Biofeedback as the Method of Reducing Stress and Anxiety at Work

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Biofeedback as the Method of Reducing Stress and Anxiety at Work

This work is dedicated to the problem of stress and anxiety at work and the possible solutions of this problem in the form of biofeedback method. Analysis of various theories of stress gives us the potential causes and consequences of stress for employees and companies. The biofeedback method is a good way to show a person how he (his thoughts, mental state etc.) influences his physical state. The biofeedback method mirrors physical state of a person and shows him the connection between physical and mental states. Within the framework of this study I conducted a field pre-experimental research in order to check whether the level of stress and anxiety will decrease after taking a course of biofeedback sessions. In the research took part top and middle managers of one Russian company. They have taken a ten-sessions course of biofeedback method and the results have shown the significant decrease in the level of stress and anxiety and significant increase in the assessment of subjective level of well-being.

All people feel it. Every day we feel pressure, tension, and we are anxious about inability to overcome different problems and difficulties. In simple words every day we are abandoned to stress and anxiety. These two states may be met in every part of human life, however, this study focuses more on work-related sphere. I want to concentrate my study on work-related stress and anxiety because people spent a lot of time at work and it is not unimportant part of our life; our job influences not only our routine life, but our health, our relationship with other people, etc.

People work every day and get a lot of different information from random sources. The high information stream and plenty of various duties and demands keep us feeling frustration, tension, and inability to overload difficulties. Such feelings cause stress. Work-related stress is the stress when high work demands and pressure do not match to person's abilities and knowledge and he/she cannot cope with it (“Stress at the workplace,” 2010). Stress is not a disease, but there are also exist some symptoms which may serve as indicators of `alarm reactions' in us. There are several characteristics of a stress victim: decline in work performance, refusal to cooperate with colleagues, negative behavior toward other people, turnover and absenteeism of personnel, mental and physical breakdown (Lambert et al., 2003). Stress is not so bad condition, but only if its duration is not long. Only chronic stress may cause symptoms mentioned above and make a person ill. We can find evidence that high and long-term stress can cause problems with heart or immunity system, hormones, lead to depression and decrease quality of sleep (Schneiderman et. al, 2005, Iacovides et. al 2003, Melchior et. al 2007, Romswinkel et. al 2018, Ohlman et. al 2018). So, stress may become a source of problems for both a person and a company where the person works. For a person it leads to decrease in health (physical and mental), for a company it causes economic complications because its workers do not perform on a high level. All these lead us to a point that there should be methods that help reduce or overcome stress; and these methods exist and there is a various range of it. Linda Rhoades and Robert Eisenberger (2002) in their literature review deduced three major categories of working aspects which can reduce stress at work: fairness and supervisor support, organizational rewards, and favorable job conditions. However, it is useful to implement not only work-related sources of stress reduction but also psychological methods in order to attack stress combined and more effective. There are some studies which show that using psychological methods (stress-management techniques, yoga, relaxation techniques, etc.) and sport exercises may help to reduce stress at work and increase work performance and work satisfaction of employees (Majidi et al. 2012, Chiesa & Serretti 2009, Smith et al. 2007, Wolever et al. 2012, Hartfiel et al. 2010).

During this study I focus more on the biofeedback method as one of ways to reduce stress at work. Biofeedback will be beneficial for an employee because he will learn how to influence his mental state through physiological parameters (pulse, breath, temperature etc.), and the awareness that he can control his body may give power to overcome with difficulties in his life. Physiological parameters can be measured with special tools (biofeedback devices) and these devices make real-time measurements of parameters that translate the mental state into physiological state. Thus, by means of physiological parameters a person can control and influence his mental state as reverse process (Lemaire et al., 2011; van der Zwan et al., 2015). Biofeedback method is successfully used in clinical and sports spheres for rehabilitation and reducing stress among disabled and sportsmen (Trofimova et al., 2018). However, it may be possible to use this method among employees for fast and successful reduction of work-related stress.

