What is Biofeedback?

DHHS Publication No (ADM) 83-1273 This Material was written by Bette Runck, staff writer, Division of Communication and Education, National Institute of Mental Health.

NATIONAL INSTITUTE OF MENTAL HEALTH- Division of Scientific and Public Information-Plain Talk Series- Ruth Kay, Editor

Biofeedback is a form of treatment, a technique that trains people to improve their health by developing the capacity to detect signals received by their own bodies. Physical therapists use biofeedback to help stroke victims regain movement in paralyzed muscles. Psychologists use it to help tense and anxious clients learn to relax. Some specialists use biofeedback to help their patients cope with pain.

Chances are, perhaps unknowingly, you have already used biofeedback yourself. You've used it, for example, if you have ever taken your temperature or stepped on a scale. The thermometer tells you whether you're running a fever; the scale whether you've gained weight. Both devices "feed" information "back" to you regarding your body's actual condition. Given this information, you can take the necessary steps to self regulate and improve your condition. When you're running a fever, you go to bed and drink plenty of fluids. When you've gained weight, you likely consider exercising and resolve to eat less.

Clinicians utilize biofeedback in a similar way that you rely on your scale or thermometer. Their equipment can detect a person's internal bodily functions with far greater sensitivity and precision than a person can alone. This information can be valuable, as both patients and therapists use it to direct and gauge the progress of treatment.

For patients, biofeedback functions like a kind of sixth sense, which allows them to "see" or "hear" certain activities from inside their bodies. One of the most commonly used type of biofeedback techniques, for example, picks up electrical impulses in the muscles and translates them into a signal that patients can detect easily. It may trigger a flashing light bulb, or activate a beeper every time muscles grow more or less tense. In this way a patient can track their bodily functions and self-regulate.

Like a pitcher learning to throw a ball across a home plate, the biofeedback trainee, in an attempt to improve a given function, like learning the process of self-relaxation, monitors his performance. When a pitch is off the mark, the ballplayer adjusts the delivery so that he performs better the next time he tries. When the light flashes or beeps too often, the biofeedback trainee makes the necessary adjustments, which are finally reflected in the normalization of the signals. The biofeedback therapist acts as a coach setting goals, guiding expectations and giving recommendations on how to improve performance.

""To educate about biofeedback is essential to my practice as a life strategist. I utilize these essential tools for assisting my clients in achieving their goals.".-Audrey Marlene

The Beginnings of Biofeedback

The word "biofeedback" was coined in the late 1960s to describe laboratory procedures then being researched and practiced to train experimental subjects to alter brain activity, blood pressure, heart rate, and other bodily functions that are not usually controlled voluntarily. At the time, many scientists predicted that, one day, biofeedback would give us a major degree of control over our bodies. They believed, for instance, that we would be able to "will" ourselves to be more creative by intentionally changing the patterns of our brainwaves. Some even believed that biofeedback would one day make it possible to substitute many drug treatments that often cause uncomfortable side effects in patients with high blood pressure and other serious conditions.

Today, most scientists agree that such high hopes were unrealistic. Research has demonstrated that biofeedback can help in the treatment of many diseases and painful conditions. It has shown that we have a significant degree of control over more so-called "involuntary bodily functions" than we once though possible. Nonetheless, research has also shown that nature limits the extent of such control. Scientists are now trying to determine just how much voluntary control we can exert.

"By understanding the basics of biofeedback, you will begin to realize the powerful tools available in helping to minimize negative thought patterns and enable more positive thinking and positive psychology"- Audrey Marlene

How is Biofeedback Used Today?

Clinical biofeedback techniques that grew out of these early laboratory experiments and procedures are now widely used to treat a list of conditions that continues to grow over time. These include:

  • Migraine headaches, tension headaches, and many other types of pain.

  • Disorders of the digestive system

  • High or low blood pressure

  • Cardiac arrhythmias (irregularities, sometimes dangerous, in the rhythm of the heartbeat)

  • Raynaud's disease (a circulatory disorder that causes uncomfortably cold hands)

  • Eilepsy

  • Paralysis and other movement disorders

    Specialists who provide biofeedback training range from psychiatrists and psychologists to dentists, internists, nurses, and physical therapists. Most rely on many other techniques in addition to biofeedback.

    Many patients are amazed when they see, first-hand, relatively quick results reflected in the biofeedback equipment. Certain individuals learn to identify the circumstances that trigger their symptoms and are usually taught some form of relaxation exercise. They may also be taught how to avoid or cope with stressful events. In some cases, a simple change in their habits lead to significant improvements in their quality of life.

