Described more formally, biofeedback uses sensors that can monitor a variety of different physiological processes. The on-going information is then fed back to the person in visual or auditory form. With this information, the person can become aware of these processes and can then learn to control them in a manner more consistent with healthy functioning.

This learning and increased mind-body communication can be used to produce (1) a generalized decrease in arousal and tension throughout the body or (2) a highly specific physiological response or patterning of responses, depending on the person's goals.

What physiological processes can be measured with biofeedback?

Some of the biological responses that can be measured and fed-back to the person (hence the term bio-feedback) are: muscle tension, skin surface temperature, respiration, carbon dioxide output, sweat gland activity, heart rate, heart rate variability and brain wave activity. Using the computer-generated feedback (a visual display and/or sounds), a person can become more aware of these particular physiological activities and learn to self-regulate them. For example, hand temperature (which is a reflection of blood flow) can be increased or decreased. Breathing can be changed from hyperventilation to normal breathing.

How does biofeedback do what it does?

First, sensors that measure different bodily (physiological) processes of interest are attached to the person in order to pick up signals. For instance, sensors that measure muscle tension may be attached to a muscle or muscles. The sensor detects ("senses") the activity in the muscle. The signal from the muscle is then shown on a computer screen in a form that provides on-going information about what the muscle is doing -- how tense it is and how the tension level changes over a period of time. This feedback signal may be displayed in any number of forms. A common form is a line graph that moves higher and lower on the screen as changes in muscle tension occur. This gives the person immediate feedback about exactly what the muscle is doing. With the feedback, the person can become aware of habitual patterns of muscle use and of degrees of muscle tension and activity he or she was not formerly able to detect. Then it is possible to begin to control what the muscle is doing. Overly tight muscles can generally be relaxed.

In a similar manner, other kinds of sensors attached to the body can measure other bodily processes. A heat-sensing device may be attached to a finger to measure changes in temperature, which reflects changes in blood flow to the area. Sensors attached to the top of the head pick up the EEG (electroencephalograph) signal, or brain wave activity. (EEG feedback is often called "neurofeedback".) A strain gauge around the trunk of the body detects how a person is breathing.

Is biofeedback safe?

One very important thing to know is that biofeedback does not do anything to the person. Sensors only "sense", or pick up, what is going on in the person and mirror it back to the person. It does not put anything into the person. Biofeedback doesn't do anything to you. It only provides you with information about yourself. It is then up to you to use that information in some way. A trained biofeedback therapist can help in guiding you and making suggestions, but only you can effect the changes.

What does biofeedback help with?

Biofeedback can assist in the treatment or management of a variety of disorders, such as:

• Anxiety, panic disorder, phobias -With biofeedback, the person learns how the body expresses anxiety responses like hyperventilation, muscle tension, cold extremities, and how the mind fuels these responses with thoughts of danger and doom. With this awareness and the guidance of a biofeedback therapist, the person can learn to lower excessive physiological arousal and alter maladaptive cognitions. Often techniques such as systematic desensitization are used to help the person become less sensitive and reactive to situations.
• Tension and migraine headaches -With feedback of muscle tension, one gains greater awareness of tension in the head and neck and learns to release that tension. Physiological quieting, including hand warming training to reduce vascular constriction, has been shown to be helpful in eliminating or reducing the frequency and severity of migraine headaches.
• Respiratory disorders -Hyperventilation, or overbreathing, is an all-too-common problem that often goes overlooked as a trigger for many conditions such as panic, performance anxiety, heart palpitations, light-headedness and dizziness (even fainting), and asthma. Feedback of breathing style and of carbon dioxide shows clearly whether a person's breathing is adaptive or non-adaptive.
  
• Stress Management -As we all know, stress causes many systems of the body to go into over-drive, as it prepares for action (the "fight or flight response"); action that generally can't be carried out, because we can't fight or flee. Because the body isn't designed to be in over-drive for long periods of time, physical symptoms often develop when there is chronic stress. Stress management training with biofeedback helps the person reduce this stress response. Biofeedback facilitates overall quieting by relaxing the muscles, soothing breathing, and calming the heart and brain wave activity. Because of the connection between the mind and the body, a quieter body generally means a quieter mind, which also reduces the stress response.
  
• Pain Management  -With biofeedback, individuals discover what automatic body habits may increase or even cause pain. Retraining these habits often considerably reduces pain, and in some cases, eliminate it. An example of this would be neck pain from unconscious muscle bracing that the person becomes aware of and can release, with the help of biofeedback. Elimination of pain is not always possible, so "management" of it becomes even more important. Creating a quieter body and mind and learning to breath in ways that relax the nervous system help the person to cope with pain better and often, to reduce it significantly.
• Some of the other applications of biofeedback include insomnia, pelvic muscle disorders such as incontinence, TMJ disorder and high blood pressure.
  

The Biofeedback Certification Institute of America (BCIA) is the national certifying body for biofeedback providers. Providers holding certification must be health care professionals, have completed training in certified biofeedback training programs and passed written and practical examinations. They are required to recertify regularly by documenting continuing education in the field or by re-examination. The term "BCIAC" means the person is a certificant of the BCIA. The term "BCIA Senior Fellow" means a person has been continuously certified for more than 17 years.

Who can benefit from biofeedback?

In all cases, it is important to determine if a health or physical condition is amenable to biofeedback. Some conditions require prior evaluation from a health care provider to ascertain this. This should be discussed with the biofeedback therapist.

People who want to be to be an active participant in their own health and healing are good candidates for biofeedback. Because biofeedback only provides you with information, and doesn't do anything to you (as medications do), you must make use of this information. You must be willing to practice new ways of using your body. Old, dysfunctional habits can only be replaced with practice of the new, healthier habits. This requires putting to use what you learn during the session when you are outside the session, in your everyday world.

If becoming more aware of how your body functions and of the relationship between your mind and your body is of interest to you, you will enjoy and benefit from biofeedback. It is usually very exciting to see what your body is doing at a level unknown to you before and to see how you can affect what it is doing.

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