How Biofeedback Works

Biofeedback is a mind-body technique that involves using visual or auditory feedback to teach people to recognize the physical signs and symptoms of stress and anxiety, such as increased heart rate, body temperature, and muscle tension.

By learning how to control physical and psychological effects of stress using biofeedback, people are able to learn how to relax their minds and bodies and better cope with the symptoms of stress.

The goal of biofeedback is to make subtle changes to the body that result in a desired effect. This might include relaxing certain muscles slowing heart rate or reducing feelings of pain. Some of the functions that people can learn to control include:

• Blood flow
• Blood pressure
• Heart rate
• Muscle tension
• Pain perception

The Association for Applied Psychophysiology and Biofeedback defines biofeedback as a process that allows people to alter their physiological activity in order to improve health or performance. Utilizing precise measurement instruments, information about the body's functions is provided to the user.

Types of Biofeedback

There are many different types of biofeedback. The specific approach you choose to utilize might depend upon what you hope to accomplish and what your therapist or physician recommends.

Respiratory Biofeedback

Respiratory biofeedback involves wearing sensor bands around the chest and abdomen to monitor breathing rates and patterns. With training, people can learn to have greater control over their breathing rates which can help in a variety of situations including when experiencing anxiety.

Heart Rate Variability Biofeedback

With heart rate variability biofeedback, patients wear a device connected to sensors in either the ears or fingers or sensors placed on the wrists, chest, or torso. There is some evidence that heart rate variability biofeedback might be useful for a number of different disorders including asthma and depression.

Galvanic Skin Response

Galvanic skin response, also known as skin conductance, is a type of biofeedback that involves measuring the amount of sweat on the surface of the skin. This type of biofeedback is a useful marker for detecting levels of emotional arousal.

Aside from the obvious thermoregulatory function of sweat, emotional stimulation can also easily trigger sweating. The more strongly people are aroused, the stronger their skin conductance will be.

Blood Pressure Biofeedback

Blood pressure biofeedback involves wearing a device that provides information about the patient's blood pressure. These devices often guide the user through relaxation techniques that may use visual cues, breathing exercises, or music.

Thermal Biofeedback (Temperature Feedback)

In thermal biofeedback, patients wear sensors that detect blood flow to the skin. Because people often experience a drop in body temperature during times of stress, such devices can help people better detect when they are starting to feel distressed. A low reading on one of these monitors can indicate a need to utilize some stress management techniques.

Neurofeedback (EEG Biofeedback)

Neurofeedback involves utilizing electroencephalography (EEG) to measure brain wave activity. Scalp sensors are connected to an EEG device. Neurofeedback is sometimes used as a non-invasive treatment for attention-deficit/hyperactivity disorder (ADHD), pain, addiction, anxiety, depression, and other disorders.

Electromyography

With electromyography, sensors are placed at various points on the body and connected to an EMG device. This device detects changes in muscle tension over time by monitoring electrical activity that results in muscle contractions.

Techniques

Biofeedback is often considered a type of training rather than a treatment. With training and practice, biofeedback can be used to help people develop new skills that may help them to better cope or perform.

A biofeedback session will often last between 30 and 60 minutes. A typical course of treatment often includes four to six sessions, although eight to 10 sessions are also not uncommon. The duration of treatment and the number of sessions required depends on many factors, including:

• How well you respond to the training
• The condition you are focusing on
• Your goals for treatment

During a typical biofeedback session:

• Electrical sensors will be connected to specific areas of your body, depending upon the type of response being measured.
• These sensors will be connected to a measurement device that will provide feedback on your physical responses.
• During your session, your therapist will guide you through different mental exercises that may involve visualization, meditation, breathing, or relaxation techniques.
• As you perform these activities, you will receive information on your physical response from the measurement device.

