Biofeedback relaxation training: a rediscovered mind-body tool in public health

Abstract: More attention is turning to mind-body approaches in public health with the increased realization of the importance of the stress-disease relationship. This paper reintroduces biofeedback relaxation training (BFRT) as a mind-body tool for stres management to address stress-related disease in public health practice. Public health practitioners are provided with a responsible assessment of the integration of relaxation approaches into the treatment of stress-related diseases and conditions in public health as well as theoretical background for of the like kind integration. The implementation issues and implications for the use of BFRT among public health professionals as an instructional technology for stres management are discussed.

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Before BFRT can be introduced, it is important to discuss stres its relation to disease, and the importance of gaining awareness of the mind-body connection. Following this discussion, an introduction of BFRT its relation to health promotion theory, and its application and implementation issues are presented

STRESS

Cox (1978) defined stres as any influence that disturbs the natural equilibrium of the material part and includes within its concern physical injury, exposure, deprivation, and all kinds of disease and emotional disturbance. In the 1997 Hans Selye Memorial prelection Chrousos stated that despite marked advances in stres research there remains to be confusion as to what stres is commonly Selye has been quoted as saying that, "Life exists through maintaining a complex dynamic equilibrium or homeostasis, which is constantly challenged through intrinsic or extrinsic adverse forces or stressors" (Chromo 1998) During this discourse stress was defined as a state of threatened homeostasis, which is reestablished by dint of a complex repertoire of physiologic and behavioral adaptive rejoinders of the organism. In addition, biologic stres was defined as the "nonspecific answer of the body to any demand made on it" according to the latest definition Hans Selye used (Chrousos, 1998)

greatest in quantity recently, Weiner acknowledged the specificity of stressor rejoinders by describing stressors as selective crushings from the physical and social environment that threaten or challenge an organism and elicit compensatory replication patterns (Pacak, 2001). Chrousos and Gold have defined stres as a state of disharmony or of threatened homeostasis, evoking physiologically and behaviorally adaptive replications that can be specific to the stressor or generalized and nonspecific and that usually be found stereotypically, producing a "nonspecific" stres syndrome when the threat to homeostasis caps a threshold (Pacak, 2001).

Definitions of stres may vary however, what is important to recognize is that individuals share public physiological responses to stress. Public health professionals ne to understand in what way varying physiological and psychological answers to chronic stress affect long-term health consequences

STRES AND DISEASE

Individuals reply to novel and challenging environmental information cognitively and physiologically via activation of the sympathetic nervous combination of parts to form a whole (SNS) and the hypothalamic-pituitary axis. This rejoinder can influence health status. The output to effectors of the SN is diffuse, resulting in widespread issues throughout virtually all of the a whole s of the body. An example of this output is outlined in Figure 1 In this example, the events of SNS output on life-blood pressure (BP) are shown.

[FIGURE 1 OMITTED]

As seen in figure 1 exposing to endogenous or exogenous stres stimulates undefined areas of the central nervous a whole The responses of the central nervous a whole are integrated by the hypothalamus and involve coordinated activities of several neuroendocrine a whole s to produce metabolic, circulatory, and behavioral consequences Specifically, in response to stres the hypothalamus (1) stimulates autonomic center within the medulla activating the sympathetic nervous a whole (2) releases corticotropin-releasing factor (CRF) activating the anterior pituitary gland, and (3) stimulates the posterior pituitary gland. Stimulation of the SN springs in sympathetic nerve discharge and succeeding release of norepinephrine from peripheral power endings and epinephrine from the adrenal medulla. Norepinephrine bring outs contraction of arteriole smooth muscle, resulting in a rise in BE Epinephrine shows an increase in heart rate and the force of cardiac contraction, contributing to a rise in BP Simultaneously adrenocorticotropic hormone (ACTH) from the anterior pituitary gland stimulates the adrenal cortex to release aldosterone and cortisol. Aldosterone increases sodium and water retention through the kidney. Cortisol, in cooperation with catecholamines, increases cardiac output and BE Lastly, vasopressin, from the posterior pituitary gland, increases water retention. This increase in water retention, together with contraction of arteriolar polished muscle and increase in the rate and force of cardiac contraction, ensues in a rise in life-current pressure.