Biofeedback

GENERAL BIOFEEDBACK….
MONITOR AND CONTROL YOUR OWN HEALTH.

What is Biofeedback?
What is the Goal of Biofeedback?
Why Biofeedback?
Which Biological Processes Does Biofeedback Monitor?
Biofeedback Devices.
What Happens During Biofeedback Treatment?
Who Can Offer Biofeedback Treatment Services?
Conditions Treated By Biofeedback.
Evidence Based Practice in Biofeedback and Neurofeedback.

In a way, the word bio - feedback is self explanatory. The “bio” is short for “biological”, and the “feedback” refers to the information “fed back” or “given back” to the person undergoing biofeedback.

What is the Goal of Biofeedback?

The goal of biofeedback is, first, to enable an individual to observe his or her own biological processes, which are too subtle for normal awareness. The ability to monitor our own processes is enhanced by the use of mechanical and electronic devices. The second goal of biofeedback is to train the client or patient to control the biological processes that they are monitoring. This is known as physiological self-regulation.

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Why Biofeedback?

There are at least three reasons why one would take part in biofeedback.

To learn to control physiological processes associated with ill health. Examples include: Learning to dilate peripheral blood vessels (as medications do) in order to reduce blood pressure; learning muscle relaxation to deal with pain symptoms such as headache and neck pain; achieving relaxed brain states for the treatment of anxiety and depression.
Biofeedback is a non-invasive treatment, in the sense that you can achieve some of your biological treatment goals without medication or surgery. Persons on treatment using biofeedback should however, should never stop or reduce medications without the approval and supervision of their regular medical practitioner.
Self-improvement: To improve concentration, memory, and creativity.
Peak performance in sport and other areas of life.

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Which Biological Processes does Biofeedback Monitor?

Most of our actions, feelings, and thoughts are controlled by processes that are too subtle or microscopic for us to be aware of them. We normally consider these processes to be autonomic, involuntary, or subconscious. Here are some examples.

Heart beat	We normally feel we have no control over what our heart does. For example, when we are afraid it beats faster. The electrical activities of our hearts normally proceeds without our awareness or control.
Blood Volume	Our blood vessels dilate and constrict in response to changes in the environment such as heat or physical exertion. The same dilation and constriction of blood vessels also takes i response to emotional states like fear, anger, and excitement. As the blood vessels dilate, there is more blood volume in the vessels, and we can detect this with biofeedback devices.
Temperature	This is related to blood volume just described above. Blood is warm. Fear or panic for example, reduces blood volume in the vessels of the skin. Reduced blood = reduced peripheral body heat. We then become cold (with fear).
Muscle Activity	Muscle activity, such as lifting a ball, is a voluntary act, and is not normally a direct target of biofeedback. However, muscle action such as the tensing of our face and jaw muscles when angry or trembling in fear, occur involuntarily, and they are the result of the smooth autonomic muscles. Even in the performance of voluntary actions, such as lifting a weight, we are not normally aware of or in control of, the electrical activity at the microscopic level in the muscle, the single motor neuron.
Sweating	When we are in an intense emotional state, we do not decide to sweat. It just happens. This type of sweating is not the same as sweating during physical exertion which takes place in order to cool the muscles and the body. This is the kind of sweat we refer to as “breaking into a cold sweat”
Breathing	Emotional states and behavioural disorders like anxiety and depression are associated with several features of abnormal breathing: Beauty, surprise, pleasure, and other events can “take our breath away” as we momentarily stop breathing. During anxiety, depression, and concentration, we find ourselves breathing dysfunctionally, i.e. too fast, too shallow, and in the wrong part of the body (breathing movements taking place more in the chest than the abdomen). Breathing is one of the most accessible biological process for voluntary control during biofeedback.
Brain waves	All behaviour is the result of electrical activity of the brain. When we sleep or relax, we produce slow brain waves. On the other hand, when we focus attention or consciously try to solve problems, we produce fast brain waves. We are normally not aware of or able to control these biological processes.

