Biofeedback Therapists

Biofeedback therapy is a treatment that over the last three decades has shown considerable promise for patients with a wide range of conditions and disorders. Because it can be adapted to so many uses, it has developed more as a complementary skill than as a separate career. Biofeedback therapists come from a variety of backgrounds—physicians, social workers, psychologists, physical therapists, chiropractors, speech pathologists, even dental hygienists, among others. These professionals incorporate biofeedback learning techniques into the more traditional treatments they regularly provide. While it is not impossible to have a career in biofeedback without underlying training in a different field, few people are trained only as biofeedback therapists. It is true, however, that many therapists with experience in other disciplines choose to focus their practices largely on biofeedback.

An understanding of the uses of biofeedback begins with an understanding of the effects of stress. Stress often arises from major life changes, such as divorce, the death of a loved one, a move to a new home, or even celebrating holidays with family. In such high-stress times, a person's body undergoes "fight or flight" reactions. The body reacts physiologically to a person's mental and emotional concerns.

The effects of a typical fight-or-flight situation, such as a mugging or assault, may be considerable. A person reacting to such a potentially life-threatening situation will experience physiological changes. Much smaller stresses to a person's system, such as anxiety the night before an important exam, can also have lingering negative effects. An exam is not a life-threatening situation, but if someone perceives it that way, these perceptions can cause the same types of physiological changes.

Some people are terrified to speak in front of a group. There is no physical danger, but the speaker feels threatened in nonphysical ways—he or she may trip, forget lines, mispronounce words, fail at getting a message across, or be ridiculed. The speaker becomes nervous and tense, activating the fight-or-flight response when there is no real reason to do so.

Scientists believe that if people can learn to make themselves ill in this way, by moving their body systems out of balance, they might very well be able to learn to reverse the process and make themselves well. Biofeedback training teaches patients to restore balance to their body systems by voluntarily controlling generally involuntary reactions to various forms of stress.

There are three primary forms of biofeedback therapy; they involve the measurement of skin temperature, muscle tension, and brain waves. Each form is useful in a different range of disorders and conditions, and the list continues to grow.

Skin temperature biofeedback is often used with a therapeutic technique called autogenic training. Skin temperature is affected by blood flow, which is affected by stress. When a person is tense, blood vessels narrow, limiting the flow of blood in the body and causing skin temperature to drop. Biofeedback therapists place sensors on the hands or feet to determine blood flow. Autogenic training involves mastering passive concentration, and when properly practiced, helps the patient relax deeply through a number of repeated formula phrases. ("My right arm is heavy. My right arm is heavy. My right arm is heavy. My left arm is heavy. …") The relaxation improves blood flow and raises skin temperature. These techniques have been shown to aid patients suffering from severe migraine headaches, Raynaud's disease (a disorder of the blood vessels in the extremities characterized by extreme sensitivity to cold), and hypertension, or high blood pressure, among other complaints.

Muscle tension biofeedback, or electromyograph (EMG) biofeedback training, involves using sensitive electrodes to detect the amount of electrical activity in muscles. Auditory and visual feedback helps patients learn to control the pace and intensity of this activity. Autogenic training may be used in these situations as well to encourage relaxation. Many disorders respond to EMG biofeedback therapy, including tension headaches, anxieties, phobias, and psychoses.

The last line of research is the study of brain waves using electroencephalography (EEG), or neurobiofeedback. Brain waves display certain characteristic rhythmic patterns. Beta rhythms are fast and have small amplitude; they predominate when you are awake or mentally aroused. Alpha rhythms, the first to be identified in EEG biofeedback therapy, are extraordinarily symmetrical, have large amplitude, and increase in most patients when they close their eyes and relax their bodies. Theta rhythms continue the slide toward sleep and increase as a person becomes drowsy, corresponding to early dreaming states. Delta rhythms are irregular and occur in heavy, dreamless sleep. Biofeedback training that teaches patients to seek the alpha state has been shown to be helpful in the treatment of epilepsy, attention deficit disorder, autism, and obsessive-compulsive disorders, among other maladies. Scientists currently are exploring the use of EEG training in enhancing creativity and improving learning.

EEG biofeedback is noninvasive and painless, according to EEG Education & Research. At the start of an EEG biofeedback session, the therapist interviews the patients about his or her symptoms and family medical history. Then the therapist starts the EEG session by placing one sensor on each ear of the patient and one or more sensors on the patient's scalp. The patient's brain waves are monitored and analyzed using an amplifier and computer-based instrument. The results are shown to the patient via a computer monitor or video game. The therapist asks the patient to interact with the video game or items on the screen. When positive brain activity occurs, the biofeedback process continues. When negative brain activity ensues, the process is modified to steer the brain back toward positive activity. EEG Education & Research reports that EEG biofeedback therapy gradually encourages the patient's brain to respond to the cues that it is being given, and "a 'learning' of new brain wave patterns takes place."

A biofeedback therapist's approach depends on his or her primary training. Physicians use biofeedback to complement medical remedies. Social workers use biofeedback to help patients cope with the social and emotional effects of chronic and sometimes debilitating problems. Music therapists use music and rhythm in conjunction with biofeedback to help patients understand and control physiological and emotional reactions. Other professionals who might use biofeedback therapy include nurses, psychiatrists, physical therapists, and anyone involved in health care or counseling work.

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