Biofeedback Therapy

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What is Biofeedback Therapy? What is it used to treat?

Biofeedback is a technique you can use to learn to control some of your body's functions, such as your heart rate. During biofeedback, you're connected to electrical sensors that help you receive information about your body. This feedback helps you make subtle changes in your body, such as relaxing your breathing and regulating your heart rate variance (described below) 

Biofeedback appeals to people for a variety of reasons:

  • It's non-invasive.
  • It might reduce or eliminate the need for medications.
  • It might enhance the benefits of medications.
  • It might help women who can't take medication during pregnancy.
  • It helps people feel more in control of their health.

Source: Mayo Clinic

Which of the Biofeedback services are currently available in primary care?

Currently, the biofeedback program at UHS Primary Care offers two services:

  1. Coherence practice (mind-body synchronicity; explained below)
  2. Test/Performance anxiety management

Both services measure your heart rate variability (HRV) and focus on practicing to learn to control your breathing to achieve an active, grounded state of mind and body for better performance and reduced anxiousness.

We plan to add additional biofeedback services to the program at a later time. 

How does Biofeedback therapy work? (what to expect during the session)

Some biofeedback devices, such as the one you’ll use at the Tang Center, measure physiological changes in your body, such as your heart rate activity and skin changes, by using one or more sensors attached to your fingers or your ear. The sensors plug into your computer.

Using computer graphics and prompts, the devices then help you master stress by helping you to pace your breathing, relax your muscles, and think positive self-statements about your ability to cope. Studies show that these types of devices might be effective in improving responses during stress and inducing feelings of calm and well-being. 

Source: Mayo Clinic

The primary reasons to use guided breathing patterns with biofeedback services are:

  • To promote balance in the nervous system
  • To practice meditation and self-awareness
  • To activate the parasympathetic and recovery systems
  • To open up the respiratory pathways that may be suffering from prolonged shallow breathing

Source: Elite HRV

What is Heart Rate Variability (HRV)?

Heart rate variability is a measure of the beat-to-beat changes in heart rate. The normal variability in heart rate is due to the synergistic action of the two branches of the autonomic nervous system (ANS)—the part of the nervous system that regulates most of the body’s internal functions. The sympathetic nerves act to accelerate heart rate, while the parasympathetic (vagus) nerves slow it down. The sympathetic and parasympathetic branches of the ANS are continually interact to maintain cardiovascular activity in its optimal range and to permit appropriate reactions to changing external and internal conditions. The analysis of HRV, therefore, serves as a dynamic window into the function and balance of the autonomic nervous system. 

Source: HeartMath Science

Why does Heart Rate Variability (HRV) matter?

Greater Heart Rate Variability (a higher HRV score) at rest generally indicates better health, a younger biological age, and better aerobic fitness. However, Heart Rate Variability is affected by everything from your mindset to air quality, to age, and exercise patterns.

What is good for you depends on your individual circumstances, your starting point, and your goals. Comparing you to yourself over time is generally the most important and effective method of reaching your goals. That being said, it’s nice to know where your starting point falls on the spectrum.

Source: Elite HRV 

Abnormal low heart rate variability (HRV) is associated with both medical and psychiatric disorders. HRV biofeedback is a recently developed technique that aims to modulate HRV in ways that have beneficial effects on mental and emotional functioning. The magnitude and specific characteristics of HRV are related to the body's ability to adapt to stress. Low HRV generally corresponds to relatively greater susceptibility to stress

Source: Psychology Today  

What is Coherence? Why are we using coherence rate as a marker?

Coherence is a state of optimal function, marked by the development of smooth, consistent patterns in heart rate variability. It represents the synchronicity of two important parts of your autonomic nervous system (sympathetic and parasympathetic). Higher synchronicity between these two systems means higher synchronization between your heart and mind.

When engaging in biofeedback services, this synchronization is represented in the form of a coherence score. A higher coherence score means higher synchronization between your mind and heart and a smooth pattern in your heart rate variability.  

It is important to notice that while relaxation is a part of coherence, relaxation, and coherence are not the same. Relaxation is a low-energy state in which the individual rests both the body and mind, typically disengaging from cognitive and emotional processes. In contrast, coherence generally involves the active engagement of positive emotions. Psychologically, coherence is experienced as a calm, balanced, yet energized and responsive state that is conducive to everyday functioning and interaction, including the performance of tasks requiring mental acuity, focus, problem-solving, and decision-making, as well as physical activity and coordination. 

Source (read for more information): HeartMath science 

What is the role of breathing in regulating Heart Rate Variability (HRV) and achieving Coherence?

Since we can’t directly control our heart rate, we use our breathing patterns to regulate the activity of our heart and the autonomic nervous system. However, it is important to focus on not just slow and rhythmic breathing, but also on positive emotions. While breathing rhythmically is a useful intervention to initiate a shift out of a stressful emotional state and into increased coherence. However, this type of cognitively-directed paced breathing can require considerable mental effort and is difficult for some people to maintain. Positive emotions appear to excite the nervous system at its natural resonant frequency and thus enable coherence to emerge and to be maintained naturally, without a conscious mental focus on one’s breathing rhythm.

Source (read for more information): HeartMath science  

How often should I use biofeedback? 

The frequency of your biofeedback sessions will be prescribed and monitored by your behavioral health provider. Please feel free to ask any questions related to how or how often to use biofeedback to your behavioral health provider.  

How do I sign up for it? Is there a cost? 

Biofeedback services are only available upon being referred to the program by a behavioral health provider, as a part of your mental health treatment. If you’d like to be connected to the program, please speak with your behavioral health provider or your primary care provider. The services are only available to registered UC Berkeley students, and free of cost. We do not bill your insurance. 

Biofeedback Therapy Instructions 

Please watch the orientation video for the biofeedback service you were referred to.

Biofeedback - Anxiety Module

Biofeedback - Anxiety