Biofeedback, posture and breath: Tools for health

Posted: December 1, 2022 | Author: | Filed under: ADHD, behavior, biofeedback, Breathing/respiration, CBT, cognitive behavior therapy, computer, digital devices, education, emotions, ergonomics, Evolutionary perspective, Exercise/movement, healing, health, laptops, mindfulness, Neck and shoulder discomfort, Pain/discomfort, posture, relaxation, screen fatigue, self-healing, stress management, Uncategorized, vision, zoom fatigue | 2 Comments

Two recent presentations that that provide concepts and pragmatic skills to improve health and well being.  

How changing your breathing and posture can change your life.

In-depth podcast in which Dr. Abby Metcalf, producer of Relationships made easy, interviews Dr. Erik Peper.  He discusses how changing your posture and how you breathe may result in major improvement with issues such as anxiety, depression, ADHD, chronic pain, and even insomnia! In the presentation he explain how this works and shares practical tools to make the changes you want in your life.

How to cope with TechStress

A wide ranging discussing between Dr. Russel Jaffe and Dr Erik that explores the power of biofeedback, self-healing strategies and how to cope with tech-stress.

These concepts are also explored in the book, TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics.  You may find this book useful as we spend so much time working online. The book describes the impacts personal technology on our physical and emotional well-being. More importantly, “Tech Stress” provides all of the basic tools to be able not only to survive in this new world but also thrive in it.

Additiona resources:

Gonzalez, D. (2022). Ways to improve your posture at home.

Resolving a chronic headache with posture feedback and breathing

A breath of fresh air: Breathing and posture to optimize health

Posted: April 3, 2022 | Author: | Filed under: behavior, Breathing/respiration, CBT, cognitive behavior therapy, emotions, ergonomics, Exercise/movement, health, mindfulness, Neck and shoulder discomfort, Pain/discomfort, posture, self-healing, stress management, Uncategorized | Tags: | 1 Comment

Most people breathe 22,000 breaths per day. We tend to breathe more rapidly when stressed, anxious or in pain. While a slower diaphragmatic breathing supports recovery and regeneration. We usually become aware of our dysfunctional breathing when there are problems such as nasal congestion, allergies, asthma, emphysema, or breathlessness during exertion.  Optimal breathing is much more than the absence of symptoms and is influenced by posture. Dysfunctional posture and breathing are cofactors in illness. We often do not realize that posture and breathing affect our thoughts and emotions and that our thoughts and emotions affect our posture and breathing. Watch the video, A breath of fresh air: Breathing and posture to optimize health, that was recorded for the 2022 Virtual Ergonomics Summit.

Reduce stress, anxiety and negative thoughts with posture, breathing and reframing

Posted: October 19, 2019 | Author: | Filed under: behavior, Breathing/respiration, emotions, Exercise/movement, posture, stress management, Uncategorized | Tags: , , , , , | 4 Comments

This post has been adapted from Peper, E., Harvey, R., & Hamiel, D.  (2019). Transforming thoughts with postural awareness to increase therapeutic and teaching efficacy.  NeuroRegulation, 6(3), 153-169.  doi:10.15540/nr.6.3.1533-1 

When locked into a position, options appear less available. By unlocking our body, we allow our brain to unlock and become open to new options.

Changing positions may dissolve the rigidity associated with a fixed position. When we step away from the conflict, take a walk, look up at the treetops, roof lines and clouds, or do something different, we loosen up and new ideas may occur. We may then be able see the conflict from a different point of view that allows resolution.

When stressed, anxious or depressed, it is challenging to change. The negative feelings, thoughts and worries continue to undermine the practice of reframing the experience more positively. Our recent study found that a simple technique, that integrates posture with breathing and reframing, rapidly reduces anxiety, stress, and negative self-talk (Peper, Harvey, Hamiel, 2019). 

Thoughts and emotions affect posture and posture affects thoughts and emotions. When stressed or worried (e.g., school performance, job security, family conflict, undefined symptoms, or financial insecurity), our bodies respond to the negative thoughts and emotions by slightly collapsing and shifting into a protective position. When we collapse/slouch, we are much more at risk to:

When we are upright and look up, we are more likely to:

Experience how posture affects memory and the feelings (adapted from Alan Alda, 2018)

Stand up and do the following:

  1. Think of a memory/event when you felt defeated, hurt or powerless and put your body in the posture that you associate with this feeling. Make it as real as possible . Stay with the feeling and associated body posture for 30 seconds. Let go of the memory  and posture. Observe what you experienced.
  2. Think of a memory/event when you felt empowered, positive and happy put your body in the posture that you associate with those feelings. Make it as real as possible. Stay with the feeling and associated body posture for 30 seconds. Let go of the memory and posture. Observe what you experienced.
  3. Adapt the defeated posture and now recall the positive empowering memory while staying in the defeated posture. Observe what you experience.
  4. Adapt the empowering posture and now recall the defeated hopeless memory while staying in the empowered posture. Observe what you experience.

Almost all people report that when they adapt the body posture congruent with the emotion that it was much easier to access the memory and feel the emotion. On the other hand when they adapt the body posture that was the opposite to the emotions, then it was almost impossible to experience the emotions. For many people, when they adapted the empowering posture, they could not access the defeated hopeless memory. If they did access that memory, they were more likely be an observer and not be involved or emotionally captured by the negative memory.

Comparison of Posture with breathing and reframing to Reframing 

The study investigated whether  changing internal dialogue (reframing)  or combining posture change and breathing with changing internal dialogue would reduce stress and negative self-talk more effectively.

The participants were 145 college students (90 women and 55 men) average age 25.0 who participated as part of a curricular practice in four different classes.

After the students completed an anonymous informational questionnaire (history of depression, anxiety, blanking out on exams, worrying, slouching), the classes were divided into two groups. They were then asked to do the following:

  • Think of a stressful conflict or problem and make it as real as possible for one minute. Then let go of the stressful memory and  do one of the two following practices.
    • Practice A: Reframe the experience positively for 20 seconds.
    • Practice B: Sit upright, look up, take a breath and reframe the experience positively for 20 seconds.
  • After doing practice A or practice B,  rate the extent to which your negative thoughts and anxiety/tension were reduced, from 0 (not at all) to 10 (totally).
  • Now repeat this exercise except switch and do the other practice.  (Namely, if you did A now you do B; if you did B now you do A).

RESULTS

Overwhelmingly students reported that sitting erect, breathing and reframing positively was much more effective than only reframing as shown in Figure 1 and 2.figure 1

Figure 1. Percentage of students rating posture, breath and reframing practice (PBRP) as more effective than reframing practice (RP) in reducing negative thoughts, anxiety and stress.slides Figure 2. Self-rating of reduction of negative thoughts and anxiety/tension

Stop reading. Do the practice yourself. It is only through experience that you know whether posture with breathing and reframing is a more beneficial than simply reframing the language.

Implications for education, counseling, psychotherapy. 

Our findings have implications for education, counseling and psychotherapy because students and clients usually sit in a slouched position in classrooms and therapeutic settings. By shifting the body position to an erect upright position, taking a breath and then reframing, people are much more successful in reducing their negative thoughts and anxiety/stress. They report feeling much more optimistic and better able to cope with felt stress as shown by representative comments in table 1.

