I have several reservations and comments about this posting.
Marion writes:
> Hayley
> Whilst I can not advise you on where to get a tape, I can give some other
> advice. I have supervised a number of student projects looking at
> relaxation and we have found that if 'normal' subjects are used then
> measures like heart rate are not likely to show any significant change
> regardless of the technique used. Subjects who are not experiencing the
> physiological effects of tension achieve their normal resting heart rate
> very quickly after being placed in a relaxing environment,
> regardless of any intervention.
(1) I would not place much stock in "student projects", since
clinical experience shows that the level of experience of the
trainer has a lot to do with outcomes in relaxation training.
Teaching people to relax is a very skilled art as well as science.
Expecting students to be skilled is like letting first year medical
student perform surgery. Not likely to be satisfactory.
(2) heart rate is very difficult to influence, since it is highly
regulated and "self-leveling" anyway. There has been a lot
of research in the biofeedback field in recent years under the
title of "cardiovascular regulation" which you should consider.
Look at the work of Richard Gevertz and others at the
Prof. Psych. school in San Diego for more details.
(3) There is a long history of progress in the biofeedback field
concerning the relative efficacy of various relaxation
techniques, which confirms your statement about the relative
equivalence of various techniques. However, it has been
shown that when biofeedback techniques are used, and the
method is "training to criteria" (e.g., raising peripheral
[finger] temperature to 96 degrees F in 20 minutes), the
results are superior to other techniques such as one might
find on relaxation tapes.
> We have tried other measures including skin
> conduction level
> but have been equally unsuccessful.
In clinical practice it is common to use (1) surface EMG,
(2) temperature and (3) skin conduction levels simultaneously
in computerized biofeedback systems to get a better picture
of which of the various systems (autonomic or somatic) is
not relaxing. Complex interactions are often the rule, and
it takes a lot of clinical experience to determine just what is
"wrong" with an individual patient. Heart rate is very
slow to change significantly, most likely not much during the
course of a semester-long project.
> We have also tried using as subjects,
> students immediately prior to examinations as they report feeling
> stressed, but that didn't work either.
It isn't clear "what" didn't work --- the prime suspect here
would be your therapeutic interventions and timing.
Since it takes several weeks, at least, to learn relaxation
skills, it would be worthless to intervene on the eve of an
exam.
>
> My feeling is that if you want to seriously compare two relaxation
> techniques then you have to use subjects who are suffering from chronic
> stress that has led to physiological change.
Actually, at least on this side of the pond, virtually any person
on the street qualifies for that criteria. Perhaps life is quieter
in your country, but here many "normal" people suffer the
subtle physiological changes caused by chronic stress.
One cause of failure in research like this is that the techniques
used, and the way they are used, is simply not effective. Since
1986, with the publication of the monograph ""From The Ghost
in the Box To Successful Biofeedback Training" (available at
http://www.incontinet.com/ghost.htm), researchers have been
alert to a number of common errors. Here is the table of
contents for chapter 2:
==============================================
Methodological and Conceptual Errors 13
Error #1: Insufficient number of training sessions 13
Table 1: Studies with minimal training 14
Error #2: Insufficient length of each training session 16
Error #3: Homework exercises are not given 17
Error #4: Failure to maximize internal locus of control 19
Error #5: Failure to provide adequate cognitive support 22
Error #6: Double-blind designs 25
Error #7: Failure to establish training criteria 30
Error #8: Using a relaxation control group for comparison to biofeedback
training 35
Error #9: Failure to incorporate mental/emotional variables in biofeedback
training 39
Error #10: Failure to establish reliability measures and confidence bands
43
Figure 1: EMG Confidence Bands 45
Error #11: Failure to control for adaptation 48
The Mastery Model 50
Error #12: Failure to train to mastery 50
=======================================
The book is "shareware" ($5) on the internet, but you
don't have to pay unless you admit it has changed your
whole outlook on the subject.
Finally, in recent years there has developed in the biofeedback
field a specific interest area called "Optimal Functioning" or
"Peak Performance". In fact, the March issue of the news
magazine "Biofeedback" is devoted to this topic. (See it at
http://www.aapb.org/public/articles/index.cfm?Cat=18)
Visit other pages there for more information about using
biofeedback to enhance the skills of "normal" subjects.
And one more observation: There is so much BAD research
published about biofeedback and relaxation, etc., that this
week the President of the AAPB (Association for Applied
psychophysiology and Biofeedback) has established a "Task
Force on Research Methodology" that is charged with
defining general standards of evaluating and grading published
research in the field.
Hope this helps,
John Perry, PhD, BCIA-C (Senior Fellow)
Chair, AAPB Insurance and Legislative Committee
>
> Marion Trew
> University of Brighton
>
> > ----------
> > From: Hayley Rackham[SMTP:[log in to unmask]]
> > Reply To: - for physiotherapists in education and practice
> > Sent: 18 June 2001 17:25
> > To: [log in to unmask]
> > Subject: Laura Mitchell
> >
> > Hello All,
> > I am hopefully returning to university in spetember for my
> third and final
> > year of my Physio degree.
> > My dissertation topic is to investigate the effectiveness of
> the mitchell
> > relaxation technique compared to breathing exercises in the supported
> > sitting position by measuring heart rate pre and post intervention.
> > I was wondering if anyone knows how to get hold of a mitchell tape, or
> > will
> > I have to make my own? Apparently mitchell tapes were sold
> around the time
> > the book 'simple relaxation' was around but this is now out of print.
> > Any suggestions?
> >
> > H.R
> >
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