A Therapist’s Guide

Using HeartMath® Tools

with

Clients with Post-Traumatic Stress,

Addictions, Chronic Pain, Grief and Loss

Sara G. Gilman, PsyD, LMFT

Marriage and Family Therapist
Fellow, American Academy of Experts in Traumatic Stress
EMDRIA Approved Consultant
Encinitas, CA
A Therapist’s Guide: Using HeartMath® Tools with Clients with
Post-Traumatic Stress, Addictions, Chronic Pain, Grief and Loss
Introduction: A message to my fellow therapists and caregivers

As you well know, people suffering from the after effects of psychological trauma are often left
with high levels of anxiety, hypervigilence, poor sleep, depression and a deteriorating quality of
life. Finding effective and worthwhile tools to enhance their stability and relieve stress-induced
symptoms in their day-to-day life can help bring their mind, body and spirit back into balance.

As psychotherapists and mental health professionals we are in a unique position to help many
people restore their lives. Our heartfelt hope for this guidebook is to support healthcare
®
professionals in using the HeartMath tools and technology. Over the years we have learned that
®
many therapists would like to know how to integrate the techniques (Quick Coherence
™ ®
Technique, Inner Ease Technique) and the emWave heart rhythm coherence monitors into
their practice.

The purpose of this guide is to share how therapists are using HeartMath tools in their work with
clients who suffer from posttraumatic stress disorder, addictions, chronic pain, grief and other
trauma related conditions. You will find simple ways to introduce these tools to your clients, along
with rich clinical and case illustrations from colleagues around the world who have developed
effective protocols for the HeartMath technologies with a variety of clinical populations.

In over 25 years of clinical practice I have studied many treatment modalities and like you, have
taught my clients skills that help them to heal and grow. Without exception, the HeartMath tools
are the most utilized tools I teach. I have learned to observe and listen to my clients. The
immediate and ongoing benefits they obtain through the use of these tools have been wonderful
to watch. At first, I thought this was too simple and was curious about why there was such a high
level of compliance and positive reports. I then decided to learn more through my own use and
the many educational opportunities HeartMath offers. This guide is meant to assist you in
streamlining your approach to implementing these tools. In the back of this guide are additional
resources to help you navigate the learning curve to greater utilization of the HeartMath
technologies.

I want to thank the many therapists and health care professionals who willingly shared their
knowledge and experience in this guide. With this Spirit of collaboration, we help each other
impact the many lives we all come in contact with. I also want to thank HeartMath for their
support, professionalism and vision to bring hope and healing to the world.

From My Heart to Yours,

Sara G. Gilman, PsyD, LMFT

Marriage and Family Therapist
Fellow, American Academy of Experts in Traumatic Stress
EMDRIA Approved Consultant
Encinitas, CA
www.saragilman.com

HeartMath is a registered trademark of the Institute of HeartMath. Quick Coherence is a registered trademark of Doc Childre. Inner-Ease is
a trademark of Doc Childre. emWave, emWave2, Personal Stress Reliever and Coherence Coach are registered trademarks of Quantum
Intech, Inc.

©  Sara  Gilman  2018/  [email protected]   1

Treating the Traumatized Client
Following traumatic experiences, clients come to us suffering from symptoms of anxiety,
flashbacks, intrusive thoughts and images, hypervigilance, sleep disturbances, nightmares,
avoidance behaviors, attention problems, etc. This dysregulation of the Autonomic Nervous
System over time can severely impact a person’s quality of life and ability to function in daily
activities. Often people have lost confidence in their ability to calm themselves down and feel a
sense of comfort in their own bodies and mind. How often have we heard clients say, “I just
thought I had to live like this.”

From a neuroscience perspective we know that the traumatized client may be stuck in a fight or
flight mode of response to the world around them. The new field of neurocardiology has
discovered that the heart communicates directly with the amygdala and is involved in creating
emotional experience. Learning to down regulate the Autonomic Nervous System is an
empowering experience for clients. They connect with their own ability to activate the innate
healing wisdom of their heart. This becomes a useful new resource that is strengthened over time
during their treatment.

Before the processing of traumatic material, it is imperative to assist clients in regulating their
current level of functioning. The success in this phase of safety and stabilization is critical to the
positive outcomes of processing traumatic material. At this stage, the HeartMath techniques –
®
Quick Coherence and the Inner Ease™ Techniques – should be viewed as resource tools to
assist in grounding and stabilizing in the moment. As treatment progresses, these same tools are
used to manage emotional states that become overwhelming.

This guidebook provides you with the knowledge to help your clients:

1. Gain useful tools to manage affect and overstimulation of the Autonomic Nervous
System.
2. Provide in session mastery of anxiety and stress response, which builds personal
confidence for further processing of traumatic material, in lowered states of arousal.
3. Intervene with themselves in between sessions for affect management skill building.
4. Discharge Autonomic Nervous System freeze response – releasing immobilizing energy.
5. Increase Adaptive Information Processing skills.
6. Increase Heart-Brain synchronization.
7. Increase the body’s natural regenerative processes.
8. Maintain mental and emotional stability.
® ®
The emWave2 handheld and the emWave Pro products, developed by HeartMath, are
advanced heart rhythm monitors that allow you to observe the heart’s changing rhythms – called
Heart Rate Variability (HRV) – in real time. Since emotions are reflected in the heart rhythm
pattern the emWaves provide the therapist and the client a window into the emotional state of
the client. Research has shown that the incoherence or coherence of the heart rhythm pattern
has direct influence on the rest of the body’s functions, mental and emotional states, and overall
well-being.
®
HeartMath techniques easily integrate into any modality of treating the traumatized client.
Practicing these techniques with the emWave technology will improve the quality and coherence
of the heart rhythms of your clients. Improving heart rhythm coherence can reduce their stress
and reset their physiology.

©  Sara  Gilman  2018/  [email protected]   2

The Heart–Brain Connection and the Role of Emotions
Most of us were taught in school that the heart is constantly responding to “orders” sent by the
brain in the form of neural signals. However, it is not as commonly known that the heart actually
sends far more signals to the brain than the brain sends to the heart! Moreover, these heart
signals have a significant effect on brain function – influencing emotional processing as well as
higher cognitive faculties such as attention, perception, memory, and problem-solving. In other
words, not only does the heart respond to the brain, but the brain continuously responds to the
heart.

HeartMath research has demonstrated that different patterns of heart rhythm (which accompany
different emotional states) have distinct effects on cognitive and emotional function. During stress
and negative emotions, when the heart rhythm pattern is erratic and disordered, the
corresponding pattern of neural signals traveling from the heart to the brain inhibits higher
cognitive functions. This limits our ability to think clearly, remember, learn, reason, and make
effective decisions. (This helps explain why we may often act impulsively and unwisely when
we’re under stress.) The heart’s input to the brain during stressful or negative emotions also has
a profound effect on the brain’s emotional processes—actually serving to reinforce the emotional
experience of stress.

In contrast, the more ordered and stable pattern of the heart’s input to the brain during positive
emotional states has the opposite effect—it facilitates cognitive function and reinforces positive
feelings, emotional stability and perceptual clarity. This means that learning to generate increased
heart rhythm coherence by sustaining positive emotions not only benefits the entire body, but also
profoundly affects how we perceive, think, feel, and perform.

As the heart rhythms become more coherent (smooth and ordered), it can help release the
emotional stress and balance affect, which often results in the reduction of traumatic stress
symptoms such as flashbacks, sleep disturbances, hyper arousal and concentration problems.

© Institute of HeartMath 2011

HeartMath’s Quick Coherence and Inner-Ease Techniques presented in this manual are
simple and effective ways to bring your body systems into synchronous operation
allowing you to move through life in a state of ease.

©  Sara  Gilman  2018/  [email protected]   3

When you begin teaching these techniques to your patients, keep it simple. Here are some
essential steps to follow:

1. Self Discovery: Use the two tools yourself in your day-to-day life. Practice yourself so
you become comfortable with the steps. Obtain and learn to operate the emWave2
device and emWave Pro software program. The more comfortable you are with this the
easier it is to teach it.

