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Biofeedback Overview
- Biofeedback,
Applied Psychophysiology and Self Regulation
- Areas of Impact
Headache, Pain, Stress, stroke and post-surgical neuromuscular
rehabilitation, ADD/ADHD, Optimal
Functioning, learning, athletic performance, head injury,
neurobehavioral continuum functioning, Psychoneuroimmunology,
exacerbation of disease, violence, destructive impulsive behavior, habit
disorders, occupational health and injury, quality of life, dental
applications, incontinence, PMS, insomnia, anxiety disorders, addiction
and alcoholism, headache, Post traumatic stress disorders (battle
fatigue, hostage syndrome), performance enhancement.
- Ways of Impact
- -Prevention; child and employee education
- -re-normalization of disregulated body/mind-body systems and
balances
- -calming of over-reactive responses-- stress, anger, impulse, habit,
hyperactivity
- -increasing
underactive processes- attention, good feelings, alertness, muscle
strength, blood flow to extremities
- -re-education and rehabilitation with added body information and
awareness
-enhanced performance; life, emotions, athletic, business,
military (B-52 bomber pilots, for example)
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- Bottom Line Highlights
- -decrease prescription drug use and related medical management costs
- (Headache, blood pressure, pain, epilepsy, asthma, diabetes,
anxiety, Raynauds)
- -avoid surgery with behavioral interventions/cures
- -enhanced job performance and attendance-- decreased absenteeism,
better attitude
- -faster return to work, less medical costs
- -enhanced immune functioning, better coping with cancer, HIV, AIDs.
- Reduced Rx and Tx costs.
- -Decrease or eliminate incontinence. This reduces admissions to
nursing home, reduces caretaking costs, need for surgery or medicine.
- -Rehab; increase return to function, decrease home health aid and
nursing home need.
- -reduced costs
from stress and will power related habit disorders.
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Mechanisms
of action and Functions leading to Efficacy
Biofeedback and self awareness and regulation techniques teach
people to develop greater awareness of their mental and physical behavior.
People learn to take greater control and responsibility for their health
and as they become more aware of unhealthy or symptom perpetuating
behaviors, such as tensed muscles, constricted blood vessels
(hypertension), over-reactive nervous system activity, rapid heart rate,
respiration or sweat gland activity, or exaggerated, racing or upsetting
thoughts.
Biofeedback devices magnify or zoom in on body behaviors so people get
more information than their normal sensory awareness provides. The
feedback information is combined with coaching, training and sometimes
therapeutic interventions aimed at producing more healthy, normalized or
more effective functioning.
Biofeedback is virtually always integrated with self awareness coaching
and self regulation training. Skills and strategies to build increased
self awareness and control are practiced by the individual just as a
musical instrument skill is practiced. After a while (3 months in one
study) the skills begin to become automatic reflexes. The result is a more
stable, more normalized physiology and mind body interaction. Drug use is
gradually weaned under the supervision or in cooperation with the
prescribing physician. |
EMG Muscle Biofeedback measures electrical activity created
by muscle contractions. Often used for relaxation training and peak performance
training, stress and pain management (headache, back, TMJ, etc.). Also used for
urinary and fecal incontinence,vulvodynia (pelvic pain) muscle balancing,
kinesiology (repetitive strain injuries such as carpal tunnel syndrome, thoracic
outlet syndrome, etc.)
Thermal or Temperature Biofeedback uses some kind of
temperature sensor either electronic, computerized, liquid crustal, or a glass
thermometer to detect changes in temperature of the extremity-- usually
fingertips, but sometimes toes. Stress, or nervous system excitation/arousal
causes blood vessels in the fingers to constrict, reducing blood flow, leading
to cooling. Thermal biofeedback is used to train people to quiet the nervous
system arousal mechanisms which produce hand and or foot cooling. This is often
used for relaxation, stress and pain management, arthritis, anxiety, Raynaud's,
irritable bowel and other applications. It is widely used since the cost of a
simple biofeedback card or digital electronic thermometer is the lowest for any
form of biofeedback. Even young children have no trouble learning this.
While the elderly find it useful for diabetic neuropathy and intermittent
claudication as well as arthritis.
EEG biofeedback or Neurofeedback trains the central nervous
system, feeding back brain electrial activity, called brainwaves. This is the
fastest growing field in biofeedback, with many new applications being developed
every year. Popular applications include ADD/HD, depression, anxiety, insomnia,
closed head injury, Optimal Functioning, Creativity and Peak Performance, O.C.D.,
O.D.D., anger, Autism, and more.
SCL/GSR/EDR (Skin Conductance Level/Galvanic Skin Response/Electrodermal
Response) These are all measures of physiological activity in the skin.
Part of it is based on sweat gland activity. This measure is very useful for
relaxation and stress management training, and is also used in a bilateral mode
for ADD/HD. It can also be very useful with hyupnosis and in constructing
systematic desensitization hierarchies.
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Problems
and Obstacles
The
current medical model is based on a band-aid approach-- fix and repair
what's broken. The biofeedback model teaches people to become aware of and
maintain with self control a healthy state. Skills acquired with the aid
of biofeedback continue to be used long after they eliminate the symptoms.
The current medical model drugs a problem or surgically removes it. The
idea of re-setting a person's nervous system and other body systems to a
new, healthier level, and maintaining them through trained skills is not
generally used in medicine, except for a weakly emphasized set of areas
where physical exercise is recommended.
The health care system is set up so doctors who perform surgery or get
paid to medically manage patients on medication lose income if they make
referrals for biofeedback and self regulation.
The concept of Biofeedback aided stress reduction as a preventive
intervention is not addressed by most health insurance companies and HMOs.
Yet it is widely used by enlightened corporations and a few HMOs, plus the
military, VA hospitals and even in third world countries, like Russia and
Mexico..
Biofeedback research is criticized because it is not done using double
blind controlled studies like drug studies. Double blind studies require
that the patient and therapist not know which treatment or placebo is
being provided. When the treatment requires training for increased patient
awareness the double blind concept becomes an impossible contradiction in
terms. If you want to train a batter to hit a ball, the batter needs to
know how to make the swing being tested. A double blind study might try to
prevent the batter from seeing where the ball went after it was hit, or it
might try to prevent the batter from knowing if the ball was even it. The
idea is ridiculous. The information is part of the learning process. The
same standards have been repeatedly applied to biofeedback research and
research proposals. Researchers have repeatedly reported that funding
sources are not available if the word biofeedback is used, but they open
up if other euphemisms are used. ANother problem is that biofeedback is
based on producing health, whereas most research aims at specific
diseases.
M.D. research panels with serious conflicts of interest have repeatedly
set research standards which blindly treat patients like laboratory rats.
The problem is not in the lack of double blind studies. The problem is
that double blind studies treat people like laboratory animals without
minds, without the ability to take responsibility for their behavior. This
is a symptom of the paternalistic medical model which assumes the patient
will play a minimal role in his or her care-- one of the reasons the
character strengths of self responsibility and self reliance are eroding
in the US.
NIH says it is investigating alternative health care approaches.
Acknowledging the huge level of utilization of these services and the
turning away from the medicine establishment is a good step. But the $30
million budget is probably a tiny fraction of what NIH spends on
sputum, urine and and stool samples. The mind body connection is an
incredibly powerful one. Biofeedback and self regulation have evolved as
scientific approaches to systematically utilize the potential for making
the mind body system a resource in the health care equation rather than an
ignored, irritating variable to be managed with drugs. |
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