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Beyond Biofeedback – Drs Elmer and Alyce Green

Seymour Furman (1973) reports the use of biofeedback training in the treatment of five patients suffering from functional diarrhoea but manifesting no organic pathology. Commenting on the current treatment of such disorders, Furman says,

 "While the extent of disability can be overwhelming, the present status of treatment leaves much to be desired. Anti-cholinergic drugs, low-residue diets, and opiate derivatives for relief of abdominal cramps constitute the major modalities. Traditional insight-oriented psychotherapy and classical analysis have been unimpressive in relieving the presenting symptomatology.”

The five patients were all female, ranging in age from fifteen to sixty-two years. Biofeedback was provided by an electronic stethoscope placed on the patient's abdomen as she sat in a semi-reclining chair in a pleasant, unstressful atmosphere. The amplified bowel sounds, played back through a loudspeaker, gave instantaneous audible feedback to both patient and operator, enabling them to converse without interrupting the signals.

In a series of thirty-minute sessions the patients practiced alternately increasing and decreasing peristaltic action (movement in the bowels). Imagery was used in achieving the desired response, and the patients were impressed by their ability to be aware of and control formerly subliminal sensations. They were praised for each success.

All five patients were housebound to some degree, and had resigned themselves to this limitation of their freedom, planning their lives around their disability, making sure, for example, that a toilet was always quickly accessible. All reported that their symptoms were intensified by stress. Four of them had been under medication over a long period of time. The number of sessions required to achieve autonomic control varied among patients, yet all of them showed some degree of control within five training sessions. Furman states that although some of the patients did not achieve excellent control of peristaltic action, "Most impressive was the high correlation between the achievement of even partial or intermittent control and the remission of symptoms.”