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I
TEACH STRESS MANAGEMENT;
WHAT DOES BIOFEEDBACK
HAVE TO DO WITH ME?
Laurie
van Someren, M. A.
This article appeared in the 10/99 issue of STRESS NEWS,
the quarterly journal of ISMA-UK
Most
teaching of stress management gives people tools and training
to help them to help themselves. In contrast to the medical
model of I am ill, doctor - give me pills! Stress Management
training offers concepts from the wide range available,
and help in applying them to the particular situations the
sufferer finds distressing. This might include advice on
cognitive restructuring, to allow the sufferer to reconceptualise
the way they are treated by someone else to make it more
bearable. Or it might be as simple as a concept about time
management.
One group of sufferers who are particularly hard to help
is those who feel themselves as powerless Victims, unable
either to alter the stressors they work under, or their
physical reaction to them. You may flinch with recognition
of the type! But it is the work of two to three minutes
with a Relaxometer to show them: First that the harmless
little box tells them something about what is going on inside
them. When the pitch of the tone goes up, they are getting
more aroused. Then that if they sit back, relax, and compose
themselves a bit, the pitch of the tone DOES go down. They
CAN relax! This recognition that they themselves have the
capacity to get to a more relaxed state is the starting
point for powerful interventions.
Depending on the particular sufferer, you may want to emphasize:
Here is a mind-body link they were not aware of, in them
right now, waiting for them to seize and use it. Here
is what they need to develop the skill of relaxing. They
have the general idea it is a good thing, but they don't
know what to do next. What they need, and get from the instrument
quickly and persuasively, is the knowledge of how they are
doing. Here is the tool to use while they practice rehearsing
in their mind the difficult situations they expect to encounter,
first in a mild form, then in more and more intense forms.
Each time the rising pitch of the tone tells them the imagined
stress is getting the better of them, they back off, shift
focus away from the stressor and on to the tone, and work
on making it go down.
It is in fact fairly difficult to put briefly into words
How to Relax and most of us seem to lose the skill in early
childhood! But it is easy to learn the skill again. Some
of us in ISMA find it comes easily now, but our clients
are those for whom it is hard. What they need is the prompt
feedback, which is an indispensable part of learning any
skill. And if they are relaxed, they cannot be anxious too.
Take a particular example. A sufferer sits (or lies), having
already learned what the tone means, thinking about going
on holiday in an aeroplane, which has always induced panic
before. Just a little thought gives a big rise in the pitch
of the tone. But he is not in fact about to take off; he
is simply thinking of it. Because the tone has risen, he
ceases thinking of flying and works on getting the tone
back down; it comes down. Then he gently move his thoughts
back to flying, and of course the pitch goes up again, but
this time it does not go up quite so much. Each time the
sufferer works on lowering the tone. This stage really does
benefit from a friendly helper or coach working with the
sufferer. For other people the coach is hardly necessary;
the sufferer knows they feel better when they are relaxed
but they cannot reach the happy state of relaxation. Here
their goal is simple - get the pitch of the tone down! As
they succeed so they relax. Everyone who uses the Relaxometer
finds they CAN relax in a suitable peaceful setting, and
then they can start to learn the skill, and then go on either
just getting more and more relaxed, or applying it to particular
problems.
One
productive use has been with stammers, who stammer at least
partly because they are anxious about stammering. Given
help in learning to manage their anxiety, they are much
better able to handle their condition.
Biofeedback,
then, is a tool, an educational aid, for learning valuable
skills. In practice many of the psychologists who use Relaxometers
do so in a psychotherapeutic way, but that is because of
the clients they see, and is not necessary. The Relaxometer
can give very valuable insights to people with no psychological
problems at all - just a stress problem.
Biofeedback instruments are all intrinsically very safe,
because they depend on the user having the motivation to
continue to use the feedback sound to control themselves.
Any discomfort removes the incentive to continue. (There
is a small group of people with low blood pressure who may
feel faint or dizzy if they get too relaxed, but people
with stress problems usually have high, rather than low,
blood pressure).
The Relaxometer and similar instruments provide biofeedback
of just one measure, Galvanic Skin Response, because it
is simple, quick and useful. GSR is a key indicator of the
Fight or Flight reaction in the autonomic system. Autonomic
arousal is easy to recognize when it is extreme - we break
out in a sweat. But such a strong sign is rare, and it is
the job of GSR instruments to make clear to the user the
much smaller changes that do occur all the time, but that
we do not usually notice. They can be caused by as simple
a thing as a noisy vehicle passing, or the realization we
have forgotten to do something. As experienced relaxers
we may notice these, but our clients need help in detecting
and responding.
Other types of Biofeedback are also widely used - muscle
tension feedback where a wrong muscle tension pattern has
been learned - tension headache, writer’s cramp, the
dental problem called TMJ syndrome, and simple stiff necks.
This sort of feedback is also used in rehabilitation medicine,
where it can enormously increase the function of muscles
damaged by injury to the nerves, or to the brain, or to
the muscles themselves. Whole books are written about this
area alone.
Temperature feedback from the fingertips allows people to
learn deeper relaxation and seems especially valuable where
circulatory problems occur, as in PMS, Reynaud's Disease,
and migraine. Like GSR feedback, this feedback has been
used in very effective work to reduce chronic high blood
pressure. Feedback of brain electrical activity or EEG is
more complex to decipher and use, but is very powerful.
It has applications in addiction, Attention Deficit/Hyperactivity
Disorder, chronic anxiety, and optimal performance.
While these modes of Biofeedback are complex and often need
some training to be useful, the simplest and cheapest form
of Biofeedback, of Skin Response, is also easy for everyone
to understand and to use, and is the most relevant to helping
people with stress problems.
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