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Biofeedback: F.A.Q. Getting Started as a professional

Biofeedback is an exciting field with many dimensions, for both Professionals and laymen.

Basic facts about the major biofeedback feedback "modalities"-- the different phsyiological systems measured.

Common Questions that beginning professionals and laymen ask

1. Is there certification in biofeedback
2. Is there a national biofeedback Organization?
3. What's the difference, if any, between biofeedback and neurofeedback?
4. What does it take to get started doing biofeedback?
5. Using biofeedback for personal growth and exploration.
6. What's the difference between biofeedback and relaxation training?
7. How do I evaluate Stress and client/patient improvement as training/therapy progresses. (a reply to a question from a South African Psychologist)
8. A colleague asked: How do they do it?" How do cats,rats, monkeys, and people voluntarily change their
brain waves.

Basic facts about the major biofeedback feedback "modalities"-- the different phsyiological systems measured.

EMG Muscle Biofeedback measures electrical activity created by muscle contractions. Often used for relaxation training and peak performance training, stress and pain management (headache, back, TMJ, etc.). Also used for urinary and fecal incontinence,vulvodynia (pelvic pain) muscle balancing, kinesiology (repetitive strain injuries such as carpal tunnel syndrome, thoracic outlet syndrome, etc.)

Thermal or Temperature Biofeedback uses some kind of temperature sensor either electronic, computerized, liquid crustal, or a glass thermometer to detect changes in temperature of the extremity-- usually fingertips, but sometimes toes. Stress, or nervous system excitation/arousal causes blood vessels in the fingers to constrict, reducing blood flow, leading to cooling. Thermal biofeedback is used to train people to quiet the nervous system arousal mechanisms which produce hand and or foot cooling. This is often used for relaxation, stress and pain management, arthritis, anxiety, Raynaud's, irritable bowel and other applications. It is widely used since the cost of a simple biofeedback card or digital electronic thermometer is the lowest for any form of biofeedback. Even young children have no trouble learning this. While the elderly find it useful for diabetic neuropathy and intermittent claudication as well as arthritis.

EEG biofeedback or Neurofeedback trains the central nervous system, feeding back brain electrial activity, called brainwaves. This is the fastest growing field in biofeedback, with many new applications being developed every year. Popular applications include ADD/HD, depression, anxiety, insomnia, closed head injury, Optimal Functioning, Creativity and Peak Performance, O.C.D., O.D.D., anger, Autism, and more.

SCL/GSR/EDR (Skin Conductance Level/Galvanic Skin Response/Electrodermal Response) These are all measures of physiological activity in the skin. Part of it is based on sweat gland activity. This measure is very useful for relaxation and stress management training, and is also used in a bilateral mode for ADD/HD. It can also be very useful with hyupnosis and in constructing systematic desensitization hierarchies.

1. Is there certification in biofeedback

Yes, there is certification. It can be very useful as a credential for marketing your practice. If you are licensed, then you may not be required to get the certification, but either way, it is a good idea to get a description of the criteria for certification from the BCIA (Biofeedback Certification Institute of America.) It is the ethical responsibility of all practitioners to learn enough about, develop enough skill in and get adequate training in biofeedback to practice it competently.

If you are a layman seeking a trainer, make sure you ask about training, supervision, years of experience, number of clients previously seen and if the trainer has actually undergone the biofeedback training process him or herself.

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2. Is there a national biofeedback Organization?

There are actually several.

A] The bigger and older one is AAPB Association for Applied Psychophysiology and Biofeedback. 303-422-8436

It publishes a magazine and a scientific journal, holds an annual meeting of about 600 attendees, plus it offers a number of useful publications, some of which are very helpful in negotiating with insurers or hospital committees.

Most important, AAPB is, at this time, the world's biggest advocacy organization for the field of biofeedback in terms of insurance, legislation, publicity, integration into the healthcare mainstream. We strongly advocate that if you are getting into or are already involved with biofeedback, anywhere in the world, that you join AAPB to support its advocacy efforts and get its magazine and journal.

