Have you ever felt out of control? Like your body was running you instead of you running it? If you’ve ever experienced a panic or anxiety attack, you know what I’m talking about. But this can extend to how pain can rule our lives, or having to endure the emotional whiplash of our ever-changing moods. And if you add stress into the mix? Watch out. Stress can do wonders to our body, and not in a good way. Give it long enough and it impacts our sleep, our mood, our weight, our relationships, our work performance, our very perspective on life. And what are we left to do? There’s therapy, medication, lifestyle adjustments, but what if they don’t do the trick?
What if I told you there is a way for you to get back in the driver’s seat of your own life, and all you had to do was learn how to communicate in a new way with your body. A pioneer of the field of Biofeedback once said, “We have not been informed that our bodies do what they are told, if only we knew how to tell them.” Biofeedback is the art of learning how to tell our bodies what to do, instead of them getting to dictate how we feel or what we do. If this resonates at all with you, I invite you to continue reading, and to discover which biofeedback modality might suit you best.
What is Biofeedback?
Biofeedback is a mind-body technique that allows you to alter physical activity in order to improve physical and emotional health and performance. Those in the field of biofeedback developed each technique by asking the question, what if? If we can measure something physiologically, like heart rate or muscle activity, can we do something to improve it? Amazingly, they found the answer to be yes. And thus, biofeedback was born. The goal of biofeedback is to improve the connection between you and your autonomic nervous system, which controls automatic physiological processes such as heart rate, muscle tension, temperature, blood pressure, respiration, and perspiration, by learning how making subtle changes to these different physiological functions can result in a desired effect, such as a reduction in stress, pain, and symptoms of anxiety, depression, or panic. This is accomplished by applying sensors to your body that can detect heart rate, respiration rate, perspiration, muscle tension, even brain wave activity. Changes in each result in a visual or auditory cue, which creates the feedback loop between biology and your consciousness, and with practice and coaching, you learn how to take conscious control of those automatic bodily functions and effect change. [1]
Types of Biofeedback
There are several modalities of biofeedback, including Temperature Biofeedback, Respiration Biofeedback, Galvanic Skin Response Biofeedback, EMG Biofeedback, Heart Rate Variability Biofeedback, and EEG Biofeedback. Each have their own sensors and can be trained alone or combined with others, and each have their strengths and weaknesses when applied for certain struggles. Practicing any kind of biofeedback takes time, dedication, effort (what we call passive effort), and practice.
The Autonomic Nervous System (ANS) works a lot like a pulley system. It has two sides: the Sympathetic and Parasympathetic Nervous Systems. The Sympathetic Nervous System (SNS) is the revving of the engine that is the ANS. It increases the heart rate, produces sweat on the palms to increase friction if you need to climb or leap something, ratchets up the respiration rate to get in more oxygen, reroutes blood flow to the core of the body for protection, and pauses bodily functions like digestion that are unnecessary when there is danger and you need to GO. In contrast, the Parasympathetic Nervous System (PNS) is our “rest and digest,” the breaks to the ANS engine. It slows down the heart rate, respiration rate, and dries up the hands. It raises temperature in the extremities and restarts paused bodily functions like digestion.
The Sympathetic Nervous System (SNS) is the revving of the engine... in contrast, the Parasympathetic Nervous System (PNS) is our “rest and digest,” the breaks to the ANS engine.
Ideally, the two work in balance with each other, but too often, one is more activated than the other, resulting in high stress levels, anxiety, or agitation (SNS activation), or resulting in lethargy, depression, or isolation (PNS activation). Biofeedback is learning to leverage this pulley system to its advantage - because if you can find a way to make your temperature rise, or your muscles to relax, or your skin to dry up, all of that activates the PNS, which means the body has no choice but to relax and down-shift out of fight-or-flight mode.
Respiration Biofeedback
Respiration Biofeedback uses a band wrapped around either the chest or abdomen to measure your respiration rate as well as the volume of air taken in and expelled each breath cycle. Breath plays a critical role in many of the biofeedback techniques, and is a linchpin of sorts when it comes to learning how to influence your nervous system. In fact, breath is so intricately tied to the nervous system that you can breath in one nostril to activate it and the other to relax it.
The training that ensues teaches you to gain better control over your diaphragm, and to manipulate your breath in several different ways in order to effectively reduce stress and anxiety. Respiration biofeedback finds its strength in reducing stress and anxiety, and can also be used to help arrest a panic attack, but if your struggle lies elsewhere, such as with chronic pain or migraines, or depression, you’re better off learning a different biofeedback technique.
Temperature Biofeedback
Temperature Biofeedback is perhaps the oldest of the biofeedback techniques. Tibetan monks practice this during their meditations. They are able to sit in a cold room and use their breathing to keep their body temperature high, so that when other monks dip towels into frigid water and place them across their shoulders, their temperature is not lowered and it’s not long before steam begins to rise off the towels, until they are dried and new, wet towels are added.
