A form of therapy that has been created to improve the bodies reactions and subsequent malfunctions related to internal and unseen medical conditions.

The human body is a complex system of muscles, bones, ligaments, tendons, and organs. The word complex is used as these body parts are covered by skin and cannot be seen.

Biofeedback has been created to place electrodes on different areas of the body on the clients skin.

These electrodes can measure how the body is performing and focus on specific problematic areas.

Once identified the therapist can teach the patient how to relax these areas. For example, when treating anxiety, the heart can be seen to beat much faster when under stress.

The therapist can show the heart rate on the monitor and the difference between a stressed heart and a relaxed heart.

By looking at the monitor the patient will learn what reactions reduce the stress placed on the heart and learn to practice these techniques and implement them at home.

This form of therapy does not use medication and has no known contradictions.

Biofeedback Therapy and How it is administered

Biofeedback Therapy connects a person to a specially designed Biofeedback machine. This equipment is specifically designed to read the body’s internal reactions.

Known as the Nervous System, the way the heart beats, specific muscles that may not be working properly, skin temperature, how the body reacts to pain and brain activity can be monitored to gauge what is happening inside the body?

  • Heart beats
  • Skin Temperature
  • Body’s reaction to pain
  • Brain activity

Take migraine headaches for example. If related to tension and stress, the Biofeedback machine will identify the areas of the body that are being put under stress.

Such as clenching the jaw, tension in the neck and specific muscles that are tensing instead of their natural relaxed state (prior to movement).

The administrator of the therapy will have a monitor screen set up that both parties can see. This monitor will show an ECG type pattern. This is instructive as an elevated spike can show the area of concern.

The aim of the sessions is to lower the spike to a ‘body safe’ level i.e. a level that allows for previous pain or discomfort to be alleviated.

Considering tension or stress headaches, the electrodes can detect the muscles around the jaw which are tense, and the monitor will display this. The therapist will talk through the readings on the display monitor, so the client understands them.

The therapist through trial and error will be able to work out the specific areas to be ‘relaxed’ or focussed on and will identify these to the patient. Using diagrams and explanations of how the specific muscle is supposed to perform unstressed.

Then practicing a technique such as clenching and realising the muscles around the jaw (progressive muscular relaxation) can be undertaken and new readings can be obtained.

The intention is to teach the patient how to self-administer these techniques just prior to a headache starting by identifying changes are occurring in their own bodies.

Then begin the Biofeedback recommendations to stop the headache before it even occurs.

This is the desired outcome and can be met by frequent Biofeedback sessions and close following of the Aftercare Programme the therapist has outlined. Such as performing specific exercises three times per day, for example.

Biofeedback Therapy – Areas of Treatment 

Biofeedback can be used to treat a variety of health conditions related to The Nervous System.

The Nervous System – is comprised of nerve cells and fibres, this network conveys messages between parts of the body. These messages tell certain parts of the body how to react and when to act.

Biofeedback can treat conditions that are having trouble deciphering these messages or these messages have become hampered in some way.

For example, the signals that tell the heart to beat at a certain speed to regulate the flow of oxygen in and carbon dioxide out the body can become compromised.

In High Blood Pressure HBP the force of blood pushing against the hearts blood vessels is regularly too high and is dangerous if left untreated.  Stressful situations can cause blood pressure to spike.

Although not the No 1 contributor to HBP stress and attacks of anxiety can cause temporary increases of BP in an already elevated state these attacks can again become dangerous to life.

Biofeedback can work to reduce anxiety levels in the interim and protect the body against unnecessary spikes then focus on a more long-term basis on reducing HBP altogether.

Conditions the Biofeedback Machine can treat:

  • Migraines (in particular tension or stress related)
  • Chronic Pain
  • Incontinence
  • Anxiety
  • High Blood Pressure
  • Attention Deficit Hyperactivity Disorder ADHD
  • Coronary Obstructive Pulmonary Disorder COPD
  • Raynaud’s Disease
  • Injury
  • Asthma
  • Constipation
  • Epilepsy
  • Rheumatoid Arthritis
  • Post-Traumatic Stress Disorder PTSD
  • Obsessive Compulsive Disorder OCD
  • Substance use disorders

As can be seen the list is quite extensive and new areas have been and will continue to be added to the list as therapists’ experiment with different conditions.

