BIOFEEDBACK - An Interview with Robert Whitehouse, EdD
(www.breathewellnow.com)
See Biography below

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By Ellen Hughes

With an impressive list of titles, (Licensed Psychologist, BCIA certified in Biofeedback, AAPM certified in Pain Management, Somatic Experiencing Practitioner), Dr. Whitehouse, an Adjunct Assistant Professor of Sport Psychology at the University of Denver, was the expert regarding biofeedback.  He agreed to not only speak with me, but also to hook me up to the biofeedback computer and take readings.  I think you will find this interview quite enlightening.

* * *

SOE:  What is the definition of biofeedback?

If you look at the web page from bcia.org (Biofeedback Certification of America), it carries the new definition of biofeedback.  Or look at the website for aapb.org, the national organization.  Mine is slightly different because I was waiting for a new one to come along.  But it’s 4 things.  Biofeedback is a mind-body education or therapy:

1. That utilizes biomedical electronic instrumentation to assess, monitor and train appropriate physiology
2. to help a client/patient gain awareness and either
1. control over psychophysiological dysregulation as in stress, disease or injury or
2. psychophysiological mastery for optimal function
3. When training is involved, physiologic information (like heart rate, muscle tension, respiration, electrodermal activity, skin temperature, brainwave activity) is fed back, i.e. presented visually or auditorially or tactilely, usually immediately, to the client, and usually along with
4. the coaching of a specialist trained in self-regulation strategies and skills and working within the scope of her/his pratice.

SOE:  Was the second website aapb.org?

Yes.  That’s the national membership organization.  Actually, it’s an international membership organization.  I used to be on the Board and I was the insurance chair. Most of the Workers Comp systems now cover biofeedback.  And a lot of the personal injury protection plans of the past.  Because we have lost personal injury protection here in this state (Colorado), people have to go through their insurance companies.  90% of doctors refer for biofeedback.  In one study, about 1% of people are actually getting it.  That’s terrible.  If 90% are referred, 90% should get it. 

Now there are some new avenues of approval there.  In this state (Colorado) many of the insurance companies, they are saying “No, we don’t reimburse under the biofeedback treatment code.”  However, I’m a licensed psychologist, I’m able to provide it as part of psychotherapy, as long as that’s not the only thing we do.  That would be bad if it were not for the fact that insurance companies are telling us to go ahead and do that.  And in this state (Colorado), (it’s not necessarily the same in every state), biofeedback is not its own Ph.D. discipline even though it has a Master’s and Ph.D. program.  Physiology is another name for that. 

SOE:  Biofeedback is a complementary treatment, is that how you would term it?

It’s actually, well, when we gave our briefing to the decisionmakers in Washington, a congressional briefing, there are applications for which it has already been accepted.  It’s complementary or alternative for those which it’s not been approved yet.  There are 34 different fields.  What they were responding to was for the applications for which it has been accepted - like incontinence.  Like headaches.  Like anxiety, etc. 

As a board member, I was the one who always pushed for the broader definitions so that it’s not just for psychologists.  About 60% of the national membership is psychologists.  But there are physical therapists, there are all these different fields and you can see those listed on www.bcia.org.  They are looked up as part of what we are doing.

(He is now hooking me up to the biofeedback machine. First I place a cannula – breathing tube – in my nose and hook it up around my ears.)

So let me start with this.  This is the heart rate monitor that just works by clipping on your earlobe.  It also measures the CO2 of your breathing so it measures that as well. 

SOE:  I have problems breathing.

It turns out that a lot of what had previously been considered medically unexplained symptoms can be explained by the new term what’s called “overbreathing”.  Any time you drop your CO2 levels, you get more oxygen into the lungs.  What you need is the delivery of the oxygen from the lungs to the brain and to the tissues.  And that comes with how much CO2 you have.  You used to be taught you were supposed to get rid of all your CO2.  That’s totally, totally wrong.  It’s such a precious gas that we have to keep 85% of the CO2 that we bring in.  Because we don’t get the oxygen delivered….It’s called a mesa canula.  In this case, we are not giving it to you, we are measuring what’s acting on your own.  So we will measure heart rate and all these different things.

You mentioned you have a breathing problem?  Of what sort? 

SOE:  I have nodules in my right lung.

