The Clinical Handbook of Biofeedback by Inna Z. Khazan

Author:Inna Z. Khazan
Language: eng
Format: epub
Publisher: Wiley
Published: 2013-03-03T16:00:00+00:00

Physiology and Mindfulness in Temperature Biofeedback

Peripheral temperature depends on the diameter of the arterioles, small blood vessels that supply blood to the periphery of the body. The walls of arterioles, as is the case for all blood vessels, contain smooth muscle tissue that is innervated by sympathetic nerves. When the sympathetic nervous system is activated (i.e., stress response), action potentials travel down the sympathetic nerves to the neuromuscular junctions within the blood vessels, where norepinephrine is released. Norepinephrine (also known as noradrenaline), in turn, stimulates alpha-adrenergic receptors of the vascular smooth muscle to cause the blood vessels to constrict. When blood vessels constrict, blood flow decreases and so does the temperature of the skin.

Notice that there is no parasympathetic (i.e., relaxation response) innervation of the blood vessels. That is, the parasympathetic nervous system cannot act directly on the blood vessels to cause vasodilation. In order for the blood vessels to dilate and for peripheral temperature to increase, the sympathetic action has to decrease, thereby decreasing the amount of norepinephrine binding to the alpha-adrenergic receptors. In other words, your client has to learn to turn off the sympathetic response in order to raise finger temperature.

This is where active effort becomes particularly counterproductive. Effort, by definition, involves sympathetic activity. Increased sympathetic activity triggers vasoconstriction. Passive volition is the only way to allow the sympathetic response to quiet and for blood vessels to dilate, thereby raising peripheral temperature.

The easiest way to encourage passive volition is through language. As was discussed in the section on mindfulness, certain words have strong associations in our minds. Words like work, try, and effort are strongly associated with sympathetic activity. Words like allow, guide, let, and permit are associated with parasympathetic activity and quieting of the sympathetic activity. Before beginning thermal biofeedback, encourage your clients to let go of temptation to produce effort and focus on allowing the finger and/or toe temperature to rise.

Mindfulness practice focused on temperature sensations in the body (included in Appendix II) is a great way to begin thermal biofeedback, as it will allow your client to become aware of sensations related to the rise and fall in finger and toe temperature with no pressure to produce change. Initial passive stance will then allow your client to utilize techniques aimed at raising finger and toe temperatures without effort.

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