Biofeedback and Neurofeedback in Talk Therapy

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Psychologists and psychotherapists are not all just having people sit in a chair or lay on a couch to just have people talk to them about their problems.  They are using evidence-based, science-based tools to help them address the body as well as the mind.  Science is proving that the body is involved in problems like anxiety, PTSD, and trauma.  It’s not all in the mind.  The mind has to work through the brain, so problems of the mind also involve the brain.  Neurofeedback is among the tools that can be used to affect the brain.  Encouraging the brain to increase or decrease various signals that can be picked up with neurofeedback equipment can help to train the brain to decrease unhealthy patterns that may be related to clinical symptoms.

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How to Reduce Stress

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Stress is a problem that we all experience.  It is not getting less, if anything it may be increasing.  Recent political and racial tension and the current pandemic have added layers to the stress that we all have been already living with.

Here are a few things you can do to reduce the negative effects of stress on your physical and mental health.

Reduce your exposure to stress.  Identify sources of stress in your life.  This includes people, places, and things.  Note the ones that you can make choices about that will reduce your stress.  There may be people that you feel stressed around.  Even though you may still need to spend time around them, you may be able to arrange to spend less time around them.

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Stress Symptoms

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There is a lot of talk about stress these days.  First of all, here is how dictionary.com defines stress.

  1. pressure or tension exerted on a material object.
  2. “The distribution of stress is uniform across the bar”
  3. synonyms:
  4. pressure · tension · strain · tightness · tautness · tensity
  5. a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances.

In this article, I am going to be focusing on number 5, the mental or emotional strain or tension definition.  Stress tends to trigger the fight, flight, or flee response which is supposed to be an emergency state which lasts for only a short time.  When there is not a short-term emergency requiring a physical response then the state can last for a long time and even become chronic.  It may also be triggered repeatedly over a long period of time.  When this happens, negative symptoms can result.  Here are just a few of the negative symptoms that can develop as a result of mental or emotional stress.

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Skin Conductance Biofeedback

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Skin Conductance can be both one of the simplest yet one of the most complex modalities of biofeedback at the same time.  More stress, the reading goes up.  More relaxed, the reading goes down.  Simple, right?  Not so fast.  Make sure we are not actually talking about resistance measures which are exactly opposite from conductance.  Besides two opposite measures of conductance and resistance, we should also add skin potential.  When I was introduced to biofeedback way back in 1984, GSR or Galvanic Skin Response was the common feedback modality for monitoring changes based on sweat activity.  The readings in Ohms would go down when there was more sweat on the skin because resistance was decreasing and it would go up if the amount of sweat decreased because resistance was increasing.  The audio tone was reversed so that it went up when the subject was responding to something and got lower when they recovered or calmed down.

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Stress and Sleep

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Sleep problems including insomnia are an excellent application of Peripheral Biofeedback and EEG Biofeedback (Neurofeedback). They are also among the major symptoms caused by stress.  It is difficult to fall asleep while the body is tense or your brain and nervous system is in fight-fight-freeze (emergency) mode.  It is difficult to fall asleep if you close your eyes and your brain is still too busy.

Not getting enough sleep is a problem for between 28.5% – 41.1% of adults in the USA according to CDC 2014 statistics. The term they use is “short sleep duration”, defined as less than 7 hours of sleep per night for adults (see CDC – Data and Statistics – Sleep and Sleep Disorders).  People who have short sleep duration also have other health risks at a higher rate than others.  Some of these shared risks include obesity, physical inactivity, alcohol use, and smoking.  Short sleepers also reported these ten chronic disorders at a higher rate than those who get enough sleep:

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Biofeedback Assisted Relaxation Therapy

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In Biofeedback when we talk about B.A.R.T we are not talking about that crazy kid on the popular cartoon series, The Simpsons, we are talking about a very popular protocol which can be widely applied for various conditions.  Rather than seeing it as a specific protocol I see it more as a concept.  When practitioners are learning biofeedback for the first time, they are usually very interested in learning very specific protocols for the conditions they expect to be working with like headaches, anxiety, insomnia, and depression.

They expect a specific guide as to which modalities, what goals, and the number of sessions to work on each modality for each application.  That would be nice.  It makes things simpler and makes it easier to plan.  It doesn’t always match reality for the individual that is in front of you.  Now, what is B.A.R.T.?  It is an acronym for Biofeedback Assisted Relaxation Therapy.  It’s kind of like a generalized protocol that helps to counter the stress response by using biofeedback to teach clients to regulate their physiology using multiple modalities including surface EMG, Skin temperature, Skin conductance, Heart Rate/Heart Rate Variability, Respiration, and EEG.   I decided to talk about this after reading Don Moss’s article, Biofeedback-Assisted Relaxation Training:  A Clinically Effective Treatment Protocol in the Summer 2020 issue of Biofeedback Magazine.

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Stress at Work

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Most of us spend at least 8 hours of our day at work.  If you ask many people, they will say they hate their job.  Even if you don’t hate your job there are usually many moments every day at work that you would describe as stressful.  It’s nice to visit a therapy office for a biofeedback, talk therapy, or relaxation session where you sit in a nice comfortable chair and listen to relaxing music.  For a moment your troubles can seem to disappear and you feel totally relaxed.  This is helpful.  It can break the chronic stress condition that many people are stuck in.  The problem can be that after the session you go back out into the real world and have to manage until the next visit that may be a week or two away.

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Hypertension Biofeedback and Neurofeedback Protocols

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According to the American Heart Association web site statistics, almost half of the adult population in the United States of America can be considered to have high blood pressure.  A hard to believe 45 percent of those who have hypertension do not have it adequately controlled.  That sounds pretty terrible to me.  Even with all of the medications that are prescribed such a low number of people have their blood pressure under control.  Many people are even prescribed 2 or 3 or even more blood pressure medications to attempt to bring the levels to an acceptable level.  This tells me that it is not a simple problem.  Medication alone may not be enough to normalize blood pressure.  Even when medication does normalize blood pressure it may not be the best long-term solution. There are many things that can elevate blood pressure that should be addressed in order to help normalize blood pressure.

Here is a link to a PDF file that lists and discusses things that could increase blood pressure, Blood Pressure Raisers, Learn what could raise your blood pressure:  https://www.heart.org/-/media/files/health-topics/high-blood-pressure/tylenol-hbp/bp-raisers.pdf?la=en

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Neurofeedback Home Training

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Neurofeedback training has been shown to be effective for helping people with conditions like ADHD, insomnia, anxiety, seizures, and brain injuries.  Clients usually visit a neurofeedback professional 1-3 times per week for a series of anywhere from 10-30 or even more sessions.

Some people have asked about devices that they can use themselves at home.  It is not something that I would decide on lightly.  Neurofeedback providers are cautioned to be careful when working with clients even if they are trained and experienced.  It would make sense that an untrained layperson should be even more careful when working on their own brain or the brain of a family member.  Not that they are invasively working on the brain as with surgery.  They are rather working on the brain through training changes in the electrical impulses that allow the neurons to communicate and make things happen in the brain.  This is very important stuff and you don’t want to make mistakes with it if you can avoid doing so.

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The Stress of being black

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People like to think they know what the stress of being black is like.

If you’re not, you don’t.

Think about the stress of having a final exam in high school or college coming up.

You worry about it for two weeks or so leading up to it and it is very hard and stressful.  You get to the time of actually taking the exam and it is very stressful.  Then, the exam is over.

Being black is not like that because it’s never over.  Every morning you wake up you have to deal with the stress associated with being black all over again.

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