4 Biopsychosocial Strategies to Optimize Performance at Work

Did you know you can train and improve attention, reasoning, processing speed and tolerance for stress? It’s no secret that exercise is good for your body and mind, but what if I told you it can actually change your brain? Not some theoretical change well suited for an academic debate, but a physical and observable change. A shift that can improve your performance and make your work feel easier?

In this article I am going to cover 4 evidence-informed strategies for training the brain, to help you raise your threshold for high performance!

  1. Using Evidence to Inform Beliefs

Before we discuss the specific programs we can use to target the brain, let’s start by improving our understanding about the relationship between stress and our body and brain. Many people have learned a negative association with stress and there is no shortage of information on how to reduce and avoid it. Here’s the problem–while there are certainly examples of negative stress, there is a growing body of research telling us that our perception of stress plays a critical role in how it affects us!6,7 

Consider a recent study where authors made significant efforts to test this theory. The authors followed 174 Navy SEALS candidates through their notoriously challenging training. Even in this extreme environment, they found a “stress-is-enhancing” mindset predicted greater persistence through training, faster obstacle course times, and fewer negative evaluations from peers and instructors.8 Further evidence has demonstrated this mindset can even reduce the development of depression and anxiety symptoms in students faced with high levels of stress.9

This information is not meant to dismiss anyone’s personal experience with stress. However, it’s important to know the extent to which one believes the effects of stress are enhancing, rather than debilitating, is associated with greater health and well-being.9 We can use this important message to re-frame our beliefs about stress and improve our resilience! 

Exercise and Anxiety- Some Clarity 

Anxiety disorders form the most common type of mental illness4 and reports from the CDC and WHO show anxiety is on the rise.1-2 Entrepreneurs may be particularly vulnerable as they often face additional workloads, role ambiguity, role conflict, along with social and psychological uncertainties. These elevated circumstances of risks and uncertainties can increase anxiety.5 Given the correlation between perceived stress and burnout,5 actionable tools are needed to combat this anxiety. 

We have already covered one tool–reframing. Some of those same job demands we just defined as negatives, like role ambiguity, have also been observed to exert a positive and significant impact on the employees’ levels of innovativeness.10 Imagine how this information can change your experience with role ambiguity!

  1. Tools for Training Anxiety

The World Health Organization (WHO) recently updated their physical activity guidelines and indicated for the first time that the recommendation of 150 to 300 minutes of moderate intensity aerobic physical activity or 75 to 150 minutes of vigorous physical activity throughout the week is also beneficial for reducing symptoms of anxiety. It turns out, what’s good for your heart is also good for your brain! 

To dive a little deeper, let’s explore this connection between the brain and heart so wecan leverage this information to improve our ability to combat anxiety. I’m pleased to say some recent advances in science can give us some direction!

One way clinicians measure the relationship between the brain and heart is by assessing heart rate variability (HRV). HRV represents fluctuations in the time intervals between successive heartbeats. You likely recall heart rate as the number of heart beats in a minute. Well, as it turns out, the heart is not a metronome. I admit I borrowed this statement from Dr. Fred Shaffer, in his 2014 article published in “Frontiers in Psychology.”11 Dr. Shaffer is a biological psychologist, Professor of Psychology, and former Department Chair at Truman State University, and has added some wonderful articles on HRV.

When there is an inconsistent time between heart beats, this is called an arrhythmia. You might be thinking this is bad and certainly in a context of pathology, where the electrical signals from the heart are affected, arrhythmia can be problematic. What is less commonly known is that very small changes in the time between heartbeats is actually normal and is representative of heart and nervous system regulation. When appropriately driven by the nervous system, HRV is proposed to actually display elements of improved mental and physical health!

It’s helpful to think about HRV as a display of the body’s flexibility to maintain homeostasis, which is largely regulated by the heart and brain. This means the body can adapt to multiple stimuli in a given day, actually, even in matter of seconds, to meet the body’s demands. So you could say there is an evolutionary benefit to having this system flexibility.

  1. How to Train and Improve HRV?

HRV is a little complex, even being referred to as chaotic by scientists that study it.12 Let’s use the KISS method here and review the most studied mechanism accounting for HRV. When we train HRV, our main target mechanism is the baroreceptor reflex.

The Baroreceptor Reflex in Three Steps

  1. Little pressure sensing neurons called baroreceptors, located in the heart and large arteries, detect a rise or fall in blood pressure and increase or decrease their signal, respectively.
  2. These signals travel through a nerve to reach the brain stem–the breathing center of the brain.
  3. This signal leaves the brain stem through another nerve and travels to the heart, causing the heart to adjust its rate of contraction.

Why does this matter? When you inhale, heart rate increases and blood pressure decreases and when you exhale, the opposite happens. So this means you can use breathing exercises to train your HRV!

Scientific evidence has consistently demonstrated that slow paced breathing is a central component of increasing HRV.12,13 It turns out the baroreceptor reflex has a resonance frequency, around 0.1Hz or one cycle every 10 seconds. If we can match this frequency with our breathing rate, by taking one breath every 10 seconds, it tends to produce the largest increase in HRV!