Okay, okay.  So they are sure that the tightness is from the nodules?  Because that can be one of the first symptoms of overbreathing, too.  Were you not breathing correctly?  You find that you are having a breathing problem or short of breath or any of that.  What do you do for it? 

SOE:  At the point of breathing problems, I do deep breathing exercises, EFT and some other exercises.

So show me how you would do the deep breathing.

SOE:  I would take in a deep breath, count to 10, hold it for 4 X 10 and then push out for 2 counts of 10. 

Okay, so why don’t you do two rounds of that.  Whenever you are ready.  Or if you want you could wait until I hook you up to a couple of other things.  Why don’t we do that?

SOE:  I also use another breathing exercise I learned a few weeks ago.  Women put left thumb over right and men put right over left.  And then put your arms up.  Breathe in and out through your nose slowly and then breathe in fast.  He called that Firebreath.

Right.  And then how do you end that?  The extended exhale that make a person lightheaded or hyperventilate during the Firebreath, during everything else.  It doesn’t matter how fast or how slow or how deep or how shallow.  It only matters that we get the right breathing chemistry.

(We are looking at the monitors)

SOE:  Am I at 27 breaths per minute?

Well, let’s see.  1……24. 

SOE:  And some people breathe only 6 times a minute?

Yes.  In fact, there are some approaches out there that say it…we would test you to see what should be the breathing rate that you should practice staying at to reset everything in your body.  It’s between 4 – ½ and 7 for most people. That works for some people but I don’t see most people actually doing it.

You should always be using the diaphragm but that’s a little different than belly breathing.  And you don’t need to breathe all of the way down into the belly.  You can if you get good breathing chemistry.  Then that’s going to have more positive benefits on your heart rate.  If you have good breathing and good pattern, it’s called Heart Rate Variability (HRV). You do not want a steady heart rate.  They used to think that we should have a steady heart beat. Now we know that’s a predictor of all cause mortality.  We have hundreds of research articles on that.  All causes of mortality are predicted by unchanging or inerratic heart rate.  Where there’s not much rhythmic variability between them.  You want to have greater variability. 

Here we are looking at your heart rate.  This is fairly steady.  We want to see, as you breathe in your heart rate speeds up.  As you breathe out it slows down.  That’s one pattern.  I can take a screen capture of that, too, if you want. 

SOE:  So whatever you breathe in, you should push out?

Not push out – just let it out.  It will go out when it’s out.

SOE:  And by doing that, the CO2 levels will be at the correct level for the body?

Well, in general.  It increases the chance of that.  Some people go on chronic overbreathing and so we don’t know unless we actually test.  I’m going to reset everything to make sure we’ve got correct readings.

SOE:  How do people breathe who are chronic overbreathers?  Deeply?  To me, overbreathing means it would be deep. 

Overbreathing is actually the term used for shorting themselves of oxygen.  It is counter-intuititive.  That’s the term. 

We have all these stress related illnesses.  So we can measure the stress response.  We can measure the physical systems that are out of whack.  We can measure if there is muscle tension or if there is headaches.  We have the diagnosis and then we see the correlates of that.  Where your muscles are tight.  When you’re breathing…It works with health conditions or emotional conditions.  We can see what is out of bounds and then coach on how to recover from that. 

There are a lot of techniques that are utilized.  In the past there was a heavy emphasis on relaxation, to bring the body out of the stress response into a relaxation response.  It’s a whole set of new of awareness and skills that are saying, “Hey, we don’t always have to be either stressed or relaxed.  There is a place of balance in the middle.  We know what that balance looks like now.  The heart rate pattern is often called “coherence”. 

Everything starts to normalize.  So the aim, in part, is the normalization of any physiology that is out of whack from physical reasons or emotional reasons.  I took it a step further and say that ultimately we are aiming for optimization. 

My motto, my personal motto is an acronym, it’s Opt for the Best.  The acronym is the

O is for Optimal
P is for Performance
T is for Training

   for the

B for Body
E for Emotions
S for Spirit
T for Thought  

This started with studies back in the 50’s where they discovered that with rats with electrodes implanted in the brain and in the pleasure center, we learned they were able to control their urinary output for the sake of food.  Then they discovered they could control their heart rate.  They could make it go up and make it go down.  Even embryonic chicken eggs, they learned to control their heart rate. And then even a rat can learn to blanch one ear and blush the other ear for the sake of food.  So when they realized that, the physiology was that much under control even though the textbooks call the internal physiology the “involuntary”, it’s only normally involuntary until we bring awareness and conditioning and criteria into it.  So they said, “My goodness, if a rat can do this, what can humans do?” 

