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Biofeedback Society of California Conference 2014 – The ‘Common Core’ of Biofeedback and Neurofeedback

by Siegfried Othmer, PhD

BSC Conference 2014
M y own theme at the conference was the common core of biofeedback and neurofeedback. This has actually been a recurring theme. This was a topic that I had covered back in 2006 at this same conference, which was also held in Northern California. At that time the talk was part of a multi-ring circus, and the only folks in attendance were neurofeedback people. The attempt to heal the breach between the two disciplines had not found its audience. By now, of course, the terrain is very different, at least at the conceptual level, if not at the level of practice. Most of the older biofeedback practitioners are sticking with their knitting, as far as I can tell. Change is being introduced with the new people entering the field, most of whom are no doubt being attracted by the greater glamour, and the bracing challenge, of brain training.

So what is the common core of biofeedback and neurofeedback? Irrespective of the modality employed, the target is the regulatory behavior of the central nervous system. The measures are either more or less direct correlates of neural activity, or they reflect functions being regulated by neuronal networks. In both domains, the means to the end involves training the system to reside in calmer states. This is most obviously the case with somatic biofeedback, but it holds true as well in the case of neurofeedback. The promotion of both alpha and SMR/beta amplitudes leads to states of lower arousal. The strong bias of ILF training is toward calmer states as well. This common ground is being sought because residence in calm states presents a therapeutic opportunity.

What happens under these favored conditions is plainly a facilitation of the re-ordering of neural network functional connectivity, one that cannot take place while the system is mounting responses to external challenges. An analogy from the real world comes to mind: To quote the infamous Donald Rumsfeld: “You go to war with the army you have.” By the same token, when the nervous system is under challenge, it rallies whatever resources it has at its command. The external challenge is always given priority. Hence it governs the response, and it does so all the more when the response capability is marginal, as in the disregulated brain. The committing of resources makes them unavailable for other objectives. In particular, this is not an occasion for repair and restoration. For as long as the external challenge persists, it remains the priority for the nervous system.

Through long experience with relaxation techniques, both instrumentally-aided and autonomous, the therapeutic benefit of merely ‘unloading’ the system has been firmly established. The brain will likely seize the opportunity for its own refurbishment to the degree that it is able, just as it does during sleep. With the provision of feedback the process becomes both more active and more predictable. The feedback either provides direction to the brain in its journey to recovery, or it provides mere information, which presents its own challenge to which the system must react. ILF training is a case in point.

The emerging theory of resting state organization of the brain provides the underpinnings for this model. The division between task-negative and task-positive networks can be understood by analogy to the division of the autonomic nervous system into sympathetic and parasympathetic arms. It is the parasympathetic-dominant state that presents the therapeutic opportunity. By the same token, within the CNS our primary concern is with the internal organization of the Default Mode Network, one that becomes more available for adaptation while the system is not otherwise occupied. As it happens, infra-low frequency neurofeedback can be largely understood in terms of such internal engagement within the Default Mode, because once the signal has been recognized for what it is, the control loop effectively becomes internalized.

What biofeedback of any kind brings to the table, then, is to make what happens in a state of relaxation into an active process, one that subtly engages the regulatory networks. Over time, regulatory competence improves. The particular advantage conferred by neurofeedback in this case is that it takes us closer to the core regulatory machinery itself. The control loop is closed more tightly with what the brain is actually managing at every moment. The price paid is that it takes us further away from measures that we can relate to. By the same token, it takes us toward more general and diffuse effects of the training, at the expense of specificity.

Ideally, one would want to engage a signal that reflects the brain’s activity most sensitively. Here we get to take advantage of a key organizing principle of the brain, and indeed of self-organizing systems in general: the order parameter. The most obvious feature of the EEG is its organization in terms of frequency. The EEG frequencies are the order parameters of our regulatory system. The implication is that the brain will resist interference with its frequency-based organization. Brain stimulation is an obvious interference, but feedback can be seen the same way.

Each of the frequency domains is individually organized as a resonant system, and it is characteristic of resonant systems that system response is very strongly dependent on frequency within the vicinity of the resonance frequency. If we then choose to operate near the resonance frequency, we will have a feedback system of extraordinary sensitivity. Such is the case with our infra-low frequency training.

In reflecting on our current state of affairs, one is struck by the natural complementarity of these two approaches to improving self-regulation. On the one hand we have the immediacy, the clarity, and the specificity of the measures of peripheral physiology, and on the other hand we encounter our regulatory machinery at a more remote, deeper, and more abstract level. We may lack a natural comfort level with this domain, but we are attracted by its clinical effectiveness.

The humbling reality is that no single approach assures optimal regulation of all the subsystems. For all the generality of effects that neurofeedback offers, it still does not fully displace the benefits that can be derived from targeted training of peripheral physiology. For the training of optimal functioning, an inclusive and comprehensive approach is advisable.

Siegfried Othmer, PhD

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