While this frequency will vary slightly from person to person, with many protocols varying from 6.5 to 4.5 breaths every minute,12 six breaths per minute (that’s one breath every 10 seconds) seems to be a good average. There is no universally adopted dosage for how long to perform these exercises but consider a minimum of 10-15 minutes every day as a starting point. Anecdotally, many of my patient’s seem to benefit from placing this breathing exercise in a specific time where stress is elevated or it’s time to calm down the system. Common examples include:

  • Before and after board meetings
  • Before bedtime, once the individual is in bed
  • Directly after a workout, during a “Cool down” walk or cycle

4. Tools for Training Cognitive Performance

We know athletes train for things like strength, power and speed development, but many athletes also train to improve cognition. Let’s review some examples of how high achievers can use the same training tools as athletes, to improve their performance during a work day.

When I ask high achievers what they would want from a wellness program, they tend to say different versions of the same thing: “I want my day to feel easier.” “I want to be able to do more in less time.” “I want to crush my day”–this is a common one!

We know from the scientific evidence that exercise is now widely recognized for it’s ability to produce short-term improvements in cognitive performance. While most of this evidence is looking at a spectrum of moderate to intense exercise, there is a recent increase in studying the potential benefits of light physical activity (LPA) and high-intensity interval training (HIIT) for improving cognition. Why does this matter? The improvements in cognition translate nicely to improving work performance!

The good news is that some studies have shown an improvement in condition with as little as 5 minutes of light physical activity, typically repeated throughout the day. Scientists have also observed improved cognition in as little as 12 minutes of HIIT. Isn’t it nice to see some variety in training protocols? Not everyone enjoys the same type of exercise intensity or duration, so this gives you some options for training your brain.

Lets go over a few examples of how this can be used in the workplace and get some context. As it turns out, context really matters! If people don’t know why they are doing an activity, they don’t tend to stick with it. Aligning a program with someone’s goals may not only improve their participation, it can improve their training response.

If someone asks me to improve their cognitive performance with exercise, I want them to know the protocols I’m covering here–LPA and HIIT, have been shown to increase brain derived neurotrophic factor (BDNF). BDNF is a protein that plays a key role in maintaining and improving several brain functions. In this case, we are trying to increase BDNF because these increased levels are associated with improvements in memory and cognition! 

Now that you know this training aligns with the goal of improved cognitive performance and why this is worth your time, lets review the protocols! Keep in mind these are averages are taken from large scale research reviews14 and there are many studied protocols. These averages are useful because they allow some flexibility for those starting a program. Please note, these are examples for informational purposes only. Anyone considering starting an exercise program should speak with their healthcare team! 

High Intensity Interval Training (HIIT) Protocol

HIIT involves a work:rest ratio. The work interval is a very hard effort! On a scale of 1-10, with 10 being maximal effort, work intervals are typically as high as 8-10/10! The work interval is often performed for upwards of 60 seconds. There are two options for the rest interval, active and passive. Active rest is just a less intense version of the work interval. If your work interval was sprinting either on foot or on a bike, you would simply perform a walk or slow cycling respectively, for the active rest interval. Active rest intervals are typically between 3-6/10 on the intensity scale. A passive resting interval, using the aforementioned examples, would be standing in place or simply sitting on the bike, with no work being performed. Both passive and active rest intervals are typically performed up to 4 minutes. 

HIIT can be performed many ways. Biking, running, swimming and whole body calisthenics are all great options! It’s so important to choose a program that people identify with. You should see the smile I get when I tell a yoga or pilates practitioner they don’t have to run to get these benefits! 

Light Physical Activity Protocol

The key here is a low intensity, low duration activity we can perform many times throughout the day. This protocol is focused on minimizing the impairments in cognition that scientists have observed as a result of prolonged sitting.15-18 Let’s briefly pause on this comment, so it’s not taken out of context. The evidence examining the relationship between cognition, prolonged sitting and LPA is in its infancy! There are still many unanswered questions. For instance, age and cardiovascular fitness level seem to be major factors in one’s cognitive response to prolonged sitting and physical activity. These are some of the many reasons why subjects vary in their responses within research studies. I say this because I don’t agree with promoting a fear of sitting! Many of my patients, especially those with anxiety, report elevated levels of stress when their worksite wellness protocols focus on the negative impacts of sitting. This takes us back to the “Stress is enhancing” mindset I tend to promote within my training protocols. 

Now for the good news! With as little as 5 minutes of LPA, performed for every hour of sitting, improvements in cognition have been observed! For those looking for some wiggle room, I have found many high performers tend to prefer a protocol that does not disrupt a flow state. For those who feel like they’re experiencing this state, where the work flow seems effortless, they can consider longer physical activity breaks, with a lower frequency dosage, so the flow state isn’t disrupted. In other words–layer more activity before or after the flow state. 

Just like the HIIT protocol, there are many options for LPA. Marching in place with a height-adjustable desk, using a treadmill desk, riding a bike, participating in standing/walking meetings, yoga and pilates are all great ways to increase LPA. 

These are all examples of how high performers can use evidence-informed tools to improve performance during their work day. By reframing our ideas about stress, mastering the inherent power of breathing, and fine tuning our physical activity, we can change the structure and function of our brain to improve our performance! I’ve had many patients and clients benefit from the Biopsychosocial model of training. This is a well-supported approach to training and healthcare that emphasizes the crucial connections between the brain and body. 

My name is Dr. Lee Skinner and I am a human performance strategist. I train entrepreneurs and corporate professionals to perform better by using tools developed for elite athletes. You can contact me on instagram @doc.skinner1 or email me at lee@thephysioremedy.com


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