BIOFEEDBACK

Biofeedback is a relatively new therapeutic tool that is showing increasing promise in the treatment of a wide variety of psychological problems and symptoms. Biofeedback is very useful for achieving stress reduction, reducing anxiety and alleviating psychosomatic symptoms.

Biofeedback: A working definition.

Biofeedback is a therapeutic technique that attempts to produce in a client the ability to control certain physiological processes. The means to do this include monitoring the physiological response in the client and displaying the signals generated by the monitoring technique to the therapist and client. The therapist utilizes different techniques to facilitate the acquisition of such control (none of the techniques used in the Counseling Center include surgical or pharmacological adjuncts).

Biofeedback is an educational process in which the client is helped to learn to control certain physiological processes. The client assumes the responsibility and becomes an active participant in his/her own improvement. In addition to improving the specific problem, the client increases his/her feelings of self-control and personal mastery.
It is important to note that in biofeedback only the client can actually produce the desired changes through following the therapist's instructions and regular practice.

The biofeedback therapist is a person trained in the use of this therapeutic tool.

Biofeedback: Uses.

Biofeedback is a primary treatment for moderate or severe migraine syndromes, tension headaches and Raynaud's disease. Biofeedback is also an important adjunctive therapy for the following conditions:

• Stress reduction
• Anxiety
• Stuttering
• Bruxism
• Asthma
• Hyperactivity
• Spasmodic torticollis
• Functional gastrointestinal disorders

Biofeedback and Stress Reduction.

Biofeedback is used in a variety of stress and anxiety producing situations. These situations involve job- or study-related physical and psychological problems, as well as those cases where a person wishes to learn to relax more. In all these cases, structured stress and anxiety reducing interventions using biofeedback has proven to be effective. Biofeedback has shown essentially no negative side effects in any of these situations.

Biofeedback limitations: Contraindications.

Biofeedback seems to have a very low potential for damage (if used properly, of course.) There are no absolute contraindications and few relative contraindications for biofeedback:

• Unevaluated symptoms. Biofeedback should not be used for treating unevaluated symptoms.
• 1a. Unevaluated symptoms, Medical: Biofeedback almost always produces an enhanced feeling of general well-being (APA Task Force, 1980). Symptomatic relief can mask underlying problems. For a safe and effective application, a medical evaluation of the client is required before applying biofeedback.
• 1b. Unevaluated symptoms, Psychological: Biofeedback is contraindicated for psychoses and major affective disorders.
• Cognitive impairment. Cognitive impairments that interfere with an understanding of the biofeedback process can preclude successful treatment.
• Apprehensive clients: If a client views biofeedback with apprehension the procedure should not be applied.

Here are some helpful guidelines to determine who would (or would not) benefit from biofeedback:

• Physiological responsivity: The client should show some level of physiological responsivity otherwise the biofeedback procedure will not be very useful.
• Motivation: The client should be motivated. Reading an article or a brochure about biofeedback or talking with a former successful client can help the client understand the benefits of this procedure.
• Personality characteristics: Clients with rigid personality traits are not very responsive to a psychologically- or a psychophysiologically-based treatment technique.
• Secondary gains: Clients getting excessive sympathy and attention from their symptoms may not be willing to give up on those. This problem should be solved before biofeedback is attempted.

The biofeedback equipment must be sophisticated enough to measure the response under treatment. If the equipment is not sensitive enough, it will not register small changes and the client will tend to get discouraged.

Biofeedback can be used alone or in conjunction with other techniques such as autogenic training, guided imagery and Jacobson's technique.

Biofeedback: The Role of the Client.

Biofeedback will be useful if and only if the client is willing to take the time necessary to learn the self-control skills and then practice them conscientiously as needed. The therapist may have designed the best program, but unless the client follows it, no benefit will be obtained.

Carlos Zalaquett, Ph.D.
Spring 1993.