Article: Adding Biofeedback to your Eating Disorders Practice

There is not just one way to do neurofeedback. Instead there are several camps that have each developed diverse yet successful approaches. Neurofeedback is done by some in a training model with the goal to optimize neurological functioning in people with or without symptoms. Others prefer a practice model that uses subjective and/or objective assessments such as a QEEG brain map to "target" neurofeedback training. For example, people with high anxiety, physical tension and incessant thinking frequently have excessive high frequency "beta" brainwave activity over the central sensorimotor and parietal association cortices. And there are several other approaches to the same case such as focusing on inter-site coherence, reducing turbulence of the EEG or training up regional cerebral blood flow with hemoencephalography (HEG). Other popular approaches to training will boost alertness, e.g., less frontal/central theta with more mid-range beta power or training will aim for a more relaxed state, e.g., more sensorimotor rhythm or more posterior alpha rhythm eyes closed. Neurofeedback equipment is generally more powerful, complex and expensive than peripheral biofeedback. Neurofeedback equipment can cost $1100 - $5000+. Most manufacturers have a version of their systems for clients to train at home under clinical supervision.

Take Home Points
With careful observation of what is really going on psychophysiologically, you can help people take charge of themselves. With this comes an increasing sense of self-efficacy and a belief in the controllability of previously uncontrollable emotional states. As this happens, much of the out-of-control panic feelings patients have will dissipate. Depression begins to lift rapidly and enduringly as patients realize there is actually something they personally can do to improve the way they feel and the way they operate their nervous system.

Your patients can benefit from learning to lower their anxiety and improve their ability to drop themselves at will into an emotionally and physically relaxed, but mentally alert and focused state. This is easy enough to promote with a variety of biofeedback methods, ranging from peripheral feedback of muscle tension and autonomic indicators to various aspects of the brain's electrical activity. A final excellent reason to add biofeedback to your practice is that patients volunteer to stay in treatment longer when neurofeedback is offered to them (Scott et al. 2005).

Historically, biofeedback efficacy has been recognized for some decades now, but it has been trivialized as relaxation training when in fact it offers a powerful pathway for enhanced self-regulatory status of the whole nervous system. This has particular import for conditions with a significant neurophysiological component that impedes recovery by conventional therapeutic methods. The role of biofeedback in recovery is particularly compelling when the dysregulation manifests in so many different systems, as is the case in eating disorders and in addictions, (Trocki, 2007).

References
Association for Applied Psychophysiology and Biofeedback: http://www.aapb.org

Biofeedback Certification Institute of American: http://www.bcia.org

International Society for Neurofeedback and Research: http://www.bcia.org

EEG neurofeedback for treating psychiatric disorders. OubrÃ � A. (2002) Psychiatric Times, July 1, 2002, from click here

Benson, Herbert; Klipper, Miriam Z. 2000 Relaxation Response, New York, NY, Harper Collins.

The Neurological Basis of Eating Disorders. I: EEG Findings and the Clinical Outcome of Adding Symptom-Based, QEEG-Based, and Analog/QEEG-Based Remedial Neurofeedback Training to Traditional Treatment Plans. Peter N. Smith, PsyD, Marvin W. Sams, ND, Leslie Sherlin, BA. Presented at ISNR conference 2006.

Schwartz, M. & Olson, R. (1995). A historical perspective on the field of biofeedback and applied psychophysiology. (pgs 3-18). In M.S. Schwartz (Ed). Biofeedback: A Practitioner's Guide (2nd Ed). New York: Guilford Press.

Leher, Paul M, Woolfolk & Robert L. & Sime, Wesley E. Eds, (2007), Principles and Practices of Stress Management, New York, NY, The Guilford Press.

Neurofeedback in Psychological Practice. Masterpasqua, Frank; Healey, Kathryn N. Source: Professional Psychology: Research and Practice December 2003 Vol. 34, No. 6, 652-656

Is there an Anti-Neurofeedback Conspiracy? Karen F. Trocki Journal of Addictions Nursing, Volume 17, Issue 4 December 2006 , pages 199 202

Allen, K.D. (2006). Recurrent Pediatric Headaches: Behavioral Concepts and Interventions - JEIBI 3 (2), 211-218 http://www.behavior-analyst-online.org

Yucha, C. & Gilbert, C. (2004) Evidence-Based Practice in Biofeedback and Neurofeedback. Association for Applied Psychophysiology and Biofeedback. Colorado Springs, CO. Effects of an EEG Biofeedback Protocol on a Mixed Substance Abusing Population, William C. Scott, David Kaiser, Siegfried Othmer, and Stephen I. Sideroff, American Journal of Drug and Alcohol Abuse, 31(3), 455-469 (2005)

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