Problem statement. There is a varied range of ways to reduce stress at work, but majority of these methods influence the cause of stress or change person's attitudes towards stressors. There should be methods which reduce stress and anxiety within the framework of stressing situation and I believe that biofeedback method is one of them. The research question of the study is to check whether the level of stress and anxiety will decrease after taking a course of biofeedback sessions. Consequently, the goal of the study is to reduce the level of stress and anxiety by means of using biofeedback method at work.

Novelty. There are researches where experimenters receive data from physiological parameters, but it does not include a training component; participants are just aware of their physical state but are not taught to change it consciously (Lemaire et al., 2011). It is highly important for researchers to be aware of physical state of their participants but there is little evidence where changes of physical parameters are used as a training component, where biofeedback devices play a role not only of a physical state mirror but also as a helper for achieving better mental state. That is why the biofeedback method should be used not only in special rehabilitation spheres but also for working people. In this research I added a training component that allows participants in real-time to learn how to change their mental state through physical.

Practical significance. The results of this research may be applied in big companies for creating special psychological rooms, where employees can take part in relaxation events in order to reduce stress and boost their performance.

Theoretical background

Theories of stress and anxiety

Biofeedback is one of modern ways in the problem of stress reduction. And it is also a good opportunity for people in learning to control their bodies in order to keep out of anxiety. However, before going deeper into the biofeedback method I want to dedicate a few words to the reason for biofeedback using - stress and anxiety feelings.

Classical theories of stress

Stress has become a center of scientist's interests in the middle of the last century. The classical view about influence of stress on the human body was presented by H. Selye. He noticed a similar reaction of organism on infections and other harming for body situations (Selye, 1978). He called this reaction “General Adaptation Syndrome” (GAS) and divided the reaction into three stages: alarm reaction (fight-or-flight response), stage of resistance (adaptation process) and stage of exhaustion (too long adaptation leads to exhaustion of resources and can cause death) (Ibid). Also, Selye suggested a model of eustress and distress (Selye, 1975). According to this model eustress enhances the physical and mental state of the body, it is “good” stress because it may increase body's adaptation skills and increase mental abilities, but for a short period of time. If such stress lasts for a long period of time, it becomes distress (in this paper just stress). Persistent stress (distress) that is not resolved through coping or adaptation may increase anxiety or withdrawal (depression) behavior. As endocrinologist Selye developed a “physiological” theory of stress. This theory explains physiological mechanisms of appearing and duration of stress and how stress influence human's body. However, this theory does not cover the psychological aspects of stress.

The psychological aspects of stress were covered in another classical theory of stress - the Transactional theory of stress developed by Lazarus and his colleague (1984, 1987). According to this theory, feeling of stress appears when a person perceives that the demands are higher than his/her personal or social resources which he/she can use. The important factor of the transactional theory is the personal perception (appraisal) of the situation. Lazarus developed two stages of cognitive appraisal: primary and secondary appraisal. According to Lazarus, two factors influence a person in perceiving the situation as stressful: 1) the threatening tendency of stress, and 2) the assessment of resources required to minimize the stress (Lazarus & Folkman, 1984). Primary appraisal concerns the meaning of the situation for a person and how the situation influences him/her. At this stage, a person decides whether the situation is a threat. The secondary appraisal includes the aspect of dealing with the situation, where the person decides whether he/she has enough abilities to solve the situation. Figure 1 provides a graphical description of the Transactional theory.

Fig. 1 The Transactional theory

Except for the appraisal component of the theory the picture includes one more important component - coping strategies. According to Lazarus, coping is a process of changing cognitive and behavioural efforts in order to control demands that are assessed as stressful (Lazarus & Folkman, 1984). He defined two types of coping: problem-focused coping (change the situation) and emotion-focused (change the relation to the situation). Each coping mechanism may be considered as a way of master different skills (e.g. emotional skills, problem-solving skills, task-related skills etc.) (Baqutayan, 2015). Problem-focused coping is about changing the stressful situation or the source of stress. This type of coping has a goal to reduce the demands of situation and enlarge the resources in order to deal with it. Such coping mechanism often leads to increasing of the level of control and reduces stress considering that situation may be changed (Ibid). Emotion-focused people try to find positive sides in a problem but they do not change the structure of the problem or their perception considered with this situation (Zamble & Gekoski, 1994). In the most stressful situations people tend to combine both types of coping (Lazarus & Folkman, 1980). Problem-focused and emotion-focused coping types include a wide range of stress reduction techniques, for example, planning, social support for delegation of duties, or for maintaining good mood, humor, etc. (Carvet & Weinttraub, 1989).

