by Rick Ostrander, MA, RAODAC
Stress is a topic which seems to surface in more and more conversations. “She stressed me out . . . I was so stressed I forgot her name . . . The stress around here is too much . . . I thrive on stress” are just some common expressions. Fortunately, in recent years, we have improved our understanding of how the brain and body work in response to stress.
We all experience stress but too much of it can be overwhelming and exhausting. Hans Selye, M.D., a pioneer in stress research, defines stress as “the non-specific response of the body to any demand made on it (when external demands exceed resources).”1 He identified three primary stages to adapting to stress. The first is called the alarm reaction to the stressor which ultimately activates the autonomic nervous system. Secondly, the resistance stage occurs as the body acclimates itself and adjusts to the stressor. Finally, comes the exhaustion stage if stress occurs for too long and the residual effects of stress add up. Ultimately, illness and death can occur.
Today, it is clear that the mind and body are interrelated. Stress, therefore can be considered a complex physical and emotional reaction. This reaction is largely based on perception. In other words, if one perceives a situation as stressful then they will respond accordingly. What is stressful to one person may not be to another. Our body will prepare us for stress through both conscious and unconscious pathways, whether we are aware of it or not. A thought is first registered in the brain which ultimately leads to activation of the nervous system in the body. A complex series of events occur in a an extremely small amount of time. Thinking stressful or fearful thoughts during this time further increases the body’s attempt to prepare to fight or flee. This will occur whether or not such preparation is necessary.
In a fast paced and stressed-filled world, many people are primarily unaware of stress signals in their body until it demands attention. For example, one can receive information from the body that they are emotionally fearful. Butterflies in the stomach, sweating, shakiness, etc. These signals can also be denied on a cognitive level, “I am not nervous . . . there is no reason to be.” However, the body is a more reliable indicator of nervous tension and stress. Therefore, it is important to tune into the body’s signals. This is a skill which can be improved with biofeedback training. A biofeedback therapist can help coach the learning of new self-regulation skills.
Stress may tend to build up as the day progresses. This can be referred to as the staircase effect. If we do not have time to adapt to the stress then we go into the next stress situation with some residual stress. This is similar to taking another step up on a staircase. If we climb too high, the pressure builds. Short-term relaxation techniques at different times during the day can prevent the stress from building to an unmanageable level. Cognitive coping strategies and biofeedback training helps improve these skills. As awareness increases, there is greater ability to discern between tension and relaxation and there are more options to do something about it.
Biofeedback continues to emerge as a viable and scientifically based treatment for an increasing number of conditions. Biofeedback is a therapeutic tool which provides physiological information in order to help individuals improve self-regulation skills. The principles of biofeedback are used every time you use a thermometer. Similarly, sensitive biofeedback instruments are used to measure your body’s physiological processes such as temperature, skeletal muscle tension, and heart rate, which are often not generally within one’s awareness. Biofeedback treatment sessions are usually held one to one with the patient and therapist. Therapy takes place in a comfortable chair in a room free of distractions. Each aspect of treatment is thoroughly explained to the client.
For thermal biofeedback, a thermistor is gently attached to the hand, with a small piece of tape in order to measure peripheral skin temperature. During stress, blood vessels become constricted and pass less warm blood. Thermal biofeedback training helps individuals combat the stress response which is measurable as an increase in skin temperature.
The next part of the of the session may be spent reviewing recent stressors of the past week, educating the client about their symptoms, teaching coping strategies, and reviewing how to integrate relaxation strategies into their life. Most of the session is then spent on practicing a relaxation exercise. This may include progressive muscle relaxation, breathing exercises, visualization, imagery, or other related techniques such as meditation. Patient’s can be given a compact disk to practice between sessions. Well designed research continues to be conducted which supports biofeedback to treat symptoms which are intensified by stress. The Association for Applied Psychophysiology and Biofeedback (AAPB) has established efficacy for clinical biofeedback.
The following diagnosis have met efficacy criteria for treatment by biofeedback therapy:
- Anxiety Disorders
- Attention Deficit and Hyperactivity
- Essential Hypertension
- Headaches including stress induced migrane