Biofeedback - clocking your body
What is biodfeedback and how can you use it?
I often talk to young people and adults about “having your brain in your hands”. This is about having your brain and body in your hands. Let’s talk about biofeedback.
Before you read on, two important reminders:
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Biofeedback
Biofeedback is any objective measurement of how your body and/or brain react to certain actions. The point is to help you make positive changes to your body and brain. Using biofeedback you can lower blood pressure, slow heart rate, calm breathing, reduce your body’s stress response and control your thoughts.
There are different ways of doing it and some require expensive gadgetry that you typically won’t have at home. But some don’t. Some of the methods require a simple gadget that you either have or might choose to buy. I will also show you how you can make use of biofeedback techniques without any special gadgets at all.
Let’s be clear about what biofeedback is and what it can do:
Imagine you were hooked up to a blood pressure (BP) monitoring machine. If you took some BP readings while doing breathing exercises to relax, you should see the BP readings change in response to your breathing exercises. This feedback would show you that you were doing the breathing correctly and what that felt like. It would be helping you understand the feeling of doing the relaxation exercises correctly. Then you’d be able to do the same thing even when not hooked up to the machine.
So the “feedback” from the machine helps you see what you are doing wrong or right - because as you alter your mental and internal physical actions, the machine gives you objective feedback.
Using gadgets to give biofeedback
1. Home blood pressure monitors
Adults in the UK are now recommended to have a home BP monitor and take their own BP. People with high cholesterol or any increased risk factors for cardio-vascular incidents (strokes, heart attacks etc) are especially recommended to do this. The machine is not expensive and it’s easy to use.
As I said in the example above, practising a breathing or any other kind of relaxation exercise is a brilliant thing to do while taking your BP. You get real-time evidence that you are doing it right and it is very satisfying to see your BP drop from the first reading.
Doing this was solely responsible for my husband finally understanding how to use a breathing exercise to relax. I had told him many times what to do but, for some strange reason, my telling him what to do did not have the desired effect. But when a machine told him…
2. Pulse oximeters
This is an even cheaper gadget but measuring something different: a) your heart rate as measured by the beating of your pulse and b) the oxygen levels in your blood. It’s the first measurement that is relevant here: how fast your heart is beating, particularly when you are “at rest”. Your “resting heart rate”. Resting heart rate is a good measure of cardiovascular fitness.
NB: a blood pressure monitor also gives your pulse reading but the pulse oximeter is a bit easier to use, cheaper, smaller and handier. But BP is not the same as pulse rate.
Generally speaking we are looking for our resting heart rate to be nice and slow. “Nice and slow” is different for everyone. A very physically fit person will usually have a lower resting heart rate than someone who takes little physical exercise and is unfit. Age, weight and genes all play a part. My husband’s resting heart rate is always slower than mine. We both do the same amount of exercise - perhaps he does a little more cardio, to be honest - but the difference may be because he has been a runner for many more years than I have and he has built up really good fitness during that time. His resting heart rate is usually low 50s and mine is low 60s. Mine is a decent score but his is “better”. You can start to learn what your typical resting heart rate is and then do some things to reduce it.
(The British Heart Foundation has great information about heart rate here.)
You can use the pulse oximeter in one or both of these two ways:
The same way as the BP monitor - to practise breathing/relaxing exercises
As a more general record of how your physical exercise programme is lowering your resting heart rate
3. Fitness trackers
This is a more expensive but much more comprehensive method. Depending on which make you choose, you get a lot more information than BP and/or heart rate.
(Disclaimer: I love my Garmin Vivoactive 5, which I’ve had for a year, after having a Fitbit for around 10 years. I liked my Fitbit, too. This is not an article comparing the two - I’m just talking about what I get from my Garmin. (Obviously, other makes are available, including the Apple watch. Again, I’m not comparing and I’m not saying Garmin is the best, just using it as the example I know most about.)
These are the measurements I get from my Garmin and how I use them for biofeedback:
All these present the data so I can look at them over any time-frame: that day, week, 4 weeks, year, last year.