Reframing Posture, breath and reframing
After changing my internal language, I still strongly felt the same thoughts. I instantly felt better about my situation after adjusting my posture.
I felt a slight boost in positivity and optimism. The negative feelings (anxiety) from the negative thoughts also diminished slightly. The effects were much stronger and it was not isolated mentally. I felt more relief in my body as well.
Even after changing my language, I still felt more anxious. Before changing my posture and breathing, I felt tense and worried. After I felt more relaxed.
I began to lift my mood up; however, it didn’t really improve my mood.  I still felt a bit bad afterwards and the thoughts still stayed. I began to look from the floor and up towards the board. I felt more open, understanding and loving. I did not allow myself to get let down.
During the practice, it helped calm me down a bit, but it wasn’t enough to make me feel satisfied or content, it felt temporary. My body felt relaxed overall, which then made me feel a lot better about the situation.
Difficult time changing language. My posture and breathing helped, making it easier to change my language.
I felt anger and stayed in my position. My body stayed tensed and I kept thinking about the situation. I felt anger but once I sat up straight and thought about breathing, my body felt relaxed.
Felt like a tug of war with my thoughts. I was able to think more positively but it took a lot more brain power to do so. Relaxed, extended spine, clarity, blank state of mind.

Table 1. Some representative comments of practicing reframing or posture, breath and reframing.

The results of our study in the classroom setting are not surprising.  Many us know to take three breaths before answering questions, pause and reflect before responding, take time to cool down before replying in anger, or wait till the next day before you hit return on your impulsive email response.

Currently, counseling, psychotherapy, psychiatry and education tend not to incorporate body posture as a potential therapeutic or educational intervention for teaching participants to control their mood or reduce feelings of powerlessness.  Instead, clients and students often sit slightly collapsed in a chair during therapy  or in class.  On the other hand, if individuals  were encouraged to adopt an upright posture especially in the face of stressful circumstances it would help them maintain their self-esteem, reduce negative mood, and use fewer sadness words as compared to the individual in a slumped and seated posture (Nair, Sagar, Sollers, Consedine, & Broadbent, 2015).

THE VALUE OF SELF-EXPERIENCE

What makes this study valuable is that participants compare for themselves the effects of the two different interventions techniques to reduce anxiety, stress and negative thoughts. Thus, the participants have an opportunity to discover which strategy is more effective instead of being told what to do.  The demonstration is even more impressive when  done in groups because nearly all participants will report that changing posture with breathing and reframing is more beneficial.

This simple and quick technique can be integrated in counseling and psychotherapy by teaching clients this behavioral technique to  reduce stress. In Cognitive Behavioral Therapy (CBT), sitting upright can help the individual replace a thought with a more reasonable one. In third wave CBT, it can help bypass the negative content of the original language and create a metacognitive change, such as, “I will not let this thought control me.”   

It can also help in Acceptance and Commitment Therapy (ACT) since changing one’s body posture may facilitate the process of “acceptance” (Hayes, Pistorello, & Levin, 2012). Adopting an upright sitting position and taking a breath is like saying “I am here, I am present, I am not escaping or avoiding.” This change in body position represents movement from inside to outside, movement from accepting the unpleasant emotion related to the negative thoughts toward a “commitment” to moving ahead, contrary to the automatic tendency to follow the negative thought. The positive reframing during body position or posture change is not an attempt to color reality in pretty colors, but rather a change of awareness, perspective, and focus that helps the individual identify and see some new options for moving ahead toward commitment according to one’s values. This intentional change in direction is central in ACT and also in positive psychology (Stichter, 2018).

CONCLUSION AND RECOMMENDATIONS

We suggest that therapists, educators, clients and students get up out of their chairs and incorporate body movements when they feels overwhelmed and stuck. Finally,  this study points out that mind and body are affected by each other. It provides another example of the psychophysiological principle enunciated by Elmer Green (1999, p 368):

“Every change in the physiological state is accompanied by an appropriate change in the mental-emotional state, conscious or unconscious; and conversely, every change in the mental-emotional state, conscious or unconscious is accompanied by an appropriate change in the physiological state.”

The findings of this study echo the ancient spiritual wisdom that is is central to the teaching of  the Zen Master, Thich Nhat Hanh.  He recommends that his students recite the following at any time:

Breathing in I calm my body,
Breathing out I smile,
Dwelling in the present moment,
I know it is a wonderful moment.

References

Alda, A. (2018). If I Understood You, Would I have This Look on My Face?: My Adventures in the Art and Science of Relating and Communicating. New York: Random House Trade Paperbacks.

Cuddy, A. (2012). Your body language shapes who you are. Technology, Entertainment, and Design (TED) Talk, available at: www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are

Green, E. (1999). Beyond psychophysics, Subtle Energies & Energy Medicine, 10(4), page 368.

Hayes, S. C., Pistorello, J., & Levin, M.E. (2012). Acceptance and Commitment Therapy as a unified model of behavior change. The Counseling Psychologist 40(7), 976-1002.

Michalak, J., Mischnat, J., & Teismann, T. (2014). Sitting posture makes a difference-embodiment effects on depressive memory bias. Clinical Psychology and Psychotherapy, 21(6),

Nair, S., Sagar, M., Sollers, J. 3rd, Consedine, N., & Broadbent, E. (2015). Do slumped and upright postures affect stress responses? A randomized trial. Health Psychology, 34(6), 632-641. 

Peper, E., Booiman, A., Lin, I.M., & Harvey, R. (2016). Increase strength and mood with posture. Biofeedback. 44(2), 66–72.

Peper, E., Harvey, R., & Hamiel, D. (2019) Transforming thoughts with postural awareness to increase therapeutic and teaching efficacy.  NeuroRegulation, 6(3), 153-169.

Peper, E., Harvey, R., Mason, L., & Lin, I-M. (2018). Do better in math: How your body posture may change stereotype threat response. NeuroRegulation, 5(2), 67-74.

Peper, E. & Lin, I-M. (2012). Increase or decrease depression: How body postures influence your energy level. Biofeedback, 40(3), 126–130.

Peper, E., Lin, I-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood. Biofeedback, 45(2), 36-41.

Risking, J.H. & Gotay, C.C. (1982). Physical posture: Could it have regulatory or feedback effects on motivation and emotion? Motivation and Emotion, 6(3), 273-298.

Stichter, M. P. (2019). Positive psychology and virtue: Values in action. The Journal of Positive Psychology, 14(1).

Tsai, H. Y., Peper, E., & Lin, I. M. (2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23–27.

Westfeld, G.E. & Beresford, J.J. (1982). Erectness of posture as an indicator of dominance or success in humans. Motivation and Emotion, 6(2), 113-131.

 

 

“Don’t slouch!” Improve health with posture feedback

Posted: July 1, 2019 | Author: | Filed under: behavior, digital devices, ergonomics, health, Neck and shoulder discomfort, posture, self-healing, Uncategorized | Tags: , , | 3 Comments

“Although I knew I slouched and often corrected myself, I never realized how often and how long I slouched until the vibratory posture feedback from the UpRight Go 2™ cued me to sit up (see Figure 1).”  -Erik Peper

Fig 1 Erik wearing uprightFigure 1. Wearing an UpRight Go 2™ to increase awareness of slouching and as a reminder to change position.

For thousands of years we sat and stood erect. In those earlier times, we looked down to identify specific plants or animal track and then looked up and around to search for possible food sources, identify friends, and avoid predators.  The upright, not slouched posture body posture, is innate and optimizes body movement as illustrated in Figure 2 (for more information, see Gokhale, 2013).

Fig 2 baby and adultFigure 2. The normal aligned spine of a toddler and the aligned posture of a man carrying a heavy load.

