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Guide XIII-020

Sudarshan Kriya (Art of Living)

Sri Sri Ravi Shankar1981India
A 31 · L 60 · M 913 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: Sudarshan Kriya as the Art of Living Foundation publishes it (artofliving.org course pages for "Art of Living Part 1" / Happiness Program, the Teacher Training page, and Art of Living Foundation Canada's medical-information letter to physicians); the research-delivery format from the veterans trial of Bayley et al. 2022 (Project Welcome Home Troops) is noted where it differs. The breathing technique itself is restricted: it is taught only by Art of Living-trained teachers inside the course, so this guide gives the public outline only and covers the psychotherapist's work around it.

Sudarshan Kriya is a breathing practice taught by a modern spiritual organisation; it is not a psychotherapy. The Art of Living Foundation describes Sudarshan Kriya (a trademarked name) as a breathing technique using "specific natural rhythms of the breath" which, in its words, eliminates stress, fatigue and negative emotions. The organisation states that its founder, Gurudev Sri Sri Ravi Shankar, "cognized" the kriya on 17 September 1981 on the banks of the Bhadra river in Shimoga, after a period of silence and fasting, and that it became the cornerstone of all Art of Living programmes [source: Art of Living, What is Sudarshan Kriya]. The phrase "cognized" is the organisation's own religious framing and is reported here as its account, not assessed.

Core idea of change, as attributed: the organisation holds that rhythmic breathing releases stress and negative emotion. In the clinical literature, Brown and Gerbarg (2005) proposed a neurophysiological model in which the breathing sequence increases parasympathetic drive, calms stress-response systems and produces a state of "calm alertness"; the authors themselves state the mechanisms are not yet clarified [source: Brown & Gerbarg 2005, Part I abstract]. For the therapist, change happens outside the session (in the course and home practice); the therapist's job is assessment, safe referral, client-led integration and monitoring [synthesis].

Evidence status in one line: randomised trials exist in depression and PTSD, including a 2022 non-inferiority trial in veterans comparing SKY with Cognitive Processing Therapy; the organisation's wider health claims (immunity, blood pressure, respiratory function) are its own and SKY is not a treatment for physical disease [source: Bayley et al. 2022; Art of Living, What is Sudarshan Kriya].

2. Framework

2a. The organisation's course structure (as published)

  • Entry course. Sudarshan Kriya is taught in "Art of Living Part 1" (also called the Art of Breathing, or the Happiness Program/Happiness Programme), with age-matched versions (e.g. YES!, Yesplus, ART Excel for younger people) [source: Art of Living, How to do Sudarshan Kriya; Art of Living Teacher Training].
  • Format. Either six days of roughly 2–3 hour sessions on weekdays and half-days at the weekend, or a three-day format running Friday evening to Sunday afternoon. The course is described as experiential, with interactive sessions [source: Art of Living, How to do Sudarshan Kriya].
  • Delivery. Taught "only in the course environment" by a trained teacher, who leads it with a recorded instruction track of the founder's voice and supervises participants personally. The recording is not sold [source: Art of Living, How to do Sudarshan Kriya].
  • Home practice. After the course participants learn a shorter version ("Short Kriya") for daily home use [source: Art of Living, How to do Sudarshan Kriya].
  • Follow-up. Weekly group follow-up sessions at local centres, where the full kriya is done with the recording; graduate programmes follow [source: Art of Living, How to do Sudarshan Kriya; What is Sudarshan Kriya].
  • Public outline of components. Published research names the practice's components only in general terms, including ujjayi ("victory breath"), bhastrika ("bellows breath") and the Sudarshan Kriya cyclical breath itself, without instructions [source: Brown & Gerbarg 2005, Part I abstract; Bayley et al. 2022]. Art of Living Canada's physician letter notes that the practice includes faster breathing done under a teacher's guidance and a resting phase lying down [source: Art of Living Canada, Medical Information Form]. No sequence, rhythms, counts or instructions are given here; the technique is course content restricted to certified teachers.
  • Research-delivery variant. In Bayley et al. 2022, SKY was a 5-day intensive (3 hours a day) followed by ten 60-minute group sessions twice weekly (25 contact hours, groups of 3–6), with an optional short daily home routine [source: Bayley et al. 2022].
  • Teachers. Teacher Training requires having taken the Happiness Programme or Yesplus, at least one year of daily Sudarshan Kriya and Sahaj Samadhi Meditation practice, and age 18+; it is a two-week immersive training, after which selected graduates teach the entry courses [source: Art of Living Teacher Training]. Ongoing re-certification requirements are not published on that page [uncertain: not verified].

