What's the problem with biofeedback?

In the 1970's I worked in a children's rehabilitation facility in Canada and Biofeedback tools and techniques were being used routinely.  It was generally accepted as a powerful strategy set based on learning principles.  We would start with physiological monitoring and once we understood where we could get leverage to make beneficial change we put biofeedback to work. Making the person aware of aspects of their physiological state and rewarding "success" is the essence of the approach.

It wasn't a "silver bullet" to cure all ills - nor was it like a pill that you could use blindly and still have therapeutic value.  When I moved back to the UK in the 1980's my attention was elsewhere so I didn't notice that biofeedback had "gone out of fashion".  It still puzzles me that biofeedback and it's little sister (neurofeedback) are still not widely accepted, practiced or understood in the UK.  

Maybe part of the problem is that there are apparantly so many applications and approaches. If things are presented as a universal panacea it does undermine credibility. The bottom-line is that there are many approaches to utilsing biofeedback that produce effective results and the technology available has never been better.  The evidence base tends to be that typical of rehabilitation with small sample sizes or single case study designs but this is entirely appropriate to the context which simply cannot use the same approaches to evidence as with a drug.

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Here are a couple of paragraphs that hint at why biofeedback approaches can be so powerful

  • A brain without a body cannot think - the brain does not issue commands to the body parts it hosts conversations
  • The brain is servant - not master of the body
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If these statements don't support your view of reality you are not alone but recent science - for example described within the framework of "Embodied Cognition", Neurocardiology and Polyvagal Theory - show that the so called mind and body are not separate at all.  These fields continue to thow light on how the body consists of interconnected electrical and chemical communication systems that bind the brain, heart, muscles, organ systems, senses and more. These fields are overcoming the centuries of belief in the separation of the mind and body with the brain as some sort of master controller.

Back in 1872 Darwin acknowledged that there was a dynamic neural relationship between the brain and the heart.  He acknowledged that there was two-way communication between the brain and the heart and viscera. Later work described the autonomic nervous system (ANS), peripheral nervous system and the so called fight or flight response.   Until very recently the ANS was viewed as primarily a balancing act between the so-called sympathetic and parasympathetic branches with vagus nerve involvement to moderate the systems response.  A threat detected in the environment resulted in a disconnection from the ability to think, a powering up of the fight or flight response and an eventual settling back into a steady state. Many techniques - meditation, chi kung, yoga, dance etc have proved effective in rebalancing an out of balance ANS and Stephen Porges Polyvagal Theory has started to suggest why all of these apparently diverse techniques work.

A modern system such as the NeXus 10 offers multimodal measurement - the foundation for biofeedback when combined with BioTrace+ software

So what should be our starting point with biofeedback?  Whilst neurofeedback seems to be a hotter topic in the media - perhaps because it's assumed the brain is more important - I would suggest that even if neurofeedback training is your eventual goal, you should start with biofeedback and monitor a wide number of physiological signals. This approach will ensure you don't miss a vital clue in how the individual being monitored is responding for example to stress.  A relaxed and balanced state is identified through looking at the sensors outputs.

A modern system such as the NeXus units allow multiple signals all to be captured with fidelity - heart rate, EDA, respiration rate, skin temperature and more all at once. This broader view of what is going on in the human body reflects modern scientific thinking.  Physiological monitoring is the starting point. Once you see the variables that give you leverage for beneficial change you can apply to biofeedback to create a learning opportunity.

BiofeedbackDerek Jones