By Siegfried Othmer, PhD
Amajor divide within the field of neurofeedback is the basic question of whether we are aiming to improve function or to expunge dysfunction. This distinction was highlighted crisply many years ago when one of the early researchers, Barry Sterman, said that if he could not identify a deficit in the EEG he would be ethically compelled to send the client home. There would be nothing for him to do.
On the other side of the debate we have the sharply drawn argument that even if a deficit is being targeted, the brain solves the problem by means of the enhancement of function. It is function that banishes dysfunction, and indeed matters could not be otherwise. We don’t do brain repair. The only answer to bad brain behavior is good brain behavior. So why not target the enhancement of function in the first place? One can think of this in terms of the standard reward/punishment dichotomy. Think about the training of Shamu. The training is based entirely on the encouragement of the desired behavior. The worst that can happen is the withholding of a reward. So it is with training the brain.
We now know that brain function can always be improved. Additionally, we are able to train functions that have no obvious headroom limit: memory, intelligence, fine motor control. Folks do not have to qualify by deficit. This also simplifies the approach. Just as Leo Tolstoy’s unhappy families are each unhappy in their own way, brain dysfunction particularizes in each individual, reflecting both genetics and life history. Function, on the other hand, is organized nearly the same way in all of us. It’s like Leo Tolstoy’s happy families. Fairly standard training protocols take us a long way toward enhancing functional capacity.
We gain benefits in terms of research also. There is no placebo model for extraordinary performance beyond the norm. We do not have to argue about “regression to the mean.” Every individual serves as his own control in the training. We are training with reference to the pre-training baseline in each case.
In the accompanying Figure we show the results for an impulsivity measure in some 5,746 individuals who each had nominally twenty sessions of infra-low frequency neurofeedback at the hands of hundreds of clinicians around the world. Yes, that curve represents over 100,000 sessions of infra-low frequency training. Every person so tested (as of 2014) is included in the plot. The black curve shows the normative distribution. The green curve shows the pre-training distribution, and the red curve shows the post-training distribution. Observe that there has been a significant population shift to values above the norm, which goes along with a partial depletion of the deficited population. This plot demonstrates that protocol-guided infra-low frequency neurofeedback is best understood as a training toward optimal brain function. The deficit model falls short.
For further details, see the discussion of this Figure in the full paper.