2b. The psychotherapist's framework alongside it [synthesis]

No published psychotherapy protocol for working alongside Art of Living is known; the following phases are synthesis.

  1. Exploration and assessment (usually within ordinary sessions): what the practice or the movement means to the client, their goals, and medical-psychiatric suitability. Move on when the client's aim is clear and contraindications have been reviewed.
  2. Informed decision and referral: share the organisation's own published precautions, liaise with the prescriber/GP where relevant, and refer to a certified teacher. Move on once the client has chosen (course, alternative such as meditation only, or not at all).
  3. Integration: debrief course and home-practice experiences in the client's own words; link to treatment goals the client chooses. Continue as long as the client finds it useful.
  4. Monitoring and adjustment: watch mood, sleep, dissociation and medication adherence; respond to adverse experiences; coordinate with the teacher if the client wishes.
  5. Review: revisit whether the practice still fits, including any relationship with the group itself.

Session counts for the therapist's work are not given by any source.

3. Guiding principles

  • The technique stays with certified teachers. Never teach, demonstrate or coach the kriya or its components in therapy; refer to the course [source: Art of Living, How to do Sudarshan Kriya].
  • Client-led. The client decides whether the practice enters therapy and in what words; the therapist follows their language and goals [synthesis; source: Vieten et al. 2013 abstract on including religious and spiritual issues in assessment and treatment planning].
  • Screen using the organisation's own precautions. Art of Living Canada lists seizure disorders, bipolar I and II, schizophrenia/schizoaffective disorders and major surgery in the previous 8 weeks as contraindications for learning SKY, and notes pregnancy was traditionally discouraged with no safety data either way [source: Art of Living Canada, Medical Information Form]. Practical meaning: these clients see their doctor before enrolling.
  • Medicines stay with the prescriber. The same letter warns against stopping medication because of euphoric effects. Practical meaning: never advise on medicines; route any medication question to the prescriber [source: Art of Living Canada, Medical Information Form].
  • Tell the teacher about health conditions. The organisation asks participants to inform the instructor of pregnancy, high blood pressure or a psychiatric disorder so that special directions can be given. Practical meaning: help the client prepare that disclosure [source: Art of Living, How to do Sudarshan Kriya].
  • Expect variation. The organisation states each person's experience varies. Practical meaning: no outcome is promised; ask rather than predict [source: Art of Living, How to do Sudarshan Kriya].
  • Adverse effects are real in contemplative practice. Meditation adverse events had a pooled prevalence of about 8% in one review and can occur without prior mental-health history. Practical meaning: give balanced information and monitor [source: Farias et al. 2020].
  • Not a substitute for indicated treatment. In veterans with PTSD, SKY was non-inferior to CPT on PTSD symptoms but inferior on depression and affect measures at one year. Practical meaning: offer it as a client-chosen adjunct or option, not a replacement for evidence-based care the client needs [source: Bayley et al. 2022].
  • No physical-disease claims. Health claims are the organisation's; SKY is not a treatment for physical illness [source: Art of Living, What is Sudarshan Kriya].
  • Concepts attributed. Terms such as "kriya", "cognized" or the founder's title "Gurudev" are the organisation's; use them as the client does without endorsing or dismissing them [synthesis].
  • Role boundaries. The therapist is not the client's teacher or guru; avoid dual relationships (e.g. attending the same centre in a teaching role, recruiting clients to courses) and handle self-disclosure of one's own practice cautiously [synthesis; professional ethics codes, not verified here — uncertain].
  • Competence. Vieten et al. (2013) propose 16 basic spiritual and religious competencies for all psychologists, across attitudes, knowledge and skills. Practical meaning: assess spirituality routinely and seek consultation when out of depth [source: Vieten et al. 2013 abstract].
  • Group dynamics, even-handedly. Notice the client's relationship with the organisation as well as the technique, without labelling the group [synthesis].

