Research Stories

by Diane Boudreau

"Bald-faced fear" is how Bruce Cryer describes his mental state the day he stood onstage at the Shubert Theatre on Broadway. Cryer was auditioning for his first Broadway role, and he knew that a legendary director was sitting in the house.

"I just hoped he was far enough away that he couldn't see my knees shaking. My body was reacting as if a giant saber-toothed tiger was waiting to eat me," says Cryer.

Even hours after the audition, when he was safe at home, Cryer felt exhausted from the day's anxiety.

"I realized that to perform at a high level I had to learn to manage that stress," he says.

Cryer began learning stress-management techniques to help quell his stage fright. He went on to enjoy a successful career acting, singing and dancing on Broadway. Today, he still gets up in front of audiences regularly, but not as an entertainer. Now, as CEO of a California-based company called HeartMath, he helps other people learn how to manage their stress.

Cryer shared his story in front of a diverse audience at Arizona State University in August 2008. The group of healthcare workers, university employees, and others had one thing in common–job stress. Cryer was training them to use HeartMath's tools and techniques for reducing stress and increasing well-being.

The training is part of a collaborative study between HeartMath and Kathy Matt, a neuroendocrinologist, researcher, professor, and administrator at Arizona State University.

Matt spends her days surrounded by stress. Yet she is remarkably easygoing as she darts from classroom to lab to medical facilities throughout Phoenix and beyond. She studies people with job stress, people with post-traumatic-stress-disorder, and over trained athletes, among others. She looks at relationships between stress and hormones and how they are affected by exercise, diet, gender, and disease. In short, she studies all things stress.

"What's been fun most recently is the work we're doing with HeartMath," says Matt, who also has duties as ASU's associate vice president for clinical partnerships and research infrastructure. "It's an upscale version of biofeedback. This is exciting because it allows us to show individuals how their thoughts can change their physiology!"

Changing the beat
HeartMath produces hand-held monitors that measure heart rate variability (HRV). They also offer techniques and training tools–such as computer games–that teach users to change their HRV voluntarily.

HRV is the measure of beat-to-beat changes in heart rate. When you measure your pulse, you are measuring the average number of beats per minute. But your heart rate actually changes with every single beat.

It turns out those changes are related to your health. Having a high level of variability with smooth transitions is a good thing.

"High heart rate variability means your cardiovascular system is very elastic. It is capable of high highs and low lows," says Matt. "It's like a new rubber band. You stretch it and it goes right back."

A growing body of research links HRV with health. For example, studies have shown that people with low HRV are more likely to suffer from depression, develop high blood pressure, and die after a heart attack. Studies have also shown that stressful emotions, such as anxiety or anger, are associated with reduced HRV.

HeartMath teaches a simple technique called "Quick Coherence" to reduce stress and improve HRV. It involves the following three steps:

1. Heart Focus: Focus your attention on your heart.
2. Heart Breathing: Begin to breathe slowly and deeply, and imagine your breath moving through your heart with each inhale and exhale.
3. Heart Feeling: Think about a positive experience or event in your life that made you feel excited and passionate, successful, or loved and loving. Try to recreate the feelings that the experience brought on.

HeartMath's PC-based HRV monitor shows just how effective this technique is. Cryer asked for a volunteer to come to the front of the room. He hooked the sensor to her earlobe. A computer display of the woman's HRV appeared on a projector screen for everyone to see.

Cryer asked the woman to think about a situation that stresses her out. Almost immediately, her HRV became shallow and choppy. Next, Cryer asked her to do the Quick Coherence technique. In just moments her HRV improved drastically.

HeartMath sought out Matt to help them study how HRV relates to biochemistry. Matt is measuring several hormones and neurotransmitters in her stressed-out subjects before and after HeartMath training. These include cortisol, NPY (neuropeptide Y), prolactin, ACTH, and oxytocin. All of these chemicals are involved in the human stress response.

The making of stress
Hormones are Matt's forte–her background is in endocrinology.

"I have always looked at how the environment interacts with the brain, which is translated into endocrine changes," she explains.

Stress starts with something in the environment. Perhaps you are being chased by an attacker, or getting chewed out by your boss. Whatever the circumstances, your brain perceives a threat and signals your body to release a cascade of hormones. These hormones trigger changes in your body that help you to fight or run away from the threat.

Some of the effects of this stress response are elevated heart rate and blood pressure, dilated pupils, and the release of sugar into the bloodstream. Bodily functions that aren't required for immediate survival–such as digestion, reproduction, and immune function–are suppressed.

"The stress response is innate. It's carried in all animals including humans. It's an important response for survival and it's not something we want to go away," says Matt.

The problem is that the stress response prepares your body for physical exertion. If you run away from an attacker or dig your way out of a cave-in, you burn up all that sugar and send a message to your brain to stop churning out stress hormones.

"But with psychological stress you never burn it off because there's no physical demand," explains Matt. "And there's no feedback from the body to keep it in check and turn off the response appropriately."

In our post-industrial society, most of the stress we experience is psychological, not physical. Your body might crave sweets when you are fielding e-mails and phone calls at work, but a rush of sugar isn't what you need to get the job done.

It's not surprising, then, that scientists have found links between chronic stress and a variety of health problems, including heart disease, high cholesterol and diabetes. Some experts estimate that more than 70 percent of all doctor visits are due to stress-related ailments.

Whole-life health
"Are our lives filled with more stress than previous generations?" asks Matt. "No, but the stressors now are usually uncoupled from physical stress. In earlier times, if you had stress the solutions often had physiological outlets. Now, the more you are stressed at work, the less time you have to go to the gym, and the more fast food you eat. These behaviors compound the problem and prolong the stress response."

Matt is particularly interested in ways to integrate mind/body health into everyday life. Stress and its health effects are a significant problem in our society.

"As we consider sustainability, I think we should consider the challenges to human sustainability. Understanding stress and how to mitigate our response to stress is important to our society and its progress," says Matt.

Matt and her colleagues teach a block in the medical school curriculum that is focused on mechanisms of integration at the new University of Arizona College of Medicine at the Phoenix Biomedical Campus. The classes explore how humans respond to the environment through the nervous, endocrine, and immune systems.

She also spent a year as a health policy fellow for the Health, Labor and Pensions Committee in Washington, D.C., where she helped write the Medicare Wellness Act and a home health bill.

"One thing I learned there–it really is a paradigm shift to think about prevention. You have to spend money on healthy people to maintain health and decrease disease risk. Prevention is a hard sell when we don't have the money to provide adequate health coverage for all," Matt says.

"I think we will have to work with healthcare economists to generate the data to convince insurance companies that prevention makes sense and saves dollars. Some insurers will cover costs of health clubs and complementary medicine, but not all of them."

On top of all her current work, Matt has many dreams for the future.

"I'd like to see basic and clinical research latched together in real-time, to create an optimum performance and health institute to put these things together. It would involve evidence-based health promotion, disease prevention, and peak performance."

With her plans and research projects, plus teaching and managing clinical partnerships, does Matt herself ever feel completely stressed out?

"I have been extremely fortunate," she says. "I don't see my job as stressful. It's a great opportunity and I love what I do."

The HeartMath study is funded by HeartMath. For more information, contact Kathleen Matt, Department of Kinesiology, College of Liberal Arts and Sciences, 480.965.7906. Send e-mail to kmatt@asu.edu