Practice in Clinical & Health Psychology

What is Biofeedback?

Have you ever wished you could simply will your symptoms to disappear? With biofeedback you may be able to learn how to rely less on medications and more on the power of your mind to reduce your symptoms, improve your overall health, and generally feel better.


The word "biofeedback" was coined in the late 1960s to describe laboratory procedures (developed in the 1940s) that trained research participants to alter their brain activity, blood pressure, muscle tension, heart rate and other bodily functions that were believed to be involuntarily controlled by means of the autonomic nervous system. 

"Bio" is a combining word form meaning "life". "Feedback" denotes the concept of giving back information. In simple terms, "biofeedback" means feeding back information about life responses or bodily processes such as skin temperature, muscle tension, heart rate, blood pressure, brain wave activity, etc. Since every cell and function of the body can be influenced by the brain, "feeding" information "back" to the individual about what his/her body is doing influences the system.


Imagine peering inside your body and being able to see how parts of it are working. Imagine watching your muscles.our heart or your breathing, and observing changes as you directly modify these processes. It is possible to do exactly this with biofeedback.


Biofeedback is not just passive monitoring and measurement of physiological processes. Biofeedback is a training technique in which persons are taught to improve their health and performance by becoming more aware of, and using, physiological signals from their own bodies. Biofeedback is done so that the individual will become actively involved in controlling his/her own physiology in some desired manner; hence the term applied psychophysiology.

For example, one commonly used biofeedback device uses sensors taped to the skin to pick up electrical signals from the muscles and translate these signals into a form that the patient can detect. This device triggers a flashing light or activates a beeper every time muscles become more tense. If the patient wants to relax tense muscles, he/she must try to slow down the flashing or beeping. Patients learn to associate sensations from the muscles with actual levels of tension and develop a new, healthy habit of keeping muscles only as tense as necessary for as long as necessary. After such biofeedback treatment, individuals are then able to repeat this response at will without being attached to the sensors.

Other biological functions which are commonly measured and used in similar ways to help people learn to control their physical function are peripheral skin temperature, heart rate, blood pressure, respiration, electrodermal activity or skin conductance, as well as brain blood perfusion and brain wave activity.



Clinicians rely on biofeedback machines in somewhat the same way that you rely on your scale or thermometer. Their machines can detect a person's internal bodily functions with far greater sensitivity and precision than the person can do alone. This information may be valuable. Both patients and therapists use it to gauge and direct the progress of treatment.

Although some people initially viewed these practices with skepticism, researchers proved that many individuals could indeed learn to alter their involuntary responses by being "fed back" information either visually or audibly about what was occurring in their bodies. In addition, studies have shown that we actually have more control over so-called involuntary bodily functions than we once thought possible. As a result, biofeedback can be very effective in training individuals with techniques for living a healthier life overall— whether one is afflicted with a medical condition or not.

While there may not be a precise definition for biofeedback, the following example may demonstrate how we all use biofeedback at one time or another. You may not have given much thought as to how you learned to ride a bicycle, and yet you employed a form of biofeedback in the learning process. If you had to consciously think of all the steps it takes to ride a bicycle, you may not have gotten past the first one. As you pedaled the first few shaky meters, your brain was processing the feedback it was getting from your body as it sought to balance on the bike. Your brain made automatic adjustments in your body's weight distribution and centre of gravity in order to achieve the balance necessary so you could keep pedaling and stay on the bike.

The application of biofeedback to health disorders is not new. In the ancient world, especially Eastern cultures, Yogis were able (and still are) to control so-called 'involuntary body reflexes' such as respiration and heart beat. By slowing down body functions, they were able to induce conditions that a more active or conscious body could not.

Biofeedback has found increasing acceptance in the psychological profession as practitioners seek alternative methods to drug therapies. For many people, living with pain and stress has become the price for living in the modern worId. While drug therapy might be effective, there are many people who are concerned about drug side effects. Moreover, drugs do not give you personal control over symptoms in the same way that biofeedback can. For some disorders, drugs only mask the more unpleasant symptoms but fail to correct the underlying problem but biofeedback together with appropriate psychotherapies— such as cognitive, behavioral, or schema-based therapies— can  frequently give us the tools to actually correct the conditions that cause psychological or physical health problems.



Biofeedback has been demonstrated especially effective in the treatment of acute and chronic illnesses that are stress-related, anxiety-driven or involve autonomic nervous system dysfunction. More recently, biofeedback of brainwaves or EEG has demonstrated efficacy in the treatment of seizure disorders, alcohol and drug addictions, and attention-deficit disorder in both children and adults. EEG biofeedback is also showing great promise in the treatment of other brain-based disorders such as anxiety, depression, insomnia, and cognitive and motor dysfunction resulting from head injury or stroke.

