What is Biofeedback Training?

Biofeedback is a training technique that assists individuals with changing their physiological state to improve their physical and mental health. Biofeedback instruments measure and monitor heart function, breathing, and skin temperature. These instruments rapidly and accurately provide feedback information to the user. With the coaching of a biofeedback specialist, this data is integrated with feedback on thinking, emotions, and behavior, which leads to desired physiological changes. After practice, the ability to change one’s physiological state can be done without instrumentation. Research has shown that biofeedback is an effective therapy for reducing anxiety and depressive symptoms and stress related medical conditions, such as insomnia, chronic pain, hypertension, and irritable bowel disease.

Heart Rate Variability Training

A particular biofeedback modality, heart rate variability training, trains individuals to better manage their body’s response when symptoms, such as stress, occurs. Heart rate variability training involves intentionally altering heart rate activity, abdominal breathing and emotions to achieve a state of calm alertness and positive energy, known as coherence. Both the mind and body are in synch and harmony.

The heart and brain are in constant communication, influencing emotional processing and higher cognitive functioning. When we experience negative emotions, our heart rhythm pattern becomes erratic and inconsistent. This impacts the brain’s ability to engage effectively in higher level cognitive functions, such as controlling our impulses, making decisions and reasoning. Alternatively, when we are calm and experience positive emotions, our heart rhythm patterns stabilize and develop a consistent pattern, which impacts the brain’s ability to think more clearly, rationally and efficiently (see figure below). The top part of the graph shows heart rate variability when a person experiences frustration, while the bottom graph reflects heart rate variability when a person feels appreciation. As you can see, emotions have a direct impact on the heart’s functioning.

Biofeedback Training

During biofeedback training, we are focused on examining heart rate variability (HRV).  HRV is a natural beat-to-beat variation in the heart rhythm. This variation is due to the interaction in our autonomic nervous system between its two branches: the parasympathetic and sympathetic system. The sympathetic branch accelerates the heart rate, while the parasympathetic branch slows it down. During times of stress, the sympathetic system dominates and this can significantly increase the heart rate. Conversely, the parasympathetic system is instrumental in calming and slowing the heart rate down. When these systems are out of sync, this causes erratic HRV.

Heart rate variability training

In general, the greater the variability the better. Very low HRV is a sign of advanced biological aging and is associated with higher risk of disease. Improved HRV is an important indicator of positive health. During HRV biofeedback training, we are focused on altering HRV in such a way that it becomes consistent and stable with a shift towards increased parasympathetic activity. This resonates throughout the body and brain, inducing a state of calm alertness and optimal functioning. We do this specifically by engaging in a positive emotional state and diaphragmatic breathing. We normally breathe at about 14 to 20 breaths per minute. When we are stressed, the breathing rate can be even higher. During biofeedback, you learn how to breathe at about 6 breaths per minute (5 seconds during inhale and 5 seconds during exhale). At this rate, your heart and breathing synchronize, inducing a state of coherence.

If you are experiencing any of the following conditions, biofeedback therapy might be helpful to you.

  • Anxiety and Stress
  • Depression
  • Stress related medical conditions, such as insomnia, chronic pain, hypertension, and irritable bowel disease.


Biofeedback Certification International Alliance. (2008). Overview of Biofeedback. Retrieved from http://www.bcia.org/i4a/pages/index.cfm?pageid=3524

McCraty, R. (2002). Heart Rhythm Coherence: An Emerging Area of Biofeedback. Biofeedback, 30(1), 23-25. Retrieved from http://www.resourcenter.net/images/AAPB/Files/Biofeedback/2002/BIOFEEDBACKSPRING_02.pdf


Dr. Rae Mazzei is a board certified practitioner of biofeedback. She uses HRV training either as a stand alone therapy or as a component of a more comprehensive treatment to address a wide range of mental health issues. Biofeeback can be an especially useful adjunct to counseling. If you are interested in biofeedback, she will work with you to develop a personalized treatment plan. Please contact us at 847-386-8829 to ask any questions about biofeedback and how it can help you.