BIOFEEDBACK

Biofeedback is the practice of applied psycho-physiology. It involves the use of

sensitive, medical grade equipment to obtain physiological measures of heart rate, heart
rate variability, pulse height, skin temperature, electomyographical muscle activity, blood
pressure, skin conductance, respiration rates, and even levels of oxygen saturation or
carbon dioxide levels in the breath. Biofeedback measurements are not only noted by
the clinical psychophysiologist, they are fed back to the patient in a meaningful ay.
!atients are taught to loer blood pressure and heart rate, improve heart rate variability
"vagal tone# and reduce their stress levels using a variety of techniques.
Biofeedback-Assisted Relaxation Training :
Biobehavioral treatment also includes training children to use active coping skills.
$hese coping skills include not only the aforementioned positive lifestyle habits and
adherence to preventive and abortive medication regimens, but also biofeedback-
assisted relaxation training (BART).
%elaxation training usually involves one or more of the folloing techniques&
progressive muscle relaxation, diaphragmatic or deep breathing, and guided imagery.
!rogressive muscle relaxation training involves alternate tensing and relaxing of various
muscle groups throughout the body. Its goal is to teach the child the contrast beteen
tension and relaxation via systematic physical manipulation. 'iaphragmatic or deep
breathing involves systematic inhalation and exhalation. (gain, the child learns the
relationship beteen tension and relaxation by attention to breathing, hich produces
somatic changes in a systematic fashion. )uided imagery relies on a cognitive means of
producing a state of relaxation. In this procedure, the child visuali*es a pleasant scene
or favored activity, such as playing in the oods or taking a ride on a favorite
amusement park attraction, to achieve a state of relaxation. %elaxation training is used
most often ith children + years of age or older. ,oever, ith developmentally
appropriate ad-ustments to the training procedures, relaxation training procedures,
especially those emphasi*ing imagery, have been used successfully ith preschool-age
children and intellectually challenged children. In practice, because of the cognitive,
attentional, social, and emotional demands of the treatment, the use of standard
relaxation training protocols is best suited for older children.
.hildren need to be able to understand the rationale of using relaxation to
combat feeling such severe pain. $hey also must be able to concentrate on their bodily
sensations for an extended time and have the social and emotional maturity to learn ho
to both manage stress and sustain the practice necessary to acquire and maintain
relaxation. It is quite rare for a child to experience problematic effects from learning
relaxation. /ne exception involves a child becoming emotionally upset because of the
novelty of the sensation of relaxation. $his sensation might be especially problematic for
a child ho has experienced a number of traumatic events that are relived in a state of
relaxation. Biofeedback is most often used as an ad-unct to relaxation training to address
migraine. Instrumentation is used to monitor the physiologic effects of relaxation and0or
to facilitate the learning of relaxation skills by providing visual and0or audio feedback
about actual changes in otherise invisible bodily processes. 1hen described in this
manner, it is evident that biofeedback itself is not a treatment modality. %ather,
biofeedback instrumentation is used to enhance self-control and relaxation training.
$herefore, in our biobehavioral approach to care, this technique is referred to as BART.
Biofeedback instrumentation is used in the relaxation treatment process to
accomplish three goals: (1) to make the child aare of ph!sical responses" (#) to
teach control of these responses" and ($) to transfer or generali%e these skills to
use in e&er!da! life.
'Biofeedback' is a form of complementar! and alternati&e medicine ((A)) hich
in&ol&es measuring a sub*ect+s bodil! processes such as blood pressure" heart
rate" skin temperature" gal&anic skin response (seating)" and muscle tension and
con&e!ing such information to him or her in real-time in order to raise his or her
aareness and conscious control of the related ph!siological acti&ities.
By providing access to physiological information about hich the user
is generally unaare, biofeedback allos users to gain control over physical processes
previously considered automatic. %esearch has demonstrated that biofeedback can help
in the treatment of many diseases and painful conditions. It has shon that e have
more control over so-called involuntary bodily function than e once though possible.
But it has also shon that nature limits the extent of such control. 2cientists are no
trying to determine -ust ho much voluntary control e can exert. Biofeedback can be
used by coaches and educators to help people function better and by therapists as part
of treatment for many disorders including anxiety, urinary incontinence, fecal
incontinence and constipation, migraine headaches, tension headaches, (',', ('',
pain from improperly functioning muscles in the -as, shoulders, back, etc., irritable
boel syndrome, phobias, non-cardiac chest pain, high and lo blood pressure,
epilepsy, paralysis and other movement disorders, stress, and many other types of
problems.
2pecialists ho provide biofeedback training range from psychiatrists and
psychologists to dentists, internists, nurses, physical therapists, and other mental health
professionals. 3ost psychotherapists rely on many other techniques in addition to
biofeedback. !atients usually are taught some form of relaxation exercise. 2ome learn to
identify the circumstances that trigger their symptoms. $hey may also be taught ho to
avoid or cope ith these stressful events. 3ost are encouraged to change their habits,
and some are trained in special techniques for gaining such self-control. Biofeedback is
not magic. It cannot cure disease or by itself make a person healthy. It is a tool, one of
many available to health care professionals. It reminds physicians that behavior,
thoughts, and feelings profoundly influence physical health. (nd it helps both patients
and doctors understand that they must ork together as a team.
