Perusal of the biofeedback literature 3 reveals a trend that is a source of tremendous frustration to biofeedback practitioners who were, like myself, trained as research-minded psychophysiologists. In countless well controlled studies demonstrating clinical effectiveness for biofeedback (that is, Elmore and Tursky, with migraine headache patients; 6 Harrison, Carlsson, and Berggren, with dental phobic patients 7 ) there exists no significant correlation between the degree of physiologic control in biofeedback training for a particular patient and the degree to which that patient clinically benefits from biofeedback. It is true that this failure to establish such an association may be more a measure of our ignorance in the area of dynamic physiologic functioning than a total breakdown of the central theory of how biofeedback works. At present, however, this finding persistently forces authors to conclude that there must exist therapeutically powerful nonspecific actions of biofeedback in order for it to work so well but not, apparently, in the particular way in which we want it to work. Contemporary behavioral treatment literature has borne witness to an assault on the notion that anxiety, and the inhibition of anxiety responses, so crucial to the theory behind systematic desensitization, 17 best captures the nature of phobic disorders and most clearly suggests the path to treatment. These new treatments emphasize learning coping skills, 13 providing patients with guided mastery experiences 15 that are designed to enhance self-efficacy, 1 and assailing against negative response propositions, 8, 12 response propositions being images in patients’ heads of themselves behaving phobically. Surely any judicious therapist would attempt to capitalize on the value of all of these treatment metaphors in trying to help a given patient. It is particularly true, however, that by simply conducting biofeedback therapy properly, one may be said to access them all. Biofeedback is, by definition, a highly active form of treatment, enlisting the patient's involvement in all aspects of the therapy, with training on the instruments at each visit, the completion of record keeping and other “homework,” the daily practice of relaxation exercises, and so forth. Biofeedback therapy continually provides patients with active coping skills having to do with the understanding and control of their phobic behavior. Patients are provided with direct, guided mastery experiences during the treatment sessions in the form of their performance on the biofeedback instruments. Doing well in biofeedback training is a guided mastery experience, not merely the discussion in therapy of what a patient might do to have one. In terms of enhancing self-efficacy, biofeedback is the only treatment that can give a patient a conspicuous, objectifiable episode of self-mastery in 20 minutes or less! Negative response propositions are assailed in true psychophysiologic fashion by having patients imagine themselves behaving in the opposite fashion (cognitive intervention) while they are keeping themselves relaxed (physiologic control).