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The Psychology of Biofeedback

As winter wanes and the year picks up speed, New Year’s resolutions typically peter out and eager new exercisers often disappear from the gym. For fitness and wellness professionals, this can be a frustrating time. But if we recognize this phenomenon and engage our clients early with tools that keep them motivated, we can help people stay on track. Biofeedback mechanisms—like pedometers, heart rate monitors and body bugs—can help clients recognize their reactions to different experiences and eventually empower clients to gain some control over their internal biological processes. Through skillful use of these tools in the training environment, we can help clients develop their own motivation to change their exercise behavior.

Is Ignorance Really Bliss?

The poet Thomas Gray suggested in the 18th century that ignorance is bliss. Certainly, it can be tempting to float through life, not worrying about what we don’t know. But what if our ignorance is hindering us from achieving something greater? What if we evolve the phrase to say, “Awareness is powerful”?

As exercise professionals, we know a lot about raising heart rates and targeting muscle groups; we know which response we want to elicit from tissue based on time under tension or the load we choose. Physically, our clients may see results quite quickly, but even so, they may not persevere with training, simply because their behaviors or actions were not rewarded through cognitive association.

Biofeedback tools immediately measure clients’ contribution, telling them exactly where they are in relation to where they want to be, promoting ownership of the program and feeding into the reward system of the human brain (Schwartz & Schwartz 2003). By offering clients an environment full of feedback tools that trigger awareness of performance—and therefore create cognitive associations—we can affect clients’ psychology and foster greater exercise adherence.

The Brain’s Reward Systems

The human being is uniquely wired to seek pleasure and avoid pain. As a stimulus from our environment enters our brain, it is first registered by the limbic system. A stimulus can originate from inside the body or outside the body; either way the limbic system processes the stimulus and determines what type of urge or desire it is. The urge or desire is then sent on to the cortex, which instructs the body to act on the initial stimulus. When the action satisfies the urge, we are rewarded, and the activity triggers signals that travel back to the limbic system, which responds by releasing opioid-like neurotransmitters. These neurotransmitters raise circulating dopamine levels and create a feeling of satisfaction or pleasure (Carter 2009). When the same stimulus presents itself again, the body recognizes it and begins to associate it with the feeling it generated the first time.

For instance, if our body is presented with an external stimulus of a nice cold pool on a hot summer day, our limbic system takes that cold pool and turns it into a desire or urge, which in this case may be to cool down our internal temperature. The desire is sent on to the cortex, where the higher centers of the brain tell us to act by putting on a swimsuit and jumping in. We are immediately cooled off, and this result satisfies the desire we had, so the limbic system releases its opioid-like neurotransmitters, increasing our dopamine levels and leaving us satisfied. If presented again with a cold pool on a hot summer day, we automatically associate it with the positive feelings we recall from our first encounter, and more than likely we will jump in again.

Understanding how the brain functions in response to stimuli and how it processes stimuli to initiate the brain’s reward centers, we can begin to apply feedback tools in the training environment with the purpose of playing on those reward mechanisms and facilitating change through positive association.

Here’s one example: A pedometer, which has the basic function of counting steps, gives a person a stimulus that indicates how much he or she moves. Assuming the client is wearing the pedometer with a goal in mind (e.g., feeling better by moving more or achieving a personal best for steps walked), the body will then take the information the tool provides and turn it into an urge or desire to meet that goal. This urge or desire is then processed through the cortex, the body responds through action, and the action satisfies the urge or desire, triggering the reward pathways in the brain. As a feedback mechanism, the pedometer is now providing awareness of behavior, and because of that awareness the pedometer will trigger the reward pathways again and again, when the client looks at it.

The Psychology Behind Biofeedback

Biofeedback mechanisms increase awareness of behaviors: clients know how many steps they have taken, how high their heart rates are or how many calories they have consumed and burned. When this awareness stimulates clients to positive action, they are rewarded, and once rewarded, they are satisfied—but the same action will not continue to yield satisfaction indefinitely. At some point, the stimulus must change slightly, initiating a different action or response, in order to keep triggering the reward pathways.

Biofeedback mechanisms provide a continuous feedback loop, and the feedback (or stimulus) changes as clients’ performance or efforts change. Consequently, within the supportive environment of a trainer-client relationship these mechanisms can provide motivation for behavioral change. Furthermore, as discussed below, the feedback feeds into the innate psychological needs of the human psyche.

Self-determination theory, originated by psychologists Edward Deci and Richard Ryan, states that human beings have three innate psychological needs: competence, autonomy and relatedness. When those needs are satisfied, we are motivated, productive and happy (Pink 2009). So when we help clients experience competence, autonomy and relatedness within a workout program, we foster attainment of goals, exercise adherence and satisfaction because clients’ essential psychological needs are met.

A heart rate monitor is a perfect example of a biofeedback tool that, if employed well, can help clients meet all three psychological needs. The monitor gives millisecond-by-millisecond feedback of how a client’s body is responding to an exercise session.

Competence. First, using this tool to measure exercise intensity fuels competence: when a supportive trainer cues a client to get to a particular heart rate during an exercise and the client commits to reaching that goal, the heart rate monitor can provide a stimulus for the client to act. For example, if the monitor shows that the current rate is 10 beats per minute lower than it needs to be, this stimulus urges action by the client. The action, whether it be increasing the tempo of the exercise or moving through a greater range of motion, is rewarded when the client sees the heart rate increase. And in the very moment when the rate hits the target number, the client has the experience of having successfully accomplished a goal using his or her own ability and effort. The client feels “competent” at the given task. As the workout continues, and the trainer selects different heart rates for the client to aim for, the client will continue to act on the heart rate monitor’s feedback and will successfully meet more goals, thus building greater competence.

Autonomy. Second, a heart rate monitor can foster the client’s need for autonomy if the trainer accommodates this. Although the trainer will suggest a desired outcome and cue a specific heart rate to correlate with this goal, the need for autonomy can be satisfied if the client gets to choose how he or she will raise heart rate to the desired level. This freedom gives the client a greater sense of owning the workout, and this stronger connectedness with the program may help promote adherence (Pink 2009).

Relatedness. Last, relatedness develops as a sidebar to competence and autonomy. Relatedness is not only the need to feel part of something; it is also the need to care sincerely about others and have others care sincerely about us. Relatedness encourages us to accept responsibility—for the well-being of others as well as ourselves (Beaumont 2009).

During a series of training sessions, a client-trainer relationship forms, and trainer and client build trust and rapport. When the trainer chooses to use a heart rate monitor to provide play-by-play biofeedback of how hard the client is working, the client is likely to feel an enhanced synergy of working together toward desired goals. The trainer communicates earnest interest in the client’s progress through the use of a biofeedback device that accurately displays improvement. In turn, the client experiences this collaborative energy and is further stimulated to achieve and sustain more progress.

A biofeedback device by itself may or may not stimulate change. However, as viewed through the framework of Deci and Ryan’s theory, we see how applications of biofeedback tools and related client-trainer communications can further the satisfaction of client needs for competence, autonomy and relatedness.

Tools for Change

Awareness is powerful! By implementing biofeedback mechanisms in our programming, we are doing more than giving clients numbers that indicate how much they are moving, or how hard they are exercising, or how many calories they are consuming and burning. Used in tandem with our own motivational skills, biofeedback tools can promote behavior change and help clients stay active for life.

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