2. Educate: Briefly describe what heart rhythms are and what it means to be in coherence.
Allow some time to educate your client regarding the effects trauma has on the mind and
body. Recommend they read “Transforming Stress” by Childre and Rozman.

3. Introduce: Create your own way of introducing the tools that fits your style and
addresses the benefits of practicing in session together. You can write up your own
script or introduction. For example: “Today you’re going to learn an easy and effective
way to reduce the impact of stress on your body and emotions.” Practice by introducing it
to a friend or family member.

4. Practice: Give the client an opportunity to use the techniques and/or the emWave
products consistently, not just during trauma processing. You can explain, “The heart is a
muscle, muscle has memory and must be exercised regularly to stay in shape. To
strengthen this muscle and its’ natural ability to be in a state of coherence, (in the flow, in
the zone) it must be practiced over and over, during non-stressful times as well as during
stressful times.”

5. emWave Technology: When using the emWave technology in session, you can learn a
lot by observing how the client moves in and out of coherence. An easy way to develop a
keen observing eye in this process is to use your emWave device daily. You will discover
firsthand what helps and hinders the process. By strengthening your own coherence
skills you will be able to better facilitate your client’s processing.

6. Complete history of current symptoms and identifying triggers: Whichever

psychotherapy methodology you subscribe to HeartMath tools can play a vital role in
resource development, affect regulation and reduction of symptoms. During history
taking it will be important to ask about bodily responses to trauma symptoms. As you
integrate the emWave technology into your treatment you can go back and check the
original reported symptoms for their frequency and intensity. (What we find with clients
who use the emWave technology consistently over time is a significant reduction of
symptom frequency and intensity.)

7. HeartMath tools as resource development: It is particularly important for the highly

traumatized client to have a clear and dependable connection to positive inner resources.
When someone has been suffering for a long time, connecting to positive resources can
seem like a distant memory. As they learn to connect to themselves through the
HeartMath tools a sense of relief and hope is often reported.

8. Set realistic expectations for the traumatized population: It may seem awkward to
ask a highly agitated or traumatized client to generate a positive feeling as in the Quick
Coherence Technique. At the beginning you may find responses like, “relief or hopeful”
rather than “joyful or confidence”. Most people can come up with a small thing they are
grateful for such as being in the session, petting their cat or that they are still alive. Start
wherever they are. Using guided imagery can help a blocked client gain a sense of calm
or peace.

9. Session closure: Ending sessions in a state of coherence will not only help the client
make the transition to the outside world, it will also help deepen the therapeutic

©  Sara  Gilman  2018/  [email protected]   4

 relationship. Practicing heart focused breathing together creates an environment of safety
and trust. When both client and therapist are in a coherent state together a genuine
exchange of communication easily occurs.

Two tools: The Quick Coherence® Technique, Inner-Ease™ Technique

These techniques can be done with or without the emWave monitors. For further
®
descriptions refer to HeartMath’s Practitioners Guide, The Coherence Coach CD,
Transforming Stress book or take the HeartMath Interventions clinical training program for
health care professionals. These resources can be found at www.heartmath.com (See
Additional Resources at the end of this guidebook)

The Quick Coherence Technique:

 is a friendly way to help people begin to take responsibility for their own
emotions.
 helps reduce the impact of stress on your mind and body and reduces the
energy drain, so you can feel more renewed.
 allows you to step back from your racing mind and your emotionally charged
feelings.
 gives you a chance to pause your emotions and thoughts long enough to
consider the consequences and options.

There are three steps to the Quick Coherence Technique. It is often helpful for traumatized
patients to practice and learn the first two steps until they become calm and comfortable with the
process. This can help them gently neutralize negative states such as fear, anxiety, anger, etc,
and help them to find a more neutral state. The steps are below.

Step 1 – Heart Focus: Gently focus your attention in the center of your chest – in the area of
your heart. (Most people think that the heart is on the left side of the chest, but it’s really closer to
the center, behind the breastbone.) If you like you can put your hand over your heart to help. If
your mind wanders just gently shift your attention back to the area of your heart.

Step 2 – Heart Focused Breathing: As you focus on the area of your heart imagine your breath
is flowing in and out through that area. This helps your mind and energy to stay focused in the
heart area and your respiration and heart rhythms to synchronize. Breathe slowly and a little
deeper than you’re used to, perhaps to a count of 5 in and 5 out. Do this until your breathing feels
smooth and balanced, not forced. Continue until your emotions have become calmer and the
emotional charge around issues or thoughts has become more neutral.

The simplified steps to a more neutral state are … Heart Focus, Heart Focused Breathing.

This will help:

 Stop the impact of stress on your body.
 Disrupt intrusive thoughts or images.
 Eliminate the energy drain.
 Remove the drama or significance of a situation.

Step 3 – Heart Feeling: Make a sincere attempt to recall a positive feeling by remembering a
time when you felt a sense of comfort or calm inside and try to re-experience it. You can

©  Sara  Gilman  2018/  [email protected]   5

remember a beautiful place in nature that you like to visit, or a person you love or care for, a pet
or a favorite activity. It can also be a feeling of appreciation or gratefulness for people or
experiences. Bring these feelings into your heart area and attempt to re-experience them as you
breathe easily and deeply.

Sustain the positive feelings by continuing with the Quick Coherence steps for a few minutes at
first, then increasing the length of time as you become more comfortable with the process.

The simplified steps of the Quick Coherence Technique are . . .

Heart Focus . . . Heart Focused Breathing . . . Heart Feeling

Each step is important.

 The Quick Coherence Technique (QCT) can be practiced anytime, anywhere

with your eyes open or closed, for any length of time. It empowers you to
self-regulate, to shift from one way of feeling to another. QCT goes beyond
the relaxed or neutral state by changing the emotional memories and
patterns that underlie stress. The technique gets your heart rhythm into a
smoother, more regulated pattern reflected by the emWave monitors, and
helps you to reset yourself from the impact of your inner stress.

 Practicing QCT creates more positive new emotional reference points that
can be assessed in stressful situations.

 The power of QCT comes from self-activated, positive feelings. With a little
practice positive feelings become easier to generate and begin to feel
natural.

The Quick Coherence Technique is very effective in the stabilization phase of treatment and
resource development. It can also be beneficial in helping patients arrive at their own insights and
solutions to their problems.

Helping Patients to Realize Their Own Solutions

When patients become more coherent they often see their stressful issues from a broader, more
balanced perspective. I’ve often found it beneficial to suggest they ask themselves what might be
an efficient, effective attitude or action that might resolve the issue. I suggest they quietly sense
any change in perception or feeling and share it with me. I ask them to sustain the new
perception or feeling as long as they can.

Case Illustration:
Dave MacDonald, LCSW, EMDRIA Certified Therapist, Atlanta, Georgia
The Practitioners Guide, p.16. Emotional/Behavioral Disorders Case Study 1, Clinical
Psychology.
“I have a private psychotherapy practice in the Martin Luther King, Jr. National Historic Site in
downtown Atlanta, Georgia. I also spend a day each week in an urban low cost clinic. I work with
adults ranging in age from their early 20’s into their 70’s. In both practice settings most of my
patients are city dwellers. They present with a spectrum of diagnoses ranging from Generalized
Anxiety Disorder to Complex Post Traumatic Stress Disorder. Some seek to resolve creative
blocks limiting their art and others are seeking freedom from lives interrupted by intrusive
recollections of a painful childhood. I introduce each of them to the emWave heart rhythm
monitors regardless of their presenting problem.

©  Sara  Gilman  2018/  [email protected]   6

I usually present the emWave monitors in this manner: I tell my patients that change, while
sometimes desirable (and always inevitable) is nonetheless often contrary to the habitual nature
of humans.

I explain that psychotherapy will often stir up memories and emotions and that part of their
therapy will involve my teaching them some basic skills. These skills, in emotional self-regulating
as practiced with the emWave monitors, will help them to understand and manage these
“periods” so they might make the best therapeutic use of them.

