Can worrying hurt…literally?

Can worry actually be painful? Does stress lead to chronic pain? Check out this New York Times article for insight into who worry and stress can potentially lead to chronic pain–and what biofeedback can do to help. 



Child bullying victims still suffering at 50, study finds

Bullied boy at school

If you think every child moves past the trauma caused by childhood bullying, think again. A recent study released from King’s College London shows that the effects felt from childhood bullying can be felt long into adulthood. To read the full article, click here.

Spring Break Travel with Children: Beating the Stress

FamilyAre you and your family planning a vacation over spring-break or perhaps sometime this summer? In this article, Dr. Lisa Gordon, PhD, from the Family Institute at Northwest University shares her insights about how to make your next family vacation as stress-free and fun as possible for both you and your little ones. Click here to read more.

The Rise of Superhero Therapy: Comic Books as Psychological Treatment

Photo by Shutterstock

Mental health professionals are always looking for new and insightful ways to better understand our clients, especially children who may have a difficult time articulating their feelings.  Check out this article by Alex Suskind where “[a] band of renegade therapists has been treating patients with something a bit unorthodox: superheroes. Just think of them as the Justice League of comic book treatment.”

All hands on deck—how to cope with a soldier’s homecoming

Soldiers returning from war face a huge adjustment, as do their families. Transitioning back to everyday life can take more time than is expected, and can be very stressful. However, there are resources and experts available to help ease the transition—both for soldiers and their family members. The American Psychological Association provides tips, warning symptoms, and resources to help everyone involved in these homecomings. Click here for more information on how to make the readjustment to everyday life.

What is Biofeedback & Neurofeedback Lecture – Mcgill University 2011

Have you ever wondered about the science behind biofeedback? Check out this lecture that was given to electrical engineering students at Mcgill University.


I have created a list of frequently asked questions to help explain what biofeedback is and how it can be used as a treatment modality. These questions will also be posted on this site under the dropdown menu for “Counseling.”

1. What is biofeedback?

Simply put, biofeedback is a dynamic and experiential treatment modality used by health care professionals to show patients the mind-body connection. Biofeedback helps enhance awareness and communication between the mind and body.

During a biofeedback session, the therapist will use equipment to monitor a patient’s physiological responses to stressors like pain, difficult circumstances and stressful topics. Physiological changes can be triggered by discussion of sensitive topics—for example, if the patient feels stressed while talking about a situation, their heart rate may increase. Therapists will also monitor changes in physiological responses like changes in breathing, muscle tension, sweat response and temperature. The therapist uses graphs and other feedback produced by the equipment to show the patient how stressors are affecting them physiologically. By understanding the correlation between physical responses to mental and physical issues, patients will develop an internal locus of control. Patients will have a growing awareness of their involuntary responses to stressors and pain, and with the assistance and direction of the therapist, learn ways to control their physiological and mental reactions. As the therapy progresses, the patient will likely see both positive mental and physiological improvements.

2. Is biofeedback only for certain disorders or does it have multiple uses?

Biofeedback can assist in the management of many disorders, such as:

  • Chronic pain/illness
  • Anxiety
  • Stress
  • Hypertension
  • TMD (TMJ)
  • Headaches
  • Fibromyalgia
  • PTSD
  • and other disorders

3. How many biofeedback sessions do I have to do before I see results? What kinds of results can I expect?

Results are immediate, and patients will begin to understand the mind-body connection in the first session. Biofeedback equipment provides intuitive results in the form of graphs and charts that the therapist will explain to the patient.

As therapy progresses, the patient will have a visual understanding of their progress, and be able to make gradual, natural changes in their bodily functions and mindset.

Biofeedback will help you better understand your body’s physiological responses to stressful circumstances or the onset of pain. As you begin to understand these correlations and progress in therapy sessions, you will experience both emotional and physical healing. Remember, the benefits of biofeedback are maximized when it’s used in conjunction with counseling.

4. Does biofeedback hurt?

No, none of the equipment is invasive.

Sensors that measure different body/physiological processes will be attached to you in a non-invasive manner in order to pick up various signals. For example, sensors that measure muscle tension will be attached to a muscle or group of muscles. The signal will show on a computer screen in a particular form that gives you on-going information about what the muscle is doing – how tense it is, and how that level of tension changes – often as a response to an emotional or mental state.