,atients+ Responsibilities :
Biofeedback places unusual demands on patients. $hey must examine
their day-to-day lives to learn if they may be contributing to their on distress. $hey must
recogni*e that they can, by their on efforts, remedy some physical ailments. $hey must
commit themselves to practicing biofeedback or relaxation exercises every day. $hey
must change bad habits, even ease up on some good ones. 3ost important, they must
accept much of the responsibility for maintaining their on health.
,o 'oes Biofeedback 1ork 4
3ost patients ho benefit from biofeedback are trained to relax and modify their
behavior. 3ost scientists believe that relaxation is a key component in biofeedback
treatment of many disorders, particularly those brought on or made orse by stress.
$heir reasoning is based on hat is knon about the effects of stress on the body. In
brief, the argument goes like this& 2tressful events produce strong emotions, hich
arouse certain physical responses. 3any of these responses are controlled by the
sympathetic nervous system, the netork of nerve tissues that helps prepare the body to
meet emergencies by 'flight or fight.'
$he typical pattern of response to emergencies probably emerged during the
time hen all humans faced mostly physical threats. (lthough the 5threats5 e no live
ith are seldom physical, the body reacts as if they ere& $he pupils dilate to let in more
light. 2eat pours out, reducing the chance of skin cuts. Blood vessels near the skin
contract to reduce bleeding, hile those in the brain and muscles dilate to increase the
oxygen supply. $he gastrointestinal tract, including the stomach and intestines, slos
don to reduce the energy expensed in digestion. $he heart beats faster, and blood
pressure rises. 6ormally, people calm don hen a stressful event is over especially if
they have done something to cope ith it. 7or instance, imagine your on reactions if
you8re alking don a dark street and hear someone running toard you. 9ou get
scared. 9our body prepared you to ard off an attacker or run fast enough to get aay.
1hen you do escape, you gradually relax.
If you get angry at your boss, it8s a different matter. 9our body may prepare to
fight. But since you ant to keep your -ob, you try to ignore the angry feelings. 2imilarly,
if on the ay home you get stalled in traffic, there8s nothing you can do to get aay.
$hese situations can literally may you sick. 9our body has prepared for action, but you
cannot act. Individuals differ in the ay they respond to stress. In some, one function,
such as blood pressure, becomes more active hile others remain normal. 3any experts
believe that these individual physical responses to stress can become habitual. 1hen
the body is repeatedly aroused, one or more functions may become permanently
overactive. (ctual damage to bodily tissues may eventually result.
Biofeedback is often aimed at changing habitual reactions to stress that
can cause pain or disease. )an! clinicians belie&e that some of their patients and
clients ha&e forgotten ho to relax. -eedback of ph!sical responses such as skin
temperature and muscle tension pro&ides information to help patients recogni%e a
relaxed state. The feedback signal ma! also act as a kind of reard for reducing
tension.
What is biofeedback ?
Biofeedback is a treatment technique in hich people are trained to improve their
health by using signals from their on bodies. !hysical therapists use biofeedback to
help stroke victims regain movement in paraly*ed muscles. !sychologists use it to help
tense and anxious clients learn to relax. 2pecialists in many different fields use
biofeedback to help their patients cope ith pain.
.hances are you have used biofeedback yourself. 9ou8ve used it if you
have ever taken your temperature or stepped on a scale. $he thermometer tells you
hether you8re running a fever, the scale hether you8ve gained eight. Both devices
5feed back5 information about your body8s condition. (rmed ith this information, you
can take steps you8ve learned to improve the condition. 1hen you8re running a fever,
you go to bed and drink plenty of fluids. 1hen you8ve gained eight, you resolve to eat
less and sometimes you do.
.linicians reply on complicated biofeedback machines in somehat the
same ay that you rely on your scale or thermometer. $heir machines can detect a
person8s internal bodily functions ith far greater sensitivity and precision than a person
can alone. $his information may be valuable. Both patients and therapists use it to
gauge and direct the progress of treatment.
7or patients, the biofeedback machine acts as a kind of sixth sense hich
allos them to 5see5 or 5hear5 activity inside their bodies. /ne commonly used type of
machine, for example, picks up electrical signals in the muscles. It translates these
signals into a form that patients can detect& It triggers a flashing light bulb, perhaps, or
activates a beeper every time muscles gro more tense. If patients ant to relax tense
muscles, they try to slo don the flashing or beeping.
:ike a pitcher learning to thro a ball across a home plate, the
biofeedback trainee, in an attempt to improve a skill, monitors the performance. 1hen a
pitch is off the mark, the ballplayer ad-usts the delivery so that he performs better the
next time he tries. 1hen the light flashes or the beeper beeps too often, the biofeedback
trainee makes internal ad-ustments hich alter the signals. $he biofeedback therapist
acts as a coach, standing at the sidelines setting goals and limits on hat to expect and
giving hints on ho to improve performance.