I want to teach my patients how to “soothe” and “ground” themselves. I help them learn that they
can change their minds about a problem by using the emWave monitors to shift the emotional
state. They discover new ways to manage their emotions rather than feeling controlled by them.
The emWave monitors quickly and easily show them the power of their own thoughts and feelings
and the immediate effect they can have on their body. One goal of therapy, stated or not, is
always to heal the past in the present and thereby free the future for new possibilities. The
emWave monitors are valuable tools that help my patients learn that they can change their minds.

I use the emWave technology in conjunction with these psychotherapeutic techniques:

1. Psychodynamic/Insight Oriented (talk) Therapy

2. Eye Movement Desensitization and Reprocessing (EMDR) I believe the emWave Stress
Relief System – now called the emWave Pro – has many elements similar to EMDR. One
primary similarity being the attention paid to multiple stimuli. Similarly, I think of the
emWave Stress Relief System as helping the user to “reprocess or rethink” ideas that
may have gotten “stuck” due to strong emotion or dysfunctionally stored information. I
suspect the emWave Stress Relief System might have a similar effect on sub-clinical
problems that professionally administered EMDR has on more florid clinical issues.

3. Peak Performance Enhancement.

Case Illustration:
Jeffrey W. Smith, MFT,
EMDRIA Approved Consultant
Vista, CA

“I use HeartMath’s emWave Pro with a large screen monitor for my clients to observe real-time
feedback of their Heart Rate Variability (HRV) during their clinical treatment. This unique tool is
significantly beneficial to both the patient and clinician/coach by being able to evaluate and track
their progress in self-regulation while processing traumatic events/memories. The emWave Pro
monitors the patients pulse and plots the data in an interactive presentation that depicts low,
medium and high states of coherence using a dynamic chart, colors and sound tones to entrain
the mind/body/field. Being able to move from low to medium and on to high coherence is
powerfully rewarding to the patient. They experience increased attunement with their thoughts,
emotions, body sensations and environmental awareness. I encourage my clients to also use the
emWave hand held unit at home and outside the clinical setting to reinforce the trauma recovery
process. As clients learn to shift from low to high states of coherence in a variety of settings and
circumstances, they feel empowered and confident to move through their past traumas and really
begin living their life dreams.”

©  Sara  Gilman  2018/  [email protected]   7

Frequently Asked Questions from Therapists – “What if…?”

What if the client cannot identify a positive feeling or find anything to appreciate?
When a client is unable to clearly identify and recapture a positive feeling, usually it is because
they are trying to identify a big feeling. Remember that feelings such as love often have a bitter
and a sweet side to them. The client suffering from trauma and loss may be emotionally
disengaged due to the pain. Start small with a quiet or calm place in their body or a recent
moment of relief. Look for subtle shifts such as a spontaneous deep breath, change in posture or
muscle tone, increased swallowing, then use your own intuition to help the client see this as
positive. Acknowledge this may be difficult at first and with practice their ability will improve in
time. The heart focused breathing can be helpful here until they develop a greater comfort level
with a calmer state.

What if the client has great difficulty identifying feelings and distinguishing between
feelings and bodily sensations of emotional arousal?
In some cases, the client may be suffering from Alexithymia, where they have difficulty identifying
and describing feeling to others. Primary Alexithymia is more of an enduring psychological trait
where Secondary Alexithymia is a state that is dependent upon and disappears after a stressful
situation has changed. This may be seen in cases of PTSD and physical trauma. Using
HeartMath tools in these cases requires patience and encouragement. They may find working
with emotions produces symptoms of anxiety or depression and often will be unable to tell that
the change in the autonomic arousal system is separate from their feelings of stress, even if there
are improvements in coherence ratios. Clients with secondary alexithymia may limit their use of
emotions in a self-protective way to avoid recalling overwhelming emotions. Start slow with heart
focus and heart breathing and let them describe what they are experiencing. You can assist them
by asking questions like; “If the feeling were a color, what color would it be? If it had a texture or
shape?” Helping them feel safe while encouraging this process will help them move forward.
(Special clinical considerations should be emphasized when working with clients with significant
attachment disorders or dissociative disorders.)

What if the person is uncomfortable breathing slowly?

When asked to breathe slowly, a client did not want to do it. When the therapist asked why, she
said “My grandfather who abused me would tell me to breathe slowly while he was hurting me, I
can’t do it.” The therapist simply said, “Ok, for now can you simply refocus your attention to your
heart.” She started with that and as trust developed and information about the impact of traumatic
stress was introduced, the client was able to begin to breath along with the exercises, while
orienting to the current time and without being consistently triggered from the past events.
Remember these tools are about emotional refocusing and restructuring thoughts and feelings
while breathing.

The following technique can also help.

Inner-Ease™ Technique* – Basic Steps

(1) If  you  are  stressed,  acknowledge  your  feelings  as  soon  as  you  sense  that  you  are  out  of
sync  or  engaged  in  common  stressors—  feelings  such  as  frustration,  impatience,
anxiety,  overload,  anger,  being  judgmental,  mentally  gridlocked,  etc.
(2) Take  a  short  time  out  and  do  heart-­‐focused  breathing:  breathe  a  little  slower  than
usual;  pretend  you  are  breathing  through  your  heart  or  chest  area.

©  Sara  Gilman  2018/  [email protected]   8

(3) During  the  heart-­‐focused  breathing,  imagine  with  each  breath  that  you  are  drawing  in  a
feeling  of  inner-­‐ease  and  infusing  your  mental  and  emotional  nature  with  balance  and
self-­‐care  from  your  heart.  It’s  scientifically  proven  that  radiating  love  and  self-­‐care
through  your  system  activates  beneficial  hormones  and  boosts  your  immunity.
(4) When  the  stressful  feelings  have  calmed,  affirm  with  a  heartfelt  commitment  that  you
want  to  anchor  and  maintain  the  state  of  ease  as  you  re-­‐engage  in  your  projects,
challenges  or  daily  interactions.

It’s ok if a disruption takes you out of the ease-state throughout the day; just reset your intention
with a genuine heartfelt commitment and start again. You’ll have to reset your commitment
periodically, yet soon you can remain longer in the ease-state and with lower maintenance. In a
short time, with practice, you won’t need to labor through all the steps. You will be able to skillfully
and consciously just “breathe” yourself into the ease-state.

* Reprinted by permission of Doc Childre. Download and share with others as long as you attribute the work to Doc Childre
without changing it in any way or using it commercially.

A therapist describes his experience with HeartMath tools after Hurricane Katrina:
Natural disasters, critical incidents, medical traumas and military combat all require immediate
response to manage life threatening stress and trauma. HeartMath has developed a Short-term
crisis/Trauma Protocol (Heal the Moment). This protocol helps to neutralize stressful emotions
and increases the ability to think clearly in times of extreme stress. This protocol is taught in the
HeartMath Interventions Certification training for health professionals.

Butch Robicheaux, LCSW

Clinical Director, Family Services of Greater Baton Rouge
Butch and other therapists used HeartMath tools in the first six weeks following Hurricane Katrina.
In his YouTube presentation (http://www.youtube.com/watch?v=E61WHQD2OvU) he discusses
how the hurricane survivors had lost everything, were displaced and grieving. They were suffering
from severe anxiety. He talked with them about our inability to control our outside environment
but we can control how we will perceive things and how we will respond. Teaching the Quick
Coherence Technique produced immediate relief for many adults and children.

PTSD and Military Personnel

Troops returning from Afghanistan and Iraq are experiencing the highest rates of PTSD in the
history of the military. It is reported that an average of 18 returning service members commit
suicide each day. It is clear the stress of military service affects those enlisted and their families.