Being tall and erect allows the head to freely rotate. Head rotation is reduced when we look down at our cell phones, tablets or laptops (Harvey, Peper, Booiman, Heredia Cedillo, & Villagomez, 2018). Our digital world captures us as illustrated in Figure 3.

Fig 3 head down computer cellphoneFigure 3. Captured by the screen with a head forward positions.

Looking down and focusing on the screen for long time periods is the opposite of what supported us to survive and thrive when we lived as hunters and gatherers. When we look down, we become more oblivious to our surroundings and unaware of the possible predators that would have been hunting us for food.

This slouched position increases back, neck, head and eye tension as well as affecting respiration and digestion (Devi, Lakshmi, & Devi, 2018; Peper, Lin, & Harvey, 2017).  After looking at the screens for a long time, we may feel tired or exhausted and lack initiative to do something else. Our mood may turn more negative since it is easier to evoke hopeless, helpless and powerless thoughts and memories when looking down than when looking up (Wilson, & Peper, 2004; Peper, Lin, Harvey, & Perez, 2017).   In the down position, our brain has to work harder to evoke positive thoughts and memories or perform cognitive tasks as compared to when the head is erect (Tsai, Peper, & Lin, 2016; Peper, Harvey, Mason, & Lin, 2018).  By looking down and focusing at the screen, our eyes may begin to strain. To be able to see objects near us, the extraocular muscles of the eyes contract to converge the eyes and the cilia muscles around the lens contract to increase the curvature of the lens so that the reading material is in focus.

Become aware how nearby vision increases eye strain.

Hold your arm straight ahead of you at eye level with your thumb up. While focusing on your thumb, slowly bring your thumb closer and closer to your nose.  Observe the increase in eyestrain as you bring your thumb closer to your nose.  

Eyestrain tends to develop when we do not relax the eyes by periodically looking away from the screen.  When we look at the horizon or trees in the far distance the ciliary muscles and the extraocular muscles  relax (Schneider, 2016).

Head forward posture increases neck and back tension

When we look down and concentrate, our head moves significantly forward. The neck and back muscles have to work much harder to hold the head up when the neck is in this flexed position. As Dr. Kenneth Hansraj, Chief of Spine Surgery New York Spine Surgery & Rehabilitation Medicine reported, “The weight seen by the spine dramatically increases when flexing the head forward at varying degrees. An adult head weighs 10-12 pounds in the neutral position. As the head tilts forward the forces seen by the neck surges to 27 pounds at 15 degrees, 40 pounds at 30 degrees, 49 pounds at 45 degrees and 60 pounds at 60 degrees.” (Hansraj, 2014).  Our head tends to tilt down when we look at the text, videos, emails, photos, or games and stay in this position for long time periods. We are captured by the digital display and are unaware of our tight overused neck and back muscles. Straightening up so that the back of the head is re-positioned over the spine and looking into the distance may help relax those muscles.

To reduce discomfort caused by slouching, we need to reintegrate our prehistoric life style pattern of alternating between looking down to being tall and looking at the distant scenery or across the room. The first step is awareness of knowing when slouching begins. Yet, we tend to be unaware until we experience discomfort or are reminded by others (e.g,  “Don’t slouch! Sit up straight!”). If we could have immediate posture feedback when we begin to slouch, our awareness would increase and remind us to change our posture.

Posture feedback with UpRight Go

Simple posture feedback device such as an UpRight Go 2™ can provide vibratory feedback each time slouching starts as the neck as the head goes forward.  The wearable feedback device consists of a small sensor that is attached to the back of the neck or back (see Figure 1). After being paired with a cellphone and calibrated for the upright position, the software algorithm detects changes in tilt and provides vibratory feedback each time the neck/back tilts forward.

In our initial exploration, employees, students and clients used the UpRight feedback devices at work, at school, at home, while driving, walking and other activities to identify situations that caused them to slouch. The most common triggers were:

  1. Ergonomic caused movement such as bring the head closer to the screen or looking down at their cell phone (for suggestions to improve ergonomics see recommendations at the end of the article)
  2. Tiredness
  3. Negative self-critical/depressive thoughts
  4. Crossing the legs protectively, shallow breathing, and other factors

After having identified some of the factors that were associated with slouching, we compared the health outcome of students who used the device for a minimum for 15 minutes a day for four weeks as compared to a control group who did not use the device. The students who received the UpRight feedback were also encouraged to use the feedback to change their posture and behavior and implemented some of the following strategies.

  • Head down when looking at their laptop, tablet or cellphone.
    • Change the ergonomics such as using a laptop stand and an external keyboard so that they could be upright while looking at the screen.
    • Take many movement breaks to interrupt the static tension.
  • Feeling tired.
    • Take a break or nap to regenerate.
    • Do fun physical activity especially activities where you look upward to re-energize.
  • Negative self-critical, powerless, self-critical and depressive thoughts and feelings.
    • Reframe internal language to empowering thoughts.
    • Change posture by wiggling and looking up to have a different point of view.
  • Crossing the legs.
    • Sit in power position and breathe diaphragmatically.
    • Get up and do a few movements such as shoulder rolls, skipping, or  arm swings.
  • Other causes.
    • Identify the trigger and explore strategies so that you can sit erect without effort.
    • Wiggle, move and get up to interrupt static muscle tension.
    • Stand up and look out of the window and the far distance while breathing slowly

Posture feedback improves health

After four weeks of using the feedback device and changing behavior,  the treatment group reported significant improvements in physical and mental health as shown in Figure 4 & 5.

Figurer 4

Figure 4. Using the posture feedback significantly improved the Physical Health and Mental Health Composite Scores for the treatment group as compared to the control group (reproduced from Mason, L., Joy, Peper, & Harvey, 2018).

Fig 5

Figure 5. Pre to post changes after using posture feedback (reproduced from Colombo, Joy, Mason, L., Peper, Harvey, & Booiman, 2017).

Summary

Slouched posture and head forward and down position usually occurs without awareness and often results in long-term discomfort. We recommend that practitioners integrate wearable biofeedback devices to facilitate home practice especially for people with neck, shoulder, back and eye discomfort as well as for those with low energy and depression (Mason et al., 2018).  We observed that a small wearable posture feedback device helped participants improve posture and decreased symptoms.  The vibratory posture feedback provided the person with the opportunity to identify the triggers associated with slouching and the option to change their posture, behavior and environment. 

As one participant reported, “I have been using the Upright device for a few weeks now. I mostly use the device while studying at my desk and during class. I have found that it helps me stay focused at my desk for longer time. Knowing there is something monitoring my posture helps to keep me sitting longer because I want to see how long I can keep an upright posture. While studying, I have found whenever I become frustrated, tired, or when my mind begins to wander I slouch. The Upright then vibrates and I become aware of these feelings and thoughts, and can quickly correct them. This device has improved my posture, created awareness, and increased my overall study time.”

Suggestions to reduce slouching and improve ergonomics

How to arrange your computer and laptop: https://peperperspective.com/2014/09/30/cartoon-ergonomics-for-working-at-the-computer-and-laptop/

Relieve neck and shoulder stiffness: https://peperperspective.com/2019/05/21/relieve-and-prevent-neck-stiffness-and-pain/

Cellphone health: https://peperperspective.com/2014/11/20/cellphone-harm-cervical-spine-stress-and-increase-risk-of-brain-cancer/

References

Colombo, S., Joy, M., Mason, L., Peper, E., Harvey, R., & Booiman, A. (2017). Posture Change Feedback Training and its Effect on Health. Poster presented at the 48th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, Chicago, IL March, 2017. Abstract published in Applied Psychophysiology and Biofeedback.42(2), 147.

