Adapted from: Peper, E., Pollack, W., Harvey, R., Yoshino, A., Daubenmier, J. & Anziani, M. (2019). Which quiets the mind more quickly and increases HRV: Toning or mindfulness? NeuroRegulation, 6(3), 128-133.
Disruptive thoughts, ruminations and worrying are common experiences especially when stressed. Numerous clinical strategies such as cognitive behavioral therapy attempt to teach clients to reduce negative ruminations (Kopelman-Rubin, Omer, & Dar, 2017). Over the last ten years, many people and therapists practice meditative techniques to let go and not be captured by negative ruminations, thoughts, and emotions. However, many people continue to struggle with distracting and wandering thoughts.
Just think back when you’re upset, hurt, angry or frustrated. Attempting just to observe without judgment can be very, very challenging as the mind keeps rehearsing and focusing on what happened. Telling yourself to stop being upset often doesn’t work because your mind is focused on how upset you are. If you can focus on something else or perform physical activity, the thoughts and feelings often subside.
Over the last fifteen years, mindfulness meditation has been integrated and adapted for use in behavioral medicine and psychology (Peper, Harvey, & Lin, 2019). It has also been implemented during bio- and neurofeedback training (Khazan, 2013; Khazan, 2019). Part of the mindfulness instruction is to recognize the thoughts without judging or becoming experientially “fused” with them. A process referred to as “meta-awareness” (Dahl, Lutz, & Davidson, 2015). Mindfulness training combined with bio- and neurofeedback training can improve a wide range of psychological and physical health conditions associated with symptoms of stress, such as anxiety, depression, chronic pain, and addiction (Creswell, 2015, Khazan, 2019).
Mindfulness is an effective technique; however, it may not be more effective than other self-regulations strategies (Peper et al, 2019). Letting go of worrying thoughts and rumination is even more challenging when one is upset, angry, or captured by stressful life circumstances. Is it possible that other strategies beside mindfulness may more rapidly reduce wandering and intrusive thoughts? In 2015, researchers van der Zwan, de Vente, Huiznik, Bogels, & de Bruin found that physical activity, mindfulness meditation and heart rate variability biofeedback were equally effective in reducing stress and its related symptoms when practiced for five weeks.
Our research explored whether other techniques from the ancient wisdom traditions could provide participants tools to reduce rumination and worry. We investigated the physiological effects and subject experiences of mindfulness and toning. Toning is vocalizing long and sustained sounds as a form of mediation. (Watch the video the toning demonstration by sound healer and musician, Madhu Anziani at the end of the blog.)
COMPARING TONING AND MINDFULNESS
The participants were 91 undergraduate college students (35 males, 51 females and 5 unspecified; average age, 22.4 years, (SD = 3.5 years).
After sitting comfortably in class, each student practiced either mindfulness or toning for three minutes each. After each practice, the students rated the extent of mind wandering, occurrence of intrusive thoughts and sensations of vibration on a scale from 0 (not all) to 10 (all the time). They also rated pre and post changes in peacefulness, relaxation, stress, warmth, anxiety and depression. After completing the assessment, they practice the other practice and after three minutes repeated the assessment.
The physiological changes that may occur during mindfulness practice and toning practice was recorded in a separate study with 11 undergraduate students (4 males, 7 females; average age 21.4 years. Heart rate and respiration were monitored with ProComp Infiniti™ system (Thought Technology, Ltd., Montreal, Canada). Respiration was monitored from the abdomen and upper thorax with strain gauges and heartrate was monitored with a blood volume pulse sensor placed on the thumb.
After the sensors were attached, the participants faced away from the screen so they did not receive feedback. They then followed the same procedure as described earlier, with three minutes of mindfulness, or toning practice, counterbalanced. After each condition, they completed a subjective assessment form rating experiences as described above.
RESULTS: SUBJECTIVE FINDINGS
Toning was much more successful in reducing mind wandering and intrusive thoughts than mindfulness. Toning also significantly increased awareness of body vibration as compared to mindfulness as shown in Figure 1.