VERY important: do not become obsessed by your device scores. It’s great if the results show you ways you can be healthier and fitter or nudge you into doing a bit better but obsession with numbers and stats on their own is not healthy. And over-exercising can be dangerous, just as under-exercising can be.
Also, never aim for huge, fast changes in your body behaviour. Nudge your scores rather than burn them.
Resting heart rate (and heart rate when active or stressed) - I can see how that has been over different time frames or drill down into exactly what I was doing at a particular time when my rate went sky-high. I can use that info to predict the next spike and, if I remember, act on it if I wish to. It’s really interesting to see what kind of situations (eg social) send my heart racing. And it’s encouraging to see the resting rate drop as I get fitter. Another thing you notice is that if you are unwell, for example with a cold virus, resting heart rate increases. (You cannot prevent this - it’s your body’s attempts to fight off the illness - but you can be aware of it and rest more.)
Sleep quality and length - I am under no illusions that this is terribly accurate. A fitness tracker can only guess at what your sleep is doing, based on your heart rate and how much you do or don’t move about, which is very inadequate. It cannot properly tell whether you were in deep or light sleep, as this can only be detected by brain waves, which a fitness tracker can’t measure. But when I compare it with how I think I slept, it’s generally accurate. Fairly. The Garmin then suggests reasons why my sleep was or wasn’t good. It might tell me I had a good/bad amount of activity/rest during the day or I went to bed too late or whatever. And it will suggest a change to follow.
NB Sometimes it’s very inaccurate. Recently it told me I’d had a one hour 40 minute nap when in fact I had been on my feet all day! Also, although I often have terrible nights, I’m very good at lying extremely still and slowing my heart rate, so the Garmin thinks I’m asleep.
Body battery - I really like this one. It is based on many factors: how much sleep I had and how much energy I burn during the day, how much stress it thinks I had, and how well I’ve balanced the various things that drain energy and replenish energy. It’s a rough score but useful and I can alter my actions to try to keep the BB score high. (Mine is usually rather low. Once it went down to 1% and I was wondering what would happen when it got to zero. Spoiler alert: nothing.)
Stress - this is based on the device noticing when I had a high heart rate while not doing physical exertion. As with the body battery score, I can take steps to improve it and it reminds me to do relaxation exercises or take time out to lower the score.
HRV (Heart rate variability) status - this is more complex than simple heart rate. It measures the difference between space between heart beats depending on what you’re doing. Generally and within reason, a high HRV reading is good, and indicates that your heart adapts well to the different needs placed on it. I find it fascinating that most of the time my HRV score is very good but if I have any kind of minor illness it becomes poor and this effect happens not immediately but after a period of several days and only recovers quite a few days after I’ve recovered from the illness. So, there’s not much I can do about this except take extra care of myself during the recovery period of an illness and not expect full strength too soon.
Also, if I noticed that my HRV was slipping, I could look at what I should be doing differently to rebuild that normal healthy life.
VO2 Max - this measures the maximum volume of oxygen per minute per kg of body weight your blood can carry when exercising. The higher the score the better your heart health in terms of ability to exercise and this is associated with longer age - or, more importantly, a healthier longer age. I’m happy to say that mine is rated “excellent” and I am apparently in the top 15% for my age and sex.
You can’t instantly change your VO2 Max score but once you know that high intensity workouts (short but hard) are the best way to improve it, a score that drops a little bit can push you to do a bit more of this type of exercise.
Fitness age - now I do love this and my husband and I have a bit of a competition going on! You know your actual age (in my case 63) but the Garmin tells you your “fitness age”. Obviously, this is based on some limited info (more of that in a moment) but the reason I like this is that most days my fitness age is apparently 56.5! (Pause for applause. Thank you.)
This is based on a combination of:
BMI (Body Mass Index) - a calculation of weight and height, which I obviously have to input
Resting heart rate - needs to be a healthy figure for age/sex
Vigorous minutes - I am supposed to do 75 vigorous minutes a week (based on age/sex) and I always do far more than this
Vigorous days - on at least three days a week I have to do something that counts as vigorous activity, such as at least 30 minutes of running.
