Flowly
Health Talk 03: Biofeedback and How it Can Help: A Conversation with world class expert Dr. Gevirtz
bioAbout Health Talk
Living with a chronic condition can feel isolating. Health Talk by Flowly was born from wanting to bring often isolated voices into the fold, and connecting different ideas, experiences, and tools to your own health journey.
We talk to health practitioners and chronic health patients to deconstruct the chronic condition journey— from how many have managed the challenging diagnosis experience, to new tools and tips that might help you. We cover conditions including chronic pain, anxiety, autoimmune diseases, and more.
Hosted by Celine, the founder of Flowly, this weekly podcast will dive into conversations with world class researchers, practitioners, and even more importantly, chronic condition warriors themselves.
Search “Flowly” on Apple Podcast or Spotify to find Flowly Health Talk!
This is an in-depth conversation about biofeedback with Dr. Richard Gevirtz, truly one of the most respected and pioneering experts in this space.
How does biofeedback work? What does it do? What does it have to do with Olympic level athletes? In this Health Talk, Celine tackles these questions with Dr. Gevirtz.
Dr. Gevirtz is a distinguished professor of psychology for the California School of Professional Psychology at Alliant International University. He’s been doing psychophysiology and biofeedback research and clinical work for the last 30 years. Dr. Gevirtz was also the former president of the Association for Applied Psychophysiology and Biofeedback. His primary research focus is in understanding the physiological and psychological mediators involved in conditions such as chronic muscle pain, fibromyalgia, and gastrointestinal pain. Dr. Gevirtz has studied applications of heart rate variability, biofeedback of pain, anxiety, cardiac rehabilitation, etc.
*This transcript is auto-generated
hey y'all my name is Celine and i'm the
founder of Flowly and your host today
for health talk by Flowly
as some of you might know Flowly is a
mobile platform for chronic pain and
anxiety
and we use biofeedback to help you train
your relaxation system your nervous
system
and really help you manage all the
symptoms around it
in our health talk we talk to chronic
pain patients
advocates mental health warriors as well
as professionals in the industry and
space
to really learn from their expertise
today's guest is someone our whole team
has looked to for guidance
because he's such a foremost expert in
the biofeedback space
and we have Dr. Richard Gevirtz he's a
distinguished professor
of psychology for the california school
of professional psychology at alliant
international university
he's been doing psychophysiology and
biofeedback research
and clinical work for the last 30 years
dr Gevirtz was also the former
president for the association for
applied
psychophysiology and biofeedback his
primary research focus
is in understanding the physiological
and psychological mediators
involved in conditions such as chronic
pain
fibromyalgia gastrointestinal pain
and dr rivers has studied applications
of heart rate variability
biofeedback for pain and anxiety and
cardiac rehabilitation
just to name a few so welcome to health
talk richard
thank you good to be here so i wanted to
jump into
the interview first by asking you what
is biofeedback because i think some of
our community members know it but
many people have never had contact with
biofeedback so what is it
so biofeedback is a field that started
about 45 years ago when we started
getting a good enough technology to
measure physiology in a way that we
could
show it to the subject or client
and so biofeedback predicated on the on
the
um plasticity of the nervous system was
thought
that if somebody could see what their
physiology was doing maybe they could
change it
and little by little we've understood
the field better and better as time was
going on
started off with very crude measurements
finger temperature
muscle tension uh just basic heart rate
but as technology has gotten better
we've been able to measure more and more
things about
physiology and feed them back including
eeg feedback heart rate feedback or
reliability feedback
as well as the traditional ones like
skin conductance
and temperature so it's a field that is
growing
steadily um it has the disadvantage of
being in
space between traditional
science and alternative medicine
nih considers this alternative medicine
and when we apply for it they say no no
it's established science it shouldn't be
an alternative medicine
so it little by little it's kind of
finding its own
niche in that space but it has grown
steadily over those many years
what does biofeedback actually look like
like let's say today someone wants to
try traditional biofeedback um where do
they go
and what does a session actually what
does it look like
well there's a there's a certification
institute called
biofeedback certification international
association
bcia and they
certify the expertise of practitioners
and so it would vary depending on what
the problem was but
they would go to a practitioner who has
equipment that they would put
finger finger leads on ecg leads maybe
ec g leads on um
other kinds of things like that and then
after an assessment the person would
look at a screen
and they would see some aspect of the
physiology that there
that the clinician is trying to get them
to change
and then they would work on that using
relaxation breathing
uh or just straight um mental techniques
to try and change these things
and it would vary tremendously it might
be an athlete trying to
you know pro golfer trying to be able to
make 12-foot putts
just to learn a very specific skill to
do that it could be someone who's
depressed who has to learn to kind of
change their whole physiology
together with their mental uh techniques
or it could be physical disorders like
