An Institutional Case Study: Emotion Regulation With HeartMath at Santa Cruz County Children's Mental Health

This case study from Santa Cruz County Children's Mental Health Agency (CMH), California, reviews the use of measurement of heart rate variability (HRV) to enhance emotional regulation of patients. CMH serves seriously emotionally disturbed youths, many of whom have been separated from their parents for a prolonged period or have been vulnerable without the consistent presence of their caregivers. In this study, the HRV pattern was calculated as high coherence, medium coherence, or low coherence. According to Thurber et al, heart rhythm coherence "is experienced as a calm, balanced, yet energized and responsive state that is conducive to everyday functioning and interaction, including the performance of tasks requiring mental acuity, focus, problem solving and decision making, as well as physical activity and coordination."(1(p39)) In the HeartMath program, there was a game in which high coherence was rewarded with a rainbow that dropped coins into a vessel. When coherence was low, the rainbow and coins disappeared until coherence was reached again. We measured HRV using a finger or ear sensor in individual sessions using a computer-based program from HeartMath Institute, Boulder Creek, California. After juvenile offenders overcame their initial fear of being hooked up to a potential lie detector, I instructed them in "Quick Coherence"(1) and asked them to imagine breathing into the area of their heart. The participants created a library of positive feelings, thoughts, and memories on which they could focus. After a period of positive focus and rhythmic breathing, the clients were often able to move into medium or high coherence. In this state, they noticed that they felt calmer. I explained that they could use this tool to improve their mood. I also practiced alongside the youths in order to demonstrate the technique. The detained youths learned quickly, requested repeated sessions, and learned to combine breathing with recalling the good people, places, foods, and feelings in their lives that sustained them. We could also decrease coherence through the use of negative words such as "loss of privileges" on their side or "pay cut" on mine and then move back to coherence with suggestions of positive mental images.