Traditional Approaches-Psychological:  Related Paper

Effective Treatments Index

Biofeedback and Stress

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Biofeedback and Stress

Eric J. Collins, III
           In today’s fast-paced life one can not help but think that people are always confronted by various kinds of stress from work, school, from everyday routine, or even going from one class to another.  Because of everyday stressors and tensions, people get tired, worn out, torn apart from the supposedly normal state of living. This paper is aimed at looking at biofeedback as people’s way of coping up with stresses everyday.  It shall look at the many advantages of biofeedback, its principles and how it affects the body as well as its use as an intervention for clients with mind-body malaise. Biofeedback is based on the principle that if we can learn to become aware of some body function of which we normally overlook, then we can learn to control that function. Technical biofeedback implies the use of sophisticated instruments that can measure brainwave activity, blood pressure level, skin temperature and heart rate.  Jeanne Achterberg reports that every clinical function that can be measured can be brought under control. (Achterberg, 1985, p. 196).

The brain generates electrical rhythms that occur in four groups, each of which can be correlated with a state of awareness or particular brain activity.

1.      Beta waves – Beta waves are the normal working rhythm of the brain; they are faster and indicate more frenetic activity. A relaxed person shows very little beta.

    2.      Alpha waves – Alpha waves are building blocks for higher levels of awareness. In conjunction with theta, they indicate a calming down or emptying of the mind, usually with physical relaxation.

    3.      Theta waves – These occur during creative inspiration and meditation.

    4.      Delta waves – This is the rhythm of sleep, but they are found in many people in response to new ideas.

           Among those who pioneered biofeedback techniques were Elmer and Alyce Green, who wrote the definitive book, Beyond Biofeedback, in 1975. Biofeedback techniques were also pioneered by Dr. Joe Kamiya in San Francisco. He monitored a subject’s alpha rhythms with an EKG (electroencephalogram) device. When alpha rhythms were being generated to a feeling of well-bring, and most subjects could learn to turn it on or off.

      In addition to the EEG to measure brain waves, biofeedback also uses the ESR (electrical skin resistance meter), which indicates physical arousal and relaxation. This is connected to the palm of the hand, and the meter readings to relate to the behavior of the autonomic system. The rate of blood flow varies with body tone and causes change of polarization of the sweat gland membranes. The polarization varies according to how tense or relaxed we are. The reactions which make us tense or relaxed are reflected in the fight or flight response or in the relaxation response. Stress increases the blood pressure and heart rate, the amount of muscle tension, and oxygen usage. Relaxation increases circulation to skin and organs and lowers heart rate and muscle tension.

      Using the data from both the EEG machine and ESR device, beta rhythms and low skin resistance accompany panic states while alpha rhythms and high skin resistance indicate relaxed states. Separating physical and mental states is the purpose of many medication techniques. Thus, we can have a relaxed body and an alert mind when we need to or an active body and a relaxed mind.

                                            Manifestations of Anxiety

      Everyone in a variety of ways experiences anxiety. At times, we are acutely aware of its presence. On other occasions it affects us unconsciously. Often we mask or disguise its presence, to others and to ourselves. Ernest Hemingway noted that many bullfighters are prone to frequent yawning prior to entering the bullring. Some people complain of being bored at times when she might appropriately have been distressed. Disguising anxiety only helps to keep people from recognizing the cause. The anxiety is still there.

      The manifestations of anxiety are limitless. Suffice it to say that ll the major pathways of expression—affective, motoric, somatic and cognitive—are used at different times by all of us in our encounters with anxiety. In the affective realm anxiety varies from a mild form of uneasiness to worrying to nameless panic.

Approaches to the Biofeedback Intervention

      Biofeedback has been used effectively to teach subjects to control abnormal heart rhythms, to indicate stomach acidity in the case of ulcers, to control migraines and headaches, to help in retraining the muscles, and to benefit a wide range of diseases. Jeanne Achterberg states that those who are most successful in using biofeedback techniques are those who have strong ability to visualize and those who are highly motivated (Achterberg, 1985, p. 196).

            Stress-reducing techniques, such as biofeedback, and various types of mental exercise that relax the body, like autogenics and hypnosis, are helpful in controlling diseased states that arise from imbalances in the nervous system. Through the use of a device attached to a person’s fingertips, the biofeedback machine is able to help people monitor their inner states and learn to relax, thereby lowering blood pressure and controlling asthma attacks and other physiological processes. Hypnosis and autogenics help to achieve physical relaxation. Once an individual has mastered this, he/she can move into higher meditative states of awareness. 

