Pranayama (nadi shodhana, kapalabhati, bhastrika, ujjayi, bhramari)

Domain X · Body, movement, breath & physical · India

What it is

Pranayama is the yogic practice of regulating the breath. In the Yoga Sutras attributed to Patanjali it is the fourth of eight limbs (2.29); in the Hatha tradition the key text is the Hatha Yoga Pradipika, attributed to Svatmarama (15th century), which presents breath practices together with breath…

Format

• (a) How yoga bodies position it. The Common Yoga Protocol places pranayama after loosening practices and postures and before meditation, within one structured session, and lists kapalabhati, nadi shodhana / anuloma viloma, sheetali and bhramari among its practices, each traced to the Hatha texts…
• Phase 1: Screening and framing (first session in which breath work is raised). Goals: medical and psychiatric screening (Section 4.1), checking the client's cultural and religious relationship to yoga, agreeing a secular or tradition-respecting framing, and establishing the client's ordinary…

Who practises it, and how they are trained or regulated

• Who holds teaching authority. Teaching authority rests with lineage teachers and recognised schools (for example the Iyengar, Sivananda, Bihar/Satyananda, Krishnamacharya-derived and Sri Sri / Art of Living traditions) and, for therapeutic yoga, with yoga therapists credentialed by bodies such as the International Association of Yoga Therapists (IAYT). Psychotherapists should not present themselves as pranayama…
• What it is. Pranayama is the yogic practice of regulating the breath. In the Yoga Sutras attributed to Patanjali it is the fourth of eight limbs (2.29); in the Hatha tradition the key text is the Hatha Yoga Pradipika, attributed to Svatmarama (15th century), which presents breath practices together with breath retention (kumbhaka) and body locks (bandha). B. K. S. Iyengar's Light on Pranayama is the best-known…
• A clinical account of how change might happen. Research reviews describe pranayama as producing shifts in autonomic balance (for slow, humming and alternate-nostril practices, a move towards parasympathetic activity as indexed by heart-rate variability), along with changes in attention and self-reported stress; fast techniques (kapalabhati, bhastrika) are described as activating and produce different effects from…

Evidence status, as the guide reports it

• Evidence status (brief). A meta-analysis of randomised trials of breathwork in general found a small-to-medium reduction in self-reported stress compared with controls, with most trials at moderate risk of bias (Fincham et al. 2023). A review of bhramari reported benefits on stress, anxiety, sleep…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• air hunger or breath-holding at the switch (remind: no pause needed); confusion about sides (reassure; the sequence matters less than ease); nasal blockage causing strain; arm fatigue;…
• light-headedness on standing; the client leaving in a dissociated or very relaxed state before driving (wait until fully alert). Working: the client leaves alert and with a clear, safe plan.
• a client who feels the practice conflicts with their faith; expectation of a cure; a client who wants to please the therapist. Working: the client can restate the stop rule and chooses to try.
• artificial pacemaker or stent; epilepsy; hernia; backache from a slipped disc; recent abdominal surgery; menstruation; pregnancy and the period shortly after childbirth; hypertension or heart…
• high blood pressure; any heart problem; hernia; vertigo; hyperacidity; ulcer; recent abdominal surgery; "too much heat in the body"; stroke; hyperthyroidism (NIOS). High blood pressure, heart…

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.