However, these are classical theories, they explain the concept of stress generally, but it does not give us an opportunity to get closer to the work-related problems. In theories of work-related stress we may see the shadow of classical theories, but they go deeper to the cause and consequences, in particular this sphere.

Theories of work-related stress

Work-related stress is the stress when high work demands and pressure do not match to person's abilities and knowledge and he/she cannot cope with it (“Stress at the workplace,” 2010). This is general definition of what may be considered as work-related stress, and it covers, in general form, everything that various theories of work-related stress arise. However, it is necessary to understand the problem of work-related stress not in general but in certain points of view. There are several theories which concentrate particularly on the aspect of the working environment and how stress at work influences employees: their wellbeing and performance at work. The Effort-Reward Imbalanced theory states that efforts and rewards with opportunities at work are some kind of “contract”; and imbalance in this “contract” may lead to stress (Siegrist, 1996). According to the Person-Environment Fit theory, work-related stress appears when there is little or no concordance between resources and abilities of a human and his working demands (Caplan, 1987). The Job-Demand Control (JDC) model focuses more on the balance between the person's working demands and his autonomy (Karasek Jr, 1979). According to this model there are four types of work environment: passive/active job, and low strain/high strain job, see fig.2 (Ibid).

Fig. 2 The Job-Demand Control Model

Looking at figure 2 we may identify what kind of job are here. The low strain job hides the routine work, people usually get bored more quickly than in other types because there is no development and challenging tasks. The passive job is about making a few or no work-related decisions, they just do what has been said and do not feel pressure and do not have motivation to learn something new. The opposite types are active and high strain jobs. The active job is about personal responsibility for the work-related decision-making and intrinsic motivation for development, people here do not feel pressure because they are psychologically ready for work demands and challenges; they like it. And the most stressful type is the high strain job - people play the role of a “blue-collar”, lack of control leads to deadlines which increase the risk of stress.

However, the JDC model was further developed and scientists added one important component, which serves as a coping component - the social support (Johnson & Hall, 1988). The new model was named the Demand-Control-Support model and according to it social support may serve as a helping buffer (coping mechanism) between high job demands and employees. Cooper, Palmer and Thomas (2001) developed the model which explains stress-related difficulties at the workplace. Authors of this model named seven potential sources of stress: the culture of the organization, demands, control, work-related relationships, discussion of changes, job role, and support. They described in the model individual symptoms of stress (e.g. headaches, increased blood preacher, sleep and gastrointestinal disturbances etc.) and organizational symptoms (e.g. increased sickness absence, staff turnover, and hostility, reduced staff performance, staff morale and loyalty). According to this model long presence and duration of these symptoms lead to negative outcomes, such as health problems and burnout of employees, or reduced profits and litigation for a company. And the last but not the least theory which I want to cover is the Conservation of Resources (COR) model (Hobfoll, 1989). This model includes not only work-related stressors but also covers general life stressors because our performance at work may be influenced by family situations and other thoughts which not particularly connected with work. According to this model people care the most about resources and stress may appear when a person feels that he has a little or no resources to cope with a problem. People, in their nature, try to collect and maintain their resources (time, energy, objects, conditions and etc.) and work or relationships may lead to stress because people lose more than they want of their resources during effective performance (Hofboll, 2001) and it results in job dissatisfaction and anxiety. However, such resource as self-esteem may coordinate conflict and stress (Hofboll, 2002). Thus, people have important resources which they can lose but also they have resources which can help them to cope with the big loss.

Summarizing all information about stress from observed theories it is easy to name some major causes of work-related stress: an incorrect appraisal of situation or resources, the imbalance between efforts and rewards at work, high job control and demands, work-related conflicts, organizational culture, organizational changes. These causes are potential threats for an employee and they may lead to serious problems with health or trigger anxiety.

