Reprinted from In Touch - Volume 1 Issue 1 copyright 1992
Marc Lehrer, Ph.D. Clinical Director, Biofeedback Clinic of Santa Cruz

Biofeedback is the use of methods to help a person learn how to change and control physical responding. The parts of the body most usually worked with include: temperature of hands and feet, muscle activity in the face, forehead, neck, shoulders and back, respiration rate and breathing rhythm patterns, sweating in the palms and fingertips, heart rate and normalization of heart rate patterns, and brainwave patterns. The computerized Biofeedback utilized in my clinic allows you to see and understand changes in your physical and emotional responding with both color computerized displays and musical tones from a synthesizer.

Biofeedback can be useful in helping to treat some forms of OCD and trichotillomania because you can discover alternative ways to release and reduce tension, while also learning to reduce overall stress levels. Once stress is reduced, you can apply other ways of relating and behaving that you know are better for you without being so vulnerable to fall back into the of patterns of stress protection.

A typical course of Biofeedback treatment at my clinic is about 8 - 15 sessions with lots of home practice assignments. One great aspect of this type of treatment is that you become capable of recognizing when you are doing better with stressful situations, which can usually also help with many self concept concerns.

Two strategies using biofeedback for hair pulling seem most helpful. First, the most direct approach is to provide muscle feedback regarding muscle tension levels on the face, forehead and neck areas. The goal is A) reduce muscle tension in these areas and B) provide a more healthy focus upon the face and head in terms of stress relief.. In this sense muscle biofeedback can help to provide what I call a new better bad habit of being occupied and perhaps preoccupied with reducing muscle tension levels.

The second approach involves use of breathing feedback (using a rubber belt that shows when you breathe into your abdomen), temperature feedback, and feedback involving sweating of the hands. Each of these feedback methods have the potential to reduce anxiety, and to distract attention from the undesirable behavior. More importantly, each, when done well, results in good to overwhelmingly good feelings of relaxation.

Biofeedback is just a series of techniques and learnings that anyone can do. Hair pulling is also a form of biofeedback in that the puller gets feedback when stroking and / or pulling, when looking at or eating the hair, when counting the hair or when realizing she or he has pulled the hair by other indications such as a pile of hair on the floor.

As a therapist who uses biofeedback and hypnotic suggestion I ask you to consider use of these techniques as a way to provide new habit patterns. If we don't know that there can be a better world, perhaps some of us won't try to find it.