Author: Len Ochs
All forms of central nervous system dysfunctions include problems
taking in, processing, organizing, and retrieving stimulation. And
all methods of treating such problems — from depression, to the
spectrum of brain injuries, many pain syndromes, movement disorders,
emotional hyper-reactivity (PTSD, etc), hyper-energetic states
(ADD/ADHD), etc., involve stimulation. When, in 1990, I conceived of
feeding back stimulation that was resonant with the EEG — which was
shortly thereafter entertained by Chuck Davis — an entire new field of
neuroscience was opened, one in which there was no experience to draw
upon. In the development of the LENS software, using J&J’s
equipment, there have been many false steps along the way. In
fact, the entire development of the LENS system is grounded in errors
that happened in many dimensions, but which has worked out rather
well — either because of them or in spite of them.
Each stimulation system has its own sets of physiological reactions.
I dropped sound and lights six year ago because all
microprocessor-based systems produce emissions, which, with the
lights, were too intense for patients. When these systems — using
J&J hardware — lessened symptoms with an average average (this is
not a doubling typo, because there are many averages, depending on
the problem treated) treatment duration of 11+ sessions without lights, I never looked
back, and could never see why I would be interested in the
traditional neurofeedback approaches — which I used since 1975.
While it seems true to me that all the neurofeedback clients and
patients I’ve talked with for nearly thirty years have all sounded
the same — receive the same essential benefits from no matter which
neurofeedback process they’ve used, the stimulation family of
procedures produced the same results in much less time. While
these are still neurofeedback processes in the strictest — if not in
the conventional — sense of the word, they are so different from
those processes in place in May, 1976, the date the FDA deems as
defining biofeedback — actually they all need to be headed for new
FDA certification — which requires expensive research. This means
Chuck’s system, and mine. It’s only a matter of time. As any
manufacturer will tell you, adhering to standards is expensive.
We’ve had one NIH block-grant study of TBI, and just received another
NIH study (to U. Oregon’s Health Sciences University) in
Fibromyalgia. This’ll be a double-blind, randomized controls study
— which we can do easily.
Now, in my opinion, if a manufacturer isn’t headed for FDA
certification — and if the system isn’t built to provide the data
for such certification as ours is — the manufacturer is doing the
customer a disservice — because that system will not head for the
mainstream, and will be far more expensive in the long run to both
the public and to the therapists.
The smallest part of the LENS software is the biofeedback software.
The most expensive part of the software is a statistics-rich report
generator, which generates a wide range of therapist reports helping
the clinician to empirically formulate treatment plans. But even
more, it gathers data that is usable in any scale research, from
single-subject designs to large double-blind studies. It allows
clinicians to sell home trainer systems to patients and monitor their
clinical progress or lack thereof, keeping the use of home trainers
Then, there is the conceptual basis underneath the LENS system, which
integrates the use of the system with the best of clinical
neuropsychophysiology and behavioral biophysics, and ties the
evaluational process to the treatment process in an empirical way,
and allows the therapist to customize treatment for patients on a
day-by-day basis. In a way that no other neurofeedback system allows,
the empirical rationale for treatment decisions is always there — in
the best way that I can provide.
Please note that I consider our system primitive as such: extremely
fast for cases of simple to moderate difficulty, and really not any
better than anything else for the complex cases. And because it is
so fast, the more complex cases are accelerated through a set of what
Steve Rothman calls “unintended negative effects”, which has been shorthand
for our lack of knowledge about the normal course of recovery for
immensely complex problems in patients with profound hypersensitivity
and hyper-reactivity. These problems accrue to any neurofeedback
system. We have all treated cases from every system out there that
had such unintended negative consequences. It’s only a matter of time before
any manufacturer’s equipment is tested against patients with unknowably
complex problems, leading to results that frighten therapist,
patient, and parents, if the patient is the parent’s child. There
are no exceptions to this. To think otherwise, from my experience,
is quite naive.
So we have to understand more about the physiology of human suffering
and complexity. We all need to develop tools that will allow our
understanding to grow. The pricing of the LENS system includes the
funding of components that will help this process by both allowing
such research to continue, and allow the clinician as good an
understanding as we can derive at any point in time.
The problems that I personally work with are unspeakably complex and
difficult; and I always use the LENS software in a context of other
procedures when needed. It’s not good for anywhere near everything;
although, it has been far better than anything else I’ve used or seen
used for my own professional needs as a clinician.
In contrast, in relation to my own growth and development, after having ho-hum
results with other systems, the LENS system changed my life. I had a
mild head injury just after birth and had trouble sequencing, taking
in information, using abstraction, etc, until I actually treated the
head injuries of others. When I heard how they sounded, I realized
that I needed treatment. While I can still get pretty wifty when
stressed, I simply could not be functioning as I do now without
using the system — and I had used every system there had been prior
to 1993, without noticeable results.
I think the neurofeedback field severely needs to grow up. Working
in a marketplace where there are severely complex CNS problems, we
need to realize that if we want to operate efficiently, and justify
our existence with documentation, we can and will cause frightening
disruption at times. For as the brain drops its previous inefficient
and taxing compensations for problems, there will be
disorganization and disruption, not to mention pain — that are all
perfectly plausible and reasonable consequences of the reorganization
We need to understand the physiology of such processes so
that we can predict them to the stalwart and desperate patients who
are willing to undertake such a journey. There are many who are too
anxious and fearful to either administer such procedures, or to go
through such processes. But for those that do, there have never been
anything other than success — so far. There will at some point be
exceptions because we know far from everything, and far from what we
need to know. This is why we use informed consents: to say that
while we are most careful, we do not know everything, and there can
be unpleasant surprises. But so far, they have all been easily
reversible — unlike what happens with medication.
And for the record, my practice now includes, or has included, such
problems as: autism, fetal alcoholism, tuberous sclerosis, several
people who have died and been resuscitated and who suffer anoxic
problems leading to a CP-like problems, coma, post-stroke, post
bleed, post shaken baby paralysis and light coma, several cases of
terrible epilepsy, Tourette’s, regional complex pain syndrome,
fibromyalgia, ADD/ADHD, dementia post surgery, and post mild and
severe acquired head injuries. I have worked with ages 18 months
through the 90s.
I need a system that operates simply so that I can look at the data
and think about what I’m doing, why I’m doing it, to leave a paper
trail to let others observe and share what I’m doing, and so that I
can do it better, hopefully, next time.
I’m open to all questions.