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Biofeedback is a technique that has been used by psychologists, medical specialists and coaches for many years. It has a well-established track record of success in dealing with health issues, and in promoting peak performance. But what exactly is Biofeedback?
In Biofeedback, the individual is trained to improve their own health and well-being by learning to read various signals from their body. For example, it teaches the person to become aware of various physiological processes that occur under stress, all of which would normally pass-by unnoticed and unrecognised. It usually does this by using small sensors, typically attached to the body with Velcro or an earlobe clip (see illustation, below) . These sensors gather information on the activities going on in a particular bodily systems of interest. This activity is then presented back to the individual, often in the form of a visual display on a computer screen, so that it may be used to guide health and lifestyle choices.
One example of a very common-place form of biofeedback (in fact so common, that most people hardly appreciate that it is biofeedback), is the blood pressure monitor. Most people will be familiar with the little machine and arm-cuff, typically used by nurses and GPs to check on your blood pressure. The readings can be used to help guide changes that you might need to make to your diet or exercise routine if your blood pressure reading is found to be elevated.
In other words, the blood pressure biofeedback being provided by the monitor is helping you to adjust elements of your lifestyle and activities for the purpose of increasing your well-being and achieving better health – that’s biofeedback at its purest.
An example of biofeedback which is a little less common place is the use of a small device that measures the temperature of your hands and helps you learn to increase this by managing muscle tension. What you are really learning through this form of biofeedback is how to relax the vessels in your hand in order for blood to flow more freely through your body. For some people, learning to do this proves to be a very effective way to manage headaches; often allowing them to take control of their condition without need for medication.
Commonly used forms of Biofeedback
Psychologists and doctors use biofeedback from a wide range of bodily functions to help patients. The equipment used may range from a computer programme that measures just one physiological function, through to having a multi-functional system that provides feedback about many bodily functions all at once. Which sort of biofeedback is given will depend on the problem the clinician is seeking to help you with.
Some of the more frequently measured physiological functions used in biofeedback training include:
Electromyogram (EMG) – This measures the level of tension in muscles by means of small sensors placed over the area of the body being monitored. Common sites for measurement include the neck, shoulders and the face all of which are frequently sites of muscle strain, particularly in people experiencing high levels of stress and anxiety. People in such situations are often completely unaware of just how tense their muscles have become, until the tension becomes so intense that it is experienced as shoulder pain or headache. Giving feedback from these areas enables the person to “catch” the tension and deal with it before it reaches the point of being painful.
Galvanic Skin Response (GSR) – This is sometimes also referred to as Electrodermal Skin Response (ESR or EDR), and measures electrical conductance in the skin. In fact, skin conductance is associated with the tiny sweat glands on the skin surface, which unlike sweat glands in other parts of the body which sweat when it’s hot, release their sweat in times of stress, or when the person is feeling emotional or anxious. The more these glands sweat, the greater the level of conductance recorded at the skin surface. It is possible to learn to manage GSR with feedback, thereby having a positive effect of the negative state of mind that is producing the rise in sweating. One point of interest is that GSR measurement is also at the basis of lie detector technology.
Electroencephalogram (EEG) – This measures and provides feedback on brain activity. EEG is one of the most complicated forms of Biofeedback to measure. It records brainwave activity by picking up the tiny pulses of electricity generated by the brain when it is active. These brain waves are the categorised into different groups (alpha, beta etc.), with each group being associated with differing levels of activation in the brain (e.g. excited, sleepy, relaxed etc.). This sort of biofeedback is used to help treat a wide range of psychological (and some physical) problems and, because of the sophistication and expense of the equipment, is generally only done by a psychologist or neuro-scientist in the clinic. There have been moves to make this technology accessible for home use, however, this is not yet widely available.
Heart Rate Variability (HRV) – This measures the very subtle variation in the time gap between each heart beat. The gap between any two beats is rarely equal, but the difference is so tiny that it is imperceptible without using very accurate equipment to record it. HRV is affected by emotions, thoughts and stress. The HRV pattern displayed on a computer screen as biofeedback provides the individual with an accurate indication of activity in their autonomic system, which is the specialised part of the nervous system which underlies all of these feelings. Increased activity in the autonomic nervous system during periods of anxiety appears as a spikey line of HRV activity on the screen. As the individual uses this feedback and begins to develop ways of entering a calmer state of mind, the HRV pattern on the monitor will become visibly smoother and more rhythmical, confirming that the action the person is taking to control of their anxious feelings is effective.
