Treatment protocol for stress-related disorders consists of an initial evaluation combining interview questions with
computer technology. After the initial assessment, several treatment modalities are used including computer-assisted
stress management and relaxation techniques. One such program is heart rate variability training (HRV), a computer
program that utilizes breathing and its impact on heart rate to better balance the autonomic nervous system. Several
of these techniques are then practiced at home to help lower the body’s emotional response thereby decreasing
stress-related symptoms such as headache, stomach discomfort, and anxiety. After chronic illness or with ongoing
stress the body’s autonomic nervous system can respond with hyper-sensitivity and hyper-reactivity to everyday stressors
resulting in distressing symptoms. Combining biofeedback with skill-based learning of behavioral and relaxation
techniques helps to calm the over-active nervous system, thereby lessening the associated symptoms.
The number of treatment sessions is dependent on: 1) severity of symptoms and 2) follow through on home practice. Average number of sessions is between 3 and 4 when home practice is consistent.
Case examples:
Young woman diagnosed with IBS was concerned about returning to school and sitting through classes without gas pains and bathroom runs. Had one session including HRV training and relaxation techniques. The client reported practicing daily. On last phone call, one month post treatment, client stated she was doing well, feeling well with fewer troublesome symptoms, and reported the techniques had actually improved her ability to concentrate in class.
Older woman (upper 70s) diagnosed with colonic inertia (severe constipation). Colon surgery with resulting colostomy was being recommended at the time of the referral. Initial evaluation revealed an inability to move her bowels but every three to four days with intense pain and the help of dulcolax. After one session of learning abdominal breathing she felt a “release in her belly”. Starting the next day she was moving her bowels four times a day without pain. Came for two more sessions to reinforce learning and build a repertoire of techniques to use as needed. Found that there was an emotional trauma that probably triggered the initial episode. Did a phone call for a 3-month followup. She still reports moving her bowels regularly and without pain.
Thirtyish woman troubled by constant anxiety for about five months, although had suffered with panic attacks in the past. After second session of HRV training was no longer waking up as often with anxiety and felt her brain was less “chatty” or distracting. After third session patient was sleeping through the night five out of seven days. Patient stopped after 4 treatments.
Fifteen year old teenager suffering with debilitating headaches for 6 years. Also suffered from fatigue and hyper-reactivity to stress. After 13 EEG, 4sEMG and 4 HRV sessions, patient experienced fewer headaches per month despite suffering a bout of pneumonia, taking SAT for 3 ½ hours and taking final exams. Energy remained good despite the increased stress.
