Biofeedback training is a technique in which the subject learns to monitor and gain control over automatic reflex body functions, by using information obtained from various types of machines. These body functions are translated into auditory and visual signals through electrodes attached to the subject. Biofeedback is mostly used for learning to relax in conditions and diseases caused by stress.

Developing Stress-Recording Machines

Machines that were designed to show the automatic reflexes of the body existed earlier, including one that provided instrumental feedback on the muscles. The real beginning of biofeedback, however, was in 1958 at the University of Chicago. While conducting research on sleep and dreaming, Joseph Kamiya chanced into training students to produce alpha brain waves. Being deeply interested in the nature of human consciousness, he used an electroencephalograph (EEG) to detect and monitor the state of dreaming. Using the feedback from the EEG, Kamiya’s students were able to learn how to change their states of mind and to achieve an alpha state, that is, the most relaxed waking state. Later when Kamiya continued his research at the University of California in San Francisco, he designed a machine that became the prototype for today’s alpha training equipment. Subjects were connected to a machine they could hear. The machine emitted a particular tone as an indication when the subject was in the alpha state. Within a few days of repeating the experiment with different frames of mind, the students found that they had learnt how to maintain an alpha state of ‘relaxed alertness’ by themselves.

This concept of instrument feedback training was soon applied in other fields too. Neal E. Miller at New York’s Rockefeller University taught rats to regulate blood flow even though they were paralysed with curare. Until these experiments in the late 1960s, the nervous system was understood to have two distinct functions: voluntary and involuntary. Walking, speaking, and waving were considered voluntary actions. Vital life-maintenance functions such as breathing, heartbeat, and blood flow were taken to be entirely involuntary and automatic. Miller’s experiments and more later, proved otherwise. Elmer and Alyce Green at the Menninger Foundation in Kansas did a lot of meaningful work on blood flow and hand temperature work. They demonstrated that people suffering from migraines were able to relieve pain by controlling the muscle tension that caused it and learning to relax the muscles involved.

How Biofeedback Works

In biofeedback training, machines monitor and mirror the performance of certain bodily functions. The heart rate, body, hand, or finger temperature, muscle tension, skin conductivity, and brain waves can all be translated into auditory or visual signals via electrodes attached to the subject. Training is guided by a counsellor or scientist who supports the learning process with positive encouragement and suggestions. These help the subject to use the signals to modify specific activities. The advantage of biofeedback is its promotion of self-responsibility. People can take the skills into daily life, learning to monitor their physiological changes.
The machine and the training itself do not stimulate the brain or change muscle activity. Using the machine is like stepping on the bathroom scale or looking in a mirror. It tells you how you are doing.

Biofeedback devices do not induce relaxation by themselves, but can be used to learn the knack. One is encouraged to become receptive to messages pertaining to tension or relaxation, or warmth or coldness, given out by one’s body, usually by imagining a warm and relaxing situation. Subjects report suddenly discovering that they can do it but cannot explain how. With practice, many also learn to relax without instrument, through autosuggestion.

George S. Everly, Jr., and Herbert Benson, M.D., two Harvard University professors, point to research that shows that during the state of stress, the brain is signalling a constant rate of stress response and secreting chemicals which may inhibit immune-system functioning. The brain thinks it must gear up to fight or flee an outer battle, that is, the stress, and thus postpones or ignores its task of healing the inner sickness. Relaxing the stress response releases the body’s immune forces to take on the defence functions.

Meditation, progressive relaxation, autogenic training, imagery and other relaxation techniques all have this benefit of shutting down the stress response and facilitating normal healing. Biofeedback training, when applied to stress reduction, focuses on very specific physiological functions with the help of a machine; it is a technologically supported relaxation training.

Biofeedback is now used to regulate a variety of physiological functions which were earlier thought to be uncontrollable. There are four basic instruments used for medical applications:

1. EMG or Electromyograph Feedback measures the amount of electrical charge in muscle fibres, revealing how tense they are. EMG is used for general relaxation, anxiety reduction, phobic desensitisation; back, shoulder, and neck pains, tension headaches, neuromuscular re­education, amongst other physiological applications.

2. Monitoring the skin temperature with a thermometer shows vasomotor activity (ease of blood circulation controlled by constricting or relaxing the smooth muscles around the peripheral blood vessels). It is effective for migraines, cold hands and feet, asthma, and hypertension, and is used in psychotherapy.

