Biofeedback for Relaxation Techniques in Headache Management
In the previous article, we reviewed the relationship between headaches and anxiety. Given this well-established connection, promotion of the relaxation response is a key goal for many seeking to reduce the frequency and intensity of headaches.
It would be nice if stress reduction were as simple as popping your favorite CD into the stereo or kicking your heels up on the couch for a few minutes. Unfortunately, it’s often not that easy, especially in the face of recurrent pain. Without the proper skills—that’s right, skills—in place, you may not get far in your quest for the elusive relaxation response. Even after weeks of doing various exercises in deep breathing, mental imagery, and muscular relaxation, the migraineur may be left to wonder: is this stuff really going to work, or is relaxation just another gimmick to be filed away with snake oil?
Real Step-by-step Progress in Relaxation Training Skills
With biofeedback, you can verify whether your new relaxation skills really are working. The proof is in the electronic sensor that monitors different physical functions that occur during the relaxation response. Depending on the type of biofeedback, you might see the rise and fall of your finger surface temperature on a computer monitor. Or, you might hear a tone that fluctuates with the levels of muscle tension in your forehead, neck, or shoulders. This feedback provides a window into your body’s functions, and it does so in a way that is comfortable and non-invasive.
With time and practice, better body awareness translates to better body control. Once the ability to evoke a relaxation response is established through the biofeedback equipment, it becomes easier for clients to apply the relaxation skills during their daily activities. Typically, after a few weeks of practice in biofeedback, many individuals naturally begin to apply their new skills to real-life situations. Of course, a good biofeedback practitioner will go a step beyond this natural learning process, by helping the client to develop individually tailored strategies for generalizing the skills.
Advantages of Biofeedback
The enhanced learning curve that comes through biofeedback is just one of the positive aspects of this type of treatment. Many clients like the fact that biofeedback involves neither needles nor drugs. A related advantage is the fact that, unlike with various headache and pain medications, there are few if any negative side effects associated with biofeedback. Also, the fact that biofeedback is a teaching tool for relaxation means that once the skills are learned, you can continue to benefit as long as you choose to maintain practice; there is no continuing cost after treatment is completed.
Finding a Biofeedback Practitioner
As in all areas of medicine and allied health, there are highly effective biofeedback practitioners as well as less skilled ones. If you are interested in finding a good clinician, you should plan to do a little research. Your primary care physician, neurologist, or migraine headache specialist may have information about where to find biofeedback providers in your area. Additionally, two good internet resources are the websites of the Association for Applied Psychophysiology and Biofeedback (aapb.org) and the Biofeedback Certification Institute of America (bcia.org). When you contact a potential provider, it’s a good idea to ask how long they’ve worked in biofeedback, what health conditions they have treated, and whether they are certified in biofeedback. Although there are effective clinicians who are not formally certified, finding a practitioner who has met certification requirements helps you to be more assured of your choice in a practitioner.
Biofeedback clinicians who work with migraine headache are often masters or doctoral level psychologists, but you may also find practitioners in counseling, physical therapy, and other allied health professions. What’s most important from a consumer standpoint is that you find a professional who has specific experience in treating headache conditions.
What About Insurance?
The willingness of health insurance companies to reimburse for biofeedback therapy varies among insurance carriers as well as among different health conditions. Fortunately, because the effectiveness of biofeedback for migraine is particularly well-documented, the chance of receiving insurance reimbursement is often greater than for other health conditions. Contact your insurance provider for further information, and solicit assistance from health care professionals familiar with your history and diagnosis. As an alternative to direct insurance, some individuals may be able to use flexible healthcare spending accounts or make affordable out-of-pocket payments. Such options are well-justified by the pain relief and improved functioning that the therapy can provide.
From Headache Understanding to Ability to Cope
The challenge of using relaxation skills to control migraines is not so much in understanding the connection between mind and body (you’ve already figured that out); the challenge is in building new skills to override the automatic and often subtle effects of anxiety on migraine pattern and intensity. If you’re willing to explore, biofeedback can help to light the way.
written by Luke Patrick, PhD
Luke Patrick, Ph.D. is a licensed psychologist practicing in Portland, Oregon. He specializes in the psychological management of chronic illness, as well as biofeedback and sport psychology.
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