Dr. Richard Gevirtz's Journey from GSR to Heart Rate Variability
- Fred Shaffer
- 14 hours ago
- 9 min read
The field of heart rate variability biofeedback (HRVB) represents one of the most significant advances in applied psychophysiology, fundamentally transforming our understanding of autonomic regulation and therapeutic intervention.
Dr. Gevirtz is one of the most gifted, consequential, and generous educators, mentors, and researchers in this emerging field.
Dr. Richard Neil Gevirtz's journey, spanning nearly six decades, illuminates how scientific discoveries emerge through serendipitous encounters, dedicated mentorship, and persistent curiosity combined with technological innovation. His comprehensive narrative, published in Applied Psychophysiology and Biofeedback, provides both a historical perspective on HRVB development and insights into its therapeutic potential across diverse clinical conditions.
His odyssey exemplifies scientific progress, beginning with rudimentary galvanic skin response measurements and evolving into sophisticated real-time cardiovascular biofeedback systems. His work contributed to a paradigm shift from primarily sympathetic nervous system interventions to accessing the previously elusive parasympathetic branch, opening therapeutic frontiers for conditions ranging from pediatric gastrointestinal disorders to post-traumatic stress disorder.
Early Foundations in Psychophysiology
Gevirtz's journey began in 1964 as an undergraduate at the University of Wisconsin, where Peter Lang's graduate course, titled "Blood, Sweat, and Tears," introduced him to psychophysiology during its foundational years—the same year the journal Psychophysiology was established. As Gevirtz describes, "Peter Lang was an amazing scholar, teacher, and mentor and, as such, he re-lit my (and generations of American and international researchers) interest in the scientific study of the mind/body connections."
Under Lang's mentorship, Gevirtz conducted his senior thesis examining systematic desensitization for snake phobia. Using primitive equipment, he measured heart rate as participants approached a snake: "I then spent hours using a mechanized arm to record heart rates as the participants approached the snake. This heart rate data was not very useful, but the experience was significant for me." This early cardiovascular exposure proved prophetic: "When technology advanced to quantify heart rate without a roomful of equipment and an electrical engineer, you can imagine that it grabbed my attention."
After graduate school, Gevirtz moved to St. Mary's College in Minnesota, where Tom Budzynski's Chautauqua Course rekindled his interest in biofeedback. This led to collaboration with Mark Schwartz at Mayo Clinic and his entrée into the Biofeedback Society of America.
The San Diego Era and Early Limitations
In 1980, Gevirtz moved to San Diego, establishing a biofeedback practice while teaching at the California School of Professional Psychology. He developed one of the first graduate Clinical Psychophysiology and Biofeedback courses and assumed leadership roles, including heading the Biofeedback Certification Institute of America.
During this period, available modalities were limited to "skin conductance, electromyography, peripheral temperature, respiration rate, and heart rate (but only in 5 s averages)." These approaches were constrained by their inability to access parasympathetic functioning directly. Gevirtz's humorous attempt to measure parasympathetic activity illustrates the field's limitations: "I tried measuring the weight of cotton swabs that were placed in the mouth to measure salivary flow, which is mediated by the parasympathetic nervous system (yuck!)."
The Emergence of Heart Rate Variability Biofeedback
The transition to heart rate variability represented a fundamental paradigm shift. Steve Porges' influential 1995 paper proposing vagal withdrawal, rather than sympathetic activation, as the primary component of everyday stress "really ignited my interest in exploring HRVB both clinically and in research." Collaboration with Paul Lehrer proved essential, as they recognized "the potential of access to the parasympathetic branch of the autonomic nervous system."
Working with equipment companies, particularly Jan Hoover at J&J Engineering, they were able to "produce screens with a graphic representing beat by beat heart rate (also known as inter-beat interval)." This technological capability marked the birth of practical HRVB applications.
The Vaschillo Connection: Resonance Frequency Theory
The pivotal moment occurred during the 1997 Society for Psychophysiological Research meeting on Cape Cod, where Gevirtz and Lehrer spent days with Evgeny and Bronya Vaschillo. "This is where the concepts of resonance frequency, training the baroreceptors, and increasing autonomic homeostasis were firmed up."
The Vaschillos' contribution of resonance frequency theory—recognizing that breathing at approximately 0.1 Hz maximizes heart rate variability amplitude—provided the crucial missing piece for optimizing HRVB interventions and created the scientific rationale for remarkable clinical outcomes.
Clinical Applications and Research Findings
Gastrointestinal Disorders: Remarkable Outcomes
Pat Humphreys' pediatric gastroenterology study demonstrated striking results: "the simplest approach, the biofeedback only group, was most effective in lowering gastrointestinal symptoms (especially abdominal pain). In fact, that group showed a 97% reduction in pain compared to the fiber alone group's 36% reduction."
