The process toward awareness of bodily feeling and biofeedback

Abstract

Patients with psychosomatic disorder or functional somatic disorder display difficulties in identifying emotional or bodily feelings. We have conducted psychophysiological stress profiling (PSP) in those patients and healthy controls, and investigated the relationship between psychophysiological index and subjective bodily feeling. Our previous studies suggested that the relationship between objective and subjective estimation in the patients would differ from that of the controls. In the present study, we performed PSP in 52 patients with psychosomatic disorder and 30 healthy controls. Changes of psychophysiological index (skin conductance level/forehead electromyogram as a index of mental/physical tension) in pre-/in-/post-stress and subjective feeling (mental and physical tension) were investigated. Psychophysiological index did not significantly differ between the patient and the control group, but subjective bodily feeling differed between two groups. Patients had the same physiological tension as controls, but felt higher tension than the controls. Especially in physical tension feeling, patients showed less variant pattern. Chronic high tension makes it difficult to feel relax sensation, which would lead patients to conditions of "alexisomia". Discussions about the process toward awareness of bodily feeling and biofeedback were made through a case of psychosomatic temporomandibular disorder. The case, at the beginning, showed high bodily tension, had a tendency toward intellectualization rather than somatic consciousness, and showed reduced awareness of bodily feelings. Through the approaches including biofeedback, the functional linkage between intellection and sensory recovered and the whole awareness of bodily feeling was heightened. Ikemi, et al. stated availability of biofeedback for encouraging the awareness of bodily feeling. Biofeedback adapts subjective bodily feeling to objective state of body. Through such process, functional dissociation among the cerebral level for cognition, the limbic level for emotion, and brainstem level for bodily feeling would resolve. The awareness of bodily feeling leads awareness of emotional feeling, and also leads awareness of mind-body interaction.