Biofeedback Therapy in the prevention of stress and emotional burnout of top managers

Zentsova Natal'ya Igorevna Doctor of Psychology Professor, Department of Clinical Psychology and Pedagogy, First Moscow State Medical University named after I.M. Sechenov (Sechenov University) 119421, Russia, Moscow, Novatorov str., 378 7226325@gmail.com

Relevance. In 2022, global events took place in the world, which were accompanied by high uncertainty and the strongest emotional stress. All this affected both managers at all levels and their teams as a whole. According to Kontakt InterSearch Russia, which implements projects in the field of management consulting, search and selection of top managers for corporate positions, in 2022, 28% of Russian company executives turned to psychologists, of which 14% did it regularly. At the same time, 31% of top managers constantly experience stress ^[10].

A study of well-being practices among top managers conducted in February 2023 showed that of 572 Russian company executives, more than half noted an increase in psychological stress, 37% indicated recycling on weekdays and 12% work daily, including weekends. At the same time, only 18% rate their professional level as high, 74% of respondents maintain it at an average level ^[8].

Thus, the stress tolerance of top managers, the ability to overcome anxiety in difficult times, is crucial for the successful operation of the team. The head, independent of external circumstances, makes more effective decisions. At the same time, resistance to adverse circumstances does not imply the complete absence of non-resource states, but, on the contrary, the ability to recognize and change them with the help of various psychotherapeutic techniques.

Novelty. At the same time, there is a need to find innovative methods to increase stress tolerance and emotional burnout of top managers. One of these methods is biofeedback therapy (biofeedback). Its principle is to analyze the state of organs and body systems according to certain indicators, in real time and conscious management of them ^{[2, pp.6-12]}.

BOS therapy is one of the most promising areas in preventive psychotherapy. At the initial stage of emotional burnout, the methods of BOS therapy are especially attractive, as they make it possible to prevent crisis states. During its implementation, approaches similar to cognitive therapy are used, contributing to the acquisition of skills to overcome stressful conditions. In this regard, BOS therapy will allow top managers to adapt their behavior, using biological feedback, towards a greater degree of self–regulation and homeostaticity.

The purpose of the study is to substantiate the use of the BOS simulator for the prevention of stress and emotional burnout of top managers.

The methodological basis of the research was the work:

– Yu.A. Naumova, N.Y. Khalina ^[5], V.G. Konovalova ^[4] on emotional burnout as a professional deformation of managers;

– V.M. Barshai, T.A. Rybkina ^[2], S.V. Guryeva ^[3] on the use of biofeedback for the correction of a psychoemotional state;

– A.V. Aladysheva ^[1], I.P. Yastrebtseva, V.A. Krivonogova ^[7], D.P. Hatch ^[6] on the influence of self-regulation on human internal reserves.

The study of the problem of stress prevention and emotional burnout of top managers is based on general logical methods of analysis, synthesis, generalization. As well as the methods of practical psychological research – testing, observation, evaluation method.

During the biofeedback session, the patient sits down in a comfortable chair. Sensors are installed on the head or on the body with the help of a special gel, which register the trained physiological signals and transmit them to a computer. The computer displays these signals in the form of a moving graph or game image, individual sounds or music varying in volume. Thus, a person can directly observe how the body's performance indicators change and learn to consciously manage them ^{[1, pp.86-87]}.

The patient is not a passive object of manipulation, but the main actor of the psychotherapeutic process. BOS therapy is painless and safe. The absolute contraindications to Bos therapy are:

1. The presence of serious signs of mental disorders, volitional sphere and intelligence;

2. Serious cardiac arrhythmias;

3. Diseases of internal organs in the decompensation stage

Relative contraindications:

1.Acute and acute chronic infectious and inflammatory diseases

diseases;

2. Injuries of the central nervous system, spine and chest in acute

period;

3. Pain syndrome of any origin;

4. Epilepsy and other conditions that provoke convulsive syndrome in

hyperventilation type of breathing;

5. The presence of a diaphragmatic hernia;

An individual program is prepared for each patient at the Nakhabino Harmony and Health Rehabilitation Center, which includes different types of trainings and their combinations.

