Biofeedback is a mind-body technique that teaches people in therapy how to better control the body’s involuntary responses to facilitate improved health. When we scratch our nose, jog in a park, or sit on a chair, we are performing voluntary bodily actions which we consciously control. However, other important bodily functions such as the regulation of blood pressure, pain perception, skin temperature, gastrointestinal activity, heart rate, and brain waves are controlled involuntarily—and often unconsciously—by the nervous system. With the use of electric sensors and other equipment, biofeedback therapy helps people in treatment gain greater awareness of what is happening inside their bodies and make subtle changes to their thinking in order to control how their bodies respond to certain health conditions or other stimuli.
Biofeedback and the mind-body connection are concepts which have been known and utilized for thousands of years. Evidence of this is observed in the modern day practices of techniques such as yoga and Pranayama (breathing exercises). Scientific support for these concepts arose in the 19th and 20th centuries, with key research conducted by Claude Bernard (who introduced the concept of homeostasis in 1865), J. R. Tarchanoff (who, in 1885, demonstrated that voluntary control of heart rate is possible), Alexander Graham Bell, Norbert Wiener, Burrhus Frederic Skinner, Donald Shearn, George Mandler, and Maia Lisina, among others.
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When people are able to gain insight into their body’s biological mechanisms, they are often better able to control their actions and reactions. Many people who practice biofeedback techniques are able to increase their mindfulness and body awareness, and some even learn to regulate involuntary body functions such as their own heart rate and blood pressure. Biofeedback is one approach often used by physical therapists to help victims affected by stroke redevelop muscle function. Biofeedback techniques may also be used in pain management, enabling individuals who were previously limited by their pain to improve their quality of life and function more comfortably.
Published studies also show that biofeedback therapy may provide positive results in the relief of stress-related symptoms. Mental health professionals may use biofeedback techniques in conjunction with other treatment modalities to help people who experience nervousness or tension during the therapeutic process. Biofeedback may help both the therapist and the person in therapy identify stress-related behaviors and explore more positive reactions to stress-inducing stimuli. Biofeedback has been used to ameliorate various mental health issues, and evidence suggests it may be especially useful for increasing impulse control and treating anxiety.
Some physical and mental health professionals believe that with enough advancement and understanding of this type of therapy, people may eventually develop the ability to reduce the risk of heart attacks, strokes, and other related health concerns. Biofeedback may be used by people of all ages and by individuals in various stages of health and development. Even individuals who show no visible symptoms of adverse health may benefit from the understanding they gain when they are better able to relate to their body’s functionality.
When used with other therapeutic approaches, biofeedback has been effective in the treatment of a wide variety of health concerns, including:
- Excessive stress
- Lower back pain
- Temporomandibular joint issues (TMJ)
- High blood pressure
- Obsessive compulsive behaviors
- Rheumatoid arthritis
- Attention-deficit hyperactivity (ADHD)
- Posttraumatic stress (PTSD)
- Physical injury
- Chronic obstructive pulmonary disease (COPD)
- Raynaud’s syndrome
Biofeedback therapy may utilize a wide variety of specialized equipment depending on the physiologic functions being monitored. These biofeedback sensor modalities include:
- Electromyographs (EMG): provides data on muscle tension
- Feedback thermometers: offers data on skin temperature
- Electrodermographs (EDG): measures the electrical properties of the skin, which are often linked to the activity of the sweat glands
- Electroencephalographs (EEG): measures brainwaves and other electrical brain activities and are commonly used for neurofeedback
- Pneumographs: measures chest expansion, chest contraction, and respiration rate
- Photoplethysmographs (PPG): provides data on blood flow through a digit (for example, a finger), blood volume pulse, heart rate, and heart rate variability
- Electrocardiograms (ECG): offers information about the heart’s electrical activity and heart rate variability
- Hemoencephalographs (HEG): measures the relative amounts of oxygenated and deoxygenated blood in the brain area
- Capnometers or capnographs: provides insight into the quality of a person’s breathing by measuring the partial pressure of carbon dioxide gas in exhaled air
- Rheoencephalographs (REG): measures blood blow in the brain
- Air pressure devices: commonly used to measure muscle performance
While working with a therapist who uses biofeedback therapy, the person in therapy will typically have a variety of sensors attached to different parts of the body. These sensors are installed by the therapist, and they send electrical signals to a display monitor which is usually visible to the person being treated. The data received is fed back to the individual in the form of flashing lights, images, or sounds, each of which corresponds to a specific physiological activity. The individual learns to adjust bodily reactions by changing thoughts, mood, or behavior.