            Until two decades ago, one of the most tenaciously held beliefs of Western science was that there are certain parts of the human body we can consciously control—our “voluntary” systems—and others over which we have no conscious control—the “involuntary” systems. Among the involuntary components of our body were thought to be the rhythm and amplitude of our brain waves, blood vessel expansion and contraction, blood pressure, rate of healing and strength of our immune system, and secretion of hormones. Then, in the 1960s, sophisticated devices were constructed to measure minute changes in the bodies of laboratory animals. Scientists found that if the minute changes measured by the machines were somehow amplified and “fed back” to the animals, so that when they were performing a desired task, such as making one ear grow hot and other grow cold, they would receive a “positive reinforcement,” such as a pellet of food or a blast of electrical stimulation to their pleasure centers, then the animals were able to learn to control virtually every part of their bodies—even those long believed to be “involuntary”—and could learn this control quite rapidly. (Miller, 1961 and DiCara, L. 1970).

            Scientists wondered what would happen if humans were hooked up to these devices, and instead of being rewarded with a food pellet, were rewarded by a flashing light, a clicking, or some other clear signal. Early experiments by psychophysiologist Joe Kamiya, of Lanley Porter Neuropsychiatric Institute of the University of California Medical Center, involved monitoring subjects’ brain waves, and Kamiya found that within an hour, most subjects could learn to manipulate their supposedly involuntary brain waves and generate large quantities of alpha waves. Oddly, the subjects could never explain how they were able to generate alpha waves; in fact, if they tried to do it, alpha waves disappeared. All they could say was that they just somehow “knew it” when they were in alpha. Subjects of Cade learned not through being taught any specific mind-control techniques but by monitoring real-time feedback, in the form of flashing lights indicating their brain-wave patterns. (Cade 1979).

Biofeedback and visualization

          The use of visualization therapy or guided imagery are meaningful biofeedback intervention techniques such as “simple visualization and direct suggestion using imagery, metaphor and story telling, fantasy exploration and game playing, dream interpretation, drawing, and active imagination.” All this relaxes the mind that is the ultimate goal of biofeedback for helping clients. In active imagination particularly, unconscious elements are said to be “invited to appear as images” that surface to the conscious mind (Bresler 2004). Among the widespread uses of guided imagery that are said to have caused it to be widely accepted in mainstream medical practice are those for teaching “psycho physiologic relaxation”, resolving conflicts, enhancing self-esteem, alleviating anxiety and depression, improving memory, relieving physical and psychological symptoms. It also includes overcoming habits that threaten one’s health such as smoking and taking dangerous drugs, helping patients prepare for greater toleration of surgical procedures, accelerating body healing responses, stimulating creative thinking, and enhancing athletic performance (Bresler 2004).

          The roots of visualization therapy or guided imagery are said to go back to the time of the ancient Hebrew mystics, who are said to be intimate with the deep relationship between events and the images that are associated with those events, with the relationship often said to go “beyond normal experience”. Such roots are said to have extended to modern times, where images are used to penetrate and bring the subconscious to waking consciousness. Such use range from Rorschach’s use of standardized ink-blots to link the psychological relevance of those ink-blots to internal mental and emotional states, to Freud’s use of free association to read and interpret the unconscious and the images that are produced in free association, to treating diseases such as cancer (Bresler 1992). Guided imagery is said to be a good representation of medicine more as an art than as a science. Focusing on self-knowledge as opposed to passive psychotherapy and life direction as opposed to an obsession of pain and diseases (Bresler 1992).

          Bresler outlines ten important points about guided imagery that he deems essential knowledge for all psychologists (Bresler 2004). One, clients and therapists use imagery all the time. Two, he notes that imagery has “powerful physiological consequences”. Three, imagery is said to be the language of the unconscious mind. Four, guided imagery has been used to treat patients more than any other known medical intervention. Five, guided imagery can change moods. Six, guided imagery can be used to raise self-esteem and inner support. Seven, it can be used for overcoming habits and for conflict resolution. Eight, guided imagery is used to overcome resistance, and is said to be the fastest and easiest way to do so. Nine, guided imagery can be used to convert insights into action. Finally, guided imagery can be taught to patients so that it is used creatively and interactively depending on how the self changes (Bresler 2004

Guided Imagery Perspective

             A study reviewing the literature on the formation of adult attachment security found that generally, such literature differentiates between those whose attachment style are said to be secure and those whose attachment style are said to be insecure. In lay terms, people who feel secure in their relationship attachments with significant others are said to score low on anxiety and avoidance measures, or measures on how partners are perceived to be unresponsive in times of need and be insincere about their goodwill. People who are insecure in their significant relationships, on the other hand, are said to score high on those same measures (Mikulincer et al 2002, pp. 406 - 407). A common thread in the existing literature that relates to guided imagery principles is the finding that “securely attached persons hold more positive self-views than persons who score high on the anxiety dimension” (Mikulincer et al 2002, p. 406).  Such positive self-views can be construed as including positive guided images undertaken by those who are considered secure in their vital relationships with others. 

            All these years, science and culture have developed various types of mind-body techniques that are aimed at addressing the growing concern of people to find better ways of intervention to cope up with the stressors of life.  In the field of science alone, meditation in general, is used as an alternative cure to improve quality of life to patients. In line with cultural developments, meditations continue to evolve as a way to cleanse the spiritual well being of people.

