Sharron Grainger MSc, BSc, PSI, MIACP

Frequently Asked Questions

Who is Your Biofeedback Training Provider?

Sharron Grainger is a Psychologist and Psychotherapist and has received the
required Post Graduate Certification in Applied Psychophysiology. 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 Neurofeedback and Biofeedback.

What is Biofeedback?
Biofeedback Training (BFB) has been extensively researched for the past 40 years. It
is a 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)

In essence, Biofeedback training is much like physical therapy insofar as it requires

active participation on the part of patients with regular practice between training
sessions. Biofeedback is a self‐regulation technique through which patients learn to
voluntarily control what were once thought to be involuntary body processes. This
intervention requires specialised equipment to convert physiological signals into
meaningful visual and auditory cues, as well as a trained biofeedback practitioner to
guide the therapy. Using a screen, patients get feedback that helps them develop
control over their physiology. Just as looking into a mirror allows one to see and
change positions, expressions, etc., biofeedback allows patients to see inside their
bodies, with a trained practitioner serving as a guide directing them to use the
feedback to regulate their physiology in a healthy direction.

What does it involve?

Biofeedback Training does not involve anything invasive – it is based on learning. In
conjunction with Cognitive Behavioural Therapy (CBT) my goal is to train you to
balance your brain and body to have optimal functioning and health. I start with an
extensive assessment, which includes a Clinical Interview, psychological and physical
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,
Sharron Grainger MSc, BSc, PSI, MIACP

respiration, muscle contractions, finger temperature and skin conductance are

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.

Is Biofeedback Safe?
Yes. There are no ‘side-effects’ to Biofeedback Training in the same way there would
be to chemicals or medications as there is nothing at all being introduced into your
body and measurement is done using sensors only.

Will it hurt or will I feel anything?

No. When you do Biofeedback Training I monitor and record what your Psycho-
physiology is presenting using passive sensors recording your temperature or heart
rate. Nothing is ever sent to your body via these sensors. These sensors are called
electrodes. To help these sensors get a good signal, sometimes I use a conducting
gel which might feel a bit cold, but that is all you’ll feel!

How does the training work?

Quite simply Biofeedback Training allows you to gain more control over the way your
brain/body connection and (Autonomic) nervous system works.

During a biofeedback session, electrodes or sensors are attached to your skin or

fingers. These electrodes or 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 when for example, a video,
animation or music will play. 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 do it again thus
reinforcing the behaviour.
Over the course of Biofeedback Training your Psycho-physiology (brain/body) gets
better and better at operating in this new way. You will be required to continue working
at your training outside of the clinic, in addition to making changes to certain
behaviours to move towards your goals.

What Methods are Used?

There are several different biofeedback methods. These protocols help to train the
body back to balance, increase positive coping and ability to handle the demands of
everyday life, while at the same time decreasing pain and suffering. Determining the
method that's right for you depends on your health problems and goals. Biofeedback
methods can include:
Sharron Grainger MSc, BSc, PSI, MIACP

 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. It may be used for anxiety, asthma and irregular heartbeat.

 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. It may be used for back pain, headaches, anxiety disorders and
muscle retraining after injury.

 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. It can be used for pain and anxiety.

 Thermal: A sensor known as a thermister is attached to your fingers or feet

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. It may be used
for headache and Raynaud's disease.

What can Biofeedback Training be used for?

I use Biofeedback only in well researched efficacy rated protocols in the following
areas:

Stress/Anxiety. Stress/Anxiety 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.

Headaches/Migraine. Headaches are one of the best-studied biofeedback uses.

Muscle tension and stress can trigger migraines and other types of headaches, and can
make headache symptoms worse. There is good evidence that biofeedback therapy
can relax muscles and ease stress to reduce both the frequency and severity of
headaches. Biofeedback seems to be especially beneficial for headaches when it's
combined with medications.
Sharron Grainger MSc, BSc, PSI, MIACP

Chronic pain. By helping you identify tight muscles and then learn to relax those
muscles, biofeedback may help relieve the discomfort of conditions like low back
pain, abdominal pain, temporomandibular joint disorders (TMJ), and fibromyalgia. For
pain relief, biofeedback can benefit people of all ages, from children to older adults.

Hypertension or High Blood Pressure. Evidence on the use of biofeedback for high
blood pressure has been mixed. Although the technique does seem to lower blood
pressure slightly but it can take 20 or more sessions to improve. Biofeedback isn't as
effective as medication for blood pressure control.

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. The ultimate goal of all biofeedback therapy is to stabilise, normalise and
optimise psychophysiological functioning through teaching physiological flexibility.
Over time patients can learn to self-regulate without feedback screens in front of
them.

How effective is Biofeedback Training?

When you walk, or even move your hands, your body 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
harness the power of your mind and 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, I will attach sensors to either your fingers
or muscles and we will monitor your physiological activity. You will be asked to watch
the screen and get an animation, music or movie to play. The animation, music or
movie 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 we move through sessions. Patients report that
these sessions are generally comfortable.

At your first session I start with an extensive assessment, which includes an intake
interview to identify history, symptoms and any diagnoses you may already have.
You will complete psychological and physical 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 or do you not
react enough? 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 are measured during
Sharron Grainger MSc, BSc, PSI, MIACP

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 make the
necessary corrections.

How Many Sessions Will I need?

Each biofeedback therapy section lasts approximately 45 minutes. Usually, you can start
to see biofeedback benefits within 10 sessions or less. 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 I will
review your data around sessions 6 and discuss with you any necessary changes to
your protocol. I guarantee that I will never recommend unnecessary sessions and it is
up to you if you wish to take my recommendations on board. Furthermore, if I deem
you to be unsuitable for Biofeedback I will inform you.

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 this is variable. At the initial consultation and assessment we can work
out the schedule together.

Click here to see a short video showing what happens during BFBT

When will I see the benefits?

Some people report feeling some positive effects as early as 3 or 4 sessions in, 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 inside and just as
importantly outside of the clinic 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 to let yourself fall back into old habits which would support
old psycho-physiological patterns and therefore not maintain any benefits gained
from training.
Sharron Grainger MSc, BSc, PSI, MIACP

How do make or break appointments?

Appointment Schedule
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.

It is important that you invest in your Biofeedback Training programme and that you
make it a priority as you would a hospital or dentist appointment. I am happy to
provide a letter detailing an explanation for your absence from respective
commitments upon request.

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 I 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
The centre cancellation policy is listed below. The cancellation policy will also be
discussed at your first session.

If you cannot make your next appointment please 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.
‘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.
Rescheduling appointments.
It is your responsibility to make contact to reschedule missed appointments to keep
up the training schedule. Due to the volume of bi-weekly appointments, I 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.
Sharron Grainger MSc, BSc, PSI, MIACP

Where can I read more about Biofeedback Training?

If you would like to read more about Biofeedback Training please see below:

The Association for Applied Psychophysiology and Biofeedback, Inc.

(www.aapb.org)

The Biofeedback Foundation of Europe supports education, training and research

activities in biofeedback. (www.bfe.org)

The Biofeedback Certification International Alliance is the only certification body for
individuals who meet education and training standards in Neurofeedback and
Biofeedback. (www.bcia.org). Note: Sharron Grainger is trained and adheres to the
BCIA Blueprint of Knowledge Statements for Board Certification in Biofeedback
(www.BCIA.org)

You will find some instructional and information videos available on YouTube
(www.youtube.com).