In "Heart Rate Monitoring, Part 1: Taking the Guesswork out of Training with Biofeedback" we looked at the physiological importance of biofeedback mechanisms (specifically, heart monitors) and how heart rate monitors give personal trainers information that is invaluable in training clients at the right intensity every single workout. In part 2, we will take a look at how biofeedback affects us psychologically and the impact it can have on behavioral change.
The Psychology of Biofeedback
As a personal trainer, I didn’t always utilize heart rate monitors. And when my clients had them, I wasn’t utilizing them correctly either. Nonetheless, as soon as I understood their importance and started to systematically implement them into my clients’ programs and truly track their performance each workout, I noticed something very unique happen mentally and emotionally to each and every client that used the heart rate monitoring system.
Having that initial experience of biofeedback automatically validated everything I was trying to tell clients in regard to tweaking their intensity. They could visually see exactly where “they” were at, creating ownership of what was happening. The ability to see that their heart sometimes wasn’t recovering when they wanted it to or wouldn’t jump as high as they had hoped during some exercises created a competitive atmosphere. I did nothing different with my training style but tell them to try to hit a certain zone during certain exercises, and they would automatically put more effort into the workout than I had ever seen before. The quick feedback was maximizing their workouts tenfold, and giving them a feeling of power that they now dictated how far and how fast and how long they needed to go.
“The whole is greater than the sum of its parts” is a well-known gestalt phrase in psychology. In relation to exercise and biofeedback, biofeedback is not the “whole” solution; it can, however, be a very important “part” in helping to establish change within a client. Ultimately, our job as fitness professionals in helping someone reach a fitness goal is to change the behaviors that got them where they’re at in the first place. Biofeedback is one important tool that can help establish that change. In some cases, “feedback signals are important for the physiological information…in other cases, the signal helps shape or reinforces cognitive changes” (Schwartz & Schwartz, 2003).
If you went outside right now and guessed the temperature, chances are you would guess in the right ballpark, but not be able to guess the exact degree. And you probably would use past experiences with temperature you have stored in your mind to come to a fairly accurate guess on what the temperature could be at that moment. However, in order to know the exact temperature we would need a thermometer. In the example of heart rate monitors and exercise, the heart rate monitor becomes a temperature gauge of how hard the workout is. Without it we are just considering how we feel and relating it to experiences we have had during previous workouts. In terms of biofeedback, “the signal can provide enhanced proprioception at this point and more information than a person is aware from internal cues” (Schwartz & Schwartz, 2003).
Behavioral Models for Biofeedback Success
When we become more aware of what is happening internally at a specific moment, certain behaviors can be rewarded, reinforced, and further developed as a result of biofeedback. Let’s now take a look at different behavior models in psychology to better understand how biofeedback allows the fitness professional to create new behaviors and reinforce those behaviors as the feedback changes with progress through a fitness program.
Model 1: Physiological changes result in symptom changes.
“Making information from the target physiological system available to the patient will allow the patient to gain control” (Schwartz & Schwartz, 2003). Knowing what is happening internally during exercise gives the exerciser a sense of control. The exerciser can then focus on things like breathing to decrease heart rate or control tempo and size of movement to increase it. Having control in exercise can equal ownership and power.
Model 2: Cognitive changes (beliefs and expectations) lead to symptom changes.
This model of behavioral change through biofeedback is one of the most powerful, as it suggests that “the process of biofeedback with its performance feedback and verbal encouragement from a therapist result in cognitive changes. These changes include positive expectations, perceived success, and reduced anxiety and symptoms associated with a reduced sense of helplessness” (Schwartz & Schwartz, 2003). Positive expectation and perceived success are important components of change.
Human expectations stem solely from our belief systems. “Beliefs determine our behavior and the only way to permanently change our behavior is to eliminate limiting beliefs” (Lefkoe, 2011). Biofeedback gives us information and feeds into our belief systems, creating a powerful connection with what we know and then what is currently happening within our body during exercise. Given the success that occurs and the ability to control that success through biofeedback mechanism, trainers can help to create some of the strongest changes in the behavioral model and change the "limiting beliefs" of the client, since “positive and negative expectations can be formed solely by beliefs; they also can be formed by conditioning” (Lefkoe, 2011). The conditioning provided by biofeedback mechanism translates into positive expectations based on the performance effort that is put into it. “Expectations become self-fulfilling by altering our performance and actions, which ultimately affects what happens in the future” (Sharot, 2011).
The "instant" reading of biofeedback can give immediate gratification, and stimulate the reward centers in the brain that something has been accomplished. When reward centers of the brain are triggered an emotional connection can be developed to the success that was achieved and the behavior occurs again in the future seeking more reward. Therefore, the biofeedback is encouraging behavioral changes through the belief system and expectation of success.