The duration of the session is 30-50 minutes, the course is from 10 to 40 sessions. Today, more and more specialists around the world are choosing the biofeedback method as a safe alternative to drug treatment. This is a training of biofeedback abilities, the effect of which a person retains for many years ^{[7, pp.6-20]}.

During BOS therapy, the body's work is visualized in a playful way. There are the following types of trainings:

1. DAS – BOS (breathing training), used to relieve stress, improve overall immunity, normalize vegetative state;

2. EEG – BOS (electroencephalographic), which, in turn, is divided into α – relaxation, β – rhythm concentration, or θ –rhythm of the rapid phase of sleep;

3. EMG – BOS (muscle relaxation), aimed at relaxing the clamped muscles. As a rule, this is the upper part of the trapezius muscle, which can cause muscle and headaches ^{[2, pp.6-12]}.

In the work of Yu.A. Naumova and N.Y. Khalina, three stages of the development of emotional burnout in managers are noted. At the first stage, there is a tendency to constant relaxation during the working day, memory impairment, interruptions in the performance of motor functions. At the second stage, there is a decrease in interest in the results of work and communication. At the same time, apathy increases by the end of the working week, somatic manifestations are traced (lack of strength, migraine, lack of dreams during sleep), high excitability. The last stage of emotional burnout is characterized by a complete loss of interest in the work process and in life in general, emotional loyalty, and chronic lack of strength ^{[5, pp.310-312]}.

V.G. Konovalova also notes the fact that emotional burnout of top managers refers to a specific professional deformity, which includes the following components: emotional and/or physical exhaustion, depersonalization and reduced work productivity ^{[4, pp.6-10]}.

Thus, top managers may have any of the functions considered violated, therefore, BOS therapy is not only indicated, but also necessary. It helps to solve problems with relaxation, inability to relax or concentrate in a timely manner, etc.

To train relaxation and concentration, there are various oriental practices (yoga, qigong, etc.), trainings, and various types of art therapy. But in these cases, it is not always possible to assess the current state of your body.

BOS therapy makes it possible to make such an assessment. At the same time, it is associated with certain skills:

– first, it is the control of the bioelectric activity of the brain (α - relaxation, β – rhythm of concentration, or θ – rhythm of the rapid phase of sleep). If necessary, they are normalized with the help of special training;

– secondly, it is a skill of voluntary muscle relaxation. This skill is quite difficult to develop, since in most cases muscle stiffness becomes a habit.

– thirdly, this is the skill of diaphragmatic relaxation breathing, namely abdominal breathing. It should be noted that there are two types of breathing, it is stressful (chest type of breathing) and relaxed (belly breathing).

The main assessment of health is related to breathing, and if it is carried out with the stomach, then there is a short inhalation and a long, smooth exhalation. At the same time, the diaphragm works, the abdomen inflates and returns to its original position on exhalation.

As you know, breathing is directly related to the work of the heart. On inhalation, the pulse quickens, on exhalation it decreases. For us, the difference between the maximum heart rate on inspiration and the minimum on exhalation is important. It is called DAS (respiratory arrhythmia of the heart). According to this indicator, it is possible to accurately assess the level of human health, the level of his ability to relax or concentrate ^{[6, pp.61-63]}.

Of all the skills discussed above, breathing training is the most manageable, accessible. Through breathing, you can easily turn on a person's internal reserves, using the capabilities of the BOS therapy method.

Let's consider a training aimed at developing these skills among senior managers using special software. Before starting work, it is necessary to introduce a person to the type of "effortless belly breathing". You need to put one hand on your stomach. When inhaling, the abdomen must be inflated, and when exhaling, the abdomen must be retracted. Inhalation is done through the nose, exhalation is carried out smoothly through the mouth.

BOS technology is designed to diagnose and correct human health by developing the skill of diaphragmatic relaxation breathing (DRD or "belly") with maximum respiratory arrhythmia of the heart using biofeedback in heart rate (HR).

This type of breathing is called "Smetankiu breathing". The skill of diaphragmatic relaxation type of breathing with maximum DAS allows a person to synchronize the work of the most important body systems, respiratory and cardiovascular, relying on multimedia visual and auditory signals understandable even to children.