Health Applications

Health applications and clinical studies of mind body biofeedback techniques have penetrated the health care system especially in the care and treatment of stresses and reducing pain among patients.  The meditative aspects of meditation are found to be effective in lowering biochemical byproducts of stress, decreasing heart rate and blood pressure because health patients respond to relaxation. Despite the considerable number of positive effects of meditation, if practiced wrongly and improperly,  could lead to “considerable psychological and physiologcial problems” (Meditation, 2005). 

It is reported that meditation can cause adverse effects such as “depression, relaxation-induced anxiety and panic, paradoxical increases in tension, impaired reality testing, confusion, disorientation and feeling 'spaced out'. It can trigger emtional stock bank.”

As we begin to learn how to sense ourselves in various ways and conditions, we will quickly see that the sensation of pain or intense effort in our pursuit of physical fitness usually signals a wrong relationship not only to what we are doing, but, perhaps even more importantly, to ourselves. The nervous system is so constructed that it learns best when effort is the least possible to accomplish a particular action. According to experts, feeling of effort is really the overall sensation of our attempt to reorganize ourselves to perform a certain action, and has little to do with the work actually done. For example, observe yourself as you bend your wrist. Do it several times as gently as you can, without any expectation of what it should feel like. Next, bend your forearm in the same way. No reorganization of your body should be required to carry out these actions, and unless you have an injury of some kind to your wrist or arm you will experience the same sensation of effortlessness in both instances. Though your wrist weighs less than your arm, the ratio between the muscle performing the action and the action itself is approximately the same in both cases, thus the sensation of "no effort" is the same.

                                         Summary and Conclusion                                              

Mindful Meditation is a breakthrough concept that has helps millions of people today in terms of managing struggles in life. It is said that “Mindful Meditation does not only help ordinary people but also those who are in pain physically and those who are sick. Coping with pain and stress from illnesses is more than enough agony for the patients, but with the Mindful meditation, patients could find better ways to relieve them from pain.

For ordinary people who are faced with stress and tensions or pressures in life because of problems, worries and anxieties, Mindful meditation is the key and an alternative way to deal with them.  It is doable, it is a way to release those anxieties and renew us to a fresh new start of clearer, more objective way of dealing with them. Mindful Meditation sets us to become aware of our inner self and to learn how to appreciate what we have. We learn to become sensitive to others.  Indeed, Biofeedback is tool that can help us become caring people to the environment we grow up in.  It helps seek out the true potential and value in life. We become more responsive to the needs of the times. This then impacts the kind of world we live and for now, through Mindful meditation, we truly can make a difference.

          <>Indeed, the path to real fitness starts with sensing ourselves in action. Whatever we are doing, we can innovate and try to do it more simply and easily. By trying to reduce the amount of effort we put into an action, for instance, or by exploring other ways to perform it, we can begin to learn more about our own individual motivations, problems, and capabilities. And as we experiment with and observe our efforts at physical fitness, we will also see how the particular image we have of ourselves constantly interferes with our body's own inherent intelligence, and that for true fitness we will have to find a way to transform this image, to make it more flexible and sensitive in harmony with our real potential. If we can continue trying in this way over a long period of time, we will begin to experience fundamental changes in both our self-image and functioning taking place as if on their own. Thus, we will begin to understand that real fitness, like real living, depends more on self-knowledge and awareness than on effort, discomfort, and pain.


Achterberg, J. Imagery in Healing: Shamanism in Modern Medicine.
Boulder, CO: Shambhala Pubns., 1985, p. 196.

Bresler, D. 2004, What Every Psychologist Should Know About Guided Imagery, Academy for Guided Imagery. Retrieved Oct. 17, 2006 at:

Bresler D. 1992, Health Promotion and Chronic Pain, Challenges and Choices, Health Promotion and Chronic Illness: Discovering a New Quality of Health. Cologne: The Federal Centre for Health Education and the Regional Office for Europe of the World Health Organization. Retrieved Oct. 17, 2006 at:

Cade, C. Maxwell and N. Coxhead. (1979). The Awakened Mind: Biofeedback and the Development of Higher States of Awareness, New York: Delacorte Press.

DiCara, L. (1970). Learning in the Autonomic Nervous System. Scientific American, January 1970.

Meditation methods include the following 3 common types: Concentration Meditation, Mindful Meditation and Transcendental Meditation. (2005) InnerVibrance.Com. Retrieved Oct. 17, 2006 at:

Mikulincer, M, Florian, V., Cowan, P., and Cowan, C. 2002, Attachment Security in Couple Relationships: A Systematic Model and Its Implications for Family Dynamics, Family Process 41(3). Retrieved Oct. 17, 2006 at:

Miller, N. (1961). Learning and Performance Motivated by Direct Stimulation of the Brain. In Electrical Stimulation of the Brain, ed. D. Sheen. Austin: University of Texas Press.