Eric Sowder's subsequent research provided mechanistic evidence using ambulatory HRV monitoring: "We found a strong correlation (r = 0.62) between reductions in pain intensity and increases in HRV measures taken during quiet periods during a school day." Mark Stern and Rob Guiles' outcome study of 27 consecutive pediatric cases achieved "full remission in 63.6% and partial remission in 36.4% of patients."
Cardiovascular Applications
Jessica Del Pozo's research with post-coronary artery disease patients demonstrated that "measures of resting baseline HRV (Standard Deviation of Normal to Normal R waves (SDNN) and Root Mean Square of Successive Differences (RMSSD) could be increased by about 50% with HRVB training, while the controls showed no change."
Kim Swanson's congestive heart failure study found significant functional improvements, which stimulated research by Chris Moravec and Mike McKee at Cleveland Clinic. Their innovative work examined cardiac tissue after transplantation: "The HRVB group had scores closer to normal than those of the treatment as usual group and better than a group on a Left Ventricular Assist Device (LVAD)."
Primary Care and Cost-Effectiveness
Meredith Ryan's family medicine study demonstrated both clinical and economic benefits: "For the 6 months following the treatment time period, monthly medical expenses were differentially reduced in this group such that the average monthly individual patient costs were $72 lower in the treatment group compared to $9 lower in the comparison group (p < 0.001)."
Pregnancy-Induced Hypertension
Sandy Cullins' research produced remarkable maternal-fetal outcomes: "On average, infants in the RSA BF group were born at 34.00 weeks while those in the TAU group were delivered at 30.43 weeks. On average, infants in the RSA BF group had a 35% higher birth weight than those in the TAU group."
Mental Health and Performance Applications
Ben Strack's sports performance study with elite high school baseball hitters found: "In a test of actual batting performance against a pitching machine, the HRVB group improved by 25%, while the control group showed no improvement."
Terri Zucker's PTSD research demonstrated that "increases in HRV were significantly associated with PTSD symptom reduction. The HRVB group also showed significantly more reduction in depression symptoms than the progressive relaxation group." Subsequent research at DeBakey Veteran's Hospital showed "The HRVB group lowered their scores by 18% compared to a 9% reduction, for the treatment as usual group, on the Clinician Administered PTSD Scale (CAPS)."
Neurophysiological Mechanisms
Starr MacKinnon's research using Heartbeat Event-Related Potentials found that during six-breaths-per-minute breathing, "the signal was 26% percent greater during the 6 breaths per minute segment, compared to baseline and 36% higher than during the positive emotion induction."
Christine Huang's training study demonstrated neuroplasticity: "We found that the HRVB condition as compared to the controls increased their baseline resting HRV by 25% and that the HRV group exhibited statistically significant increases in baseline heartbeat event-related potentials, while the relaxation control group did not." These results provide evidence that HRVB training produces lasting changes in vagal afferent pathways.
Future Research Directions
Gevirtz identifies crucial questions requiring investigation, including optimal training parameters, the relationship between physiological and clinical changes, and mechanisms of action. Scientific inquiries include whether "baroreflex gain translate to symptom improvement" and "Is gastric motility affected by HRVB?"
Technological innovations continue expanding therapeutic possibilities, with questions about integrating EEG feedback with traditional HRV training and optimizing accessible applications while maintaining training quality.
Conclusion
Dr. Gevirtz's journey from measuring crude heart rate data to developing sophisticated HRVB interventions exemplifies how scientific progress emerges through curiosity, collaboration, and technological advancement. The consistent efficacy of HRVB across seemingly unrelated conditions suggests it targets fundamental regulatory mechanisms rather than condition-specific pathology.
As Gevirtz concludes: "It is with great satisfaction that I discover (often, daily) the worldwide explosion of interest in HRV and HRVB. It is my hope that we will see the applications we have studied and used, implemented in medical and mental health settings and that researchers will continue to probe the applications and mechanisms of HRVB."
His odyssey exemplifies the iterative nature of scientific progress, beginning with rudimentary galvanic skin response (GSR) measurements and evolving into sophisticated real-time cardiovascular biofeedback systems. His work has contributed to a paradigm shift from primarily sympathetic nervous system interventions to accessing the previously elusive parasympathetic branch, opening new therapeutic frontiers for conditions ranging from pediatric gastrointestinal disorders to post-traumatic stress disorder.
The significance of this journey extends beyond individual research contributions to encompass the broader evolution of psychophysiological science. As Dr. Gevirtz notes, his experiences were shaped by "lucky opportunities, wonderful mentors and colleagues," demonstrating how scientific breakthroughs emerge through collaborative networks and mentorship relationships that span generations of researchers.