The Beginnings of Biofeedback
$he ord 5biofeedback5 as coined in the late ;<=>s to describe laboratory
procedures then being used to train experimental research sub-ects to alter brain
activity, blood pressure, heart rate, and other bodily functions that normally are not
controlled voluntarily. (t the time, many scientists looked forard to the day hen
biofeedback ould give us a ma-or degree of control over our bodies. $hey thought, for
instance, that e might be able to 5ill5 ourselves to be more creative by changing the
patterns of our brainaves. 2ome believed that biofeedback ould one day make it
possible to do aay ith drug treatments that often cause uncomfortable side effects in
patients ith high blood pressure and other serious conditions.
$oday, most scientists agree that such high hopes ere not realistic. %esearch
has demonstrated that biofeedback can help in the treatment of many diseases and
painful conditions. It has shon that e have more control over so-called involuntary
bodily function than e once though possible. But it has also shon that nature limits the
extent of such control. 2cientists are no trying to determine -ust ho much voluntary
control e can exert.
How is Biofeedback Used Today?
.linical biofeedback techniques that gre out of the early laboratory procedures are no
idely used to treat an ever-lengthening list of conditions. $hese include&
3igraine headaches, tension headaches, and many other types of pain
'isorders of the digestive system
,igh blood pressure and its opposite, lo blood pressure
.ardiac arrhythmias "abnormalities, sometimes dangerous, in the rhythm of the
heartbeat#
%aynaud8s disease "a circulatory disorder that causes uncomfortably cold hands#
?pilepsy
!aralysis and other movement disorders
2pecialists ho provide biofeedback training range from psychiatrists
and psychologists to dentists, internists, nurses, and physical therapists. 3ost rely on
many other techniques in addition to biofeedback. !atients usually are taught some form
of relaxation exercise. 2ome learn to identify the circumstances that trigger their
symptoms. $hey may also be taught ho to avoid or cope ith these stressful events.
3ost are encouraged to change their habits, and some are trained in special techniques
for gaining such self-control. Biofeedback is not magic. .t cannot cure disease or b!
itself make a person health!. .t is a tool" one of man! a&ailable to health care
professionals. .t reminds ph!sicians that beha&ior" thoughts" and feelings
profoundl! influence ph!sical health. (nd it helps both patients and doctors
understand that they must ork together as a team.

$he value of a feedback signal as information and reard may be even
greater in the treatment of patients ith paraly*ed or spastic muscles. 1ith these
patients, biofeedback seems to be primarily a form of skill training like learning to pitch a
ball. Instead of atching the ball, the patient atches the machine, hich monitors
activity in the affected muscle. 2troke victims ith paraly*ed arms and legs, for example,
see that some part of their affected limbs remains active. $he signal from the
biofeedback machine proves it. $his signal can guide the exercises that help patients
regain use of their limbs. !erhaps -ust as important, the feedback convinces patients that
the limbs are still alive. $his reassurance often encourages them to continue their efforts.
Types of Biofeedback Instrumentation :
/lectrom!ogram -- $his is the most common form of biofeedback measurement.
(n ?3) uses electrodes or other types of sensors to measure muscle tension. By the
?3) alerting you to muscle tension, you can learn to recogni*e the feeling early on and
try to control the tension right aay. ?3) is mainly used as a relaxation technique to
help ease tension in those muscles involved in backaches, headaches, neck pain and
grinding your teeth "bruxism#. (n ?3) may be used to treat some illnesses in hich the
symptoms tend to orsen under stress, such as asthma and ulcers.
,eripheral 0kin Temperature -- 2ensors attached to your fingers or feet measure your
skin temperature. Because body temperature often drops hen a person experiences
stress, a lo reading can prompt you to begin relaxation techniques. $emperature
biofeedback can help treat certain circulatory disorders, such as %aynaud8s disease, or
reduce the frequency of migraines. $he physiological process behind the temperature
drop associated ith the stress response is quite simply vasoconstriction "blood vessels
narroed by the smooth musculature in their alls#
1al&anic skin response training -- 2ensors measure the activity of your seat glands
and the amount of perspiration on your skin, alerting you to anxiety. $his information can
be useful in treating emotional disorders such as phobias, anxiety and stuttering. $his is
the method most commonly used by a lie detector machine.
/lectroencephalogram -- (n ??) monitors the activity of brain aves linked to
different mental states, such as akefulness, relaxation, calmness, light sleep and deep
sleep. $his is the least common of the methods, mostly due to the cost and availability of
an ??) machine.
Origins of Biofeedback :
6eal 3iller, a psychology !h.' and neuroscientist ho orked and studied at
9ale @niversity, is generally considered to be the father of modern-day biofeedback. ,e
came across the basic principles of biofeedback hen doing animal experimentation
conditioning the behavior of rats. ,is team found that, by stimulating the pleasure
centers of the rats8 brains ith electricity, it as possible to train rats to control
phenomena ranging from their heart rates to their brainaves. @ntil that point, it as
believed that bodily processes like heart rate ere under the control of the autonomic
nervous system and not responsive to conscious effort.
