What Is Biofeedback Therapy?

For those experiencing stress, a few types of treatment may reduce the impact of these symptoms. One such treatment is EEG biofeedback therapy, which targets an individual's physical and emotional responses to stress and distressing stimuli.

Biofeedback & stress

Biofeedback is a complimentary and alternative medicine or treatment that targets the specific effects of stress on the body. Stress is not always negative, and a small amount of stress may help you act in essential situations like a school test or a challenging drive. However, prolonged stress or an activated fight-or-flight response may cause harmful or distressing physical and emotional symptoms.

Stress can occur when you perceive a threat that does not exist or feel anxiety. When it does, your nervous system activates and prepares you to run, fight, or freeze. However, without action, your pent-up energy may cause you further distress. Symptoms of an overactive nervous system may include: 

• Muscle tension
• Pain
• Tension headaches
• A racing pulse 
• Fatigue
• Higher blood pressure
• An upset stomach
• Shortness of breath
• Sweating
• Appetite changes
• Dry mouth
• Chest pain

Long-term stress may also be associated with the following conditions and symptoms: 

• Depression 
• Anxiety disorders 
• Chronic headaches
• Chronic pain
• Sleep disorders 
• Heart disease
• Weight changes 
• Autoimmune conditions 
• Gastrointestinal problems
• Memory concerns
• Post-traumatic stress disorder (PTSD) 

Learning how to target stress and calm your nervous system can be beneficial. Many solutions are available, including relaxation training, cognitive-behavioral therapy (CBT), mindfulness, and biofeedback. 

Biofeedback definition

According to the Association for Applied Psychophysiology and Biofeedback (AAPB), experts in the field define biofeedback as follows:

“Biofeedback is a process that enables an individual to learn how to change physiological activity for the purposes of improving health and performance. Precise instruments measure physiological activity such as brainwaves, heart function, breathing, muscle activity, and skin temperature. These instruments rapidly and accurately "feed back" information to the user. The presentation of this information — often in conjunction with changes in thinking, emotions, and behavior — supports desired physiological changes. Over time, these changes can endure without continued use of an instrument.”

Biofeedback is type of behavioral medicine used to prevent or treat various conditions. The therapist tracking biological signals notes involuntary bodily functions like heart rate, muscle tension, blood pressure, and skin temperature. Tracking these involuntary functions involves using sensors that provide electrical stimulation to view your responses to stimuli visually and show you how your body responds to stress when it occurs. 

As you watch the display, you may work to make changes such as deepening your breathing, focusing on your heart rate, or imagining a calming scenario. Your therapist may teach you additional methods of controlling those responses. After practicing this technique for several sessions with the sensors, you can learn to do it independently without the sensors or the biofeedback practitioners.

What's treated during biofeedback therapy? Treatment for blood pressure, mental health conditions, and more

Many physical health conditions can be impacted by mental health issues or stress. One example is chronic obstructive pulmonary disease (COPD). Shortness of breath from stress and anxiety can take a serious toll on health. COPD includes a range of respiratory issues that can be triggered by stress.

Some of the conditions treated with biofeedback are stress-related. Others involve involuntary muscle tightening, anxiety, or other biological symptoms. Conditions it can help prevent or improve may include the following: 

• Anxiety
• Asthma
• Attention-deficit/hyperactivity disorder (ADHD)
• Chronic pain
• Constipation
• Incontinence
• Fibromyalgia
• Tension-type headaches and migraines
• High blood pressure
• Irritible bowel syndrome
• Raynaud's disease
• Tinnitus
• Eating disorders
• Stroke
• TMJ
• Depression
• Epilepsy
• Rheumatoid arthritis
• Injury
• COPD

Talk to your therapist or primary care provider before partaking in a new type of therapy treatment like biofeedback. 

Therapeutic biofeedback process

When you attend a biofeedback therapy session, a biofeedback practitioner may connect you to a device with small sensors to measure your body’s responses to different stimuli. Your reactions are shown on a monitor through signals from the sensors. You can see the target response as it is happening to you. Often, you may be exposed to a stressor or talk about a challenging situation with your therapist while observing your vital signs. 

Through the screen, you gain immediate feedback on your physiological signals based on the body's functions and reactions. As you make changes through coping mechanisms like deep breathing, you can notice how your body reacts. The biofeedback therapist may teach you several relaxation exercises for making those changes.

