Building resilience and preventing burnout with coherence strategies

Feeling jaded? Worried you can’t cope? This article focuses on coherence strategies to help you enjoy your practice without experiencing burnout.

What with compassion fatigue, running a busy practice and taking care of family, how can we do it all? This article focuses on coherence strategies to enhance your mental wellness, help prevent stress-related disease, and take better care of yourself and your body so you can enjoy practice without experiencing burnout.

Research shows that those who care for others, out of vocation or compulsion, are often challenged in caring for themselves. In the last decade, there have been several interesting, though ominous, studies on the morbidity and troubles of veterinarians. Veterinarians are more likely to experience mood disorders and suicide than other occupational groups.1 Stress also affects our support staff. Workload, death and dying, and conflict with veterinarians are prominent sources of stress for veterinary support staff that affect health.2

Many causes of stress can be outside the workplace. The death of people or animals, relocation, relationship breakdowns, serious illness in the family, accident, financial disaster and many more can take an incredible toll on our wellness – mentally, emotionally and physically.  It’s easy to get caught up in the day-to-day operations of clinical practice and forget about taking care of our own heads and hearts.

The gut brain and heart brain

We possess intelligence that goes beyond the brain. Neurotransmitters and their receptors are situated in the brain, gut, skin and heart, and complex intra-organ nervous systems are being found in other organs. So it is no surprise that our mental states are capable of promoting or suppressing healing mechanisms in different regions of the body. Positive or negative states of mind are locally experienced and can impact regulatory functions.

Emotional experiences and memories are stored in many parts of the body, not just the brain. Neuropharmacologist Dr. Candace Pert famously stated: “Your body is your subconscious mind. Our physical body can be changed by the emotions we experience…. And unexpressed emotions are literally lodged in the body.”3

Dr. Pert says that a feeling sparked in the mind or body will translate as a released peptide. Organs, tissues, skin, muscle and endocrine glands all have peptide receptors that can respond to, access and store emotional information. The way a peptide stimulates a receptor determines whether an experience arises in conscious awareness or stays at the level of the subconscious. A survey of 700 people showed that different emotional states are associated with topographically distinct and culturally universal bodily sensations.

The physiology of the heart

The heart is now recognized as a highly complex system with its own functional “brain.”5 Research shows that the heart is a sensory organ and a sophisticated center for receiving and processing information. Signals from the heart to the brain influence the function of higher brain centers involved in perception, cognition, hormonal and emotional processing.6 The nervous system in the heart (“heart brain”) enables it to learn, remember, and make functional decisions independent of the brain’s cerebral cortex, and afferent information from the heart can influence brain activity in the subcortical, frontocortical, and motor cortex areas.7

The heart generates the largest electromagnetic field in the body. Electrically it is about 60 times greater per ECG in amplitude than brain waves per electroencephalogram. The magnetic component of the heart’s field, which is around 100 times stronger than that produced by the brain, is not impeded by tissues and can be measured several feet away from the body with Superconducting Quantum Interference Device (SQUID)-based magnetometers. McCraty6 found that the clear rhythmic patterns in beat-to-beat heart rate variability are distinctly altered when different emotions are experienced.

These changes in electromagnetic, sound pressure, and blood pressure waves produced by cardiac rhythmic activity are “felt” by every cell in the body, further supporting the heart’s role as a global internal synchronizing signal. McCraty8 also provides evidence that this energy is not only transmitted internally to the brain but is also detectable by others within its range of communication. McCraty9 also presents data which shows that a transference of electromagnetic energy produced by the heart occurs when people touch or are in proximity.

If the electromagnetic field generated by the heart can affect those around us, the implications are huge. How we affect people in our proximity (clients, staff, vendors) and how they affect us is related to our emotions. Pioneering researchers in neurocardiology coined the term coherence to describe a “mental and emotional state that people experience when they are in-sync – when the heart, brain, and nervous systems work with more harmony and efficiency”. Extensive research into the rhythms of the heart demonstrates that feelings will dictate heart rhythms. When we experience positive emotions such as joy, gratitude and love, a pattern of cardiac coherence is seen. Anxiety, stress, anger or sadness create a pattern of chaos in our cardiac frequencies. Positive emotions feel better subjectively, but also tend to increase synchronization of the body’s systems. This improves energy levels and enables us to function with greater efficiency and effectiveness, creating a system-wide coherence.

Correlates of physiologic coherence include:10

  • Increased synchronization between the autonomic and parasympathetic nervous system
  • A shift toward increased parasympathetic activity
  • Increased heart-brain synchronization
  • Increased vascular resonance
  • Entrainment between diverse physiologic systems

Measurable benefits of coherence

The ability to alter one’s emotional responses is central to overall well-being and to effectively meeting the demands of life’s challenges. McCraty found that regular practice of intentionally simple self-regulation techniques, most of which instruct users to place their attention in the center of the chest and then self-activate a feeling of calmness or a positive emotion, can lead to lasting increases in the ability to self-regulate and maintain composure, leading to:

  • Reduced stress, anxiety and depression
  • Decreased burnout and fatigue
  • Hormonal balance
  • Enhanced immunity
  • Lower blood pressure
  • Improved digestion
  • Increased energy
  • Improved cognitive performance and enhanced learning, including access to intuitive capacities.

Moving from head to heart

Practicing coherence techniques can assist us in moving from head to heart in all aspects of our practice. We need to assess ourselves. Are we practicing out of chaos or coherence? How do we influence our patients, clients, team and family members? We can teach ourselves the benefits of emotional self-regulation strategies and mind-body coherence using the techniques outlined below as well as many others to suit each individual.

