Biofeedback

Protocol for Migraines & Some Patients with IBS

Consider This Therapy For:
This specialized type of training allows people to gain control over physiological reactions that are ordinarily unconscious and automatic. Malfunctions in these automatic responses contribute to a wide variety of medical problems. In study after study, biofeedback has shown the ability to help bring such counterproductive reactions back into line, providing significant relief for many of the people who try it.

Although it's not a sure cure, biofeedback helps many people with chronic pain, including the pain of arthritis, muscle spasms, and headache (both migraine and tension headache). It can reduce tension and anxiety, combat chronic insomnia and fatigue, alleviate depression, reduce hyperactivity and attention deficit disorder, and even help overcome alcoholism and drug addiction. Some people have found it helpful for controlling high blood pressure or an abnormal heart rate. It's also useful for retraining, reconditioning, and strengthening muscles after an accident or surgery, restoring loss of control due to pain or nerve damage, and overcoming urinary (or bowel) incontinence.

For asthmatics, biofeedback offers the possibility of controlling bronchial spasms and reducing the severity of attacks. Many victims of Raynaud's disease (periodic loss of circulation in the fingers) have been able to rectify the problem through biofeedback. The technique has helped others deal with digestive disorders such as ulcers, irritable bowel syndrome, acidity, dysfunction of the esophagus, and difficulty swallowing.
      
Biofeedback is under study as a potential aid in the treatment of a number of other ailments as well, although results are more mixed. It may help relax the muscles in temporomandibular joint syndrome (TMJ). It appears to reduce the severity and frequency of seizures in some (though not all) epileptics. It can help ease the symptoms of chronic fatigue syndrome. It has even been tried as a remedy for chronic constipation, motion sickness, and the uncontrollable tics and compulsions of Tourette syndrome.

How the Treatments Are Done
Biofeedback is not a passive treatment. It requires your intensive participation as you learn to control such normally involuntary ("autonomic") functions as heart rate, blood pressure, brain waves, skin temperature, muscle tension, breathing, and digestion.

At your first session, you'll be asked a few questions about your own health and that of family members. The biofeedback therapist will then apply sensors to various points on your body. The location depends on the problem that needs treatment. If you have migraines, sleep problems, and mood disorders, for example, the electrodes are often attached to your scalp; to treat heart problems and muscle tension, they will be placed on your skin. Other possible sites include the hands, feet, or fingers.

The sensors are connected to a computer, a polygraph, or another piece of monitoring equipment that provides instant feedback to you on the function you're trying to control, such as the tension in a particular set of involuntary muscles or circulation to a specific part of the body. Some biofeedback machines signal changes graphically on a computer display, others beep, buzz, or blink to indicate the strength or level of the function you're targeting.

The therapist will teach you mental or physical exercises that can help you affect the function that's causing a problem. You can easily gauge your success by noting any changes in the intensity, volume, or speed of the signals from the machine. Gradually, you'll learn to associate successful thoughts and actions with the desired change in your involuntary responses.

Once you've thoroughly learned an effective pattern of actions, you'll be able to assert control without the aid of the feedback device.

Among the feedback instruments you're most likely to encounter are the following:

   Electromyographs (EMGs) measure muscle tension. Therapists use them to relieve muscle stiffness, treat incontinence, and recondition injured muscles.

   Skin Temperature Gauges show changes in the amount of heat given off by the skin, a measurement that indicates any change in blood flow. These gauges are used in the treatment of Raynaud's disease, high blood pressure, anxiety, and migraines.

   Galvanic Skin Response Sensors (GSRs) use the amount of sweat you produce under stress to measure the conductivity of your skin. They are often used to reduce anxiety.

   Electroencephalographs (EEGs) measure brain-wave activity. Conditions that may benefit from training on these machines include attention deficit/hyperactivity disorder, tooth grinding, head injuries, and depression (including bipolar depression and seasonal affective disorder).

   Electrocardiographs (ECGs) monitor the heart rate and may be useful in relieving an overly rapid heartbeat and controlling high blood pressure.

   Respiration feedback devices concentrate on the rate, rhythm, and type of breathing to help lessen symptoms of asthma, anxiety, and hyperventilation and promote relaxation.

   Along with biofeedback training, the therapist may also give you instruction in deep breathing, meditation, visualization, and muscle relaxation--all of which may aid in relieving stress-related symptoms.

   Treatment Time: Sessions usually last between 30 minutes and 1 hour.

   Treatment Frequency: In most cases, people can learn to raise or lower their heart rate, relax specific muscles, lower blood pressure, and control other functions in 8 to 10 sessions. Some problems, such as attention deficit/hyperactivity disorder, take longer--sometimes up to 40 sessions.

Depending on the severity of the problem and the technique used, therapists suggest you attend 1 to 5 sessions per week.

What the Treatment Hopes to Accomplish
Biofeedback is a "mind over matter" form of therapy that has only recently begun to filter into mainstream medicine. Although ancient Greek, Chinese, and Indian healers were convinced that the mind could influence the body, either causing illness or curing disease, the concept fell into disrepute as Western medicine began to discover the infectious agents and chemical malfunctions that lie at the root of so many familiar ailments. It was only when modern instrumentation made it possible to measure subtle changes in unconscious physical reactions that medicine once more turned its attention to the mind-body connection.

Although biofeedback promises to remedy certain ailments through disciplined mental effort, it has nothing in common with other forms of mind-body therapy such as meditation and yoga. It does not rely on maintenance of some sort of theoretical balance or harmony in order to achieve its effects. Instead, it seeks control over specific, measurable physiological reactions that have somehow gone awry. As such, it can prove especially useful for any disorder caused or aggravated by involuntary muscular tension or tightening. Like other forms of mind-body therapy, it's entirely useless for fighting infections, curing cancer, relieving allergies, or healing injuries.

Who Should Avoid This Therapy?
If you use a pacemaker or have a severe heart disorder, check with your doctor before using a biofeedback device that measures your perspiration output. These machines use a small amount of electricity to produce readings, and, even though no problems have been reported to date, there is a chance that they may affect your pacemaker or damage your heart.

What Side Effects May Occur?
Like other mind-body forms of therapy, biofeedback is notably free of side effects. Indeed, it's often turned to by people seeking a respite from the side effects of conventional medicines.

How to Choose a Therapist
Select a biofeedback therapist with training in psychology and, ideally, physiology. He or she should be certified by the Biofeedback Certification Institute of America. Directories of biofeedback practitioners are available from the Institute.

You may also check with a biofeedback association in a major city near you, ask your physician for a recommendation, or (as a last resort) find a therapist in the Yellow Pages.

When Should Treatment Stop?
If you see no improvement in 10 to 20 sessions, or if your problem worsens, you're probably one of the people for whom biofeedback doesn't work. You should discontinue the training and ask your doctor about other alternatives.

See a Conventional Doctor If...
Although biofeedback is harmless--and can often be helpful--it is not a substitute for regular visits to the doctor if you have a serious chronic condition such as diabetes, epilepsy, heart disease, or high blood pressure. For such problems, failure to continue conventional care can be more dangerous than any alternative you care to try.
   Likewise, if you try biofeedback to help ease depression, do not suddenly drop other forms of treatment. Continue to see your doctor. Eventually, he may be able to reduce the dosage of your antidepressant medication as you continue your training.
   Remember, too, that if your biofeedback techniques suddenly fail to work, you may be facing a new medical problem for which biofeedback is ineffective. At such times, it's wise to see your doctor for a thorough diagnosis.

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Protocol for Migraines & some Patients with IBS