Types of Biofeedback 

The types of machines used by the trained therapists such as psychiatrists, physiotherapists and psychologists are used to monitor various areas of the body.

The following monitoring machines are used:

Electromyogram EMG: The machine is used to measure muscle activity and tension. The following conditions such as stress headaches, anxiety disorders, back pain, recovering muscles post injury and incontinence.

Take incontinence the pelvic floor muscles may have become impaired and during sudden movements such as exercise, coughing, sneezing etc urine may leak. This can be incredibly frustrating for the sufferer.

The EMG can detect muscles that may not be functioning normally, and the patient can be given exercises to strengthen weakened muscles and/or relax tight ones.

This type of therapy is favoured by many as no medications are used to treat the condition.

Heart Rate Variability HRA: As the title implies this machine measures conditions related to the rhythm or rate of heartbeat. Conditions such as irregular heartbeat, asthma, anxiety, COPD and High Blood Pressure can be regulated and improved by use of specific techniques.

Followed by review on the HRA to see if the heart has regulated. High Blood Pressure may require more sessions to regulate. As many as 20 whereas most other conditions may take only 10.

Neurofeedback EEG: ADHD and Epilepsy can normally be measured by this machine created to measure brain waves.

Electrodermal Activity EDA: is used to monitor anxiety by measuring the sweat produced by the human body. As it is used to monitor sweating it can also be used to monitor pain.

Thermal: is used to monitor the temperature of the skin, this model is used for Reynaud’s Disease and Headaches for example.

Treatment Methods to improve Biofeedback Monitoring 

Mindfulness: this type of meditation is particularly effective for anxiety, where the heart begins to beat faster in a response to the external environment or negative thought patterns and belief systems.

During practising the art of Mindfulness, the patient can focus on their heart for example and breath deeper and longer concentrating on slowing the heart down. Whilst being in the here and now.

Being present in the moment is particularly beneficial as fear and anxiety underpin anxiety. Worrying about the future can bring on such an attack as can living in the past.

Tense/relax muscle techniques, known as Progressive Muscle Relaxation, this form of therapy starts at the lower extremities and slowly works its way up the body until it reaches the top of the head.

The client is encouraged to find a quiet, comfortable place free from distractions and slowly work the way up the body focussing on one major muscle group or area at time.

The muscle is tightened and then released upon release the client is asked to focus on how that part of the body now feels. Using visualisation techniques to visual a smooth calm area.

This technique is used to reduce tension throughout the body and can be practised anywhere once confident.

Relaxation Techniques such as guided meditations are an effective way of reducing the heart rate and feelings of stress and/or anxiety. Guided meditations can be given to the client to take home and practice.

This type of meditation can be short and effective on a lunch hour from work or last thing at night before going to sleep.

Deep Breathing exercises slow down the heart rate and pump more oxygen rich blood around the body. This form of relaxation is helpful when anxious. As the human body tends to take smaller breaths.

Smaller breaths encourage the heart to work harder and muscles to tense. The opposite effect works with deep breathing.

Guided Imagery is used to focus on a specific image to restore calm and serenity to the body. Commonly a beautiful sandy beach can be used or a walk in a flower lined garden.

Biofeedback and Substance Use Disorders

Biofeedback Therapy can be helpful in the management of substance use disorders when popular medicine does not agree with the patient.

Using Biofeedback can monitor the affects drugs and alcohol are having on the body and work to reduce these stresses, gaining an element of control around involuntary effects of substance use disorder.

If the underlying symptoms such as stress and anxiety can be managed the patient may feel more motivated to cease their use of alcohol and drugs as the body feels less of the associated effects.

Biofeedback can also be used to treat cravings or withdrawals. When cravings occur the Biofeedback machine can be used to identify how the body reacts under this stress and coping mechanisms can be implemented such as: Mindfulness, Deep Breathing Techniques or Visualisation Techniques.

The same applies during withdrawal.