Some conditions that are treatable or can be improved with biofeedback are…

  • Anxiety Disorders, including panic and OCD
  • Asthma
  • ADHD/Attention-Deficit Disorder
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Chronic Pain Disorders
  • Headaches (both migraine and tension)
  • High Blood Pressure/Low Blood Pressure
  • Insomnia
  • Irregular heart rhythms
  • Irritable Bowel Syndrome
  • Knee Pain/Patella Femoral Syndrome
  • Muscle guarding and bracing
  • Panic Attacks
  • Cold hands or Raynaud’s Syndrome
  • Stress-Related Health Problems
  • TMJ and jaw tension
  • Traumatic Brain Injury
  • Stress-Related Health Problems

Biofeedback therapists are professionals-- most often psychologists-- who are trained in biofeedback technologies and their application to human functioning. Many biofeedback practitioners are certified through the Biofeedback Certification International of Alliance (BCIA).

Typically a bachelor's or master's degree in a health care field is required followed by didactic biofeedback education, clinical supervision, and physiology coursework. The BCIA's requirements for certification are quite stringent and include a code of ethics.

Many biofeedback practitioners are also members of such voluntary professional groups as the Association for Applied Psychophysiology and Biofeedback (AAPB).

[NOTE: Dr. Horst Mueller is a registered psychologist with BCIA certification. He is also a member of AAPB.]

Pros and Cons of Biofeedback

Biofeedback may appeal to you for several reasons:

  • It can reduce, or even eliminate, your need for medication.
  • It has the potential to help conditions that have not responded to medication.
  • Even in cases that are responding well to medications, biofeedback can be effective as an adjunctive therapy to increase positive response and possibly reduce the amount of medication required.
  • Unlike many medications that may simply mask symptoms, biofeedback often affects the underlying physiological imbalance that may be the root of your illness.
  • It is non-invasive and proven generally safe with minimal risk of adverse effects.
  • It helps puts you in charge of your own healing by providing measurable feedback, allowing you to monitor your progress and learning.
  • It can decrease your medical costs.

On the other hand, you may be hesitant to try biofeedback because experts aren't entirely sure how the therapy works. Many people who have tried biofeedback can't explain how they're able to control their bodies to relieve their symptoms.

Biofeedback is a learning tool, not a magic pill or instant cure and, therefore, requires a relatively high degree of commitment and effort.

Although biofeedback by itself has been shown to be an effective treatment for many different health problems, it is often more effective as part of a broader treatment strategy that may include psychological or lifestyle counselling, changes in activity or exercise and nutrition, and other physical therapies.

Medical practitioners generally view biofeedback as an adjunct or complementary treatment to more conventional medical and pharmacological treatments.

To truly assess whether biofeedback is effective in treating your particular symptoms, keep a daily diary to monitor your use of the treatment as well as how you feel before, during and after the therapy.


Biofeedback for Stress Reduction. Probably the most common application of biofeedback is in teaching individuals to better manage stress. A biofeedback practitioner can use his/her biofeedback equipment to help you become aware of when your body is responding in an unhealthy manner to stressful situations-- say with tensed muscles or shallow, rapid and erractic breathing-- and help you learn to control this reaction. Biofeedback is very effective in teaching people how to reduce their physiological "flight or fight" response to physical and psychological stressors.

Biofeedback for Headaches. Several published studies compiling the results of previous research have found that people can effectively reduce the frequency and severity of headaches by up to 50% or more with biofeedback training. According to American Academy of Neurology guidelines, thermal biofeedback along with relaxation training and electromyographic (EMG) biofeedback may be helpful in preventing migraines. Thermal biofeedback involves changing your skin temperature, and thus your blood flow, while EMG biofeedback involves altering your muscle tension.

Biofeedback for High Blood Pressure. Although research to date has found conflicting results, biofeedback may be helpful in lowering high blood pressure. With effective biofeedback training-- especially heart coherent breath training-- you may be able to lower your blood pressure by 6-12 mm Hg. While this is less than you can generally expect from medications, even relatively small decreases in blood pressure can be beneficial for your health. Moreover, there is some evidence pointing to biofeedback as particularly helpful for individuals with higher blood pressure.

Biofeedback for Raynaud's Syndrome. In this condition, spasms in the blood vessels supplying your hands and feet reduce the blood flow to these parts of the body. As a result, your fingers or toes may become numb or painful and the skin turn white or even blue. Thermal biofeedback, in which you learn to influence blood flow by observing your skin's temperature, may decrease the severity and number of Raynaud's attacks.

Biofeedback for Stroke Rehabilitation. Biofeedback may be a useful tool in helping people regain functions that have been affected by a stroke. For example, biofeedback may help stroke-related paralysis, loss of balance, and difficulty swallowing, according to a recent study.