Devi, R. R., Lakshmi, V.V., & Devi, M.G. (2018). Prevalence of discomfort and visual strain due to the use of laptops among college going students in Hyderabad. Journal of Scientific Research & Reports, 20(4), 1-5.

Ehrlich, D.L. (1987). Near vision stress: vergence adaptation and accommodative fatigue.Ophthalmic Physiology Opt.,7(4), 353-357.

Gokhale, E. (2013). 8 Steps to a Pain-Free Back. Pendo Press.

Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical Technology International, 25, 277–279.

Harvey, R., Peper, E., Booiman, A., Heredia Cedillo, A., & Villagomez, E. (2018). The effect of head and neck position on head rotation, cervical muscle tension and symptoms. Biofeedback. 46(3), 65–71.

Mason, L., Joy, M., Peper, E., & Harvey, R. (2018).Wearable Posture Feedback Training: Effects on Health. Poster presented at the 2018 meeting of the 49th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, Orlando, FL. April 11-14.

Mason, L., Joy, M., Colombo, S., Peper, E., & Harvey, R. (2017). Biofeedback Strategies to Increase Social Justice and Health Equity: A wearable device to teach awareness of posture and improve self-care. Presented at the 19th Annual meeting of the Biofeedback Federation of Europe, Aveiro, Portugal, April 24-29th, 2017. Abstract in Applied Psychophysiology and Biofeedback,43(1), 93

Peper, E., Harvey, R., Mason, L., & Lin, I-M. (2018). Do better in math: How your body posture may change stereotype threat response. NeuroRegulation, 5(2), 67-74

Peper, E., Lin, I-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood.  Biofeedback.45 (2), 36-41.

Peper, E., Lin, I-M, & Harvey, R. (2017). Posture and mood: Implications and applications to therapy. Biofeedback, 35(2), 42-48.

Schneider, M. (2016). Vision for Life.  Berkeley, CA: North Atlantic.

Tsai, H. Y., Peper, E., & Lin, I. M. (2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23-27.

Wilson, V. E., & Peper, E. (2004). The Effects of Upright and Slumped Postures on the Recall of Positive and Negative Thoughts. Applied Psychophysiology and Biofeedback, 29(3), 189- 95.

 

 

Posture and mood: implications and applications to health and therapy

Posted: November 28, 2017 | Author: | Filed under: Neck and shoulder discomfort, posture, self-healing, Uncategorized | Tags: , , , , , , | 5 Comments

This blog has been reprinted from: Peper, E., Lin, I-M, & Harvey, R. (2017). Posture and mood: Implications and applications to therapy. Biofeedback.35(2), 42-48.

Slouched posture is very common and tends to increase access to helpless, hopeless, powerless and depressive thoughts as well as increased head, neck and shoulder pain. Described are five educational and clinical strategies that therapists can incorporate in their practice to encourage an upright/erect posture. These include practices to experience the negative effects of a collapsed posture as compared to an erect posture, watching YouTube video to enhance motivation, electromyography to demonstrate the effect of posture on muscle activity, ergonomic suggestions to optimize posture, the use of a wearable posture biofeedback device, and strategies to keep looking upward. When clients implement these changes, they report a more positive outlook and reduced neck and shoulder discomfort.

Background

Most people slouch without awareness when looking at their cellphone, tablet, or the computer screen (Guan et al., 2016) as shown in Figure 1. Many clients in psychotherapy and in biofeedback or neurofeedback training experience concurrent rumination and depressive thoughts with their physical symptoms. In most therapeutic sessions, clients sit in a comfortable chair, which automatically creates a posterior pelvic tilt and encourages the spine to curve so that the client sits in a slouched position. While at home, they sit on an easy chair or couch, which lets them slouch as they watch TV or surf the web.Figure 1 three collapsed positions

Figure 1. (A). Employee working on his laptop. (B). Boy with ADHD being trained with neurofeedback in a clinic. (C). Student looking at cell phone. When people slouch and look at the screen, they tend to slouch and scrunch their neck.

In many cases, the collapsed position also causes people to scrunch their necks, which puts pressure on their necks that may contribute to developing headache or becoming exhausted. Repetitive strain on the neck and cervical spine may trigger a cervical neuromuscular syndrome that involves chronic neck pain, autonomic imbalance and concomitant depression and anxiety (Matsui & Fujimoto, 2011), and may contribute to vertebrobasilar insufficiency –a reduction in the blood supply to the hindbrain through the left and right vertebral arteries and basilar arteries (Kerry, Taylor, Mitchell, McCarthy, & Brew, 2008). From a biomechanical perspective, slouching also places more stress is on the cervical spine, as shown in Figure 2. When the neck compression is relieved, the symptoms decrease (Matsui & Fujimoto, 2011).

Figure 2 head collapseFigure 2. The more the head tilts forward, the more stress is placed on the cervical spine. Reproduced by permission from: Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical Technology International, 25, 277–279.

Most people are totally unaware of slouching positions and postures until they experience neck, shoulder, and/or back discomfort. Neither clients nor therapists are typically aware that slouching may decrease energy levels and increase the prevalence of negative (hopeless, helpless, powerless, or defeated) memories and thoughts (Peper & Lin, 2012; Peper et al, 2017)

Recommendations for posture awareness and training in treatment/education 

The first step in biofeedback training and therapy is to systematically increase awareness and training of posture before attempting further bio/neurofeedback training and/or cognitive behavior therapy. If the client is sitting in a collapsed position in therapy, then it will be much more difficult for them to access positive thoughts, which interferes with further training and effective therapy. For example, research by Tsai, Peper, & Lin (2016) showed that engaging in positive thinking while slouched requires greater mental effort then when sitting erect. Sitting erect and tall contributes to elevated mood and positive thinking. An upright posture supports positive outcomes that may be akin to the beneficial effects of exercise for the treatment of depression (Schuch, Vancampfort, Richards, Rosenbaum, Ward, & Stubbs., 2016).

Most people know that posture affects health; however, they are unaware of how rapidly a slouching posture can impact their physical and mental health. We recommend the following educational and clinical strategies to teach this awareness.

  1. Practicing activities that raise awareness about a collapsed posture as compared to an erect posture

Guide clients through the practices so that they experience how posture can affect memory recall, physical strength, energy level, and possible triggering of headaches.

A. The effect of collapsed and erect posture on memory recall. Participants reported that it is much easier evoke powerless, hopeless, helpless, and defeated memories when sitting in a collapsed position than when sitting upright. Guide the client through the procedure described in the article, How posture affects memory recall and mood (Peper, Lin, Harvey, and Perez, 2017) and in the blog Posture affects memory recall and mood.

B. The effects of collapsed and erect posture on perceived physical strength. Participants experience much more difficulty in resisting downward pressure at the wrist of an outstretched arm when slouched rather than upright. Guide the client through the exercise described in the article, Increase strength and mood with posture (Peper, Booiman, Lin, & Harvey, 2016) and the blog, Increase strength and mood with posture.

C. The effect of slouching versus skipping on perceived energy levels. Participants experience a significant increase in subjective energy after skipping than walking slouched. Guide the client through the exercises as described in the article, Increase or decrease depression—How body postures influence your energy level (Peper & Lin, 2012).

D. The effect of neck compression to evoke head pressure and headache sensations. In our unpublished study with students and workshop participants, almost all participants who are asked to bring their head forward, then tilt the chin up and at the same time compress the neck (scrunching the neck), report that within thirty seconds they feel a pressure building up in the back of the head or the beginning of a headache. To their surprise, it may take up to 5 to 20 minutes for the discomfort to disappear. Practicing similar awareness activities can be a useful demonstration for clients with dizziness or headaches to experience how posture can increase their symptoms.