Biofeedback and the drawbacks

Duration – sessions can be from 10 to 20. Biofeedback is not known as a quick fix. The equipment used by the therapists should not be rushed. Initial analysis to detect the problem areas may take time. Once identified trial and error occurs until the patient finds the best technique to improve this area of concern

Price – prices vary from practitioner to practitioner and may be too expensive for the patient to undertake. If the NHS provide this service for their condition the waiting list may be considerably lengthy.

Finding a therapist – clients are encouraged to do their homework and once they find a potential therapist read their credentials, qualifications and any reviews they may have. There are not may Biofeedback Therapists in rural areas of the UK and potential clients may need to travel to access this form of treatment.

It may not work – clients are encouraged to be open-minded and optimistic about treatment however in some cases Biofeedback may not work.

Patient may feel discouraged – if Biofeedback does not produce results clients may feel despondent about their future recovery.

Biofeedback – Positive Participant Outcomes

Doesn’t use medications to treat condition – known as non-evasive form of therapy no drugs are administered by the therapist. The techniques allow the body to self-heal.

Can be used in conjunction with medicine – although no medicines are prescribed this form of therapy can be used alongside the use of specific medicines to promote further improvements to ill health.

Patient becomes on teacher – once taught the client can then use the practices at home and administer them daily or as and when required without the assistance of their therapist.

Quality of life can greatly improve – if conditions are managed then the ultimate aim can be achieved. Patients can feel revived and unburdened from the medical condition they initially sought help for.

Patients condition feels validated – this is empowering as they have a trained professional that listens to their concerns and believes them. The Biofeedback monitor can also show the patient what is going wrong. This can be empowering if they have previously felt undervalued or disbelieved by medical professionals or family members.

Biofeedback Therapy is a treatment that uses electrodes placed in different parts of the body to monitor the bodies responses to stress, physical trauma and anxiety.

The information gathered from the electrodes is displayed on a machine by means of flashing lights, images or spikes. This information can be used to show the patient how their body reacts to certain situations or how it is underperforming.

Once identified relaxations techniques such as Mindfulness, Guided Imagery and Progressive Muscular Relaxation can be taught allowing the body to heal itself from the inside out.

Does Abbeycare deliver Biofeedback Therapy?

Abbeycare does not currently offer Biofeedback Therapy. Abbeycare delivers Cognitive Behaviour Therapy and Holistic Therapy.

As with all therapy’s there are similarities in approach.

Abbeycare delivers meditation sessions aimed at quieting the mind and destressing the body. Biofeedback also encourages a form of Meditation known as Mindfulness to regulate the body’s heart rate in a response to environmental stressors.

Where can I find a Biofeedback Therapist?

Biofeedback Therapy is available through the NHS for the treatment of specific conditions such as stress incontinence. However, the NHS will not use this form of treatment for all the health problems outlined.

Private therapists can be found in your area on the web after inputting where to find Biofeedback Therapists in my area.

Some Private Healthcare organisations also deliver Biofeedback, and this can be checked by contacting your provider.

How much does it cost?

Biofeedback varies in price and can cost a few hundred pounds to a few thousand depending on who delivers the sessions. Prices vary due to practitioners expertise and qualifications. And the type and sophistication of the machines used.

How long are sessions and how many do I need to go to?

The length of sessions will be negotiated with the therapist. In most reports around 10 sessions are recommended. However, conditions such as High Blood Pressure may require more.

The patient may also want to return for a top up or regular re-programming session.

Some therapists also offer packages and in some cases these can be more cost effective when balanced with the length of time the therapist spends working through the health conditions.

Can Biofeedback help me stop using drugs/alcohol?

The delivery of Biofeedback is not related to ceasing the use of alcohol or drugs but can be used to help in the withdrawal from these substances.

The body systems can encounter stress related symptoms during withdrawal such as a racing heart. The machine can be used to show the patient the heart beating and the speed at which it is beating at.

Patients can them perform techniques with the therapists guidance to reduce the heart rate displaying a less intense feature on the monitor.

The same applies to any anxious feelings during withdrawal.


About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.


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