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
that really struck me when we first
talked and when i was first learning
about biofeedback or even the
hrv itself and resident frequency was
that it's been used for
thousands of years um but only now are
we figuring out how to make it more
accessible to everybody
um and one of the things i think also
fascinated me about your work is that
you work from
you work with everyone from like chronic
pain patients chronic illness
illness patients kids to high
performance athletes
and i think you know most of our
population comes from the chronic
health chronic illness space but they
might be curious about
how does biofeedback help athletes
um and you know what are some of your
experience around that
yeah well the the most the most uh
convincing
application is with athletes in
situations like
putting in golf hitting in baseball
uh gymnastics for a short gymnastics
routine
uh diving where
your pre the pre anxiety going into the
activity really does determine how well
you're going to do
now as your anxiety levels go up your
muscles become less fluid in their
motion
they don't move as smoothly you're not
as good of control of your autonomic
nervous system as you want it to be in
the optimal range
so anything that has that strong
emotional component to it has really
helped
by learning how to be doing it
one of the the the most fun group i work
with are
rhythmic gymnastics these are adorable
little asian kids mostly
who uh and their coaches are russians
and bulgarians who are very very tough
and so these kids and i don't if you
know that sport it's the one with the
hoops and the
uh wall and it's right a lot of dancing
yeah tumbling and dancing to music with
apparatus
and you can imagine how stressful it
would be you're throwing a ball away up
in the air catching on your neck
doing a flip so these little kids um
they're you know like eight to 12 year
olds mostly
get stressed before they go on and that
little bit of stress makes a big
difference to their performance at that
elite level
i'm talking about kids in the top 50 in
the
country right so when we taught them
when we taught them the technique we
just teach them how to do the
biofeedback just before they go on and
they get their autonomic direct system
into that optimal flow
and they definitely improve their
performance wow
that's really cool yeah and for those
who don't richard you're based in san
diego which is a big
golfing epicenter so i'm sure you get a
lot of golfers working with you
yeah we get some of those and it turns
out that on our campus there's a gym
that they run out to the
rhythmic gymnast kids so all of them in
san diego come
it's right across the street from our
office yeah
that makes sense yeah i've pretty much
seen all of those kids and they're
it's real fun to work with because
they're all adorable
you were talking about the heart rate
variability um
and then you know how you integrate it
into like a biofeedback practice
uh maybe for some people would be
helpful to
understand what is the actual uh
correlation between practicing that type
of biofeedback
with helping pain or helping
anxiety relief so it depends on the
disorder
um so it turns out that when people
breathe at that resonance frequency
it has several effects on the body one
of them is that it changes a reflex in
the body of the reflex between blood
pressure
called the barrel reflex and we've got
good studies to show that when people
practice regularly they actually
changed this reflex which was never
thought to be
changeable it was thought to be an
immutable reflex
now we know that there's enough
neuroplasticity in the body that it can
be changed
with practice on a daily basis and again
that's why it's been around for
many many years so that's one
function but we also know we think that
the
breathing at this frequency has it seems
to bombard the brain
through a pathway called the vagal
afferent pathway
some people may have heard about vagal
nerve stimulators which stimulate this
pathway
externally so that pathway is a powerful
pathway into the brain it tells the
brain everything going on in the body
otherwise the brain wouldn't know what's
going on how to regulate it and it looks
like that pathway is greatly stimulated
by this technique as well
so for pain and anxiety and depression
for those patients we see with those we
have to try to fit it into what we think
is going on
for the depression it looks like this
technique actually directly stimulates
the vagal afferent pathway
in a way similar to electronic
stimulation
and that seems to have anti-depressive
effects on the brain
almost a direct biofeedback technique on
the brain without
we usually combine it with talk
therapies but
which is what you should do but even
without it it seems to have some impact
um for other kinds of things for
for pain it depends on the nature of the
pain but the most common pain is a
chronic muscle pain
like low back pain attention headache
neck pain arm pain uh what we've worked
out is that there's a mechanism
that a little nodules in the muscles
called trigger points
are affected by the sympathetic nervous
system by that accelerator
and what we pretty sure happens is with
practice
the parasympathetic break governs that
sympathetic
input into these trigger points so that
when that pain is released in the
