Patient motion during treatment is well understood as a prime factor limiting radiotherapy success, with the risks most pronounced in modern safety critical therapies promising the greatest benefit. In this paper we describe a real-time visual feedback device designed to help patients to actively manage their body position, pose and motion. In addition to technical device details, we present preliminary trial results showing that its use enables volunteers to successfully manage their respiratory motion. The device enables patients to view their live body surface measurements relative to a prior reference, operating on the concept that co-operative engagement with patients will both improve geometric conformance and remove their perception of isolation, in turn easing stress related motion. The device is driven by a real-time wide field optical sensor system developed at The Christie. Feedback is delivered through three intuitive visualization modes of hierarchically increasing display complexity. The device can be used with any suitable display technology; in the presented study we use both personal video glasses and a standard LCD projector. The performance characteristics of the system were measured, with the frame rate, throughput and latency of the feedback device being 22.4 fps, 47.0 Mbps, 109.8 ms, and 13.7 fps, 86.4 Mbps, 119.1 ms for single and three-channel modes respectively. The pilot study, using ten healthy volunteers over three sessions, shows that the use of visual feedback resulted in both a reduction in the participants’ respiratory amplitude, and a decrease in their overall body motion variability.