Using Biofeedback to Reduce the Health Damages of Stress

Biofeedback is a set of techniques in which patients learn how to control involuntary body responses such as brain activity, blood pressure, muscle tension and heart rate. It can be used to help treat a variety of mental and physical health problems, including conditions such as asthma, high blood pressure, incontinence, headaches and panic attacks. The goal of biofeedback is to alter patients' habitual reactions to stress, because these reactions produce physical responses which, over time, can lead to pain or disease.

"There is a pattern that all human beings go through called the fight-or-flight pattern," says George R. Jacobson, PhD, Medical College of Wisconsin Associate Professor of Psychiatry and Behavioral Medicine. "Basically it's a response to fear, although it's hard to tell the difference between fear and anger."

The sympathetic nervous system reacts to stress by arousing the nervous system and releasing hormones to sharpen the senses, quicken the pulse, deepen respiration, and tense the muscles.

At the same time, blood pressure dramatically increases to supply our muscles with the oxygen they need to function optimally. "Blood at the surface of the skin is drawn away and goes to the body's interior," Dr. Jacobson explains. "That's why when people get scared, they get pale. It also reduces the probability of bleeding when you are injured."

Amazingly, the brain does all this instantaneously and without our conscious control, says Dr. Jacobson.

Short-lived or infrequent episodes of stress pose little risk, although they can cause problems such as mood and sleep disturbances, upset stomach and headache. But when stressful situations go unresolved, the body is kept in a constant state of activation, causing deterioration and reducing the body's ability to repair and defend itself. As a result, the risk of injury or disease escalates. Studies suggest that stress plays an important role in several types of chronic health problems - especially cardiovascular disease, musculoskeletal disorders, and psychological disorders.

Monitoring the Stress Response
"The purpose of biofeedback is to make you aware of those physiological responses of which you are normally unaware. It brings to your attention the biologic activity of various body systems associated with tension," Dr. Jacobson explains. Biofeedback teaches patients to modify these responses.

During biofeedback sessions, devices are used to monitor the patient's physiological response to stress. Monitors can be used to track a patient's heart rate, muscle tension, moisture on the fingertips and brain waves. Patients learn to associate their responses with these physical functions, then are instructed to relax and concentrate on controlling the reading on the tracking device.

Sessions typically are 30 minutes to an hour long. "It takes some practice - there are no one-minute miracles," says Dr. Jacobson, who instructs patients to take the tracking devices home and repeat the techniques for 10 minutes two or three times a day.

Once his patients have mastered the control of involuntary body functions through routine practice, the device can be removed from the process. Occasionally, patients might want to refer back to the device and its readings in order to check on their progress.

In addition to the use of the tracking devices, patients are taught relaxation exercises, techniques to identify the circumstances that trigger the flight-or-fight response, and how to avoid and cope with stressful events. They also learn self-control techniques and are encouraged to change habits that compromise their health.

Giving the Patient Control
Biofeedback can be used in the treatment of conditions such as migraine or tension headaches, digestive system disorders, high or low blood pressure, and cardiac arrhythmias (abnormal heart rhythms). It can also contribute to treatments for epilepsy, circulatory disorders, and movement disorders.

"People with digestive disorders can swallow a little radio transmitter, about the size of a dime," Dr. Jacobson explains. "As the radio transmitter passes through the body, it beeps as it moves through the digestive system; a receiver picks up the beeps so the users can hear it. They can learn to alter the way their digestive system works so food passes through more or less quickly, as needed."

As they realize they can exert control over their automatic responses, patients typically feel empowered; often they are able to reduce their intake of medication.

A positive outlook is vital for biofeedback to work, Dr. Jacobson says. "Hope is a marvelous motivator. Without hope there is no point to do much of anything."

George R. Jacobson, PhD, Associate Professor of Psychiatry and Behavioral Medicine, practices at the Behavioral Health Center at Tosa Center.

This article includes information from the National Institute of Mental Health and the National Institute for Occupational Safety and Health.

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.