Headaches: Better Coping Through Biofeedback
Created 06-14-2008
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
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 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 Understanding to Ability
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.
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.
By Luke Patrick, PhD
