How Can Biofeedback Help Manage my Stress?
By: David Lechnyr, LCSW
Biofeedback is a fancy way of saying that we look for signals from our biology in order to tell us how relaxed or stressed we are. If we were as observant as Sherlock Holmes, we could possibly perform biofeedback by merely observing one’s body language and responses.
However, most of use aren’t that keenly aware of the subtle differences in body language. To compensate for this, we use machines which can measure signals (heart rate, electrical signals, etc.) of our body and turn the results into visual feedback by numbers, sounds, gauges and other information.
By learning how to control our physical responses, we can increase our ability to control our response to a variety of issues including depression, stress, anxiety and chronic pain. In order to accurately measure these responses, we use machines which are designed to detect certain aspects of our biology. This can be done in terms of temperature changes, muscle tension, electrical skin conductivity, brain waves and the heart’s own electrical activity. These measurements can tell us a great deal about how our body reacts to stress. When used alongside other therapeutic techniques, it can help us to determine which methods work best for our own personal learning style. Often, we can be surprised at the results since how our body reacts is often unknown even to the most astute person.
In managing anxiety and stress-related disorders, some clinicians employ biofeedback training as an adjunctive tool in the overall treatment program for their patients. Neurofeedback and Biofeedback are well-proven techniques in the treatment of both physical and emotional disorders with a variety of applications for managing chronic pain, migraine and tension headaches, tension and stress syndromes and psychosomatic disorders. Neurofeedback therapy can and should be thought of as an adjunctive tool to be utilized within the overall health care treatment regimen. A good example of how this works would be a case where a chronic pain patient improves, but as the physical symptoms are alleviated, a number of behavioral or anxiety-related problems emerge. The integration of both psychotherapy and biofeedback techniques have traditionally yielded impressive therapeutic results, especially in changing or modifying a patient’s life style response patterns. As such, neurofeedback training can be an effective clinical approach to treating various psychophysiological and emotional disorders.
EEG Biofeedback (aka Neurofeedback)
Neurofeedback is a type of Biofeedback. With this, brain wave patterns can be observed, analyzed, and controlled with EEG, or electroencephalographic biofeedback. From this description, one would get the impression that it is similar to diagnostic tools employed by neurologists. But EEG biofeedback is not a diagnostic procedure; its main function is to help patients observe and control brain wave or thinking patterns, as a visual guide or indicator of tension states. It is especially helpful in the treatment of insomnia, pain and obsessive focusing on thoughts of pain, and in training the obsessive-compulsive thinkers to relax their minds. This technique can also be applied in treating phobic disorders, anxiety states, GI distress, and in helping to uncover unconscious material in psychotherapy.
This biofeedback instrument is designed to observe the electromyographic (EMG) or responsive activity of the muscles of the body. The individual learns not only how to reduce muscle tension, but more importantly, how to control muscle spasms and activity in various areas of the body. The opportunity for immediate feedback of information from specific muscle areas allows the individual to learn what activities, exercises, positions, postures, and stretches will help, or possibly make the tension or spasm worse. Since every person is different, the EMG instrument will help to design an individualized program of exercises, and triggers (techniques) that will help to reduce bodily stress, tension, and resulting pain. This is not a diagnostic EMG as utilized by a neurologist, but is a device which feeds back immediate visual and audio information to the individual. Patients are more apt to follow-through with home practice because they feel in control of the machine, which is helping them to personally discover how to help themselves. They tune-into their bodies, rather than block bodily awareness; so they can, eventually, give themselves their own feedback without the machine, which is the goal of biofeedback treatment. It is up to the patient to follow through on home practice consistently if there is to be any progress.
Peripheral blood flow, or vasodilation and constriction, can be measured with temperature biofeedback. Dilation or constriction of the peripheral vessels leads to changes in blood flow which the patient learns to control with the aid of a thermistor placed on the skin surface of the dominant hand and fingers. Minute changes in temperature are fed back to the patient immediately which allows him or her to identify what techniques help facilitate vasodilation/relaxation. This provides for a deep sense of relaxation of the autonomic system and stabilization of the vascular system. It is especially helpful in the treatment of migraine headaches, and even more importantly, in identifying how the body reacts to physical and emotional stress.
Minute changes in the skin potential and conductance can be measured on the galvanic skin response (GSR), or dermograph, biofeedback instrument. Changes are affected by emotions, survival responses — for example, injuries (i.e.; fight or flight responses) — breathing patterns, thoughts, and overall tension levels. It is a very sensitive and responsive instrument that is helpful in the treatment of stress reactions, hypertension, hyperventilation patterns, and in overall arousal levels. This instrument can easily demonstrate how irregular and increased breathing rates can increase internal tension levels. Many patients will deny hyperventilating until they are attached to the GSR biofeedback instrument. They will then immediately become open to learning more appropriate responses and breathing patterns, which are conducive to relaxation. The key at this point is to help them incorporate these learned responses into their daily lives.
Treatment with Biofeedback
Biofeedback, when used in combination with Cognitive-Behavioral Therapy (CBT), can be an effective treatment in regulating our responses to anxiety, stress and panic. An average of 6-10 sessions are spent on basic biofeedback training. It is not uncommon to learn that we are more stressed than we suspect and that control of our anxiety is more difficult than we had previously imagined.
It is important to remember that biofeedback sessions are quite time consuming, with up to an hour required for each appointment. Therefore, a physician may wish to involve a mental health professional as the primacy biofeedback therapist for individuals with chronic pain or stress-related problems. Then, he or she can work along with the physician to integrate the entire treatment process of the patient.
To allow for the full integration of the biofeedback techniques into the patient’s life, it is important to provide for several follow-up sessions after the initial weekly treatments. This is done by having the patient return in a month for another session and then again several more times at 2-3 month intervals. This helps to ensure that patients will continue to practice the techniques learned, allows for overcoming any blocks in progress, and emphasizes the importance of continued use of such techniques in order to acquire full lifestyle changes. Biofeedback instrumentation holds much hope and assistance for some of the more difficult and previously unyielding problems of a psychophysiological nature.