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BIOFEEDBACKA Mind‐Body Approach for Reducing Stress
Wanda Mandell, Psy.D.
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“Biological Feedback” (bio‐feedback)– coined in 1969
Biological activity is collected, processed, and conveyed back to the individual in a meaningful way. The individual uses this data to learn how to modulate his or her own biological activity to improve self‐regulation and health.
raw biological activity
meaningful info
Biofeedback: Mind‐Body Help for Stress
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Chronic Stress
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‐ Peaks of stress
‐ Valleys of relief
Baseline
We learn to reset to a new “normal” across time
Stress can Be Sneaky
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!
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“SNS” “PNS”
Arousal Resting
System System
(Accelor‐ (Brake)
ator)
Autonomic Nervous System(Automatic, Unconscious, Involuntary)
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The Good News!
Stress Levels Over Time
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Physical Headaches
Indigestion
Stomachaches
Sweaty palms
Sleep difficulties
Dizziness
Back pain
Tight neck, shoulders
Racing heart
Restlessness
Tiredness
Ringing in ears
Behavioral Excess
smoking
Bossiness
Compulsive gum chewing
Critical attitude
Skipping meals
Decrs exercise
Loss of sleep
Jumpiness
Grinding teeth at night
Overuse of alcohol
Compulsive eating
Difficulty getting things done
Emotional Crying
Emptiness
Nervousness
Boredom‐ no meaning to things
Edginess
Feeling powerless to change things
Overwhelming sense of pressure
Anger
Loneliness
Unhappiness for no reason
Easily upset
Cognitive Trouble
thinking clearly
Forgetfulness
Lack of creativity
Memory loss
Inability to make decisions
Thoughts of running away
Constant worry
Loss of sense of humor
Racing thoughts
Fixating on one something
Relational Resentment
Loneliness
Clamming up
Lashing out at others
Lack of intimacy
Intolerance
Hiding
Distrust
Less contact with friends
Using people
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ASSESSING STARTING POINTS IS IMPORTANT
BF Measures Automatic Events:
1. Finger temperature
2. Perspiration
3. Peripheral blood flow
4. Muscle tension
5. Breathing*
6. Heart Rate Variability
7. (Neurofeedback)
BF Taps into the Autonomic Activity
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ANS affects finger temperature – how?
Simulation
Like PT: training then daily practice
Keep track of progress, triggers
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1. BF and Finger Temperature
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1. Sit with feet flat on the floor2. Breathe deeply3. Think ‘warm, heavy, relaxed’, etc.4. Keep it up until completely relaxed5. Aim: 95F for 5 minutes
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Volition is making a decision. Passive volition a BF term
Thinking too hard, competing, willing change to happen—do not work.
BF control is ‘letting go’: allowing yourself to take your foot off the accelerator and engage the braking system
Check your thoughts: “I can’t relax”, “It won’t work for me”. Breathe out worry. Breathe in adventure. And have fun experimenting.
Taking Control by Letting Go Paradox“Passive Volition”
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2. BF and Perspiration
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Electro‐Dermal Activity (EDA) aka Galvanic Skin Response (GSR). Measures electrical properties of the skin.
2 electrodes on the skin; low voltage is applied
BF does not measure amount of sweat. It measures electrical conductance. The more sweat, the more current in the circuit
BF and Perspiration cont’d
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Photoplethysmograph (PPG)
Aka BVP, Blood Volume Pulse
Based on peripheral Blood Flow
Shines a light through the flesh,
backscatters, signal indicates
blood volume.
ANS effect on blood flow
Example: Stress Erasers
3. BF for Peripheral Blood Flow
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4. BF for Muscle Tension
Forehead to Trapezius
Forehead, corrugator muscle
Bruxism (grinding teeth)
Jaw clenching
Jaw +/or neck tension = HA
Stiff neck
Muscle knots: base of neck,
shoulder blades, spine
Tension Triangle
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Muscle BF EMG BF – “electromyogram”
Sensors are placed on the skin over any muscle
Measures electricity from muscle contractions
Relaxation and/or strengthening taught
BF for Muscle Tension
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Progressive Muscle Relaxation – except fibromyalgia
Regular exercise‐ conditions body to cope w/stress, rid toxins
Yoga, stretches
Neck rolls, shoulder shrugs, pinching shoulder blades
Relax tongue and forehead
Sitting in one place > 1hr is too long.