Stress and Anxiety

According to the American Psychological Association (APA) anxiety is “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure”(Anxiety, n. d.). Anxiety is not a bad feeling; without this emotion people probably tend to be reckless or engaged in activities that may lead to harm (Bennett, 2011). However, anxiety, if it leads to a long period of time, like stress, may cause different health and mental problems (Lee et al., 2015). Spielberger divided anxiety as a “state” and as a “trait” (Spielberger, 1966). State anxiety is an emotional state which exists at a given moment of time and at the particular level of intensity. This state is characterized by subjective feeling of tension, worry, apprehension, nervousness, and also by activation of autonomic nervous system (Ibid). Trait anxiety is a relatively stable individual difference in predisposition to anxiety; this means that people have different level in perceiving stressful situations as dangerous or threatening with rising in intensity of their state anxiety reaction (Ibid). According to Meijer's research (2001) there is a connection between state, trait anxiety and stress. Meijer found that in stressful conditions pupils with high level of trait anxiety showed worse performance in math test and the level of state anxiety increased faster and was higher in comparison with pupils with lower level of trait anxiety. However, stress influenced performance of both low-level and high-level trait anxiety pupils (Meijer, 2001). In the other research, Grases and her colleagues (2006) studied the level of anxiety of science students before period of exams and during the exam session.

The researchers tested the level of anxiety not only with psychological tests but also with urine biomarkers (magnesium excretion). The results showed that in stressful conditions of the exam session there was a significant increase in the level of anxiety in comparison with tests before the exams (Grases et al., 2006). Connection between stress and anxiety may be traced not only in different situations but also high anxiety and stress have similar effect on humans well-being and health. Khan and Khan (2017) in their review showed that stress leads to anxiety and it can be connected with activation of hypothalamic-pituitary-adrenocortical (HPA) axis; high level of cortisol leads to higher predisposition to anxiety. The research of Kabra and Nadkarni (2013) provide evidence that anxiety is very common for people suffering from Irritable Bowel Syndrome (IBS). Fond and his colleagues (2014) also provide in their meta-analysis that patients with IBS have higher level of anxiety and depression in comparison to healthy people. Stress and anxiety both influence the development of sleep problems. Almojali and his colleagues (2017) showed in their research that high level of stress leads to poor sleep among medical students. In the research of Spoormaker and van den Bout (2005) was shown the connection between anxiety and sleep complaints. The results showed high level of interrelatedness between anxiety and sleep complaints. Anxiety and stress may be the cause of the development of cardiac diseases (Blumenthal and Smith, 2010; Schneiderman et. al, 2005).

Thus, stress and anxiety, if they continue for a long period of time, may cause different health problems among people. And it increases the necessity of improving coping methods and strategies for different groups of people and creating a wide range of coping techniques that may be suitable for different people.

Biofeedback

The biofeedback method is one of the modern ways in making unconscious physiological processes of human body conscious, “visible” for a person. With the help of special devises, a computer screen, a person may learn to control and manipulate his body. The screen of computer serves as a “mirror”, through it the person sees all changes in real-time situation. More formal definition of what is biofeedback, gives us the Associations of Applied Psychophysiology and Biofeedback (AAPB). According to the AAPB, “biofeedback is a process that enables an individual to learn how to change physiological activity for the purposes of improving health and performance. Precise instruments measure physiological activity such as brainwaves, heart function, breathing, muscle activity, and skin temperature. These instruments rapidly and accurately “feed back” information to the user. The presentation of this information -- often in conjunction with changes in thinking, emotions, and behavior -- supports desired physiological changes. Over time, these changes can endure without continued use of an instrument” (Biofeedback, n. d.). The learning process takes place in several stages, the first is the fixation of the necessary sensors on the human body, they transmit a signal to the computer. The computer processes the signals and provides the person with visual and audio stimuli in order to adjust his measured physiological parameters. And based on this feedback, the person learns to manipulate his body and control unconscious processes. Figure 3 presents this method visually.