Research joins with practical applications in addressing the after-effects of

Military Combat.
In July of 2010, the journal, Alternative Therapies in Health and Medicine published an article
entitled; Cardiac Coherence and Posttraumatic Stress Disorder in Combat Veterans, by Jay P.
Ginsberg, PhD; Melanie E. Berry, MS; Donald A. Powell, PhD
It reads:
“All 10 of the pilot study participants expressed enthusiasm about their experience in the HRV
pilot study and their perception of its benefit to everyday living. The PTSD+ veterans were

©  Sara  Gilman  2018/  [email protected]   9

particularly enthusiastic about the benefits of HRV, as shown by this statement that one of the
PTSD+ veterans made to study personnel during the final debriefing:
“I am an OIF and Gulf War veteran. I recently returned from Iraq, where I experienced 5 IEDs and
1 RPG explosions. To deal with all the pain I felt after I got back I self-medicated for several
months with alcohol and marijuana, but after weaning off of both I was determined not to use
narcotics of any kind to cope with the pain. Being part of this experimental HRV training program
has changed my life and given me a practical, non-medicated way to reduce the pain and handle
the stress. One time in particular, stress from the relationship with my wife was robbing me of
sleep and causing me to lose control. I remembered the emWave tool and after about 30 minutes
of practice I was calm and able to go back to sleep. The benefits of HRV training are so much
better than medication because I am learning a way to self-regulate anywhere, anytime without
risk of dependency or that drugged feeling. I’m so grateful for being part of this pilot study. My last
BP reading was 115/76, compared to previously when it was 120/95. My heart rate has dropped
from the 90s to the 70s.”

A veteran therapist has a passion for working with Military Veterans who suffer from
PTSD.
Dr. Jonathan Douglas, Ph.D., Clinical Psychologist
Barrie, Ontario.
“I’ve been using HeartMath software products in my clinical practice since the late 90s, and have
always found them to be highly beneficial in my treatment of anxiety disorders in general. The
emWave device added significantly to the utility of HRV training, providing my patients with the
opportunity to practice at home or on the street.

My current practice is based largely on the treatment of Veterans and active Members of the
Canadian Forces. Most of my patients have PTSD. In this population, the emWave device is
particularly and uniquely beneficial. I compare the motion of the LED lights to sitting at a
campfire: the stimulus naturally draws the attention, and it’s easy to remain focused on it. This
means that flashbacks, dissociation, irritability and anxiety can be handled with a device that can
be carried in a pocket or purse, and which provides nearly instantaneous grounding. With
practice, the [heart focused] breathing exercises have the potential to reduce the frequency of
such events—and the “coolness” factor [of the emWave monitors] encourages my patients to get
that practice regularly.

When treating trauma, a phase-oriented approach is best. Phase One involves stabilization. This
includes the assessment phase; psychoeducation about the disorder; and the introduction of
cognitive behavioral techniques aimed at symptom reduction, including relaxation strategies and
grounding techniques. It’s in this phase that I introduce the emWave program and device. Phase
Two includes confronting triggers and memories through exposure techniques such as
EMDR. This more challenging phase is made more tolerable by the patient’s familiarity with the
Phase One interventions, and the emWave device often helps to deal with the sequelae to a
tough session. Phase Three focuses on rehabilitation, and again, the emWave device can be
beneficial in increasing stress tolerance, improving sleep, and reducing fatigue, all of which will be
helpful as we return the patient to his or her productive life.

I continue to use the emWave Pro program as well, which allows me to provide detailed coaching
on the process of learning the technique. I generally begin teaching about HRV with training on
my computer in my office. Introducing the device is then quite simple: I explain that the
[emWave2 portable] device contains essentially the same software, allowing them to transfer
their training to the use of the device. I lend them the device for use at home, and if they choose
to keep it, they can reimburse me for the purchase price later on. (The devices are not covered
by Veterans Affairs Canada at this time. However, I have often had success getting other
insurance providers to cover their cost).

©  Sara  Gilman  2018/  [email protected]   10

Once I have trained the patient in the use of the device, I often don’t use it again within the
sessions; however, I frequently use the breathing techniques which they have learned. Deep
breathing is a component of exposure therapies such as EMDR, and I suspect that their prior
learning of HRV and practicing with the device helps my patients use the deep breathing more
effectively. Indeed, once the patient is well trained with the device, taking just a few a deep
breaths likely becomes a stimulus which leads to the conditioned response of feeling calmer,
more relaxed, and more centered.

What’s more, HRV device training teaches people to be aware of the feeling of their beating
heart. This sensation may have formerly been a signal of an impending panic attack—and may
have been something of a self-fulfilling prophesy, leading to anxiety whenever they felt their heart
beating. Through training, anxious patients can learn to not only tolerate the sensation of their
beating heart, but to use that sensation for their own benefit.”

Complex posttraumatic stress = complicated symptoms and complicated

treatment.
Complex trauma can result from sexual abuse, physical abuse, emotional abuse, domestic
violence, childhood neglect, torture, military combat and experiences where someone is exposed
to multiple life threatening events. Treatment for C-PTSD requires a multi-modal approach.
Problems associated with this disorder include emotional dysregulation, dissociation,
psycholgocial fragmentation, interpersonal problems, loss of a sense of safety, trust and self-
worth. There is a tendency for these clients to be re-victimized. One of the most important
features in C-PTSD is the person’s loss of a coherent sense of self.

Therapists who work with this population have effectively used HeartMath tools as part of their
integrative treatment.

Jeri Lynn Schroeder M.S., M.A., LCPC

Portland, ME
“One of my clients in his early 60's with complex PTSD, learned to manage his flashbacks
through utilizing HeartMath tools. He has never wanted to work directly with his trauma.”

Eye Movement Desensitization and Reprocessing (EMDR) Therapy

EMDR is a comprehensive psychotherapy treatment approach developed by Dr. Francine
Shapiro in 1986. There are over 20 controlled research studies to date and it is the most
researched treatment for PTSD. EMDR is a top rated therapy for the treatment of PTSD. Many
EMDR trained therapists have integrated HeartMath tools into their trauma treatment either in the
early phases of resourcing and stabilization or later in the ‘future template’ phase.

Andrew M. Leeds, Ph.D.

EMDRIA Approved Consultant
Director of Training
Sonoma Psychotherapy Training Institute
(http://www.heartmath.com/health-professionals/health-professionals-speaker-series.html)
“I use the emWave computer based technology in my practice in two distinct and different ways.
First, I use it to help selected patients develop self-capacities for emotional and physiological self-
regulation. These patients find the visual feedback from the emWave Pro program helpful to
validate their perceptions and skills for self-soothing. Some of these patients go on to purchase
the technology for use in their homes or workplace settings. I also have used the emWave Pro

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to monitor certain patients during standard and modified EMDR procedures to detect changes in
their physiological states that may be difficult to directly observe. These patients tend to be
survivors of severe early neglect and abuse with avoidant or disorganized insecure attachment
who developed rigid dissociative defenses (in Cluster C related personality disorders) or
structural dissociation of the personality (in DDNOS or DID). Sudden increases and decreases in
heart rate and heart rate variability appear to be associated with spikes in arousal and
subsequent dissociative changes in discrete state when these patients exceed their "window of
tolerance" or encounter external or internal threat cues. The emWave Pro has helped me to
recognize these moments more easily and to help me to clarify whether my interventions are
resolving (or triggering) these patients' clinical issues.”

Carol Maker, LCSW

Inner Courage LLC, Portland Oregon
“In working with highly traumatized clients it is important to see the results of Heart Rate
Coherence in the context of the full clinical picture.

For instance, a DID (or suicidal) client may have one part of the self able to obtain coherence and
one part that may not, making coherence achieved with HeartMath one of several important
indicators in the assessment of safety issues.

And although some trauma victims may find HeartMath immediately helpful, others may not find it
soothing at first. For these patients, letting go of hyper-vigilance can be irritating or even terrifying,
as they have relied on this state to survive and may not have access to other states.

Therefore, in my experience, we should refrain from making a clinical judgment about not being
able to achieve coherence as "bad" or as "resistance." Ideally, the successful use of HeartMath
tools with trauma processing (as in EMDR) allows a client to understand they have an available
relief from the symptoms whenever they want, and that they are strong enough to face the
emotions with proper clinical support.”

