Managing the Stress Response: The Use of Biofeedback
and Neurofeedback with Olympic Athletes
Margaret Dupee, MA, BCB, and Penny Werthner, PhD
University of Ottawa, Ontario
Keywords: elite athletes, optimal performance, biofeedback, neurofeedback, stress response
Excessive stress and tension are major threats to optimal
athletic performance. The goal of this project was to help the
athletes optimize the management of their stress response
through self-awareness and self-regulation of the activation
levels of their autonomic and central nervous systems.
Fifteen elite athletes preparing for the Vancouver 2010
Olympics underwent an EEG and psychophysiological stress
assessment, as well as a bio–neurofeedback (BNFK) training
intervention. Both athletes and coaches reported that the
bio–neurofeedback intervention helped the athletes in
managing the stress of training and competition and was
a factor in producing better performances.
Coaches, athletes, and sport psychologists agree that the
manifestation of excessive stress and tension before and/or
during competition are major threats to the ability of the
athlete to meet or exceed their performance goals (Sime,
2003). Athletes with greater psychophysiological self-
regulation over somatic (physical) and cognitive (mental)
components of anxiety have a greater sense of personal
control over their performance, and cope better with the
stress of competition (Hatfield & Hillman, 2001). In study-
ing the ability to adjust physiological and psychological
activation levels, Bois, Sarrazin, Southon, and Boiche
(2009) also found that frequent use of strategies for manag-
ing emotional control predicted superior sport performance.
Logically then, management of the stress response should
be a high priority for elite level athletes.
Responses to stress are observed in multiple psycho-
physiological systems, with linkages between the nervous
system, the endocrine system, and the immune system, all
of which form the collective heart of the stress response
(Cacioppo, 1994). Intervening at the level of the nervous
system through the use of biofeedback and neurofeedback
assessment and training can enhance an athlete’s compet-
itive advantage (Sime, 1985). As William James put it,
‘‘The greatest thing in all education is to make our nervous
system our ally instead of our enemy,’’ (James, 1899).
It is from this perspective that we began working with elite
Canadian athletes preparing for the Vancouver 2010
Olympics, in order to assist them in going from ‘‘good to
great’’ in the management of their stress response.
Specifically, our work with these athletes was based on
the belief that the focus/relaxation dynamic is a crucial
component of optimal performance. When this dynamic is
disrupted, the human body and mind suffer, as does the
The bio–neurofeedback (BNFK) training focused on enabling
each of the 15 athletes to learn how to manage the activation
levels of their autonomic and central nervous systems. In
order to achieve this, an intervention was designed to
optimize four skills: (a) a calm, narrow focus; (b) brief
recovery, which involved quieting both the autonomic
nervous system (ANS) and central nervous system (CNS)
for 1–3 minutes; (c) the ability to switch between narrow
focus and brief recovery at will (Thompson & Thompson,
2003); and (d) deep recovery, which involved quieting the
ANS and CNS for 6–20 minutes.
To gain insight into each athlete’s autonomic and central
nervous system activation levels and patterns under stress
and in recovery, we conducted a psychophysiological stress
assessment and an 18-site electroencephalography (EEG)
assessment on each athlete. The initial assessment used the
Optimal Performance Assessment (Biofeedback Foundation
of Europe Optimal Performance Suite) created by Vietta
Wilson (2006), followed by a second assessment using
the The Learning Curve (TLC) 18-site EEG assessment
developed by Peter Van Deusen (2006). Measures were
gathered in seven areas: EEG, surface electromyography
(SEMG), respiration rate, heart rate, heart rate variability,
skin conductance, and peripheral body temperature. From
the data, we identified how each athlete responded to
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EAssociation for Applied Psychophysiology & Biofeedback
Fall 2011 |Biofeedback
stress and their activation levels. Their ability to recover,
both mentally and physically, was also of interest.
Generally speaking, analysis of the assessment data
revealed good to excellent focusing skills and a less well-
developed ability to put the body and mind in recovery. With
respect to the autonomic nervous system, some athletes did
not return to baseline after the stressor/task and occasionally
went in the opposite direction, where they became more
activated in recovery. The most consistent pattern was seen
in the heart rate variability (HRV) measure. Almost without
exception, athletes had higher HRV during the stressor/task
than during recovery, indicating that their cardiac and
pulmonary systems were more coherent during a task than
in recovery. In the central nervous system, an examination of
the percentage of slow, medium, and fast waves revealed
higher than target values in the fast waves (beta and high
beta). The athletes most often produced higher than target
values in the temporal lobes.
