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Beyond Biofeedback – Drs Elmer and Alyce Green

Raynaud's disease is a vascular dysfunction characterized by reduced blood flow in the hands and feet. .....

Since temperature training in the hands was proving useful in the treatment of migraine, which is a vascular problem in the head, it was reasonable to suppose that it might prove useful in the treatment of Raynaud's disease.

Shortly after working with Lillian Petroni, Elmer tried this technique with a woman from out of town who stopped at the research building to see us. Although her purpose in coming to Topeka was to inquire about biofeedback for headache control, she complained that she had Raynaud's disease too.

Elmer asked if she would like to try the temperature trainer for her hands while at the lab, and when she answered yes, he took her through a training session. To her surprise, her hands turned from a rather dull gray-blue to a normal pink color as she succeeded in warming them in the first session. That was our only contact with her, except for a letter a year later saying that her Raynaud's problem had been greatly reduced after using the Autogenic Training phrases.

Dr. Sargent did not have time to conduct a biofeedback research project for Raynaud's disease, but he did accept a few Raynaud's patients.

His assistant, Barbara Pearse, had suggested an intensive five-day temperature-training program for migraine sufferers unable to take part in the migraine research project. Barbara, a warm and dedicated young woman, met with a surprising amount of success with this five-day training procedure, and was able to include a few Raynaud's cases. One of these patients had suffered migraine headaches for many years, until she was in a serious automobile accident. Then the headaches disappeared and were replaced by Raynaud's disease.

When she began her treatment, all her fingertips had sores on them. She was extremely nervous but was determined and diligent in practice. She completed her five days of training with a feedback meter and returned to her home in lowa with instructions to continue to practice the exercises at least three or four times daily. Three weeks later she wrote to Dr. Sargent and Barbara saying that lowa had had eight inches of snow and that for the first time in years she had been able to shovel the snow from her porch.

She could warm her hands almost every time she tried and believed she was doing very well, adding, "This is the first time I have been able to type in six years, and am I ever rusty!" In January she wrote again, saying that she was still progressing, that it had been twelve degrees below zero and her hands "have not turned blue-not once." She also felt that she was much calmer, and added, "For some reason I don't understand, I am regaining my memory." She had "lost almost all recall" following the accident. She told of crocheting an afghan, a sweater, and a skirt since Christmas, and ended her letter by saying, "My outlook is completely different. I really feel like a new person." This last remark is one that we and many others working in biofeedback hear frequently.

Sympathetic firing is controlled from the brain, at the hypothalamus, so in order to warm the hands volitionally it is necessary to turn down sympathetic tone at the source: the hypothalamic control center. Because this control center regulates blood flow throughout the body, when a person learns to warm the hands, vascular relaxation and rebalancing often occur over the entire body.

Presumably, this is what takes place when the temperature-control technique is used to treat migraine and Raynaud's disease. Learning to warm the hands at will, then, is essentially learning to decrease activation in the sympathetic nervous system.

The stresses of life activate the sympathetic nervous system, also known as the "fight-or-flight" system. Such activation increases blood pressure and heart rate, bringing about general activation of the body. If the tension level in the sympathetic nervous system does not drop when the crisis has passed, when the need for activation is over, but instead remains high, then psychosomatic disorders may ensue.