Fig. 3 The process of biofeedback method

The biofeedback method is not a treatment; it is an active training (Frank et. al, 2010). During the training, the person nurtures a new functional system, which ensures the organization and execution of various behavioral acts aimed at obtaining useful results (Trofimova et. al, 2018). There are various ways how to give feedback to the person, the most popular are two of them. The first type of feedback instructs the person about his actions by means of signal degradation (when the person doing wrong) or improvement (when everything is right). Signal may be different, usually it is various pictures or sounds. Another type of feedback is a game. The game feedback has a lot of advantages. The biofeedback method itself as a training is an active process, it makes the person become an active ruler of his learning, however, the game biofeedback added several significant components into this process and makes it more attractive for people. The first component is a competition, the person competes with himself because he should surpass his previous results and with other people, if the training takes place in a group (Savchenko, 2004). The game process itself increases motivation of people and makes them to play more. Also game condition helps to model different scenario of stressful situation and game decrease the level of perception of the situation as stressful and dangerous (Ibid).

The biofeedback method may vary not only in a way of representing stimuli, but also in a building of the training session model. Dana Frank and her colleagues (2010) single out two models of biofeedback training. The first model is the operant conditioning model. The main idea of the model is to increase the stimulus in order to motivate the person to change his physiology. The person learns to react on stimuli and improve his skills. This model uses in a variety of researches, medical and sports centers. It is very useful in rehabilitation sphere, sport, and medicine because patients and sportsmen tries to improve their physiological parameters in order to become healthier and overcome with movements difficulties or other diseases. Another model is the psychophysiological psychotherapy model. This is the model which effectiveness I want to check and prove because the main idea of the model is to help to overcome with difficulties and diseases which have a stress component. Thus, this model should be effective in decreasing stress through awareness that stress has an effect on our body. During training sessions within the framework of this model people may not only improve the skills in physiological control, but also with the help of psychologist can learn to associate their physiological state with psychological (mental) state (Ibid). From the theoretical point of view, the biofeedback method is viewed as one of the best method not only for patient and sportsmen during rehabilitation period, but also for ordinary people to handle with stress and other unhealthier emotional difficulties. There are various studies and experiments which prove the effectiveness of this method. According to results of Russian scientists, participants who have taken part in HVR biofeedback training have higher results in a logical task (26%) in a stressful situation than participants from control group (Ramendik, 2015). Dzhafarova and her colleagues (2002) had proven that the game biofeedback is highly effective method in self-regulation learning because participants at the end of the course might consciously cut down their heartbeat and activate parasympathetic nervous system. If we look at the latest research made by Cheng and his colleagues (2019), where they created several group with different conditions (stress, anxiety, measurement of depression level), we will see that correction of HVR made through deep breathing training also leads to activation in parasympathetic nervous system and greater activation of parasympathetic nervous system helped participants to cope with symptoms of depression, anxiety and stress. Sutarto and her colleagues (2012) conducted research on manufacture operators. They showed that after breathing biofeedback sessions workers indicated the significant decrease in feeling of anxiety and depression, also their level of stress was lower than baseline.

Analyzing and summarizing all theoretical information, the hypotheses of the research are the following: (1) The level of stress and anxiety among employees will be lower after the biofeedback session than before it. (2) Subjective evaluation of employees' well-being will be higher after the biofeedback sessions than before it. (3) The level of stress, anxiety and subjective well-being between two genders will be different before the biofeedback session, but will not be significantly different after the biofeedback sessions.

Method

Sample

The sample consists of top and middle managers of one Russian company. It includes males and females. All of them have high education and work in the company more than one year. Sampling is not random. According to analysis in GPower program (Faul et al., 2007) minimal required sample size is 54 participants. However, in order to get reliable data, the sample is above 100 participants. Sample consists of two parts: the general sample which includes all managers which completed course of sessions (N=301; male 60.8%, female 39.2%; age min=28, max=77, M=50.3 SD=10.96) and the little sample which includes managers who completed course of sessions and filled in all three tests (N=118; male 54.2%, female 45.8%; age min=28 max=76 M=49,42 SD=10.21).