)a*or modalities of Biofeedback .nstrumentation
Electromyograph --
(n electromyograph, or ?3) is the one of the most commonly used modalities in
biofeedback treatment. (n ?3) in a biofeedback setting typically uses electrodes in
order to measure muscle action potentials. $hese action potentials result in muscle
tension. $he patient can learn to recogni*e the ay tension sub-ectively feels by using
the ob-ective ?3) readings, and as a result learn to control the muscle tension. ?3) is
used as a relaxation technique to ease tension in the muscles causing backaches, neck
pain, $3', incontinence, and tension, migraine, and cluster headaches. ?3) is also
used in the process of muscle rehabilitation, such as in cases of paralysis resulting from
.erebral !alsy, stroke, and incomplete spinal cord lesions.
i) Feedback thermometer --
Thermal Biofeedback
$his test measures skin temperature and can indicate problems ith blood flo. 2ensors
attached to your fingers or feet measure your skin temperature. 2tress leads to a fall in
body temperature because arteries constrict causing blood flo to be limited to
necessary organs and extremities. $his reduced blood flo leads to problems like
migraines and %aynaudAs disease "an ailment in hich blood circulation can not reach
fingers or toes#. @sing thermal biofeedback can help individuals recogni*e these
symptoms and train their body to vasodilate.
( thermistor attached to the sub-ect8s digits or eb dorsum measures the
sub-ect8s skin temperature. Because there is a correlation beteen a drop in body
temperature and the patient8s experience of stress, a lo temperature reading indicates
the need to begin relaxation techniques. $emperature biofeedback can also help in
treating certain circulatory disorders, such as %aynaud8s disease, and can reduce the
frequency and severity of migraines. $he physiological processes hich are being
trained in this modality are vasoconstriction and vasodialation, here blood vessel si*e
is a result of the contraction and relaxation of smooth musculature in the vessel alls.
$he mechanism being trained in arming exercises is a beta-adrenergic vasodilator
mechanism.
0kin Temperature
2hat is it3
Skin Temperature is a measure of a person's state of relaxation. We have all touched
someones hand that felt very cold. Some people always seem to have warm hands.
Learning to increase your finger tip temperature is called Temperature training. This
is one of the most basic techniques used in iofeedback.
4o do !ou do it3
( 2kin $emperature measuring instrument is used to continuously monitor the
temperature. ( small sensor is attached to a finger or toe using tape or a velcro band. If
finger arming is being carried out the sensor can be lightly held beteen thumb and
finger, hen using this be aare that the reading can be increased for a short time by
holding the sensor tighter but this can not be done for long. (t the beginning the person
is asked to think about arming their hand "or foot# getting armer. Bisuali*ation helps,
but the effective visuali*ation varies from person to person. ?xamples are thinking of
having your hands in front of a arm fire or in a arm muff. 1ithin a short time the
$emperature reading ill start to change. $his gives positive feedback that the person is
doing the correct thing. 6ote this should be carried out in a arm room , C>deg . or =D 7
for best results. /ften hen someone first tries this they try to hard and the reading ill
go don, then if they relax the reading ill start to rise. 1ith practice the amount of
temperature rise ill increase. !ractice needs to be done for at least C> min. a day an
tice a day is better. It is useful to record the start and finish levels to get some idea of
improvements over time.
2hat is it used for3
$emperature training is an effective ay of learning relaxation and increasing the blood
flo to the extremities. $he 2kin $emperature reading is an indication of autonmic
response and can be used in psychotherapy for giving information on a persons
resistance. $emperature training is a very good ay of helping a person become more in
tune ith their body. In conditions involving chronic pain e.g. %heumatoid arthritis,
temperature training helps to reduce the pain and improve a person8s general outlook. It
is used as an effective treatment for %aynaud8s disease, high blood pressure, migraine
headaches, //2 "%2I# and for general relaxation.
What equipment do I need?
$he only equipment is a thermometer. (n electronic model is best as it ill allo
changes of >.;'eg to be seen. Being able to see small changes is important hen
starting out as initial changes may be small. It must also update the reading at least
every C seconds. Beare that most lo cost thermometers only update the reading
every ;> seconds and this is too slo to be useful in Biofeedback. $he sensor should
not be to large as the larger the sensor the sloer the response. Basic lo cost
temperature trainers typically only have a digital readout, but are a very useful basic tool
and home trainer. 3ore advanced instruments measure 2kin $emperature and display it
as a sound and bargraph. .omputer systems often have a selection of displays
ii) Electroencephalograph
(n electroencephalograph, or ??) monitors the activity of brain aves. $hese
brain aves correspond to different mental states, such as akefulness "Beta aves#,
relaxation "(lpha aves#, calmness "$heta aves#, and light sleep and deep sleep
"'elta aves#. ??)s are useful in the treatment of anxiety and (','.