With this technique, a sensor is attached to a forefinger in order to measure the temperature of that finger. By employing a combination of breathing and visualization techniques, you can learn to raise the temperature of that hand. In essence, you’re learning how to dilate constricted blood vessels in that finger, which allows for more blood to flow, and thus more heat in that finger. The Dalai Lama learned this technique and mastered it to such an extent that you could place a sensor on his pinky and a second one on this thumb, of the same hand, and you could measure a ten degree difference between the two sides of his hand.This technique is taught for many reasons, the foremost being to help relieve migraine pain, to help those with Raynaud’s Disease, and as another way to reduce stress, as a natural byproduct of stress is a drop in body temperature.
Galvanic Skin Response Biofeedback
Galvanic Skin Response (GSR) Biofeedback measures the amount of perspiration produced in the sweat glands. Stress and emotional arousal typically result in clammy or sweaty hands, and so learning how to constrict the sweat glands and reduce the amount of sweat produced will influence the nervous system and calm the mind and body. GSR biofeedback’s strength lies in nervous system arousal, or activation, so anxiety, panic, and stress are effectively influenced here, but not pain or low-energy emotional struggles like depression. Fun fact, Temperature Biofeedback and GSR Biofeedback work inversely from each other, meaning you can measure both at the same time, and as you raise your temperature, your GSR lowers, and vice-versa.
EMG Biofeedback
Electromyographic (EMG) Biofeedback works with muscles. Sensors are placed on specific muscle groups, like the shoulders, neck, or across the forehead, to measure changes in tension by monitoring the electrical activity resulting in muscle contractions. By learning how to locate and target just those muscle groups, you can reduce the tension in areas causing you pain due to muscle tightness. This is especially effective for chronic tension headaches or TMJ pain. By reducing muscle tension, blood flow is able to increase in that area, resulting in increased temperature, which also reinforces the reduction of tension and stress in the body.
HRV Biofeedback
Heart Rate Variability Biofeedback (HRV) is the newest form of biofeedback. It uses a sensor that measures pulse rate, attached either to the ear lobe or a finger, in order to detect the variability of your heart rate. On average, the heart should beat about seventy beats per minute, but that beat changes, increasing and decreasing, throughout that minute. As you breathe in, the heart rate increases (SNS activation), and as you breathe out, it decreases (PNS activation). The different between the highest beat and lowest beat is your heart rate variability. This is something cardiologists measure on each of their patients, because your HRV is a good indicator of heart health and can show if you are at risk for a cardiovascular event, as a low HRV would. The goal, then, is to increase your variability. An athlete with a healthy heart might have a 30 or more beat interval, where as someone who is at risk for a cardiological event might have a 5 beat interval.
By employing breathing techniques layered with mindfulness and emotional state shifting techniques, you can not only improve your heart rate’s variability, but you can also improve your sleep, your mood, your emotional response to pain, reduce your stress levels, and break automatic negative thought loops. For this reason, HRV Biofeedback is an effective tool for many ailments. Including dysautonomia syndromes such as Postural Orthostatic Tachycardia Syndrome (POTS). HRV Biofeedback can be used to strengthen one’s vagal tone and even out extreme fluctuations in heart rate and blood pressure. For being such a simple technique to learn, it packs a powerful punch, and is something everyone would benefit from learning.
EEG Biofeedback
EEG Biofeedback, or as it is better known as, Neurofeedback, works directly with brain wave activity. While all the other techniques of biofeedback necessitate the person learning it to take an active role and hone a skill neurofeedback allows the person to be more passive. There are multiple different types of neurofeedback, but each one uses sensors that are strategically attached to the head, which allows the practitioner to observe the brain’s function millisecond by millisecond, and feed that information back to the brain, usually by way of movies, tv shows, or video games. The brain is rewarded for changing its own activity and learning to function more efficiently. It is a gradual but effective process that leverages the brain’s natural ability of neurogenesis and neuroplasticity (click here to learn more about neuroplasticity) to both birth new neurons and form new connections between neurons anywhere in the brain, which means neurofeedback can be applied to any aspect of the brain, and thus its function, that we can measure. For decades, neurofeedback has been used to help symptoms of anxiety, depression, sleep disturbances, attention deficits, developmental delays, migraines, seizure activity, behavioral and emotional disturbances, trauma, and more. For a deeper dive into neurofeedback, click here.
Is there Risk with Biofeedback?
One question many people have when it comes to biofeedback is if there is any risk involved. Can learning this technique harm you at all? When taught and learned correctly, there is very little to no risk. Biofeedback is considered a safe form of therapy. However, it is not a form of medical treatment and cannot be used to “cure” medical or psychological conditions. Biofeedback is a training technique used to teach you how to better communicate with your own body in order to impact and reduce various physical or psychological symptoms, but is not a medical cure or treatment therapy.
What Makes a Good Biofeedback Practitioner?
Biofeedback professionals do not operate under a medical license, but should have certification of their education and experience. Board Certifications do exist as the highest form of credentialing in this field, with the gold standard being board certifications from the Board Certification in Biofeedback from the Biofeedback Certification Institute of America (BCIA).
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