Glossary
autonomic nervous system: the division of the nervous system responsible for regulating involuntary physiological functions including heart rate, blood pressure, digestion, and respiratory patterns. Comprises sympathetic (arousal) and parasympathetic (calming) branches that maintain homeostatic balance.
baroreflex: a crucial homeostatic mechanism that maintains blood pressure stability by detecting changes in arterial pressure through specialized receptors and reflexively adjusting heart rate, cardiac contractility, and vascular resistance to counteract pressure changes.
biofeedback: a therapeutic technique that provides real-time information about physiological processes (such as heart rate, muscle tension, or brain activity) to enable conscious control over typically involuntary functions through learning and practice.
functional gastrointestinal disorders (FGIDs): a group of chronic gastrointestinal conditions characterized by persistent symptoms without identifiable structural or biochemical abnormalities, including irritable bowel syndrome, functional dyspepsia, and functional abdominal pain.
heart rate variability (HRV): the physiological phenomenon of variation in time intervals between consecutive heartbeats, reflecting the dynamic interplay between sympathetic and parasympathetic nervous system influences on cardiac rhythm and serving as an indicator of autonomic balance and cardiovascular health.
heart rate variability biofeedback (HRVB): s specialized therapeutic intervention that trains individuals to optimize their heart rate variability patterns through paced breathing at their individual resonance frequency, typically around 0.1 Hz (six breaths per minute), to enhance autonomic balance and improve various health conditions.
heartbeat event-related potentials (HEPs): specialized EEG signals that represent the brain's processing of cardiac information, measured as electrical brain activity time-locked to heartbeats, providing insights into interoceptive awareness and brain-heart communication pathways.
interoception: the ability to sense internal bodily signals including heartbeat, breathing, hunger, and other visceral sensations, playing a crucial role in emotional awareness, decision-making, and overall well-being.
parasympathetic nervous system: the "rest and digest" branch of the autonomic nervous system, primarily mediated by the vagus nerve, responsible for promoting recovery, digestion, and energy conservation while counterbalancing sympathetic arousal.
psychophysiology: an interdisciplinary scientific field that studies the relationship between psychological processes (thoughts, emotions, behaviors) and physiological responses (heart rate, brain activity, hormones), providing objective measures of subjective experiences.
resonance frequency: the specific breathing rate (typically between 4.5-6.5 breaths per minute, around 0.1 Hz) at which an individual achieves maximum heart rate variability amplitude, creating optimal conditions for cardiovascular system training and autonomic balance enhancement.
respiratory sinus arrhythmia (RSA): the natural and healthy variation in heart rate that occurs during breathing cycles, with heart rate typically increasing during inspiration and decreasing during expiration, serving as a marker of parasympathetic nervous system function.
RMSSD (Root Mean Square of Successive Differences): a time-domain measure of heart rate variability that quantifies short-term variability by calculating the root mean square of differences between consecutive heartbeat intervals, primarily reflecting parasympathetic activity.
SDNN (Standard Deviation of Normal to Normal intervals): a time-domain measure of heart rate variability that calculates the standard deviation of all normal heartbeat intervals over a recording period, reflecting overall autonomic nervous system activity.
sympathetic nervous system: the "fight or flight" branch of the autonomic nervous system responsible for mobilizing energy and resources during stress or threat, increasing heart rate, blood pressure, and alertness while preparing the body for action.
vagal tone: a measure of parasympathetic nervous system activity, often assessed through heart rate variability indices, reflecting the influence of the vagus nerve on cardiac function and serving as an indicator of stress resilience and emotional regulation capacity.
vagus nerve: the longest cranial nerve, serving as the primary pathway for parasympathetic nervous system communication between the brain and major organs including the heart, lungs, and digestive system, playing crucial roles in regulation of heart rate, breathing, and emotional responses.
References
Gevirtz, R. N. (2022). From GSR to heart rate variability: A long and winding (actually, wiggly) road. Applied Psychophysiology and Biofeedback, 47(4), 299-303. https://doi.org/10.1007/s10484-022-09540-8
About the Author
Fred Shaffer earned his PhD in Psychology from Oklahoma State University. He earned BCIA certifications in Biofeedback and HRV Biofeedback. Fred is an Allen Fellow and Professor of Psychology at Truman State University, where has has taught for 50 years. He is a Biological Psychologist who consults and lectures in heart rate variability biofeedback, Physiological Psychology, and Psychopharmacology. Fred helped to edit Evidence-Based Practice in Biofeedback and Neurofeedback (3rd and 4th eds.) and helped to maintain BCIA's certification programs.
Support Our Friends