Steve Sawyer, LCSW, CSAC

Clinical Director/ Co-Owner
Dynamic Interventions & New Vision Wilderness Program, Germantown WI
“Throughout my last 10 years of intensive trauma and attachment focused clinical interventions
the science of HeartMath has proven to be one of my most effective tools when used in
combination with other advanced clinical interventions. This is based in the evidence from
hundreds of interventions that I have both supervised and performed. The state of high
coherence makes all forms of clinical intervention easier to implement and helps produce a long
lasting effect. For instance, in EMDR therapy I have noticed a state of high coherence allows for
the client to more effectively identify targets, and perpetuates bi-lateral stimulation to work more
effectively by preventing dissociation.
Another key variable in trauma treatment is the perception of real or imagined powerlessness.
HeartMath’s protocols are a self-empowering approach to calming the nervous system. The
techniques allow traumatized clients to take charge in their own therapeutic process eliminating
the helplessness response. In my work with wilderness therapy the sense of powerlessness is
imminent and HeartMath’s techniques are a crucial buffer keeping our clients from becoming over
stressed. Coherence focused interventions ensure that the therapeutic process can continue
without the rise of defenses, shame, and fear responses that accompany trauma allowing for
continuous therapeutic gain. The neurological effects of HeartMath practice are truly a therapeutic
catalyst in trauma treatment. HeartMath tool practice is empowering in the healing process
through the clients own efforts and allows for advanced interventions like EMDR, Traumatic
Reprocessing models, or Narrative work to occur without the strong internal resistance.”

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Jeri Lynn Schroeder, M.S.,M.A., LCPC
Portland, ME
“I introduce HeartMath tools to every one of my clients on the second session. I think about the
heart breathing as part of resourcing. When actually doing EMDR, I emphasize the connection
with the heart as a grounding support for staying in the process. I ask my clients to practice
extending the Quick Coherence Technique (QCT) once or twice a day starting with five minutes
and then ask them how the practice is going as a follow up. I also teach them to use QCT during
conflict with another person by noticing the energy arising from the conflict, ask them to connect
with their heart and find something they appreciate about the other and extend that towards the
other or just send compassion towards the other. I feel like the science and research behind the
HeartMath system and the simplicity and empowerment of these skills provides us with solid,
profound, applicable tools to offer to our clients.”

Emergency Service Personnel and First Responders

911 Call Center Operators experience near daily exposure to callers in the midst of life-and-
death traumas. They have frequent and direct contact with traumatizing events including "Officer
Down" calls, the suicide of callers, calls involving death or injury of a child and more. Repeated
exposure to this kind of acute stress can have a serious personal impact on operators including
life-changing problems in mental and physical health, job performance, and their relationships.
The case study results below presents how HeartMath tools have helped operators reduce their
stress both in-the-moment and over the long term.

Jim W. Marshall III, M.A.

Director, MasterCare Institute, PC, Founder 911 Training Institute
Petoskey, Michigan
“Following my discussions with HeartMath staff and reading the peer reviewed journal articles on
Coherence, and subsequently purchasing my own emWave device, I have felt compelled to
educate my clients and the 911 professionals I train about HeartMath. There is simply too much
value to be gained in personal health and peak performance to overlook this science
and technology. When offering psycho-education, I hear myself sounding like a spokesperson for
a treatment, service, and technology that I don't profit personally from espousing. I know that
comes from personal conviction that it is simply best for my clients and students. That has been
the case with HearthMath tools. Self-medication and ignorance must give way to self regulation of
stress among those who struggle with anxiety, depression, trauma; and any process folks can
learn that empowers such skill building should be on the top of our list as helpers!”

Sarasota County 911 Call Center: HeartMath Training Results

Sarasota County, FL

Comparative Results Highlights: All numbers are average paid per quarter over a one-year
period. The control group did not receive HeartMath training or any other stress management
training. These individuals were chosen due to similar job, stress, and working conditions, and
were used as a comparative basis for results.

Significant improvements in the HeartMath trained group include

• Medical Expenditures – The control group average Medical Paid per quarter increased
by 19%. The HeartMath trained group average per quarter decreased by 11%.

©  Sara  Gilman  2018/  [email protected]   13

 • Total Medical and Pharmacy Expenditures – The control group average per quarter
increased by 30%. The HeartMath trained group average Total Paid per quarter
increased by 8%.

• Utilization
o ER Visits / Admissions
 Control group decreased by 17% per quarter.
 The HeartMath trained group decreased by 50% per quarter.
o Scripts
 The control group number per quarter increased by 30%.
 The HeartMath trained group increased by 9%.

• Risk Index (RI)

o The control group average RI increased by 20%.
o The HeartMath trained group average increased by 10%.

• Care Gaps (CG)

o The non-intervention group average number of CG’s decreased by 11%.
o The HeartMath group average decreased by 22%.
o While surprising that the non-intervention group showed a reduction in CG’s
without some form of intervention, the HeartMath group showed twice the
improvement of the non-intervention group.

Risk Index (RI) – Indicator of health status based on unhealthy habits and activities
(lower is best)
Care Gaps (CG) – Gaps in an individual’s medical care that could lead to a medical incident
(lower is best)

Addiction Recovery: When Trauma and Addiction Collide

Many people who are recovering from substance abuse and other addictions experience high
levels of daily anxiety and mood changes. It is common knowledge that a high incidence (30-
50%) of people who suffer from substance use disorder also have PTSD. PTSD is known to
negatively affect outcomes in SUD treatment. What addiction therapists see is once a client is
clean and sober symptoms of PTSD resurface (anxiety, hypervigilence, arousal, flashbacks,
insomnia). Living with these symptoms over time can increase the urge to return to substances to
medicate the discomfort. Current research supports a self-medication model and recommends
using integrated interventions for overall improved treatment outcomes.
Therapists and clients have discovered how HeartMath tools easily integrate into addiction
treatment. Educating substance abusers about hyperarousal in the limbic centers of the brain
helps them understand the inner brain-driven decisions that previously were inexplicable to them.
Educating them about the relationship between trauma and substance abuse helps them see how
one impacts the other. Heart focused breathing and the Quick Coherence Technique are effective
tools to integrate early in treatment. Helping clients understand their trauma symptoms and giving
them tools to intervene sooner than later may help to prevent relapses. The tools can be utilized
for urge reduction as well.

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Case Illustration:
For Robert, emotional relapses of explosive anger always preceded his relapse into drinking.
After years of this rollercoaster he joined Alcoholic Anonymous to address his alcohol addiction.
His sobriety was going well. He attended weekly AA meetings and worked closely with his
sponsor going through the 12 steps of the program. His anger resurfaced which created fear and
anxiety of the explosiveness returning. While working through the steps with his sponsor, Robert
was triggered by a traumatic memory when he was 5 years old, which connected him to the
origins of his explosive anger. Robert entered therapy to address the underlying traumas. I
explained the vicious cycle of trauma and substance abuse and how they negatively affect each
other when left untreated. I then explained the HeartMath concepts regarding hyper-arousal of
the limbic system and the impact on heart rate variability. I taught him heart focused breathing
and the Quick Coherence Technique along with emWave technology for daily emotional
management and as a precursor to trauma processing with EMDR therapy. Robert reported an
increased ability to manage his anxiety and irritability at home and at work. His inner confidence
grew. The trauma processing through EMDR resulted in a positive reconnection to his younger
self. The sting of the trauma was transformed into a positive sense of self. He remarked that
using the HeartMath tools helped him know he could soothe himself as well as shift his current
emotional state. He also reports his current irritability is related to present day life stressors and
he now knows what to do to manage it.

Amy Hudson, Ph.D., CADC

Supervisor, Chemical Dependency Unit, Mississippi State Hospital
Jackson, MS
“We have treated more than 250 people at this point, the vast majority of them from the chemical
dependence treatment program I supervise, and virtually all of them receiving HRV training with
the emWave Pro. I continue to be thrilled and moved by the results they achieve. Early sobriety
is difficult, partly because the nervous system has become so unbalanced by drug and/or alcohol
abuse. HRV training addresses that problem at its root. I know with complete confidence that
many of these trainees have increased their chances of staying sober immensely by learning how
to get into the “zone”. It's also amazing how well HeartMath training fits with 12-Step concepts.
Meditation and conscious contact with a Higher Power are very, very hard concepts for a lot of
folks to grasp, and they are ESSENTIAL to recovery (in the 12-Step model). Once patients have
experienced the "zone" through Quick Coherence and use of the emWave Pro, they get it. For
many of them, that becomes their way of meditating and connecting with their Higher Power.
Suddenly two of the most elusive but most important 12-Step tools are completely available to
them at any moment. It is very exciting to see. We continue to be absolutely thrilled with the
emWave technology. Just wanted you to know how much we are appreciating the HeartMath
system down in Mississippi!”

