Biofeedback is a technique that allows individuals to monitor their own body processes so they can learn to control their body processes.
Biofeedback originated within the field of psychophysiology, a discipline that measures physiological responses as a way of studying human behavior. Quite simply, biofeedback allows individuals to use their minds to improve their physical and mental health by controlling body functions. The types of functions that can be controlled include brainwaves, muscle tone, heart rate, and pain perception. With the guidance and training of a biofeedback therapist, patients become more aware of specific body systems using instruments that provide information on the activity of these systems in conjunction with changes in thoughts, emotions, and behavior. Biofeedback has been applied successfully to treat a variety of health conditions such as migraine headaches and hypertension. It is also applied to study types of behavior in conjunction with thoughts, emotional responses, and higher cognitive functions. Biofeedback training involves monitoring physiological responses for therapeutic purposes as well as, or in addition to, research purposes.
The biofeedback technique uses instruments to give people continuous information about different body functions, including physiological processes such as heart rate or blood pressure. Using special equipment with electric sensors that deliver the feedback, recorded information from the body is relayed back to the individual through a changing tone or meter reading. The feedback information helps the individual focus on making certain subtle changes in the body, which may include relaxing specific muscles. With practice, people learn strategies that enable them to achieve voluntary control over the specific processes involved. For example, individuals who are trying to control their blood pressure level may see a light flash whenever the pressure drops below a certain level. They may then focus on their thoughts or emotions at that moment and deliberately repeat them to keep the pressure level low. Initially, they may be asked to simply try and keep the light flashing for as long as possible and are given verbal reinforcement for their efforts. Eventually the modified body functions may be maintained without the use of biofeedback equipment. Many people are attracted to biofeedback as a treatment because it is noninvasive, may reduce the need for medication or be a replacement for medications that have not worked well, can be used during pregnancy while many medications cannot, and allows patients to take charge of their own physical or mental health issues.
Biofeedback training may continue for several days or weeks while the individual tries to keep the light flashing for longer periods in subsequent sessions. Eventually they will need to produce the desired response without electronic feedback, a goal that can be accomplished using various methods. The learned response can be practiced at the end of the training session or at home between sessions. Random trials may also be conducted without feedback during the sessions. An alternate strategy is the gradual and systematic removal of the feedback signal during the training sessions. After the initial training is completed, individuals may return to the biofeedback facility so that their retention of skills can be assessed.
Biofeedback training has been used in treating a number of different health conditions. Monitoring patients’ heart rates has been used successfully to help people control heartbeat irregularities (arrythmias), including premature ventricular contractions (PVCs) and tachycardia. People with high blood pressure (hypertension) have learned to control their blood pressure through the use of biofeedback. Physicians have been particularly successful in using neuromuscular feedback to treat complaints arising from tension in specific muscles or muscle groups. Tension headaches have been alleviated through the reduction of tension in the forehead (frontalis tension), and biofeedback-induced relaxation of forehead muscles has also been effective in treating asthma. Relaxation of the face and neck muscles has been helpful in improving the speech of people who stutter. Feedback from muscle groups has helped with the rehabilitation of stroke patients and patients with neuromuscular disorders such as foot drop. These patients may be unable to relax or contract muscles at will, and biofeedback can make them aware of small, otherwise imperceptible changes in the desired direction, allowing them to repeat and eventually increase such changes. Relaxation of specific muscles may help people reduce chronic pain, reduce the side effects of chemotherapy, relieve constipation or irritable bowel syndrome, treat incontinence, or even improve overall physical performance. Raynaud's phenomenon, facial pain, and temporomandibular joint dysfunction have also been treated successfully with biofeedback.
Neuromuscular biofeedback has been an effective tool in the treatment of stress and chronic anxiety when psychotherapy and medication have not produced satisfactory results. By learning deep muscle relaxation, anxious patients, including those with related conditions such as insomnia, may experience reduced symptoms. Even for patients who have been able to achieve relaxation through other means such as meditation or progressive relaxation, biofeedback can be a valuable supplementary technique that offers special advantages. For example, a therapist may be able to track closely the points at which a patient tenses up and, with the patient's help, identify which thoughts are associated with the tension. Using biofeedback, the patient learns to apply these specific thoughts either to avoid or reduce anxiety and tension or to relieve stress.
One type of biofeedback involves monitoring brain activity using electroencephalographs (EEGs). Seizures can be reduced in patients with epilepsy using EEG biofeedback techniques that involve EEG activity near the sensorimotor cortex, known as sensory motor rhythm. Brain wave activity is also of interest in connection with alpha waves, which are thought to characterize a desirable state of relaxed alertness. Patients have been taught to increase their alpha rhythms in three or four 30-minute conditioning sessions, resulting in relaxation and stress reduction. Eventually they learn to achieve an alpha state without the electroencephalograph instrumentation.
A task force made up of members of the Association for Applied Psychophysiology and Biofeedback and the International Society for Neurofeedback developed a protocol by which to analyze the use of biofeedback for specific physical and psychological disorders. The result was a number of published reports supporting the effectiveness of biofeedback for treating attention deficit disorder, substance abuse, and alcoholism. Scientists continue to investigate biofeedback interventions as possible treatment for a variety of physical diseases and neurological disorders.
See also Conditioned stimulus ; Conditioning .
Barlow, David H., and V. Mark Durand. Abnormal Psychology: An Integrative Approach. Belmont, CA: Cengage Learning, 2009.
Evans, R. W. “A Rational Approach to the Management of Chronic Migraine.” Headache 53, no. 1 (January 2013): 168–76.
Linden, W., and J. V. Moseley, “The Efficacy of Behavioral Treatments for Hypertension.” Applied Psychophysiology and Biofeedback 31, no. 1 (May 2006): 51–63.
Sutarto, A. P., M. W. Wahab, and N. M. Zin. “Resonant Breathing Biofeedback Training for Stress Reduction Among Manufacturing Operators.” International Journal of Occupational Safety and Ergonomics 18, no. 4 (April 2012): 549–61.
Association for Applied Psychophysiology and Biofeedback, 10200 W. 44th Ave., Ste. 304, Wheat Ridge, CO, 80033, (800) 4778892, http://www.aapb.org .