(n ??) monitors the activity of brain aves linked to different and deep mental states,
such as akefulness, relaxation, calmness, light sleep and deep sleep. $he brain emits
electrical signals of various frequencies. /nly a fe of these aves can be tied to
specific disorders or mental states. $he folloing are classification of brain aves&
(lpha, Beta ,$heta, and 'elta aves. $his is the least common of the methods, mostly
due to the cost and availability of an ??) machine.
Biofeedback 5seful for /pileps!
Biofeedback, short form for biological feedback, is basically the monitoring of internal
body states. 1atching and listening to sensitive instruments that mirror psycho-
physiological processes helps you understand body processes hich you are not
normally aare of.
(n electronic instrument detects, amplifies, and then gives you immediate information
"feedback# about your on conditions, such as& brain ave activity "??) or
electroencephalograph#. $his feedback guides you as you become more in touch ith
your mind and body. $his aspect of Biofeedback is very useful in case of ?pilepsy.
$his is because people ith epilepsy have brains that continuously misfire "not -ust
during sei*ures#. $his is one ay neurologists make a diagnosis. $his continuous
misfiring often involves only a fe brain cells, no bigger than the point of a pin. 1hen
brain cells surrounding the misfiring or damaged cells are activated, a sei*ure may
occur.
$here ere several researches conducted to demonstrate the relevance of biofeedback
for epilepsy.2ince the ;<+>As researchers have demonstrated in over E> controlled
studies that a special form of brain ave biofeedback - no called neurofeedback -
safely and effectively trains the brain to stabili*e its activity. $he treatment has been
used successfully ith all types of sei*ure disorders. /ften the effects are permanent.
In training sessions, computeri*ed biofeedback instrumentation detects and displays the
brain aves on a computer screen. $he program allos for simultaneous inhibition of
slo ave ??) "the brain ave activity associated ith sei*ure disorders# hile
reinforcing mid-range frequencies associated ith preventing sei*ures.
3uch of the learning takes place simply ith practice hile receiving positive
reinforcement from the computer. (fter enough training sessions the aura rate goes
don and so does the sei*ure rate. 6o one knos exactly hat occurs as e learn to
normali*e the brain ave activity "produce ??) patterns hich donAt trigger sei*ures#,
but it orks.
!atients ho have sei*ures triggered by anxiety or stressful situations may benefit from
this therapy, in addition to their sei*ure medications.
iii) Photoplethysmograph
!hotoplethysmographs, or !!)s, in biofeedback are used to measure peripheral blood
flo, heart rate, and heart rate variability",%B#. $o measure ,%B, !!)s measure the
varying distances beteen heart beats, also knon as the interbeat interval "IBI#. $his
data guides users in finding a breathing pattern that increases their variability. !!)s are
also helpful in biofeedback treatment for some types of cardiac arrhythmias.
4eart rate &ariabilit!
4eart rate &ariabilit! "4R6# is a measure of the beat-to-beat variations in heart rate. It
is usually calculated by analy*ing a time series of beat-to-beat intervals from the ?.), of
beat-to-beat intervals derived from an arterial pressure tracing or of beat-to-beat
intervals derived from a pulse ave signal measured by means of a
photoplethysmograph "!!)#.
Barious measures of heart rate variability have been proposed, hich can roughly be
subdivided into time domain, frequency domain and geometric measures. ,%B is
regarded as an indicator of the activity of autonomic regulation of circulatory function,
although controversy exists over hether this is an accurate metric for analy*ing
cardiovascular autonomic control. (lterations "mostly reductions# in ,%B have been
reported to be associated ith various pathologic conditions such as hypertension,
hemorrhagic shock, and septic shock. It also has some utility as a modest predictor of
mortality after an acute myocardial infarction.
Time domain measures
( simple example of a time domain measure is the calculation of the standard deviation
of beat-to-beat intervals. In other ords the time intervals beteen heart beats can be
statistically analy*ed to obtain information about the autonomic nervous system. /ther
time domain measures include root mean square of the differences beteen heart beats
"r322'#, 66E> or the number of normal to normal complexes that fall ithin E>
milliseconds, and p66E> or the percentage of total number beats that fall ith E>
milliseconds.
-re7uenc! domain measures
( common frequency domain method is the application of the discrete 7ourier transform
to the beat-to-beat interval time series. $his provides an estimation of the amount of
variation at specific frequencies. 2everal frequency bands of interest have been defined
in humans.
,igh 7requency band ",7# beteen >.;E and >.F ,*. ,7 is driven by respiration
and appears to derive mainly from vagal activity or the parasympathetic nervous
system.
:o 7requency band ":7# beteen >.>F and >.;E ,*. :7 derives from both
parasympathetic and sympathetic activity and has been hypothesi*ed to reflect
the delay in the baroreceptor loop.
Bery :o 7requency band "B:7# band beteen >.>>GG and >.>F ,*. $he origin
of B:7 is not ell knon, but it had been attributed to thermal regulation of the
body8s internal systems.
@ltra :o 7requency "@:7# band beteen > and >.>>GG ,*. $he ma-or
background of @:7 is day0night variation and therefore is only expressed in CF-
hour recordings.
