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Inna Z. Khazan - The Clinical Handbook of Biofeedback: A Step-By-Step Guide for Training and Practice with Mindfulness

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Inna Z. Khazan The Clinical Handbook of Biofeedback: A Step-By-Step Guide for Training and Practice with Mindfulness
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To my family for always being there This edition first published 2013 2013 - photo 1

To my family for always being there

This edition first published 2013

2013 John Wiley & Sons, Ltd.

Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wileys global Scientific, Technical and Medical business with Blackwell Publishing.

Registered Office

John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial Offices

350 Main Street, Malden, MA 02148-5020, USA

9600 Garsington Road, Oxford, OX4 2DQ, UK

The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

For details of our global editorial offices, for customer services, and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell.

The right of Inna Z. Khazan to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

Library of Congress Cataloging-in-Publication Data

Khazan, Inna Z.

The clinical handbook of biofeedback : a step by step guide for training and practice with mindfulness / Inna Z. Khazan.

pages cm

Includes bibliographical references and index.

ISBN 978-1-119-99371-1 (pbk.)

1. Biofeedback trainingHandbooks, manuals, etc. 2. Mindfulness-based cognitive therapy. I. Title.

RC489.B53K45 2013

616.89'1425dc23

2012047738

A catalogue record for this book is available from the British Library.

Cover image: Zphoto / Shutterstock

Cover design by Cyan Design

List of Figures

Quicksand Metaphor Illustration
Frontalis Sensor Placement
Narrow and Wide Upper Trapezius Placement
Mastoid-to-Mastoid Placement, Back and Side View
Temporal-to-Mastoid Placement, Side View
Typical Relaxation Profile Pattern
An Example of a Mostly Healthy Stress Profile
Stress Profile with Increasing Levels of Arousal and Little Recovery
Stress Profile with Evidence of Increased Activation during Recovery
Normal Respiration
Overbreathing
Examples of Different Breathing Patterns
Healthy Breathing and Overbreathing
(a) The Normal ECG Complex PQRST; (b) An ECG with Three R-R Intervals
Heart Rate Variability Oscillations
Respiratory Sinus Arrhythmia (RSA)
Faster and Slower Frequency Wave
Higher and Lower Amplitude Oscillations
MaximumMinimum HRV
Spectral Analysis of HRV
Low Frequency Meditators Peak
Heart Rate, Percent of LF Peak, and MaxMin HRV during RF Determination
Needle EMG Activity at Trigger Point and Surrounding Muscle Tissue
Example of Wide and Narrow Sensor Placement
Surface Electromyography Readings from the Forearm Muscle Using Wide and Narrow Sensor Placement
Surface Electromyography Recording made with Wide and Narrow Band-Pass Filter from the Same Upper Trapezius Muscle
Spectral Analysis of sEMG Signal from a Nonfatigued and a Fatigued Upper Trapezius Muscle during a Sustained Contraction
Example of Upper Trapezius Assessment Results
Muscle Recovery Assessment of a Healthy Muscle and a Chronically Tense/Fatigued Muscle
Example of Working-at-the-Computer Assessment Results
Upward Tonic Shift in Skin Conductance Response Following a Stressor
Downward Tonic Shift in Skin Conductance Response
Stair-Stepping Pattern in Skin Conductance Response during a Stress Profile
Optimal Skin Conductance Response following a Stressor
Masseter Sensor Placement

List of Tables

The Dos and Donts of Mindful Biofeedback Practice
Listing of Smaller Scale Biofeedback Devices Available to Date
Template for Interpreting Breathing Assessment Results
Resonance Frequency Breathing Rate Determination Template
Approximate Counts for Inhalation/Exhalation for Various Breathing Rates
Examples of Striation Direction of Muscles Most Commonly Used with sEMG Biofeedback
Postural and Position Changes to Facilitate Muscle Tension Deactivation
Examples of Quick Relaxation Skills Based on Longer Practices to Facilitate Muscle Deactivation Training
Classification of BP by the JNC

Acknowledgments

There are many people who made this book possible. While this acknowledgments page cannot possibly do justice to their invaluable contribution, I will do my best to give thanks.

First, I would like to thank my teachers and mentors. Satya Bellerose was my first biofeedback teacher. Satya, thank you for not only teaching me biofeedback, but for inspiring me to pursue it as a career. Thank you to Saul Rosenthal for his mentorship and support for this book. I am grateful to Judy Krulewitz for her support and wisdom every step of the way.

Christopher Germer has been my mindfulness teacher and mentor for many years. He has also been my guide throughout the process of writing this book. Chris, thank you for introducing me to the power of mindfulness, helping me work through the kinks of integrating biofeedback and mindfulness together, and, most of all, for believing that this endeavor is worthwhile.

I would like to thank the experts in the field of biofeedback who have kindly shared their knowledge and expertise with me during the preparation of this book. A special thank you to Richard Gevirtz for his support at the early stages of this journey; his generosity in giving advice; sharing knowledge, materials, and images; and reviewing the heart rate variability (HRV) chapter of this book. I owe a debt of gratitude to Erik Peper for his advice in the writing of the electromyography (EMG) chapter, invaluable suggestions for its improvement, sharing images, and overall encouragement. To Peter Litchfield, thank you for so generously sharing your time in going over the intricacies of breathing physiology and training, sharing the breathing questionnaire, and the loan of the CapnoTrainer capnometer for testing out the protocols and capturing screen shots. I am grateful to Paul Lehrer for letting me pick his brain in the early stages of planning this book and sharing his tremendous knowledge and expertise in the field of HRV.

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