4. Intervention inventory

The kriya itself is restricted and is not an intervention the therapist delivers. The inventory below is the psychotherapist's own work around it. Unless a source is tagged, the steps are [synthesis].

4.1 Exploring meaning and goals

  • Purpose / when: First conversation in which a client mentions Art of Living, SKY or the founder; also when a client already practises. Establishes whether this is a stress-management technique, a spiritual path, a community, or all three for them.
  • Steps: (1) Ask open questions about how they came to it and what it gives them. (2) Note the client's own vocabulary (e.g. "Kriya", "Gurudev", "follow-up") and use it. (3) Ask what they hope will change, and whether they want it discussed in therapy at all. (4) Record the answer as part of the formulation; a structured cultural or spiritual assessment such as the DSM-5-TR Cultural Formulation Interview may be used [uncertain: not verified]. Routine assessment of religion and spirituality is one of the competencies proposed by Vieten et al. 2013 [source: Vieten et al. 2013 abstract].
  • Example language (illustrative): "You mentioned the breathing course. What does that practice mean to you — is it mostly a tool, or part of something bigger?" / "Would you like it to be something we talk about here, or keep it separate?"
  • Watch for: Working: the client speaks freely and sets the agenda. Caution: idealisation that leaves no room for doubt, or shame about wanting to talk about it; either is information, not a problem to fix.

4.2 Medical and psychiatric suitability screening, with doctor liaison

  • Purpose / when: Before a client enrols, or when an enrolled client has a relevant condition.
  • Steps: (1) Review the conditions Art of Living Canada itself lists for physicians: seizure disorders (rapid breathing may lower carbon dioxide and the seizure threshold, especially in the first sessions), bipolar I and II (theoretical risk of mania or hypomania, possible effect on lithium clearance), schizophrenia and schizoaffective disorder (theoretical risk of dissociative or psychotic episodes), major surgery within 8 weeks (pressure, hernia, wound and pain concerns), and pregnancy (no safety data either way) [source: Art of Living Canada, Medical Information Form]. (2) Add, from research exclusion criteria, recent mania or psychosis, recent suicidal intent, current substance dependence and severe traumatic brain injury as reasons for extra caution [source: Bayley et al. 2022 exclusion criteria; their use as clinical screens is synthesis]. (3) If any apply, ask the client's consent to contact their GP or psychiatrist, or encourage the client to take the organisation's physician letter to them. (4) Document the decision as the client's, made with medical advice.
  • Example language (illustrative): "The organisation itself asks doctors to look at a few conditions before people learn this breathing. Given your history of seizures, would you be willing to take their form to your neurologist first?"
  • Watch for: Pressure (from friends, the group, or the client's enthusiasm) to skip medical review; minimising of past manic or psychotic episodes. Working: the client brings back a clear medical view.

4.3 Informed referral to a certified teacher

  • Purpose / when: The client wants to learn SKY, or wants an alternative.
  • Steps: (1) Explain plainly that the technique is taught only in the course by a trained teacher, with weekly group follow-ups and a shorter home practice afterwards [source: Art of Living, How to do Sudarshan Kriya]. (2) Give balanced information: possible benefits as the client hopes, plus the fact that contemplative practices can bring anxiety, low mood or unusual experiences in a minority [source: Farias et al. 2020]. (3) Direct them to the organisation's own course listings and its "talk to a certified teacher" route rather than videos or informal teaching [source: Art of Living, What is Sudarshan Kriya]. (4) If the client is screened out of SKY, note that the organisation's physician letter mentions some such clients choosing Sahaj Samadhi Meditation instead [source: Art of Living Canada, Medical Information Form]; any such choice is the client's, with medical advice. (5) Do not receive referral fees or recruit to courses.
  • Example language (illustrative): "This is something you learn in person from one of their teachers — I can't teach it and wouldn't want to. If you go, let's talk afterwards about how it went."
  • Watch for: Clients trying to self-teach from online clips of rapid breathing; a sense the therapist is "selling" the course. Working: the client makes a choice they own.

