Using Biofeedback to Manage Stress

Young woman with eyes closed, close-upAn overwhelming majority of complaints in primary care practitioners’ offices are related to stress. One of the most common questions I hear in my psychotherapy practice is, “Is there something I can do that will help me calm down and get in control of myself right away when I get upset or overwhelmed?” While many people are willing to take medication, others want to find a way to manage stress naturally, using mind/body methods such as biofeedback.

Heart rate variability (HRV) biofeedback is a very effective technique that can be learned in a stress management practitioner’s office and then practiced at home in as little as 5-10 minutes a day. HRV biofeedback is an ideal way to achieve an optimal state of mind/body harmony by creating awareness of when the stress response starts and stopping it in the moment.

Through practice virtually anyone, even a young child, can learn to develop internal awareness and self-regulation skills. These skills include learning to control excess physiological arousal, mediating unhelpful thought patterns and utilizing positive emotional states to achieve a balanced and coherent state of body, mind, and emotions. The benefits of doing so are numerous. Stress-related health issues can be reduced or prevented, and we can all benefit from learning how to decrease the effects of unpleasant effect of stress in the moment when we feel angry, anxious, or frustrated.

I use the Heart Math emWave system in my office. It is a computer software program with a finger or ear clip sensor that is designed to illustrate how quickly the heart rhythm pattern responds to changes in thoughts and emotions. It allows me to show people how their mental state affects their heart and their nervous system. When we are stressed, the heart rhythm has a jagged, incoherent pattern. The in breath causes the heart rate to speed up, and the out breath causes it to slow down. By combining slow, gentle rhythmic breathing with a positive emotional state, the person changes the pattern to a smoother, wave-like pattern.

The emWave system allows the individual to experience in real time that they can learn to control the body’s stress response. Through observing the changes on the computer screen and associating them with a calm, balanced internal state, the individual learns how to create and maintain the optimal condition for stress reduction and healthy functioning. Coherence is more than relaxation. Coherence is known to be the optimal state of healthy functioning for both heart and brain, the two major organs which determine our ability to bounce back from the dramas and the traumas of life. Coherence has also been referred to as being in the flow state, being in the zone, or other labels given to the ideal balance of heart, mind, brain, and body in which peak performance occurs.

The emWave system is typically found in a psychotherapist or physician’s office, but anyone can learn the Heart Math Quick Coherence Technique without a biofeedback practitioner. Quick Coherence is a simple, easy-to-use three-step technique:

Step 1: Heart Focus: Focus your attention on your chest, in the area of your heart. You can place your hand gently over your heart to assist in developing this focus.

Step 2: Heart Breathing: While continuing to focus on your heart, pretend you are breathing through your heart, rather than your lungs. Breathe in slowly and gently to a count of 5 or 6 (4-5 seconds) and then breathe out slowly and gently to a count of 5 or 6 (another 4-5 seconds). Don’t rush or force your breathing. Take your time and continue as you notice a natural inner rhythm that feels comfortable.

Step 3: Heart Feeling: While continuing with Heart Focus and Heart Breathing, find a positive feeling like care, compassion, appreciation, or gratitude. It may be toward a special person or pet, an activity, or a place you enjoy or where you had fun. If nothing comes to you, simply focus on a positive attitude or sincere belief. The key is the deliberate shift from a negative or neutral mental state to a positive one.

Anyone can utilize this technique, and I have personally taught it to children as young as 6 years old. It is very helpful to take mini-coherence breaks during the day when you are working on an intense project or studying for hours at a time. We learn better when we are in a state of coherence. Practicing this technique and using it often is the key. Try using it before an exam or when you have a job interview or anticipate a difficult conversation with your boss or partner.

Teach it to your children and have them practice it regularly, especially if they have school anxiety or worry about being liked by their peers. Use it in combination with time-out strategies to help them regulate their bodies and minds more quickly and easily. When having a challenging discussion with family members that is not going well, suggest taking a short coherence break and resuming in a few minutes when you are all in a more optimal state for compromise.

If you find that you need more assistance with stress management or are interested in working with a biofeedback practitioner, Good is a great place to find someone in your area with the skills and expertise you are looking for. You can find more information on Heart Math emWave and the Quick Coherence Technique at

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • cindy

    July 16th, 2013 at 10:49 PM

    stress gets to me easily.nothing like bein stress free and reveling in the freedom from this tyrant.breathin exercises do help and although I have not tried this very technique generally breathing exercises have helped provides a lifeline to those like me who could get easil overwhelmed by default.I have suggested breathing exercises to others but now it seems like this is one new exercise I should try myself.thank you for this.

  • Rae

    July 17th, 2013 at 4:16 AM

    hehehe I just need to have a portable one so I can stay hooked up to it all the time!

  • Diann Wingert, LCSW, BCD

    July 17th, 2013 at 1:18 PM

    Rae, You can actually purchase a home unit, called the emWave 2 from the folks at Heart Math. They just reduced their prices for all of their coherence based products, so the timing is great. The emWave 2 is meant to be used 5-10 minutes a day to monitor and practice coherence building.
    Good luck ! Diann

  • Diann Wingert, LCSW, BCD

    July 17th, 2013 at 1:24 PM

    Cindy, I am so happy to hear you are finding relief and release from anxiety and stress through the use of breathing techniques. Not only are they effective and safe, you don’t need any special equipment, they can be used anytime and anywhere but breathing techniques are very empowering. You can help yourself feel better just by deliberately doing something that comes naturally, in a very focused manner. Remember, coherence is more than relaxation. It helps create a truly optimal state in the human body, but combining stress reduction with the focused shift to a positive mindset. I hope you enjoy using it ! Be Well, Diann

  • YJL

    July 18th, 2013 at 4:24 AM

    I have tried yoga and meditation, while never biofeedback, and those work pretty well for me. I would presume that you do a lot of focused breathing through this? And how would I find someone trained to help me if this is something that I would loike to further pursue?

  • Diann Wingert, LCSW, BCD

    July 18th, 2013 at 2:12 PM

    Dear YJL, You can try connecting with a heart math emwave biofeedback practitioner by visiting the website and using their locator service. If you are in the vicinity of Pasadena, CA. I would be happy to work with you. Good Luck, Diann

  • Biofeedback Equipment

    September 25th, 2013 at 6:02 AM

    Anyone can utilize this technique, and I have personally taught it to children as young as 6 years old. It is very helpful to take mini-coherence breaks during the day when you are working on an intense project or studying for hours at a time.

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