The American Academy of Pain Management is an organization oriented toward integrated pain management, and welcomes health professionals of any stripe. To further insure that hierarchical status is not promoted, the name tag does not give a hint of pedigree. The ISNR did the same, with both standing in contrast to the AAPB, where labels could be attached to labels down the lapel, to make sure the world knew who the truly important people were.

There were lots of talks on migraine, so it is still very much an issue in pain management. One talk in particular was memorable. It was by an Alaskan who interspersed his talk with a slide of his ultralight sitting on the snow. This could hardly be a conventional talk. He insists on the patient making all the necessary lifestyle adjustments (such as improving sleep hygiene) before any medical intervention is even considered. He announces perfectly seriously that “I make the patient do everything before I do anything.” He makes people maintain a headache diary, one that makes them track known triggers and other lifestyle factors, as well as recording any aspects of prodromes. This helps to identify and confirm the connection with specific triggers, and thus increases commitment to the program. He also asks them to start taking certain supplements, such as Vitamin B-2, magnesium, and CoQ-10 and he closely monitors their progress. These measures alone are sufficient in his experience to bring about a reduction of between 50 and 90% in migraine incidence over a period of weeks to months. (more…)

I came a day early to the ISNR Conference to hear Val Brown at an all-day Workshop under conditions where he had a friendly audience, and where he wasn’t being challenged. Most of what was presented was already familiar to me, but it was nice to hear how he chose to present the information. Val often relies on the sailing analogy, that one cannot trim the sails in advance, but rather must adapt to the conditions. When the sails luff, an adjustment is called for. In the case of the EEG, the luffing is most likely to occur in the high and low frequency ranges. Running NCP is a matter of keeping the sails in proper trim (in this case sixteen of them), and so is neurofeedback in general.

In the afternoon Sue Dermit Brown talked about her utilization of NeuroCarePro. She now does all of the clinical work, since Val does not have a license to practice in Canada. Sue said that after a period of experimentation with other site pairs than C3 and C4 she is now utilizing those other site pairs less and less. This trend is opposite from ours. Val suggests that the way he uses information from the whole EEG spectrum makes other sites more superfluous. That must be true at least to some extent, or Sue would feel more rewarded for site-shifting than is apparently the case. Sue is also doing less alpha-theta training than before, and she does not know why that is the case. “Becoming asymptomatic is really a matter of the eyes-open work,” says Sue, and we very much agree. It is quite possible in our own case that the extension of eyes-open work to lower frequencies gets some of the work done for which we used to rely on alpha/theta. NCP intrinsically covers the whole band, and Sue may be benefiting from the same effect as experience is gained with the system. (more…)

I reported on this conference in Salt Lake City two weeks ago, and here is another installment. On the second day of the conference there was a lot of discussion about juvenile probationers. Ron Muir presented on an innovative Charter School that he had started for probationers, which despite many handicaps was producing some excellent results with a program focused almost entirely on the kids’ educational needs.

Jerry Ross and Mike Phillips presented on initial outcomes of a demonstration program in Orem Utah for at-risk youth. This comprehensive program was based on earlier successes of Narconon, an anti-drug program started under the aegis of Scientology. This parentage made a lot of people uncomfortable, but I was there to see the data. The program involves detoxification combined with nutritional intervention, along with other aspects of the program that addressed educational and social needs. (more…)

This year the 12th annual Lindamood-Bell Conference overlapped with our Woodland Hills training course, but nevertheless I was able to take in two days of the conference in Anaheim at the invitation of Pat Lindamood. Some years ago we visited the Lindamood-Bell operation in San Luis Obispo, and we found considerable openness to our view of the world, even though our respective methods of remediation are worlds apart. Since that time there have been a number of cross-referrals. The Lindamood-Bell program focuses on reading disorders specifically. This is another field dominated by strongly held opinions that often go well beyond what solid research can support.

Pat Lindamood and Nanci Bell stepped onto this terrain many years ago with a targeted, intensive approach to training specific aspects of the reading process. Initially, they were driven by empirical findings of success. More recently, research has begun to backfill with supporting models. By now the Lindamood-Bell program is well-established nationally, and their conference attracts nationally known researchers. (more…)

I left the ISNR Conference with my head full of rich detail, but over time it is easier to discern the deeper trends. First of all, the conference was anchored by some top mainstream scientists who have seriously bitten into neurofeedback. They are now very committed to this field, and they will carry on through their publications and graduate students, and through presentations at other conferences. They will be bringing up the rear with sound research. There were also first-rate presentations by the indigenous leaders of our field. And new capabilities are being developed on the instrumentation side. Quite unambiguously the forefront of this field is still in the hands of the scientist/practitioners, the clinicians, and the engineers.

On the matter of stimulation
Perhaps the development of greatest import at this time is the maturation that we see in the area of the stimulation technologies. I have been watching that development with intense interest over the years, but there was always a serious philosophical barrier. There was this conceptual divide between active training and passive driving, and we have always preferred to stay on the training side of that divide. This calls upon the active involvement of the client or patient in the work being done. It involves a learning component. We can say unabashedly that we are not doing anything to the brain. This is all very comforting, both to the clinician and the client, and it keeps the technique more unambiguously in the domain of psychology. (more…)

We have just returned from the 14th annual meeting of The American Academy of Pain Management. It was held in Denver at the Adam’s Mark Hotel, where the AAPB had its meeting two years ago. The organization is relatively young. It is reminiscent of the biofeedback community in several ways: It has a multi-disciplinary membership and attendance. It favors a multi-disciplinary approach to its subject. It also feels itself on the outside of the mainstream. Pain has not been taken seriously as a discipline within medicine for very long. And many of the conditions treated—such as fibromyalgia, chronic fatigue syndrome, and multiple chemical sensitivity—themselves have an equivocal status within medicine. Hence there is a sense of second-class citizenship just as we suffer in biofeedback. There is the wish to be recognized within the larger medical community, of a message not being heard, and of the message being preached to the choir. The exhibit area was flooded with gadgetry from various sources, and here Chinese herbal remedies were to be found shoulder to shoulder with ionic detoxifying baths and infrared healing wands. It was quite the bazaar for the gadgeteer.

The differences between the AAPM and the AAPB were just as pronounced, however. Attendees were mostly MDs, and clearly these were the ones who were willing to think independent thoughts. They were predominantly clinicians from the trenches rather than researchers from academia. In other words, they had all been humbled by the intractability of chronic pain in their own practice, and of the inadequacy of any simple models. Another significant point of difference was that the nametags did not show pedigree, so you could not tell who was an MD and who was not. That meant everyone had to treat everyone else respectfully, both in the lecture halls and in the exhibit area. (more…)