4.4 Preparing disclosure to the teacher

  • Purpose / when: A client with a health or psychiatric condition is enrolling. The organisation asks participants to tell the instructor about conditions such as pregnancy, high blood pressure or a psychiatric disorder, so the teacher can give special directions [source: Art of Living, How to do Sudarshan Kriya].
  • Steps: (1) Help the client decide what to disclose (diagnosis, triggers, panic history, trauma reactions to lying down or eyes closed). (2) Rehearse a short script. (3) Agree a personal opt-out plan: they may sit out any part, open their eyes, or leave the room.
  • Example language (illustrative): "What would you want the teacher to know so they can adjust things for you? Let's write two sentences you'd feel okay saying."
  • Watch for: Shame about disclosure; belief that sitting out means failing. Working: the client discloses and keeps their opt-out.

4.5 Medication adherence and mood monitoring

  • Purpose / when: Clients on psychiatric medication, especially with bipolar history, during and after the course.
  • Steps: (1) Note the organisation's own warning that euphoric effects may tempt people with bipolar disorder to stop medication [source: Art of Living Canada, Medical Information Form]. (2) Agree a simple daily check of sleep, energy, irritability and racing thoughts for the course week and the following fortnight. (3) Route every medication question, including a wish to reduce, to the prescriber. (4) Agree in advance what signs will prompt contact with the psychiatric team.
  • Example language (illustrative): "If you feel so good you start wondering whether you still need your medication, that's exactly the moment to call your psychiatrist before changing anything."
  • Watch for: Reduced sleep with high energy, pressured speech, grandiosity; spiritual framing of an elevated mood. Working: stable sleep and mood; medication decisions stay with the prescriber.

4.6 Post-course debrief and client-led integration

  • Purpose / when: First session after the course, then as the client wishes.
  • Steps: (1) Ask what happened, in their words, including physical sensations, emotions and memories. (2) Normalise variation; the organisation itself says experiences differ [source: Art of Living, How to do Sudarshan Kriya]. (3) Ask what they want to take from it into daily life and into therapy goals. (4) Link insights to the existing formulation only if the client finds that useful.
  • Example language (illustrative): "What was the course like for you — in your body, your feelings, anything that came up?" / "Is there something from it you'd like to keep using between our sessions?"
  • Watch for: Unprocessed distress, emerging trauma memories, a sense of failure if nothing dramatic happened. Working: the client can describe the experience and choose what to keep.

4.7 Supporting home practice as the client's choice

  • Purpose / when: Client has completed the course and wants help keeping the short daily practice or attending follow-ups.
  • Steps: (1) Treat practice as the client's goal, not a homework assignment from therapy. (2) Use ordinary behavioural problem-solving for scheduling (time, place, cue). (3) Never correct or coach the breathing itself; technique questions go to the teacher or follow-up group [source: Art of Living, How to do Sudarshan Kriya]. (4) Review benefit and cost together periodically.
  • Example language (illustrative): "You said mornings work best. What gets in the way on the days it doesn't happen?"
  • Watch for: Rigidity or guilt about missed practice (see 5, scrupulosity-like patterns); escalation to more intense or longer practice without teacher guidance. Working: flexible practice that fits life.

4.8 Grounding and dose-reduction for distressing experiences

  • Purpose / when: The client reports anxiety, panic, dissociation, intrusive memories, insomnia or unusual perceptions during or after practice. Lindahl et al. 2017 mapped 59 kinds of challenging meditation experiences across cognitive, perceptual, affective, somatic, conative, sense-of-self and social domains, lasting from days to, rarely, over a decade [source: Brown University news on Lindahl et al. 2017].
  • Steps: (1) Validate; such experiences are documented and not the client's fault [source: Brown University news on Lindahl et al. 2017]. (2) Use non-breath grounding in session: orienting to the room, feet on the floor, naming objects, eyes open. (3) Encourage the client to discuss reducing or pausing practice with their teacher, rather than pushing through [synthesis]. (4) Review sleep, diet and exercise, which Lindahl et al. list among influencing factors [source: Brown University news]. (5) Point the client to specialist support for meditation-related difficulties such as Cheetah House [source: Cheetah House VCE page]. (6) Escalate to medical or crisis care if risk, psychosis or mania appear.
  • Example language (illustrative): "Let's keep your eyes open and notice five things you can see. You don't need to do any special breathing right now." / "Would you be willing to ask your teacher about pausing the long practice for a while?"
  • Watch for: Worsening after each session, derealisation persisting beyond the practice, inability to sleep. Working: symptoms settle with grounding and reduced practice.