trigger point it stays released
when you practice this biofeedback
and we've done a lot of work on that for
that kind of pain
for other kinds of chronic pain it's not
as dramatically effective
but the pathways that the brain
processes pain are affected by this
biofeedback as well
so people with like nerve pain or other
kinds of pain that
can modify that pain processing
by having the brain kind of process it
differently using this technique
right you know that's sort of the the
range of things going on with those
kinds of problems yeah and we've also
found like when we did case studies and
we're in the middle of clinical trials
now that
uh doing the sessions themselves often
are helpful for
relaxing uh feeling a little less pain
or less
anxious feeling more relaxed but we were
just talking about
you me and my co-founder julian before
this interview started that
consistency in practice is also very key
for biofeedback
and the way though our team talks about
is kind of like you know you gotta
go to the gym to work out your muscles
is that kind of how you think about it
or
you know why is it so important that
practice is part of your biofeedback
yeah so if you're trying to build up
muscle strength you can't just go to the
gym once
you've got to go on a regular basis and
keep on going if you want to maintain
that muscle strength so this is the same
thing
and that's why probably meditation
techniques have been
daily for thousands of years right it's
not a one-time thing
yep so it looks like people need to
practice to keep those reflex changes
going that we're doing
they need to practice reasonably
regularly i mean i don't think
you have to be a fanatic about it but
when people practice pretty
regularly they seem to do it the other
thing is when you practice regularly you
over learn the technique so when you
need it you can use it
very quickly so even without about
feedback we find like our
our girls they're not allowed to use
biofeedback in their gym when when
they're performing
but they've learned this technique so
well in practice that they can implement
it immediately without
actually having feedback right then and
there so there's a couple of reasons
why it's important to practice on a
regular basis
yeah and what do you recommend like
daily few mi
ten minutes a day something like that
let's say minimum 10 minutes a day we
would prefer
20 minutes but we know most people's
lives don't allow for 20 minutes
right well nowadays with the pandemic
probably people have nothing else to do
but anyway
yeah it looks like 10 minutes is kind of
doable for most people
yeah if they really and if they're
really serious about it 20 minutes a day
seems to be
good and more is better the these the uh
gurus that we studied in india do it all
day long and they have remarkable
physiology i mean but yeah
most of us aren't going to do that but i
mean when you think about
squeezing in 10 minutes a day that's
pretty easy just think about 20 minutes
a little harder but
some people do that very nicely that's
what we that's what we think
we've actually found a lot of our users
will do it like 10 minutes in the
morning and then 10 minutes
at night so they break it up so that
it's easier for them
that's great yeah for some people it's a
very good
sleep inducer right so
not for everybody but for some people so
uh we
we've worked on studies with insomnia
and we combine it with uh
a cbt kind of interventions with
insomnia it seems to really help
uh help people go to sleep and stay
asleep i want to ask how did you begin
your work in this space like it's not
it's you know it's really
been picking up steam over the past i
don't know a few decades but
how did you even start well i was lucky
enough to be a student of one of the
one of the giants of the field of
psychophysiology
the measurement of psychological factors
on
physical physiologic physiology named dr
peter lang
still going strong in his 90s down in
florida
uh and so he uh it was a student of the
university of wisconsin in madison
and he offered an advanced class that he
led me into called
blood sweat and tears the subtitle it's
like something or other blood sweat and
tears and
he was a ve he's a brilliant brilliant
guy and it was a
very inspiring course so it just
inspired me to really try to understand
this mind body i was always interested
in mind body
connection i thought that was an
interesting phenomena
and so at the time we had some
technology and i did some research with
him on that
but as the technology grew it got more
and more possible to study this and
then we realized there were some
applications of this in the beginning of
the field of biofeedback
so i was dabbling in biofeedback while
being an
uh faculty member and then realized that
this was really a powerful technique so
i started doing
part-time clinical work together with my
academic work
and then began to develop a whole
pattern of research
at the same time i had a colleague in
the field i mean dr paul lehrer
out in rutgers who was also doing
similar kinds of things mostly focusing
on
asthma and we were good friends and
great colleagues and so we kind of began
to figure this out together
in this heart rate variability about 15
18 years ago
we didn't really know we were doing but
we figured it out little by little
with the help of a brilliant russian
scientist named evgeny veshilo
who was the cosmonauts
