To my family for always being there
This edition first published 2013
2013 John Wiley & Sons, Ltd.
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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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