Figure 1. Differences between mindfulness and toning practice.
There was no significant difference between toning and mindfulness in the increased self-report of peacefulness, warmth, relaxation, and decreased self-report of anxiety and depression as shown in Figure 2.
Figure 2. No significant difference between toning and mindfulness practice in relaxation or stress reports.
RESULTS: PHYSIOLOGICAL FINDINGS
Respiration rate was significantly lower during toning (4.6 br/min) as compared to mindfulness practice (11.6 br/min); heart rate standard deviation (SDNN) was much higher during toning condition (11.6) (SDNN 103.7 ms) than mindfulness (6.4) (SDNN 61.9 ms). Two representative physiological recording are shown in Figure 3.
Figure 3. Representative recordings of breathing and heart rate during mindfulness and toning practice. During toning the respiration rate (chest and abdomen) was much slower than during mindfulness and baseline conditions. Also, during toning heart rate variability was much larger than during mindfulness or baseline conditions.
Toning practice is a useful strategy to reduce mind wandering as well as inhibit intrusive thoughts and increase heart rate variability (HRV). Most likely toning uses the same neurological pathways as self-talk and thus inhibits the negative and hopeless thoughts. Toning is a useful meditation alternative because it instructs people to make a sound that vibrates in their body and thus they attend to the sound and not to their thoughts.
Physiologically, toning immediately changed the respiration rate to less than 6 breaths per minute and increases heart rate variability. This increase in heart rate variability occurs without awareness or striving. We recommend that toning is integrated as a strategy to complement bio-neurofeedback protocols. It may be a useful approach to enhance biofeedback-assisted HRV training since toning increases HRV without trying and it may be used as an alternative to mindfulness, or used in tandem for maximum effectiveness.
TAKE HOME MESSAGE
1) When people report feeling worried and anxious and have difficulty interrupting ruminations that they first practice toning before beginning mindfulness meditation or bio-neurofeedback training.
2) When training participants to increase heart rate variability, toning could be a powerful technique to increase HRV without striving
TONING DEMONSTRATION AND INSTRUCTION BY SOUND HEALER MADHU ANZIANI
For the published article see: Peper, E., Pollack, W., Harvey, R., Yoshino, A., Daubenmier, J. & Anziani, M. (2019). Which quiets the mind more quickly and increases HRV: Toning or mindfulness? NeuroRegulation, 6(3), 128-133.
Kopelman-Rubin, D., Omer, H., & Dar, R. (2017). Brief therapy for excessive worry: Treatment model, feasibility, and acceptability of a new treatment. Journal of Psychotherapy Integration, 29(3), 291-306.
van der Zwan, J. E., de Vente, W., Huizink, A. C., Bogels, S. M., & de Bruin, E. I. (2015). Physical activity, mindfulness meditation, or heart rate variability biofeedback for stress reduction: A randomized controlled trial. Applied Psychophysiology and Biofeedback, 40(4), 257-268. https://doi.org/10.1007/s10484-015-9293-x
How can you demonstrate that yoga practices are beneficial?
How do you know you are tightening the correct muscles or relaxing the muscle not involved in the movement when practicing asanas?
How can you know that the person is mindful and not sleepy or worrying when meditating?
How do you know the breathing pattern is correct when practicing pranayama?
The obvious answer would be to ask the instructor or check in with the participant; however, it is often very challenging for the teacher or student to know. Many participants think that they are muscularly relaxed while in fact there is ongoing covert muscle tension as measured by electromyography (EMG). Some participants after performing an asana, do not relax their muscles even though they report feeling relaxed. Similarly, some people practice specific pranayama breathing practice with the purpose of restoring the sympathetic/parasympathetic system; however, they may not be doing it correctly. Similarly, when meditating, a person may become sleepy or their attention wanders and is captured by worries, dreams, and concerns instead of being present with the mantra. These problems may be resolved by integrating bio- and neurofeedback with yoga instruction and practice. Biofeedback monitors the physiological signals produced by the body and displays them back to the person as shown in Figure 1.
