STD diagnosis and treatments. To meet this need, we developed a program we called The HeartMath Solution for Health. We introduced our basic premise—to optimize the ability of the autonomic nervous system to function at its peak capacity for health. With scientific evidence, we provided tools to help people to monitor and increase the activity of the parasympathetic nervous system and also to develop skills for using their breath as a way to balance the sympathetic and parasympathetic nervous systems. We also developed a toolkit for creating heart-centered programs to support health. At this point, we still are not sure exactly how to describe the HeartMath solution. However, we do have clear examples of it in use and a long list of studies that clearly document our solutions and research findings. As we begin to offer the heart-centered program more widely, people will learn that HeartMath is more than a tool for better mental health. It is an approach that can support the development of health, self-esteem, and happiness in people of all ages. It is a lifestyle program—a way of life. We will explore in more detail the science underlying this program, as well as the benefits of learning to use your breath as a tool for improving emotional and physical well-being. We will also explain how you can use the tools to develop your own custom heart-centered program that will help you optimize your health and well-being. The Science of the HeartMath Solution Our scientific discoveries—and the data on which they are based—have taken place over two decades of experimentation, research, and clinical observations. The HeartMath Solution has been verified through countless lab studies, clinical trials, and field tests that are now published in prestigious scientific journals. This research is peer reviewed. The data is validated. They have been replicated and replicated again by independent researchers around the world. In many ways, we have come full circle to the teachings of Dr. Bernard's original research. We discovered that the heart was communicating with the brain in the same way that the two brains of a predator (or prey) talk to each other. When either brain isn't in balance with the other, there is conflict. In the case of predators, it means that the brain is in fear—the sympathetic nervous system is in charge. This creates a threat-response bias, which results in chronic stress. In the case of prey, it means that there is not sufficient parasympathetic control. This results in chronic tension, which then feeds back into the sympathetic nervous system, creating even more stress. This conflict was happening in our research participants. The data showed that when people experienced extreme positive or negative emotions, as measured in a laboratory setting, these emotions produced an increase in levels of a stress hormone called cortisol. In their book Peak Performance, Jeff Davidson and Tom Bartow make the distinction between negative and positive emotions. These terms refer to emotions that you feel and those that you express. Fear or stress has to do with what you experience internally, whereas courage or love or empathy or joy has to do with what you choose to express. Even though we experience these emotions, our actions come from our intention to express either love or fear. The data showed that when negative emotions are dominant, the autonomic nervous system is suppressed, and the prefrontal cortex has a difficult time getting its message to the brain stem—the place where our fight-or-flight system starts. We are not likely to be in fight mode in a situation that we find unpleasant. This was the case in our study. Even when people were happy, their sympathetic nervous system had little control over the effects of negative emotions. We even saw a decrease in parasympathetic activation when we measured participants' physical symptoms during negative emotion activation. These results were later replicated by a number of researchers. Once we saw these results, we knew we needed to find out what effect these negative emotions had on our breath. Our first studies focused on negative emotions because these emotions are more prevalent and have a greater impact on our health. Our first studies looked at anxiety. While participants were breathing rhythmically (more about that in Chapter 1), we attached an electrode to the wrist, and their galvanic skin response (GSR) was recorded. The GSR measures changes in skin conductivity that are associated with emotional changes. In our first study, we found that high-stress-inducing emotions increased GSR, and anxiety was one of the primary emotions that increased GSR. We did further studies on the effect of negative emotions, and we also discovered that when people held their breath for a prolonged period of time, their blood pressure increased. In our next study, we were interested in trying to use more of a laboratory-based approach to help people learn how to manage stress. Our objective was to support people to use breath work as an easy-to-do way to increase their calmness and reduce their stress. To do that, we needed a way to give people immediate feedback on their progress. This enabled us to measure their progress in a scientific way. We chose to test the technique by looking at their heart rate variability (HRV), which is a measure of how fast and how stable heart rate is. People with higher HRV tend to have more of the parasympathetic nervous system activity and less sympathetic activity. With this approach, we measured HRV and breathing simultaneously. We also did a similar study using the GSR (which measures skin conductivity) as a measurement of a person's level of relaxation. The combination of the two methods gave us a good measure of the person's level of stress. These studies showed that there is a very strong relationship between the change in breathing pattern and HRV. This correlation occurred whether we were measuring people's stress through emotional experience or the change in heart rate. In our first full-length study, which was published in the Journal of Applied Psychophysiology and Biofeedback, we showed that the changes in people's breathing can change their physiology when there is no other feedback provided. In this study, people learned to use their breath to increase their HRV and to decrease their anxiety, as measured by GSR, within a 15-minute period. That was significant because it proved that the brain could learn to change its function and its communication with the rest of the body through changes in the breathing pattern. In our next study, published in Biofeedback and Self-Regulation, we were able to link the effect of changes in breathing to increases in HRV and a decrease in GSR. The average person usually uses about 5–6 breaths per minute when they are resting. With this baseline rate of breathing, people increase HRV by 31 percent and decrease GSR by 41 percent. The changes are consistent throughout the experiment and reflect a new way of using our autonomic nervous system. During stress, it appeared that people were using breathing in an attempt to control their emotional experience. Our findings were supported by extensive research and published in major peer-reviewed journals in cardiology, physiology, and psychology. The studies in the field of clinical psychology all focused on depression. We published one study showing that when you change your breathing pattern and increase your parasympathetic activity, it has a significant effect on depression. There was also a correlation between the reduction in heart rate and depressive symptoms. We have also studied fear-related behaviors, such as people who suffer from agoraphobia, and again we have seen that they have an increased level of fear that can be decreased by teaching them how to control their breathing pattern. We have also examined the link between anger and cardiovascular health. We did a study using anger-evoking pictures and found a strong correlation between stress and heart rate. The participants in our study who were able to keep their breathing relatively steady were able to reduce their stress. We also found that there was a correlation between heart rate and emotional experience, such as the level of anger and emotional intensity. These studies demonstrated that the technique that we had developed—breath work—has an impact on the autonomic nervous system, as measured by HRV. Our studies showed a correlation between the reduction in sympathetic nervous system activity and the increase in parasympathetic activity. We used the measures of the heart and breath to do so. We found that the amount of time it takes for the heart to beat and the amount of time the breath is held are strongly related to how calm we are. These measures give us an objective way to measure changes in our physical health. It was especially interesting to find that people with higher rates of physical health had less stress in their lives and also were able to use breathing to achieve balance. In fact, when we measured their stress, we found that people who were highly stressed also had lower rates of parasympathetic activity, while people who were not stressed or healthy had the highest parasympathetic rates. To help you understand the scientific validation that underlies this program, we will give you examples of scientific data related to each of these points. We will also introduce you to some of our patients and how they use the program in their everyday lives. As you read this chapter, you will see that we have not developed just another program or a set of tools; we have created a new way of looking at the heart and the body—a way that has been used to help millions of people and is now being used by millions more. As you will also see, we have developed a program that can lead to real changes in the way you think, your emotional well-being, and how well your body functions. The Health Challenge We live in a world of stress. The constant stress that our culture places on us is an unfortunate reality. It is possible to be more aware of stress and its impact, but some stressors are