In this interview with the psychologist Dr Melanie Lenger find out how Biofeedback as a supplement in the inpatient treatment of Depression can be used. She discusses the effectiveness of biofeedback, particularly in improving body awareness and symptoms such as a flattening of affect and drive problems, and gives valuable tips on how to successfully implement the method in an inpatient setting.
Question: In your opinion, how effective is biofeedback as a supplement in the inpatient treatment of depression or affective disorders in general?
Answer: Biofeedback can work very well as an icebreaker in an acute psychiatric setting. Patients train their body awareness, i.e. the connection between „How am I feeling?“ and „How is my body feeling?“. This is something that many people don't realise or haven't thought about for a long time. Measuring what my muscle tension and breathing are doing and feeling „How am I doing?“ is very important. Biofeedback is a clear behavioural medicine method that many patients can engage with well. Patients develop a great deal of trust and you can map the feeling of emptiness and sadness to a certain extent. This leads to further therapeutic discussions. Overall, I find biofeedback to be very helpful when it is used as a supplement. It can offer valuable support to many patients.
Question: Which Training parameters have you found particularly helpful when working with depressed patients who often suffer from a flattening of affect and drive problems? What can help to improve these symptoms?
Answer: As with all standard biofeedback treatments, the breathing parameter is also very important for depression because many patients have not experienced the connection between body and psyche for a long time. Breathing is something they can change quickly and feel well, so it's important to start with that. Heart rate variability training can also be useful if breathing is working well. Activation training such as progressive muscle relaxation is also helpful. Many depressed patients experience themselves as tired and emotionally flat, but rarely as relaxed. Through relaxation, they can learn to feel themselves again and be active, which can be very helpful. In addition to breathing, heart rate variability, muscle tension and skin conductance are important parameters. Skin conductance is more difficult to manoeuvre at the beginning and requires pre-training, but it provides valuable feedback when patients realise: „I'm at operating temperature.“ Therefore, I would personally start with breathing, muscle tension and heart rate variability.
Question: In an inpatient setting, what is important if you want to establish the method so that it is successfully accepted by staff and patients? Do you have any tips on how to achieve this?
Answer: If you work in an inpatient setting, for example as a psychotherapist, clinical psychologist, psychiatrist or physiotherapist, you have direct access to the method if you appropriately trained is. When patients are referred for treatment, biofeedback can be used as part of clinical-psychological treatment, relaxation training or behavioural activation, for example. If you support the method that you are already using with the biofeedback device, it often becomes a sure-fire success. Patients report their positive experiences during the ward round: For example, „I did this yesterday, it did me a lot of good, I understood it“ or „I wasn't aware that this could be imaged, I thought it was only psychological“. As a result, you quickly get the next referral. Biofeedback has a fast success rate, and once you use it, word spreads quickly among the patients and the team. I haven't experienced any difficulties in a multi-professional team so far.
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