One set of equipment includes a device "Hardware fitness complex", heart rate sensors with a fastening belt, a power supply, a connection cable to a computer ^[9].

The training is aimed at increasing DAS by biofeedback, by increasing the pulse rate on inhalation and decreasing it as much as possible on exhalation. Before conducting the lesson, it is necessary to familiarize the patient with the instructions:

1. Put on the pulse sensors, turn on the electronic unit and run the Training DAS software on the computer.

2. Create a group and enter your details (full name, date of birth).

3. Select and start an activity.

4. To carry out breathing according to the "belly without effort" type.

5. When inhaling, the column rises on the screen (the abdomen inflates), and when exhaling it falls (the abdomen retracts).

After the end of the lesson, a results window will open, where a pulsogram in the rhythm of breathing, a table with DAS indicators, and the respiratory rate in each minute of the lesson will be presented. There is also an assessment for the occupation, work and rest periods. The average respiratory rate for periods of work.

To get full information about the results of the lesson, click the "report" button.

When analyzing the results, it is necessary to pay attention to the evaluation of the work, it depends on the value of the DAS. The higher the score, the more DAS, which reflects the positive dynamics of learning. The average respiratory rate decreases during work periods, which is a good result.

The pulsogram during rest and work periods are similar to each other, this indicates positive changes, the trained skill is consolidated.

The use of breathing according to the "Smetankin Method" allows a person to easily learn "belly breathing", which increases DAS. This, in turn, contributes to a more coordinated work of the main body systems responsible for the general condition in physical and emotional terms.

DAS indicators are influenced by emotions, physical activity, stress, sleep, nutrition, etc. The higher this value, the better the main body systems function.

When evaluating the results of the formation of the breathing skill by the "Smetankin method", the following conditions must be taken into account:

1. Diaphragmatic breathing should be free, effortless.

2. The mark in the biofeedback training sessions should gradually increase and become equal to 4-5.

3. It is necessary to reach the maximum value of DAS in each respiratory cycle (Table 1).

4. A long, even exhalation is required.

5. Slowing of the respiratory rate (BH) depending on age (the upper limits of BH are 8.)

Table 1

The value of respiratory rate depending on age ^{[3, pp.85-90]}

The results of the study: BOS therapy was used in the prevention of emotional burnout of an insurance company manager. The age is 50 years old. The gender is male.

The classes were aimed at teaching the skill of diaphragmatic relaxation type of breathing to synchronize the work of the most important body systems: respiratory and cardiovascular. The work used a computerized portable portable electroencephalograph recorder "Encephalan-EEGR-19/26", a modification of "Mini" with the installed software "Functional biofeedback with BOS "Reactor".

A total of 14 trainings were conducted. In the first lesson, the following indicators were obtained (Table.2): the score for the performance was 2 points, the average BH is 18.3 breaths / min.; the score during normal breathing is 1 point (DAS – 2 beats / min.); the score during the training with BOS is 2 points (DAS – 5 beats / min.)

Table 2

DAS and BH indicators in the first lesson

At the last lesson, the following results were obtained (Table.3): the score for the lesson is 5 points, the average BH was 14.6 breaths / min.; the score during normal breathing is 4 points (DAS is 13 beats / min.); the score during the training with BOS is 5 points (DAS is 19 beats / min.).

Table 3

DAS and BH indicators in the last lesson

After the entire set of classes using the "Smetankin Breathing" method, significant improvements in all indicators occurred: breathing slowed down, the score increased both during normal breathing and during the training with BOS.

Conclusion. Stress tolerance of managers is a very important indicator of the success of strategies and decisions taken. The current situation is characterized by an increase in simultaneously executed projects, an increase in obligations to partners, government agencies, and employees. Managers have an increasing level of problems, and the cost of error is becoming higher. Under these conditions, the use of BOS therapy allows you to prevent crisis states even at the initial stage of emotional burnout. During its implementation, managers get the opportunity to acquire skills to adapt their behavior through feedback, physiological communication, and self-regulation. The results of the training allow us to talk about the effectiveness of this method to increase the stress tolerance of top managers. Thus, BOS therapy is a promising direction for the prevention of stress and emotional burnout.