What Is It?
Biofeedback is a mind-body technique in which a practitioner uses a special monitoring machine to teach people how to control bodily functions, such as heart rate, blood pressure, skin temperature, and muscle tension, in order to improve their health and well-being.

The first important studies on biofeedback were conducted in the late 1960s by Barbara Brown, of the Veterans Administration Hospital in Sepulveda, California, and Elmer and Alyce Green of the Menninger Foundation, a clinical and research center for mental illness in Topeka, Kansas. Prior to these studies, it was thought that the body's autonomic functions--heart rate, digestion, blood pressure, brain waves, and muscle behavior, for example--could not be voluntarily controlled. The researchers' studies of Indian yogi masters showed that the nervous system and metabolic rate could be consciously regulated. Their work led to an exploration of the use of biofeedback for a wide range of physical ailments, including migraine headaches, insomnia, and circulatory and gastrointestinal disorders.

How Does It Work?
During biofeedback, the therapist uses electronic equipment to help you understand how your body responds physiologically to various situations--to stress, pain, or other conditions. The therapist will also teach you relaxation techniques, such as guided imagery and progressive muscle relaxation, to provide a way to actively control these bodily responses.

While biofeedback is known to be quite effective for stress, it differs from other stress-reduction techniques in that it focuses on a particular stress response--tension in the neck and shoulders, for example, or variations in breathing patterns--rather than on relaxing the whole body. With help from the therapist, you learn to control the actions of your nervous system during and after times of stress.

The therapy has also shown promise for ailments such as diabetes and incontinence that may not be stress related. For such conditions you might be taught to increase blood circulation to a specific part of your body or to control a very particular muscle group.

What You Can Expect
During a biofeedback session, you will sit comfortably in a quiet room. The therapist may tape sensors to your forehead or arm to measure the amount of tension in your muscles. You might also have a heat sensor taped to a finger (as you relax, your finger grows warmer). A small machine wired to the sensors then measures responses such as muscle tension, skin temperature, heart rate, and breathing, and translates them into audio or visual signals. You can then use a relaxation technique the therapist has taught you to modulate the signal, which is typically a series of beeps, a flashing light, or a changing image on a computer screen.

By paying attention to the "feedback" from the monitoring machine you can tell how well you are progressing with the therapy. When you make the "correct" response--by relaxing your tense jaw, for instance--you get positive feedback from the machine: The light stops flashing, the beeping stops, or the image on the computer screen changes from an angry face to a happy one. Once you learn to adjust your body's reactions, you'll begin to recognize how the correct (healthier) response feels. The goal is to be able to duplicate this response on your own, without the help of the biofeedback equipment. Like most skills, the more you practice, the more adept you will become at altering the feedback.

Getting hooked up to a biofeedback machine doesn't hurt and is an easy process. You automatically send signals to the machine and it measures them. Most people require between five and 10 sessions to learn how to recognize and control their bodies' responses.

Many health insurance polices now cover biofeedback training to help patients cope with chronic stress-related health problems.

Health Benefits
During the past 25 years, research has demonstrated biofeedback's significant health benefits. Studies show that the therapy can help people control headaches caused by muscle contraction or dilated blood vessels better than some conventional treatments. The therapy has also aided patients recovering from strokes in regaining gait, grip, grasping ability, and other hand functions. In addition, biofeedback can be an important adjunct therapy in the treatment of alcoholism and drug addiction. It may also serve to counter the physical tension associated with many illnesses.

Other ailments for which biofeedback is also frequently used include complications from diabetes, Raynaud's disease, and incontinence.

It is important to note that while biofeedback helps people control bodily functions and change behavior, it can't address deeper emotional and psychological issues that may be involved with stress or chronic pain. If these problems persist, you may want to consider counseling or psychotherapy.

How To Choose a Practitioner
Most biofeedback therapists are licensed physicians, clinical psychologists, or other healthcare professionals who have taken special training in this technique. The Biofeedback Certification Institute of America in Wheat Ridge, Colorado, provides the major certification program for biofeedback practitioners. Look for a therapist who has experience treating the particular problem for which you are seeking help, and choose someone you feel comfortable with. Remember that the success of the treatment will depend in part on the level of trust you are able to develop with your therapist. Your primary-care physician also may be able to give you a referral to a biofeedback therapist. Many health insurance palns now provide partial coverage for biofeedback therapy.

Cautions
If you wear a pacemaker or have a serious heart disorder, consult your doctor before undertaking biofeedback.

Biofeedback can help people with diabetes control their circulation but it could also change the need for insulin and other medicines. Be sure to monitor blood sugar carefully if you are using this therapy.

Biofeedback devices sold for home use vary widely in quality. Ask a physician or biofeedback therapist for advice about a good brand before making a purchase.

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