By Amita Nijhawan October 1999 You can control your internal body functions with biofeedback, a no-drug, hi-tech system that claims to cure many ailments. Every minute your heart is pumping blood, your liver is secreting acids, your kidneys are processing waste. But you are not conscious of all this mad activity. Your body efficiently slogs on without any external monitoring—except from the brain, which anyway is not under your control. Now what if you were told by wisps of research drifting in from the West that you can control your body’s internal processes? At least to a certain degree. This is biofeedback, a science that claims to cure anything—from headaches to cerebral palsy—by giving us the power to ‘manipulate’ certain physiological as well as neurophysiological activities. To an uninformed observer, the sight of a biofeedback session may look like something straight out of a science-fantasy. In a typical setting, the patient sits in a soundproof room, surrounded by blinking electronic gadgets. Electrodes taped on her skin surface, forehead, chest or any part of the body chosen as the target area, are attached to a machine that makes audible clicking noises and flashes signals of varying intensity and frequency. So, what’s actually happening here?To answer this, it is necessary to first understand the concept of feedback. A student preparing for a competitive exam routinely solves sample papers so that her performance is at its peak on the actual test date. After each sample test, the student assesses herself with the help of answers provided. In the process, she learns of ways to improve her test performance. All along, she has been getting precise feedback at every step—reinforcing the chances of correct response. Giving a physical analogy of the same process, Dr Sunil Mittal, who practices biofeedback at the Delhi Psychiatry Center (DPC), India, says: ‘When you eat, after a point your body tells you that you have had enough and are satiated. The body is effectively giving you feedback to stop eating.’ In biofeedback, the body’s constant activity is recorded by different machines for different purposes. While the electrocardiograph (ECG) monitors the heart and is used for coronary troubles, the electroencephalograph (EEG) reads brain waves to help treat epilepsy. The electromyograph (EMG) monitors signals emitted by moving muscles and is used to restore movement to paralyzed limbs. The galvanic skin resistance (GSR) instrument measures the electrical conductivity of the skin and gauges the overall tension levels. Each machine amplifies the body’s electrical signals and translates them into signals and sounds that the patient can observe directly. Any increase or decrease in the body’s internal activity leads to a proportionate change in the frequency of the signals observed. So, when the signals become less intense, the patient realizes that whatever she has just done, has worked.Biofeedback is particularly helpful for stress-related ailments such as headaches, insomnia, ulcers and even asthma. At the Delhi-based Vidyasagar Institute of Mental Health and Neuro-Sciences (VIMHANS), this technique is used to treat tension and migraine headaches. Elaborates Dr O.C. Kashyap, a psychiatrist at VIMHANS who has been trained in biofeedback in Canada: ‘We always use relaxation exercises along with this therapy. Together, they are quite effective in reducing tension.’ Describing how the technique works on anxiety, Dr Mittal says: ‘Anxiety is a result of conditioning. If you’ve felt anxious in a certain situation, you later begin to associate anxiety with that particular situation. There are two ways to get out of this: by avoiding the situation altogether or by changing your negative reaction. Biofeedback helps you in the latter by making you relax in a safe environment while imagining the situation. Later, you learn to relax whenever the same situation arises.’ However, biofeedback targets only the bodily manifestation of stress, not the stressful situation. Biofeedback also works on limbs that have been paralyzed because of a stroke, nerve damage or cerebral palsy. Treatment is focused on trying to restore as much movement as possible. Recently, the technique has proved to be effective in cases of epilepsy, Parkinson’s, Alzheimer’s and infertility. Drug addicts going through withdrawal symptoms also get relief through biofeedback. A young addict, fighting to overcome her intense cravings, writhes in pain, has palpitations and acute insomnia. At that time, the only escape seems to be another dose. Biofeedback helps the addict relax, control severe panic and allows her to sleep. The cost of a biofeedback session varies from institution to institution. At the DPC, it comes as part of a complete psychiatric treatment plan on the recommendations of the doctor. However, in hospitals such as Delhi’s All India Institute of Medical Sciences (AIIMS), not many can afford biofeedback. Neither is it popular. According to Dr Manju Mehta of AIIMS, patients can practice relaxation therapy at home but biofeedback does not share this advantage. ‘There are biofeedback machines that can be used by a patient at home,’ says Dr Mehta, ‘but these are expensive.’ Most psychiatrists, however, state that biofeedback can work wonders—provided the patient is appropriately selected. Says Dr Ritu Nehra, clinical psychologist at the Post Graduate Institute of Medical Education and Research, Chandigarh, India: ‘We can’t get carried away. Biofeedback doesn’t work with everyone. The patient has to be willing to try it and also needs to be stable enough to start it. But in most cases, patients get impatient with biofeedback and prefer orthodox methods instead.’ Nonetheless, those who have gone through biofeedback have no doubts about its efficacy. F.V. Kumar, who runs a construction company in Delhi, is one such satisfied person. A highly stressful lifestyle led him to the DPC. After initial weekly biofeedback sessions at the clinic, Kumar now practices the techniques at home for about half-an-hour every day. And the results have been upto the mark. ‘I can leave my work in the office and not mentally carry the load with me,’ says Kumar. ‘Now I have the patience to see another’s point of view’. According to Mrinal, wife of Mansher Singh, captain of the Indian shooting team, biofeedback helped reduce her husband’s anxiety levels on the field. This has increased his concentration levels and consequent success rate. Biofeedback may still make sense till the point you are hooked on to the machine, but how do the results actually spill over into real life? According to Dr Mittal, it teaches the subconscious mind certain cues that bring about relevant reactions in the body. ‘It’s like thinking about your favorite dish,’ he says. ‘The moment you visualize the food, your mouth starts watering. Similarly, the biofeedback session teaches you to relax at the command ‘Relax!’ When you give yourself the same command in an actual situation, your body knows what to do.’ In fact, you don’t even need to hook on to a machine to check the effect of biofeedback. Just try this simple exercise. Put fingers on your pulse and start regulating your breath pattern. Soon, you will notice a change in your pulse rate. Simple, isn’t it? Biofeedback scores over other therapies on various counts: it is non-chemical, noninvasive, has no side effects, and gives you verifiable data on the state of your body. Most importantly, biofeedback is one treatment that teaches you to treat yourself. All you need to do is overcome your fear of resembling a cyborg controlled by ominous machines. In the era of the omniscient chip, this is not asking for too much, is it?
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