Learning how to control the body’s activity may promote improved physical and mental health. For example, a person who experiences frequent headaches may learn how to identify tense muscles which contribute to headaches and relax them to reduce pain. Common relaxation techniques which may be taught during treatment include mindfulness meditation, deep breathing, guided imagery, and progressive muscle relaxation.
A standard biofeedback session may last from 30 to 60 minutes; however, the length of each session, the number of sessions required, and the type of biofeedback techniques used will depend on the issues being experienced and how quickly the person in treatment learns to control involuntary physiologic functions without the use of equipment.
Biofeedback has a variety of applications outside of the realm of therapy. Because the approach has been shown to increase relaxation, reduce anxiety, sharpen concentration, and promote optimal functioning, it has been useful for individuals involved in exercise/fitness, education, sports, business, and military activities. Many people believe they can gain a competitive edge if they train their mind and body to work together.
People who work in the justice system may benefit from certain biofeedback devices such as polygraphs (lie detectors). Video game designers are currently exploring the possibility of improving the gaming experience by incorporating biofeedback. For people interested in personal growth and development, the approach can be used as a tool for increasing self-awareness and self-exploration.
As biofeedback therapy tends to produce general feelings of well-being, the treatment may provide symptomatic relief without addressing underlying medical concerns. People experiencing cognitive impairment may find it difficult to comprehend and execute the steps necessary for successful treatment.
The use of electrodes and other unfamiliar mechanical devices may cause some individuals to feel apprehensive, thereby affecting the readings. Unusual readings may also arise due to “noise” from surrounding electrical signals, extreme room temperatures, or poor contact between electrodes and skin. As biofeedback equipment is primarily used in treatment settings, there may not be enough specialized equipment available to satisfy the needs of all individuals seeking treatment. Less expensive equipment may not give accurate readings.
Some critics claim that biofeedback is nothing more than a costly form of muscle relaxation. Therapy may become expensive for people who require numerous sessions of treatment, and many insurance policies do not cover biofeedback therapy.
- Beckham, A. J., Greene, T. B. & Meltzer-Brody, S. (2013). A pilot study of heart rate variability biofeedback therapy in the treatment of perinatal depression on a specialized perinatal psychiatry inpatient unit. Archives of Women’s Health, 16, 59-65, DOI 10.1007/s00737-012-0318-7
- Mayo Clinic. (2013). Biofeedback: Using your mind to improve your health. Retrieved from http://www.mayoclinic.org/tests-procedures/biofeedback/basics/what-you-can-expect/prc-20020004
- Medline Plus. (n.d.). Biofeedback. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/002241.htm
- Morina, N., Maier, T., Bryant, R., Knaevelsrud C., Wittmann, L., Rufer, M., Schnyder, U. & Muller, J. (2012). Combining biofeedback and narrative exposure therapy for persistent pain and ptsd in refugees: A pilot study. European Journal of Psychotraumatology, 3, http://dx.doi.org/10.3402/ejpt.v3i0.17660
- The Association for Applied Psychophysiology and Biofeedback. (n.d.). About biofeedback. Retrieved from http://www.aapb.org/i4a/pages/index.cfm?pageid=3463
- Weil, A. (n.d.). Biofeedback. Retrieved from http://www.drweil.com/drw/u/ART00466/Biofeedback-Dr-Weil-Wellness-Therapies.html
Last updated: 04-20-2016
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