An Interdisciplinary Approach:
Reducing Pain & the Effects of Stress and
Trauma…Biofeedback, Neurofeedback & Alphastim
for 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
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Get to know Biofeedback for your patients with
10 Interactive Questions, covering 4 Categories,
in 30 minutes
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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 #1
Which of these complementary or alternative
medicines would you be most likely to consider for
your complex pain patients?
1. Acupuncture
2. Chiropractic
3. Medical nutrition therapy
4. Biofeedback (includes neurofeedback)
5. Medications
6. Hypnosis
7. Meditation, Yoga or Tai Chi
8. Massage
9. Exercise Therapy
10. None of these
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Interactive Question #2
Is the following statement true or false?
Board Certification is available for biofeedback
specialists.
1.True
2.False
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Interactive Question #3
Which of these is NOT a type of biofeedback:
1.
2.
3.
4.
5.
6.
7.
8.
9.
EMG Training
EEG Training
Temperature Training
Hemoencyphalography (pirHEG) Training
Heart Rate Variability (HRV) Training
Skin Conductance Training
Respiration Training
None of these are types of Biofeedback
All of these are types of Biofeedback
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Theoretical Framework of Health
Physiology
Pathology
Biochemistry
Thoughts
Emotions
Behaviors
Biological, Psychological, and
Social
All play a roll in human functioning,
disease, illness, and chronic pain
Overview of Biofeedback Modalities
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.
Source: BCIA
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?
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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.
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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.
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RESILIENCE: Biofeedback emphasizes training individuals to selfregulate, gain awareness, increase control over their bodies, brains,
and nervous systems, and improve flexibility in physiologic
responding.
Interactive Question #4
Is the following statement true or false?
All Biofeedback techniques are non-invasive.
1. True
2. False
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Interactive Question #5
Is the following statement true or false?
Biofeedback is an evidence-based practice.
1. True
2. False
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Interactive Question #6
Based on meta-analysis of current scientific biofeedback
studies, for which of the following diagnoses is biofeedback
rated as an “efficacious treatment of choice”?
1.Anxiety
2.Migraine and/or tension-type headaches
3.Chronic Pain Syndromes
4.Insomnia
5.Neuromuscular disorders
6.Irritable bowel syndrome (IBS)
7.Essential hypertension
8.None of these
9.All of these
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Interactive Question #7
What 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 time
3.I tell them to come back in six months, and hope
things have resolved on their own
4.I tell them medicine can’t help, seek a psychologist
5.I would refer them to a complementary/alternative
medicine expert
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Who is the Ideal Patient for Biofeedback?
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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
Skilled at SelfRegulation, SelfSoothing, Relaxation
Resilient to Effects of
Stress
Psychologic
Improved Mood
Stability
Able to Adjust Pain
Perception
Interactive Question #8
Have 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. Yes
2. No
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Benefits of Biofeedback
Recovery from
Stress Response
Brain-Heart-Breath
Entrainment
Physiologic
SNS and PNS
Regulation
Pain Modulation
Substantiated Results in the Literature
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Reduces blood pressure in
hypertension (McCraty, 2001)
Improves asthma (Lehrer, 2000)
Increases calmness and wellbeing (Friedman, 2000)
Increases emotional stability
(McCraty, 2001)
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Improves cognitive performance
(McCraty, 2001)
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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.Definitely
2.Likely
3.Unsure/Still Skeptical
4.Not likely
5.Not at all
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Interactive Question #10
I have a much better understanding of how
Biofeedback Training contributes to positive
outcomes with pain patients.
1.Yes
2.No
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Hands-on Mock Client Session
You are invited
to a
Live Action Demo
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