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How Heart Coherence Training Helps In Stress Management

Heart Rate Variability is one of the best known and most commonly used biofeedback parameters. HRV training aims for a state known as heart coherence, where heart rate speeds up and slows down again in sync with the breath (speeding up on the inhalation, and slowing on exhalation).

heart coherence

There is considerable research interest in HRV biofeedback thanks to a growing body of evidence for the benefits of heart coherence, which include:

  • calm, emotionally-balanced yet alert and responsive focus
  • improved cognitive performance – problem solving, decision-making, perceptual acuity
  • enhanced sense of well-being (contentment, peace, vitality) and reduced depression, anxiety, anger and hostility
  • improved sense of energy and reduced fatigue and burnout
  • improvements in physical health parameters: reduced hypertension, improvements in functional capacity in heart patients, improved blood sugar regulation in diabetics, improvements in asthma.

(This list is drawn from a paper by McRaty et. al. which offers supporting evidence - follow this link to see the paper.)

Coherence Training

In the literature there are two routes to training heart coherence. The first is by breathing slowly and regularly and abdominally, at about six breaths per minute which seems to be some sort of physiological resonance point for coherence. The second is by generating positive emotions, such as gratitude, kindness and good will. (Personally I suspect that the two methods combined work best – I don't think positive emotion will generate much coherence unless it also triggers a move to slow regular breathing.)

Physiological Mechanisms

How is it that coherence is able to produce these wide-ranging benefits? What is the physiological mechanism?

There appears to be two main factors, plus a third which is a little fuzzier and less well established by research.

1. Heart coherence exercises the parasympathetic nervous system (the carrier of the relaxation response)

The parasympathetic nervous system is one of two branches of the autonomic system which regulates or modulates several body systems (without requiring conscious participation). For example the parasympathetic slows heart rate (while the other branch, the sympathetic, speeds it up).

Parasympathetic influence is what drives the coherence response: during exhalation, parasympathetic tone is directed to the heart, slowing it down, while during inhalation, a sort of gate is closed on this influence, effectively blocking it, so the heart rate bounces back up again.

It seems that regular practice of coherence training as described above serves as a kind of exercise for the parasympathetic system, gradually strengthening it over time.

2. Heart coherence activates the prefrontal cortex – the seat of executive function

There is evidence that activity in the prefrontal cortex correlates with increased parasympathetic activation. The connection probably runs both ways. Parasympathetic activation is carried to the heart in the vagus nerve, and the vagus also carries information back in the other direction – maybe all the way to the prefrontal cortex.

The prefrontal cortex is the part of the brain behind your forehead, and it plays a major role in executive function, which includes:

  • Focus and concentration
  • Emotional regulation and body regulation – balancing over-excitement and under-arousal
  • Motivation and emotional drive – the ability to formulate values, goals and purposes
  • Sense of self, and self-monitoring – being conscious of what you say and do, and knowing that it is appropriate
  • Self-organisation – the ability make decisions, to formulate a considered plan of action, and to hold to it in the face of distractions, as well as to update it appropriately. The ability to check impulsiveness
  • Empathy – the ability to appreciate the minds of other people, and to understand how our own behaviour impinges upon them. Ultimately this is the basis of our moral awareness.
3. Body systems entrainment / synchronisation

The heart generates the strongest electromagnetic field in the body, and the heart beat is a strong rhythm in this field that seems to work like a sort of metronome in the sense that it sets the pace for other oscillatory systems in the body, including EEG in the brain (i.e. brainwaves). (Of course the heart beat is not constant like a metronome – the gap between beats varies.)

It's not clear how significant this synchronisation of body systems is, but director of research at the Heathmath Institute, Rollin McCraty, thinks it represents a particularly efficient mode of functioning for the whole body.


Coherence training is one of the three biofeedback modalities used in my Stress Resilient Mind programme - training resilience skills using biofeedback and mindfulness. All three relate to optimal breathing – coherence is actually the third and last to be introduced, as I consider it the icing on the cake. I don't want to under-emphasise its importance but I do believe it's important to know about other aspects of optimal breathing first.

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