Biofeedback Training (BFB) has been extensively researched for the past 40 years. It is a non-invasive scientifically validated way of enabling an individual to learn how to change physiological activity for the purposes of improving health and performance. Precise instruments measure physiological activity such as brainwaves, heart function, breathing, muscle activity, and skin temperature. These instruments rapidly and accurately “feed-back” information to the user. The presentation of this information — often in conjunction with changes in thinking, emotions, and behaviour — supports desired physiological changes. Over time, these changes can endure without continued use of an instrument.
-Definition adopted by BCIA, AAPB, and ISNR (May 18, 2008)
Biofeedback is the use of instrumentation to mirror psychophysiological processes that the individual is not normally aware of, which may be brought under voluntary control. It helps you gain control over how you react to stress by teaching you skills to help quiet and balance your nervous system. The result is a state of calm and deep relaxation in your body and your mind. This leads to a feeling of empowerment and self-worth as you become successful in altering your body’s responses. Biofeedback training is like physical therapy insofar as it requires active participation and regular practice between training sessions. It is a self‐control technique through which individuals learn to voluntarily regulate what were once thought to be involuntary bodily processes. This treatment requires specific instruments to convert physiological signals into detailed visual and auditory cues, in addition to a specifically trained biofeedback practitioner to guide the therapy. Using a screen, individuals get feedback that helps them acquire control over their physiology. Just as looking into a mirror allows one to see and change expressions, etc., biofeedback allows you to ‘see inside’ your body, alongside a trained biofeedback practitioner who functions as a guide training you to use the feedback to regulate your physiology.
What does it involve?
Biofeedback Training is not invasive – it is based on learning. In conjunction with CBT – Cognitive Behavioural Therapy – the goal is to train you to balance your brain and body to its best functioning and health. You start with an extensive assessment in your first session, which includes a Clinical Interview, psychological and physiological symptom questionnaires including a Psycho-Physiological Stress Profile. This combination of CBT and Biofeedback Training enables faster learning and generalization by reinforcing the use of skills that allow the brain to function at a higher, more efficient level. During the Physiological Stress Profile (PSP) your heart rate, respiration, muscle contractions, finger temperature and skin conductance may be measured during rest, stress, recovery and during paced breathing periods. This test shows your trainer how your body is functioning and what types of interventions will be helpful to decrease symptoms and increase health and well-being.
Who is Your Biofeedback Training Provider?
Sharron Grainger is the Centre’s lead Psychologist & Psychotherapist and has undergone Post Graduate Certification in Applied Psychophysiology. Sharron is currently the only certified therapist in Ireland using Biofeedback as an addition to CBT – Cognitive Behavioural Therapy. She is certified in the use of General Biofeedback and EEG Neurofeedback which is required to meet the Biofeedback Certification International Alliance (BCIA) standards. The BCIA is the only worldwide certification body for individuals who meet education and training standards in Biofeedback and Neurofeedback. Biofeedback and CBT are both short term goal directed treatments. Both approaches are heavily related to learning theory and based on relaxation techniques and desensitization. Thoughts, emotions and interpersonal processes can have an impact on the success of both interventions. You can learn more about Sharron on her bio page here.
Is Biofeedback Safe?
Yes. There are no ‘side-effects’ to Biofeedback Training as there is nothing being introduced into your body and measurement is achieved using sensors only.
Will it hurt or will I feel anything?
No. When you do Biofeedback Training your trainer will monitor and record what your Psycho-physiology is presenting using passive sensors recording your temperature, heart rate or muscle tension. Nothing is ever sent to your body via these sensors. These sensors are also called electrodes. To help these sensors get a good signal, sometimes a conducting gel is used which might feel a bit cold, but that is all you will feel!
How does the training work?
Biofeedback Training allows you to gain more control over the way your brain/body connection and (Autonomic) nervous system works. During a biofeedback session, the sensors are attached to your skin or fingers. These sensors send signals to a monitor, which displays a sound, animation or video that represents your heart and breathing rate, skin temperature, sweating, or muscle activity.
When you are under stress, these functions change. Your heart rate speeds up, your muscles tighten, you start to sweat, and your breathing quickens. You can see these stress responses as they happen on the monitor, and then get immediate feedback as you try to stop them. You will be rewarded on screen with for example, a video, animation, tone or music playing. When your Autonomic Nervous System (ANS) is not functioning efficiently, you will receive no feedback. By doing this, you learn through “Operant Conditioning”. This is simply learning through consequence. For example if you do something that gets you a reward, you are more likely to repeat it again thus reinforcing the behaviour.
Over the course of Biofeedback Training your Psycho-physiology (brain/body) gets better at functioning in this new way. You must continue working at your training outside of your sessions, in addition to making changes to certain behaviours to achieve your goals.
What Methods are Used?
There are several different biofeedback methods. These methods help to train the body back to balance, increase positive coping and the ability to handle the demands of everyday life. Determining the method that’s right for you depends on your health, problems and goals. Biofeedback methods can include:
- Breathing: During respiratory biofeedback, bands known as strain gauges are placed around your abdomen and chest to monitor your breathing pattern and respiration rate.
- Heart rate: This type of biofeedback uses finger or earlobe sensors with a device called a photoplethysmograph to measure your heart rate and heart rate variability.
- Surface Electromyography (sEMG): This method of biofeedback involves placing sensors over your skeletal muscles with an electromyography (sEMG) to monitor the electrical activity that causes muscle contraction. This measures muscular tension and holding. Excessive tension drains energy and can lead to such problems as tension headaches, TMJ, muscle spasm and weakness.
