Biofeedback Mastery

Biofeedback Mastery

Have you ever wondered what Biofeedback is all about? Uncover these unique information on Biofeedback! Are you in constant pain? Do you wish you could ever just find some relief? If so, you are not alone. Relieving chronic pain can be difficult and frustrating.

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Biofeedback is best understood as a closed feedback loop consisting of a person or other animal, a response, a means to detect the response, and a mechanism for displaying the response to the person or animal the response is thus fed back. For example, a person can be instructed to increase his or her heart rate the heart rate is displayed by a monitor and fed back to the person a feedback loop is thereby established. Biological systems have numerous, reflexive feedback loops to maintain homeostatic integrity for example, body temperature, blood sugar, blood pressure, and endocrine levels. Fluctuations are kept within narrow limits by such feedback loops. However, biofeedback learning is not reflexive it is more closely associated with higherorder learning processes. One motive for the development of biofeedback was to devise therapies for volitional control over processes considered automatic and reflexive. Processes such as heart rate, blood pressure, and gastric secretion change...

Bender Test and Child Neuropsychopathology

Bender (1938) reported on the abnormal test productions of Francine, a schizophrenic child. Additionally, the Bender Test has been used in the identification of children with learning difficulties (Koppitz, 1975), determination of the neuropsychological correlates of hyperactivity and inattention in school children (Brito, Pereira, & Santos-Morales, 1999), and neuropsychological assessment of the effects of stimulant medication (Brown & Borden, 1989) and biofeedback training of children with Attention Deficit Hyperactivity Disorder (Hodes, 1989).

Psychological Treatment Outcome of Headache

The three primary psychological approaches to headache are relaxation therapy, biofeedback, and cognitive-behavioral therapy. Because they are felt to have both psychological and physiological effects, the first two approaches are frequently called psychophysiological interventions. In practice, they are often combined with each other as well as cognitive-behavioral therapy. Please refer to the appropriate sections of this encyclopedia for more detail concerning these treatments.

The Vascular Hypothesisexotic But Persisting

Reduced peripheral blood circulation has also been discussed as the cause of PLMS. Ancoli-Israel et al. (65) reported that about a third of elderly subjects with significant PLMS complained about cold feet, and in a case study thermal biofeedback training reduced the PLMS index dramatically in a single patient. In a small case series (66), treatment with the alpha-receptor blocker phenoxybenzamine was initiated in six PLMD patients (one subject with RLS). Follow-up polysomnograms of four patients revealed a reduction of PLMS in three of them. However, for the single RLS subject, the treatment had no positive impact on restless legs symptoms. The authors regarded the subjective complaints of cold feet and observed decreased peripheral pulses as the consequence of an overactive sympathetic nervous system (SNS) possibly mediated by norepinephrine. Arguments in favor of this include that the SNS has a normal 20- to 40-second periodicity (67) that matches that of PLM nicely. However,...

Assessment and Treatment of PTSD

A third psychotherapy approach is anxiety management, variously referred to as relaxation training, stress inoculation, or biofeedback training. This approach does not focus on the trauma itself, but is instead geared toward teaching an individual the requisite skills for coping with stress, often via the use of relaxation. For this reason, anxiety management is often an adjunctive treatment to trauma-focused treatments.

Prescription Privileges

Psychologists are not newcomers to the arena of physical interventions. Jansen and Barron (1988), in reviewing this topic, asserted that biofeedback techniques, alarm bells for bed-wetting, galvanic skin responses, and polygraph assessments are examples of physical interventions already used by psychologists. Direct involvement of physical interventions by psychologists have also included behavior management procedures with children. The authors pointed out that even though psychologists have been active in the development of physical interventions, they have been automatically excluded from prescribing medications because they are not physicians.

Sexual Pain Disorders Dyspareunia

Dyspareunia refers to genital pain associated with intercourse (ApA, 2000). Vulvar vestibulitis is the most common type of premenopausal dyspareunia, whereas vulvar or vaginal atrophy is mostly reported by postmenopausal women. Women with these types of dyspareunia complain of pain in the vulvar area or anterior portion of the vagina upon penetration. The assessment of the type of dyspareu-nia should include information on the location, quality, intensity, time course, and meaning of the pain. The few studies that have examined treatment efficacy showed a moderate success rate of cognitive-behavioral techniques and biofeedback. The cognitive-behavioral approach includes education and information about dyspareunia, training in progressive muscle relaxation and abdominal breathing, Kegel exercises to train the patient to identify vaginal tenseness and relaxation, use of vaginal dilators, distraction techniques to direct the patient's focus away from pain cues, communication training,...