Variables

I have three variables, which I am going to measure and analyze. The first variable - level of stress is measured trough HRV-test (Heart Rate Variability test), which uses the Baevsky's formula to calculate the level of stress. HRV-test is based on differences of time intervals between heartbeats and is used in psychophysiological field in order to reflect emotional strain, stress and anxiety (Nickel & Nachreiner, 2003; Jцnsson, 2007). The second variable is the level of anxiety, which consist of two types - state and trait anxiety. Both types of anxiety are measured trough STAI by C. D. Spielberger. The third variable is the subjective well-being. This variable is measured by using test “САН”.

Materials

In this study, I used three measurements (two questionnaires and the heart rate monitor test). Full variants of questionnaires available in Appendix 1.

Questionnaires STAI and “САН”

The test STAI (State and Trait Anxiety Inventory) was developed by C. D. Spielberger and adapted by Hanin (Spielberger et al., 1983). STAI includes 40 items (20 S-Anxiety and 20 T-Anxiety). This test is based on 4-point Likert scale, example of S-Anxiety item 7. Меня волнуют возможные неудачи; example of answers: нет, это не так; пожалуй, так; верно; совершенно верно; example of T-Anxiety item 29. Я слишком переживаю из-за пустяков; example of answers: почти никогда, никогда, часто, почти всегда. Correlation between scales is .65; according to Spielberger correlations between scales provide implications of the construct validity of STAI. Cronbach's б for S-Anxiety and T-Anxiety is .90 and .93, respectively (Spielberger et al., 1983).

The test “САН” measures subjective well-being of participants. It is based on three scales well-being, activity and mood (Doskin et al., 1973). These scales have 7-point Likert-type scale and the mean of these scales reflect subjective psychophysiological state of the participant.

Heart rate variability monitor test

I measured the stress level by using the HRV-monitor (heart rate variability monitor) (fig.4) and program calculated the stress level based on Baevsky's formula (1) (Bayevskiy et al. 1984)

(1) ИН=AMo/(2*dRR*Mo)

Where ИН - level of stress, AMo - mode amplitude (percentage of cardiointervals falling into a modal bin), dRR - difference between the maximum and minimum cardiointerval, Mo - mode.

Fig. 4 the HVR-monitor

During the test computer register each heartbeat and its duration and demonstrate in the form of diagrams and graphics (fig. 5).

Fig. 5 the testing process

All three instruments (tests) are included in the commercial software AVC-Disnet (Audio-visual complex Disnet). This software provides the opportunity to make tests on the computer, calculate the final results of each participant, and keep all the data in the database.

Procedure of the study

This is pre-experiment because I was not allowed to ask all managers to complete all three tests. This is field experiment in a real company during its working process. This pre-experiment includes 10 meetings with each of them. The first and the last meeting include the measurement procedure. I measured the baseline level of stress (via HVR-monitor), level of anxiety (via STAI with who it was possible), and level of subjective well-being (via “САН”) and then measured the final state at the last meeting. All measurements conducted via computer (participants make tests on the computer) and all data are kept in the program AVC-Disnet. The study plans everyday meetings and they take one hour. The employee practices the relaxation method during this hour. The participant can monitor and change his physiological state through sensors on his body. I use special software BF (biological feedback) “Reacor” (БОС «Реакор»). This program lets not only to control the physiological state, but also gives positive stimulation when a participant changes his state in accordance with the goal of training or negative stimulation when it is not. Thus, participants go through 10 meetings and learn to control their physical state. The measurements of the last meeting provide the information about changing in mental state of the participant; how his level of stress, anxiety and well-being has changed. In order to exclude for future statistical analysis data from participants who had during the meetings unusual working condition (unplanned meetings, working trips, and other unexpected events) which may influence their state, I asked them at the last meeting about their “timetable”, where it unusual for them, or do they feel extra pressure? Their answers let me to control somehow the outside influence because I exclude the participants with extraordinary events during the experiments.

Statistical analysis

In accordance with my hypothesis I use Student's t-test for dependent samples in order to determine the changes to an intervention in the group.

Results

The sample consist of two groups of participants: general group and group with anxiety measurement (Table 1). Group of participants is created for convenient calculation, however, in real situation smaller group is a part of a bigger one.