- Galvanic Skin Response (GSR): Sensors attached around your fingers or on your palm or wrist with an electrodermograph (EDG) measure the activity of your sweat glands and the amount of perspiration on your skin, alerting you to anxiety. This measures the Galvanic Skin Response or sweat gland activity. Sweat gland activity is highly sensitive to emotions and thoughts. This measurement will help you identify significant emotional and cognitive stressors.
- Thermal: A sensor known as a thermister is attached to your fingers or feet to measure your blood flow to your skin. Because your temperature often drops when you’re under stress, a low reading can prompt you to begin relaxation techniques. This measures peripheral blood flow and vascular constriction. Blood flow measurements are very responsive to stress and relaxation. By watching the rise and fall of your finger temperature, you will become aware of internal feelings associate with stress and relaxation.
What can Biofeedback Training be used for?
At the Centre we currently use Biofeedback in well scientifically researched efficacy rated protocols in the following areas: Stress/Anxiety/Panic Attacks.
Stress/Anxiety and panic attack relief is one of the most common uses of biofeedback. Biofeedback lets you become more aware of your body’s responses when you’re stressed and anxious. Then you can learn how to control those responses. You can read more about how this works in our blog post Using Biofeedback to Control Anxiety.
In addition Biofeedback also helps to make patients aware of the thoughts, feelings and behaviours related to their physiology. The goal of biofeedback treatment is to help you achieve the best level of balance for the wide variety of situations in your life. Over time you can learn to self-regulate without feedback screens in front of of you.
How effective is Biofeedback Training?
When you walk, or move your body, your bodily functions such as skin temperature and blood pressure are controlled involuntarily by your nervous system. You don’t have to think about making your heart beat faster. It just happens in response to your environment, like when you’re nervous, excited, or exercising. Utilising the Biofeedback technique can help you to gain more control over what were traditionally thought of as involuntary functions. The purpose of biofeedback is to become aware of what’s going on inside your body, enabling you can gain more control over your health.
What happens at the session?
During each Biofeedback Training session, sensors are attached to either your fingers or muscles and your physiological activity is monitored. You will be asked to watch the screen and get an animation, music, tone or movie to play. The animation, etc. will play based on your physiology and as it is being fed back to you, you can begin to gain some control over it as sessions progress.
At your first session an extensive assessment is completed, which includes an intake interview to identify health history, symptoms and any diagnoses you may already have. You will complete psychological and physiological symptom questionnaires. You will be oriented to the equipment and introduced to the function of the Autonomic Nervous System (ANS). We will also discuss your goals for Biofeedback Training.
At your second session a Psycho-Physiological Stress Profile will be conducted to find out about the functioning of your nervous system. Are you too reactive? Do you recover well after exposure to a stressor?
During the Psycho-Physiological Stress Profile (PSP) your heart rate, respiration, muscle contractions, finger temperature and skin conductance may be measured during rest, stress, recovery and during paced breathing periods. This test shows us how the body is functioning and what types of interventions will be helpful to decrease symptoms and increase health and well-being. Once we find out how your nervous system is functioning, we can set goals and make the necessary corrections.
How Many Sessions Will I need?
Usually, you can start to see biofeedback benefits within 4 – 6 sessions. Each session lasts approximately 45 minutes.
Biofeedback Training is learning a new skill. It is impossible to predict how many sessions an individual may require to not only make changes to the functioning of your nervous system, but to establish these changes. The number of sessions needed differs from person to person, and particularly from children to adults. However, your data will be reviewed with you around session 6 and any necessary changes to your protocol will be discussed with you. We guarantee that you will never be recommended unnecessary sessions and it is up to you if you wish to take the trainer’s recommendations on board. Furthermore, if you are deemed to be unsuitable for Biofeedback training, you will be informed.
How often do I need to attend sessions?
This varies with your personal circumstances. A minimum of one session per week is needed in order to satisfy the requirements for efficient learning. Research recommends two sessions per week initially for optimum learning, with a review thereafter, but again this is variable. At the initial consultation and assessment you can work out the schedule together with your trainer.
When will I see the benefits?
Some people report feeling some positive effects as early as 3 or 4 sessions, but for most people it tends to take longer depending on your goals, your own input, your age, etc. With continued reinforcement and training both at, and just as importantly outside of, your sessions, these positive effects become more noticeable and stable.
As with any physical training, people see benefits at different rates and other factors apart from the training itself will have an influence. As a result, it can take varying amounts of time to see changes. Results gained with BFB Training are largely well maintained; particularly if you sustain the behavioural changes that go along with them. It is important to not let yourself fall back into old habits which would support old psycho-physiological patterns and therefore not maintain any benefits gained from training.
It is vitally important that Biofeedback Training is made a priority as you engage in the programme. You will be required to participate fully to gain the best results from your time and you should make it a priority as you would a hospital or dentist appointment.
Being late for an appointment
If you arrive late for an appointment, your session will finish at the appointed time to facilitate appointments coming in after you. Therefore your trainer will have to alter the amount of Biofeedback Training you receive during the session as to not interfere with the next appointment.
Cancellation of an appointment
If you cannot make your appointment it is very important that you give at least 24 hours’ notice of cancellation. Failure to do so will result in you being charged the full rate for the cancelled appointment. You can pay either over the phone by Debit Card that day or before the next scheduled session. The cancellation policy will also be discussed at your first session.
‘No show’ for an appointment
If no effort is made to cancel an appointment, you will be charged the full fee for the missed session. You can pay either over the phone by Debit Card that day or before the next scheduled session.
It is your responsibility to make contact to reschedule missed appointments to keep up the training schedule. We may not be able to facilitate a change in schedule, however, the Centre will make every effort to facilitate you and may put you on a waiting list for a cancellation and contact you if a session becomes available.