Coping with Pain and Stress Related to Illness

There is a growing recognition for the need to treat individuals with this disease from a multidisciplinary perspective. There are now comprehensive SCD centers that emphasize the importance of integrating psychosocial and educational programs with clinical and basic science research. The goals of these centers often include providing multiple types of psychological treatments such as biofeedback and individual and family therapy along with traditional medical management approaches to enhance pain management and overall coping in patients and their families.

Technological Consequences

Another prominent method aimed at the development of self-regulation is biofeedback, in which internal processes are transduced to make them publicly observable. The strategy is to monitor and thus control such internal events as brain waves, muscle signals, and electrodermal responses by visually observing them as on a cathode ray oscilloscope or by hearing them through an external speaker. Biofeedback holds considerable promise for helping us to better understand our internal world much research is currently in progress in this important area. There are, however, difficulties in its clinical application, such as the dependency of the learner on a biofeedback signal. Consequently, if the desired changes in behavior occur in the clinic, they may not be lasting and generalized to the patient's everyday world. Nevertheless, a revolutionary consequence of biofeedback and progressive relaxation is that they provide the opportunity to study a person's internal world, just as classical...

Application and Techniques of Behavior Modification

Other behavior modification techniques include modeling, a vicarious process in which individuals learn a behavior by watching someone else perform it biofeedback and various cognitive methods, such as relaxation training, thought stopping, and covert sensitization. Biofeedback is a technique that teaches people to regulate physiological functioning by presenting moment-by-moment information about the status of the body system. The form of relaxation that is most commonly applied in behavior modification is progressive muscle relaxation, which has the person alternately tense and relax separate muscle groups. Once the relaxation response is mastered, the procedure can be used by itself or as part of systematic desensitization. Thought

Psychotic Syndromes

In patients with chronic mild or moderately severe anxiety, benzodiazepines, used sparingly for a few weeks to several months, can be helpful. When chronic treatment is necessary, buspirone, tricyclic antidepressants, and MAO inhibitors may be utilized in selected patients, particularly those with concomitant depression. Beta-blockers may also be useful in certain cases. Referral to a neuropsychologist or psychotherapist for training in self-reliance and relaxation techniques including biofeedback, meditation, and self-hypnosis should also be considered. The treatment of obsessive compulsive disorders should involve both pharmacological and psychological measures. Medications can significantly reduce the symptoms in over 50 percent of patients. Clomipramine is generally considered the drug of first choice, but other drugs with serotonergic properties such as fluoxetine, paroxetine, and clonazepam can be used.

Psychological Approaches to Blood Pressure Reduction

Because of the perceived importance of the sympathetic nervous system in the etiology of essential hypertension, the vast majority of studies examining psychological interventions aimed at lowering blood pressure have focused on interventions that were thought to alter sympathetic nervous system functioning. These include studies employing various relaxation and meditation strategies as well as more direct methods of physiological control obtained via biofeedback. The most recent psychological intervention efforts have added cognitive behavioral stress management components to the more commonly used relaxation strategies to optimize stress-reducing components of these psychological interventions. Let's examine each of these types of psychological intervention and supporting empirical work. Biofeedback of Cardiovascular Parameters Biofeedback is the process of bringing information pertaining to typically undetectable physiological states into awareness for the purposes of gaining...

Self Control Strategies and Goals of Self Control

A self-control strategy refers to a family of techniques that an individual practices in a regular, systematic manner to influence cognitive and behavioral activity in a desired direction. Self-control techniques include behavioral self-control, hypnosis, biofeedback, meditation, and guided imagery, among others. These techniques utilize certain components, which can be analyzed and compared based on the

Gastrointestinal Dysmotility

Idiopathic fecal incontinence may be associated with delayed conduction in the pudendal nerves and denervation changes in the sphincter muscles. High-fiber bulking agents may be beneficial because semi-formed stools are easier to control than liquid feces. Fecal disimpaction is indicated in some patients. Daily tap water enemas aid in clearing the residue from the rectum between evacuations and may improve continence. Biofeedback may be successful in some cases. Patients who undergo surgical sphincter repair may gain some continence for solid stool, although the presence of pudendal neuropathy is associated with a poor outcome. Other surgical treatments include colostomy, artificial anal sphincters, and creation of a neosphincter with muscle grafts.

