advanced pranayam breathwork

Dr Patricia Gerbarg and Dr Richard Brown are Professors of Clinical Psychiatry and with colleagues describe observed benefits, contraindications and recommendations for advanced pranayam breathing techniques; Kapilibhati, Bhastrika, Sudarshan Kriya.

This interview with Dr Gerbarg and Dr Brown describes their experience of Sudarshan Kriya Yoga (SKY breath) documenting the extensive health benefits for many people, and adverse effects for some, then built on their experience to develop their Breath-Body-Mind program with no reported adverse effects.

“…I was blown away by what I experienced, and what the others experienced,” said Dr Gerbarg. She delved into studying and researching what she saw happening with participants, which included a loss of anxieties and worries….We found the faster breathing techniques to cause adverse reactions in some vulnerable people, particularly those with bipolar disorder, anxiety disorders, posttraumatic stress disorders, and seizure disorders. Since we were not able to convince the Art of living Foundation to allow us to adapt the program to the needs of individuals with mental illness, we withdrew from the organization after about five years of study.”

Newtown Yoga Festival Headliners Encourage ‘Back To Balance’
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Anxiety, panic, mania, flashbacks, dissociation, psychosis, seizures as well as cardiovascular and respiratory adverse effects were observed as ‘precipitated and exacerbated’ by Sudarshan Kriya in some of 200 people after South East tsunami 2004 plus later clinical referrals. Sudarshan Kriya is a modern trademarked set rhythm of breath patterns and includes ‘Associated Practices’ of Ujjayi, Bhastrika, breath holds and meditation.

Dr Shirley Telles and Nikamal Singh of Patanjali Yoga Foundation additionally describe Sudarshan Kriya as a modern form of Kapilibhati (breath of fire). They show an extensive table of breath and meditation techniques with detailed descriptions of observed health benefits and adverse effects. Kumbhak (period of breath holding), Bhastrika (bellows breath), Kapilibhati (breath of fire) and some forms of meditation are described as causing adverse mental health effects particularly anxiety, dissociation, flashbacks and psychosis in some people.

There are extensive recommendations and clinical guidance for instructors of Sudarshan Kriya, Bhastrika and Kapilibhati described in Dr Patricia Gerbarg and Dr Richard Brown’s 8 published studies below (2005 to 2018), read my summary here.


  • Muskin. R.P. Gerbarg. P.L, Brown R.P, (2013), p121 to p140. Complementary and Integrative Therapies for Psychiatric Disorders, An Issue of Psychiatric Clinics, l e (The Clinics: Internal Medicine) 1st edition
  • Jerome Sarris, Patricia L. Gerbarg, Richard P. Brown, Philip R. Muskin (2015). Chapter 110, “Integrative and Complementary Medicine in Psychiatry” in (eds) Tasman, Allan. Kay, Jerald., Jeffrey A. Lieberman, Michael B. First, Mario Maj “Psychiatry”. Fourth edition vol 2.

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