    One thing is clear, though. Biofeedback is not magic. The equipment cannot cure diseases or improve a person’s health by itself. Like many other things, it is a tool available to health care professionals. It reminds them that behavior, thoughts, and feelings profoundly influence physical health. It is not only incredibly empowering for an individual, but also a testament to the improvements he or she is capable of achieving regarding his or her quality of life when recognizing the effects of undesirable behavior and acting to change them. It also helps both patients and biofeedback practitioners understand that they must work together as a team.

    "Understanding the benefits of biofeedback opens a new world in terms of safe and effective alternatives for treating certain conditions." - Audrey Marlene

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    Patients' Responsibilities

    Biofeedback places unusual demands on patients. It motivates them to examine their day-to-day lives to learn if they may be contributing to their own distress. They must recognize that they can, by their own efforts, remedy certain physical ailments. They must commit to changing bad habits and practicing biofeedback or relaxation techniques every day. Above all, they must accept that they, themselves, are the ones responsibile for creating the necessary conditions and seeking solutions and to maintain their own health.

    "To reap the benefits of biofeedback, you must muster up the discipline to implement the necessary changes in your life".-Audrey Marlene

    How Does Biofeedback Work?

    Scientists cannot yet explain the details of how biofeedback works. Most patients who benefit from biofeedback are trained to modify their behavior, which often implies learning how to relax. Most experts believe that relaxation is a key component in biofeedback treatment, particularly those brought on or exacerbated by stress. Their reasoning is based on what is known about the effects of stress on the body. In brief, the premise of biofeedback is that stressful events produce strong emotions, which evoke certain physical responses. Many of these responses are controlled by the sympathetic nervous system, a network of nerve tissues that helps prepare the body to meet emergencies through "flight or fight."

    The typical pattern of response to emergencies probably emerged when all humans faced mostly physical threats. Although the "threats" we now live with are seldom physical, the body reacts as if they were. Our pupils, for example, dilate to let in more light. Sweat, on the other hand, drips out of our pores to reduce the chance of cuts on our skin. Blood vessels near the skin contract to reduce bleeding, while those in the brain and muscles dilate to increase the oxygen supply. The gastrointestinal tract, including the stomach and intestines, slow down to reduce the energy expensed in digestion. The heart beats faster, and blood pressure rises.

    Normally, people calm down when a stressful event is over; especially if they have found a solution or a given way to better cope with it. For instance, imagine your own reaction if you're walking down a dark street and hear someone running towards you. You get frightened. Your body is preparing you to ward off an attacker and likely mustering up the necessary adrenalin to run fast enough to get away. After you escape, you gradually relax.

    If you get angry at your boss, it's a different matter. Your body may prepare to fight. But since you want to keep your job, you do your best to ignore your angry feelings. Similarly, if on the way home you get stalled in traffic, there's nothing you can do ameliorate the situation. These predicaments can literally make you sick. Your body has prepared for action, but you cannot act as you wish or feel. Individuals differ in the way they respond to stress. In some cases, a given function --blood pressure, for example—heightens in activity while others remain normal. Many experts believe that individual physical responses to stress can become habitual. When the body is repeatedly agitated, one or more functions may become permanently overactive. Actual damage to bodily tissues may eventually result.

    Biofeedback is often aimed at changing habitual reactions to stress that can cause pain or disease. Many biofeedback practitioners believe that some of their patients and clients have simply forgotten how to relax. Feedback regarding physical responses such as skin temperature and muscle tension provides information to help patients recognize a relaxed state. An improved signal in feedback may also give the patient confidence because of their ability to reduce tension. It's like a piano teacher whose frown turns to a smile when a young musician finally plays a tune properly.

    The value of a feedback signal as information and positive reinforcement may be even greater in the treatment of patients with paralyzed or spastic muscles. With these patients, biofeedback is used primarily as a form of skill training, like learning to pitch a ball. Instead of watching the ball, the patient watches the biofeedback equipment, which monitors the activity of the affected muscle. With the signals given out by the biofeedback equipment, stroke victims with paralyzed arms and legs, for example, can often see that parts of their affected limbs still remain active. This signal can serve as a guide to determine exercises that help patients regain use of their limbs. Perhaps even more important, the feedback convinces patients that their limbs are still alive, which encourages them to continue their efforts.

    This Material on Biofeedback was provided through:U.S. Department of Health and Human ServicesDivision of Communications and Education, National Institute of Mental HealthPublic Health Service - Alcohol, Drug Abuse and Mental Health, Administration 5600 Fishers LaneRockville, MD 20857 USA

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