HRV biofeedback — training the autonomic system.
Heart-rate variability biofeedback at resonant frequency. The simplest, most evidence-supported autonomic intervention we use — and one of the easiest to take home as a daily skill.
A breath, a sensor, and a signal.
A small sensor on the finger or earlobe records the beat-to-beat variation in heart rate. The patient breathes at their resonant frequency — typically around six breaths per minute — while a screen shows their heart-rate variability rising and falling with each breath. Over sessions, the autonomic system learns to spend more time in the regulated, vagally-mediated state the breath pattern encourages.
Sessions are 30 minutes. We teach the breath-pattern in clinic and ask patients to practise daily at home, supported by a free app and our printable resonant-breathing guide.
Among the strongest evidence in the modalities we use.
Lehrer et al's 2020 systematic review and meta-analysis reports significant improvements across emotional regulation, physical health markers, and performance under pressure. Goessl, Curtiss, and Hofmann (2017) report meta-analytic effects on stress and anxiety. Pizzoli et al (2021) report effects on depressive symptoms when used as adjunct.
It's also one of the few modalities patients can largely self-administer once trained. Cost, scalability, and side-effect profile are all favourable. View the bibliography →
Often the first lever, sometimes the only one needed.
For patients with anxiety presentations, chronic stress, burnout, or performance demands, HRV biofeedback is often where we start. It's well-tolerated, the home-practice carries low risk, and many patients see autonomic shifts within the first six sessions.
For patients with broader neuropsychiatric presentations, HRV biofeedback runs alongside other modalities — usually neurofeedback and functional neurological exercises — within a single integrated programme.
A few clarifications.
- HRV biofeedback is not a cure for anxiety or any other condition.
- It is not equivalent to consumer wearable HRV tracking. The training method matters; the resonant breath-pattern matters; the in-session calibration matters.
- It does not replace psychological therapy, medication, or primary medical care.
- Some patients with significant cardiac arrhythmia or autonomic conditions need medical clearance before starting. We screen for this in intake.
Your brain.... Your call.
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Scope & safety
We work alongside — not in place of — primary medical and psychological care. We do not diagnose neurological or psychiatric conditions from EEG, and we do not prescribe or alter medication. If you or someone you know is in crisis, call 000 or Lifeline 13 11 14.