What Is Biofeedback & How Does It Create Positive Change?

Biofeedback is a tool for training and developing the skill-set of self-regulation. What does self-regulation mean? What skills are we talking about? And how does biofeedback work to achieve this goal?

Your body is constantly responding to your thoughts and experiences - and in turn your physiology conditions how you think and feel. This is the mind-body connection, and it's the foundation on which biofeedback is based.

Self-regulation essentially means the ability to manage the mind-body connection, so that you can guide yourself into healthy, positive and productive states of mind and body.

In biofeedback we use devices to track changes in the physiological side of the mind-body connection (which may happen outside of awareness). We feed the changes back in real time via computer, for example as a changing graph or sound.

This feedback is the basis for creating change through learning:

• Gaining insight: into how thoughts and feelings affect you, and what works and what doesn't work in terms of influencing emotional states.
• Developing mind-body skills: learning to access (the physiology of) resourceful states such as calm, clear focus. Learning happens automatically in the brain, unmediated by the thinking, judging mind.
• Building brain fitness: through exercise, you can build fitness in your brain so you're better able to handle stress as it arises in life.

The following video expresses these ideas more fully.

Biofeedback is self-empowering - you're not the passive recipient of treatment. Because the benefits come from learning:

• biofeedback is a safe, non-invasive therapy
• the benefits of biofeedback training are lasting.

What Can We Measure?

Effective biofeedback parameters are easy to measure, reflect your mental and emotional state, and are relatively easy to influence. Some examples are:

1. Muscle tension (EMG) – we tend to tighten up under stress - but we don't always notice it and it's not necessarily easy to fully release tension.
2. Capnometry – detects over-breathing which actually deprives the brain of oxygen. We know about extreme hyperventilation in the context of panic, but mild over-breathing is common and largely unrecognised.
3. Heart Rate Variability (HRV) – we're looking for a pattern of change in the heart rate known as heart coherence, which supports a calm, clear and emotionally positive mind (see graphic below).
4. Skin Conductance or Galvanic Skin Response - this simple measure of the skin is the basis of the well-known lie detector test. In actual fact it can detect any kind of emotional reactivity.

Mind-Body Skills

What are the skills that make up the self-regulation skill-set, and which biofeedback trains?

At a high level we can point to things like resilience - the ability to recover quickly and easily from set-backs. Or executive function, which includes the ability to formulate and stick to a complex long-term plan. I think these are underpinned by a set of core, basic skills which are to do with managing the mind-body connection (hence mind-body skills). In my work with clients I tended to focus on a set of five:

• Maintaining calm, clear focus – achievable when you can activate your executive brain free from the inhibitions of the stress response.
• Letting go of disturbing emotions and agitation – which manifest as stress patterns in the body.
• The ability to separate yourself from unhelpful, negative thoughs and beliefs, narrow-minded views that can otherwise dominate your consciousness. (In psychology this skill is known as cognitive defusion.)
• Accessing energy, motivation and positivity – these are underpinned by specific physiological patterns too.
• Underlying all the above is self-awareness – knowing how your thoughts & perceptions can trigger body reactions, and how these in turn condition how you think, feel, act and pay attention. Also knowing what works and what doesn't work in terms of guiding your physiology towards more positive, supportive states.

EMG or muscle tension biofeedback can provide a simple illustration of how biofeedback can help develop these skills. Suppose you're anxious about taking an exam or test. This kind of stress is likely to manifest physically as tension, e.g. in the shoulders or the brow. In this state you're more susceptible to negative thoughts such as "I'm going to fail!" which amplify the reactions.

With EMG biofeedback, you can learn to recognise when you've tightened up (self-awareness), and notice how it feels. You can learn to release the muscles, which will likely lessen the feeling of anxiety, and create a greater sense of mental space that allows you to let go of thoughts about failure.

Optimal Breathing Training

Three of the biofeedback parameters I listed all relate to breathing (viz. the first three). Breathing is an ideal window on the mind-body connection – on the one hand stress manifests as clear and specific dysfunctional breathing patterns, and on the other, learning to breathe well creates a basis for optimal health and well-being, and brain performance.

The three parameters draw out different aspects of breathing – for example muscle tension biofeedback can identify chest-based breathing and train abdominal breathing, while capnometry can identify over-breathing. Over-breathing (hyperventilation) is the most significant stressed breathing pattern because it (paradoxically) lowers oxygen delivery to brain cells.

Together the three parameters combine to form a powerful integrated optimal breathing training.

Neurofeedback: Biofeedback For The Brain

Neurofeedback is a particular form of biofeedback that's based on directly measuring brain activity. It typically works as a form of repetitive exercise, that increases your brain's "fitness" - like weight training it builds the "muscle" of your brain.

A particular strength of neurofeedback is in training focus and attention (concentration). Stable but flexible attention is skill everyone can benefit from, and moreover, anxiety and mood problems tend to show up as an inability to focus in the present moment, or preoccupation with either past (things that went wrong) or future (things that might go wrong).

(Click here to read more about neurofeedback.)