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 BIOFEEDBACK

What is it?
DEFINITION AND EXPLANATION OF BIOFEEDBACK
Biofeedback is a well-established method of empowering an individual to reduce his own experiences of physical pain and emotional stress.  Specially developed mechanical equipment monitors the patient’s physiological processes while he learns specific visualization and relaxation techniques.  The power of biofeedback is that with practice, the patient may become proficient at inducing their innate relaxation responses to control and normalize things like heart rate, muscle tension, and blood pressure. It is generally administered in a clinical setting by those trained to use the equipment and teach specialized relaxation techniques, although machines designed for private home use have recently become available.

Biofeedback equipment provides real-time audio or visual cues to help teach awareness and control of internal physical responses to stress like heart rate, muscle tension, blood pressure, sweat gland activity and brain wave patterns. Translating these internal and often hidden processes into something that can be seen or heard helps patients efficiently develop sensory awareness of what is happening in their bodies.

Like many relaxation practices, biofeedback is cumulative and it is recommended that the patient commit to practicing daily 15 to 20 minutes, preferably after a progressive relaxation or meditation, in order to have a long lasting impact on health. 

What conditions can it help?
CONDITIONS BIOFEEDBACK MAY BE HELPFUL FOR
 
Conditions that are commonly treated by biofeedback include:
 
- Chronic pain
- Insomnia
- Migraines
- Hypertension
- Cardiac arrhythmias
- Ulcers
- Chronic intestinal problems
- Reynard’s Disease
- Bruxism
- Allergies
- Weight loss
- Phobias
- Addictions
 
The Association for Applied Psychophysiology and Biofeedback says biofeedback treatment protocols have been significantly proven for:
 
- Anxiety
- ADHD (Attention Deficit/Hyperactivity Disorder)
- Hypertension
- TMJ (Temporomandibular Joint Syndrome)
- Urinary incontinence in males
- Migraine, cluster, and tension headaches

Where did it come from?
HISTORY OF BIOFEEDBACK
The origins of biofeedback trace to the beginning of the twentieth century.  Edmund Jacobsen began his research at Harvard in 1908, and throughout the 1920's and 1930's worked to develop progressive muscle relaxation as an effective behavioral technique for alleviating tension and many other functional medical disorders. He used crude electromyography equipment to monitor the levels of muscle tension in his patients during the course of treatment.

The German Johann Schultz contributed "autogenic" training in the 1930's. The autogenic technique involves repeating a set of visualizations several times a day ("My arm is warm and heavy") that induce a pervasive quieting effect of the autonomic nervous system.

Prominent behavioral psychologists B.F. Skinner and Albert Bandura also contributed to the modern version of biofeedback.  In their laboratories they conducted numerous experiments of animal behavior training.  The knowledge resulting from this study allowed them to develop specific behavioral modification systems.

Neal Miller, a Yale psychologist and neuroscientist, is commonly credited with being the father of biofeedback for his work in the '50s and '60s using electrical stimulation to train lab rats to control heart rate and body temperature at will. He examined the physical origins of the most basic of human motivations such as hunger and fear.  Miller's ideas were revolutionary at the time, although his initial research results were never duplicated. 

Research by these and other individuals put the building blocks for this new science of self-regulation in place by the 1960's. Awareness of the body/mind symbiosis continued to infiltrate the public consciousness, driving the demand for further research and practical application.
Biofeedback practitioners utilize relaxation techniques that have their roots in meditation, guided imagery, yoga, progressive relaxation and hypnosis.  Research has been done at many major hospitals including the Mayo Clinic, headache clinics, universities and other scientific institutions.

What is it based on?
THEORY OF BIOFEEDBACK
Biofeedback is based on the simple theory that the mind may be trained to consciously control almost any bodily response, even those once thought to be involuntary. Relaxation techniques taught with biofeedback primarily impact the autonomic nervous system, in particular the parasympathetic system, which calms and relaxes the body and manages processes like digestion and the beating of the heart. Patients are taught to utilize proven techniques including meditation, deep breathing, guided imagery, self-hypnosis and sensory awareness in order to impact the biofeedback readings they get from the equipment being used.

How is it done?
CLINICAL PRACTICE OF BIOFEEDBACK
Biofeedback treatment would typically include meeting with a trained practitioner for a series of about 10 sessions spaced about a week apart. Biofeedback equipment communicates in some way to the patient, for example, with an audible "beep" signal with each heartbeat. Coupled with this, the practitioner teaches the client relaxation techniques.  As the client practices the technique, they immediately see a response from the beeps whether they have become less relaxed (beeps speed up) or more relaxed (beeps slow down). By giving a tangible form of feedback, the patient is learns to recognize more easily what they need to do to see immediate results.

Some of the most common biofeedback equipment includes:

ELECTROMYOGRAPH (EMG) The EMG uses small painless electrodes to measure muscle tension that the patient learns recognize and consciously relax.

FEEDBACK THERMOMETER Readings of the patient's skin temperature are taken by a thermistor placed at the fingertips and webbing of the hand.  Low temperatures indicate shrinking of the tiny blood vessels ("vasoconstriction"), and may point to certain circulatory disorders or high stress.  
The lay population is familiar with the electrodermograph as the “Lie Detector Test”.  Sensors attached to the subject are used to detect small physical changes in sweat gland production and other galvanic skin subtleties. It may be used to treat disorders such as phobias, stuttering, and generalized anxiety.

ELECTROENCEPHALOGRAPH (EEG) Painless electrodes are attached to the patient's scalp to monitor brainwaves associated with wakefulness (Beta waves), relaxation (alpha waves), calm (theta waves) and light and deep sleep (delta waves).  This machine is primarily used in the treatment of anxiety and ADHD.

PHOTOPLETHYSMOGRAPH (PPG) Measures blood flow to the extremities, heart rate and heart rate variability (HRV), or the varying spaces between heartbeats, aka the "interbeat interval." Laboratory studies of HRV have revealed that cognitive stress can reduce HRV.  Clients may learn to identify a breathing pattern that increases their variability.

Who does it?
BIOFEEDBACK PRACTITIONERS
Approximately 1,500 biofeedback practitioners work in a variety of settings in the United States, including hospitals, clinics, and other wellness centers.  When practiced by mental health therapists it can be united with psychological treatments such as cognitive therapy.

There are a growing number of institutions that certify biofeedback practitioners including the Biofeedback Certification Institute of America (BCIA). Such organizations seek to assure the standards of care in the clinical practice of biofeedback and standardize knowledge and skill based on curriculum including classwork, supervised personal training, supervised clinical practice, and a comprehensive exam.