$he ratio of lo-to-high frequency spectra poer ":70,7# is used as an index of
sympathetic to parasympathetic balance of heart rate fluctuation, but this remains
controversial because of still little understanding of the :7 component, hich may
be affected by centrally generated brainstem rhythms, baro-reflex influences, as
ell as both sympathetic and parasympathetic inputs, etc.
1eometric measures
$he most commonly used non-linear method of analy*ing heart rate variability is the
!oincarH plot. $he !oincarH plot fits heart rate data points to an ellipse that is fitted to
to intersecting lines. 2'; and 2'C, or the standard deviations of the data points have
also been applied in the context of !oincarH analysis.
i&) Pneumograph
( pneumograph measures abdominal0chest movement "as hen breathing#, usually ith
a strain gauge. $hey are used to detect breathing rate, and correct ineffective breathing
patterns such as thoracic breathing, reverse breathing, and apnea. $hey are also often
used in con-unction ith a !!) in ,%B training.
v) Capnometer
( capnometer measures end-tidal ./C ith an infrared detector. (ll biofeedback training
that employs the use of a capnometer aims at normali*ing end-tidal ./C at EI.
.apnometric biofeedback is useful in the treatment of hyperventilation syndrome. 'uring
hyperventilation, end-tidal ./C loers from a normal level of EI to C.EI.
Respiration -eedback
$his test measures breathing rate and allos patients to learn to control conditions such
as anxiety, asthma, and hyperventilation.
vi) Hemoencephalography
,emoencephalography, or ,?) biofeedback is a method of functional infrared
imaging that indirectly measures neural activity in the brain. $here are to knon types
of ,?), passive infrared "pI%# and near infrared "nI%#.6ear infrared ,?) measures the
differences in color of light reflected back through the scalp, based on the relative
amount of oxygenated and unoxygenated blood in the brain. !assive infrared measures
the amount of heat that is radiated by the scalp at various locations of interest.
4emoencephalograph! ",?)# is a type of functional near-infrared imaging
"f6I%# of the level of neuronal activity in the brain. /ne method of doing this takes
advantage of the translucent nature of the cranium and differences in absorption rates of
various avelengths of light for oxygenated vs. unoxygenated blood. $o different lights
placed on the scalp are shone into the brain and the relative differences beteen the
amount of each light that is reflected back out through the scalp provide a relative
measure of changes in blood oxygen level. (nother method simply involves placing an
infrared sensor on the scalp to detect the amount of heat radiation at that spot. (lthough
each method detects changes in level of cerebral activity, one as it as reflected in
oxygen level, the other as reflected by thermal level, and although each method is used
for similar biofeedback purposes, e.g. treatment of migraine headaches, the pattern of
results are somehat different at times.
vii) Electrodermograph
In electrodermograph training, sensors measure the activity of a patient8s seat
glands. $he amount of electrical resistance measured on the skin indicates the level of
anxiety. $his information can then be used to treat emotional disorders such as phobias,
anxiety and stuttering. $he best-knon use of this method of biofeedback is in polygraph
machines. )alvanic skin response meters are currently gaining popularity in
hypnotherapy and psychotherapy practices, so subtle physiological changes that
indicate emotional arousal can be more easily detected.
1al&anic skin Response Training
$his technique is similar to that of a :ie 'etecting 3achine. $he activity of your
seat glands and amount of perspiration on your skin is measured by the sensors, thus
alerting you to anxiety. $his knoledge is useful in treating emotional disorders like
stuttering, phobias and anxiety.
1al&anic skin response
1al&anic skin response ")2%#, also knon as electrodermal response
"?'%#, ps!chogal&anic reflex "!)%#, or skin conductance response "2.%#, is a
method of measuring the electrical resistance of the skin. $here has been a long history
of electrodermal activity research, most of it dealing ith spontaneous fluctuations. 3ost
investigators accept the phenomenon ithout understanding exactly hat it means.
$here is a relationship beteen sympathetic activity and emotional arousal, although
one cannot identify the specific emotion being elicited. $he )2% is highly sensitive to
emotions in some people. 7ear, anger, startle response, orienting response and sexual
feelings are all among the emotions hich may produce similar )2% responses.
,ractice
)2% is conducted by attaching to leads to the skin, and acquiring a base measure.
$hen, as the activity being studied is performed, recordings are made from the leads.
$here are to ays to perform a )2% - in active )2%, current is passed through the
body, ith the resistance measured. In passive )2%, current generated by the body
itself is measured.
5ses
)2% measurement is one component of polygraph devices and is used in scientific
research of emotional arousal.)2% measurement is also becoming commonplace in
hypnotherapy and psychotherapy practice here it can be used as a method of
detecting depth of hypnotic trance prior to suggestion therapy commencing. 1hen
traumatic material is experienced by the client "for example, during hypnoanalysis#,
immediate changes in galvanic skin response can indicate that the client is experiencing
emotional arousal. It is also used in behavior therapy to measure physiological reactions
such as fear. 2kin conductance is also a factor in some modern electronics to measure
the activation of touchscreen devices. $his is notable as many of these devices that use
capacitive screens cannot be used hile earing gloves as the sensors are not triggered
by the lo conductivity of rubber or leather.