  1. Watching a Youtube video to enhance motivation.

Have clients watch Professor Amy Cuddy’s 2012 TED (Technology, Entertainment, and Design) Talk, Your body language shape who you are, which describes the hormonal changes that occur when adapting a upright power versus collapsed defeated posture.

  1. Electromyographic (EMG) feedback to demonstrate how posture affects muscle activity.

Record EMG from muscles such as around the cervical spine, trapezius, frontalis, and masseters or beneath the chin (submental lead) to demonstrate that having the head is forward and/or the neck compressed will increase EMG activity, as shown in Figure 3.

Figure 3 Head position

Figure 3. Electromyographic recording of the muscle under the chin while alternating between bringing the head forward or holding it back, feeling erect and tall.

The client can then learn awareness of the head and neck position. For example, one client with severe concussion experienced significant increase in head pressure and dizziness when she slouched or looked at a computer screen as well as feeling she would never get better. She then practiced the exercise of alternating her awareness by bringing her head forward and then back, and then bringing her neck back while her chin was down, thereby elongating the neck while she continued to breathe. With her head forward, she would feel her molars touching and with her neck back she felt an increase in space between the molars. When she elongated her neck in an erect position, she felt the pressure draining out of her head and her dizziness and tinnitus significantly decrease.

  1. Assessing ergonomics to optimize posture.

Change the seated posture of both the therapist and the client during treatment and training. Although people may be aware of their posture, it is much easier to change the external environment so that they automatically sit in a more erect power posture. Possible options include:

A. Seat insert or cushions. Sit in upright chairs that encourage an anterior pelvic tilt by having the seat pan slightly lower in the front than in the back or using a seat insert to facilitate a more erect posture (Schwanbeck, Peper, Booiman, Harvey, & Lin, 2015) as shown in Figure 4.

Figure 4 backjoy insert sitting with spine markers

Figure 4. An example of how posture can be impacted covertly when one sits on a seat insert that rotates the pelvis anteriorly (The seat insert shown in the diagram and used in research  is produced by BackJoy™).

B. Back cushion. Place a small pillow or rolled up towel at the kidney level so that the spine is slight arched, instead of sitting collapsed, as shown in Figure 5.

Figure 5 sitting with and without pillowFigure 5. An example of how a small pillow, placed between the back of the chair and the lower back, changes posture from collapsed to erect.

C. Check ergonomic and work site computer use to ensure that the client can sit upright while working at the computer. For some, that means checking their vision if they tend to crane forward and crunch their neck to read the text. For those who work on laptops, it means using either an external keyboard, a monitor, or a laptop stand so the screen is at eye level, as shown in Figure 6.

Figure 6 laptop ergonomicsFigure 6. Posture is collapsed when working on a laptop and can be improved by using an external keyboard and monitor. Reproduced by permission from: Bakker Elkhuizen. (n.d.). Office employees are like professional athletes! (2017).

  1. Wearable posture biofeedback training device

The wearable biofeedback device, UpRight™, consists of a small sensor placed on the spine and works as an app on the cell phone. After calibration the erect and slouched positions, the posture device gives vibratory feedback each time the participant slouches, as shown in Figure 7.Figure 7 UpRight collapse erect

Figure 7. Illustration of a posture feedback device, UpRight™. It provides vibratory feedback to the wearer to indicate that they are beginning to slouch.

Clinically, we have observed that clients can learn to identify conditions that are associated with slouching, such as feeling tired, thinking depressive/hopeless thoughts or other situations that evoke slouching. When people wear a posture feedback device during the day, they rapidly become aware of these subjective experiences whenever they slouch. The feedback reminds them to sit in an erect position, and they subsequently report an improvement in health (Colombo et al., 2017). For example, a 26-year-old man who works more than 8 hours a day on computer reported, “I have an improved awareness of my posture throughout my day. I also notice that I had less back pain at the end of the day.”

  1. Integrating posture awareness and position changes throughout the day

After clients have become aware of their posture, additional training included having them observe their posture as well and negative changes in mood, energy level or tension in their neck and head. When they become aware of these changes, they use it as a cue to slightly arch their back and look upward. If possible have the clients look outside at the tops of trees and notice details such as how the leaves and branches move. Looking at the details interrupts any ongoing rumination. At the same time, have them think of an uplifting positive memory. Then have them take another breath, wiggling, and return to the task at hand. Recommend to clients to go outside during breaks and lunchtime to look upward at the trees, the hills, or the clouds. Each time one is distracted, return to appreciate the natural patterns. This mental break concludes by reminding oneself that humans are like trees.

Trees are rooted in the earth and reach upward to the light. Despite the trauma of being buffeted by the storms, they continue to reach upward. Similarly, clouds reflect the natural beauty of the world, and are often visible in the densest city environment. The upward movement reflects our intrinsic resilience and growth.       –Erik Peper

Have clients place family photos and art slightly higher on the wall at home so they automatically look upward to see the pictures. A similar strategy can be employed in the office, using art to evoke positive feelings. When clients integrate an erect posture into their daily lives, they experience a more positive outlook and reduced neck and shoulder discomfort.

Compliance with Ethical Standards:

Conflict of Interest: Author Erik Peper has received donations of 15 UpRight posture feedback devices from UpRight (http://www.uprightpose.com/) and 12 BackJoy seat inserts from Backjoy (https://www.backjoy.com) for use in research. Co-authors I-Mei Lin and Richard Harvey declare that they have no conflict of interest.

This report evaluated a convenience sample of a student classroom activity related to posture and the information was anonymous collected. As an evaluation of a classroom activity, this report of findings was exempted from Institutional Review Board oversight

References:

Bakker Elkhuizen. (n.d.). Office employees are like professional athletes! (2017). Retrieved from https://www.bakkerelkhuizen.com/knowledge-center/whitepaper-improving-work-performance-with-insights-from-pro-sports/

Colombo, S., Joy, M., Mason, L., Peper, E., Harvey, R., & Booiman, A. Posture Change Feedback Training and its Effect on Health. Poster presented at the 48th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, Chicago, IL March, 2017. Abstract published in Applied Psychophysiology and Biofeedback.42(2), 147.

Cuddy, A. (2012). Your body language shapes who you are. Technology, Entertainment, and Design (TED) Talk, available at: www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are

Guan, X., Fan, G., Chen, Z., Zeng, Y., Zhang, H., Hu, A., … He, S. (2016). Gender difference in mobile phone use and the impact of digital device exposure on neck posture. Ergonomics, 59(11), 1453–1461.

Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical Technology International, 25, 277-279

Kerry, R., Taylor, A.J., Mitchell, J., McCarthy, C., & Brew, J. (2008). Manual therapy and cervical arterial dysfunction, directions for the future: A clinical perspective. Journal of Manual & Manipulative Therapy, 16(1), 39–48.

Matsui, T. & Fujimoto, T. (2011). Treatment for depression with chronic neck pain completely cured in 94.2% of patients following neck muscle treatment. Neuroscience & Medicine, 2, 71­77.

Peper, E., Booiman, A., Lin, I. M., & Harvey, R. (2016). Increase strength and mood with posture. Biofeedback. 44(2), 66–72.

Peper, E. & Lin, I. M. (2012). Increase or decrease depression-How body postures influence your energy level. Biofeedback, 40 (3), 126-130.

Peper, E., Lin, I. M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood. Biofeedback, (45 (2), 36-41.