Chronic Pain: Patients Find Relief While in Heart Rate Coherence.

Client’s coping with chronic pain can suffer from depression, anxiety, grief and loss due to the
impact their pain has on the quality of their lives. Coping with ongoing pain can be exhausting to
the mind and body. Using HeartMath tools has been shown to have a positive effect on those
dealing with physical and emotional pain.

Rollin McCraty, Ph.D., Director of Research Institute of HeartMath, explains why this relief
occurs in an article titled; “Afferent Vagal Information and Pain Perception”.
“Numerous reports from individuals who have learned HeartMath techniques indicate that they
are able to modulate pain levels by utilizing the tools. This is true of both visceral pain, such as
angina and joint pain, and coetaneous pain, such as a stubbed toe or scrape. Increased afferent

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activity associated with coherent heart rhythms evoked by the application of these techniques
affect the neural mechanisms involved in pain reduction. A number of studies have shown that an
increase in afferent vagal activity inhibits the flow of pain signals traveling to the brain. Several
mechanisms have been identified which explain how increased vagal afferent activity decreases
pain sensitivity and increases the pain threshold.”

Case Illustration:
Carol Linnell, Pain and Rehab Clinic, Centinela Freeman Health Systems, Inglewood, CA

Sally’s problem with chronic pain began about 8 years ago. She developed back and right leg
pain from a work-related injury and had surgery to correct a disc problem. The surgery was
“successful” but her pain never improved. Sally’s emotional state began to worsen. Overcoming
her fears, she decided to go ahead with a second surgery on her back. That surgery was also
“successful”, but she developed an infection in the surgical site and was bedridden for 4 months,
feeling like a total failure. Her back pain continued and she also developed right knee
degenerative arthritis.

“After my second surgery I couldn’t walk; I could barely stand up. I was given 24 visits with
physical therapy, but that was not enough. By then I needed a walker because I couldn’t stand
on my own, and used one for several years. Then I tried NOT to use the walker, but I had
balance problems and I thought using 2 canes was the solution. But that ended up not being a
good thing, but I didn’t know it – I would have been better off with the walker, because using 2
canes ended up really hurt my arms. I never really improved over the years, even though I had
occasional physical therapy, acupuncture, and psychotherapy. Besides that, all I was offered for
such a long time was a bunch of pills or an epidural shot. I still couldn’t stand for long and went
back to the walker, but couldn’t go very far. I couldn’t sit up in bed or stand up from a chair
without a pulley or assistance. I felt so lonesome, useless, and worthless by then. I had gained
weight because I was feeling “What’s the point – life’s not worth living if this is the way it’s going
to be”. I was feeling worse and worse. I was totally drained, like I was just taking up space. After
waiting for a long time, I finally heard that I was eligible for the Pain Management Program and I
cried the whole day. . I was really looking forward to the program. I wanted to do whatever it
took to get out of my mental and physical funk. I was scared. I hoped my body wouldn’t let me
down. I wanted to come out as a human being again. And I kept going. The best thing that
could have happened to me was that program. I was introduced to HeartMath and it was
wonderful. HeartMath taught me that I could handle my pain and depression. It takes practice,
and a willingness to keep trying, but it can be managed. There are real good lessons that I
learned, like that Neutral Place. I’ve really needed to use that when situations around me or my
pain gets challenging. Sometimes my knee gets so bad that I almost fall and I get angry. Then I
tell myself, “before you get all upset, just get in that Neutral Place”. Then I can shift focus to the
positive. I can deal with it then. I’m going to have a total knee replacement real soon and will
have a brand new knee. My depression level is almost non-existent now. I just don’t feed into it;
I act before it takes a hold on me, when I feel it coming on. I use HeartMath tools to find a
positive outlook, and without it I probably wouldn’t have been able to deal with all the stress and
pain I have. I’m not taking any pills anymore (except for blood pressure and thyroid). I’m off
Soma, Vicodin, Neurontin, Kepra, Topamax, and Cymbalta. I’d be taking something if not for
HeartMath. I found my attitude changed after I started using HeartMath. I really began to feel
like I could actually live with my pain. It gave me a focus. Yes, life sent me some curves, and my
pain probably won’t go away. But you have to take control of you- your feelings, your pain – and
not let it control you. I talk to my pain: “I’m not focusing on you today”. It works. I’ve expanded
on feeling heart feelings to doing things that I enjoy. I think everyone needs to find something
that they always have enjoyed or can enjoy if they can still do it. I love music. I always have,
even before I could walk. I’ve been so depressed that I didn’t feel like listening to music. I’d be
lying around and just didn’t want to get up and go all the way across the room and turn on the
music. Now I’ll be singing, dancing, and moving every body part that I can. I find it takes my

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mind off of what’s going on. My leg will still be hurting, but I move every part that I can move. It
helps to really feel better. That’s just one little thing. It’s different for others. I just know that I
have to find a different way of doing things, just as long as I can find enjoyment in my life. I saw
the psychologist I’ve been seeing for several years and he said “You’ve got your cane, but you’re
swinging it!” I don’t have back pain every day now, but my knee is the major problem. I’m going
to the YMCA 3x/week and doing what I can: getting in the pool, using a recumbent exercise
machine, and doing group exercises in a chair. I’m optimistic about my knee replacement
surgery and looking forward to an improved quality of life – volunteering, working, driving, having
fun. I’m just staying focused and not letting depression get ahold of me.”

Grief & Loss: Healing the Broken Heart

Traumatic grief or complicated mourning are conditions where both trauma and grief coincide.
Treating traumatic grief requires a high level of sensitivity and a focus on the individuality of each
case. Whether it be a sudden death or prolonged illness, a personal medical crisis where there is
a loss of functioning or one’s own impending death, each situation has stages of intense
emotional states. It is important to note that HeartMath interventions are not meant to suppress or
prevent any stages in the grief process, but should be viewed as tools to manage emotional
states that become overwhelming.

Sara G. Gilman, M.F.T.

Fellow, American Academy of Experts in Traumatic Stress
EMDRIA Approved Consultant
Encinitas, CA
“I consistently teach my clients Heart-focused breathing, Quick Coherence Technique and
extending the Quick Coherence Technique for longer periods of time within the first few sessions.
This way we can practice in each subsequent session and follow up on how they are utilizing
these tools in their day-to-day life. I reinforce this work by using the emWave2 handheld and
emWave Pro version to help clients get direct feedback. As an EMDR therapist, I have found
these tools to be excellent in stabilization. When focusing on new behaviors (future template) for
their future, I have the client get into heart rate coherence while visualizing the future experiences
and how they want to respond.”

The following Case Illustrations are from my own experience working with individuals and
underserved populations.

Case Illustration:
In her early 30’s Jen was a dynamic young women who had completed her graduate degree,
happily starting her career and engaged to be married. One day she received a phone call that
her mother was in the emergency room following a terrible car accident. Thousands of miles
away, Jen headed home to be with her. Tragically her mother died days later. 8 months had gone
by and Jen was barely functioning. Unable to get out of bed some days, difficulty sleeping,
profoundly depressed, losing weight and cried daily. She entered therapy at her family’s
insistence. She did not think anything would help saying, “nothing will bring my mom back, she
was my best friend, what is the point.” At the first session Jen was visibly shaking, had dark
circles under her eyes and had difficulty maintaining eye contact. As she began to explain what
happened to her mother she slumped down and began to quietly cry. The therapist said what
happened is important, however she would like to wait on hearing the details. She asked Jen to
shift her focus to her chest in the area of her heart and simply breathe, letting other thoughts just
go by for now. Jen replied, “I can’t, my whole heart aches, I am afraid I can’t go on.” The therapist
asked her to place her hand on her heart for now. As Jen did this, she slowly began to take short
breaths. After a few minutes she spontaneously took a deep breath and following a long exhale,

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looked up and said, “Wow, I don’t think I have been able to breath in 8 months. What happened
to me?” At this point the therapist educated her about the impact of traumatic stress on the mind,
body and spirit and how grief is a process with stages to move through. Jen kept her hand on her
heart during the entire session. As she was leaving she said, “maybe I can heal from this, I just
don’t know yet.” The therapist said, “For now, just keep breathing through your heart.”

