telles, 2009; Miller & Nielsen, 2015), meditation and breathwork are often used together (Zaccaro et al., 2018). Due to the still emerging research on the specifics of these practices, and for the purposes of this article and its intended focus, the term "breathwork meditation" will be used from this point on and describes any meditative practice that includes breathwork (e.g., mindfulness meditation), or any breathwork technique that could be used within a meditative framework (e.g., resonance breathing, diaphragmatic breathing, deep breathing).

Figure 2: Conceptual model showcasing self-transcendence's effects on behavior change (Kang et al., 2018)

The State of Traditional Science on Breathwork Meditation: a Focus on Well-Being

Western medicine is deeply influenced by the reductionistic approach to health and well-being, which is based on the tenet of Cartesian philosophy that the mind and body are two separate entities (Capra & Luisi, 2014). Under this influence, medical research in the United States and around the world has been, and still is, conducted under a similar lens (Koithan et al., 2012). Though CAM modalities, including breathwork meditation, have grown in popularity and gained a reputation as effective interventions for improving well-being (Busch et al., 2012; Reddy & Roy, 2019; Zaccaro et al., 2018), many researchers prefer traditional methods of investigation (i.e., randomized controlled trials [RCTs], feasibility studies, pilot studies) to WSR approaches (i.e., case studies, narrative analysis) for studying these complex phenomena (Koithan et al., 2012). However, given the reliability and internal validity of strong trial-and-error research methodologies, a brief review of the traditional literature on how breathwork meditation is used as an integrative modality for well-being is important in supporting the application of this intervention.

Sharma et al. (2016) conducted a pilot study on Sudarshan Kriya yoga, a breathwork meditation technique that includes 30 minutes of alternating slow breathing (respiration rate of four breaths per minute), rapid breathing (respiration rate of 30 breaths per minute), and ohm chanting, followed by 10 minutes of meditation, as an adjunct intervention for major depressive disorder. The group assigned to Sudarshan Kriya yoga found it to be a feasible practice and showed greater improvement in Beck Depression Inventory (BDI) scores and Hamilton Depression Rating Scale (HDRS) scores compared to the waitlist control (Sharma et al., 2016). Chan et al. (2015) found that breathwork meditation compared to the control group was both feasible and acceptable for patients with chronic obstructive pulmonary disease (COPD), and that it enhanced participants' emotional functioning to assist with activities of daily living (i.e., eating, bathing, cooking). Given the discomfort that may occur from certain breathing exercises in people with COPD, Ujjayi breathing, or slow and controlled diaphragmatic inhalation and exhalation with a slight throat constriction, was successfully used as a breathwork meditation technique (Chan et al., 2015).

Figure 3: Breathing and Breathwork Techniques (Kaul, 2022)

As for RCTs, Mahendru et al. (2021) investigated the effect of breathwork meditation on well-being in patients with COVID-19 who were required to stay in isolation. The breathwork meditation technique used was Nadi Shodhana, or alternate nostril breathing (ANB), where the practitioner alternates between nostrils for each round of inhalation and exhalation (Mahendru et al., 2021). ANB was found to lower participants' depression levels and stress levels and increase sleep quality (Mahendru et al., 2021). Gregoski et al. (2011) examined the effect of breathwork meditation on hemodynamic and sodium functioning in African Americans at risk for cardiovascular disease from stress-related hypertension. The authors found that Breathing Awareness Meditation, a component of Dr Jon Kabat-Zinn’s Mindfulness-Based Stress Reduction program that asks practitioners to concentrate on their breath during meditation, had the highest decrease in blood pressure, as well as noting a trend towards statistical significance for decreasing sodium excretion in the urine, compared to Botvin LifeSkills Training and the high education control (Gregoski et at., 2011). The study aforementioned indicates the impact breathwork meditation has on both physiological and psychological phenomena, and how these phenomena are interrelated when considering well-being (Gregoski et al., 2011).

Based on the results above, breathwork meditation was found to be both acceptable and feasible, to improve participants' perceptions of stress level, mood, and quality of life, among other psychological constructs, to improve physiological complications, and to be beneficial for a variety of populations and conditions. Coupled with the expansion of new physiological and neuroscientific discoveries, traditional science has paved the way for WSR to investigate the relationship between breathwork meditation and well-being through CSS principles and perspectives. This is shown in studies that investigate how neurological feedback loops affect cardiovascular and respiratory feedback loops to induce physiological changes that enhance psychological and cognitive experiences, including self-transcendence (Reddy & Roy, 2019; Russo et al., 2017; Zaccaro et al., 2018).

The State of the Science on Breathwork Meditation through a Complex Systems Science Lens: a Focus on Self-Transcendence for Well-Being

Traditional research practices are beneficial in constructing and implementing specific interventions for specific disease processes, as the knowledge obtained assists in understanding the human body, as well as influencing how alternative approaches can be employed (Koithan et al., 2012). However, solely conducting research through these traditional mechanisms creates a one-to-one, cause-and-effect vision that does not consider the whole individual, nor the nested, complex systems within the individual, or the environmental systems surrounding the individual (Ijaz et al., 2019; Koithan et al., 2012; Ritenbaugh et al., 2003; Verhoef et al., 2005). Per the literature, the principles of CSS and their role in the relationship between breathwork meditation and self-transcendence explain how these internal and external networks of systems heavily influence an individual’s self-transcendence process and well-being journey overall. Utilizing WSR approaches is imperative for further investigating this relationship.

