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Yagmur Idil Ozdemir, April 7 2021

Biofeedback - Listen to your body

How many times have we heard this golden advice: 

“listen to your heart”

or this one

“listen to your gut”

Everyday we listen to our own body to navigate through our highly complex psychosocial and physical world. Our daily decisions and actions depend on us judging a variety of external factors and how they affect us. We do this constantly by deciphering our internal messages and attributing them to correct external causes. 

We practice this matching between our external world and our inner life every day, without realising, even when we eat; we not only need to both know if a food source is available externally, but we need to “have a feel for” our stomach to understand if we need/want to eat. Based on what our stomach tells us, then we make a decision. Researchers and healthcare professionals who study biofeedback could say that this simple case of deciding to eat is an instance of using biofeedback. Dr. Inna Khazan, a Harvard-trained clinical health and performance psychologist, describes biofeedback as the clearest and most effective way to understand the messages your body is sending you, and know what kinds of changes you need to do to address them. Biofeedback is hardcoded in our survival that depends on us taking action in the outside world to meet our internal needs (Khazan, 2013, 2019)

 “Biofeedback is the clearest and most effective way to understand the messages your body is sending you, learn to recognise them before the signals intensify, and know what kinds of changes you need to make and how to make them.” - Dr. Inna Khazan

Our ability to self-regulate normally functions well to adapt us to our complex environment, and maintain our health and social wellbeing throughout our life-span. However, research shows that this ability gets disrupted by major events such as trauma, chronic stress, physical or mental illness and chronic pain. Researchers note that disruption in self-regulation is common and can also be seen in contemporary societal problems such as obesity and addiction (Heatherton & Wagner, 2011). Nearly 40% of deaths in the US are mediated through disruption in self-regulation, and further research shows that those who show better self-regulation have improved social relationships, job success and mental health (Duckworth & Seligman, 2005Tangney et al., 2004).

Our physiology is an important entry point to self-regulation of our psychological and psychosocial wellbeing . (Niedenthal, 2007, Weerdmeester et al., 2020) dysregulation in our physiological parameters underpins many problems in mental health (American Psychiatric Association, 2013, McKay & Storch, 2011). This is, to the extent that for diagnoses of generalised anxiety disorder and, posttraumatic disorder, physiological dysregulation of the individual serves as an important diagnosticis criteria ((American Psychiatric Association, 2013; Ebner-Priemer et al., 2007). Yet researchers note that a focus on physiology in mental health interventions is largely missing. 

Biofeedback describes a methodology, which can be entirely internal (and autonomous), or external (and controlled) using biofeedback devices. Biofeedback devices typically integrate physiological data collection, analysis and feedback to enable individuals to understand and regulate their health and performance. 

A biofeedback system first collects data from a variety of physiological signals our body produces, such as breathing, heart rate, muscle tension, finger temperature, through wearable or non-wearable sensors. Examples for these sensors include thermometer, breath pacers or sophisticated devices like EEG headsets. Then, the system analyses these biological signals, and displays to the individual appropriate feedback, in forms of physiological readings reflecting autonomic balance. This display can be either through vision, such as animation and games, or hearing, such as pitch in music, or haptics (Snyder et al., 2015; Yu et al., 2018). After being informed of their effect on physiological parameters of interest, individuals try different intervention methods such as breathing techniques, to bring these physiological readings to the desired range. This iterative process can look like trial and error, with the training results becoming a motivating factor for the participant.  (Yu et al., 2018).

This training can be either mentored with a healthcare professional, or done individually, with each session of 3 minutes to months, implemented in a multi-session training programme that can take up from 3 days to 3 months (Yu et al., 2018).

Biofeedback systems are extensively used in stress management as hypothalamus, a key regulator of autonomic nervous system, gets activated in response to stressors. Various studies show that certain biofeedback systems that we will further describe in our next blog posts have pronounced effect in reducing stress and anxiety (Goessl et al., 2017) 

Check our earlier blog posts which describe the neural mechanisms involved in stress and particularly chronic system, which substantially affects the balance between sympathetic and parasympathetic nervous systems that make up the autonomic balance. 

In our later blog posts we will delve in to the specific modules within biofeedback, but as a start point we will quickly highlight some commonly used biofeedback systems: 


Written by

Yagmur Idil Ozdemir


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