2kin .onductance ")2%# biofeedback instruments are the first step in bringing hypnosis
from the nether regions of the occult into the domain of science. $he use of these
instruments provides an empirical basis for hypnosis, transforming it from a personal art
to an ob-ective science.
In the past hypnosis has been a much misunderstood and frequently suspect technique
of therapeutic treatment. 2tage hypnotists, using highly responsive sub-ects and a
vaudeville shomanship approach have given the field an undeserved aura of mystery
and chicanery. 3eanehile legitimate practitioners have sometimes achieved miracle
cures hich have defied scientific explanation. 2ince the hypnotic process has never
been substantiated through scientific invertigation, the technique has remained
controversial. 2ome professionals and laymen are enthusiastic, if not fanatical, about its
value hile others have flatly re-ected it.
1ith the use of 2kin .onductance biofeedback instrumentation some aspects of the
hypnotic process can be made scientifically ob-ective thereby increasing the general
credibility of the process.
!rimary values of 2kin .onductance biofeedback instruments are&
;. ,elping clients to reach deeper levels of relaxation
C. !roviding hypnotists ith ob-ective indications of relaxation depth
G. 'emonstrating the efficacy of a characteristic induction process ith a particular client
F. Indicating hether or not suggestions given are acceptable to the client.
2econdary values are &
;. 2haring responsibility ith the client for entering a state of hypnosis.
C. Increasing the confidence of the client in the hypnotist and the hypnotic process.
G. ?stablishing a professional image of the hypnotist.
F. Improving the training and expertise of hypnotists.
$raditional hypnosis consists of three phasesJ the induction, the reprogramming
suggestions, and the return. $he purpose of the induction is to quiet the body, mind and
emotions of the sub-ect so that in the second phase full attention is brought to focus on
the issue of concern. 1hen the person is quiescent, suggestions are apt to have the
greatest impact. )iven a successful induction, the suggestions or affirmations ork best
hen&
;. the critical faculty of the client is absent
C. the client focuses on one belief, attitude, or idea
G. the client can clearly visuali*e a ne situation, habit pattern, skill or hatever is
relevant.
1hile these conditions are neither necessary nor sufficient for successfully
reprogramming the mind, most hypnotists ork toards establishing them during the
hypnotic process. 3oreover, these are general conditions useful for nearly any learning
activity, and hypnosis usually involves some learning on the part of the sub-ect.
In the initial phase hypnosis has some similarity to mediation techniques. ,ypnotists sek
to quiet the body and mind before implanting suggestion. 3ediators also begin by
quieting the body and mind. In a sense, hypnosis could be called 5 applied meditation5.
/ne difference beteen meditation and hypnosis is that hypnosis often deals ith the
notion of a subconscious mind hile meditation aims to contact a superconscious mind.
1ith instrumentation and feedback, both client and hypnotist are aare of hat is
happening and both can ork together to loer the client8s stress level. It is not a
question of the 5ill5 of the hypnotist against the 5ill5 of the client, both cooperate. $he
client takes responsibility for their on conditionJ they do not surrender their ill to the
hypnotist. $his helps to bypass the issue of trust and the hole process goes smoother
and more efficiently.
By taking inexpensive biofeedback instruments home, clients can practice more
effectively, ith greater interest, and ith ob-ective indications of their success. $he
client can learn to relax more rapidly and more deeply. $he hynotist can learn hich
induction method orks best for that person and can tell hen they are deeply relaxed.
$here is no need to test for depth by challenges- the hypnotist can simply look at the
meter or note the pitch of the sound. $his leaves him free to concentrate on preparing
and administering hypnotic prescription or otherise orking ith the client hile they
are in a deeply relaxed state. 2ometimes the hypnotist may not ish to have the tone of
the instrument audible. It may disturb the client or interfere ith tape recording.
( 2kin .onductance instrument hich has a meter has a control to turn off the sound.
1hen the sub-ecthas successfully dropped the pitch or loered the meter needle, the
operator can reset the controls to a higher level again and request the sub-ect to go even
deeper into relaxation. $his deepening process can be repeated several times during the
course of a typical induction. 1hen the client is sufficiently relaxed the next phase of the
process can begin.
'uring the induction my associates and I suggest that the person let their body go to
sleep, hile their conscious mind remain aare and alert. $his seems to be a more
accurate ay of stating hat happens. /f course the sub-ect does not go into any kind of
trance state. $ypically they experience a sensation of floating ithin the body. 1e use
the term 5nexus5 to talk ith them about that condition. In nexus, hich denotes a tie or
link, the sub-ect can either connect to his subconscious body-mind or his superconscious
mind. 6exus is not an all or none state, rather it is more like a progressive condition.
