Biofeedback and autogenic training are sophisticated techniques aimed at helping people to become more aware of certain body functions of which they are normally unaware and at teaching control of such functions. To a large extent the techniques are concerned with teaching people to induce relaxation and thus cope with anxiety, tension and stress. The ability to cope with stress is of paramount importance in relation to general health. There is a general concensus among the medical profession that many illnesses are either caused directly by stress or that stress plays an important contributory role. Among conditions associated with stress are high blood pressure, peptic ulcer, asthma, heart disease, stroke, epilepsy, headache and backache.
Historically, biofeedback is the older of the two techniques. It involves using different kinds of instruments which can relay information about what is going on in your body, so that you can train yourself to exert a degree of control over internal processes. The origins of biofeedback go back to the Indian yogis who learned to control involuntary body processes such as heart rate. Late in the eighteenth and nineteenth century scientists discovered some of the principles which govern biofeedback. The French neurologist, Charles Ferre in the early 1900s found he could monitor variations in mood by measuring fluctuations of skin resistance. Because tension increases perspiration, electrodes placed on sensitive areas of skin and attached to a monitoring device can reflect changes of mood.
Interest in the potential of biofeedback for the treatment and prevention of illness increased in the 1960s when a number of American researchers showed that they could use biofeedback to train their subjects to control brainwave activity, to reduce blood pressure, to induce relaxation states and even to learn to raise the skin temperature at the fingertips. They developed a number of different kinds of monitoring equipment which today forms the basis of biofeedback techniques, such as: . electrical skin resistance, which can monitor the degree of nervousness or relaxation. Electrodes are connected to the palm of the hand, the fingertips or the sole of the foot. . electroencephalogram (EEG), which shows brain wave patterns, reflecting different levels of consciousness and moods. . electromyogram (EMG), using electrodes attached to the forehead to measure muscle tension. . Skin temperature, which uses thermistors attached to the fingertips to monitor the temperature of the skin. In a typical biofeedback set-up the patient is connected to an instrument which monitors some bodily function such as brain activity, heartbeat, skin resistance or skin temperature. The information is relayed to the subject either as a visual sign – the rise and fall of a needle on a chart, or a change in colour – or as an auditory signal – a change in tone or in the rate of a beat. Using this signal the subject is taught to recognize which patterns correspond to stress and which correspond to relaxation. By trial and error the patient gradually learns what to do and feel to produce ‘tranquility’ and eventually should be able to reproduce the same state of relaxation without the aid of the machine.
Applications of biofeedback
Proponents of biofeedback techniques advocate its use in any illness in which tension is a component. Biofeedback has been found particularly useful in treating high blood pressure, spastic colon, migraine headaches, irregular heartbeats and backache. Its main advantage, however, is that it can be used as a means of disease prevention, by helping patients to control tension and anxiety before they result in a disease, and before patterns of tension are well established in the body.
The following examples illustrate the principle of biofeedback as it is used in the control of tension headaches and blood pressure.
Electrodes are attached to the forehead in order to measure movements of the muscles of the forehead. These movements are electronically detected, amplified and fed back to the person in the form of an auditory signal. This signal increases in pitch when the muscles contract and decreases in pitch when muscles relax. By learning to control the pitch of the tone, the individual learns to keep the forehead muscles relaxed which also ensures relaxation of the scalp and neck muscles.
This involves the control of activities that are normally assumed to be autonomic and therefore not under voluntary control. In one procedure patients are shown a graph of their blood pressure while it is being monitored and are taught ways of relaxing various muscle groups that are normally found to be tense when blood pressure is high. This involves instructing patients to concentrate on tensing and releasing the tension in particular muscles and noticing the difference in sensation. The most effective way of doing this is by tensing muscles in turn, starting with the feet and ankles arriving eventually at the muscles controlling the face and neck.
Autogenic training, or relaxation training, like biofeedback, aims at teaching the person to relax and to gain conscious control of body functions which are normally controlled unconsciously. The physiological and biochemical effects are similar to those observed in biofeedback and the technique can be used to treat a similar range of disorders. The main difference lies in the fact that autogenic training does not rely on any apparatus or equipment and can be practised almost anywhere and at anytime.
Autogenic training was developed more than fifty years ago by a German neuropsychiatrist, Professor Johannes Schultz (1884-1969). Schultz’s ideas were similar to those of an earlier therapist the French pharmacist Emil Coue (1857-1926). By 1910 Coue had pioneered a self-help therapy which basically consisted of suggesting that people should say to themselves the sentence ‘Every day, in every way, I am getting better and better’. Schultz decided to develop this form of autohypnosis into a method of using exercises to train the mind in order to influence the body.
At first sight autogenic training appears to be a simple relaxation method, but in fact it involves specialized skills that should not be attempted without training and supervision. It is usually performed in one of three positions: sitting semi-slumped on an upright chair, sitting in an armchair, or lying on the back. The eyes are closed and the legs and feet comfortably apart; ideal surroundings have as few sensory distractions as possible.
The key to autogenics is to assume an attitude of passive awareness and concentration so that the individual is passively aware of the reactions, both sensory and motor, that occur in the body. The technique involves the mental repetition of specific autogenic verbal formulae during which time the individual’s mental attention is passively concentrating on a particular part of his or her body. For instance, the verbal formula may be ‘my right arm is heavy’.
The training incorporates six such mental exercises, starting with suggestions of heaviness in the limbs, progressing to warmth in the limbs, then calmness and regularity of the heartbeat, awareness of a natural breathing rhythm, followed by suggestions of abdominal warmth and, finally, a feeling of coolness across the forehead.
The technique is learnt over a period of about two months during weekly small classes lasting two hours or so. Between classes trainees are required to practise for five to ten minutes, three or four times a day and to keep a diary of their experiences during the sessions. Once learnt it is essential to practise the technique regularly if the person wishes to continue to benefit from autogenics.
Advocates of autogenic training claim that, apart from its use in treating various disorders that can be diagnosed as stress-related illnesses, regular practise of the technique can enhance general health and well-being, and help to promote inner calm and higher levels of functioning.