Now, as it happens, yesterday my fitness age shot up to 58. I know why this was: I had a weekend that involved not much exercise (on Saturday I was cooking dinner for friends and on Saturday we were in the car most of the day so low step count and no proper exercise for both days, quite a lot of stress so a poor resting heart rate and HRV dropped a little. I’m pretty sure my weight also increased, though my Garmin doesn’t know that because I haven’t weighed myself!
This reminds me that I need to go for a run today. That will get me on track for the 3 vigorous days a week, plus the vigorous minutes, and the improved resting heart rate. I’ll be back to 57 max by the evening or tomorrow at latest, especially if I can sleep better tonight. (Edited to add: I’m now 56.5 again!)
Biofeedback with no fitness trackers at all
Here’s the secret: you can manage without any of these gadgets. You have your own brilliant measuring gadget: your brain. Once you learn what to look out for and how to be honest and insightful with what you know and how well you know your body, these gadgets really don’t do much more than confirm what you could already know yourself.
I’ll show you how in a moment but first, a couple of caveats:
You can’t tell what your BP is without a monitoring machine. You can guess whether it might be higher or lower than usual and you will probably be right more often than randomly, but you will often be wrong, in either direction. I have sometimes thought my BP must be raised because I’ve been dealing with some stress, only to find nothing of the sort.
You certainly can’t know your HRV without a gadget.
You do have to think carefully and learnt o be honest with what you detect.
How you can use your brain to get biofeedback and use it to live healthily
1. Heart rate
You can use your finger on your wrist or where the pulse is in your neck to assess whether your heart is going fast or slow. With a simple stopwatch you can be quite accurate. Here’s a description of how to do it.
2. Check (and change) your breathing
When we are anxious or stressed, our breathing changes, not only in speed but also in depth and in how our body moves with it. Without changing yours for now, try this: place one hand on your chest, high up, on your collar bone. Place the other hand much lower down, below the bottom of your rib cage, on your “belly”. Breathe normally, without changing your breathing to seem more relaxed, and decide which hand is moving more when you breathe.
If your upper hand is moving more, that’s a sign of some stress; for relaxed breathing, the lower hand should be moving more. Once you notice this, you can change this really simply, though it takes some practice before you can use it as a tool easily and almost automatically.
Internet search “belly-breathing” and choose a video that works for you to teach you how to do this.
3. Check (and soften) your tension muscles
When we are tense/stressed we automatically tighten some of our muscles. If we need to run or fight or exert ourselves, that’s great. But if we don’t, we are burning energy unnecessarily and feeling tense when tension has no advantage. That’s tiring, draining. You don’t need a machine to tell you this is happening: just check in with the muscles in your shoulders, stomach and face/jaw and you’ll see if you’re holding them tightly. Then you can soften any of them. You have control!
After a big talk I’d done on a huge stage, someone said to me: “I noticed before the talk you looked completely calm. How do you do that?” The answer is that I’d been altering my breathing to breathe low and slow, while also softening the muscles where I was holding tension. That made me feel and look at ease. It’s completely invisible to everyone else because I’ve practised it.
4. Manage your body battery
I do like the body battery function of my Garmin but it really just tells me in fairly stark terms what I already know: I have or haven’t had enough quality sleep, rest, exercise, and relaxation. The Garmin puts a number on it but actually if I really take time to listen to my body and at the same time keep tabs on what is going wrong or right in my question for a healthy body and mind, I know.
I think this is a PERFECT place to start with young people, too, because they typically “get” the idea of keeping a battery charged. We all know that certain things drain our phone battery quickly and that once the battery gets too low it stops working. It’s a good analogy, though the human body and brain are a tad more demanding.
I’m going to create a classroom activity one day soon but for now let’s think about things I know drain my body battery. You might find the same for you or you might find some differences. (Most will be the same.)