The big difference is we don’t need the electrodes implanted in the brain if it weren’t for the sake of the feedback for knowing that we are learning and that we are making progress or that we are learning from things that don’t go the direction that we want.  We learn how to get the internal controlled and there are sort of some rules and guidelines for how we do that. 

So let me borrow your left hand.  I’m going to put this on to monitor your perspiration level on these fingers.  This one measures not the breathing chemistry, but the breathing movement of your belly.  So you put this belt just below the ribcage.  Put a little stretch on this so as you breathe, the expansion will stretch.

So let me borrow your left hand.  I’m going to put this on to monitor your perspiration level on these fingers.  This one measures not the breathing chemistry, but the breathing movement of your belly.  So you put this belt just below the ribcage.  Put a little stretch on this so as you breathe, the expansion will stretch. We can measure brain waves.  You can measure the effects of hypnosis with this, too.

Right the early studies at least were saying that there was not a particular state, a physiologic state associated with hypnosis. 

I’m going to put this on your thumb.  Another heart sensor.  And then I’m going to put a muscle monitor on either on your forehead or a shoulder.  So where do you think we would find the most muscle tension? 

SOE:  Shoulder probably, I would think. 

Well, what I would be doing is a little alcohol swab on whichever side and then I would tape an electrode that sticks in here, tape it on but I don’t poke you with any needles there.  And then an electrode here in just a second.  There is everything from just the basic graphs to all sorts of games involved.

SOE:  Are the games learning tools?

Yes.  And there is a breathing one.  There is one where you fly an airplane.  There’s one on measuring heart rate.  You have probably heard of the Journey to Wild Divine or HeartMath emWave or Stress Eraser, some of those type of games.  The Journey to Wild Divine measures perspiration and heart rate.  One of my former students developed that.  I insisted that they put the heart rate in as part of what they were doing with that. 

One of the local hospitals said that they had biofeedback.  And I asked, “How did you get your training?” “Oh, well, they gave us an hour orientation.  They showed us how to put these things on a person’s fingers and then they just turn on a relaxation tape and leave.”  That’s not good.   

(He is finished hooking me up.)

Exactly.  Back to the other screen. 

SOE:  If it’s not hooked up right, you are not going to see the results or have an incorrect reading?

Right.  Exactly.  And I don’t want to give you incorrect information.  Only licensed professionals can diagnose.  They can utilize this information to help with the diagnosis but the actually instrumentation would never give a diagnosis.  Somebody has to interpret it.

SOE:  Biofeedback cannot harm anybody.  Is that a correct statement?

I think that is a correct statement.  When it is used properly, I’ve not seen any harm come.  Nor have I heard of any harm come.  One exception would be if people give mis-information or their situation is not taken into account and they are just shoved into a particular protocol.  For example, somebody who has a lot of trauma around having their eyes closed, like if they have been abused and they are not comfortable closing their eyes and they are asked to close their eyes in a dark room and just work on relaxing.  That would not be an appropriate thing to do.  So it has to be a clinician’s judgment and how best to work with.  It can be used for muscle retraining.  And muscle assessment in PT (Physical Therapy) and OT (Occupational Therapy).  It can be used in incontinence work.  It can be used for working with blood pressure, migraines, headaches, irritable bowel, cardiac recovery.  There are all these different applications.  And there are techniques or strategies that one can learn along with all of these things so you (the patient) are not just left alone, trying to figure out what is going on or how to deal with it.  You are being coached in the best of the world. 

There is a lot of the home training thing.  People buy them on their own and use them.  And generally, they are safe.  But there are some precautions that I would list for all of them, particularly around breathing.  If a person’s breathing protocol and they get lightheaded or dizzy or anxious or headache is triggered or whatever, they are probably overbreathing.  They have probably thrown off their breathing chemistry.

So let’s go back to the instrument that measures heart rate and breathing.  The blue line here in the background is measuring the breathing chemistry.  When the line is coming down, that is an inhale.  When the line is going up, that’s an exhale.  We are measuring the CO2 at the end of the tide, at the end of the breath.  So at the end of the breath we look to see how this blue line comes.  And ideally, it’s going to come up above this line.  That’s chemically good breathing.  So your breathing is below that quite a bit, so I’m not surprised that you have some breathing difficulty. 