4.9 Telling spiritual experience apart from psychiatric illness

  • Purpose / when: The client describes experiences they frame spiritually (bliss, light, energy, loss of self, feeling chosen) or that look like psychosis, mania, depression or dissociation.
  • Steps: (1) Take the client's spiritual framing seriously without confirming or dismissing it. (2) Assess function: sleep, self-care, work, relationships, risk. (3) Screen specifically for mania (reduced need for sleep, grandiosity), psychosis (fixed beliefs, hallucinations outside practice), depressive collapse and persistent depersonalisation. (4) If function holds and there is no risk, treat it as a religious or spiritual problem or experience to explore; DSM-5-TR includes a code for a religious or spiritual problem, Z65.8 [source: ICD-10-CM Z65.8]. (5) If risk or illness signs appear, arrange psychiatric assessment while respecting the meaning. Lindahl and colleagues' later paper "Progress or Pathology?" addresses differential criteria from teachers' and practitioners' perspectives [source: Cheetah House VCE page; uncertain: not verified].
  • Example language (illustrative): "That sounds like it mattered a lot to you. Alongside what it means, I also want to check how you're sleeping and managing day to day."
  • Watch for: Missing illness by spiritualising it, or pathologising a meaningful, contained experience. Working: a shared understanding that holds both meaning and safety.

4.10 Trauma-sensitive considerations

  • Purpose / when: Clients with trauma histories, including veterans; SKY has been studied in PTSD [source: Bayley et al. 2022].
  • Steps: (1) Identify likely triggers in a group breathing course: lying down, eyes closed, a teacher's voice in the dark, strong bodily sensation, others' emotional release. (2) Plan choice and control with the client (sit up, eyes open, pause, step out) and help them tell the teacher. (3) Keep a trauma-focused therapy available; in veterans, SKY was non-inferior to CPT on PTSD symptoms but CPT did better on depression and affect at one year [source: Bayley et al. 2022]. (4) Trauma-sensitive mindfulness (Treleaven 2018) is a published adaptation for meditation generally [uncertain: not verified].
  • Example language (illustrative): "If lying down in a dark room doesn't feel safe, you're allowed to sit up and keep your eyes open. Would you like to plan how you'd tell the teacher that?"
  • Watch for: Flashbacks, numbing, panic during or after the course. Working: the client keeps a sense of choice and the practice does not trigger re-experiencing.

4.11 Coordinating with the teacher (with consent)

  • Purpose / when: The client wants their therapist and teacher to share information, e.g. after an adverse reaction or to adjust participation.
  • Steps: (1) Obtain written consent stating what will be shared and why. (2) Share the minimum needed (e.g. "needs to sit out the rapid part"). (3) Respect the teacher's authority over the technique and the therapist's over clinical care. (4) Report back to the client.
  • Example language (illustrative): "Would it help if I spoke to your teacher? You decide exactly what I can say."
  • Watch for: Over-sharing; role blurring (the teacher advising on psychiatric matters, or the therapist on technique). Working: clear, limited, client-approved collaboration.

4.12 Combining with evidence-based care

  • Purpose / when: The client hopes SKY will replace therapy or medical treatment.
  • Steps: (1) Discuss what SKY has been studied for and what remains uncertain, in one or two sentences [source: Bayley et al. 2022; Brown & Gerbarg 2005]. (2) Make clear that SKY is not a treatment for physical disease and that health claims are the organisation's own [source: Art of Living, What is Sudarshan Kriya]. (3) Agree a combined plan if the client wishes: practice alongside indicated psychotherapy and medical care.
  • Example language (illustrative): "There is research on this breathing for stress and PTSD, and it might help you. I'd suggest keeping our work going alongside it rather than instead of it — what do you think?"
  • Watch for: Dropping indicated treatment; magical expectations. Working: the client uses SKY as one resource among several.

