Biofeedback: what it is and how it works

Biofeedback has proven to be a valid ally, in a therapeutic context, in the treatment of various conditions. Thanks to it it is possible to manage stress, anxiety and various disorders that affect the body and psyche.

Biofeedback allows learning to control usually involuntary bodily functions.

Thanks to this non-pharmacological treatment, it is possible for the subject to learn to exercise a threshold of control over functions such as heart rate , blood pressure, muscle tension. This technique therefore allows better management of stressful situations , providing feedback on one’s physiological states.

The objective is the general improvement of the subject’s health , with applications in favor of the performance of those who practice sports, but above all to combat various conditions. Biofeedback is a combination of psychology and technology.

Let’s find out what the principles underlying this treatment are , where to do it, who deals with biofeedback, and which conditions can be treated .

What is biofeedback?

Biofeedback  is a technique that allows you to  know, understand and learn to control your own physiological parameters . Developed in the 1960s in the United States by researchers such as Miller and Kamiya , it then spread to Europe and Italy in the 1970s.

Among the parameters taken into consideration are:

• skin conductanceor skin electrical resistance . Terms that indicate the change in the electrical characteristics of the skin following sweating
• heart rate 
• breathing and activity of the respiratory system
• temperatureand muscle activation .

To learn how to manage these parameters, training is required   which involves the use of specific equipment. The tools detect  psychophysiological signals  in real time and provide the person with  immediate feedback  on their bodily activation and physiological functions. There are numerous devices for conducting biofeedback interventions that allow the measurement of different physiological indices.

It is possible, for example, to adopt a  skin sensor  to be applied to the fingers to detect skin conductance and temperature. Or a  chest strap  to wear to measure your breathing and heart rate.

Neurofeedback

Neurofeedback, on the other hand, is a tool that, through an electroencephalograph (EEG), measures brain waves and displays the electrical activity of the brain in real time . Like a personal trainer for the mind, the goal of neurofeedback is to help you understand how your brain works and improve its performance.

The information obtained from the EEG is in fact translated into a visual or auditory signal, allowing the subject to understand their brain waves, modify them and train them . Like in a gym, the brain exercises to achieve specific goals.

What is biofeedback for?

Biofeedback  integrates the use of instruments with the therapist’s indications, allowing a gradual and increasingly conscious self-regulation of one’s physiological parameters. These, in fact, are normally involuntary, since they are controlled by the  autonomic nervous system .

However, learning to control these responses by viewing them on a computer monitor allows you to acquire greater  awareness of your own bodily states  and therefore be able to partially subject them to  voluntary control.

What is the concept on which the biofeedback technique is mainly based?

Biofeedback is based on the awareness of a particular physiological condition and the consequent implementation by the individual of strategies and behaviors necessary to modify it .

The underlying principle is: having received information on the variations of a specific physiological parameter , of which the subject was not previously aware, it is possible, to a certain extent, to control it .

For example, the subject can learn to self-regulate physiological responses , usually outside of voluntary control, and those which , generally easily controllable, have nevertheless escaped regulatory mechanisms , due to an illness or a traumatic event.

How biofeedback therapy works

Biofeedback therapy  involves an initial visit during which the basic findings from which to start with the treatment are collected.

The first meeting is in fact intended to allow the patient to take their time to familiarize themselves with their body indices. During subsequent sessions, the patient is guided by the therapist to learn techniques that allow him to  acquire greater awareness .  For example, in training sessions it is possible to initially work on  breathing management .

The patient is guided to visualize their breathing mechanics, working on inhalation and exhalation , until integrating thoracic and diaphragmatic breathing in the most efficient way for their body. Subsequently, we move on to evaluate whether the new breathing mode is effective in regulating the heartbeat, or whether it is necessary to integrate other strategies.

Where to do biofeedback and neurofeedback?

The professionals who deal with biofeedback and neurofeedback can be different. Basically, these are health professionals such as doctors, psychologists, psychotherapists and physiotherapists.

Sessions usually last less than 60 minutes . When the cases being treated are relatively simple, the beneficial effects of these treatments are achieved within 8-10 sessions . Conditions of greater complexity can also be treated in 15, 20 sessions .

The cost of a biofeedback or neurofeedback session varies from 60 to 70 euros , depending on the duration and the package chosen.

Alongside the sessions of these treatments, it is advisable for the subject to practice relaxation techniques on a daily basis, such as meditation or autogenic training or breathing exercises or, again, diaphragmatic breathing .

Biofeedback and neurofeedback: areas of application

Biofeedback and neurofeedback interventions can be used with a view to  empowerment,  i.e. enhancing individual well-being and improving people’s quality of life.

Furthermore, both techniques can be used in clinical contexts to support psychological intervention. It can  complement psychotherapy  and be a valid support technique for learning to:

• manage angerand stress
• reduce the level of  anxiety
• relax through breathing
• treat depressionand sleep disorders
• improve concentrationand learning

Conditions that can be treated

Biofeedback and neurofeedback have also demonstrated effectiveness in the treatment of a number of pathological conditions such as:

• tension headache
• gastrointestinal disorders
• tinnitus
• psoriasis
• hypertension
• bruxism
• male and female sexual disorders
• chronic pain
• fibromyalgia
• epilepsy
• urinary incontinence

In the specific case of  headache,  it is possible to integrate, during training to manage your heartbeat, some strategies to  relieve muscle tension  such as progressive muscle relaxation and autogenic training.

Among the other conditions that can be treated, social phobia , attention deficit hyperactivity disorder , post traumatic stress disorder should also be indicated .

What is pelvic floor biofeedback?

Pelvic floor biofeedback is an innovative technique that uses an electronic device to help people identify and strengthen their pelvic floor muscles .

This form of muscle rehabilitation is particularly suitable for those who have difficulty contracting these muscles correctly, often causing various problems such as:

• Stress or urgency urinary incontinence
• Mixed incontinence
• Pelvic pain
• Difficulty in sexual relationships

During a biofeedback session, a small sensor is placed inside the vagina or rectum. This sensor detects pelvic floor muscle activity and transmits it to a computer, which translates it into a visual or auditory signal.

The patient can then view or listen to the intensity of their muscle contractions in real time. In this way, he learns to recognize and correctly control the pelvic floor muscles, improving their strength and coordination.

Biofeedback and virtual reality

Biofeedback can use virtual reality to ensure that the person receives feedback on their physiological indices, through the multiple possibilities of virtual environments.

One possibility is to visualize one’s internal physiological states as alterations of the virtual environment. For example: a flame that varies its size as the patient’s breathing rate varies. The virtual environment has the advantage of showing the physiological parameters in a neutral mode, without indicating numerical values, but translating them into a graphic form that allows you to focus more on managing their trend.

At the Santagostino Medical Center, the biofeedback intervention protocol offers four training sessions that can be customized based on the patient’s needs and characteristics.