Figure 1: Biofeedback is a methodology by which the participant receives ongoing feedback of the physiological changes that are occurring within the body. Reproduced with permission from Peper et al, 2008.
With the appropriate biofeedback equipment, one can easily record muscle tension, temperature, blood flow and pulse from the finger, heart rate, respiration, sweating response, posture alignment, etc.** Neurofeedback records the brainwaves (electroencephalography) and can selectively feedback certain EEG patterns. In most cases participants are unaware of subtle physiological changes that can occur. However, when the physiological signals are displayed so that the person can see or hear the changes in their physiology they learn internal awareness that is associated with these physiological changes and learn mastery and control. Biofeedback and neuro feedback is a tool to make the invisible, visible; the unfelt, felt and the undocumented, documented.
Biofeedback can be used to document that a purported yoga practice actually affects the psychophysiology. For example, in our research with the Japanese Yogi, Mr. Kawakami, who was bestowed the title “Yoga Samrat’ by the Indian Yoga Culture Federation in 1983, we measured his physiological responses while breathing at two breaths a minute as well as when he inserted non-sterilized skewers through his tongue tongue (Arambula et al, 2001; Peper et al, 2005a; Peper et al, 2005b). The physiological recordings confirmed that his Oxygen saturation stayed normal while breathing two breaths per minute and that he did not trigger any physiological arousal during the skewer piercing. The electroencephalographic recordings showed that there was no response or registration of pain. A useful approach of using biofeedback with yoga instruction is to monitor muscle activity to measure whether the person is performing the movement appropriately. Often the person tightens the wrong muscles or performs with too much effort, or does not relax after performing. An example of recording muscle tension as shown in Figure 2.
Figure 2: Recording the muscle tension with Biograph Infinity while performing an asana.
In our research it is clear that many people are unaware that they tighten muscles. For example, Mcphetridge et al, (2011) showed that when participants were asked to bend forward slowly to touch their toes and then hang relaxed in a forward fold, most participants reported that they were totally relaxed in their neck. In actuality, they were not relaxed as their neck muscles were still contracting as recorded by electromyography (EMG). After muscle biofeedback training, they all learned to let their neck muscles be totally relaxed in the hanging fold position as shown in Figure 3 & 4.
Figure 3: Initial assessment of neck SEMG while performing a toe touch. Reproduced from Harvey, E. & Peper, E. (2011).
Figure 4: Toe touch after feedback training. The neck is now relaxed; however, the form is still not optimum. . Reproduced from Harvey, E. & Peper, E. (2011).
Thus, muscle feedback is a superb tool to integrate with teaching yoga so that participants can perform asanas with least amount of inappropriate tension and also can relax totally after having tightened the muscles. Biofeedback can similarly be used to monitor body posture during meditation. Often participants become sleepy or their attention drifts and gets captured by imagery or worries. When they become sleepy, they usually begin to slouch. This change in body position can be readily be monitored with a posture feedback device. The UpRight,™ (produced by Upright Technologies, Ltd https://www.uprightpose.com/) is a small sensor that is placed on the upper or lower spine and connects with Bluetooth to the cell phone. After calibration of erect and slouched positions, the device gives vibratory feedback each time the participant slouches and reminds the participant to come back to sitting upright as shown in Figure 5.
Figure 5: UpRigh™ device placed on the upper spine to provide feedback during meditation. Each time person slouches which often occurs when they become sleepy or loose meditative focus, the device provides feedback by vibrating.
Alternatively, the brainwaves patterns (electroencephalography could be monitored with neurofeedback and whenever the person drifts into sleep or becomes excessively aroused by worry, neurofeedback could remind the person to be let go and be centered. Finally, biofeedback can be used with pranayama practice. When a person is breathing approximately six breaths per minute heart rate variability can increase. This means that during inhalation heart rate increases and during exhalation heart rate decreases. When the person breathes so that the heart rate variability increases, it optimizes sympathetic/parasympathetic activity. There are now many wearable biofeedback devices that can accurately monitor heart rate variability and display the changes in heart rate as modulated by breathing.