(Interview continues after graphs)

Breathing in 10, holding 40, push out 20. Note very low ETCO2 of 25 Torr at the first then goes up to 32 at the end of the graph.  A chemically good breath goes above the straight line which is 35 Torr.

Continued 10,40,20

Firebreath brings severe overbreathing at first and erratic heart rate

Firebreath with ending extended exhale restores ETCO2 and HRV

Another Firebreath with extended exhale at the end.  Note that during that exhale, the HR slows as it should and then speeds up on the inhale.  Note that this breathing shifts the heart into Sympathetic dominance (the red frequencies, aka heart waves).

Here is her first Alternate Nostril Breathing (ANB) demo, done very rapidly, resulting in very low ETCO2 and Sympathetic Nervous System dominance (the red peak in heart frequencies.


 
ANB at 22 bpm but dangerously low ETCO2.

ANB at 5 bpm.  Note good HRV and better ETCO2 but still below normal.

Alternate Nostril Breathing:  Here Ellen is doing it at 7 breaths per min and getting good HRV (Heart Rate Variability) but is dropping her ETCO2 which means she is not getting enough oxygen delivered from the lungs to the brain and other tissues.

 

Now let’s see if it makes a difference…I notice you breathe with your mouth open a lot.  Let’s see what happens if you take…

SOE:  I’m doing that because of the tube.

Okay, so let your lips be lightly touching and just breathe through your nose.  We’ll see if that makes a difference here.  We don’t look at it when a person is talking. 

And this number up here tells the numbers of breaths per minute you have been breathing for the last 20 seconds right here.  If we have an accurate reading here, it looks like, well, I don’t know, do you have any chest tightness right now as you are sitting here?

SOE:  I feel a little.

Sit comfortably.  And I can do a screen capture of that, too.  If you were ever to do anything, what would you do?  You said you would sit back and take deep breaths.  It doesn’t matter how you take it in, just so you don’t let it back out through your mouth. 

SOE:  It’s a breathing exercise using a formula of 1X, 4X, 2X, where X is a variable.  You breathe in for 1X, hold for 4X and push out the breath for 2X.

The 4 is the hold.  Sure, go ahead and do it.

(I’m doing the breathing exercise.)

What I saw with your breathing was that you slowed your breathing a lot.  You were breathing about 4 or 5 breaths a minute.  Your CO2 levels came up to this level at the highest, which is still at a mild level of overbreathing.  And then right afterwards, it’s dropped back to much lower, so I don’t know if it feels tighter in here or anything else. 

So the suggestion based on this would be that you would probably benefit from the coaching around how to restore your breathing. And that can be done with the easiest, without guesswork, with the use of this instrument which measures the heart rate as well.  This is something, as is the case with some other instruments these days, it can be rented out.  People can do home practice with these things.  You can even be coached over the Internet.  You can sign on to the computer, give me permission to take over your computer screen for this.  I would set up the training screens, coach you, then at the end of that session, turn the computer back over to you and then you would know what to practice.  (For more information, please call Dr. Whitehouse at 303-417-0293)

This is happening with other aspects of biofeedback, too, but particularly this instrument so it’s moved into a whole new realm.  There are home training devices where you can do on your own or where you can be coached over the Internet. 

Now the red line up here is measuring your heart rate.  And the little red diamond is every heartbeat.  So we are looking at a minute’s worth of your breath and a minute’s worth of your heart rate.  Every time there is a little jog here, that is a different heartbeat.  So the ideal is to have a rhythmic up and down like this, where sometimes it’s speeding up, sometimes it’s slowing down.  All the rhythmic difference between the faster and the slower, the more the variability, the better.  Remember, low variability is the single best predictor of health problems, emotional problems, and lack of recovery and the best predictor of all cause mortality.

SOE:  It’s another sign that the mind and body are truly working together.

Exactly.  That’s why we have the term “psychophysiology”.  It means the “mind/body connection”.  And Elmer Green, one of the founders of biofeedback and his wife, Alyce referred to this psychophysiologic principle.

SOE:  So can you tell with the breathing exercise I did, is that a good thing for me to do or not?

It raised your CO2 levels a little bit. And it brought your heart rate more into a place of balance.  It got more variability in your heart rate.