Schwanbeck, R., Peper, E., Booiman, A., Harvey, R., & Lin, I. M. (2015). Posture Changes with a Seat Insert: Changes in strength and not EMG. Applied Psychophysiology and Biofeedback, 40, 128–129.

Schuch, F. B., Vancampfort, D., Richards, J., Rosenbaum, S., Ward, P. B., & Stubbs, B. (2016). Exercise as a treatment for depression: A meta-analysis adjusting for publication bias. Journal of Psychiatric Research, 77, 42–51.

Tsai, H. Y., Peper, E., & Lin, I. M. (2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23–27.

We thank Frank Andrasik for his constructive comments.

 

Posture affects memory recall and mood

Posted: November 25, 2017 | Author: | Filed under: Exercise/movement, self-healing, stress management, Uncategorized | Tags: , , , , , , , , , | 5 Comments

This blog has been reprinted from: Peper, E., Lin, I-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood.  Biofeedback, 45 (2), 36-41.

When I sat collapsed looking down, negative memories flooded me and I found it difficult to shift and think of positive memories. While sitting erect, I found it easier to think of positive memories.               -Student participant

Charlie BrownThe link between posture and mood is embedded in idiomatic phrases such as walking tall, standing proud, and an upstanding citizen, versus collapsed, defeated, or in a slump–Language suggests that posture and mood/emotions are connected. Slumped posture is commonly observed in depression (Canales et al., 2010; Michalak et al., 2009) and adapting an upright posture increases positive affect, reduces fatigue, and increases energy in people with mild to moderate depression (Wilkes et al., 2017; Peper & Lin, 2012).

This blog describes in detail our research study that demonstrated  how posture affects memory recall  (Peper et al, 2017). Our findings may explain why depression is increasing the more people use cell phones. More importantly,  learning posture awareness and siting more upright  at home and in the office may be an effective somatic self-healing strategy to increase positive affect and decrease depression.

Background

Most psychotherapies tend to focus on the mind component of the body-mind relationship. On the other hand, exercise and posture focus on the body component of the mind/emotion/body relationship. Physical activity in general has been demonstrated to improve mood and exercise has been successfully used to treat depression with lower recidivism rates than pharmaceuticals such as sertraline (Zoloft) (Babyak et al., 2000). Although the role of exercise as a treatment strategy for depression has been accepted, the role of posture is not commonly included in cognitive behavior therapy (CBT) or biofeedback or neurofeedback therapy.

The link between posture, emotions and cognition to counter symptoms of depression and low energy have been suggested by Wilkes et al. (2017) and Peper and Lin (2012),  . Peper and Lin (2012) demonstrated that if people tried skipping rather than walking in a slouched posture, subjective energy after the exercise was significantly higher. Among the participants who had reported the highest level of depression during the last two years, there was a significant decrease of subjective energy when they walked in slouched position as compared to those who reported a low level of depression. Earlier, Wilson and Peper (2004) demonstrated that in a collapsed posture, students more easily accessed hopeless, powerless, defeated and other negative memories as compared to memories accessed in an upright position. More recently, Tsai, Peper, and Lin (2016) showed that when participants sat in a collapsed position, evoking positive thoughts required more “brain activation” (i.e. greater mental effort) compared to that required when walking in an upright position.

Even hormone levels also appear to change in a collapsed posture (Carney, Cuddy, & Yap, 2010). For example, two minutes of standing in a collapsed position significantly decreased testosterone and increased cortisol as compared to a ‘power posture,’ which significantly increased testosterone and decreased cortisol while standing. As  Professor Amy Cuddy pointed out in herTechnology, Entertainment and Design (TED) talk, “By changing posture, you not only present yourself differently to the world around you, you actually change your hormones” (Cuddy, 2012).  Although there appears to be controversy about the results of this study, the overall findings match mammalian behavior of dominance and submission. From my perspective, the concepts underlying Cuddy’s TED talk are correct and are reconfirmed in our research on the effect of posture.  For more detail about the controversy, see the article by Susan Dominusin in the New York Times,  “When the revolution came for Amy Cuddy,”, and Amy Cuddy’s response (Dominus, 2017;Singal and Dahl, 2016).

The purpose of our study is to expand on our observations with more than 3,000 students and workshop participants. We observed that body posture and position affects recall of emotional memory. Moreover, a history of self-described depression appears to affect the recall of either positive or negative memories.

Method

Subjects: 216 college students (65 males; 142 females; 9 undeclared), average age: 24.6 years (SD = 7.6) participated in a regularly planned classroom demonstration regarding the relationship between posture and mood. As an evaluation of a classroom activity, this report of findings was exempted from Institutional Review Board oversight.

Procedure

While sitting in a class, students filled out a short, anonymous questionnaire, which asked them to rate their history of depression over the last two years, their level of depression and energy at this moment, and how easy it was for them to change their moods and energy level (on a scale from 1–10). The students also rated the extent they became emotionally absorbed or “captured” by their positive or negative memory recall. Half of the students were asked to rate how they sat in front of their computer, tablet, or mobile device on a scale from 1 (sitting upright) to 10 (completely slouched).

Two different sitting postures were clearly defined for participants: slouched/collapsed and erect/upright as shown in Figure 1. To assume the collapsed position, they were asked to slouch and look down while slightly rounding the back. For the erect position, they were asked to sit upright with a slight arch in their back, while looking upward.

Figure 1 body positionFigure 1. Sitting in a collapsed position and upright position (photo by Jana  Asenbrennerova). Reprinted by permission from Gorter and Peper (2011).

After experiencing both postures, half the students sat in the collapsed position while the other half sat in the upright position. While in this position, they were asked to recall/evoke as many hopeless, helpless, powerless, or defeated memories as possible, one after the other, for 30 seconds.

After 30 seconds they were reminded to keep their same position and let go of thinking negative memories. They were then asked to recall/evoke only positive, optimistic, or empowering memories for 30 seconds.

They were then asked to switch positions. Those who were collapsed switched to sitting erect, and those who were erect switched to sitting collapsed. Then they were again asked to recall/evoke as many hopeless, helpless, powerless, or defeated memories as possible one after the other for 30 seconds. After 30 seconds they were reminded to keep their same position and again let go of thinking of negative memories. They were then asked to recall/evoke only positive, optimistic, or empowering memories for 30 seconds, while still retaining the second posture.

They then rated their subjective experience in recalling negative or positive memories and the degree to which they were absorbed or captured by the memories in each position, and in which position it was easier to recall positive or negative experiences.

Results

86% of the participants reported that it was easier to recall/access negative memories in the collapsed position than in the erect position, which was significantly different as determined by one-way ANOVA (F(1,430)=110.193, p < 0.01) and 87% of participants reported that it was easier to recall/access positive images in the erect position than in the collapsed position, which was significantly different as determined by one-way ANOVA (F(1,430)=173.861, p < 0.01) as shown in Figure 2.

Figure 2 emotional recallFigure 2. Percent of respondents who reported that it was easier to recall positive or negative memories in an upright or slouched posture.

The difficulty or ease of recalling negative or positive memories varied depending on position as shown in Figure 3.

Figure 3 access to memoriesFigure 3. The relative subjective rating in the ease or difficulty of recalling negative and positive memories in collapsed and upright positions.