4.13 Exploring the client's relationship with the organisation

  • Purpose / when: The organisation has become central to the client's identity, time, money or relationships, or the client is considering leaving.
  • Steps: (1) Explore without labelling: what they value, what costs it carries, who they can disagree with. (2) Check general markers of coercive control as clinical practice understands them: discouraged questioning, isolation from non-members, financial or time pressure, shame for leaving [synthesis; no independent finding of such dynamics in Art of Living was found in the sources consulted]. (3) Support whatever choice the client makes, including staying, reducing involvement, or leaving; leaving may involve grief and loss of community. (4) Documented public controversy should be presented accurately: in 2016 the National Green Tribunal allowed the Art of Living Foundation's World Culture Festival on the Yamuna floodplains in Delhi but imposed an initial environmental compensation of Rs 5 crore for floodplain damage [source: Down To Earth 2016]. No independent investigation of teacher misconduct was found in the sources consulted.
  • Example language (illustrative): "What does the community give you? And is there anything about being part of it that feels harder to say out loud?"
  • Watch for: The therapist's own bias for or against the group; the client fearing judgement. Working: the client can hold both appreciation and doubt.

5. Handling problems

All guidance here is [synthesis] unless a source is tagged.

  • Client asks the therapist to teach or practise the kriya in session. Decline warmly; the technique is restricted to the course and its trained teachers [source: Art of Living, How to do Sudarshan Kriya]. Offer non-breath grounding or relaxation within your own competence instead, and refer back to the follow-up group. (Illustrative: "That's their teaching to give, not mine. Here, we can practise grounding in other ways.")
  • Client wants to learn from online videos or a friend. Explain that the organisation teaches it only in the course with supervision and that the physician letter flags risks for some conditions [source: Art of Living, How to do Sudarshan Kriya; Art of Living Canada, Medical Information Form]. Encourage the official route or a gentler alternative.
  • Overwhelm after the course (panic, crying, intrusive memories). Ground in session (4.8), reduce or pause practice with the teacher, review sleep, check risk; trauma-focused work if memories surface (4.10).
  • Elevated mood, reduced sleep, or stopping medication. Treat as possible hypomania/mania; contact prescriber or crisis team per agreed plan; the organisation itself lists bipolar disorder as a contraindication and warns about stopping medication [source: Art of Living Canada, Medical Information Form].
  • Seizure or near-faint during practice. Medical review before any further practice; liaise with the neurologist [source: Art of Living Canada, Medical Information Form for the seizure-threshold concern].
  • Non-adherence to home practice. Treat as information, not failure; explore value and obstacles; it is the client's goal, not a therapy requirement (4.7).
  • Rigid, guilt-driven practice (scrupulosity-like). If missed practice brings intense guilt, checking whether it was done "correctly", or fear of spiritual harm, assess for OCD; exposure and response prevention can be adapted with input from the client's teacher where the client wishes [synthesis; IOCDF guidance on scrupulosity not verified — uncertain].
  • Disappointment ("nothing happened"). Normalise variation [source: Art of Living, How to do Sudarshan Kriya]; explore expectations and comparison with others in the group.
  • Resistance to discussing it in therapy. Respect it; the client decides what enters therapy. Keep the door open.
  • Rupture over perceived scepticism or endorsement. Name it, apologise for any slant, restate neutrality and interest in the client's experience; examine your own religious commitments and limit self-disclosure [synthesis].
  • Pressure to keep doing more courses or spend beyond means. Explore costs and autonomy without labelling the organisation (4.13).
  • Leaving the organisation. Address grief, identity and social loss; help rebuild support outside it.
  • Pregnancy. The organisation reports no data on safety either way and that pregnant women were traditionally discouraged; route to the obstetric team and the teacher [source: Art of Living Canada, Medical Information Form].
  • Therapist is also a practitioner or teacher in the organisation. Do not teach clients, recruit them, or meet them in a teaching role; consult a supervisor about dual relationships [synthesis].

Sources

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