SCIENCE-BASED MENTAL WELLNESS
Dr. Lorrie Fisher PhD, MFT, BCN, NBCFCH
Accelerated Online Therapies
If Everyone Did HRV Biofeedback, the World Would Be Better Off
Everybody has had the experience of their heart racing in a stressful situation. And most people have had the experience of blood pressure or heart rate increasing even when it isn’t so obvious that there is stress. A well-researched, and easy-to-do, way to train your heart and circulatory system to be more resilient, is called Heart Rate Variability Biofeedback (HRVB, for short).
HRVB is done with an HRV app. There are dozens available, ranging from free to a few hundred dollars. I like Heartrate + Coherence, which is a free app. Professionally, I use HeartMath’s Inner Balance to work remotely with clients, or HeartMath’s professional version for in-person appointments. HeartMath has a free phone app called Inner Balance. Family members can share the heart rate sensor which currently runs about $195.
Initially, you will figure out by trial and error how many seconds is comfortable for you complete one breath (in and out). The average person will select 5-6 breaths per minute (which is 10-12 second per breath). Some apps ask you to place your finger over the camera light of your cell phone so your phone can monitor your pulse. The more expensive apps provide a pulse monitor that clips to your earlobe or senses your pulse in a fingertip.
The app then calculates the relationship between your heart rate and your breathing in a way that teaches your heart rate to vary more between the number of your heart beats while you inhale and the number while you exhale. This is called biofeedback. “Feedback” because it feeds back information in real time, and “bio” because the information is about your biology.
HRVB causes your nervous system to get better at staying calm and clear under stress. It increases parasympathetic (rest and restore) effects on your mind and body.
Why and how is this worth your time?
In a healthy body, heart rate is supposed to vary. It’s supposed to increase when you inhale and decrease when you exhale. Why?
Before answering that, think for a moment about how long your can go without breathing. Compare that to how long it’s possible to go without drinking water, or without eating. Breathing is WAY more urgent. Without breathing, we understand that the body dies. But why? Why is oxygen delivery so important. Clearly, it’s more important than anything else your body does.
The answer is because you’re not a plant. By that, I mean that you can’t stand out in the sun and use chlorophyll to convert solar energy to fuel for your cells to carry out their functions. Instead of using sunlight, every cell in your body uses food you’ve eaten as fuel in the form of sugars. Mitochondria in your cells break down sugars to produce ATP. (You could think of this as cellular digestion.) ATP provides energy for every cell to keep producing enzymes and proteins it needs to function.
(Do you love videos? Harvard gives us a basic illustration of this process at https://youtu.be/zJNx1DDqIVo, and a much (much) more complex video of this process, at https://youtu.be/rdF3mnyS1p0. MIT explains how ATP fuels life at https://youtu.be/1Pk39fKguX0.)
When the mitochondria spit out ATP, they also spit out hydrogen ions (H+) as a by-product. ‘Hydro’gen ions are acid. (Like ‘hydro’ in hydrochloric acid.) As hydrogen ions accumulate in the cell, the cell becomes more acid. Too much acid, and the cell burns up.
In medical school, we were trained to think: Bleeding, breathing, brain. Bleeding is first, because too much blood loss means that fixing breathing won’t work unless there’s enough circulation to get oxygen where it needs to go.
When you inhale, one hemoglobin can pick up and carry 4 oxygen molecules which journey through arteries to capillaries and transfer oxygen directly into every cell in your body. When an oxygen arrives, it joins with 2 hydrogen ions and forms water (H2O). Breathing serves to immediately avoid cellular destruction by acid. That’s why breathing is so urgent.
It’s why you’re designed so that your sympathetic nervous system, your fight or flight response, increases your heart rate as an assist every time you inhale. Heart rate and breathing work together to speed oxygen to every cell in your body.
Now you get that faster heart rate makes sense for inhaling, but what about exhaling?
When you exhale, there’s no emergency to get oxygen distributed to your cells. Your body, having just worked urgently to create energy, certainly doesn’t want to waste it. Now your heart, having just expended lots of energy to pump oxygen to every cell in your body, could take a moment to conserve energy. Fewer heart beats mean less energy expenditure.
While you exhale, your heart can go into rest and restore mode. Rest and restore is the job of your parasympathetic nervous system. Your sympathetic and parasympathetic systems work like a seesaw. As one increases its influence on heart rate, the other decreases its influence.
This seesaw relationship allows you to handle stress. Parasympathetic function is the brakes on your heart rate. Without this help, your heart rate would just keep speeding up until your heart gave out.
Not only does your parasympathetic nervous system let your heart rest, it also lets you rest. Parasympathetic function lets you feel comfortable and at ease in the world. It lets you move into sleep, to digest food, and even to feel creative or loving. When your nervous system can rest and restore, there can be an increase in creativity, musicality, and athletic or academic performance. It’s even been shown that HRVB helps damaged heart muscle calls begin to heal after a heart attack. Increased HRV lets you be more mentally and emotionally flexible. Healthier. As your parasympathetic nervous system learns how to have a greater say, there’s a subtle change in your ability to navigate life’s challenges and to rise to life’s opportunities.
The balance of your sympathetic and parasympathetic nervous system, the presence of your heart rate variability, is an indicator of biological responsiveness, of your body’s ability to respond to what’s happening around and within you. If someone is in the hospital and their heart rate becomes rigid, like an internal metronome, that shows that their body is losing the ability to adapt to their needs, and that death may be imminent.
This method takes a little bit of discipline, but now you can understand that it holds big rewards for a small effort. Indulging in daily practice, even for 5 minutes, is best. Ten minutes morning and night is even better. (But start with shorter sessions.) Putting an app on your phone, rather than your computer, may make this easier to achieve. That way the feedback is available to you when you have a break. With practice, you can greatly increase your variability and significantly improve your physical health and your mental and emotional well-being. (Without all those trips to doctors and therapists.)
A client recently said to me, "If everyone did HeartMath, the world would become sane." Maybe, just maybe, if everyone practiced HRVB there could be an end to war and personal defeat. Well, if you begin now, at least it could lower conflict and raise possibility in your world.