AAPB covers the whole range of the biofeedback field, from incontinence to pain management, instrumentation to research to headache, stress, anxiety, neurofeedback, EEG, EMG, GSR, respiration, thermal, creativity, education, women's issues, and any other topic that fits under biofeedback's very broad, multidisciplinary umbrella.

B] SSNR is the Society for the Study of Neuronal Regulation. It is a newer organization, founded in 1993, which focuses more specifically on Neurofeedback, with an emphasis on QEEG (Quantitative Electroencephalography).

It gives a subscription to the Journal of Neurotherapy with membership and holds an annual meeting of about 120 attendees.

C] Futurehealth, Inc. is a for-profit company but we organize the world's second biggest annual meeting on biofeedback, The Winter ConferenceOn Brain Function, Modification & Training which emphasizes neurofeedback, QEEG and optimal functioning, with attendance of just under 300 attendees. Rob Kall, president of Futurehealth, is an active advocate and educator for the field of bio/neurofeedback, a member of the board of directors of AAPB, the PR chair for AAPB, the founder or co-founder of two sections of AAPB (Allied Professionalsa and Optimal Functioning) and a founding member of SSNR.

Futurehealth and Rob Kall publish the BioPsy Webzine, which includes articles of interest to people working with biofeedback and other mind/body/heart/spirit topics.

D] EEG Spectrum is a for-profit company that has established a network of neurofeedback providers around the world. The company offers start-up and practice management support to affiliates.

3. What’s the difference, if any, between biofeedback and neurofeedback?

Biofeedback refers to a training or coaching process in which technology is used to help a person (or animal) get more information about his body than the normal senses provide. The information is used to raise the level of awareness about the function and eventually, to increase voluntary self control over the funciton-- such as heart rate, muscle tension, stomach acidity, skin conductance, respiratory patterns or rate, , body position or joint angle, skin temperature or brain electrical or blood flow activity.

Neurofeedback , also called EEG Biofeedback or Neurotherapy, is one variety of biofeedback which focuses on feeding back information about brain activity-- usually EEG (electroencephalographic.) It usually involves increasing or decreasing brainwave activity of certain frequencies at certain locations. Some trainers only use neurofeedback. Others combine central biofeedback "central nervous sytem" ie., EEG or Brain biofeedback with peripheral biofeedback, ie., muscle, skin temperature, respiration, heart rate, etc.

4. What does it take to get started doing biofeedback with your own equipment?

It depends! At the simplest level, you can begin using biofeedback to learn self control with a simple thermometer made of glass, a liquid crystal card or a digital electronic device such as those found on our stress management tools page. These cost just a few dollars up to less than a hundred. A nice beginning package listed on the above page which includes a number of items is the Biodigital-AD for $69.95 with the Bio-Q Stress control biofeedback kit added for $14.95.

Next, you can get into skin biofeedback-- usually, at the lower cost end, GSR. This starts, for a unit we find acceptable, at $60. (There's a $35 unit on the market we have tested. It failed. Saving $25 for something that doesn't work is not a saving. It's a waste of $35.) You can get an upgraded version of this unit for $140, which includes non-calibrated audio temperature feedback.

If you are going to use the modalities of EEG or EMG, then we suggest you consider going for at least one or two sessions to a person either certified in biofeedback or with the equivalent of biofeedback certification to help you learn how to use the equipment, set it up and develop a training strategy that will meet your needs. If you have complex or severe clinical considerations, then you should think about developing a regular relationship with a professional.

Stand-alone clinical Grade home trainers range from $500- $2000. We can put together a decent EMG and thermal trainer package for about $1450. And we often have used equipment available.

EMG standalone equipment should have a digital readout, preferably with some integration or averaging of the EMG signal over time. Most have a colored Light bar or LCD display and good audio feedback is a must if you are doing relaxation training. You don't want to spend hours in your office listening to an annoying tone!