physiologist in russia before he came
here
and so the great story he tells is they
were watching the heart rates of their
cosmonauts in space
and one of the guys every day for about
15 20 minutes would show these heart
rate patterns that were really
dramatic rises and falls
and they thought it was space sickness
they thought it was a problem so he
calls up and said yuri what's going on
he said leave me alone i'm meditating
oh that one of those cosmonauts was a
breath meditator
and was producing these patterns and so
uh evgeny
brilliant he was an engineer
physiologist figured it out what the
physiology was and really helped us
understand it
and he's now in the states and doing
remarkable stuff
also at rutgers now wow that's a really
cool story
um it also kind of leads into my next
question because
your work is inevitably tied to
technology and
as it develops it i i feel it must
change your work in some ways so how has
you know the developing tech changed how
you've thought about the space or your
research in recent years
so when i started in 1965
we needed a good-sized room and an
electrical engineer to measure heart
rate
yeah and now we're doing it with our
watches yeah
um so as the technology improved in
terms of
measurement of all the all the phenomena
uh
emg the less electromyographic muscles
that's a fairly technical tech you need
fairly good equipment with noise
cancellation to be able to do that
that's
so much better brainwave technology is
so much better
heart rate technology that finally
allows us to look at beat by beat
changes in heart rate
and that's what allowed this whole field
of hrv to occur without that
yeah so all the technology plus the
software to analyze it
um is really been fantastic and now
we're on the verge of wearable
technology that
is going to give us all this stuff and
very hopefully and fairly
cheap wearable techniques uh right now
we're waiting for the price to come down
and the wearables enough for the
scale it up to the population but that's
going to really change things like when
we have
big open scale we're talking to big
insurance companies who are looking to
scale it up
big numbers of their patients they've
done that in some places in finland they
did that with
almost every um finnish university
student has some kind of a
technique to do this that's very cool
yeah so we're totally tech we're totally
dependent on technology
yeah made all the difference i wonder if
that's a
factor in this next question because we
asked our flowley community if they had
any questions for you and this question
that came up a few times is
some of our users have done bio feedback
like in the 70s
80s um or even in recent years but as
you know
biofeedback is not totally accessible to
many people
for people living in more rural areas or
not big cities it might be hard to even
find a clinic or specialist that can do
it
um and so one of the questions was
you know if about feedback has been
studied and
clinically validated for you know many
applications
why do you think it hasn't taken off in
the mainstream
or you know why haven't more people
heard about it do you think it's
something to do with like the tech or
the accessibility
things like that um generally it's been
psychologists
who have been the practitioners but
psychologists are not known for their
high tech ability
and so you know they it's been
comfortable for them to do talk
therapies
and adding biofeedback would be it's a
push
some of them more and more of them are
doing it like it's taken a bit of
convincing to get people to learn a
whole new skill set same for physical
therapists
or other tech other technology or other
professions so that's one reason the
other reason you mentioned is the cost
and uh accessibility because you know in
a small rural area you're not going to
probably find a
practitioner just doing biofeedback yeah
but as the technology gets better we are
hoping to train like nurses and doctors
offices
or social workers or other people to do
it
and now this pandemic is forcing us to
try to use
uh ad distance technology as well
and that may actually be good for the
field we might be able to get something
in the hands of people so we can have
our sessions with them
online uh for people especially in
inaccessible areas right now it's
everybody but
eventually we'll get people back to the
clinic which we prefer
but uh but we're using the technology to
check on practice now which we weren't
doing before and that's kind of yeah
i think it's going to uh i think it's
you're seeing uh
[Music]
online uh online buzz about especially
heart rate variability
biofeedback is all over the place now
uh and the biggest segment are athletes
who are using it to check their fitness
so if you check your fitness level if
you do baseline levels every day if you
buy the equipment and do that
if your heart rate variability dips is
usually a sign of over training
um some of the best football soccer
teams in the world are doing daily
harvard variability checks and their
technique on that technique leo messi is
the probably best soccer
football player in the world for barsa
he his strength of goodness coach checks
with harvard variability every day
um i'm just saying try to gear the
training forward so that
and that of course is very sexy so
people are really interested
you gotta get the celebrities into it