HRV measurement is currently the most sophisticated biofeedback measure available for home use, with HRV technology having been incorporated into a range of computer programmes, whose aims range from teaching better patterns of breathing, through to teaching relaxation, meditation or dealing with persistently troubling thoughts.
HRV is also at the core of the most recent developments in peak performance training. This is because the benefits of HRV management include improved cardiovascular and cognitive performance, better decision making, reduced pain sensitivity and improved reaction times.
Biofeedback in action
In terms of dealing with problems, biofeedback is particularly good for those with feelings of stress, anxiety, panic, and related feelings of light-headedness and concerns about passing out. It can also help with high blood pressure, tension headaches, and inability to maintain attention and concentration.
Biofeedback’s value is not limited to dealing with problems and symptoms. It is also widely used by trainers and coaches to improve performance in students, executives, professional performers and athletes. It does this by supporting better attention, concentration and memory, more efficient breathing, relaxation, stress management and clarity of thought.
How biofeedback is used on a day-to-day basis
Dr. Audrey Sherman, who is a psychologist and author of the book “Dysfunction Interrupted – How to Quickly Overcome Depression, Anxiety and Anger Starting Now” explains the role and use of biofeedback thus:
“Let’s say you experience anxiety to a very unpleasant level. When the body is anxious, breathing, temperature and other bodily responses are off normal or off what is ideal. Stressful events and thoughts produce strong feelings or emotions that bring with them many physical responses. These responses are generally controlled by the sympathetic nervous system, which is the system in charge of emergencies.
“The typical response of the body is for the gastrointestinal system to slow down, you begin to sweat or feel hot, your pupils dilate, and blood vessels contract while those in the muscles and brain dilate to increase oxygen. Your heart may beat faster, and your blood pressure rises. If the event is specific and situational you will return to normal functioning when the danger has passed. If the event is ongoing, such as fears or ongoing abuse, your body may live in that state and it may feel normal to you even though you know at some level you are uncomfortable.
“Biofeedback is the tool that gives you the visual on this phenomenon, which is a good way help you recognise and get to know your response and, ultimately, take control of it.”
Dr Sherman continues: “You are hooked up to the machine and thinking your normal scary thoughts. You see the colours or lights or sounds the machine is registering and they indicate a high level of distress. You then use cognitive techniques and self-talk to tone this down a bit and take control. So if your thought is ‘I will never be happy or feel normal’, chances are the machine is telling you your body isn’t happy with this thought. You then replace that thought with something like ‘I am working toward happiness and am a good person’. Your body and the device will show you the difference”.
Dr Sherman also emphasises the importance of a good breathing style when trying to manage the stress response. Many people are “taught” by the stresses and strains of everyday life to breath too much (hyperventilate) through, for example, sighing frequently or breathing too quickly and shallowly. It is well documented that hyperventilating in this way can give rise to feelings of light-headedness and a sense of being about to pass out. This is a frightening prospect in itself and the thought of it alone is enough to throw the person back into even more pronounced breathing distortions.
Many biofeedback devices, particularly those based on HRV, now tend to incorporate instructions to help achieve a healthier breathing pattern. With on-screen visual guides to help you achieve a better breathing rhythm capable of keeping the stress response in check.
… and summarising the benefits of biofeedback:
Biofeedback offers people a means to control various elements of the bodily functions which are crucial to well-being and which, ordinarily, we would probably be unaware of or, at least, believe them not to be consciously controllable.
Biofeedback helps us to achieve control over these bodily functions by enabling us to observe them, in real time, usually on a computer screen – and to observe the effects of our efforts to control these processes, until we achieve our desired goal.
These goals include better management of stress and the symptoms of anxiety, leading to a calmer mind and body, improved focus and productivity, better relationships and better overall health.
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