Biofeedback is a great tool to help rewire the brain to break free from conditioned behavioral responses and adopt new, healthier habits. With practice, this is effective with many conditions and especially helpful with anxiety, high blood pressure, and chronic pain.
According to the Biofeedback Certification International Alliance (BCIA) website:
“Biofeedback is a process that enables an individual to learn how to change physiological activity for the purposes of improving health and performance. Precise instruments measure physiological activity such as brainwaves, heart function, breathing, muscle activity, and skin temperature. These instruments rapidly and accurately ‘feedback’ information to the user. The presentation of this information, often in conjunction with changes in thinking, emotions, and behavior, supports desired physiological changes. Over time, these changes can endure without continued use of an instrument.”
These strategies include more common and accessible therapies such as mindfulness, meditation, and yoga. As mentioned, practitioner-provided tools include technology to monitor heart rate variability, functional breathing, progressive muscle relaxation, and even neurofeedback. While a relative newcomer to medicine, this field continues to gain more traction as a treatment for many medical conditions.
The Stress Response
According to Stephen Porges and his Polyvagal Theory, most people respond to stressors in one of two ways. Some people mobilize and respond as if they are ready to run from the proverbial bear. This is activation of the sympathetic nervous system and leads to dilated pupils, increased heart rate, opening of the airways, and inhibition of digestion. Others tend to immobilize and feign death as a possum might do. This is activation of the parasympathetic nervous system, and the body responds in an opposite manner: constricted pupils, reduced heart rate, constriction of the airways, and stimulation of digestive processes.
While both aspects of the nervous system are critical to our survival, the body’s stress response can often lead to undesirable results such as anxiety, headaches, and high blood pressure. This is especially true if a person spends prolonged time in a state of ‘fight or flight’ constantly running from that bear for instance.
How We Treat
As mentioned in the biofeedback definition above, there are various ways we can monitor a person’s response to the world around them. On a more basic level, this may involve observation and feedback on aspects of functional breathing such as posture and length of exhalation. However, a visit could also incorporate instruments to measure heart and breath rate, the sweat response, body temperature, and even muscle tension. These all provide clues as to how an individual currently orients to the outside world, and then we can discuss how they would like to respond moving forward.
While not necessarily ideal in certain situations, these responses by the body are not flaws in our nervous system. They are safety mechanisms that have been hard-wired and reinforced for years. However, that does not mean we are unable to alter the response to a more desirable one. The key, according to Porges, is that people need to be able to reorient in safety to enact change and this takes practice.
Areas of Influence
Research shows the most efficacious results with biofeedback are with the following disorders:
- Chronic Pain
- Headaches (migraine, tension)
- Raynaud’s Disease
In addition, there is some evidence that this could be helpful with other conditions such as arthritis, diabetes, IBS, and insomnia. More research is needed for chronic lung disease, fibromyalgia, depressive disorders, and PTSD. However, preliminary findings suggest biofeedback can be helpful for these conditions as well. 
What to Expect
Consistency and at-home practice are critical to the process. Initially, we recommend 6-8 weekly hour-long sessions. The first meeting allows for a detailed history on the presenting area of concern as well as answering any questions related to biofeedback. From there, we will commit to a plan that feels safe and move forward one session at a time together. Research shows that practice of 20 minutes twice daily is most effective.
 Porges, Stephen W. The Pocket Guide to The Polyvagal Theory: The Transformative Power of Feeling Safe. New York: W.W. Norton & Company, Inc. First Edition (2017).
 Khazan, Ph.D, Inna Z. The Clinical Handbook of Biofeedback: A Step-by-Step Guide for Training and Practice with Mindfulness. West Sussex, UK: Wiley-Blackwell (2013).
 Yucha, C. and Montgomery, D. Evidence-Based Practice in Biofeedback and Neurofeedback. Wheat Ridge, CO: AAPB (2008).
 Martin, Sara. “The Power of the Relaxation Response”. American Psychological Association. (2008). Volume 39(9).