5. How long have you been administering biofeedback sessions?

I have been practicing biofeedback since 1994.

6.  What kind of qualifications do you have to do biofeedback?

I am a Licensed Professional Counselor and a Board Certified Biofeedback Practitioner. I have been in private practice since 2005. I am the past president of the NC Biofeedback Society and served as a consultant to the Education Section of the Association for Applied Psycho-physiology and Biofeedback.

7. What else can you tell me about biofeedback?

The Mayo Clinic has some excellent information about what to expect from biofeedback as a treatment modality. You can find their article on biofeedback here.

The Biofeedback Certification International Alliance (BCIA) and The Association for Applied Psychophysiology and Biofeedback, Inc.  (AAPB) also have a wealth of information on biofeedback.

I also frequently update my blog with information about relevant biofeedback articles, upcoming events, biofeedback organizations, etc.

Please contact me if you have specific questions about biofeedback that weren’t addressed on this page.

Biofeedback as Mainstream Therapeutic Modality

Biofeedback is quickly moving from what may have been seen as an “alternative” medicine to a mainstream therapeutic modality. This article from depicts many of the mind/body interactions that can be seen through the use of biofeedback. Biofeedback is often used as an adjunct modality in conjunction with cognitive behavioral therapy as well as other therapeutic modalities to address issues such as anxiety, panic disorder, chronic pain, stress and post-traumatic stress disorder.

Beneath the Sensors

The metamorphosis of an egg into a caterpillar, to a cocoon, to a butterfly is an awesome phenomenon because it is relatively rapid; maturity is achieved in a few weeks and it can proceed full circle in complete view of the observer. The changes occurring within a child are equally cataclysmic, but are cloaked by a deceptive surface appearance of a “cute miniature person.”

Many adults are prone to expect, first: that given food, support and time, this miniature adult will grow up; and, second: that there is little reason to expect significant variation and marked individual differences in the speed and nature of the developmental process, although while questioning the truth and reliability of the adult world. Though substantive research in childhood development has shown otherwise.

However, under the observable superficial behavior, the “still water” of the engaging child runs very deep indeed and on many structural levels. Truman Capote’s novel Other Voices, Other Rooms captures the child’s challenge to interpret voice intonation and intention, as he questions the truth and reliability of the adult world and the enigma of the surrounding environments outside his own inner world. Observe the child who ultimately travels alone and leaves us in his search of self through the maze of this universe and beyond.

Curiously, thus begins the process of the very foundations of biofeedback and structural constructs, as they are intrinsically intertwined in this child’s internal milieu. In reviewing the field of structuralism relative to self-regulation, structuralist theory in general promotes the belief that underlying the immediate conscious experience, there is a complete network of components which pervades all human intellectual, emotional, ideological and self actualization. (Claude Levi-Strauss).

Within a child’s ever changing view of his world, structural constructs dominate this internal milieu as codes operating at many levels: the symbolic representing the ‘depth and secrecy’ of knowing how a thing should be; the hermeneutic sorting and siftings the ambiguity of events and interpretations between the child’s internal and external environment; the semantic assigning the child’s own descriptive language and context; and the active playing out in motion ones physiological, emotional, mental topography. Children absorb themselves into an alliance with the natural world where they establish their connection and importance in the larger scheme of things. I am I and who are you?

What is there about children?

Children are uniquely human, individual,poetic, and infinitely complex. While the child may not understand these complex dynamics, nonetheless, the child experiences his own unique physical sensations in response to the vibrations within his environment. Like long tangled string, the child bobs and weaves along his little journey into the larger scheme of things and is driven by an internal highly sophisticated cross current of signaling systems that sometimes go awry. Heretofore, these covert interactions were not observable to the outside except through overt behavior and communication.

Biofeedback: the healthy breakthrough and the way in

The Biofeedback process facilitates a time-travel adventure and is the “way in”, states one adolescent, and “then I can do it by myself on the way out.” Biofeedback is a two-way express ticket to inner and outer space. With concrete evidence, the youngster observes and negotiates with his organism by self-regulating his breathing patterns, quieting the heart rhythms, hand warming, reducing inappropriate muscle tension, dysponesis hits the spot (Stroebel, E. 2005), interrupting hyper vigilance, etc. Another youngster described biofeedback as a “Traveling road show where I am the star and can get inside myself and see on the computer screen what’s going on so I can change it!”-a pragmatic translation that says, “This is healthy for me.”