Some data in groups have normal distribution (p > .05), but some do not have it. However, the sample size is big enough (more than 100) and according to some research (Fagerland, 2012) parametric methods will be more sensitive than non-parametric, in particular t-test, despite not normal distribution for bigger part of data.

Table 1. Demographic data of participants

Table 2 shows the results between pre- and post-measurements of stress and subjective well-being among all employees. Significant differences are found between before and after influence (p = .001). Table 3 shows the results between pre- and post-measurements among anxiety group. There are significant differences in level of anxiety before and after influence (p = .001).

Table 2. Comparison of stress and well-being in general group

Table 3. Comparison of anxiety

Table 4 and 5 reflect pre- and post-difference in general and anxiety groups between males and females. There is no significant difference between two genders on anxiety and assessment of subjective well-being after the influence. However, there is gender difference on the assessment of the level of stress before and after the influence, and the assessment of the subjective well-being before the influence.

Table 4. Gender differences on stress and subjective well-being

Table 5. Gender differences on anxiety

Discussion

The idea of starting doing this research was to find a method that may help office managers to overcome stress and prove that this method is useful within the framework of using during real working hours. I consider that office managers as many other people need to see the changes during psychological sessions because it may increase their motivation to continue and trust to the psychological method. That is why I paid my attention to the biofeedback method.

After the analysis of the results I should say that this method works as predicted by previous studies (Trofimova et. al, 2018; Ramendik, 2015; Kennedy & Parker, 2018). The results have shown that after the biofeedback sessions the level of stress and anxiety among managers was lower than before them. And this results may be proved by previous experiments with students, medical workers, operators etc. (Evans et al., 2008; Grases et al., 2006; Ratanasiripong, 2012). The level of subjective well-being as expected significantly increased after the biofeedback sessions. This shows that people feel better after consciousness relaxation. Probably the increase in subjective well-being may reflect the satisfaction from the ability to control the body, but I cannot say exactly it is the question of further research.

Analyzing gender differences, we see significant differences between males and females before the session in the level of stress and subjective well-being, still, there is no significant difference in anxiety level (state and trait). However, some researches with medical workers also showed similar to my results because scientists also found gender differences in stress level, but did not find it in anxiety level (Gonzбlez-Cabrera et al., 2018). I can suppose that there is the difference in perception of stress or reaction to pressure, but it is my future ways of studying. Significant differences in the level of stress between males and females after the biofeedback is also interesting because it may be the proportional decrease and consequence of the difference in initial level or it may reflect reaction to the course of biofeedback trainings.

Thus, all my hypotheses were proved, but this research opens a lot of questions for future development. The main uncontrollable component of my research - field experiment conditions - is my advantage in comparison to previous studies, but also the main limitation where smaller limitations hides. The field experiment is a good way to prove theoretical knowledge in practice and I do not want depart from this type of experiment but I want to improve it. During my research I have different restrictions because the research was a part of my working duties. I could not use all needed measurements with all participants, use diaries in order to control external stressors and daily life of employees. This will be the task for future research because the results show the effectiveness of the biofeedback method with office managers but there should be applied more formal methods of verification. This study may be considered as pilot-study because here I tried to check whether the biofeedback method will be effective and the results proved it.

Conclusion

Stress is everywhere and there are a lot of methods how to cope with it. My research like other previous experiments in the psychophysiological sphere has proved that the biofeedback method may be use not only for rehabilitation or sport needs, but also this method is useful for mentally health office managers in order to learn a new skill which may help them to reduce the level of stress and overcome with anxiety. I am aware that this research is only begging of my way, because as all experiments it has limitations which should be overpassed in future. However, the results have shown that the level of stress and anxiety among employees in a company decreased and it inspires me to find or create the conditions which cover current limitations.

I suppose that big companies should pay attention to the problem of work-related stress because many experiments and theories have proved that overloaded stress leads to decrease in employees' performance and health problems and it may be the cause of profit loses. So, results of this research once again call attention to the problem of work-related stress and demonstrates the possible solution. May be once in future all big companies will take care not only about profit, but also about their employees and will have professional recreation rooms.

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