Wellness

Using Biofeedback to Calm the Mind and Body

Using Biofeedback to Calm the Mind and Body

Using Biofeedback to
Calm the Mind and Body

Leah Lagos

Leah Lagos specializes in clinical and sport psychology at her practice in New York, where she helps clients navigate moments of stress, anxiety, and fear using heart rate variability biofeedback. The technique allows clients to tap into their body’s physiological feedback—their heartbeat—and use it to their advantage, rather than letting it take control.

We asked Lagos to explain how the process works—and to lead us through the exercises she recommends for harnessing its power. (Lagos’s just-released book, Heart Breath Mind, has more—and she’s designed an HRV app as a companion for more personalized insight.)


Using HRV to Connect the Heart, Breath, and Mind

by Leah Lagos, PsyD, BCB

When we feel overwhelmed—pushed to our limits of stress, anxiety, loss, and sadness, while feeling a lack of control—we can’t alleviate the pressure by thinking our way out of it. Stress is held in the body, not the mind. The antidote is physical.

While heart rate focuses on the average heart beats per minute, heart rate variability (HRV) measures the specific changes in time—variability—between each heartbeat. The time between beats is called an R-R interval and is measured in milliseconds. From a physiological point of view, you can consider HRV to be an index of how flexibly your body responds to and recovers from stress.

heart rate variability

Above: An unhealthy heart rate variability with constant .722-second intervals between beats.

heart rate variability

Above: A healthy heart rate variability shows variation between beats.

Medical literature has identified that limited variation in heart rate often accompanies various illnesses, such as anxiety disorders, excessive alcohol use, major depression, diabetes, and post-traumatic stress. High variation in heart rate, on the other hand, is associated with resilience, adaptiveness, and health.

During HRV biofeedback, you learn to identify a rate of breathing that optimizes heart rate oscillations. The exhale becomes longer than the inhale, amplifying the variation between beats. You learn how to control your heart rhythms to let go of stress, clear your mind, and restore homeostasis following specific stressors. For those developing an at-home practice, you can train with a pacer app on your phone or via an app that tracks your HRV and can provide direct feedback.

HRV biofeedback is not a process for relaxation. It’s systematic training to tighten the heart and mind’s ability to navigate stressful moments with precision. When it’s performed systematically, as it is when I work with my clients over the course of ten weeks, individuals create measurable improvements in how their body and mind respond to stress and recover. My clients commonly tell me that by the fourth week of training, they feel less irritated by the same stressors and can more easily let them go.

The goal of HRV biofeedback is to amplify your body’s ability to respond effectively during stress and increase your body’s ability to efficiently recover following the stressor. HRV biofeedback is also useful beyond just navigating critical moments. It hones your body’s natural response to stress and helps you achieve clarity, confidence, and resilience. HRV training can be used to increase focus and attention, elevate mood, relieve trauma, improve sleep, reduce anxiety, and enhance your overall well-being. As you increase your HRV and strengthen your parasympathetic nervous system, you may also find that your relationships improve as you become able to listen more empathetically, make better decisions under pressure, and enjoy a sense of mindfulness.

5 Ways to Overcome Stress in the Moment

These methods can help anyone adapt to stressors in specific situations. I help my clients get to a place where they can effectively use them at work, for public speaking, and in their relationships (and any other time they need them).

1. Establish a daily HRV practice. Download a breath pacer on your phone and set the pacer to either five and a half or six breaths per minute with 40 percent of breath for inhalation and 60 percent of breath for exhalation. Identify which breathing rate feels most natural to you and requires the least amount of effort. Then turn off the sound and establish a quiet place to practice your breathing in the morning and evening. Keep your eyes open while following the pacer. Practice for twenty minutes twice a day or start with ten minutes twice a day and work your way up. This exercise helps train the prefrontal lobe, which is responsible for executive functioning, and simultaneously improves your HRV.

2. Build cardiovascular resilience. I believe that resilience is a cardiovascular trait and that the faster your heart rate can return to baseline and restore its natural rhythm, the more resilient you feel and the more clearly you are able to think. You can strengthen how quickly your heart rate recovers through systematic practice. For optimal benefits, practice for twenty minutes, twice a day, for ten weeks. This plan creates measurable gains in your baroreflex, which modulates your blood pressure and heart rate. Taking ten breaths with your pacer before and during moments of stress will reduce your cardiovascular response and help you return to your baseline heart rate more quickly. Whatever path works for you, make a commitment to set aside time each day for your breathing—and stick to it.

3. Learn to belly breathe. When life gets stressful and your mind starts racing, center your heart and mind by gently directing your mental focus toward the feeling of the abdomen expanding on the inhale and contracting on the exhale. Switch off the busy brain throughout the day by taking a few low and slow belly breaths as you exhale through slightly open lips. By focusing your attention on the movements of the abdomen, you are building interoceptive sensitivity (the ability to accurately detect internal bodily sensations), which can be helpful for enhancing intuition as well as turning off the busy chatter of the mind. This can be an effective exercise to introduce to kids to calm their mind and body, too.

4. Try this breath exercise. For the last five minutes of your daily breathing practices, try connecting to stress and letting it go on the exhale. Feel the stress on the inhale by connecting to your frustration, fear, or loss of control and release the negative emotion on the exhale. Repeat for ten consecutive breaths. If you own a Fitbit or another heart rate tracker, see if you are able to decelerate your heart rate by three or more beats after ten breaths. If that is too easy, see if you are able to decelerate your heart rate by three or more beats in five breaths. With dedicated practice, you will be able to increasingly decelerate your heart rate in one or two breaths. The faster you can decelerate your heart rate on the exhale, the more you will be able to let go of stress on demand throughout your day.

5. Learn how to emotionally pivot. Remember a time in your life when you’ve felt an incredible amount of love. What are the key words that describe the emotions you felt in the moment? Pick three different moments when you’ve felt love, gratitude, or safety and write down those three moments. Take ten breaths using your pacer, focusing on one of these experiences. On the inhales, breathe in through your nose and connect to that emotional state from your selected memories. Connect to that joy. Really feel it in your heart. On the exhale, breathe out through your mouth as if you were blowing on soup and let go of any fear all the way to the bottom of your pacer. Throughout the day, practice connecting to these moments (without the pacer) so that you begin to cultivate the ability to pivot to another emotional state in times of unwanted fear and anxiety.


Leah Lagos, PsyD, BCB, is a health and performance psychologist in New York City who specializes in heart rate variability biofeedback.


This article is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.


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