3. Electrodermal or Galvanic Skin Response (GSR) is the most widely known of this class of machines, measuring subtle changes in the sympathetic nervous system which affect the moisture and, through that, the conductivity of skin. It is one part of a lie detector machine too. GSR is effective for systematic desensitisation of phobias, guided imagery, stuttering, and asthma, and is used in psychotherapy.

4. Electroencephalograph or EEG measures brain waves to indicate the rate of rhythmic activity of the state of mind. Beta waves mean that one is awake and attentive* while the alpha state is relaxed and meditative. Theta brain waves indicate day-dreaming or twilight sleep, and delta waves mean deep sleep. The EEG is used for insomnia, obsessive or compulsive behaviour, concentration and reading disorders, pain reduction, and epilepsy.

There are numerous other types of equipment that can be used. The electrodes can be hooked up to the head, hands or other parts of the body. It could be a blood pressure cuff, a GSR finger ring or a headband full of wires for an EEG, depending on what is appropriate. Howeyer, while the instruments and applications may vary, biofeedback training sessions have common elements.

For some people, it may be important from the outset to understand the connection between symptoms and the underlying physiological mechanism targeted in the training. A tension headache, for example, can be triggered by tense muscles in the neck and shoulders. The biofeedback machine monitors these muscle groups to train the headache sufferer to recognise when this tension occurs, and to ease it. Mechanical sensors take an electrical reading of the muscles, usually expressed by either sound or visual feedback — say, a beeping noise, or a bar monitor. When the muscle tenses, the beeping becomes more rapid or the bar rises. The goal is to concentrate on what one is feeling as the reading changes, to learn to recognise both the state of tension and the state of relaxation.

The practitioner provides relaxation routines to be practised at home. The machine will have already helped the patient recognise how the muscles are supposed to feel, so that after the initial sessions, one is able to perform the same skills without needing the beeps or bars. The idea is to gradually wean oneself away from the machine.

The success of biofeedback depends on three factors:
1. Motivation: Is the person inspired enough to really work at it?
2. Expectation: Do the patient and his instructor have a clear idea of what the goal is or should be?
3. Trainer competence: The patient and the instructor are like partners in a dance. Is there adequate mutual understanding?

Precautions and Prospects

Biofeedback should not be used for those who are old or weak, or those already taking some form of medication. People with heart conditions, psychotics, and those who are unable to perceive physiological changes in themselves, are not advised biofeedback training.

Biofeedback is used mostly for medical problems related to stress, though it is also useful for other situations like childbirth, incontinence, irregular heartbeats, and epilepsy. Stress-related diseases include migraine and tension headaches, high blood pressure, hyperactivity, functional colitis, gastric and duodenal ulcers, sinus tachycardia (racing heart not related to heart disease), insomnia, and muscular tics.

Biofeedback has proved effective in easing hypertension, a major cause of heart attacks. The alarm response of the autonomic nervous system increases blood pressure and mobilizes the whole body into a state of arousal. Many people are unaware of living in a semi­permanent state of tension. Through biofeedback and relaxation exercises, an individual can learn to rebound from a state of arousal to a state of calmness. This involves normalizing the heart beat and pulsation of blood, and modifying the digestion and muscular tension. Although this process takes longer than, for example, treatment with antihypertensive or tranquilizing drugs, it can reduce the risk of drug dependency and allow for a healthier way of life.

Although biofeedback instruments are useful in the treatment of physical and psychological problems, they are not essential for the development of self-awareness. If one is attentive, continuous feedback can be obtained about one’s state of health. A mirror clearly reflects fatigue, tension, or overweight. Friends can provide valuable feedback on behaviour and appearance. Most important of all, however, is one’s ability to listen to one’s own internal messages, for they are the most accurate prompters, advising one on whether he/she should be active or take rest.

Now You Know

A modern-day, highly scientific healing tool, biofeedback training is used to work on stress-related disorders and others. It helps the patient to heal himself by pointing out how much, where and when stress occurs. The techniques used are standardised and there are no reported side-effects. Though not as quick acting as drugs, it leads to a healthy lifestyle without being dependent on medicine.

With well-documented records and no special dietary requirements, biofeedback training requires an expert therapist to make it meaningful. It should not, however, be used by the aged and infirm.