Biofeedback Explained

By: Adrian Cruce

As you raise your hand to wave goodbye or climb the steps on a Stairmaster, these physical actions are under your control; however, other physiological functions, like your heart and breathing rates or skin temperature aren’t.

Biofeedback can help you take conscious control over these involuntary processes through its training technique, offering improved medical conditions like urinary incontinence and anxiety relief. Studies indicate it may also reduce stress.

Physiological responses

Biofeedback sessions use sensors attached to your body to measure physiological responses such as your heart rate, breathing rate, skin temperature and sweating; and electrical activity in your brain (also known as electroencephalographic or EEG biofeedback). A therapist then discusses each signal’s meaning in relation to your physical and mental wellbeing; for instance how feeling more or less stressed affects it; before showing you techniques you can implement at home such as relaxing certain muscles or thinking differently to control physiological markers being tracked.

Biofeedback operates under the theory that learning to regulate these involuntary processes will allow people to manage symptoms associated with many chronic conditions. Researchers don’t fully understand its mechanism, but do know it promotes relaxation. Furthermore, biofeedback may assist patients in learning self-regulation skills to avoid future health issues and potentially reduce or even eliminate need for medication altogether.

At a biofeedback session, your therapist might use electrodes or finger sensors that attach to your skin or finger sensors and send signals back to a computer screen that displays your physiological response as feedback – this may include visual changes on a display like patterns or sounds shifting, auditory tones changing volume or variations, or haptic feedback where vibrations feel on your skin from wearable devices.

Studies suggest biofeedback may be effective at treating migraine headaches and tension-type headaches, urinary incontinence and fecal incontinence, but evidence is limited and further study must be conducted.

Considering biofeedback? Talk with your physician first; they may refer you to a trained therapist, or you can search online. Sessions usually last 60-90 minutes and most people begin seeing changes within 10 sessions or fewer. Your therapist will review your progress while creating an at-home practice schedule; initially you might need to attend sessions more frequently until the training becomes routine, at which time frequency should lessen over time.


Biofeedback uses sensors to measure physiological responses and provide real-time feedback, creating a bridge between your internal state and conscious awareness. Devices measure various involuntary functions like heart rate, breathing rate, muscle tension and electrical activity in the brain and translate those measurements into visual or audible signals – such as graphs on computer screens or soothing tones – that reflect those measurements.

Goal of therapy is to help you gain control of automatic, involuntary body processes like heart beat and blood pressure changes caused by stress. Through building awareness and control over these physical states, long-term wellbeing will become possible.

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Biofeedback sessions involve attaching electrodes or sensors to your skin – typically fingertips and palms – with electrodes or sensors connected by wires, such as electrodes on an ECG machine. The sensors send information back to a monitor, which displays results either as graphs, sounds or flashes of light on its monitor screen. Biofeedback helps you gain insights into subtle body functions like your heart rate, breathing rate, sweat level or skin temperature as well as brain waves amplitude or frequency/rhythm of muscle tension through biofeedback sessions.

Researchers don’t fully understand why biofeedback works, but do know it helps relieve conditions caused by chronic stress. For instance, biofeedback appears to reduce headache and tension-type pain as well as urinary and fecal incontinence. It may also help you regain control over sleep disorders and muscles spasms.

Biofeedback techniques work by teaching you how to use your muscles correctly, such as progressive muscle relaxation which teaches how to relax muscles in your abdomen and back. Other biofeedback devices measure skin conductance which changes with emotions and stress levels – for instance people suffering social anxiety often wear GSR sensors during public presentations to measure skin conductance – this allows them to see how their heart rate responds as their stress response rises; giving feedback which enables them to practice relaxation techniques and lower their stress response, leading to long-term benefits as well as reinforce other self-regulation practices such as mindfulness meditation or deep breathing.


Training yourself to control physiological functions once considered involuntary – such as your heart rate, blood pressure and muscle tension – through biofeedback is a skill that can improve overall health according to the Association for Applied Psychophysiology and Biofeedback.

Biofeedback sessions involve using electrodes or finger sensors to monitor subtle body signals, amplified and displayed in an easy-to-read format such as video games, meaningful graphs or simple audio signals like tone variations on a tone generator. The goal is for you to recognize these signals and learn how to best manipulate them so that your physiology runs optimally.

Your healthcare provider may also teach relaxation techniques as part of your biofeedback sessions, including breathing exercises, visualization and thought modification techniques to combat chronic stress. Depending on the nature of your medical condition, weekly sessions may be required until you develop self-regulation skills you can use at home.

Biofeedback utilizes operant conditioning. Operant conditioning refers to the idea that by reinforcing certain behaviors with rewards, they become repeated. For instance, if you manage to consciously make your hand warm up and cool down via biofeedback therapy, your therapist may reward this with color or light on a feedback monitor to remind you to do it again in future sessions.

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Biofeedback monitoring typically includes monitoring blood pressure, skin temperature, muscle activity and sweating – although other signals such as heart and brain waves, breathing patterns or skeletal muscle activity may also be monitored. According to Cleveland Clinic, blood pressure, skin temperature, muscle activity and sweating are the most commonly monitored physiological parameters.

Cleveland Clinic researchers have demonstrated the efficacy of biofeedback for controlling physical functions to alleviate stress, such as urinary incontinence and muscle spasms, while also treating hypertension and anxiety disorders that are exacerbated by stress. When combined with other forms of mood therapy – cognitive behavioral therapy or psychotherapy for example – patients see greater improvements than when only one type of treatment is provided.


Biofeedback training gives individuals an opportunity to consciously manage body functions like heart rate and muscle tension. Once this skill has been learned, individuals can work toward eliminating symptoms and improving health through biofeedback techniques such as neurofeedback; thermal or sweat biofeedback; electromyography (the measurement of muscle tension); or thermomyography. While biofeedback techniques may be effective, they should only be used alongside traditional medical therapies to achieve the best possible outcome.

Biofeedback reinforcement strategies depend on the behavior being trained. According to B.F. Skinner, an esteemed researcher in operant conditioning and reinforcement, stimuli that increase frequency are considered reinforcers while events with consequences that increase frequency are called natural reinforcers. Furthermore, Skinner defined reinforcement as changes in response strength rather than subjective criteria like pleasure or value – so activities or food that subjects find pleasurable or valuable may not qualify as reinforcers unless their effects on immediate responses increase accordingly.

Contiguous stimuli, or stimuli closely tied in time and space with specific behaviors, tend to reinforce them more directly. For instance, giving a child bubbles as soon as they request them will likely reinforce that behavior more than later offering it; the rapid delivery also strengthens resistance against behavior extinction.

Different reinforcement schedules can be combined to produce various behavioral situations. For instance, an interval schedule with post-reinforcement pause will decrease response rate while fixed ratio or variable ratio schedules increase it.

Biofeedback therapy has proven highly successful for treating numerous disorders, including fibromyalgia, headaches, Temporomandibular Joint (TMJ) dysfunction and vestibulitis. As it is noninvasive and safe treatment that can be practiced at home with support from an experienced therapist who will provide tools needed for practice a patient will monitor his/her progress towards improvement.