What we let the computer do is take the heart rate and break it down a fast forward transform of the heart rate.  It breaks it down into the component frequencies like we do with the electrical signal of the brain where we break it down into brainwaves.  And it’s not commonly known that these are called “heartwaves”.  But it will be known as that in the future. 

We have only had an international classification system for this since 1996 and I have developed a new heart rate certification program.  It’s new to many people.  So, the red color over here in this instance refers to sympathetic nervous system activity as seen through the heart.  If the computer says there is not much variability here, there is more of the sympathetic nervous system activity and then how high it goes towards the amplitude of that.  We spend about 90% of our time over there which is another reason we die too soon.  We don’t need to be “on” all the time. 

The blue frequencies over here to the right, there is a combination of respiratory rate and the parasympathetic nervous system.  This is to calm the heart.  If we didn’t have the parasympathetic break working at the heart, accelerator heart, our hearts would be racing at 120 beats a minute with almost no change. 

The green, however, is now generally considered to be a combination…a synthesis, a meeting ground of the sympathetic and parasympathetic.  The green is called the low frequencies that HeartMath has started to call “coherence”.  That is a term that is starting to show up.  There are all kinds of special benefits that come when we are showing a peak in the green, when that is dominant over the others.  So it’s different than being relaxed, different than being stressed.  I like to refer to it as being “balanced”.  I call it the ABCs of the autonomic nervous System.  “Action, Balance and Calm”.  That’s just my referencing. 

And so everybody is out there to produce the techniques to get more of the green.  It means you’re increasing your heart rate variability (HRV) to get there.  So you either do it by breath or with HeartMath where you do it with using the breath and then you connect with the part of the emotional state.  Because, you see, there are emotional signatures in our heart rate.  If you are angry or anxious or real focused or relaxed or whatever, there are different patterns that show up in the heart rate.  And there are differences that show up in the temperature of the hands and the muscles. 

So we have ways of recognizing all these things and coaching to make a difference.  Like I said, there are games.  This big series of graphs could be converted into games. Here we are looking at the muscle tension in your right shoulder.  It has varied between a normal level and right now, it was up there pretty tense.  You might notice the position of your shoulder. And often when people are keying or writing or doing anything, they do this. They bring the shoulders up.  You don’t need to lift your shoulders to bring your hands up to drive, to write, to key or whatever.  That’s a contributor to a lot of pain.  How we use computers.  Actually it’s how use our muscles in dealing with them. 

Here’s the hand temperature of your hand.  Your hands are a little on the cool side.  (The sensor had pulled out)  Put it back in there.  Your hand is about the temperature of the room.  And now we are going to get an accurate reading.  This is measuring perspiration levels.  Skin conductant which is often being used as measures of trance, measures of lying, measures of emotional arousal.  Again, you are right in the middle range there.  Average. 

Anyway, biofeedback measures any physiological process that we can find a way to measure. The harder you try, the worse it works with the internal controls.  You have to learn how to communicate from the cortex to the emotional brain underneath and to the brain stem in the language which is much like in hypnosis.  You bring messages into the present, where you are most likely to get them.  It’s still taking the time to get your breathing good which many of us now consider THE primary first level skill that the breathing is right, then everything else is going to go right.  Then bring the heart rate in. If you produce this particular heart rate pattern, everything starts to normalize.  Then it’s also easier to use any of the other techniques that further enhance.

SOE:  Do babies breathe correctly?

Most of them do.  We tend to unlearn it.  Somebody gasps when there is a startle. We learn to gasp by hearing somebody else.  Or we do all these different things.  Every bit of it is learned so therefore it can be unlearned unless there are pulmonary or cardiovascular problems that would override anything, ideal learning.

So see it’s critically important that we have enough CO2 to allow the delivery of the oxygen.   What I most commonly see when people breath deeply, like, let’s have you do that…right now.  Take 2 really deep breaths with the sort that you might find people doing or suggesting that they take.  Hold your breath and see, does it come up to here.  Now, it dropped even lower.  You may start getting dizzy or lightheaded. 

