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

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

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