Handbook of Health Psychology

By Andrew Baum; Tracey A. Revenson et al. | Go to book overview

often lead to that very state of affair of symptom reduction. People suffering from a significant amount of stress and tension often feel at the mercy of this aversive emotional state, with no effective means of alleviating or personally controlling it. One of the chief attractions of tranquilizers, besides the reduction of the physiological components of stress, is that they allow individuals the comforting perception that they have a means of actively controlling the ingestion of a drug.

Indeed, this same perception of control factor can be seen in nonpharmacological treatments. For example, Goldfried and Trier (1974) demonstrated the effectiveness of muscle relaxation training in reducing anxiety when presented as an active self-control coping skill. This self-control concept has been reviewed as an important component of behavioral treatment techniques (e.g., Goldfried & Merbaum, 1973). Goldfried and Trier found that subjects who were given relaxation training presented as an active coping skill over which they exerted personal control demonstrated a significantly greater reduction in anxiety than subjects who were given identical muscle relaxation training, but that was presented as an “automatic” procedure for passively reducing anxiety.

Of course, the concept of personal or perceived control is not the entire reason why techniques such as muscle relaxation and biofeedback work. The techniques are still effective when relaxation is passively induced. There is little doubt, however, that the psychological or cognitive factor of perceived controllability plays a significant role in the stress reduction process. Indeed, the concept of self-eficacy in the treatment of maladaptive or emotional behavior has been emphasized (e.g., Bandura, 1986). A sense of self-efficacy greatly contributes to the reduction of emotional distress. Thus, direct volitional control of physiology may not only impact on the physiological component of stress, but may also simultaneously affect the other more psychological concomitants of this complex psychophysiological process.


CONCLUSIONS

Physiological self-regulation techniques such as biofeedback have an important place in the rapidly growing field of health psychology. To date, there is a great deal of research demonstrating the efficacy of these techniques in helping to manage a wide array of medically related disorders. It should again be emphasized, however, that more controlled research is needed to unequivocally document effectiveness for many of the disorders. Moreover, these techniques should be viewed merely as important adjunctive treatment modalities to be used as part of a more comprehensive treatment program. Many disorders are far too complex psychophysiologically, and will not be totally responsive to a single treatment modality. Finally, the therapeutic effects of these techniques are not only due to the direct link to physiological activity, but also the psychological process of perceived control. The further investigation of the complex psychophysiological mechanisms underlying the therapeutic efficacy of self-regulation techniques should lead to a greater refinement of training methods and a resultant more effective overall treatment strategy.


ACKNOWLEDGMENT

Some research reported in this chapter was supported by grants from the National Institutes of Health (MH46452, MHO1107, and DE10713).


REFERENCES

Adams, I. D. (1978). Improving stress management: A action- research based OD intervention. In W. W. Burke (Ed.). The cutting edge (pp. 51–78). La Jolla, CA: University Associates.

Annent, J. (1969). Feedback and humalz behavior. Baltimore: Penguin.

Bagchi, B. K. (1959). Mysticism and mist in India. Journal of the Denver Society of Psychosomatic Dentistry and Medicine, 16, 1–32.

Bagchi, B. K., & Wenger, M. A. (1957). Electra-physiological correlates of some yogi exercises. Electroencephalography and Clinical Neurophysiology (Suppl. 7), 132–149.

Bandura, A. (1986). The social foundations of thought and action. Englewood Cliffs, NJ: Prentice-Hall.

Basmajian, J. V. (Ed.). (1989). Biofeedback: Principles and practice for clinicians. Baltimore: Williams & Wilkins.

Benson, H. (1975). The relaxation response. New York: Morrow.

Birk, L. (Ed.). (1973). Biofeedback: Behavioral medicine. New York: Grune & Stratton.

Gatchel, R.J. (1980). Perceived control: A review and evaluation of therapeutic implications. In A. Baum & J. E. Singer (Eds.), Advances in environmental psychology (pp. 1–22). Hillsdale, NJ: Lawrence Erlbaum Associates.

Gatchel, R. J. (1994). Stress and coping. In A. M. Colman (Ed.), Companion encyclopedia ofpsychology (pp. 560–579). London: Routledge.

Gatchel, R. J. (1997). Biofeedback. In A. Baum, C. McManus, S. Newman, J. Weinman, & R. West (Eds.). Cambridge handbook of psychology, health and medicine (pp. 197–199). London: Cambridge University Press.

Gatchel, R. J., Baum, A., & Krantz, D. (1989). An introduction to health psychology (2nd ed.). New York: McGraw-Hill. Gatchel, R. J., & Blanchard, E. B. (Eds). (1993). Psychophysiological disorders: Research clinical applications. Washington, DC: American Psychological Association.

Gatchel, R. J., & Price, K. P. (1979). Biofeedback: An introduction and historical overview. In R. J. Gatchel & K. P. Price (Eds.), Clinical applications of biofeedback: Appraisal and status (pp. 1–11). Elmsford, NY: Pergamon.

Gatchel, R. J., Hatch, J. P., Watson, P. J., Smith, D., & Gaas, E. (1977). Comparative effectiveness of voluntary heart-rate control and muscular relaxation as active coping skills for reducing speech anxiety. Journal of Consulting and Clinical Psychology, 45, 1093–1100.

Geer, J. H., Davison, G. C., & Gatchel, R. J. (1970). Reduction of stress in humans through nonveridical perceived control of aversive stimulation. Journal of Personality and Social Psychology, 16, 731–738.

Goldfried, M. R., & Merbaum, M. (Eds). (1973). Behavior change through self-control. New York: Holt, Rinehart & Winston.

Goldfried, M. R., & Trier, C. S. (1974). Effectiveness of relaxation as an active coping skill. Journal of Abnormal Psychology, 83, 348–355.

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