Based on the BCIA education our approach has also since 1992 somewhat other focus and content which is described below
One difference between the BCIA approach and ours (since more than 20 years) is that we always focus also on the metabolic side; (a) using etCO2 and SPO2 while when using breathing training we need to identify and carefully follow individuals´ chemical/physiological consequences otherwise we do not know whether it has a biological correct effect – while absence or normalization of hypo- and hypercapnea is critical for a correct breathing training, something we almost always use in work with lifestyle related diseases and problems.
Another is that we always use a comprehensive biopsychosocial medicine toolbox where e.g. also nutrition/diet is an important part. As we focus on Individual Biological Evidenced based Documentation (moving up to normative levels when needed) – single case design – we can use individual adjusted (tailored) prototypic biopsychosocial tools with clinical confidence! Where is then biofeedback? We regard biofeedback (instrument use) as critical for individuals tailoring of their dynamic strategies. Without sophisticated information about changes – much more sophisticated than we can feel, especially in the beginning of the training period – we do know what is right or not. Over time our body learns and gives us (bodily) biological feedback. Moreover, biofeedback is unavoidable pedagogical instrument to – together with information (education) of what, why and how it (our bodily readings of such instruments) – such processes works! Even moreover, for assessment of individuals´ dynamic behaviors (reactivity, recovery, capacity to influence observed dysfunctions, effects of relaxed breathing as well as base line) is decisive for a proper examination, interpretations of data as well as for – together with the patient – construe an individualized effective treatment plan.
The above we include in additional education suggested to be used together with the BCIA educational approach, which we see as the basics of biofeedback!
Summarizing some basics we base our work in biopsychosocial (lifestyle) medicine on
Passive and active relaxation is decisive for functional, dynamic humans in real world biopsychosocial complexity. This can be measured in individuals with psychophysiological measurements revealing and validated in some crucial systems, e.g. our autonomic nervous system in general and the sympathetic one in particular. As we can measure it we can used, we can use this information to OBSERVE and SEE (including learn and understand) when we practice to improve our capacity to relax using strategies from our toolbox (see below).
This is called biofeedback, which in the beginning mostly requires sophisticated measurement while we cannot feel very small, but important changes which with practice the body learns to identify enabling us to use our bodily feelings as instrument in everyday life situations.
Among the tools in our toolbox – where others are movement, cognitive and precognitive strategies and social skills as well as diet all personalized tailored during education and supervision – is respiratory behaviors and its physiology!
Breathing, this has a central position interfacing human brain and old brain ”both-way” functioning in terms of physiological functioning (e.g. autonomic nervous system and basic cell metabolism) and psychosocial behaviors including precognitive ones. Individuals breathing behaviors can be measured with psychophysiological measurements revealing and validated in some crucial systems, e.g. pCO2 measured with etCO2 (endtidal-CO2) and SPO2 (oxygen saturation).
Based on a first examination where psychophysiological stress profiling has an important position we (a) explain individuals´ results and based and motivated on their understanding (during education in groups) we together with each patient found out the way towards increased solutions of their problems.
But, is this really evidenced based? Yes, of clinical interests is Individual Evidenced based Documentation (IBED), a kind of single case design enabling identification of the position of Hans and Greta at the planned psychophysiological observable road – also enabling us to move up from ideographic level to normative when needed.
Treatment is here biopsychosocial education medicine at proper practical levels following George Kelly´s ”man as a scientist” (Personal Construct Theory, 1955) updated to ”healthcreators”, where patients are regarded as educated resources in their own rehabilitation where biofeedback is of great importance as a validating, motivating instrument/tool for the patient!
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