Biofeedback: F.A.Q. Getting Started as a professional
Biofeedback is an exciting field with many dimensions, for both Professionals and
laymen.
Basic
facts about the major biofeedback feedback "modalities"-- the different
phsyiological systems measured.
Common Questions that beginning professionals and laymen ask
- 1. Is there certification in biofeedback
- 2. Is there a
national biofeedback Organization?
- 3.
What's the difference, if any, between biofeedback and neurofeedback?
- 4. What does
it take to get started doing biofeedback?
- 5. Using
biofeedback for personal growth and exploration.
- 6.
What's the difference between biofeedback and relaxation training?
- 7.
How do I evaluate Stress and client/patient improvement as training/therapy progresses. (a
reply to a question from a South African Psychologist)
- 8.
A colleague asked: How do they do it?" How do cats,rats, monkeys, and people
voluntarily change their
brain waves.
Basic
facts about the major biofeedback feedback "modalities"-- the different
phsyiological systems measured.
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.
1. Is there certification in biofeedback
Yes, there is certification. It can be very useful as a credential for marketing your
practice. If you are licensed, then you may not be required to get the certification, but
either way, it is a good idea to get a description of the criteria for certification from
the BCIA (Biofeedback Certification Institute of America.) It is the ethical
responsibility of all practitioners to learn enough about, develop enough skill in and get
adequate training in biofeedback to practice it competently.
If you are a layman seeking a trainer, make sure you ask about training, supervision,
years of experience, number of clients previously seen and if the trainer has actually
undergone the biofeedback training process him or herself.
- BCIA
- 10200 W. 44th Ave.Suite #310
- Wheat Ridge CO 80033
- 303-420-2902
2. Is there a
national biofeedback Organization?
There are actually several.
A] The bigger and older one is AAPB
Association for Applied Psychophysiology and Biofeedback. 303-422-8436
It publishes a magazine and a scientific journal, holds an annual meeting of
about 600 attendees, plus it offers a number of useful publications, some of which are
very helpful in negotiating with insurers or hospital committees.
Most important, AAPB is, at this time, the world's biggest advocacy
organization for the field of biofeedback in terms of insurance, legislation,
publicity, integration into the healthcare mainstream. We strongly advocate that if you
are getting into or are already involved with biofeedback, anywhere in the world, that you
join AAPB to support its advocacy efforts and get its magazine and journal.
AAPB covers the whole range of the biofeedback field, from incontinence to pain
management, instrumentation to research to headache, stress, anxiety, neurofeedback, EEG,
EMG, GSR, respiration, thermal, creativity, education, women's issues, and any other topic
that fits under biofeedback's very broad, multidisciplinary umbrella.
B] SSNR is the
Society for the Study of Neuronal Regulation. It is a newer organization, founded in 1993,
which focuses more specifically on Neurofeedback, with an emphasis on QEEG (Quantitative
Electroencephalography).
It gives a subscription to the Journal of Neurotherapy with membership and holds an
annual meeting of about 120 attendees.
C] Futurehealth,
Inc. is a for-profit company but we organize the world's second biggest
annual meeting on biofeedback, The
Winter ConferenceOn Brain Function, Modification & Training which emphasizes
neurofeedback, QEEG and optimal functioning, with attendance of just under 300 attendees.
Rob Kall, president of
Futurehealth, is an active advocate and educator for the field of bio/neurofeedback,
a member of the board of directors of AAPB, the PR chair for AAPB, the
founder or co-founder of two sections of AAPB (Allied Professionalsa and Optimal
Functioning) and a founding member of SSNR.
Futurehealth and Rob Kall publish the BioPsy
Webzine, which includes articles of interest to people working with biofeedback and
other mind/body/heart/spirit topics.
D] EEG Spectrum is a
for-profit company that has established a network of neurofeedback providers around the
world. The company offers start-up and practice management support to affiliates.
3.
Whats the difference, if any, between biofeedback and neurofeedback?
Biofeedback refers to a training or coaching process in which technology is used to
help a person (or animal) get more information about his body than the normal senses
provide. The information is used to raise the level of awareness about the function and
eventually, to increase voluntary self control over the funciton-- such as heart rate,
muscle tension, stomach acidity, skin conductance, respiratory patterns or rate, , body
position or joint angle, skin temperature or brain electrical or blood flow activity.
Neurofeedback , also called EEG Biofeedback or Neurotherapy, is
one variety of biofeedback which focuses on feeding back information about brain
activity-- usually EEG (electroencephalographic.) It usually involves increasing or
decreasing brainwave activity of certain frequencies at certain locations. Some trainers
only use neurofeedback. Others combine central biofeedback "central nervous
sytem" ie., EEG or Brain biofeedback with peripheral biofeedback, ie., muscle, skin
temperature, respiration, heart rate, etc.
4. What does
it take to get started doing biofeedback with your own equipment?
It depends!<g> At the simplest level, you can begin using
biofeedback to learn self control with a simple thermometer made of glass, a liquid
crystal card or a digital electronic device such as those found on our stress management tools page. These
cost just a few dollars up to less than a hundred. A nice beginning package listed
on the above page which includes a number of items is the Biodigital-AD for
$69.95 with the Bio-Q Stress control biofeedback kit added for $14.95.
