Contraindications worth knowing

Rapid or prolonged breathing changes blood chemistry and can intensify strong emotional and physical states. It is generally not appropriate during pregnancy, with uncontrolled cardiovascular disease or arrhythmia, with a history of seizures, with glaucoma or recent eye surgery, with recent stroke or aneurysm, or during active psychosis or bipolar mania. Gentle, slow breathwork is a different animal and is much more broadly safe.

Long stretches of silence can amplify what is already present. People with a history of trauma, dissociation, psychosis, bipolar disorder, or acute grief have sometimes had destabilizing experiences on long retreats. Start with day sits and shorter formats; look for teachers with trauma-sensitive training; and keep a therapist in the loop before committing to a week or longer.

Strong pressure or emotionally activating bodywork can overwhelm a sensitive nervous system, especially early in trauma recovery. Softer approaches, trauma-informed massage, restorative yoga, Feldenkrais, are often a better first step.

These are outside the scope of Spiritual First Aid. Legality varies. Serious cautions exist for people with personal or family history of psychosis, bipolar disorder, cardiac conditions, or on certain medications (especially SSRIs, MAOIs, and lithium). If you're considering this path, work with a licensed clinician who understands the specific interactions before anything else.

• Heated rooms: caution with cardiac conditions, pregnancy, and pregnancy attempts.
• Inversions: caution with uncontrolled high blood pressure, glaucoma, and neck injury.
• Deep backbends: caution with recent abdominal or spinal surgery.

Any practice that surfaces trauma material, regression work, intensive breathwork, psychodrama, immersive retreat, is safer when a licensed mental health clinician is available before, during, and after. If a program surfaces trauma but has no clinical support, that is a red flag.

Talk with your OB or midwife before starting intense breathwork, heated yoga, deep tissue bodywork, or plant-based protocols. Gentle movement, prenatal yoga, and talk-based therapies are typically fine, ask your care team about the specifics.

Never stop or reduce a medication because a practitioner suggested it. Only your prescriber can safely change psychiatric medication. A responsible complementary practitioner will always defer to your prescriber on this.