March 19 , 2003

Yoga of the Heart

Author: Siegfried Othmer

“The heart is the recording secretary for the ego.”
– Japanese Proverb

Caroline Grierson and Sue and I have been listening to a tape by Ira Rosenberg of a short course on Heart Rate Variability (HRV) training delivered at one of the meetings of the California Biofeedback Society. Rosenberg has been doing this work since the early eighties---another instance of clinicians in the lead in the development of a field. His experience with a variety of heart ailments is extensive, and most impressive.

The talk struck a chord with me on a number of issues. First of all, I am hopeful that self-regulation technologies will be the key to having people assume responsibility for their own health and well-being, with a diminished role played by an authority figure. Secondly, I am hopeful that the discipline imposed by self-regulation based technologies should be life-long, and not restricted to short periods in one’s life where one is paying tribute to a biofeedback therapist. Thirdly, I am hopeful that there will be a shift from a concern about deficits and diagnoses to wellness and optimal functioning. To have this idyllic future be realized, people must be able to understand the issues, on the one hand; they must not be hindered by expensive instrumentation over the long haul; and the techniques must offer multiple, broad-spectrum benefits so that they become habitual.

The modality that comes immediately to mind with respect to accessibility is the breath, and much has been said and written about that already. We are capable of working with the breath entirely through voluntary controls, and entirely without instrumentation. Matters appeared to be different when it comes to the heart. More than almost anything else in our inventory of body parts, the heart is owned by the responsible expert, the cardiologist. Here the doc still reigns supreme as the authority figure. When there is a crisis of the heart, it is immediately a medical matter. And in this fashion we have developed in our society a $65 billion cardiac care industry. Statistically it is a likelihood that at some point in one’s life the heart will have a crisis, and the only hope we are allowed is that appropriate medical care will be readily available.

Ira contradicted this traditional view in a number of ways. Not only can we usefully intervene with voluntary controls such as paced breathing, but we can even monitor our heart rate variability directly by feeling our pulse. I had been so tied into heart rate variability monitoring devices that I failed to notice that the signal is sufficiently obvious that one doesn’t need an instrument to make it observable. So this is another take-home option, although a change in mindset is also required that ceases to regard monitoring one’s heart as a medical procedure. It need not be done furtively, and with an air of foreboding. And fortunately we have come to realize that some variability is a sign of health, not of the immanence of heart failure.

Ira suggests that we should develop a “yoga of the heart” as well as of the breath. He has seen numerous cases of arrhythmia resolve with heart rate variability training, and even PVCs. The story goes on an on. He also stated the obvious when it comes to medical emergencies. When a heart goes into crisis, it is not just because some coronary artery is 82% occluded, because indeed that did not happen just with the last dietary indiscretion. The heart goes into crisis because under prevailing stresses its dynamic patterns become disturbed. These dynamic patterns are trainable, and susceptible to voluntary controls. And if that is the case, then the first resort should be to restore the proper functioning of the dynamic patterns of heart function. This then affords a window of time for dietary remedies to be applied to the problem of plaque accumulation. And, by the by, the need for major surgery may simply subside.

There are other problems of the heart that remain unmentioned, such as congestive heart failure. But clearly the majority of heart incidents have to do with disturbance of the proper timing and sequencing of heart function. This should be in the realm of functional medicine, and in the steady state these matters are all accessible to self-regulation technologies.

I am struck by the similarities that prevail between EEG training and heart rate variability training. In paced breathing we set up a somewhat artificial situation. We push several feedback loops into resonance at around six breaths per minute, thus driving the system to larger excursions, which elicits stronger reactions that eventually strengthen the various control loops. My view of EEG biofeedback is much the same. When training 15 Hz we are not trying to get the brain to operate at that frequency to the exclusion of others. Rather, we are driving a particular generator to larger excursions, thus bringing about a reaction by the brain that through repetition eventually leads to better internalized control.

Finally, we return to that traditional realm of the heart, the matter of the emotions. In the Heartmath program, the primary suggestions for good training relate not to control of the breath but rather to awareness of one’s emotional state. Whereas it may be possible to do a yoga routine while in a state of anger, one cannot similarly do the “yoga of the heart” successfully while in such a state. By mobilizing the resources of the heart one can be led indirectly to the dissolution of anger. Conversely, the answer to a brittle heart may be a warm heart.

One of the distinguishing characteristics of EEG biofeedback is that it places such a minimal demand on the person. We require only the most minimal level of engagement, of cognitive functioning, or of awareness for the training to proceed successfully. But doing the training with awareness is obviously better. And that heightened awareness is then the take-home message. If we bring together in the training the realm of the brain, of the breath, and of the heart, then we will have bequeathed access to the power of self-regulation rather permanently on that individual.

In the same tape Ira comments on the fact that even the BSC conference seemed to be taken over by EEG biofeedback. He recoiled from “EEG” being dominated by the technicians. But he also thought it was too limiting, focused as it is on cortical function. If he has that mistaken impression, it is certainly not his fault. The technicians have fallen into the same trap of being beguiled by all that richness of cortical data into a thorough-going cortical preoccupation. Fact is, one does not need to do peripheral biofeedback in order to address the hypothalamus. Or the heart, for that matter. Nearly all of the autonomic variables are accessible to us in EEG biofeedback. But the lessons we teach stop at the office door unless we also engage the person more directly in the enterprise of self-regulation, and that is where the peripheral measures come in, as well as the cultivation of heightened levels of awareness. For us to succeed, self-regulation cannot simply remain a procedure or a passing event in people’s lives. Rather, it must become a way of life, a necessary part of our education.

I believe that the enterprise of self-regulation cannot become a way of life until we are able to present a picture of integrated function, and that cannot happen until we buy into the concept ourselves as clinicians and researchers. The biofeedback field is dominated by the fragmenting perspective of ever more refined differential diagnosis, whereas its natural culmination should lie in a unitary perspective on human function. Finally, self-regulation cannot become a way of life unless we offer people a path beyond a tether to sophisticated instrumentation with complicated reinforcement schedules, and even beyond the dependency on an authority figure.

We are coming into the Second Reformation. In the first, we obtained the right of disposition with respect to our spiritual selves. In the second, some 500 years later, we are obtaining the right of disposition with respect to our bodily selves. No high-technology diagnostic scheme, expensive instrumentation, or authority figure will be able to bar the door to our essential liberation. How did we ever allow this process to take 500 years?