Leading the Way in Trauma Therapy

Trauma Institute & Child Trauma Institute

Did you ever have a mood ring? This type of ring features a clear plastic or glass “stone” with liquid inside that changes color as it changes temperature. Mood rings were generally sold along with a chart purporting to tell you what mood you were in, based on the color of the stone at any given moment. If you had a mood ring, did you ever intentionally try to get it to change color? If so, you’ve done biofeedback.

Biofeedback involves connecting a device’s sensor to your body to measure brain waves, heart rate variability, breathing depth, muscle tension, body temperature, or some other physiological indicator (Yucha & Montgomery, 2008). The gathered information is conveyed through a feedback machine that provides visuals or sounds that tangibly depict your physiological state. For example, a dot on the screen will buzz and move as you become emotionally or physiologically activated, and will become increasingly still as you relax. By being able to view a graphic real-time portrayal of mind/body activation, individuals can learn and practice various strategies for bringing their mind and body into an optimal state (Yucha & Montgomery).

That optimal state is the point of biofeedback. Biofeedback-assisted development of self-regulation skills and practices have contributed to symptom reductions in many types of mental health disorders (Schoenberg & David, 2014). Even children can do this; video game style biofeedback technologies, designed to engage children, have been successful in reducing anxiety and depression (Knox et al, 2011). A number of studies have found that biofeedback led to symptom reduction – but not cure* – among individuals with PTSD (Gapen et al, 2016; Tan, Wang, & Ginsberg, 2013).

To treat psychological trauma and associated symptoms, it is best to rely on efficient, well-tolerated research-supported treatments such as EMDR and PC, that have reliably been found to cure or substantially mitigate post-traumatic stress. Even so, there can be important roles for biofeedback. During treatment, biofeedback can be used adjunctively to promote the therapy client’s stability between sessions, as well as their ability to tolerate the trauma work during the therapy session. Furthermore, even after successful trauma healing, some people find that their hyper-arousal symptoms persist, and then biofeedback can be used to retrain the brain to a better habit of self-regulation.

You can pick up a mood ring for just a few dollars, but the higher quality biofeedback technologies cost somewhat more. Even so, biofeedback no longer requires an investment of tens of thousands of dollars for equipment that would only be owned by specialists. The technology is much more accessible now, and many devices are sufficiently small and inexpensive to be suitable for home use.

Biofeedback as a stand-alone is not going to cure PTSD. But for therapy clients – and former therapy clients – who are looking for ways to improve self-regulation, biofeedback has a lot to offer. We’ve come a long way from mood rings!

*A single study by Peniston & Kulkosky (1991) did find that biofeedback cured PTSD. However, that study had methodological issues, and the finding has not been replicated.


Gapen, M., van der Kolk, B. A., Hamlin, E., Hirshberg, L., Suvak, M., & Spinazzola, J. (2016). A pilot study of neurofeedback for chronic PTSD. Applied Psychophysiology And Biofeedback, 41, 251-61.

Knox, M., Lentini, J., Cummings, T. S., McGrady, A., Whearty, K., & Sancrant, L. (2011). Game-based biofeedback for paediatric anxiety and depression. Mental Health In Family Medicine, 8, 195.

Peniston, E.G. & Kulkosky, P.J. (1991). Alpha-theta brainwave neurofeedback therapy for Vietnam veterans with combat-related posttraumatic stress disorder. Medical Psychotherapy: An International Journal, 4, 47-60.

Schoenberg, P. L., & David, A. S (2014). Biofeedback for psychiatric disorders: A systematic review. Applied Psychophysiology and Biofeedback, 39, 109-135.

Tan, G., Wang, P., & Ginsberg, J. (2013). Heart rate variability and posttraumatic stress disorder. Biofeedback, 41, 131-135.

Yucha, C., & Montgomery, D. (2008). Evidence-based Practice in Biofeedback and Neurofeedback. Wheat Ridge, CO: AAPB.

Note: This post was authored by Ricky Greenwald, PsyD and Margot Reilly, LCSW.

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