If you hold it in, that allows some build-up of CO2.  But that’s not the desired natural way of doing it.  The natural way is that every breath comes in, whether it’s fast or slow, does not matter.  Remember, we need the right breathing chemistry, whether we are relaxing, whether we are running, whether we are fighting, whether we are at work or making love, whatever we need the right breathing chemistry.  Otherwise we are dysfunctional.  See, we have been sold a bill of goods by being told that everybody has to do slow, deep, relaxed breathing.  It has benefits if the breathing chemistry is good.  It will tend to bring the heart rate in to this desired place which will have a calming effect and start to enable other things to work well, too.  But we have been told the wrong information. 

The HeartMath Institute has done a lot of excellent research about how the heart works and how it relates to emotions, as well as health. And they have some techniques which are tried and true, well proven.  For example, even in grade school through graduate school, such phenomenal outcomes that Congress was so impressed they gave them $1.75 million to take into more schools to help with test anxiety.  I met with their lobbyists in Washington because they wanted to know more.  Actually there is some dogma attached to their technique.  The techniques work but what I find is that you can get the desired pattern other ways, too.  I find that it comes spontaneously with people.  Some West Coast researchers are also saying, “All you need to do is breathe at about 6 breaths a minute or you can test and find what gets you the highest peak here in the green.”  And that’s true.  But what I find is often when people do it, they do it deeply and I tested myself again the other day and sure I dropped because I was breathing too deeply.  But it’s good to be able to practice getting your heart in a high peak right here in the coherent pattern.  What’s called the resonance frequency to be technically correct.  It’s good to be able to produce that for many reasons.  For emotional reasons, for health reasons and so on.  However, I have to add in that qualifier, that if you are dropping your CO2 and therefore your oxygen level, that is not in your best interest.  You need to get the breathing right first or along with that. 

SOE:  There is not “one-size-fits-all” for breathing?

Exactly.  Researchers know that one size fits all is really breathing at 4 -1/2 to 7 breaths per minute, finding out whichever gives you the highest BQ, but I would qualify that and say “only if the breathing chemistry is right.”

The optimal is whatever keeps your readings above this line – 35 to 45 TOR or 35 to 45 millimeters here.  That’s chemically good breathing. 

SOE:  Does it have to do with the physical body?  A tall person would need to breathe differently than a shorter person?

A little bit, a little bit.  What they are finding is that taller people tend to breathe a little bit slower.  This is information that capnometry (the measurement of CO2) is a $450 billion a year industry in the hospital, in every surgery room, every recovery room, ambulances. They are all measuring CO2.  They are making so many decisions based on what is going on with the CO2.  It’s only now has come out of the hospitals in this form to show people how to get control of your own breathing so it’s not just monitored.  CO2 levels drops down in here, they know that symptoms are going to start showing up and what’s at risk for the person. 

SOE:  Are they teaching people breathing exercises?

Yes, they are typically teaching yoga breathing or any other deep breathing.  Of the 13,000 or 14,000 hours I have monitoring people now, I have only seen a half dozen people do the deep breathing correctly.  And of the half dozen people, most of them have been long time yoga practitioners or teachers who know that it’s about the exhale to complete.  Whenever we interrupt a breath that was not quite all the way out and rush to get another one in, we have thrown off our CO2 levels.  It doesn’t matter if it’s fast or slow, it just matters most that it’s the right chemistry. 

Most biofeedback practitioners are not measuring this.  They are doing the old way of approach using deep breathing, make it as deep as you can.  I did it for 30 years.  Then when I got my equipment, I checked it. 

The new term for “stress test” is “psychophysiological stress profile” You can abbreviate is PSP. So we can do that with breathing or we can do that with the other things.  We have people be at rest.  We give them different kinds of challenging situations.  Maybe a mental challenge.  If we are doing the breathing challenge, we have a person purposely do really slow, deep breathing and drop their CO2 and then drop it more and more. Or make it fast breathing after they have gone slow and deep until their CO2s are down to a certain level we know.  We can then see what’s going on with the physiology and then we can know how is a person responding to stress.  Whatever their resting baselines are, we then know by looking at what readings are outside the normal range, and determine where we want to aim our coaching. 

It’s to me, it is unconscionable to be coaching people about stress management or about health management without taking the actual physiological readings that match.   When you go to the doctor’s office, you are going to have somebody else take these readings beforehand.  My goal would be to have heart rate and breathing and maybe other monitors in every doctor’s office so that when you come in, you check in and while you are waiting, these readings are being taken.  You can even administer them yourself.  You get a print out and take it to the doctor and add it to the regular information.  I think every psychologist, every counselor, (unless they are absolutely unwilling, especially if they are dealing with stress, like they deal with breathing or trying to coach or whatever) should be trained in and monitoring this or have it available to somebody. 