Many biofeedback practitioners receive biofeedback training in addition to physical therapy, CBT, or other forms of psychotherapy. A typical biofeedback session involves a combination of talk therapy, monitoring biofeedback from electrical sensors, and practicing relaxation techniques. Interactive computer programs may monitor a variety of body functions, including respiratory biofeedback, muscle activity, and heart rate. During biofeedback sessions, the client may be able to observe in real-time how relaxation techniques can ease muscle tension and have benefits for lowering blood pressure.

Types of biofeedback monitors: Heart rate, breathing, and muscle tension

Biofeedback works by observing how the body reacts to stress and using relaxation training, physical therapy, and other medical treatments to treat the symptoms.

There are several types of biofeedback and devices used to practice it. The choice of biofeedback equipment may depend on your condition or symptoms. You might be paired up with computer programs and wearable devices for accuracy. Your biofeedback therapist will recommend the type of biofeedback device and method best suited to your symptoms. Using these monitors your therapist can measure certain bodily functions and recommend steps to improve health moving forward.  

You may be connected to a heart rate monitor on your finger or earlobe that monitors your blood volume and heart rate. You might also be connected to sensors on your chest or wrists while an ECG measures your heart rate. By viewing your pulse, you can know when a heightened heart rate might indicate stress or anxiety during a conversation or after viewing certain stimuli. 

Your therapist may place bands around your chest and abdomen to monitor your breathing. Through the movement of your breaths, they can track your respiration rate and breathing patterns in response to certain stimuli. 

Sensors may be placed over your skeletal muscles during your session. An electromyography machine (EMG) records the electrical activity of your muscle contractions and reports them to you on the monitor. EMG biofeedback sensors may help to determine if you tense certain muscles when stressed. Outside of therapy, muscle contraction sensors may be used after a spinal cord injury to help determine if certain muscle groups are able to contract or not. 

Sensors on your fingers, palms, or wrist, connect to a machine to measure your sweat gland activity and how much perspiration is on your skin. If you sweat when anxious or stressed, this can be a sign that you're reacting to stressful stimuli or situations. 

Using an EEG machine, scalp sensors may be placed to monitor your electrical brain activity or brain waves. These brain waves can show the therapist if there is any unusual activity that might indicate a condition like epilepsy or a reaction to high-stress stimuli. This method can be used in neurofeedback sessions as well. After a therapist measures brain wave activity they may suggest behavioral treatments or mental exercises to manage stress. 

To track your skin temperature, sensors may be placed on your feet or fingers to record the blood flow to your skin as a thermal biofeedback marker. Stress can cause your temperature to rise in some situations, sometimes creating a low fever in certain patients.  

Blood volume can be an indicator of medical conditions affecting physical and mental health. A blood volume monitor is used to detect blood volume during biofeedback sessions.

Types of biofeedback therapy devices

The sensors attached to your body may be connected to several devices by Bluetooth or through a cable. Many different devices can be used for biofeedback treatment and monitoring, falling into the following three categories of biofeedback methods. 

A computer can be used along with an interactive computer program. The program takes the input from the sensors and creates an image that you can see and respond to by pacing your breathing, relaxing your muscles, or thinking calming thoughts. Flashing lights, beeps, or other sensory information may alert you to changes in your body. 

Mobile devices are also used and can work like a computer. However, you can hold the device in your hand, and you may be able to continue some tracking after the session at home. 

Numerous wearable devices may be utilized in biofeedback or outside of sessions. For example, you might use a headband to keep track of your brain waves as you meditate. You might also use a waist or chest band to track breathing or a wearable bracelet to monitor your heart rate throughout your day. 

Caution with biofeedback

When using a biofeedback device, report any concerning symptoms or lack of progress with your therapist. While you may benefit from biofeedback in a therapist's office, try not to purchase biofeedback devices online or in person without a therapist's recommendation. Biofeedback training for mental health professionals combines a combination of a rigorous course of study and hands-on experience working with patients. There are risks biofeedback techniques could have if not performed under a professional’s supervision. 

Some commercial biofeedback devices may not be scientifically tested or are meant to gain profit from the seller. Some devices, such as a chest or waist band for tracking breathing, may be harmful if misused. If you experience adverse side effects to any treatment, let your doctor or therapist know immediately and stop using it.