Small kids love the idea that they can run the show and organize a trip inside to talk to their blood and guts, converse with their brain, and to send messages through the nerves to the cells-the red anger and angst, light blue sadness and hurt, and the yellow soothing talk all traveling down the integral highways from the brain to the heart and other places of choice-a back and forth shuttle. Kids are empowered to sooth the physical and emotional spots that hurt. The Voice of the Child is now recognized in health care as the essential key to developing interactive strategies for wellness and a substantive quality of life. Thus the child’s more silent spring within nurtures an intuitive sense of body-knowing just how a thing should be.

Explanations for parents and caregivers

Biofeedback is a safe and enjoyable non-invasive process, which involves a partnership between the child, the computerized equipment, and initially the guide. One youngster described this partnership as “The way to zip inside and peek at the mechanics so you can fix them with a “tune up!”

  • Step one
    Sophisticated technical equipment monitors and displays for observation the constantly shifting interactions between the child’s signaling systems in the brain from his thoughts, emotions, feelings, and with his self report about his physical bodily sensations and overall physiological activity. With a clear goal that individuals have healthy power to make changes and along with child oriented instructions, the child is spurred on by his own inquisitiveness and curiosity. The child learns specific experiential and cognitive skills, which he uses to fuel his own control tower for change. Neurofeedback with its multi monitoring capability records brain wave activity and subsequently shapes change with tailored training protocols. Peripheral Biofeedback facilitates changes in skin temperature, muscular activity, heart rate variability, sweat gland responses, respiratory function, and other body functions. Bingo! Twice the power for optimal health is achieved when combining neurofeedback and peripheral biofeedback.
  • Step two
    simultaneously, the data is fed back in real time in age appropriate non-threatening audio and visually fun graphics for the child’s viewing.
  • Step three
    Through an enjoyable process, the youngster can assess, discuss, and redirect ‘brain messages’ with therapeutic strategies for internal changes, i.e., self-regulate over- breathing, interrupt sustained muscle tension, or refocus impaired concentration. With practice, he can achieve an ‘alert mind and calm body’ to reduce or eliminate physical discomfort, control anxiety, improve concentration and enhance performance.
  • Step four
    The child learns how to transfer assisted biofeedback self-regulation skills into his daily life. The outcome is that this process actively impacts physical health, social behaviors, performance, achievement and overall sense of self esteem.

Biofeedback: the internal frontier

Biofeedback has opened up a once unfathomed “internal frontier” for unlimited healthy emotional and physical growth. Biofeedback applications for the classroom beginning in pre-school already have a positive track record since the early eighties (Stroebel,E 1981) for increased performance, self-confidence in ability to learn and enjoyment in the process Pediatric healthcare in general has twenty plus years of efficacy in prevention and in healing. The emergence of integrative medicine promises even greater potential for the prevention of illness and impact on the disease process, along with effective strategies in pain management and for repair. For children whose lives have been damaged by a childhood too harsh, biofeedback offers a way for them to trust in an observable safe process where they have positive internal control. They can rediscover the goodness of self and emotionally and physically heal from trauma. Self-regulation empowers the child to initiate healthy change from what hurts to what feels better by self-induced learning and transfer skills as an automatic part of his responses.

The challenge

Pediatric biofeedback challenges us to teach self-regulation as a life long skill. Even amidst the expected rapid physical and emotional developmental changes, the child benefits. As the child’s life vacillates between joyous times, normal daily stressors and unexpected traumatic experiences, the learned response to these can shape for life the individual’s choice of how to manage these challenges either in a healthy or destructive way. With biofeedback, the child has additional strategies in place for healthy solutions no matter what the challenge.

Life long skill

Some youngsters feel there isn’t any solution, no way out, as their distress invades every aspect of life. Biofeedback is not only a way out, but an on-going healthy life long tool. Not exempt from strain on their organism, and not always able to self-correct without assistance, children possess a native sense of order which seems in contradiction to the sometimes outward appearance of disorder. Their physiology is affected by the relentless demands from the external and internal environment which overrides the inherent basic body safety mechanisms for self-regulation.