The goal of the BNFK training was to enable the athletes to
learn to identify and exercise control over the activation
levels of their autonomic and central nervous systems, first
in the lab and, ultimately, when competing at various
international competitions and the Olympic Games, which
would be the most stressful environments. All 15 of the
athletes learned how to identify their optimal performance
state. Through the training, they developed the ability to
achieve optimal levels of physical activation, as well as
optimal patterns in thinking, feeling, and focusing. How-
ever, many of them admitted that at times they could not
consistently sustain these states during competition. As
Krane and Williams (2006) have noted, achieving one’s
own ideal internal climate is not a simple task.
As mentioned earlier in the article, our training program
was developed around the optimization of the four key
focus/recovery skills: (a) ability to sustain a calm, narrow
focus; (b) ability to briefly recover (wide focus); (c) ability
to switch states at will (between narrow and wide focus;
Thompson & Thompson, 2003); and (d) ability to recover
deeply. A crucial component of all four skills is the ability
to keep high beta (rumination and worry) low.
In order to work on these four key skills, each training
session was broken down into three components:
1. Quieting the ANS. This component was identified as
brief physical recovery exercises. Self-awareness and self-
regulation of muscle tension, respiration rate, heart rate,
skin conductance activity, and peripheral body temper-
ature were trained both with eyes open and eyes closed.
2. Managing the CNS. The EEG modality was used for
the three aspects of this component: (a) brief mental
recovery (wide focus), (b) narrow focus, and (c)
switching states between narrow focus and brief
recovery (narrow and wide focus; Thompson &
3. Quieting both the ANS and CNS. All seven measures,
(EEG, SEMG, respiration rate, heart rate, heart rate
variability, skin conductance, and peripheral body
temperature) were monitored for the physical and mental
deep recovery component. Paced breathing (Gervirtz &
Lehrer, 2007) was used to help them decrease activation
in both systems.
Training sessions lasted 1–1Khours in length, with each
athlete completing between 20–40 hours of training
overall. Each training session was broken down into
10 minutes for set-up, 20 minutes quieting the ANS,
30 minutes managing the CNS, 20 minutes deep recovery,
and then 10 minutes to unhook sensors and wrap-up the
session. Initial training sessions were shorter and focused
more on self-regulation of the ANS. These skills were then
used to assist with regulation of their CNS. Deep recovery
work began as a 6 minute session and over time was
increased to 20 minutes.
In order to help the athletes develop their strategies for
optimal self-awareness and self-regulation, on each training
task we asked them (and had them ask themselves for
personal reflection and learning) several questions: (a) What
is the task? (b) What do I need to be physically feeling and
mentally focused on? and (c) What strategies will I use?
Sime (2003) described the psychological preparation of
athletes for competition as ‘‘taking the brain to the weight
room’’ (p. 583). Perhaps then it is no coincidence that the
athletes in the present study often called bio–neurofeed-
back training ‘‘brain pain.’’
By far, the most common question we have been asked
was whether or not the athletes found the BNFK training
helpful and whether they liked to do it. In order to answer
this question effectively, at the completion of each
competition season, the athletes and coaches were asked if
the BNFK training was useful in helping each of the
athletes to focus better, manage their anxiety, and ulti-
mately improve their performance that season, and if they
wanted to continue to do it the following year. From the
perspective of the athletes, all 15 responded that it was very
helpful, and they wanted to continue. It is important to
note that several of the athletes did state that it was a great
deal of work learning how to manage their physical and
Dupee and Werthner
Biofeedback |Fall 2011
From the perspective of the coaches working with these
athletes, they uniformly reported that the training in
BNFK definitely helped their athletes in managing the
stress of training and competition, and they stated that it
was a factor in producing better performances.
Our experience assessing and training elite level athletes with
bio–neurofeedback techniques was an extremely positive one
for us, both professionally and personally. Working with
individuals that are highly motivated to be the best in the world
helped us refine and develop training protocols to manage the
activation levels of the autonomic and central nervous systems.
Based on this experience, we feel that bio–neurofeedback
training should be an integral part of an athlete’s training
regimen to optimally manage the stress response.
We would like to first acknowledge the generous research
funding from 2007–2010 from Own the Podium, an
organization created to lead the development of Canadian
sports to achieve podium performances at the 2010
Olympic and Paralympic Games. In order to develop and
implement this intervention, we also drew from a rich
array of knowledge and techniques developed by the
following individuals: Vietta Wilson, Lynda and Michael
Thompson, Nicolina Pavlov, Peter Van Deusen, Francois
Dupont, Richard Gervirtz, Paul Lehrer, and Les Fehmi.
Finally, we must thank the incredible technical support
team at Thought Technology for ensuring that our
equipment was always fully functional.
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Margaret Dupee Penny Werthner
Correspondence: Margaret Dupee, MA, BCB, University of Ottawa, 18 Pondside
Private, Ottawa, Ontario, Canada, K1K 4X3, email: bioneurofeedback@rogers.
Managing the Stress Response
Fall 2011 |Biofeedback