7rom the point of poer hich e call nexus, a person can direct their subconscious or
ask for guidance from their superconscious. .omplete programs ork ith all three
minds and in this sense hypnosis ought to be considered as a state of greater
akefulness rather than sleep.
1hen a person is in the nexus condition the skin conductance ill continue to reflect
changes. 2ometimes the slightest thought, orry, or distraction ill produce a skin
conductance reaction. If the hypnotist gives a suggestion hich is not acceptable to the
sub-ect the skin conductance ill often indicate this by a pitch increase. (ny comment by
the hypnotist hich has any emotional charge ill be indicated as a skin conductance
change and the hypnotist can either explore the matter immediately or note it and ask
the sub-ect about it after the session.
In reprogramming the subconscious mind via the conscious mind, e ask the sub-ect to
visuali*e hat he or she ants to happen. Bisuali*ation has been found to help imprint
the ne program. 1ith biofeedback, both sub-ect and hypnotist have an indication of the
clarity of the visuali*ation, and a means of training for improvement.
0kin (onductance )onitor
0tress - The final frontier
@ncontrolled stress prevents you from reaching your full potential. ,eadaches, phobias,
hypertension, obesity, sleeplessness, chronic pain, smoking another conditions are all
linked to and aggravated by chronic stress.
2tress is a part of everyday life, and it keeps many people from functioning at their
optimum level because they do not kno ho stressed they are or ho to control it.
Biofeedback is a idely used and medically accepted technique for teaching control of
stress. %elaxation releases energy, alloing the energy being asted on stress to be
channeled into more productive activity. :earn to control your stress, in your on home,
using Biofeedback. $he proven most effective ay to control stress and learn true
relaxation. 7eel better, sleep better, helps to achieve your personal goals.
$he Biofeed 2kin .onductance monitor measures your body8s reaction to emotional and
physical stress ith great sensitivity, and gives 8feedback8 on changes from moment to
moment in your tension level by means of a tone and meter reading. It lets you monitor
and control your stress by amplifying tiny stress related changes in y or skin into a sound
and movement on the built in meter.
2imply rap the to sensors around your finger tips and you ill see and hear ho
different events affect your stress level. Kust thinking about something stressful ill
cause a change. (s your stress increases so does the tone and the meter needle moves
up the scale.
$here are various techniques of Biofeedback that are used by $herapists and
!ractitioners so as to bring about relief to patients. $hese techniques help the patient to
identify !sychophysical symptoms and gain control over physical processes previously
considered automatic.
viii) Electromyogram (EMG)
$his is the most common form of biofeedback measurement. (n ?3) uses electrodes
or other types of sensors to measure muscle tension. $he most common muscles that
biofeedback practitioners ill use are the frontalis "the froning muscle in your
forehead#, the masseter "-a muscle#, and the trape*ium "the shoulder muscles that
hunch hen youAre stressed#. 1hen the electrodes pick up on muscle tension, the
machine gives you a signal, such as a colored light or sound. 1hen the ?3) alerts you
to muscle tension, you can learn to recogni*e and control the tension right aay. It helps
ease tension in those muscles involved in backaches, headaches, neck pain and
grinding your teeth "bruxism#. It is also useful for treating stress related illnesses such as
asthma and ulcers.
/lectrom!ograph! (/)1)
$his test helps individuals recogni*e symptoms before and during muscle tension, in-ury,
and pain. $he sensors help measure the activity of the nerves that manage muscles.
T!pes of biofeedback and their uses
Biofeedback orks by using electronic instrumentation to monitor specific physiological
activities-often unconscious-and habits of your body and then feeds it back to you. 1ith
this information, you can change those patterns of behaviour or eliminate them
completely. It is helpful in curing chronic, benign problems because it loers the use of
drugs and visits to the doctor. 2ome of the equipment it uses are&
/lectrom!ogram (/)1):
$his equipment uses electrodes or other kinds of sensors to measure muscle tension.
/nce you are alerted to muscle tension, you can begin to recogni*e your on feelings
early on and try to control the tension. 1ith ?3), you can learn to relax your muscles
that bring on backaches, headaches, neck pain and bruxism or grinding of teeth, apart
from asthma and ulcers.
Temperature biofeedback:
1ith sensors attached to your fingers or feet, you can measure your skin temperature.
1hen your temperature falls at stressful times, a lo reading can make you begin
relaxation techniques. Besides, biofeedback can also help treat %aynaudAs disease and
reduce the frequency of migraines.
1al&anic skin response training:
1ith the help of sensors, you can also measure the activity of your seat glands and the
amount of seat on your skin, hich can alert you to become anxious. 1ith this
information, you can treat emotional disorders such as phobias, anxiety and stuttering.
/lectroencephalogram (//1):
$he activity of the brain aves linked to different mental states, such as akefulness,
relaxation, calmness, light sleep and deep sleep, can be measured by an ??).
Biofeedback can also be helpful in these conditions&
It can reduce or negate the need for medication.
It can help in those conditions here medication hasnAt.
By providing measurable feedback, it allos you to be in charge of your on
healing and monitoring your on progress.
It can decrease your medical costs.