Clinical Applications of Biofeedback
Biofeedback means providing immediate information regarding physiological processes about which the individual would normally be unaware. Thus, a person might be provided with information regarding muscle potentials in the forearm, or level of blood pressure, heart rate, or perhaps the type of brain wave being produced at that moment. According to a basic premise in biofeedback applications, if an individual is given information about biological processes, and changes in their level, then the person can learn to regulate this activity. Therefore, with appropriate conditioning and training techniques, an individual can presumably learn to control body processes that were long considered to be automatic and not subject to voluntary regulation. As outlined in this chapter, there is some evidence to support the basic premise that the provision of feedback has specific effects, for instance, that information about skin temperature and muscle tension can lead to self-altered and regulated levels of each.
The basic premise regarding learned control over physiological responses has theoretical and practical implications. On the theoretical side, it means certain physiological processes controlled by the autonomic nervous system (e.g., blood pressure, heart rate, skin temperature) must be reexamined to determine the extent to which they are subject to voluntary control. On the practical side, it offers the possibility that physical maladies, such as hypertension (high blood pressure) or cardiac arrhythmias (irregular heartbeats), may be alleviated by self-regulation.
The studies reviewed in this chapter represent only a small portion of the clinically oriented biofeedback research that has been generated in the past 30 years, and, hence, they can only be considered as a representative sample of the work performed. The attempt is to describe what clinical researchers have been doing and concluding about their applications of biofeedback to specific human disorders. The potential benefits of this research are great. However, overenthusiastic or premature claims about therapeutic effectiveness could harm the field by reducing its credibility. Again, biofeedback researchers and therapists would do well to heed the advice of Miller ( 1974). who said that, "this is a new area in which investigators should be bold in what they try but cautious in what they claim" (p. xviii).
An additional research area covered in this chapter is "psychoneuroimmunology." As the name implies, this field examines the relationships among behavior, brain function, and the immune system. It is included in this chapter because factors that influence the immune response, either negatively or positively, have been studied in the context of stress, relaxation and self-regulation. The Association of Applied Psychophysiology and Biofeedback has been active in encouraging psychoneuroimmunology research through inclusion of presentations by keynote speakers and empirical papers at its annual meetings.
There are a number of questions regarding biofeedback training (BFT) that require answers. For example: