Why this new frontier of mental health is obsessed with your heartbeat

Therapy is a powerful tool in coping with big emotions—but is the next frontier just around the corner? As Jill Blakeway, DACM, finds, psychology can be complemented by a special kind of physical training. Here, the Well+Good Council member dives into the concept of psychophysiology—and it could transform the way you respond to stressful situations.

There’s a character in Showtime’s drama Billions who fascinates me. Wendy Rhodes, played by Maggie Siff, is the in-house psychiatrist and performance coach at Axe Capital, a hedge fund. She’s tasked with keeping the traders’ heads straight, an important job in an industry where a momentary lapse of judgment can cost millions of dollars.

I went in search of a real-life Wendy Rhodes while doing research for a book I’m writing about how people heal themselves. I found Leah Lagos, PsyD, a clinical and sports psychologist in New York. Her specialty is psychophysiology: the study of the relationship between the body and the mind. In particular, she teaches people how to recover from stressful events quickly so that they can perform. A large number of her clients are professional athletes, CEOs, and actors—people who execute the emotional equivalent of a high-wire act every time they go out in front of an audience. They must regularly be in control of their thoughts and emotions in order to do their jobs.

Lagos is a specialist in heart-rate variability biofeedback, a technique that trains people to change the rhythms and patterns of their heart activity. Lagos believes that the heart is at the center of emotional control and has been overlooked by an insistent focus on the brain—and she uses the technique to help patients improve cardiac health as well as to teach techniques for dealing with anxiety.

Lagos believes that the heart is at the center of emotional control and has been overlooked by an insistent focus on the brain.

We tend to think of a healthy heartbeat as being regular, but in reality, the heart varies the time between beats as it adapts to changing circumstances. Using an electrocardiogram (EKG) machine, Lagos identifies these variations in heartbeats in order to document when a person is breathing at a rate that’s ideal.

“When you inhale, your heart rate goes up and when you exhale, your heart rate goes down,” she says. “You want these oscillations to be as big as possible but you also want them to be orderly. When you’re stressed, frustrated, [or] upset, your heart rate becomes erratic. When you are relaxed, you have this beautiful, ocean-like wave.” Since your heart is a muscle, she adds, this movement can be developed.

Lagos’ protocol, which allows her patients, as she puts it, “to gain the ability to control their physiology and psychology through their heart rhythms,” is a 10-week program that includes meeting in her office once a week and doing breathing exercises twice a day.

Ultimately, she aims to help each client alter their body’s autonomic nervous system response to stress, and it’s all about focusing on what’s known as sympathetic vs. parasympathetic reactions. When you’re scurrying across a busy intersection and the light changes, setting a number of cars in motion, the body goes into fight-or-flight mode, which is also known as the sympathetic response. This is a valuable response! It amps you up and urges you to sprint to the sidewalk before the cars reach you.

But once you’ve reached the sidewalk, if you don’t switch gears—with a strong parasympathetic response to bring you back into balance—you remain in that survival state for longer than is necessary. For those who are chronically stressed, this can last for hours and sometimes even days.

Lagos’ regimen helps her patients to bolster the parasympathetic response—encouraging more heart-rate variability and a lower heart rate—in order to interrupt the sympathetic reaction sooner.

“Think of a tennis player getting ready for the US Open,” Lagos says. “They’re not thinking about which muscles to exercise—that’s what muscle memory is, and it’s the same thing with the heart.” Enough repetitions at a specific frequency, she continues, will help the heart embrace the pattern on its own. “It changes your reactivity and response to stress,” she says.

Lagos told me she envisions a future where people will see their psychophysiologists weekly instead of their psychotherapists.

Lagos studies her patients’ heart frequencies using an EKG. She does so by measuring electrical activity of the heart as they breathe at a specific pace. When breathing rate and heart rate coincide, patients reach what she considers an ideal state: resonance. “When you are breathing at your resonant frequency, you’re strengthening the parasympathetic influence to come in and break that fight-or-flight tendency,” says Lagos, “and bring you back to homeostasis.” During resonance, the rhythms of the heart create calming signals that reverberate throughout the entire autonomic nervous system.

Lagos treats a number of professional golfers who need to have a steady hand and a clear mind, but her coaching can benefit anyone who wants to get their stress response under control. In fact, Lagos told me she envisions a future where people will see their psychophysiologists weekly instead of their psychotherapists. Time will tell, but the more we learn about the mind-body connection, the stronger it appears.

Dr. Jill Blakeway, DACM, is a practitioner and teacher of Chinese Medicine and the founder and clinic director of the YinOva Center in New York City.

She is the author of Making Babies: A Proven 3-Month Program for Maximum Fertility and Sex Again: Recharging Your Libido. She’s currently writing her third book, about energy healing, for Harper Collins.

What should Jill write about next? Send your questions and suggestions to [email protected].