The empowered child

A seven year old with a chronic illness calls biofeedback “serious fun when things are yucky.” Affirm to parents that the child has a magnificent self-tool to reaffirm his importance in his treatment plan and in a wellness model to exchange dialogue with health care providers and family. Tangible strategies empower the child to deal with both the invisible invaders of illness-chronic and acute pain sensations(Carter, B. 1998), life-threatening conditions and accompanying grief; and children suffering from neglect and abuse, seemingly uncontrollable anxiety, attachment and abandonment issues, defiant/ oppositional behavior, aggressiveness, learning disabilities and attention deficits, hyperactivity, struggling families to improve communication, and school and peer related difficulties.

Healthy power within

Adults ask if young people can really understand and implement the biofeedback process. Kids are autonomic biofeedback whizzes. With eyes open, they whiz up and around the learning curve of self-regulation of their body safety mechanisms, i.e., adjusting breathing patterns, slowing down inappropriate racing feelings, calming upset stomachs, interrupting tension headaches, warming cold hands, interrupting faulty bracing and managing pain sensations. And that is just the beginning. They teach You!

Children show a remarkable capability of intrinsic and kinesthetic understanding of complex physiology and behavior without all the definition. Their Kiddie Physie is a bag full of healthy tools, metaphors, stories, strategies and sixteen healthy body friends (Stroebel, E (2006) as biofeedback buddies to help lead the way. Kids engage in unlimited safe pathways with visualization, guided imagery, and self-talk. Biofeedback calls upon all sensory capacities, imagination, and always grounded with safe exits.

Parent’s role

Most parents hurt when their child hurts. Telling youngsters “not to worry” or to “just take it easy” without strategies to do so doesn’t help long term. And often increases anxiousness. Biofeedback provides a family partnership in wellness and enhanced communication.


Biofeedback is important to an enhanced quality of life.


The last word- “I like biofeedback. It listens to me and I listen to it.” (Child age 6)


Biofeedback Magazine. (2005) Winter Vol 33. “Dysponesishits the spot: A translation for and by children.Association for Applied Psychophysiology and Biofeedback.

Capote, Truman (1994) Other Voices, Other Rooms. Vintage
Books. New York. 1994

Carter, Bernadette (1998) Perspectives on Pain. Mapping
the Territory. Arnold Press. London. 1998.

Leach, Edmund (1979) Claude Levi-Strauss. Viking Press.
New York

Stroebel, E. L. (2006) Der Kiddie Quieting Reflex-Stress management in Kindergarten und Schule.Pirker-Binder,Ingrid. Biofeedback in der Praxis, Springer. Wien.

Stroebel, Elizabeth L. (2007) Kiddie QR: A Choice for
Children. Revised 2007 –Comprehensive Program.

Stroebel, Elizabeth L. Science 81. October.Kiddie Stress American Association for the Advancement of Science.


About The Author

Elizabeth Stroebel is an internationally known lecturer and specialist in the field of applied psychophysiology for children and adolescents and co-chair of the Education Section Assoc. for Applied Psychophysiology and Biofeedback. A parent of three children and former high school and university teacher, Liz has additionally been allied with the field of applied psychophysiology for thirty years. For twelve years, she worked in the UK with Professor Linford Rees, past president of the British Medical Association and contributed to developing programs in medical settings in London, Israel and Paris. One of her major contributions to both healthcare and education is The Kiddie Quieting Response: A Choice for Children, revised 2007. She is currently authoring a program incorporating the Quieting Reflex techniques for children with chronic pain and life-threatening illness.

From NeuroConnections (ISNR) Octorber 2007

*Posted with permission from Biomedical. Click here for original story*

Finding the “state of ease”

Do you ever feel more at ease when you take a deep breath? Check out this article for more information about how breathing techniques are not only relaxing, but can help us refocus and improve our problem solving capabilities. In this article, Doc Childre, founder of the non-profit Heart Math, explores the process of settling into a ‘state of ease’ when stressful circumstances arise. Click here to view the article.