Trainers have the opportunity to amplify this reaction by giving positive praise and helping clients to connect cognitively to what is happening at that moment during the exercise. By asking clients to consciously focus on how they feel during exercise at specific rates of intensity, trainers teach them how to connect mentally with what is going on physically. This helps them transfer the work they do during personal training sessions to the training they do on their own, giving them an unbiased way to associate the physical feeling they should have when exercising on their own and recognize the level of exertion, respiratory rate, and muscle fatigue necessary to be exercising at the right intensity. This connection of mental awareness between the physical feeling and the feedback from the heart rate gives the client an associative expectation leading to symptom changes.
Model 3: Feed Forward Processes, accounting for symptom changes.
This model is one of reinforcement, and comes after the patient or client has had some experience with the feedback mechanism itself. “…the person already can execute a response and uses the feedback signals as confirmation and reinforcement” (Schwartz & Schwartz, 2003). In this model, you would see a client come to the workout eager to see her heart rate and challenge her successes from previous workouts. The visual stimulus of the biofeedback mechanism allows the “human to generate selective motor responses" based on what they are seeing. When the visual system perceives a stimulus that is informational on performance, the signal is sent up “the ventral pathway and up to areas of the inferotemperal cortex, and can even influence behavior” (VanRullen & Koch, 2003).
With the presence of a visual stimulus such as biofeedback, the exerciser’s mindset is competitive, and she is driven to improve on the feedback from last time. Unbeknownst to her, she is self-initiating what we as fitness professionals try to incorporate into every program to get results. The client comes in determined to do better than before, and her attitude will drive her to tweak her own acute variables to “beat the heart rate system.” Therefore, the biofeedback is reinforcing the behavioral changes needed to get her to her goal through feed-forward processes.
Model 4: Bandura’s Self-Efficacy Model
Albert Bandura's model relies on “immediate” feedback and success for the client, and the feedback mechanism solidifies the response in this model as it is giving millisecond-by-millisecond feedback. As a trainer, we can repeatedly tell our clients how awesome they are, how well they are doing, or that we believe in them, but they don’t necessarily believe in themselves. Self-efficacy is built on a person’s ability to see what they have done and can do. In this model, “…what I do and clearly see that I can do has more significant impact on my beliefs and behavior than what other people tell me they think I can do” (Schwartz & Schwartz, 2003). When a client repeatedly sees their heart rate hitting the correct zones and recovering quickly and doing better than it was on the previous weeks of the workout program, it is building on their own personal self-efficacy model.
As Bandura (1977) states, “Learning from response consequences is also conceived of largely as a cognitive process. Consequences serve as an unarticulated way of informing performers what they must do to gain beneficial outcomes and to avoid punishing ones. By observing the differential effects of their own actions, individuals discern which responses are appropriate in which settings and behave accordingly." Clients' success in getting in the right heart rate zones and being able to physically see it gives them a feeling of accomplishment and instills a belief in themselves, building on self-efficacy. It is the stimuli from the biofeedback mechanism that “influence(s) the likelihood of the a behavior’s being performed by virtue of their predictive function, not because the stimuli are automatically connected to the responses by their having occurred together” (Bandura, 1977). With the biofeedback mechanism providing a millisecond-by-millisecond reinforcement of his behavior, the individual begins to recognize that his performance is feeding into the outcome shown on the heart rate display, influencing his perceived success and instilling a personal belief of what he has accomplished, which builds on his self-efficacy and his personal sense of accomplishment.
Although there are many other behavioral psychology models, these are a few that fit into the psychology behind the importance of biofeedback mechanisms. Ultimately, fitness professionals must help clients make behavioral changes to reach their goals. Biofeedback mechanisms support the ability to initiate change and reinforce those new behaviors.
“Computerized bio feedback is like having a high-tech electronic chalkboard for teaching and a built in ability to measure progress. It is up to the therapist to use this technology to be the best possible teacher and communicator.” (Schwartz & Schwartz, 2003). Biofeedback provides us with the missing information to solidify the value and appropriate intensity of the workout and start to elicit behavioral changes in our clients. When we use biofeedback we give the control and power to our clients, creating a sense of ownership with the workout and the program. The feedback mechanism provides the information to reinforce, facilitate, and encourage physiological and cognitive learning with every workout. We as trainers can simply become the guide on the side, setting up the workouts to meet the client where they need to be met every time they come into the gym.
- Bandura, A. (1977). Self-efficacy: Toward a Unifying Theory of Behavioral Change. Psychological Review 84: 2: 191-215.
- Lefkoe, M. (2011, July 6). Evidence That Beliefs Determine Behavior. [Web log comment]. Retrieved from http://www.mortylefkoe.com/evidence-beliefs-determine/.
- Schwartz, N.M. & Schwartz, M.S. (2003). Definitions of Biofeedback and Applied Psychophysiology. Biofeedback: A Practitioner’s Guide (3rd edition). New York, NY; The Guildford Press: 27-38.
- Sharot, T. (2011, May 28). The Optimism Bias. TIME Magazine Online. Retrieved from http://www.time.com/time/printout/0,8816,2074067,00.html.
- VanRullen, R & Koch, C. (2003). Visual Selective Behavior Can Be Triggered by a Feed-Forward Process. Journal of Cognitive Neuroscience 15: 2: 209-217.
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