Massages to lengthen fibers
Good posture
Help for Tense Muscles(Things you Already Know)
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Reintroduces a sense of control over self: “I canmake changes”
Empowers the person
Teaches gradations: not all black or white
Body awareness
Shows the power of thought
Cautions: PTSD keeps a person on guard; anyone can have discomfort with the feeling of letting go and relaxation sensations if constant stress is ‘normal’
Other Benefits of BF
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“In a world that is straining our stress response systems with pressure, trauma, uncertainty, and threats, the autonomic system spends too much time in the fight/flight zone. The tide of distress and dysfunction, which is overwhelming health care systems, will not be stopped by medications alone, nor by one‐on‐one therapies or expensive high‐tech treatments.” (Psychiatric Times, April 2016.)
“Integrative Medicine”
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Basic BF exercises:
1. Count breaths per minute (or 30 sec x2)
2. Assess breathing movement
5. BF: Respiration
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In general for the average ‘healthy’ adult:
Breath Cycles Per Minute
18+ = triggers anxiety
12‐18 = alert, not relaxed
8‐11 = relaxed
4‐7 = coherence
Breathing Rate and Stress
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Breath Rate and GSR Biofeedback
PNS indicated by higher resistance readingSNS (sweaty hands) indicated by lower resistance readings
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Types of Breathing
Shallow breathing is chest breathing (and will move a hand resting on the chest).
Deep breathing is diaphragmatic breathing (and will move a hand resting on the belly).
Old saying:Partial breathing is partial living
Side effects of changing breathing patterns: dizziness, yawning, diaphragm pain
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Breathing Biofeedback
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It’s learning to let go of the chronically on guard tight abdominal muscles that constrict and/ or prevent deep breathing.
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Inhalation increases heart rate (SNS)
Exhalation decreases heart rate (PNS)
Respiratory Sinus Arrhythmia (RSA)
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(Straws can help)
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Wearable BF Device:The Spire
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HRV BF is where it’s at these days
HRV BF offers the best insight into overall health
This last section focuses on HRV
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6. BF and Heart Rate Variability (HRV)
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Measures From Heartbeats
There are different measures of the heartbeat:
1. Heart rate ‐ counting heart beats per minute
2. HRV is measuring time between heart beats
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More time variation occurring between heart beats indicates a healthier PNS. It is referred to as having ‘higher HRV’. Having ‘lower HRV’ means the time between heart beats is less variable and more like a metronome. Low HRV is not desired.
HRV cont’d
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Feelings of well being Negative feelings
Clear thinking Worry, burn out
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Measuring HRV Gets Very Sophisticated Why not just measure heart rate (beats per minute)? People can have low heart rate but have poor HRV ifover‐trained, overwhelmed with stress, etc.
HRV affected by overall health, fitness, and age. As well as substance ingested, sleep, illness. The heart profoundly affects the brain, including thoughts and mood states…
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Polyvagal Theory (Porges) emphasizes that autonomic nervous system functioning plays a key role in social behavior and emotion. The theory predicts disorders of social dysfunction are associated with reduced heart rate variability, an index of autonomic control, as well as social inhibition and avoidance.
Breathing low and slow (belly breathing)
Exercise (consistent and moderate)
Nutrition
Sleep
Releasing muscular tension
Letting go of anxious thoughts (quieting the mind)
Stimulating the vagus nerve (numerous ways)…
Coherence breathing…
Heart focused breathing…
Ways to Increase HRV for Resiliency
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The Vagus Nerve
One branch connects heart and brain: the mind‐body connection
More info goes from heart to brain than brain to heart.
A branch connects the face muscles, voice production
Why care about the vagus nerve?
Increased vagal tone increases HRV
Increasing HRV: VAGAL STIMULATION
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Stimulate the vagus nerve by:
Singing, chanting, humming (i.e., cat’s purring)
Controlled glottis breathing (resistance)
Cold water on face (diver’s response)
Increasing HRV: VAGAL STIMULATION cont’d
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COHERENCE is a phenomena that occurs when the rhythmic patterns of the heart and the body are in synch.
Increasing HRV: COHERENCE
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Stimulating a system at its own resonance frequency maximizes its oscillation.
Take the effect of breathing on our brain/body. It takes about 10 seconds for one breath to cycle inside our bodies.
How could this 10 second cycle be stimulated at its own frequency to maximize it?
By breathing 6 breaths per minute
This is known as coherence or resonant breathing
Traditional chanting of the Latin Hail Mary occurs at 6bpm
Zen Buddhist monks have long practiced Zazan (6pbm)
Increasing HRV: COHERENCE
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How To Use Heart Rate Variability To Increase Mental Performance
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Increasing HRV: HEART FOCUSED BREATHING
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HRV BF Devices
B
A
ED
C
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