Next, you can get into skin biofeedback-- usually, at the lower cost end, GSR. This
starts, for a unit we find acceptable, at $60. (There's a $35 unit on the market we have
tested. It failed. Saving $25 for something that doesn't work is not a saving. It's a
waste of $35.) You can get an upgraded version of this unit for $140, which includes
non-calibrated audio temperature feedback.
If you are going to use the modalities of EEG or EMG, then we suggest you consider
going for at least one or two sessions to a person either certified in biofeedback or with
the equivalent of biofeedback certification to help you learn how to use the equipment,
set it up and develop a training strategy that will meet your needs. If you have complex
or severe clinical considerations, then you should think about developing a regular
relationship with a professional.
Stand-alone clinical Grade home trainers range from $500- $2000. We can put together a
decent EMG and thermal trainer package for about $1450. And we often have used equipment
available.
EMG standalone equipment should have a digital readout, preferably with some
integration or averaging of the EMG signal over time. Most have a colored Light bar or LCD
display and good audio feedback is a must if you are doing relaxation training. You don't
want to spend hours in your office listening to an annoying tone!
Moving to computerized equipment means spending more.
The lower cost biofeedback systems offer hardware with less signal quality and fewer
software features. But that does not mean it is bad. You can also start out with a good re-conditioned/demo/used system,
since biofeedback hardware made in the last 15 years is very sturdy.
5. Using
biofeedback for personal growth and exploration.
A popular, valuable and worthwhile use of biofeedback is as an inner self exploration
tool. This powerful technology can help you to learn more about who you are and what you
can do, what your potential is and how to achieve new levels of consciousness, self
awareness, enlightenment, self control and self discipline. You can use any of the
technologies, though EEG is probably the most interesting. For a smaller budget, GSR
can be fascinating.
- 6.
What's the difference between biofeedback and relaxation training?
Biofeedback is a more specific approach to helping people determine which kind of
mind-body self regulation will best meet one's needs. Psychophysiological stress profiling
is a commonly used element in biofeedback, It enables the practitioner to identify which
body systems respond to which kinds of stressors, so the most effective training can be
implemented.
Biofeedback also gives more precise, more "contingent" feedback about self
control skill learning. The instrumentation gives objective measurement of physiological
activity so even tiny progress in the beginning can be measured. This is invaluable,
particularly to people who have been through many unsuccessful other interventions. They
can see change even before symptoms improve.
7. How
do I evaluate Stress and client/patient improvement as training/therapy progresses. (a
reply to a question from a South African Psychologist)
I am working on a day to day basis with stress and stress
related conditions. I am looking at the best device in under $500-00 that I can use to
read stress and the improvement of it after theapy. (A reading instead of sound.)
Good question. I have provided links to parts of our website which will give you more
info on some of the topics discussed.
One thing to keep in mind is that improvement
after therapy can probably best be measured by repeating a psychophysiological stress profile (PSP).
In brief, a PSP first obtains a baseline and then evaluates a variety of
psychophysiological responses to different kinds of stressors. The link gives a
detailed description of how to do one. You can use a PSP to identify which kinds of
stressor set off which kinds of psychophysiological response patterns. That enables the
practitioner to develop a more targeted and precise game (read that treatment if you work
in a reductionist pathology model) plan for helping clients move towards health and
resilience.
A simple electronic digital thermometer, with
a highly sensitive, small tip, measuring finger temperature can be useful for people who
respond with peripheral vasoconstriction. Cost $45 or, with audio biofeedback, $85, or,
our deluxe package, with an audio tape and a pocket stress thermometer card-- US$99 Low$ StressTools
A GSR unit with a meter can be useful for those clients who respond with sweat.
Cost $140 Low$
StressTools
a Surface EMG/ (Electromyograph)
would be helpful for clients who respond to stress with muscle tension, tightening and
bracing.
Cost $300 to $750. (a very popular one sells for $500, which does not require gel
Neurofeedback / EEG Biofeedback or Brain Wave biofeedback can monitor alertness, and tell you when a client is in a
deep, meditative state, compared to alert and hyperfocused state. A decent EEG starts at
$950.
We offer a computerized unit which combines EEG, EMG, GSR and heart rate for $950, so
all you need to add is Thermal, for $100. That gives you the best of all worlds for $1050,
with a shipping cost of about $75
Our top of the line professional practitioner system-- the Procomp Biograph sells for about $4500-$7000
8)
A colleague asked: How do they do it?" How do cats,rats, monkeys, and people
voluntarily change their
brain waves.
Well, to start with, I've always told my clients that the first step is awareness of different states associated with different displays on the instruments, kind of what Joe Kamiya did back at the University of Chicago, some 30+ years ago.
Then, I explain that the learning process is non-verbal. you can't just talk your way through it. You learn it using other "intelligences," borrowing from Gardner.
As your skills improve, you get a better volitional "grip" on producing the desired outcome. It comes to you more readily, qucker, with more power, integration and precision, more automatically.
Writings on Biofeedback
More to come. This page is still under construction.
3/9/00
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