The participants with a high level of depression over the last two years (top 23% of participants who scored 7 or higher on the scale of 1–10) reported that it was significantly more difficult to change their mood from negative to positive (t(110) = 4.08, p < 0.01) than was reported by those with a low level of depression (lowest 29% of the participants who scored 3 or less on the scale of 1–10). It was significantly easier for more depressed students to recall/evoke negative memories in the collapsed posture (t(109) = 2.55, p = 0.01) and in the upright posture (t(110) = 2.41, p ≦0.05 he) and no significant difference in recalling positive memories in either posture, as shown in Figure 4.

Figure 4 least most depressedFigure 4. Differences is in memory access for participants with a history of least or most depression.

For all participants, there was a significant correlation (r = 0.4) between subjective energy level and ease with which they could change from negative to positive mood. There were no significance differences for gender in all measures except that males reported a significantly higher energy level than females (M = 5.5, SD = 3.0 and M = 4.7, SD = 3.8, respectively; t(203) = 2.78, p < 0.01).

A subset of students also had rated their posture when sitting in front of a computer or using a digital device (tablet or cell phone) on a scale from 1 (upright) to 10 (completely slouched). The students with the highest levels of depression over the last two years reporting slouching significantly more than those with the lowest level of depression over the last two years (M = 6.4, SD = 3.5 and M = 4.6, SD = 2.6; t(46) = 3.5, p < 0.01).

There were no other order effects except of accessing fewer negative memories in the collapsed posture after accessing positive memories in the erect posture (t(159)=2.7, p < 0.01). Approximately half of the students who also rated being “captured” by their positive or negative memories were significantly more captured by the negative memories in the collapsed posture than in the erect posture (t(197) = 6.8, p < 0.01) and were significantly more captured by positive memories in the erect posture than the collapsed posture (t(197) = 7.6, p < 0.01), as shown in Figure 5.

Figure 5 Posture dependent ratingFigure 5. Subjective rating of being captured by negative and positive memories depending upon position.

Discussion

Posture significantly influenced access to negative and positive memory recall and confirms the report by Wilson and Peper (2004). The collapsed/slouched position was associated with significantly easier access to negative memories. This is a useful clinical observation because ruminating on negative memories tends to decrease subjective energy and increase depressive feelings (Michi et al., 2015). When working with clients to change their cognition, especially in the treatment of depression, the posture may affect the outcome. Thus, therapists should consider posture retraining as a clinical intervention. This would include teaching clients to change their posture in the office and at home as a strategy to optimize access to positive memories and thereby reduce access or fixation on negative memories. Thus if one is in a negative mood, then slouching could maintain this negative mood while changing body posture to an erect posture, would make it easier to shift moods.

Physiologically, an erect body posture allows participants to breathe more diaphragmatically because the diaphragm has more space for descent. It is easier for participants to learn slower breathing and increased heart rate variability while sitting erect as compared to collapsed, as shown in Figure 6 (Mason et al., 2017).

Figure 6 collapse and physiologyFigure 6. Effect of posture on respiratory breathing pattern and heart rate variability.

The collapsed position also tends to increase neck and shoulder symptoms This position is often observed in people who work at the computer or are constantly looking at their cell phone—a position sometimes labeled as the i-Neck.

Implication for therapy

In most biofeedback and neurofeedback training sessions, posture is not assessed and clients sit in a comfortable chair, which automatically causes a slouched position. Similarly, at home, most clients sit on an easy chair or couch, which lets them slouch as they watch TV or surf the web. Finally, most people slouch when looking at their cellphone, tablet, or the computer screen (Guan et al., 2016). They usually only become aware of slouching when they experience neck, shoulder, or back discomfort.

Clients and therapists are usually not aware that a slouched posture may decrease the client’s energy level and increase the prevalence of a negative mood. Thus, we recommend that therapists incorporate posture awareness and training to optimize access to positive imagery and increase energy.

References

Babyak, M., Blumenthal, J. A., Herman, S., Khatri, P., Doraiswamy, M., Moore, K., … Krishnan, K. R. (2000). Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months. Psychosomatic Medicine, 62(5), 633–638. 

Canales, J. Z., Cordas, T. A., Fiquer, J. T., Cavalcante, A. F., & Moreno, R. A. (2010). Posture and body image in individuals with major depressive disorder: A controlled study. Revista brasileira de psiquiatria, 32(4), 375–380.

Carney, D. R., Cuddy, A. J., & Yap, A. J. (2010). Power posing brief nonverbal displays affect neuroendocrine levels and risk tolerance. Psychological Science, 21(10), 1363–1368.

Cuddy, A. (2012). Your body language shapes who you are. Technology, Entertainment, and Design (TED) Talk, available at:  www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are

Dominus, S. (2017, October 18). When the revolution came for Amy Cuddy. New York Times Magazine, https://www.nytimes.com/2017/10/18/magazine/when-the-revolution-came-for-amy-cuddy.html?_r=0

Gorter, R. & Peper, E. (2011). Fighting Cancer-A Non Toxic Approach to Treatment. Berkeley, CA: North Atlantic Books

Guan, X., Fan, G., Chen, Z., Zeng, Y., Zhang, H., Hu, A., … He, S. (2016). Gender difference in mobile phone use and the impact of digital device exposure on neck posture. Ergonomics, 59(11), 1453–1461.

Mason, L., Joy, M., Peper, E., & Harvey, R, A. (2017). Posture Matters. Poster presented at the 48th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, Chicago, IL March, 2017. Abstract published in Applied Psychophysiology and Biofeedback, 42(2), 148.

Michalak, J., Troje, N. F., Fischer, J., Vollmar, P., Heidenreich, T., & Schulte, D. (2009). Embodiment of sadness and depression: Gait patterns associated with dysphoric mood. Psychosomatic Medicine, 71(5), 580–587.

Michl, L. C., McLaughlin, K. A., Shepherd, K., & Nolen-Hoeksema, S. (2013). Rumination as a mechanism linking stressful life events to symptoms of depression and anxiety: Longitudinal evidence in early adolescents and adults. Journal of Abnormal Psychology, 122(2), 339.

Peper, E. & Lin, I-M. (2012). Increase or decrease depression: How body postures influence your energy level. Biofeedback, 40(3), 126–130.

Peper, E., Lin, I-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood.  Biofeedback.45 (2), 36-41.

Singal, J. and Dahl, M. (2016, Sept 30 ) Here Is Amy Cuddy’s Response to Critiques of Her Power-Posing Research. https://www.thecut.com/2016/09/read-amy-cuddys-response-to-power-posing-critiques.html

Tsai, H. Y., Peper, E., & Lin, I. M. (2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23–27.

Wilkes, C., Kydd, R., Sagar, M., & Broadbent, E. (2017). Upright posture improves affect and fatigue in people with depressive symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 54, 143–149.

Wilson, V.E. and Peper, E. (2004). The effects of upright and slumped postures on the generation of positive and negative thoughts. Applied Psychophysiology and Biofeedback, 29(3), 189–195.

We thank Frank Andrasik for his constructive comments.

 

The surprising and powerful links between posture and mood

Posted: February 3, 2015 | Author: | Filed under: Uncategorized | Tags: , , , , , | Leave a comment

Enjoy Vivian Giang’s superb blog, The surprising and powerful links between posture and mood,  published by Fast Company and reprinted with permission.   It summarizes in a very readable way how posture affects health and well being.

The Surprising and Powerful Links between Posture and Mood

Why feeling taller tricks your brain into making you feel more confident and why your smartphone addiction might be making you depressed.

By

The next time you’re feeling sad and depressed, pay close attention to your posture. According to cognitive scientists, you’ll likely be slumped over with your neck and shoulders curved forward and head looking down.