Moving to computerized equipment means spending more.

The lower cost biofeedback systems offer hardware with less signal quality and fewer software features. But that does not mean it is bad. You can also start out with a good re-conditioned/demo/used system, since biofeedback hardware made in the last 15 years is very sturdy.

5. Using biofeedback for personal growth and exploration.

A popular, valuable and worthwhile use of biofeedback is as an inner self exploration tool. This powerful technology can help you to learn more about who you are and what you can do, what your potential is and how to achieve new levels of consciousness, self awareness, enlightenment, self control and self discipline. You can use any of the technologies, though EEG is probably the most interesting. For a smaller budget, GSR can be fascinating.

6. What's the difference between biofeedback and relaxation training?

Biofeedback is a more specific approach to helping people determine which kind of mind-body self regulation will best meet one's needs. Psychophysiological stress profiling is a commonly used element in biofeedback, It enables the practitioner to identify which body systems respond to which kinds of stressors, so the most effective training can be implemented.

Biofeedback also gives more precise, more "contingent" feedback about self control skill learning. The instrumentation gives objective measurement of physiological activity so even tiny progress in the beginning can be measured. This is invaluable, particularly to people who have been through many unsuccessful other interventions. They can see change even before symptoms improve.

7. How do I evaluate Stress and client/patient improvement as training/therapy progresses. (a reply to a question from a South African Psychologist)

I am working on a day to day basis with stress and stress related conditions. I am looking at the best device in under $500-00 that I can use to read stress and the improvement of it after theapy. (A reading instead of sound.)

Good question. I have provided links to parts of our website which will give you more info on some of the topics discussed.

One thing to keep in mind is that improvement after therapy can probably best be measured by repeating a psychophysiological stress profile (PSP). In brief, a PSP first obtains a baseline and then evaluates a variety of psychophysiological responses to different kinds of stressors. The link gives a detailed description of how to do one. You can use a PSP to identify which kinds of stressor set off which kinds of psychophysiological response patterns. That enables the practitioner to develop a more targeted and precise game (read that treatment if you work in a reductionist pathology model) plan for helping clients move towards health and resilience.

A simple electronic digital thermometer, with a highly sensitive, small tip, measuring finger temperature can be useful for people who respond with peripheral vasoconstriction. Cost $45 or, with audio biofeedback, $85, or, our deluxe package, with an audio tape and a pocket stress thermometer card-- US$99 Low$ StressTools

A GSR unit with a meter can be useful for those clients who respond with sweat.

Cost $140 Low$ StressTools

a Surface EMG/ (Electromyograph) would be helpful for clients who respond to stress with muscle tension, tightening and bracing.

Cost $300 to $750. (a very popular one sells for $500, which does not require gel

Neurofeedback / EEG Biofeedback or Brain Wave biofeedback can monitor alertness, and tell you when a client is in a deep, meditative state, compared to alert and hyperfocused state. A decent EEG starts at $950.

We offer a computerized unit which combines EEG, EMG, GSR and heart rate for $950, so all you need to add is Thermal, for $100. That gives you the best of all worlds for $1050, with a shipping cost of about $75

Our top of the line professional practitioner system-- the Procomp Biograph sells for about $4500-$7000

8) A colleague asked: How do they do it?" How do cats,rats, monkeys, and people voluntarily change their
brain waves.

Well, to start with, I've always told my clients that the first step is awareness of different states associated with different displays on the instruments, kind of what Joe Kamiya did back at the University of Chicago, some 30+ years ago.

Then, I explain that the learning process is non-verbal. you can't just talk your way through it. You learn it using other "intelligences," borrowing from Gardner.

As your skills improve, you get a better volitional "grip" on producing the desired outcome. It comes to you more readily, qucker, with more power, integration and precision, more automatically.

Writings on Biofeedback

More to come. This page is still under construction.