and then people pick it up
um well then what are another question
that came up is do you have any tips for
people
that are just starting with biofeedback
or um
you know what are some best metrics to
measure your progress with biofeedback
that's the
question we get a lot when people use
clothing there's a couple of metrics
that we were talking about earlier
um you can if you can get some equipment
like fully full equipment will allow you
to do this
that the person has you can get baseline
levels when that is your
your heart rate variability should be
measured when you're breathing normally
at normal situations
just sitting there reading or something
that's the only valid measurement of
your resting levels
so you can definitely see progress in
that over weeks
if you have equipment that'll do your
resting levels quick note we do do it so
people that are
our pro subscribers we actually measure
your resting heart rate variability at
the beginning of every session
so that we can give you that data point
so that's a great point yeah so
you can we have some published data
showing dramatic changes in that resting
level
so this is really not something you're
doing during the time you're just
sitting quietly
but your autonomic nervous system is
showing like a 25
more efficiency it's really like getting
a much better thermostat
imagine that you've got a crappy
thermostat so it gets way too warm
before the
ac goes on and way too cold before the
heat goes on
and you get a technician and to tune up
that thermostat so it's very quickly
switches back and forth
and comfortable temperatures all the
time
that's what happens and that shows up
with one of these metrics that you guys
use
to at the resting level um we can also
use a
another metric for practice because when
you practice what happens is the
the other metrics don't work anymore but
there is a couple of things you can look
at
some fancy ways of looking at the
practice that show
us if you're practicing effectively or
not and that practice progress usually
comes pretty quickly within a week you
should see much
better progress and again you guys are
trying to put that in as your feedback
yeah people people should be able to see
that they're getting
up to snuff pretty quickly once you hit
that peak of that though then that's it
the rest of your life it'll always be
the same but that particular one but
you'll see
gains in heart rate variability resting
levels over the course of
weeks and months yeah i know we talked
about how like you
you can only max out your hrv to a
certain level like we're not super human
but
once you get to that max though it still
takes some work to maintain it from my
understanding
right it still requires practice correct
last question is
how can people take what they learn like
in sessions like in
our platform or in other platforms like
heart math
work with you what are the best ways
they can practice
or implement it when they're not doing
the bio feedback session
first thing is what we've already said
they have to overlearn it in practice so
they really got it
just like any other motor skill right so
you can't
you can't perform well on the golf
course if you haven't practiced enough
to get your swing down right
so once you get the technique down then
you can use what we call
rescue breathing techniques in in the
situations you're in
um and so most people don't do the
dysfunctional thing they
hyperventilate when they get anxious
they'll take very big deep breaths
which works only for a few breaths but
after that makes you worse
we teach our folks to do everything from
athletes to
depressed people is when they're feeling
their physiology acting up
use their resonance frequency breathing
even four or five
slow diaphragmatic breaths and they
report to us that as time goes on they
get really good at that
yeah so they can take those a few
breaths
and and use it in for performance
for uh like they're a business meeting
that is very stressful
uh nobody has to see you're doing it you
just slowly shift your
me every day me every day
so you do that in those kinds of
situations uh
and and the if you practice it's
quite an effective technique for doing
it i mean we
you and i so yeah some years ago i had
to
get an mri and i didn't think i had any
stress about that at all
but they put you in this machine with
this thing right in your nose banging
went crazy and i realized this is
actually kind of stressful so i just
went into my residence frequency
breathing and i almost fell asleep
i was able to stay still i was able to
really calm down my anxiety they got a
really nice clear picture
so i mean i really you know i did
practice what i preached at least in
that situation
yeah i always have to remind myself that
i
preach this and i talk about this all
the time but i need to have the
discipline to do it as well
thank you so much for being here richard
because i think biofeedback
is amazing in that you're using external
tools but really strengthening
your internal resources and it's kind of
putting the power back in your own hands
to
control how you feel and so i think it's
incredible work
you've paved the path for so many people
and teams like ours
so thank you so much for joining us
today well good good work for you guys
i'm
so happy to see you going yeah thanks
richard
you
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