Things I know drain my body battery:
Bad sleep - this is the worst, particularly as it leads me to eat poorly the next day
Physical exertion - of course this is a good thing but you do need enough energy
Distress, upset, big negative emotions - which also affect sleep
Social situations - again, good things but for me super-exhausting. (This is the main one that differs between people. Extroverts often find social situations energy-boosting.)
Working too hard
Stress
Public-speaking - much as I love it and find it exciting, it’s still very exhausting
Illness
Allergic reactions - I have a condition called idiopathic angioedema which is quite severe and when I have a particularly bad reaction it can make me feel generally unwell
Overdoing the step count - I like to have a high step count, averaging 14k a day, but if I have a couple of days in a row of >20k I do feel too tired for a couple of days.
Persistent bad weather and grey skies - shouldn’t affect my body but it does. We need sunshine!
Things I know recharge my body battery:
Good sleep
Rest and relaxation - such as sitting in the warmth or having a bath
Sunshine
Good news
Being praised or valued
A healthy snack or delicious meal
Laughter
Time on my own
Being “in flow” - I’ll talk about this another day
Reading for pleasure
A gentle walk on a sunny day
There are a few things I started to add to that list but didn’t. For example, I deleted “Doing something that makes me feel like a good person” because, while it would make me feel good in some ways, it’s actually setting myself another task. And recharging your body battery is meant to be about increasing energy banks rather than using energy.
See your body battery as something more physical than psychological, though of course there’s a big connection between the two.
IMPORTANT NOTE: the Garmin body battery measurement can’t take most of those things into account because it has no idea! YOU are your own best body battery device and charger!
This is about using your own brain to check your body, to have a deep ability to know how you are feeling, how much energy you have left and not letting all the energy drain away. It’s your personal biofeedback gadget.
What to do with all this - and what not to do
Whether you use biofeedback devices, or just your own brilliant brain and body, or a combination (the best, imho) there are a few important things to do and not do with that information.
Don’t try to change everything at once - you’ll most likely be overwhelmed and fail. You can’t do everything. One or two steps at a time.
Use my Table of Wellbeing to think about how to look after the four legs of physical and mental health: food and water, exercise, sleep and relaxation.
Remember that people are different. They start with different levels of health, different advantages and challenges. Males and females have differences in typical scores (and yes, biology of male/female is important in this context and you cannot over-ride it by will power) and age also makes a lot of difference. be sure to compete only against yourself, not others. (My husband and I obviously do compete on the “fitness age” thing but we are old enough, wise enough, fit enough and mutually supportive enough for this to be fine!)
Do not overthink any of this. If you’re starting to feel negative about your body or your health, please talk to someone wise and trustworthy about whether there’s something different you could be doing or whether you’ve misunderstood something.
If you discover anything that genuinely worries you - for example that your resting heart rate is higher than reliable charts say it should be for your age - please seek proper medical advice without delay. Nothing I have said replaces medical advice.
In short
When you have a way of measuring and assessing how your body is doing, how it is responding to exercise and stress, how good its sleep is, what your cardiovascular system is doing and how it is responding to whatever life throws at it, this becomes incredibly empowering. It signposts you towards taking positive actions and making good choices.
By listening closely to your body and mind, and noticing what factors make a positive or negative difference, allows you to take control and make big changes or small tweaks. It gives you a sense of where you are and where you’re going.
However, be very careful not to let any negative feedback dominate. Sometimes, you’ll be ill, or something really tough will happen, or life will do its thing and prevent you from taking the healthy actions you desire and need.
When bad stuff happens, just take a breath and ride the storm out. Look for the next chink of sunlight, the next patch of blue sky, and do something to charge your body battery.
Top tip: whatever you can do to improve your sleep - length or quality - will reward you. That should be your focus when life is at its toughest. So many of the other things - relaxation, exercise, sunlight - wrap around into improved sleep. It’s the best thing you can do for yourself. See my Awesome Power of Sleep - and everything I’ve written on my website.