Special Issue: Integrating Mindfulness Training with Clinical Biofeedback: Practical Applications

Abstract

This special issue continues the focus of the spring and summer 2018 issues (Volume 46, Issues 1 and 2) on the benefits of integrating mindfulness and biofeedback approaches and identifies several new areas of application in pediatric biofeedback, the treatment of adults with intellectual disabilities, care for persons with respiratory illness and mechanical ventilation, and the management of chronic multiple sclerosis.The issue opens with an article by two leaders in biofeedback, who argue that mindfulness is as a natural extension of the awareness training inherent in biofeedback and other self-regulation approaches. Eric Peper and Richard Harvey compare mindfulness with other self-regulation strategies, such as progressive muscle relaxation, autogenic training, and transcendental meditation. They identify common elements shared by mindfulness with other self-regulation strategies. They also argue that most of the commonly used self-regulation strategies have comparable efficacy. They suggest mechanisms making many such self-regulation skills effective, including effects on the gamma aminobutyric acid neurotransmitter system. Finally, they call for further research to explore dropout rates, adverse effects, and other dimensions of mindfulness training.Next, Jonathan Sikorski and Olivia Hernandez-Gonzalez address the challenges in applying mindfulness-based interventions with two special populations. They point out that young children often struggle with communicating their needs, feelings, and desires with others. Adults with intellectual disabilities face similar challenges. The authors introduce practical strategies they have developed to introduce mindfulness skills for these two groups. They also use biofeedback as a tool to assist both groups in enhancing internal awareness of the link between emotions and physiological sensations. To illustrate their approach, they present two case narratives, the first a 10-year-old boy with generalized anxiety disorder, and the second a 28-year-old adult with Prader-Willi syndrome and intellectual disabilities.Urszula Klich presents a case study illustrating her clinical approach, which emphasizes teaching self-regulation and compassion. The case example in her article presents a patient with a tracheostomy who is experiencing anxiety related to pain and anxiety about eventual removal of her vent. Mechanical ventilation for acute respiratory insufficiency accounts for approximately 800,000 hospitalizations each year, and discontinuation of mechanical ventilation is challenging for patients and care teams alike. Klich combined compassion-based strategies with biofeedback to reduce anxiety about decannulation (removal of the tracheostomy tube). Her interventions included mindfulness meditation, breath training, heart rate variability training, loving kindness meditation, and the use of mindfulness strategies to ameliorate anxiety.In the final article, Donald Moss discusses the integration of mindfulness training, clinical biofeedback, and lifestyle change in the management of multiple sclerosis (MS). Moss provides a discussion of the medical diagnosis and treatment of MS, a review of the epidemiology and genetics of the condition, and a case narrative describing a 36-year-old woman with a pattern of chronic relapsing MS. This chapter also shows the use of the Pathways Model to organize treatment. The Pathways Model is an overall self-directed program of acquiring self-regulation skills and implementing lifestyle changes as a supplement to professional intervention.