Figure 4: Holism and its Pros and Cons (Cherry, 2023)

Much of the current research on using breathwork meditation for self-transcendence and its related cognitive constructs (e.g., self-consciousness, self-reflection, self-awareness) discusses forms of hyperventilation. This differs from the more commonly used breathwork meditation techniques, such as DSB or diaphragmatic breathing, that activate parasympathetic activity and induce a state of relaxation, decreasing sensations of stress and pain and creating a space for consciousness (Busch et al., 2012; Vago & Silbersweig, 2012). Regardless of the polarization between hyperventilation and hypoventilation techniques, their effects on the central nervous system, or how they are implemented and studied, both respiratory styles underpin breathwork meditation practices that in some way influence self-transcendence, leading to improved well-being.

Miller and Nielsen (2015) analyzed and synthesized case studies and conducted a quasi-experimental design with posttest semi-structured interviews to examine the effects of Holotropic Breathwork (HB), or prolonged voluntary hyperventilation, on temperament for self-awareness. For each practitioner of HB, their pretest-posttest scores for persistence temperament were reduced, indicating an increase in self-awareness (Miller & Nielsen, 2015). Kapalabhati breathing, a breathwork technique practiced during some forms of yoga where the individual forcefully exhales and gently inhales, is another form of hyperventilation that elicits cognitive phenomena (Joshi & Telles, 2009). Joshi and Telles (2009) utilized event-related potentials to capture participants’ attention to a task following kapalabhati breathing and found a statistically significant increase in attention when compared to simple breath awareness. However, Joshi and Telles (2009) found that simple breath awareness also increased neural resources to complete attention tasks, indicating the complexity of choosing a specific breathwork meditation technique as an intervention for self-transcendence and overall well-being.

Figure 5: What's the Point of Transcendence? (Harris, 2011)

The hyperventilation modalities implemented in these studies are thought to activate sympathetic activity, which increases an individual’s cognitive resources (i.e. attention, self-awareness; Joshi & Telles, 2009), and causes cerebral hypoxia, or a lack of oxygen to the brain, which can induce hyperaware, euphoric states (Kastrup, 2017). Adding to the support for employing WSR methodologies for this phenomenon, Kastrup (2017) included interviews from different studies of individuals who have experienced these hyperaware, euphoric states to highlight the relationship between physiological and cognitive occurrences (i.e., near-death experiences, cerebral hypoxia) and self-transcendence. Kastrup’s (2017) strategy parallels phenomenology, a prevalent research methodology used in nursing and human science specialities that focuses on the lived experiences of participants, including their beliefs, attitudes, and emotions about these experiences (Thomas, 2021). Reflecting the holistic theoretical underpinnings of CSS and WSR, phenomenological methodology considers diverse aspects of an individual or population, providing myriad information on how a specific experience has shaped their physical, psychological, and cognitive lives (Thomas, 2021).

Reddy and Roy (2019) discuss the stir in curiosity about the complexity of breathwork meditation as an intervention for unique conditions, populations, circumstances, and/or constructs. Self-transcendence falls under the category of being a unique cognitive construct, as it is expressed psychologically as having a sense of connection to the surrounding environment and feeling purposeful in one's existence (Kitson et al., 2020; Reed, 1991, 2013). Guided by Pamela Reed’s Self-Transcendence Theory (Reed, 1991, 2013), Fiske (2019) addresses the positive relationship between self-transcendence and well-being, and how breathwork meditation fosters self-transcendence by providing a space for intrapersonal expansion. In her discussion, Fiske (2019) notes that breathwork meditation was previously implemented with healthcare professionals and students, both of whom experienced enhanced well-being following the intervention. These deliberations by Fiske (2019), Kastrup (2017), Reddy and Roy (2019) and other authors contribute to the springboard in discovering how CSS principles and WSR methodologies further this area of research to promote well-being.

Figure 6: Whole Systems Thinking for Mental Health (Lloyd, 2020)

Conclusion

The journey of comprehending the inner workings of breathwork meditation for self-transcendence has only just begun. Current and emerging research has indicated that participation in breathwork meditation encourages cognitive and psychological experiences imperative to the self-transcendence process and an increase in overall well-being. Though RCTs and traditional science, in general, have their place in research, as they provide subsequent paths for investigation, the future state of the science on the phenomenon of self-transcendence through breathwork meditation will benefit from CSS and WSR perspectives. The phenomenon of breathwork meditation for self-transcendence, including its connection to well-being, is a dynamic occurrence that requires the holistic principles of CSS and the investigative flexibility of WSR to comprehend the benefits of these relationships (Ijaz et al., 2019; Koithan et al., 2012; Ritenbaugh et al., 2003; Verhoef et al., 2005). WSR has become increasingly popular in recent decades with its focus shifting away from designs that fit the reductionistic, traditional science model, such as RCTs, to designs that are more suitable for intricate, complex modalities in CAM, such as qualitative analyses, case studies, and quasi-experimental designs (Ijaz et al., 2019; Koithan et al., 2012; Ritenbaugh et al., 2003; Verhoef et al., 2005). In any course of action, it is imperative to remember the principles of CSS and WSR – focusing on the complexity of the whole individual and of each modality will grant the most comprehensive understanding of how breathwork meditation leads to overall healing through the self-transcendence process.

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