What Biofeedback Can Help With

Biofeedback is particularly useful for managing stress as well as a variety of conditions that may be exacerbated by stress, including:

• Attention-deficit/hyperactivity disorder (ADHD)
• Anxiety
• Brain injuries
• Depression
• Digestive disorders such as irritable bowel syndrome (IBS)
• High and low blood pressure
• Mental health conditions
• Migraines
• Pain
• Physical reactions to stress
• Post-traumatic stress disorder (PTSD)
• Relaxation and stress management
• Tension headaches

Benefits of Biofeedback

Like other approaches to treatment, biofeedback has both its own set of upsides and downsides. It may not be right for everyone, so it is important to consider the benefits and risks before you determine if it the best choice for your situation. So what are some of the reasons why you might consider using biofeedback?

It's Non-Invasive

Biofeedback may appeal in situations where other treatments have not been effective or where people are unable to take certain medications. Because biofeedback is non-invasive, patients may prefer it in situations where other treatments may be more invasive or disrupting.

It Can Complement Other Treatments

Biofeedback training can also be used as one part of a treatment approach. People often choose to utilize biofeedback to augment other treatments, including medication and relaxation strategies.

It Can Help Put You in Control of Your Emotions

Biofeedback also teaches people how to control their own responses in stressful situations, which can help people feel more in control and better able to manage the stress they may face in their daily life as well as the stress that results from another health condition.

Biofeedback can also have additional mental health benefits, including learning new techniques for coping with feelings of anxiety and managing emotional responses.

Effectiveness

While researchers are not sure how or why biofeedback works, they do know that it has shown promise in the treatment of a variety of conditions. It has been accepted by many in the medical field as an alternative treatment for mood and anxiety disorders.

• One review found biofeedback and neurofeedback to have great potential for treating mood and anxiety disorders, including PTSD, generalized anxiety disorder, and depression in adults.
• Biofeedback, specifically neurofeedback, has been shown to improve concentration and decrease hyperactivity in individuals with ADHD.
• A meta-analysis found that biofeedback reduced depression and muscle tension and improved cognitive coping in patients with chronic back pain.
• One systematic review found that biofeedback helped improve cognitive processes, mood, and anxiety in the treatment of such clinically diagnosed disorders as ADHD, Alzheimer's disease, anorexia, depression, schizophrenia, substance use disorder, and PTSD.

Things to Consider

Biofeedback is generally thought of as a safe procedure, but you should always talk to your physician or therapist about your options before you begin. Biofeedback is not necessarily right for everyone and other approaches might work better for your unique situation.

If you do decide biofeedback is right for you, be sure to check on the credentials of the professional treating you and be aware of the possible costs of your biofeedback training, including the cost per session and expenses associated with devices you may need to purchase.

Cost

Costs for biofeedback can vary considerably, often ranging from $35 to $85 per biofeedback session. Fees can vary depending upon the training, qualification, and experience of the biofeedback therapist.

There are also a number of in-home biofeedback devices and wearables available on the market. Such devices can range considerably in price, with some costing as low as $20 and more expensive ones costing thousands of dollars.

Biofeedback Devices

Biofeedback devices fall into two different categories. The first are those used by medical and mental health professionals. The second are those available on the consumer market for personal use. Remember that most of the devices you see available for purchase have not been evaluated for safety or effectiveness by the Food and Drug Administration (FDA). Talk to your therapist about which devices they recommend.

• Clinical biofeedback devices: Biofeedback devices utilized for clinical purposes are regulated by the FDA. These devices are often available through a biofeedback therapist's office or the office of another health practitioner.
• Personal use biofeedback devices: A number of biofeedback devices can be purchased for personal, in-home use from various online retailers. Such devices often involve wearing sensors that record information and can then be plugged into a computer. Other wearable devices utilize sensors that then provide information via an app on your mobile device. These devices include wearable instruments ranging from muscle sensors to skin response units to brain wave monitors.

How to Get Started

If you or someone you love thinks that biofeedback would be beneficial, start by asking your primary care doctor for a referral to a trusted practitioner. It is also helpful to check with your health insurance company to see if your policy will cover any or all of this type of treatment. 

Biofeedback is one option that may help you gain greater control over your physical responses and behaviors. Consider the potential benefits, risks, and costs associated with this type of training before you decide if it might be right for you.