The End of Life – A Matter of the Heart.

Randy was dying of brain cancer. He was an active and vibrant 60-year-old when he faced the
news of his diagnosis. Towards the end of his life I made house calls to be by his side and
support the family. His speech deteriorated so our communication was done through hand
signaling and me responding with words of comfort. One day when the struggle to talk looked so
painful for Randy, I took my hand and placed it on his heart saying, “Let’s just heart breathe
together. Let go of whatever you were thinking for now and just focus on your heart.” Keeping my
hand on his heart, gentle tears rolled down his face as his body relaxed. While we continued to
breathe together for several minutes, Randy reached up and placed his hand on my heart. We
continued to breathe together as gentle tears flowed down our faces. Randy smiled and so did I.
As the days went by I noticed something - Randy could no longer talk, however he had many
visitors and with each one who sat by his side he would place their hand on his heart and his on
theirs and they would breathe, smile and sometimes cry together.

Women’s Shelter for the chronically homeless. The residents have lived in highly stressful
environments while previously homeless. Many suffer from depression, substance abuse and
panic disorder. I asked the staff what is the number one problem they see in the women. They
unanimously said, “Anxiety.” Then I asked what the number one challenge for the staff was. The
staff described feeling overwhelmed with work and the multiple needs of the women.
I first held a staff meeting where I educated them on the effects of stress on the nervous system
and heart rate variability. I then introduced them to the emWave technology as well as heart
focused breathing and the Quick Coherence Technique. The staff began to use the tools in their
weekly meetings and teach them to the residents. Everyone joined together learning to reduce
anxiety. There have been reports of greater staff productivity; decrease feelings of burnout and
outbursts among the residents are more easily managed.

Demona Program/Case Manager

Wise Place, Inc. Residential Home for Women
“Thank you for the follow up, we are using the emWave monitors and they are great. We are
currently using them prior to staff meetings, I will use it prior to my busier days, they are also used
tremendously in case management to assist the ladies in staying on subject. This tool has also
assisted the ladies in breathing techniques and they really love to see themselves go from RED
to GREEN.”

Women’s Sober Living House

I met with the Director of a sober living house. The director described her residents as suffering
from PTSD, multiple relapses, anxiety and insomnia. I spent 90 minutes educating the residents
about the effects of stress and taught them heart focused breathing and the Quick Coherence
Technique. The emWave device was passed around to help them see the levels of coherence
and get a felt sense of the experience. Guided Imagery was added, focusing on a Safe and Calm
place in nature that was uniquely theirs. They were instructed to use the tools throughout the day
and to use the Safe place imagery along with the heart focused breathing at night before they
went to sleep. Within 2 weeks the women were reporting better sleep and more confidence in
handling situations throughout the day. A follow up session was scheduled to reinforce the

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process and address any questions. One resident in her 50’s said, “I can’t believe at my age, I’m
finally learning to breathe and how it is helping me to think more clearly.” Another resident was
surprised at how easily she was falling asleep after years of tossing and turning.

San Diego’s Survivors of Suicide Loss Foundation uses HeartMath tools to begin and end
their support group meetings.
People who have lost a loved one to suicide struggle to come to terms with this traumatic
experience. The pain, grief and loss along with facing the stigma suicide still has, can be a long
difficult process. Support groups for these survivors, provide a unique place to go where others
relate to the experience and the pain associated with it. Facilitators of these groups are generally
survivors themselves. I met with a small group of these facilitators and asked what was the most
challenging part of their leadership in the groups. They described wanting to do something to help
in the moment when someone is crying or when someone is emotionally triggered while hearing
another’s story. I spent an hour educating them about stress and heart rate variability. I then
taught them heart focused breathing and the Quick Coherence Technique. They decided it would
be helpful to begin and end each group with “heart focus, heart breathing.” Accessing a positive
feeling was added to the end of the group by asking everyone to think of a positive quality they
appreciated about their loved one. The facilitators found this to be empowering as they felt they
could offer something that would make a difference in the moment. Attendees began reporting
the use of heart focused breathing throughout the week to help them move through the pain and
grief.

Students who suffer from Attention Deficit Disorder and test anxiety use HeartMath tools
for improved performance.

Students with ADD often suffer from low self-esteem and inconsistent performance in school.
Parents observe their students’ high levels of anxiety and emotional fatigue while struggling over
homework. Test anxiety often occurs when students feel the pressure to perform in a specific
time frame. Therapists who introduce the HeartMath tools to parents and students find efficient
improvements in patience, concentration, retention and test performance.

Case illustration:

Seth, a 24-year-old young man was diagnosed with moderate Attention Deficit Disorder in junior
high school. He intermittently used prescription medications and under performed through most of
high school. In college he developed certain study habits to minimize distractions. While
beginning his intensive study schedule (6 + hours per day) for the Medical School entrance exam
(MCATS) he found his concentration inconsistent, his fatigue increasing and he became more
irritable and anxious. His mother noticed increasing dark circles under his eyes and mentioned to
him that he seemed particularly irritable. He said he wasn’t sleeping well and was beginning to
worry about he amount of time it was taking him to get through the practice tests. He began to
feel anxious about his ability to perform on the exams. She recommended he make a session
with a counselor who specialized in peak performance enhancement. He was willing and hoped
he would gain some insight into a more efficient way to move through the exams. I spent one
session introducing the emWave technology and educated him on heart rate coherence. I
recommended he spend 10 -15 minutes prior to each study period getting into heart rate
coherence with the emWave. I also told him to use it at the end of each study period and before
bed each night. After the first day of using the emWave Seth called me and left a very excited,
yet skeptical message, “I can’t believe this, but I shaved an hour off my practice test and feel
energized rather than exhausted. I’ll see if this continues.” We had a follow up phone call to
review his results and answer any questions. His gains in time and energy remained consistent,
his sleep improved and his irritability was dramatically reduced. On test day he took the emWave

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with him and spent time in the car getting into heart rate coherence. He finished the exam in the
same improved time frame and had a lot of positive feelings following the exam. His score was
well above average. It was even higher than his goal score.

Athletes suffer from traumatic stress that blocks their peak performance.
Many athletes experience traumatic events during their training or competitions. Whether it be
injuries, unexpected conditions, lost competitions or conflicts with a coach, these experiences are
stored in the mind and body and can affect the way they perform. Previous traumatic experiences
can act as a trigger to the nervous system to launch into fight or flight mode when the athlete is
performing a similar movement. Most often EMDR therapy can resolve this old material and help
to remove it as a roadblock. Adding HeartMath technology enables them to easily restore their
focus in stressful training or performance situations and to push through to the next level.
Athletes understand the importance of finding their “zone” where they access a high level of
focused attention. The “zone” is the place of optimal performance. Heart rate coherence is the
“zone” and can be achieved easily through the Quick Coherence Technique and practicing
extending the technique for longer periods of time.

Case Illustration:
A competitive cyclist came in to see me because he wanted to improve his high-speed turns. He
said he believed this is the one area he can improve his time and performance but felt something
was holding him back. He was finding himself dropping back when approaching turns in a group
then trying to play catch up after the turns. This was costing him a lot of precious time. When I
asked him to describe his experience as he takes the turns, I noticed he began to breath
shallowly and at times held his breath. He identified the negative thoughts that came up and his
constricted body sensations. In the first session I taught him the heart focused breathing and
Quick Coherence Technique with the use of the emWave technology. I suggested he use it
before and after his training rides and to simply notice what happens during his turns. The next
session he reported more focused attention during his rides and spontaneous deep breaths
during his turns. During an initial EMDR session we targeted his current angst while cornering. He
was able to recall a bicycle accident when he was eight years old. He was coming around a
corner, slid on some sand, fell, nearly hitting an oncoming car and had the wind knocked out of
him. The woman in the car got out and was visibly shaken, his mother was running up from
behind screaming in panic. It all happened quickly, no one was hurt, after getting his breath back
he rode home. The positive resolution in the EMDR session helped free him to be in the present
moment and work on his turns. He found that by getting into his coherent zone before a ride, he
was able to take turns with greater ease, clear thinking and focused breathing. He stopped
dropping back in the group and described taking turns now with a more aggressive approach
without becoming distracted.