Myofascial Pain Syndrome

Patients with MPS generally enjoy a good prognosis. The most critical elements of treatment include patient education and stretching of the involved muscle. Physical therapy may be useful for patient education, stretching instruction, and perhaps spray and stretch, a procedure where a local vapocoolant spray is used over the involved area immediately before stretching. In resistant cases, injection of the trigger point with local anesthetic, followed immediately by stretching, can produce dramatic, prolonged relief. Multiple injections may be required. For some muscle groups, physical strengthening may help resolve the condition and help to prevent recurrence. MPS is less often associated with other medical conditions, including psychological conditions, than is FM. In MPS patients the use of biofeedback and relaxation therapy may help to teach them to discriminate between unnecessarily tense muscles and relaxed ones. Improved skills in dealing with life's stresses may be useful for...

Special Headache Populations

There is now a sizable body of research attesting to the efficacy of thermal biofeedback with pediatric migraine. In addition, headaches in the elderly can also be effectively treated with biofeedback and relaxation techniques, as can those individuals who consume excessive levels of medication. A number of investigators have demonstrated that a combination treatment including relaxation therapy and biofeedback is efficacious for treating headaches during pregnancy. Because pregnant women are not able to use most pain medications, many experts have suggested that techniques such as the psychophysiological interventions and psychotherapy should be the first-line intervention for headaches during pregnancy.

Combined Migraine Tension Headache

For patients with both kinds of the primary benign headache disorders (migraine and tension-type), the results with thermal biofeedback alone are a bit lower, averaging 30-45 success relaxation training alone leads to 20-25 success. The best results come when thermal biofeedback and relaxation training are combined. With this combination treatment, results show 50-55 success rates (adding thermal biofeedback to relaxation raises success from 20 to 55 adding relaxation therapy to thermal biofeedback increases success from 25 to 55 ). Most experts strongly recommend a combination of the two treatments for these headache sufferers.


One way to help patients with an inability to deal with or communicate emotions (alexithymia) is to use nonverbal techniques, with the goal of helping the patient recognize the relationship between life situations and bodily reactions. Nonverbal therapies such as diet, meditation, physiotherapy, relaxation techniques, biofeedback, massage, and exercise are generally accepted by patients, as long as patients do not interpret their use as meaning that the physician is rejecting or discounting their somatic experience. Empirical evidence on the efficacy of these approaches is needed.

EMG in movement

These techniques of dynamic EMG have been employed to evaluate varies disease states, such as children with cerebral palsy, stroke patients and in patients with prosthetic devices. The use of gait analysis in children with cerebral palsy has allowed for better surgical intervention to influence gait function. Finally, electromyographic biofeedback has been used to improve lower extremity function after stroke (Moreland et al., 1998).

Forensic Treatment

In a civil damage situation, treatment may consist of insight-oriented or supportive psychotherapy. In addition, special methods such as behavior therapy, cognitive therapy, or biofeedback may be used for pain management or to treat anxiety or depression. The therapist must be aware that testimony may be required in court, and this may at times influence both the mental status of the client and the course of therapy. Often in such cases the therapist may find the legal situation to be at odds with the therapeutic situation. For example, it is often therapeutic for a patient who has been unable to work to return to work as soon as possible. However, this is often inconsistent with the approach being taken by the attorney. In such cases, the therapist has a responsibility to make the patient and the attorney aware of the recommendations, but the final decision as to whether to proceed on those recommendations lies with the patient.