Sustainable heart-based practice

By reconnecting to ourselves and our hearts we can help prevent burnout and greatly improve work satisfaction. We need to take the time to build authentic connections and rapport. Self-care is the foundation of care for others, so we must make it a priority in order to achieve a work-life balance. This is truly walking the talk of holistic medicine.

Coherence also means using heart intelligence alongside analytical mind modes in all aspects of our business practice, including marketing and planning; finding our niche; valuing our services and charging appropriately; training our staff and ourselves; creating the best physical environment to support our vision; developing authenticity and trust in our uniqueness; and recognizing our deeper purpose in serving others.

Introductory heart coherence technique

Use the following to increase and sustain your personal coherence. You may choose to schedule times to do it, and/or use it when you notice yourself or staff becoming stressed or challenged in any way.

  • Breathe and calm yourself in whatever way you choose.
  • Choose something you appreciate and radiate the feeling of appreciation toward it for about two minutes.
  • Evoke a genuine feeling of compassion and care for the planet, yourself, the practice, and your staff.
  • Breathe the feelings of compassion and care out from your heart to the planet or to a specific area of immediate need.
  • See yourself joining with other caretakers to participate in the healing process and generating peace for the clinic, a patient, a client, your town, country or world.

Techniques from heartmath

The HeartMath website gives you many visuals, graphs and techniques. If you follow these simple techniques, you will make great strides to improved health and success. Then you can opt to learn even more.

HeartMath Appreciation Tool

An effective way to improve mental, emotional, physical and spiritual well-being is to invoke and sustain sincere appreciation. The greater your capacity for sincere appreciation, the deeper the connection to your heart, where intuition and unlimited inspiration and possibilities reside.

Heart-focused, sincere, positive feeling states boost the immune system, while negative emotions can suppress the immune response for up to six hours. The website includes actual heart monitor readouts showing the big difference between frustration and appreciation. After appreciation, the heart rhythm becomes smooth, and this coherent pattern is a sign of good health and emotional balance.

You and your staff may want to try some of the following techniques prior to entering the exam room or beginning a procedure. You may want to hold a brief one-minute staff meeting several times a day to use the slightly longer tools; in a big clinic, you can have each team take several breaks.

1. Heart breathing and focus – Focus your attention on your heart area and breathe a little deeper than normal, in for five to six seconds and out for five to six seconds. Picture yourself slowly breathing in and out through the heart area.

2. Heart feeling – Activate a positive feeling as you maintain your heart focus and breathing. Recall a time when you felt good inside, and try to re-experience the feeling. Remember a special place or the love you feel for a close friend, relative, or cherished animal companion. The key is to focus on something you truly appreciate.

3. Appreciation list – Make a list of things you appreciate such as people, places, activities and pets, and choose one or two each morning to hold in your heart during the day. Encourage staff to list what they appreciate about working at this wonderful clinic – e.g. great clients or patients. Choose one to hold in your heart throughout the night while you rest.

4. Appreciation breaks – Take multiple appreciation breaks each day, ideally in the early morning, several while at work, once you’re home or before bed. Breathe through your heart as you focus on one or more items on your list.

5. Appreciation in the moment – Keep your list close by all day, so when stress or negative emotions occur you can choose something from your list that will quickly (in 30 seconds) evoke a feeling of appreciation.


1Fritschi, Morrison, Shirangi, et al. 2009; Platt, Hawton, Simkin, Mellanby. 2010; Cited in J Occup Health Psychol 2014 Apr;19(2):123-32.

2Foster SM, Maples EH. “Occupational stress in veterinary support staff ”. J Vet Med Educ 2014 Spring;41(1):102-10.

3Pert C. Molecules of Emotion: The Science Behind Mind-Body Medicine. candacepert. com Accessed May 28, 2015.

4Nummenmaa L, Glerean E, Hari R, et al. “Bodily maps of emotions”. PNAS 2014 111 (2) 646-651.

5Armour JA. “Potential clinical relevance of the ‘little brain’ on the mammalian heart”. Exp Physiol 2008;93:165–176

6McCraty R. “The Energetic Heart: Bioelectromagnetic Communication Within and Between People”. Clinical Applications of Bioelectromagnetic Medicine, edited by P. J. Rosch and M. S. Markov. New York: Marcel Dekker, 2004;541-562.

7McCraty R, Shaff er F. “Heart Rate Variability: New Perspectives on Physiological Mechanisms, Assessment of Self-regulatory Capacity, and Health Risk”. Glob Adv Health Med 2015 Jan;4(1):46-61.

8McCraty R, Atkinson M, Bradley RT. “Electrophysiological evidence of intuition: part 1. The surprising role of the heart”. J Altern Complement Med 2004 Feb;10(1):133-43.

9McCraty R, Atkinson M, Tomasino D, et al. In K. H. Pribram, ed. “Brain and Values: Is a Biological Science of Values Possible”. Proceedings of the Fifth Appalachian Conference on Behavioral Neurodynamics. Mahwah, NJ: Lawrence Erlbaum Associates, Publishers, 1998;359-379.

10McCraty R, Zayas M. “Cardiac coherence, self-regulation, autonomic stability, and psychosocial well-being. Front Psychol 2014;5:1090.


Dr. Barbara Fougere graduated in 1986, and was named the American Holistic Veterinary Medical Association Educator for 2011. Dr. Fougere is the principle and one of the founders of the College of Integrative Veterinary Therapies. She has continued studying over the last 26 years, and has three Bachelor degrees, two Masters degrees, three post Graduate Diplomas, several Certifications and numerous other courses under her belt.