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What you need to know to perform biofeedback effectively
Article 1: Why You Should Take an Anatomy, Physiology and Human
Biology Course
By Richard A. Sherman, Ph.D.
A competent biofeedback practitioner knows anatomy, physiology, and
human biology. If you are considering taking an A&P course, one that is
designed for potential practitioners of biofeedback as opposed to one
designed for nurses, EMTs, etc., would be more valuable. Because most A&P
courses are designed for people going into a field more closely related to
biology, they don’t concentrate on physiological factors affecting behavior
and vice versa. Rather, you could find yourself counting the bones in the
human foot. Be sure to take a course relevant to your interests.
The following discussion takes you through the topics generally
covered in A&P/human biology courses designed for biofeedback
practitioners. This is an overview and touches on the importance of this
information.
Most A&P courses begin by exploring the chemistry of life. It is easy
to dismiss this information as too basic, but it is important to understand
how neurotransmitters actually work — and the ways they don’t work — to
understand the effect on the human body of impairing this function.
Anything from the physical crimping of the synaptic and other vesicles that
carry neurotransmitters to subtle changes in their receptors can have an
overwhelming effect on our bodies and on behaviors that cannot be altered
with any amount of biofeedback training.
It is also important to understand how foods and drugs affect this
same chemistry. Ingesting the wrong things can disrupt normal operating
processes — and, thus, behaviors — which training cannot overcome.
The body’s chemistry and its organization affect transmission of
electrical currents, which can alter the signals recorded from the skin. Brain
wave (EEG) and surface muscle tension recordings (sEMG) are especially
vulnerable to the body’s currents.
Courses tend to address the very concepts of disease. Know the
difference between structural diseases (such as a crimped nerve) and
functional disorders that relate to the way a physiological system is
working (such as habitually incorrect levels of muscle tension). Structural
diseases are behind many of the functional and emotional problems treated
using biofeedback. Stress reactions cause both functional and structural
diseases. Know the underlying relationships between stress and anatomy
and physiology help identify problems which can or cannot be treated, in
addition to the selecting best approaches.
Medicines intended to treat structural disorders interact with both the
body and the mind. Many of these medicines produce the very functional
and emotional symptoms being treated. Knowing the vocabulary and
understanding the concepts behind medical test results allows improved
communication with other health care providers.
Tissue repair is another vital concept. Know how stress affects wound
healing as well as how the fight-flight response really works. This oftenmisunderstood response can override any training provided unless it is done
right.
Understand the body’s nervous systems. Know what the parts of the
central and peripheral nervous systems are, what they do, and how
they communicate. Be aware that many parts of the nervous system
continue to change throughout life, and these changes profoundly affect
mental processes, pain sensitivity, and emotions. Several neurotransmitters
are produced in one area of the brain and transported to others through, in
effect, tubes, and no amount of biofeedback training can change the
functioning of a part of the brain that simply isn’t getting its supply of
neurotransmitters. An understanding of brain blood circulation is also crucial.
The way to know what clients are reacting to or how to give them
effective feedback is to understand the sensory systems. Ponder these
questions: Are there only five senses? Did you know that pheromones are
probably among the most important social mediators?
Hormones have at least as much control over short- and long-term
behaviors as the nervous system. Without an understanding of the
endocrine system, it’s impossible to know how much of a person’s
interaction style is due to hormones. Hormones and their ever-changing
ratios impact memory systems. In fact, hormonal problems can cause many
behavioral problems treated with biofeedback.
Then there’s the skin. If you understand it, you can understand the
problems that occur when recording stress responses through the skin or
how the skin affects surface muscle tension (sEMG) and brain wave (EEG)
recordings. Also, it is critical to recognize common infectious skin diseases
that patients can unwittingly pass along.
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The muscular system is the area where basic somatic pain systems
are usually discussed. Lack of understanding of (a) how muscles work
together to produce and control motions, (b) posture – pain relationships,
and (c) the complex temporal relationships between muscle tension and pain
has led to ineffective interventions in biofeedback.
In order to understand heart rate variability and its impact on
diseases and stress, an understanding of the cardiovascular system is
required. Treating hypertension isn’t accomplished simply by teaching
people to relax. Teaching people suffering from Raynaud’s or migraines to
warm their hands has little to do with quieting the sympathetic nervous
system. Understanding the cardiovascular system is the key to treating
many related disorders we used to think were simply stress-based. For
example, reflex sympathetic dystrophy is not cured with psychotherapy.
Does teaching relaxation increase immune function? What are the
interrelationships between stress and immune system function. Did you
know that you have 2 to 5 times (200 to 500%) greater chance of
experiencing schizophrenia or other mental disorders sometime during your
life if your mother had the flu during early pregnancy? Is this due to an
immune reaction or the infection itself?
There is a lack of understanding how we breathe or the circulating
chemicals controlling the respiratory system. The cascade of problems
developed by people who habitually breathe even a bit incorrectly is
incredible. Several studies now suggest that roughly half the people who
have received diagnoses of chronic anxiety actually have breathing problems
(not hyperventilation). The anxiety often goes away without further
treatment when the breathing is corrected. Teach correct breathing is
dependent on understanding proper technique.
Likewise, the digestive system needs to be understood in order to
provide more realistic interventions for stomach-related problems. It’s false
to think that childhood migraines are independent of digestive function, and
treating fecal incontinence is based on understanding the system.
The urinary/pelvic floor system is extremely complex. Biofeedback
practitioners treat with many problems impacted by this system, ranging
from pelvic pain to urinary incontinence. Without a full understanding of the
anatomy and physiology of this system, it’s difficult to recognize what can
and cannot be helped. There’s no reason to try training some types of
voluntary muscles to sustain a contraction if they are incapable of doing so.
Knowing the types of muscles and their capabilities aids treatment.
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Misunderstanding of the way the reproductive system works has
resulted in many behavioral therapists ineffectively attempting to treat
physically based impotence and other problems with psychotherapy. There
are overwhelming genetic components associated with many personality
traits and to pain sensitivity, and not knowing the interactions can lead to a
host of ineffective treatments.
This article has provided a rationale in support of taking a course
in anatomy, physiology, and human biology in order to perform biofeedback
effectively. The author, Richard Sherman, Ph.D. is a Past President of AAPB
and teaches basic science and biofeedback training courses.
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