Biofeedback therapy is a service offered for chronic pain patients through Springfield Clinic’s Interventional Pain Management Department, whose collaborating physicians are Rohan Jain, MD, and Dylan Afeld, MD. For National Professional Social Work Month, we asked the department’s pain counselor Amy Goldstein, LCSW about biofeedback and the work she does to help patients cope with chronic pain.
Q: What is biofeedback therapy?
Amy Goldstein, LCSW: The definition of biofeedback therapy is a non-drug treatment in which patients learn to control bodily processes that are normally involuntary, such as muscle tension, blood pressure or heart rate. But I try to describe it to people as ‘really fancy relaxation techniques.”
Essentially, you can see certain vitals, representing your bodily processes, on my computer screen. I can walk you through relaxation techniques like diaphragmatic breathing and progressive muscle relaxation to help you control these processes. Control of these processes lets you control your body’s responses to stressors, such as chronic pain. We’re never going to be able to make all of your pain go away completely, but biofeedback can help you get to the next moment; we can help take a “nine” pain day on a scale of one to ten down to a “five.”
Q: How does pain counseling go with biofeedback therapy?
AG: As a pain counselor, biofeedback is just one of the tools I am able to use to help our patients. Biofeedback therapy is the actual process of looking at your bodily processes through your vitals and learning to control them. Pain counseling is where I teach you techniques to help you manage your pain.
But, we can do pain counseling without biofeedback therapy. We’ll talk more generally about how pain impacts you emotionally and psychologically, and we’ll work on relaxation and distraction techniques you can use in your daily life to help you manage your pain. Once you learn them, all of these skills can and should be done regularly at home to help you deal with your pain.
Q: When do I start seeing results from biofeedback?
AG: You can start to see results after as few as two biofeedback sessions. It’s all about the breath. Most people breathe 10-15 times per minute, and my first goal is always to get you down to six breaths per minute. I’m asking you to drop it by more than half, which can be kind of upsetting at first, but as soon as you become comfortable with this level of breathing, you can start seeing results.
Once you start to engage this diaphragmatic breathing, you can start using it immediately at home, and then you can stop coming in to see me as often. I have some patients who I see weekly, but I also have some patients I don’t see regularly who call every once in a while if they need to come in for a refresher.
Q: How does your background as a licensed clinical social worker fit in to pain counseling?
AG: I’ve been a licensed clinical social worker for seventeen years, but I started in forensics working with prisoners for the Department of Corrections in Illinois and Texas. One of the things we dealt with a lot with the Department of Corrections was pain management for prisoners who didn’t have access to pain injections or medications. It felt like a very natural transition to then come to Springfield Clinic and apply those skills here, and it’s very rewarding to be able to see progress in our patients.
Aside from being able to use counseling skills with biofeedback, it’s just easier if the person administering the biofeedback can talk to you. While I’m hooking you up to the machine, I’m checking in with you, I’m talking to you about your day, I’m assessing where you are emotionally as well as physically. If you’re tense that day, we can talk about where the tension is coming from and see if we can make improvements in the moment. Being an LCSW gives me the skills to be able to do all that.
Q: Why is it important to you that patients have access to a service like biofeedback?
AG: I think it’s so important that people have options. Biofeedback and pain counseling can work for someone who’s never been on pain medication and is looking for non-drug options, as well as someone who has been taking pain medications for so long they’re no longer effective. It can get really dark when you feel like this is the end of the road and there’s nothing left for you. This is another option, something we can try. And through pain counseling we can talk about those negative feelings and put things in place to help protect you from them.
I think it’s great that we offer this within the Interventional Pain Management Department. That shows the importance of counseling and therapy to the pain management physicians, and it removes a lot of the stigma from therapy. Dr. Jain and Dr. Afeld are showing you that, yes, this is important, we support this, we see the value in this.
Q: What should I know before coming to see you?
AG: Don’t be scared. It’s your choice, I’m not going to force you to do any of it. I’m not going to psychoanalyze you in that first meeting; I’m going to provide you with information. And if it’s something that you want to do, we’ll make it work. If you don’t, that’s okay too.