Biofeedback is the monitoring and displaying of involuntary physical responses. Biofeedback is a relaxation technique that consists of instructions, tips, and exercises your therapist teaches you. You might also partake in talk counseling during your session. Your therapist may use the following exercises to support you: 

• Progressive muscle relaxation
• Guided imagery
• Deep breathing
• Mindfulness meditation
• Talk counseling 
• Hypnosis 

Benefits of biofeedback counseling

Biofeedback may be considered a form of alternative therapy or alternative medicine. However, it can offer benefits to many clients, including the following: 

• Non-invasive monitoring of body signals 
• A potential reduced need for medication or disruptive treatments 
• Boosted effectiveness in combination with other therapies or treatments 
• A safe alternative to medications if you are unable to take them 
• A sense of power and control over your condition, stress reduction, or symptoms 

Stress and mental health

A doctor, pain physician, psychologist, or therapist can perform biofeedback with proper training. These mental health professionals may also provide other forms of counseling. A few types of counseling that may aid in stress symptoms include the following. 

Treatment based on cognitive-behavioral therapy

Cognitive-behavioral therapy (CBT) is a technique used by many therapists to help people replace unwanted thoughts and behaviors. Through counseling, you may examine the thoughts behind your emotions and behavior, identify them, challenge them, and decide whether to keep or replace them. As you adopt more favorable or optimistic thoughts, your feelings and behavior may change positively. 

Interpersonal therapy 

Interpersonal therapy (IPT) may benefit you if you experience stress related to interpersonal connections or relationships. It is a short-term process, usually lasting about two to four months. IPT can help you deal with grief, interpersonal disputes, role transitions, and rejection sensitivity. The therapist may interview you to learn more about your concerns and offer guidance based on your symptoms. 

EMDR is a technique aimed at helping people recover from psychological trauma, stress, or anxiety. The therapist uses eye movements and may ask you to partake in movements that stimulate both sides of your brain, such as holding hand buzzers in both hands or throwing a ball back and forth between your hands. Stimulating both sides of your brain may help you reprocess and remember traumatic memories to store them in a new location and recover mental processes. 

MBCT combines cognitive therapy with mindfulness meditation. Mindfulness is a way of tuning in to the present and grounding yourself within your body. As you focus on sensations, thoughts, and feelings in the present moment, you may feel closer to your environment, more in control of yourself, or less emotionally distressed. A randomized controlled trial showed that mindfulness CBT effectively reduces stress in patients. Therapists may incorporate techniques to relax muscles and calm the mind during therapy sessions. 

Systematic desensitization sessions may allow you to reduce your distress when you encounter an anxiety trigger by exposing you to it in minor increments. For example, suppose you have a stress reaction every time you get on an airplane. In that case, systematic desensitization might involve talking about a plane, looking at pictures of airplanes, imagining yourself in them, stepping onboard an airplane for a few moments, and then taking a flight. It can also be done using augmented or virtual reality. You might use biofeedback during desensitization to learn more about how your body reacts to fear. 

Physical therapy

Mental and physical health are closely linked, which is why physical therapy is also sometimes applied to biofeedback training. It can help mitigate stress-related symptoms on physical health such as muscle pain and tension. These clinics offer a variety of treatment options for stress-related physical pain and may have biofeedback services available. 

According to the Cleveland Clinic, stress can cause urinary incontinence and fecal incontinence due to tension in the pelvic floor. Physical therapy can help with pelvic floor muscle training to help alleviate symptoms of stress in that region of the body. Pelvic pain therapy assesses the flexibility and strength of the pelvic floor using biofeedback. Therapeutic approaches to treating symptoms of stress on the pelvic floor include exercises, correcting posture, breathing techniques, and relaxation training. 

Therapist options for biofeedback

You may be able to find biofeedback therapists in your area. However, as a rarer form of counseling, it might not be available in every city. In these circumstances, another form of counseling might benefit you, such as in-person or online CBT. With online therapy, you can meet through phone, video, or live chat sessions with a therapist experienced in various areas of mental healthcare. Additionally, you can pair your online counseling sessions with a heart rate monitor like a Fit Bit to learn more about how your pulse may react in daily situations. 

Studies indicate that online counseling can be more effective than in-person counseling for many mental health conditions, including depression. It may also benefit symptoms of chronic stress or prolonged nervous system hyperactivity. Through a platform like BetterHelp, you can discuss your distressing symptoms with a therapist and be matched with one of 30,000 providers specifically complemented to your preferences.