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Biofeedback Devices

Biofeedback devices detect minute physiological changes, and magnify it, in some instances as much a million times. This makes it possible for us to observe it. The computer output takes many forms. In some instances, one sees numbers on the screen corresponding to a physiological process, e.g. number of heart beats per minute. In other instances, one sees waves or line graphs indicating the dynamic amplitudes or frequencies of a physiological process over time. During biofeedback training, the physiological output can be converted into a computer game display. The display on the screen, or from computer generated audio output, corresponds to the trainee’s physiological changes.
A more detailed description of biological responses to stress is given in my book, sold on this website. : Mureriwa, J.F. Psychology is entirely physical: Taking the mind out of behavioural neuroscience. Biofeedback Laboratories (Pty) Ltd. Pretoria. Click here for our online shop!

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Sample Biofeedback Devices

Stress Cards

One of our associates checking out her stress levels on our stress card. The stress card is a special type of thermometer for finger temperature. As finger temperature increases with increased blood flow, the coloured square under the thumb changes from black through red, to green, and blue.

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Stress Thermometer

The stress thermometer, like the stress card monitors finger temperature changes associated with tension or stress. This thermometer monitors temperature changes to a tenth of a degree.

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Omnibus Biofeedback Devices

Devices such as Thought Technology’s Procomp Infiniti take multiple physiological measurements including brain waves (Electroencephalography EEG), muscle tension (electromyography – EMG), temperature (thermal biofeedback), sweat (skin conductance), heart rate (electrocardiography –ECG), and breathing (Respiration sensors). Omnibus devices are normally computerised, so that the real-time biological changes are displayed on computer screen, or audio feedback.

Screen image of a psychophysiological evaluation
Equipment and Software: Procomp Infiniti: Thought Technology Ltd

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What Happens During Biofeedback Treatment?
A person presenting for biofeedback will undergo a process that is typical of any clinical evaluation and treatment. This include,

First Session: Clinical interview to identify presenting symptoms (if any), purpose of consultation, and psychological tests if necessary.
Biofeedback Assessment Session: The therapist uses biofeedback devices to establish baselines of one or more of the physiological processes of interest such as EEG, EMG, temperature, breathing, sweating, and any other. Data is analysed for patterns of physiological reactivity, before setting up a treatment plan.
Follow-up Sessions: These are Treatment/ Training sessions: Broadly speaking, these are behaviour therapy treatment procedures and they take place as follows: The patient or client is hooked up to a device that monitors a physiological process of interest and he or she watches the live results on the computer screen. Through processes of operant conditioning, the patient or client is assisted by the therapist to learn how to control the rate, size, or direction of physiological change. By watching their own body functions displayed on the screen, and learning to use different techniques, the patient or client eventually gains mastery over the physiological process.

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Who Can Offer Biofeedback Treatment Services?

Biofeedback should only be offered by registered health professionals who should operate within their promulgated scope of practice. The health professionals include psychologists, psychiatrists, neurologists, physicians, nurses, clinical social workers, occupational therapists, physiotherapists, and any other registered health professional who has undergone additional training in biofeedback.

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Conditions Treated By Biofeedback

The Association of Applied Psychophysiology and Biofeedback (AAPB) publish, on their website a list of conditions that are treated using biofeedback:

· ADD & ADHD
· Alcoholism
· Anxiety
· Arthritis
· Asthma
· Breathing problems
· Chest pain
· Chronic pain
· Constipation
· Drug addiction
· Epilepsy/Seizure
· Fecal Elimination
· Headaches
· Hypertension
· Hyperventilation
· Incontinence
· Insomnia
· Irritable Bowel Syndrome
· Jaw area pain
· Knee pain
· Low Back Pain
· Non-cardiac chest pain
· Pain
· Phantom limb pain
· Posture related pain
· Raynaud's Syndrome
· Stump Pain
· Subluxication of the patella
· Substance abuse
· Temporomandibular Disorder
· Traumatic brain injury
· TMJ/TMD
· Urinary Elimination Disorders
· Vulvar Vestibulitis
Source: www.aapb.org [3 July, 2010].

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Evidence Based Practice in Biofeedback and Neurofeedback.

Biofeedback is more efficacious for some conditions than others. A book describing evidence based practice in biofeedback and neurofeedback can be downloaded free of charge from the AAPB website: www.aapb.org/tl_files/AAPB/files/Yucha-Gilbert_EvidenceBased2004.pdf

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