The failure of such measures should prompt physiologic investigation. Rantis et al. reviewed 51 patients with chronic constipation regarding the cost of the diagnostic evaluation and treatment outcome. Fiber, cathartics, and biofeedback therapy were successful in 33 of 51 patients (65 ), and 12 of the 18 remaining patients


In treating cases of Retentive Encopresis medical treatment is employed on a regular basis. This treatment involves using enemas for disimpaction and laxatives to promote bowel movements. However, relying on medical intervention alone diminishes the success rate of treatment of Encopresis. Cox and colleagues (Cox, Sutphen, Borowitz, Kovatchev, & Ling, 1998) compared the effectiveness of (1) 3 months of treatment for Retentive Encopresis by medical treatment alone (enemas and laxatives) (2) medical treatment and enhanced toilet training employing reinforcement, scheduled toilet sits, and instruction and modeling to promote appropriate straining or (3) medical treatment, toilet training, and biofeedback directed at relaxing the external anal sphincter during attempted defecation. They found that medical care alone reduced soilings per child by 21 , whereas enhanced toilet training and medical treatment caused a 76 reduction, and biofeedback and medical treatment yielded a 65 reduction....

Spinal Reflexes

Using electromyographic biofeedback, the stretch reflex of the human biceps brachii muscle was successfully conditioned to increase or decrease in amplitude, but also required considerable training, approximately 400 trials per session.153 Evidence for the effects of physical activity and training on the strength of spinal reflexes has also been found in active compared to sedentary people. The H-reflex and disynap-tic reciprocal inhibition responses were small in sedentary subjects, larger in moderately active subjects, and largest in very active ones.154 The reflexes were lowest, however, in professional ballerinas. The greater need for corticospinal input to the cord to stand en pointe and the sustained cocontractions involving the gastrocne-mius and soleus complex probably lead to a decrease in synaptic transmission at Ia synapses, reducing the reflex amplitude. Thus, activity-dependent plasticity in the spinal motor pools contributes to the long-term acquisition of motor skills....

Suggested Reading

B. (Eds.). (1993). Psychophysiological disorders Research and clinical applications. Washington, DC American Psychological Association. Hatch, J. P., Fisher, J. G., & Ruch, J. D. (Eds.). (1987). Biofeedback Schwartz, M. S. (Ed.). (1998). Biofeedback A practitioner's guide (2nd ed.). New York Guilford Press.

Tension Headache

With tension headache, the biofeedback approach used is electromyographic (EMG muscle tension) feedback from the forehead, neck, and or shoulders. For relaxation therapy alone, successful treatment outcomes generally range from 40 to 55 for EMG biofeedback alone, this value ranges from 50 to 60 , and for cognitive therapy, from 60 to 80 . When EMG biofeedback and relaxation are combined, the average number of treatment successes improves from about 50 to about 75 when relaxation and cognitive therapy are combined, success increases from 40 to 65 .


The use of a number of behavioral techniques is similar to their use in other psychiatric disorders and has been discussed elsewhere (Ford 1983, 1995 Wickramasekera 1997, 1999). Behavioral techniques combine a protective environment, reassurance that a full medical work-up has concluded that no permanent damage has been found and that full recovery is expected, and relaxation techniques (e.g., biofeedback, relaxation training). As is the case with hypnosis, suggestive techniques are usually incorporated as part of the behavioral treatment and include reassurance that the symptoms will improve rapidly and in fact are already beginning to improve.

Migraine Headache

For patients with pure migraine headache, hand surface temperature (or thermal) is the biofeedback modality of choice, and it leads to clinically significant improvement in 40 to 60 of patients. Cognitive therapy by itself achieves about 50 success. A systematic course of relaxation training seems to help when added to thermal biofeedback (increasing success from about 40 to 55 ), but cognitive therapy added to the thermal biofeedback and relaxation does not improve outcome on a group basis. Relaxation training alone achieves success in from 30 to 50 of patients, and adding thermal biofeedback boosts that success (from about 30 to 55 ).


Within this context, much research has been directed toward establishing effective behavioral treatments that may be employed alone or in conjunction with a variety of pharmacological regimens. These behavioral treatments include progressive muscle relaxation, meditation, yoga exercises, autogenic training, biofeedback-assisted relaxation, blood pressure biofeedback, contingency managed aerobics and diet, as well as strategies combining two or more of these programs. In addition, when pharmacological intervention is necessary, a variety of classes of antihypertensions are available. These include B-adrenergic receptor antagonists, calcium channel blockers, diuretics, angiotensin-converting enzyme (ACE) inhibitors, and others. Treatment may involve one agent or a combination of these antihypertensive agents to attain normal blood pressure, or, at least, lower blood pressure to a more acceptable level.