While it’s true that you’re sitting this way because you’re sad, it’s also true that you’re sad because you’re sitting this way. This philosophy, known as embodied cognition, is the idea that the relationship between our mind and body runs both ways, meaning our mind influences the way our body reacts, but the form of our body also triggers our mind.

In large part due to Amy Cuddy’s widly popular 2012 TED talk, most of us know that two minutes of “power poses” a day can change how we feel about ourselves. This isn’t just about displaying confidence to others around; this is about actually changing your hormones—increased levels of testosterone and decreased levels of cortisol, or the stress hormone, in the brain.

“The brain has an area that reflects confidence, but once that area is triggered it doesn’t matter exactly how it’s triggered,” says Richard Petty, professor of psychology at Ohio State University. “It can be difficult to distinguish real confidence from confidence that comes from just standing up straight … these things go both ways just like happiness leads to smiling, but also smiling leads to happiness.”

When it comes to posture, Petty explains that the way we ultimately feel has a lot to do with the associations we have with being taller. For example, if you take two people and you put one on a chair that’s above the other person, the one that’s looking down will feel more powerful because “we have all these associations” with height and power that “gets triggered automatically when certain movements are made,” he says. The function of your body posture tells your brain that you’re powerful, which, in turn, affects your attitude.

In a 2009 study published in the European Journal of Social Psychology, Petty along with other researchers instructed 71 college students to either “sit up straight” and “push out [their] chest” or “sit slouched forward” with their “face looking at [their] knees.” While holding their assigned posture, the students were asked to list either three positive or negative personal traits they thought would contribute to their future job satisfaction and professional performance. Afterward, the students were asked to take a survey where they rated themselves on how well they thought they would perform as a future professional.

The researchers found that how the students rated themselves depended on the posture they kept when they wrote the positive or negative traits. Those who were in the upright position believed in the positive and negative traits they wrote down while those in the slouched over position weren’t convinced of their positive or negative traits. In other words, when the students were in the upright, confident position, they trusted their own thoughts whether those thoughts were positive or negative. On the other hand, when the students sat in a powerless position, they didn’t trust anything they wrote down whether it was positive or negative.

However, those in the upright position likely had an easier time thinking of “empowering, positive” traits about themselves to write down while those in the slouched over position probably had an easier time recalling “hopeless, helpless, powerless, and negative” feelings, according to Erik Peper, professor of Holistic Health at San Francisco State University.

In a series of experiments, Peper found that sitting in a collapsed, helpless position makes it easier for negative thoughts and memories to appear while sitting in an upright, powerful position makes it easier to have empowering thoughts and memories.

“Emotions and thoughts affect our posture and energy levels; conversely, posture and energy affect our emotions and thoughts,” says one of Peper’s studies from 2012, and two minutes of skipping versus walking in a slouched position can make a significant difference on our energy levels. Like Cuddy, Peper’s research finds that it only takes two minutes to change your hormones, meaning you can basically change the chemistry in your brain while waiting for your food to heat up in the microwave.

Since posture affects our mood and thoughts so much, the increase of collapsed sitting and walking—from sitting in front of our computer to looking down at our smartphones—may very much have an effect on the rise of depression in recent years. Peper and his team of researchers suggest that posture is a significant contributor to decreased energy levels and depression. Slouching is also known to result in frequent headaches and neck and shoulder pains.

With so much research proving the influence posture has on our mind, Peper suggests hanging photos of people you love slightly higher on the wall or above your desk so that you have to look up. Also, adjust your rear view mirror slightly higher so that you have to sit up taller while driving. If you need reminders, Petty advises setting reminders on your phone, computer, or even a Post-It note. When you do have negative thoughts, instead of validating them by slumping over or bending your head, Petty says that you should write them down on a piece of paper, then throw that piece of paper away in the trash.

“People who throw those negative thoughts into the trash can are less affected by them then people who had the same thoughts but symbolically put them in their pocket,” he says. “It’s this idea that it’s not what we think that’s important; it’s how much we trust what we think.”

Reprinted by permission from Vivian Giang

Adopt a power posture and change brain chemistry and probability of success

Posted: October 7, 2012 | Author: | Filed under: Uncategorized | Tags: , , | 3 Comments

Less than two minutes of body movement can increase or decrease energy level depending on which movement the person performs (Peper and Lin).  Static  posture has an even larger social impact—it affects how others see us and how we perform. Social psychologist Amy Cuddy, professor and researcher from Harvard Business School, has demonstrated that by adopting a posture of confidence for two minutes—even when you just fake it—significantly improves yourchances for success and your brain chemistry. The power position significantly increases testosterone and decreases cortisol levels in our brain. If you want to improve performance and success, watch Professor Amy Cuddy’s inspiring Ted talk (http://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are.html)

Take charge of your energy level and depression with movement and posture

Posted: September 30, 2012 | Author: | Filed under: Uncategorized | Tags: , , , | 14 Comments

I felt depressed when I looked down walking slowly. I realized that I walk like that all the time. I really need to change my walking pattern. When doing opposite arm and leg skipping, I had more energy. Right away I felt happy and free. I automatically smiled.    –Student

Hunched forward at the computer, collapsed in front of the TV, bent forward with an I-pad and smart phone while answering emails, updating Facebook, playing games, reading or texting—these are all habits that may affect our energy level.  Students may also experience a decrease in energy level and concentration when they slouch in their seats.

The low tech solution is not caffeine or medications; it is episodic movement and upright posture. In the controlledresearch study published October 5, 2012 in the journal Biofeedback, Erik Peper, PhD of San Francisco State University and I-Mei Lin, PhD of Kaohsiung Medical University, Taiwan, showed that subjective energy level can quickly be increased.

In this study 110 participants rated their immediate subjective energy level and their general depression level.  The participants either walked in a slouched position or engaged in opposite arm and leg skipping (see Figure 1).

Figure 1. Illustration of slouched walking (left) and opposite arm and leg skipping (right). Reproduced from Peper & Lin (2012).

Skipping even for even one minute significantly increased energy level and alertness for all subjects. On the other hand, walking in a slouched pattern reduced the energy level significantly for those participants who had high levels of depression as shown in Figure 2.

Figure 2. Self-rating of energy level for the top and bottom 20% of the students’ self-rating of depression. Reproduced from: Peper & Lin, (2012).

For people with a history of depression, their energy level may covertly increase or decrease depending upon posture and movements. When individuals have less energy, they feel that they can do less, and this feeling tends to increase depressive thinking. They also tend to label the lower energy state as the beginning of depression instead being tired. At the same time, the lower energy state tends to evoke depressive memories and thoughts which escalate the experience of depression. This process can be interrupted and reversed by shifting body posture and performing movement.

This study offers a strategy for people with depression to reverse conditioned cues associated with posture that evoke depressive thoughts and feelings. Wilson and Peper (2004) showed previously that ‘‘sitting collapsed’’ allowed easier access to hopeless, helpless, powerless, and negative memories than sitting upright and looking up. Posture appears to be aan overlooked aspect in the prevention of depression.

There is hope if you tend to become depressed and experience low energy. Numerous participants reported that after they performed opposite arm/leg skipping they did not want to walk in a slouched position.  This suggests that this type of movement my act as a protective mechanism to avoid energy decrease and depression. Some participants with attention deficit disorders reported that after skipping they could focus their attention much better. I recommend being more aware of your body posture during the day and increasing your arm and leg skipping movements.

*Adapted from: Peper, E. & Lin, I-M. (2012). Increase or decrease depression-How body postures influence your energy level.  Biofeedback, 40 (3), 126-130.

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