Biofeedback

Research over the past 30 years has shown a distinct connection between the mind and body. Therefore, a person's thoughts and feelings are viewed as interacting with their physiological state and vice versa. Modern biofeedback grew out of the behavioral movement of the mid-1950s (Schwartz & Andrasik, 2003). In biofeedback, physiological responses (e.g., heart and respiration rate, skin temperature, muscle tension) are amplified from sensors attached to the body and fed back to the individual through a computer in the form of sounds, visuals, or both. This information can be used by the person to consciously control the measured bodily processes. With increased awareness of physiological responses, the person can learn to control his or her bodily reaction to environmental events. There are various types of biofeedback modalities used. Table 1 shows the most frequently used biofeedback modalities.

Reactions to stressful events are mediated by the autonomic (i.e., automatic) nervous system (ANS). There are two antagonistic branches of the ANS: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The SNS stimulates the body's reaction (e.g., heart rate, breathing, pupil dilation) to stressful events by preparing the person to act quickly to respond to an event. Activation of the SNS causes stress to the body, and prolonged activation can lead to organ damage and a reduction in the capability of the body's immune defenses to ward off disease. In some cases, simply the perception (real or imagined) of physiological arousal itself can trigger worry or fear, further exacerbating the physiological response. The PNS is associated with relaxation, control, and improved health status. Increases in PNS activation lead to lowered heart rate; slower, deeper breathing; and improved blood flow.

Hans Selye (1976) proposed the general adaptation syndrome (GAS) as a way of explaining the relationship between stressful events and physiological reactions to them. In the GAS, a person experiences the initial shock of a stressor that activates the SNS. In some people, this SNS arousal may diminish quickly after the stressor remits, but for others the individual remains chronically aroused (e.g., continued SNS activation), resulting in organ damage and illness. The ability of the person to cope with the stressful events and induce PNS activation leads to reduced vulnerability to disease.

Biofeedback provides individuals with direct information on SNS–PNS activation, or their level of physiological arousal. Psychologists can use this information to assist children and adolescents to learn to cope with stressful events through a variety of therapeutic techniques. The general treatment plan for using biofeedback is to help a child or adolescent to:

• Become aware of physiological changes that occur when under stress and when relaxed
• Learn to control the physiological modality in which he or she is most responsive
• Generalize the learned skill so that it can be performed anywhere but especially when the child encounters stressful events

There are numerous therapeutic techniques that are used with biofeedback to assist a child or adolescent in reducing the effects of stressful events. These techniques

...