Trauma Therapists can suffer from Compassion Fatigue & Vicarious

Traumatization
Helping others walk through the healing journey of early childhood trauma, medical emergencies,
combat, abuse, death and dying, etc. can impact even the most experienced therapist. Over time
this can take its’ toll. Managing your own stress is crucial to staying healthy.
Trauma therapy in particular has a major impact on the therapist. Some authors have written
about secondary traumatic stress disorder also known as ‘compassion fatigue’, which refers to
the effects of trauma upon psychotherapists. The nature of our work as therapists puts us at a
particular emotional risk. The daily exposure to horrific accounts of client’s traumatic experiences
can culminate in an empathic strain. This strain may result in feelings of helplessness, grief,
anger, irritability and horror, which are all classic symptoms of PTSD. Although most therapists

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are well aware of the need for self-care, some do not recognize when they are overworked and
approaching burnout.
Using the HeartMath system will help you achieve greater balance and resilience. Your continual
use of these tools will also enhance your ability to teach others. You can use the time your clients
are learning their skills in session as an opportunity to “get coherent” as well. Therapists report
feeling more energized throughout the day when they have done this. Develop a routine that fits
into your workweek.

Here are a few strategies that many therapists, including myself, have come to rely on.

1. Daily use of the emWave technology - before and after your clinical day. Before you head
home make a healthy transition by getting into Coherence and ‘letting go’ of the office
stress. It only takes a few minutes and can benefit you and your family!
2. Breathe along with your clients. Coherence in the moment! Many therapists have
reported they have more energy at the end of their workday when they have done this.
3. Take a moment in between each client to reset yourself by heart-focused breathing.
4. Use your emWave device before bed for a more restful sleep.
5. Check in on your coherence level following a particularly challenging session. You can
get into coherence quickly in between client sessions.

Jeri Lynn Schroeder M.S., M.A., LCPC

Portland, ME
“I believe very strongly from my own experience that the HeartMath skills are a source for
expanding Self Energy. When I am sitting with a client regardless of the method I am working
with, I will place my fingertips on my heart if I find myself challenged to stay centered or in Self
and it always work. I practice the HeartMath skills and a meditation practice called Heart Rhythm
Meditation, which are very similar, on a daily basis so my heart energy is very receptive and
available to me. I use the emWave tools at least once a week to check my own coherence
pattern.”

Barbara DaSilva
Certified Holistic Health Practitioner
Celebrate Wellness
St. Catharines, Ontario

“I am a Holistic Health Practitioner in St. Catharines, Ontario Canada. I do EAV Testing, and
Energy Healing. I love my career and am very passionate about helping people to achieve their
very best health – body, mind and spirit.

I always felt like something was missing in my practice. I was helping my clients, but stress was
an on-going concern and my encouragement to them to find time to do something they enjoy,
breath, meditate, exercise, etc, was easier said than done.

When I heard about the HeartMath system I was so excited because it sounded like the missing
link for helping my clients. Reading the HeartMath Solution book brought me to tears. It made so
much sense and I couldn’t wait to purchase the program and begin offering it to my clients.

The biggest surprise came when I started using the program for myself. I wanted to learn it inside
out before I presented it to anyone else. I was shocked to see how incoherent I was. I was
stressed out!! I was in denial at first because I always saw myself as “all together”, calm, nurturing
etc. However, I never did take time for myself to just breathe. I was too busy telling others to do it.

©  Sara  Gilman  2018/  [email protected]   21

I feel blessed that HeartMath’s tools and technology came into my life when it did. I’m 48 years
old and want to live a long healthy life. The stress that was going through me, that I was unaware
of, could have had very negative effects on my health.

Since I have been practicing with the HeartMath tools and understanding what being coherent
feels like, I am happier, more confident and able to listen to my intuition and trust it. I now make
sure I am in coherence before I see a client. Being in the space of “grace” that coherency puts me
into, allows me to be at the top of my game for my clients. When I’m doing energy healing, I have
had the emWave2 monitor attached to me to make sure I am coherent when bringing in healing
frequencies.

I strongly recommend and encourage anyone in the caregiving profession to utilize this program
yourself. You will be so much more effective at helping the people in your lives if you are
coherent. You will be no good to others if you become ill yourself, so make yourself matter!!

I believe it has helped me in numerous ways already and I have only been using it for month. I
approach people in a much more positive state and I’m recognizing more positive energy
returning to me from clients, friends, and family.

I am so grateful for the HeartMath tools!! I know anyone who learns them and makes them a part
of their lives can feel genuine peace at last!”

Conclusion
All of the case illustrations were drawn from actual clinical cases. Identifying information was
slightly altered for the purposes of confidentiality. All of the stories shared remind us of the innate
wisdom in the heart and mind to heal and grow. As therapists we learn to help others activate
their natural healing mechanisms for an improved quality of life. I hope this guidebook assists you
in expanding your work and improving your life. This guidebook is the just the tip of the iceberg of
information offered by HeartMath to help enhance your clinical work. There are many supportive
materials available. I’ve found the following resources helpful.

Additional Resources

HeartMath Interventions Certification Program. An in-depth clinical program delivered as five

weekly 1 hour live webinars and 2.5 hours of recorded webinars with extensive support materials.
Designed for licensed health professionals who want advanced training on adding HeartMath
tools and technologies into their clinical practice.

A Practitioner's Guide. A guide for using the emWave Pro program with clients. Includes
instructions and case studies. Free

Health Professional Webinar Series. A series of recorded webinars by experts from the fields
of psychotherapy, cardiology, pain management, medical practice, pediatrics and more share
how they are using the emWave technologies with patients and the results they are seeing.

©  Sara  Gilman  2018/  [email protected]   22

Orientation Sessions. Free one-hour tele-classes on how to use the emWave Pro program
and the emWave2 handheld unit.

The State of Ease This booklet discusses a "state of ease" that each of us can access to help
release emotional turbulence and help maintain coherent alignment between our heart, mind and
emotions. Free.

The Science of HeartMath Overview of HeartMath's 27 years of research

Books and other products

Transforming Stress, Transforming Anger, Transforming Anxiety, Transforming Depression, The

HeartMath Approach to Transforming Hypertension, Stopping Emotional Eating, the emWave
Solution for Better Sleep Guide, emWave Meditation, Prayer & Self-Help Assistant. For more
details click here

If you have questions or need help please feel free to contact the following people at HeartMath’s
Health Professional Division:

John White Carol Thompson Tom Beckman

Phone: 831-338-8711 Phone: 831-338-8781 Phone: 831-338-8745
Email: [email protected] [email protected] [email protected]

Claudia Devenport
Phone: 831-338-8785
Email: [email protected]

Sara Gilman: Brief Bio

Dr. Gilman, is a licensed Marriage & Family Therapist, with a doctorate degree in Psychology.

She is the co-founder of Coherence Associates, a professional counseling corporation in San

Diego, CA. The Coherence Associates team of counselors are dedicated to expanding human
potential through the coherence of mind, body & spirit through clinical excellence, integrity, &
compassion. Dr. Gilman is certified in HeartMath, EMDR Therapy, Disaster Mental Health, was
awarded Fellowship status with the American Academy of Experts in Traumatic Stress for her work
with emergency responders, and is past President of the EMDR International Association Board of
Directors. For over 30 years, she has specialized in the areas of Peak Performance, Mental
Toughness & Resilience for business professionals, athletes & first responders.

-Sara G. Gilman, PsyD LMFT, Encinitas, CA, www.saragilman.com

HeartMath is a registered trademark of the Institute of HeartMath. Quick Coherence is a registered trademark of Doc Childre. Inner-Ease is
a trademark of Doc Childre. emWave, emWave2, Personal Stress Reliever and Coherence Coach are registered trademarks of Quantum
Intech, Inc. HeartMath techniques are reprinted by written permission from HeartMath LLC.

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