When I have a patient, I hook them up the first time they walk in the door unless they absolutely object.  I have had one person in ten years object.  I want that physiologic data along with everything else all the time.  I don’t have to measure everything, but I want to see what is going on.  It’s the best stress test I find is just hooking people up when they come in.

Back when I was a Board member for National Association for Biofeedback, I declared I thought every school should have biofeedback in their curriculum by 2012.  I would modify that today and say I think it should be in every clinician’s office, every physician and probably every clinician’s office. 

PART 2 OF INTERVIEW

Dr. W: When I do psychology, I hook a person up the first time they walk in the door unless they absolutely object.  And I have had one person in ten years object.  I want that physiologic data along with everything else all the time.  I don’t have to measure everything, but I want to see what is going on.  It’s the best stress test I find is just hooking people up when they come in.

SOE:  Could you see, could you tell if someone is ready to snap?

Not necessarily, but I would have a lot of interpretation on what’s going on with their heart rate.  I published an article on trauma and heart rate and patterns that we see showing up.  We know how to interpret these things a lot differently than we were originally taught.  For example, imagine there was a startling thing that happened right outside here and we heard this loud noise.  The first thing we would have would be a startle reflex.  Our muscles would jump and we would turn toward trying to locate the source of the noise.  Our rates would drop for a little bit.  And then as soon as we determined if there was danger or not, if there was danger that we needed to do something to get out of the way of, our heart rates would speed up. It could double in as few as 3 seconds.  On the other hand, if we perceived something to be unsurvivable, our heart rate could drop and we would pass out or die.  It’s numbing ourselves for a compassionate death.  All these different things we now know.
 
SOE:  Could biofeedback be used at the airport for security reasons?

No because some people would show the same anxious patterns just being hooked up.  And you can also recognize stress level by that, too.  A lot of new things are going on in the field.  I started one of the nation’s first college biofeedback programs.  I learned to meditate and then I was doing a lot of research on the good outcomes of meditation and I was thinking, “Gosh, they are using polygraphs to measure all this.”  The polygraph, when we give the person the information, it’s called biofeedback.  And since I knew that biofeedback was starting up as a field, I thought, “I could maybe be one of the founders in this field.“ All physiology is psychological.  It’s all learning.  Everything that is happening is based on learning. 

SOE:  This has been so enlightening.  Thank you so much for your time. 

Biography
Dr. Bob Whitehouse, EdD, Licensed Psychologist, Board Certified in Biofeedback, BCIA Senior Fellow, Somatic Experiencing Practitioner, Diplomate, American Academy of Pain Management.  Dr. Bob Whitehouse is a licensed psychologist, educator, consultant, Somatic Experiencing Practitioner, and is board certified in biofeedback and in pain management.  He first envisioned holistic health centers in 1984 as an expansion of his own center, then at the historic Hotel Colorado in Glenwood Springs in Colorado, near Aspen and Vail.
Dr. Whitehouse has been in the field of psychology since 1969, first as a rehabilitation counselor, then professor of psychology for 15 years and founder in 1974 of one of the first college biofeedback programs, then in private practice as a psychologist, biofeedback specialist and leader, sport psychology professor, consultant, and presenter around the world on special findings about the heart, breath, gratitude and love. 

A former board member and Insurance and Legislative chair of the Association for Applied Psychophysiology and Biofeedback, he has given briefings to members of Congress and national decision makers, and was awarded two distinguished service awards for service in biofeedback. 

Dr. Bob is partnered with Jacques Kelly, RN in www.breathewellnow.com, a business offering local and over-the-internet individual sessions, group programs and seminars on breathing, HRV, and wellness. He has also developed a Heart Rate Variability and Flexibility training and certification program for those who want to help others attain what research now reveals to be an ideal heart rate pattern with many health, cognitive, and emotional benefits.  Dr. Whitehouse not only trains therapists and coaches, but works with individuals and gives seminars on the benefits and how to get the desired patterns of heart and breath.  With Dr. Rob Ivker, D.O. he is co-authoring YOUR HEALING HEART: Harnessing Heart Energy to Heal Your Body, Mind and Soul.

Contact information: BobWhitehouse@gmail.com  303-417-0293