Conclusion: Biofeedback is a useful strategy to enhance yoga practice as it makes the invisible visible. It allows the teacher and the student to become aware of the dysfunctional patterns that may be occurring beneath awareness.
Arambula, P., Peper, E., Kawakami, M., & Gibney, K. H. (2001). The physiological correlates of Kundalini Yoga meditation: a study of a yoga master. Applied psychophysiology and biofeedback, 26(2), 147-153.
Harvey, E. & Peper, E. (2011). I thought I was relaxed: The use of SEMG biofeedback for training awareness and control. In W. A. Edmonds, & G. Tenenbaum (Eds.), Case studies in applied psychophysiology: Neurofeedback and biofeedback treatments for advances in human performance. West Sussex, UK: Wiley-Blackwell, 144-159.
Mcphetridge, J., Thorne, E., Peper, E., & Harvey, R. (2011) SEMG for training awareness and muscle relaxation during toe touching. Paper presented at the 15th Annual Meeting of the Biofeedback Foundation of Europe. Munich, Germany, February 22-26, 2011.
Peper, E., Kawakami, M., Sata, M., Franklin, Y, Gibney, K. H. & Wilson, V.S. (2005a). Two breaths per minute yogic breathing. In: Kawakami, M. (2005). The Theses of Mitsumasa Kawakami II: The Theory of Yoga-Based Good Health. Tokyo, Japan: Samskara. 483-493. ISBN 4-434-06113-5
Peper, E., Kawakami, M., Sata, M. & Wilson, V.S. (2005b). The physiological correlates of body piercing by a yoga master: Control of pain and bleeding. Subtle Energies & Energy Medicine Journal. 14(3), 223-237.
**Biofeedback and neurofeedback takes skill and training. For information on certification, see http://www.bcia.org Two useful websites are:
Mind-Guided Body Scans for Awareness and Healing–Youtube Interview of Erik Peper, PhD by Larry Berkelhammer, PhDPosted: December 23, 2013
In this interview psychophysiology expert Dr. Erik Peper explains the ways how a body scan can facilitate awareness and healing. The discussion describes how the mind-guided body scan can be used to improve immune function and hold passive attention (mindfulness) to become centered. It explores the process of passive attentive process that is part of Autogenic Training and self-healing mental imagery. Mind-guided body scanning involves effortlessly observing and attending to body sensations through which we can observe our own physiological processes. Body scanning can be combined with imagery to be in a nonjudgmental state that supports self-healing and improves physiological functioning.
Breathing: The Mind/Body Connection. Youtube interviews of Erik Peper, PhD by Larry Berkelhammer, PhDPosted: December 19, 2012
Erik Peper, Respiration & Health
How we breathe is intimately connected to our state of health. We can speed up breathing to energize or slow it for a calming effect. Practice becoming more aware of the speed and depth of your breathing. Breathing diaphragmatically at 6 to 7 breaths per minute is regenerative. Breathing patterns alter physiological, psychological, and emotional processes. Conscious regulation of breathing can improve asthma, panic disorder and many other conditions. A simple change in breathing can induce symptoms or resolve them. Learn to observe breath-holding. Devices like Stress Eraser and Em-Wave teach healthy breathing at home. When we start taking charge there’s more hope. Focus on skills not pills.
Erik Peper, Mastery Through Conscious Breathing Practices
In this interview of Dr. Erik Peper, we discuss the power of Tumo breathing. This form of conscious breathing has been studied by Dr. Herbert Benson of Harvard and many other Western researchers. It is a special form of conscious respiration that increases metabolic rate and allows Buddhist monks and others who practice it to prove to themselves that they can use their minds to alter physiology. The value of such intense practices is that they allow us to gain mastery and the absolute knowledge that we have the ability to exert voluntary control over mental and physiological processes. Most Buddhist practices lead to the possibility of gaining a certain degree of mastery of consciousness.