irritable bowel syndrome where they want
to change their physiology to be able to
alleviate the symptoms
so most practitioners use some
combination of some
psychological techniques as well as the
biofeedback but some only use
biofeedback
there's a whole series of techniques
called neural feedback that uses
eeg electron cephalogram feedback
which takes many many sessions but it's
a it's an up-and-coming area
not as much good solid data yet as there
are any other areas but
certainly of great interest with many
people yes
so you mentioned there's a lot of
different types of leads and
data you can get from biofeedback i know
that for us at flowley we focus on
making
heart rate variability about feedback
most accessible because it's also a
great entry point i think for people
that have
no access or experience with biofeedback
so i'd love to get your take on um
explaining what is heart rate
variability and what is
hrv biofeedback because it's an
education process for us to try
and share you know what are the benefits
and what does hrv biofeedback actually
do for you
okay so first hrv is separate from the
biofeedback
feedback is an intervention technique
hrv has been around for a while
and it refers to the differences in
beat to beat heart rate um so basically
when most of us are familiar with heart
rate from the gym where we just measure
our average heart rate heater from a
watch
but if you measure beat by beat one our
wave to the next to the next
those distances between those airways
differ
in healthy individuals and strangely the
more they differ the better
more healthy they are opposite of what
mostly would think we think variability
would be bad but here variability is
good
reason for that is that the variability
is being controlled by
a branch of the nervous system called
the autonomic nervous system
it has two branches the sympathetic
which is the fight flight fright
and the parasympathetic which is the
rest the gesture restore branch
they're like accelerators and brakes the
sympathetic's like an accelerator
a parasympathetics like a brake and they
work together
mostly reciprocally not always
reciprocally to kind of
manage both the environment of your
internal
environment of your body making
adjustments for changes in blood
pressure
or blood flow but they also in in
adjustment to
external stimuli so when you're faced
with a very large threat
the break goes off the parasympathetic
goes off and the sympathetic goes on and
that
everyone's sort of familiar with the
fight flight response
that you get in a real major emergency
so
people can kind of think about it if
you're riding on the freeway
and suddenly the traffic stops and you
slam on the brakes and miss the car in
front of you by
two inches what's your physiological
reaction
a few seconds later after that you get
butterflies in your stomach
you get sweaty your hands get colder
your heart rate speeds up like
tremendously
everybody kind of knows what that flight
response is
that only really applies during major
threats
for the most part most of the day our
heart rate variability is controlled by
the breaking
of the parasympathetic which is making
adjustments for blood pressure
and in thinking processes and things
going on
so that's where the measurement of that
comes from and it
became important because it's really the
only way we can measure
the parasympathetic nervous system
sympathetic we can measure we've been
able to measure for a long time like
like palmer sweating
and putting electrodes on the palm and
right you get a sympathetic reaction you
your palm sweat and it shows up on this
on a scale
which is a pretty simple kind of
feedback but uh the but the
parasympathetic was much more elusive
until we had technology that allowed us
to look at
beat by the changes in heart rate and
what we know is that
the b by b changes are dominated by one
rhythm specifically
that comes from breathing and that is
when you breathe in
the brain goes off and when you breathe
out the brain goes on
so it makes sense if you think about it
when you're breathing in oxygen is
present in the alveoli
so you want your heart rate to be a
little faster take advantage of the
oxygen
but then when you breathe out there's no
oxygen there so the brake
slows the heart down and gives you
a and over a lifetime it saves you like
450 million heartbeats
because of that rhythm and that rhythm
is the major
draw is a major drive of carbon
variability but not the only one but the
once we were able to measure that we
started studying
uh swamis and gurus and tibetan monks
and asked them to do what they do when
they get centered and calm
and what we found what they all do is
they breathe at a very slow specific
rate
somewhere between four and a half and
seven breasts a minute
and their physiology is remarkable when
they do that
and we little by little came to
understand why that physiology works
that way is because they're using all
the different rhythms in their body are
lining up
becoming in a very specific coherent
fashion so that they line up so the
rises and falls and heart rate becomes
exaggerated during this
role what we call resonance frequency
breathing
and that's what the biofeedback is once
we kind of realized that the
swamis were using it we just sort of
modernized it for the
uh western market and it's basically
kind of high-tech
specific kind of meditation that comes
from this kind of visual breathing
with the technology though we can find
that resonance frequency very
easily now and uh
as your product is doing and once we
find that and people practice that on a
regular basis
we get some of the same benefits that
the swami's got that the guru's got
which is
very good blood pressure regulation very
good anxiety regulation very good
emotion regulation these are things that
come
with that kind of thing that's why we
always say it's a brand new idea it's
been that's 2500 years old
yeah yeah i love that and i remember