On Mindfulness, CBT and Biofeedback
Nimrod Tom Oren and Arnon Rolnick.
Presented in the European conference for behavioral and cognitive therapy, Jerusalem 2015
Therapy is about change – Change in symptoms, mood, ability to function, in quality of life. And change, we used to think, implies control: for what are we trying to do if not to regain control, over our lives, our symptoms, our inner experience and our emotions? It is this line of thinking which led to the adoption of biofeedback behavioral therapy. The aim was to acquire conscious control over what used to be considered autonomous functions of our nervous system – muscle tension, blood flow, peripheral temperature, even neurological activity. By moderating these, we could heal many ailments, such as headaches, tinnitus, asthma, anxiety and eating disorders, even depression, and the list goes on.
But lately we have been realizing that much of the psychopathology of our clients lies not in their symptoms, but in their reactions to their symptoms. Panic attacks are fed by a tendency to interpret normal arousal signals as catastrophic, social phobia is hinged on the inability to sustain even the slightest embarrassment – a necessary everyday experience in social situations. The attempt to forcefully restrain their symptoms leads our clients to even more stress and a deep sense of losing control, which then to the belief that the initial catastrophic interpretation was correct and to continued attempts to repress the symptoms. The result is a vicious cycle of fear, avoidance, and a gradual exacerbation of symptoms, until finally a full-blown pathology is developed.
Taking heed from mindfulness therapy, we would like to turn the tables on the old approach: to forgo control, to accept. Experiments have shown that efforts to control or suppress thoughts, emotions, and sensations, or to consciously bring about relaxation result in an exacerbation of symptoms and suppression of the immune system. Paradoxically, when our clients fully accept their sensations, emotions and thoughts, change occurs, almost by itself. What biofeedback allows us is an open-window into both our sensations our habitual reactions to those sensations. When we are aroused, do we fuss over our arousal? What do we do when we are unable to relax? Employing this deep technique of observing, accepting, and letting go, we get quicker, more stable results – autonomous moderation is learned faster, and symptoms subside and lose their significance.