"I'll Kiss It and Make It Feel Better:" Behavior Modification Through Biofeedback

There are multiple DSM categories of Anxiety Disorders, which each affect individuals in various ways (1). However, most people whose lives are influenced by Anxiety Disorders are able to recognize their symptoms. As soon as panic sets in, individuals with Anxiety Disorders are generally able to predict what will happen next. Such anxious individuals will become inconsolably and seemingly irrationally worried and flustered. Their intense fear may be accompanied by physical symptoms such as heart palpitations, nausea, chest pain, shortness of breath, or tension headaches. Thus, because sufferers know how painful situations like this can be, individuals with Anxiety Disorders tend to do everything possible to avoid triggers (2).

Despite the fact that I have been interested in Anxiety Disorders and other such related matters for as long as I can remember, this course has peaked my curiosity in alternative treatment methods. Although medication and traditional therapy are the most commonly used and most widely accepted methods of addressing Anxiety Disorders, there are other, non-pharmaceutical, methods, which are becoming increasing popular. Biofeedback is one such treatment option. It excited me due to the fact that it is based on the premise of the brain modifying itself, or rather the mind modifying the brain (3).

Biofeedback is essentially the process of learning to voluntarily control body functions that are normally assumed to be automatic. The name biofeedback was created to describe the technique itself, which involves a practitioner “feeding back” physiological information to the patient who generated the information. Thus, in biofeedback “the patient is no longer the object of the treatment, [but rather] is the treatment” [page 3] (3).

Biofeedback is used to treat numerous other ailments, including asthma, migraines, diabetes, alcoholism, epilepsy, and eczema (4). However, for the purposes of this paper I will be focusing on the use of biofeedback to treat Anxiety Disorders.

In order for biofeedback to take place, a specific physiologic activity is first identified. Electrodes or transducers that are connected to a patient and a machine, which then monitors this activity. The electrodes or transducers send information to the machine regarding the patient's heart rate, blood pressure, muscle tension, or brain waves. The machine then releases a signal to the patient describing changes in their physiologic activity. Depending on what type of biofeedback equipment is used, the signals can be visual, auditory, or sensory. Through these signals, the patient becomes aware of processes in their own bodies that they had previously accepted as involuntary. This awareness can lead to control, as patients of biofeedback become able to focus on actively changing the way their bodies react to specific situations. Young children, who are generally extremely open-minded, are often treated with a method similar to biofeedback. For example, when a child falls off the swing, his parent will often “kiss it to make it feel better.” Although this action has no medical power according to western beliefs, it often is enough to make the child feel better. Thus, although the cut may have not miraculously healed, the child has used his mind to convince his brain that he is no longer in pain. He modified the response in his brain to create a different, more desired, output (3).

Biofeedback is learning (6). It is voluntary control, presented in a concrete manner. Through biofeedback patients make intent decisions in order to reach a set goal. Patients use their mind in order to change their brains, their minds, and their bodies (3). This distinction between mind and brain is one that I have only come across in one of the books I read throughout the course of my research. However, I feel as though it is helpful in understanding biofeedback. As the science, or art, is based on one's ability to heal oneself, the concept of the mind and brain working symbiotically functions well. If the activities of the brain are made available to the mind, thus allowing them to work in a balanced manner, the effects of stress can be relieved (3). This is assuming that the mind has control over the function of the brain, and vice versa

However, biofeedback does not produce positive results in all patients experiencing Anxiety Disorders. A 1973 study conducted by Raskin et. al proves this. In this study, ten patients who had suffered from chronic anxiety for over three years and who in the last two years had undergone individual psychotherapy and taken medication without seeing positive results were treated with biofeedback. Only four subjects out of ten showed an improvement in anxiety related symptoms. However, five out of the six patients suffering from insomnia showed an improvement and all four of the patients with tension headaches were cured. There are also cases in which biofeedback proves to be extremely helpful to patients with Anxiety Disorders. For example in a 1975 controlled study by Townsend, House, and Adams, a group of patients with chronic anxiety who had undergone psychotherapy were compared with a group of patients who had undergone biofeedback. The biofeedback patients showed more positive results (5).

In order for biofeedback to produce positive effects, the patient must be willing to begin treatment. The patient plays an active role in biofeedback and must be ready to participate in the process. Patients must believe in both biofeedback's ability to make a difference and in their own ability to create change. They must be ready for therapy, and be willing to be confronted with a significant amount of traumatic material. Patients must be willing to actively address situations that trigger anxiety outside of treatment sessions and to read about biofeedback, methods of relaxation, and anxiety. They also must be willing to make a commitment to a series of biofeedback sessions in order for treatment to be effective. Although it seems that biofeedback will never be able to completely eliminate the need for pharmaceutical therapy or traditional counseling, it is a strong alternative method. It also remains safe, and extremely fascinating, as it evokes the human ability to heal self-heal. With biofeedback, the brain modifies its own behavior through education. Biofeedback proves that the brain (and the mind) is able change itself without synthetic help (i.e. medication). Biofeedback seems to have the strongest results in people who are most excited about the program and most willing to participate in treatment. However, I also question whether or not it is effective for all types of Anxiety Disorders. For example, due to the fact that the biofeedback session itself can be equated to the situation of a test, would such a program be effective for individuals with a specific testing anxiety? Perhaps biofeedback is best paired with medication and or counseling, and best accompanied with a prescreening process. This process would determine who the treatment would be most effective for, and who the treatment would not benefit, thus eliminating wasted time, effort, and stress.

(1) Granvold, Donald K. Cognitive and Behavioral Treatment: Methods and Applications. Pacific Grove, CA: Brooks/Cole Publishing Company, 1994.

(2) Tuma, A. Hussain & Maser, Jack (Ed.). Anxiety and the Anxiety Disorders. Hillsdale, NJ: Lawrehce Erlbaum Associates Publishers, 1985.

(3) Brown, Barbara B. Stress and the Art of Biofeedback. New York: Bantam Books, 1977.

(4) Yates, Aubrey J. Biofeedback and the Modification of Behavior. New York: Plenum Press, 1980.

(5) Birbaumer, Niels & Kimmel, H. D. Biofeedback and Self-Regulation. Hillsdale, NJ: Lawrehce Erlbaum Associates Publishers, 1979.

(6)
http://www.jstor.org/view/0002936x/ap060910/06a00180/1?searchUrl=http%3a//www.jstor.org/search/BasicResults%3fhp%3d25%26si%3d1%26Query%3danxiety%2bAND%2bbiofeedback%26wc%3don&frame=noframe&currentResult=0002936x%2bap060910%2b06a00180%2b0%2c0F&userID=a56ad3a1@brynmawr.edu/01cce4405f00501b9b80c&dpi=3&config=jstor. JSTOR Article, on the JSTOR website.