An Interdisciplinary Approach:Reducing Pain & the Effects of Stress and Trauma…Biofeedback, Neurofeedback & Alpha-stimfor the Patients of Primary Care Physicians

Melanie Berry, MS, BCB, BCBS, FAIS

Carolinas Biofeedback Clinic, LLC

www.CBFclinic.com

888.317.5605

Agenda: 10, 4, 30 Get to know Biofeedback for your patients with

10 Interactive Questions, covering 4 Categories, in 30 minutes Define it Teach you what conditions it is used for Help you select the right patients Help set your expectations for results

Let’s begin with 3 questions…

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Interactive Question #1Which of these complementary or alternative medicines would you be most likely to consider for your complex pain patients? 1. Acupuncture2. Chiropractic3. Medical nutrition therapy4. Biofeedback (includes neurofeedback)5. Medications6. Hypnosis7. Meditation, Yoga or Tai Chi8. Massage9. Exercise Therapy10. None of these

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Interactive Question #2Is the following statement true or false?

Board Certification is available for biofeedback specialists.

1.True2.False

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Interactive Question #3

Which of these is NOT a type of biofeedback:

1. EMG Training2. EEG Training3. Temperature Training4. Hemoencyphalography (pirHEG) Training5. Heart Rate Variability (HRV) Training6. Skin Conductance Training7. Respiration Training8. None of these are types of Biofeedback9. All of these are types of Biofeedback

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Theoretical Framework of Health

Biological, Psychological, and Social

All play a roll in human functioning,disease, illness, and chronic pain

ThoughtsEmotionsBehaviors

PhysiologyPathologyBiochemistry

Overview of Biofeedback Modalities

Source: BCIA

Modality Description

Brainwave (EEG)

Uses scalp sensors to monitor the brain’s electrical activity using (EEG) sensors

Breathing Uses bands placed around the abdomen/chest to monitor breathing pattern and pace and calculate resonant breathing frequency.

Heart Rate Variability (HRV)

Uses a finger/earlobe sensor to measure heart rate and calculate heart rate variability and coherence.

Muscle (EMG) Uses sensors placed over skeletal muscles to monitor the electrical activity that causes skeletal muscle contraction.

Sweat Gland (GSR)

Uses sensors placed around the fingers to monitor changes in skin moisture produced by sweat glands.

Temperature Uses a finger sensor to measure changes in blood flow controlled by dialating and constricting blood vessels.

Psychosomatics and Psychopathology

“Autonomic Imbalance and

Decreased Parasympathetic Tone in particular may be the final common pathway linking negative affective states and dispositions,

including the indirect effects via poor lifestyles, to numerous diseases and conditions as well as

increased mortality, and it may also be implicated in psychopathological conditions”.

Thayer & Brosschot, 2005, p. 1053

What is Biofeedback? BASIC: Biofeedback is a technique that enables an individual to

learn how to change maladaptive physiological activity and correct dysfunctional Autonomic Nervous System (ANS) activity

SCIENTIFIC: Biofeedback instruments are used to “feed back” information about physiological processes, assisting the individual to increase awareness of these processes and to gain voluntary control over body and mind.

HOLISTIC: Biofeedback is based on the recognition that changes in the mind and emotions affect the body, and changes in the body influence the mind and emotions.

RESILIENCE: Biofeedback emphasizes training individuals to self-regulate, gain awareness, increase control over their bodies, brains, and nervous systems, and improve flexibility in physiologic responding.

Interactive Question #4Is the following statement true or false?

All Biofeedback techniques are non-invasive.

1.True2.False

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Interactive Question #5Is the following statement true or false?

Biofeedback is an evidence-based practice.

1.True2.False

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Interactive Question #6Based on meta-analysis of current scientific biofeedback studies, for which of the following diagnoses is biofeedback rated as an “efficacious treatment of choice”?

1.Anxiety2.Migraine and/or tension-type headaches3.Chronic Pain Syndromes4.Insomnia5.Neuromuscular disorders6.Irritable bowel syndrome (IBS)7.Essential hypertension8.None of these 9.All of these

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Interactive Question #7What do you do with the patient that does not get better despite all your efforts and continues to return to your practice?

1.I tell them there is nothing more I can do for them 2.I tell them to keep trying what we are already doing, give it time3.I tell them to come back in six months, and hope things have resolved on their own4.I tell them medicine can’t help, seek a psychologist5.I would refer them to a complementary/alternative medicine expert

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Who is the Ideal Patient for Biofeedback? Individuals who want a more active role in their own

health care Ones looking for non-invasive treatment options Those who WANT or NEED alternatives to meds Cases involving past trauma Patients who express hopelessness or helplessness Multi-symptom, complex cases in which conventional

interventions have minimal success Pain patients with secondary anxiety, depression,

insomnia, PTSD, etc.

NOTE: Skeptics are welcome!

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What it Looks Like in the Individual

Camp Pendelton, Neurofeedback, PTSD Veteran

Benefits of Biofeedback

Interactive Question #8Have you ever had a patient who is experiencing unrelenting pain, but for whom there is no apparent anatomical origin (i.e., via X-ray, MRI, CT scan, etc.)?

1. Yes2. No

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Benefits of Biofeedback

Substantiated Results in the Literature

Reduces blood pressure in hypertension (McCraty, 2001)

Improves asthma (Lehrer, 2000)

Increases calmness and well-being (Friedman, 2000)

Increases emotional stability (McCraty, 2001)

Improves cognitive performance (McCraty, 2001)

Improves hormonal balance (McCraty, 1998)

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The greatest revolution of our time is the knowledge that human beings, by changing

the inner attitudes of their minds, can transform the outer aspects of their lives.

-William James

Interactive Question #9

How likely are you to think of biofeedback as a possible intervention for one of your pain patients?

1.Definitely2.Likely3.Unsure/Still Skeptical4.Not likely5.Not at all

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Interactive Question #10I have a much better understanding of how Biofeedback Training contributes to positive outcomes with pain patients.

1.Yes2.No

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Hands-on Mock Client Session

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You are invited to a

Live Action Demo