Hysteria and Hysteresis

by Siegfried Othmer | January 25th, 2006

There is a Buddhist saying, “you can never step into the same river twice.” And it may similarly be true that we never train the same brain twice. One of abiding mysteries about our way of training is that the advantages of optimizing reward frequency can be so obvious to us and yet remain so obscure to others. Many stay with the standard frequencies and their clients appear to do fine. Indeed we used and taught those techniques for many years; we saw nothing wrong with them then; and we got good results overall with the people who stayed with the program.

An answer may lie in a fairly common experience that we encounter in training, to which attention should finally be drawn. When we walk down the reward frequency in the hunt for the optimum, we will often end up toggling back and forth when we near the endpoint in order to verify our observations. In taking the reward frequency back up the person will often respond very differently than what they reported on the way down. This is not an isolated finding. It is more typical than not. We know this phenomenon from the field of magnetism, where it is referred to as hysteresis. The current state of the magnetization of the lump of material is given not only by the current magnetic field in which it is embedded, but also by the prior exposure history. The magnetic material remembers its past history. Matters may be similar with the brain. It responds not only to what we are reinforcing in the moment, but to a certain extent it is affected by its cumulative training history. That is also where the analogy ends. One response to this phenomenon is for us to consider the neurofeedback training as more of a journey, with each step to a certain extent another venture into the unknown rather than being merely a repetition.

Another kind of explanation is to be had by analogy. When Sue does Irlen screening the procedure is fairly systematic from beginning to end. By the time the screening is undertaken, Sue already has a good idea that the person exhibits the susceptibility. It is largely a matter of bringing the person along in that understanding, and of scoping out the appropriate and approximate remedy. But the process will likely hold many surprises for the client. At the outset, the person may not be aware at all that the visual system is under strain. As soon as the right overlay is found, however, the nervous system has a chance to relax into a more comfortable state. Then, when the overlay is again removed and the person once again confronts the contrasts of black lettering on a sheer white background, the nervous system will revolt at the insult. The person may well rear back suddenly or just avert the gaze. It will be quite apparent to the person that he or she is in fact intolerant to the full spectrum exposure. Black-on-white is just no longer ok, and the change in responsiveness may have transpired over mere minutes.

The state of disregulation could only be discerned from the vantage point of better regulation, and this seems to be true in the above instances both at the conscious level and at the level of the nervous system. The moment the nervous system has the opportunity to reach a state of better regulation, it accommodates at once. It is as if a new standard is set. The new state becomes something intrinsically desirable; it becomes the new reference standard.

So we might well have a situation in which training at the standard bands (SMR and low beta) is helpful, and the trainee may have no complaints. But if that same person had the chance to experience optimized training, he or she might well no longer sit still for the training at the original frequency. So just as it is possible for most of the world to remain oblivious to Irlen Syndrome, it is similarly possible for neurofeedback clinicians to insist that they see no evidence that other training frequencies may be better than the standard ones. There is really no alternative to testing the model directly, and the results will then speak for themselves.

So if a certain dogmatic clinician were to assert that he has never experienced a bad session with standard training protocols, then it is true by the same token that he has never had a person complain of a strained visual system as a result of such a session either. The two propositions amount to the same thing. Yet demonstrably some 20% of the population are candidates for Irlen screening, and perhaps even a higher percentage among those who come to see this person for training. The nervous systems at issue have not been given the opportunity to be discriminating. We owe every one that chance.

We are not talking about subtle effects here. We’ve no doubt all had the experience of seeing people try the traditional light and sound systems. Some will rip the LED glasses off as fast as they can after just having put them on. Their systems are intolerant to the optical stimulation. One can see comparable reactions to the training in the SMR band after a person has found their optimum reward frequency to be something different. And this will occur even though the session likely started out at the SMR band without apparent ill effects. Training under the right conditions will apparently build intolerance to the wrong ones because the brain sees no reason to continue to tolerate disregulation.

It would be reasonable to expect that the right training would increase one’s tolerance to environmental insults in general, and that should include training under non-optimal conditions. That remains true, and there is no conflict here. The above reports are from the first session, where we necessarily range farthest afield in search of the right reward frequency. This is before the status of disregulation has been substantially remediated. The objective that we seek is the best state of regulation of which that particular nervous system is capable at that moment. Trained under those conditions (i.e., optimized frequency), the person appears to be maximally tolerant to the exercise. There is no apparent risk of overdosing, such as there might be with any non-optimal training.

If the above is true, then one might expect that extended training should lead to a much greater tolerance to a variety of protocols. That may be true to a certain extent, but another factor creeps in. One has the sense that the brain learns over time to respond more specifically to the training, and perhaps more quickly. In surveying the field we know that a variety of neurofeedback techniques can get us to first base with ADHD. More subtle and specific objectives that may be undertaken later will benefit from more targeted training. So at best the whole training experience should be seen as a learning opportunity by the clinician to define and refine the path forward as training goes on.

The above suggestion that hysteresis is an important factor in neurofeedback surely does not come as a complete surprise even to the traditional biofeedback practitioner. There is the awareness first of all that the anxious person has to a certain extent accommodated to his or her disregulated physiology and may sense any rapid change in that ambient as a discomfort, or even as a threat. So one has to move the person gradually toward calmer states, in a manner such that one never gets too far ahead of the person’s comfort zone. In addition to the obvious physiological dependency that has developed in such a case, there is the psychological dependency as well. No rapid accommodation toward a new ambient level of functioning is likely to be welcomed by the anxious person. One could similarly cite the example of OCD behavior, of thrill-seeking behavior, or of the “rage that protects” in the case of the RAD child.

Given the pervasive clinical reality that people in general accommodate to their respective disregulations, it is all the more remarkable that with our new training approaches we can so radically shift a person’s comfort zone both physiologically and psychologically, to the point that over the course of a half-hour session the client’s prior state of being is already in an excluded zone where the person no longer wishes to reside. This brings us much closer to the ideal of “real-time neurofeedback,” where the reference is now to the feedback loop that involves the clinician. With an optimally responsive technique, applied to a highly sensitive and disregulated client, the direction in which one must move can become apparent within mere minutes, a judgment that will then be validated by subsequent experience.

In the technique of neurofeedback, we have sensitized the client to his own state to a degree that exceeds all our original hopes and expectations. We are remiss if we do not bring the clinician to a comparable sensitivity to the nuances of this process. Once that is accomplished, then it is of secondary concern whether the “Ansatz” of training issues from a QEEG-type of analysis or from a standard protocol perspective. If one allows this process to unfold naturally and organically, and if one’s inventory of techniques is sufficiently comprehensive, then there will be a migration through training toward the particular method that is most appropriate to any client. Traceability to the original Ansatz may be poor in general, sufficient perhaps even to render the debate over primacy of QEEG-driven versus protocol-driven training moot.

The process by which training approaches are optimized is by now robust. The process comes, after all, with a built-in correction strategy, provided one is not too doctrinaire in one’s approach. This has been shown to be true irrespective of whether the starting point in training involves inter-hemispheric or lateralized placements. For this reason, if that process eventuates in an optimized training strategy involving the 3-6 Hz band, or even 0.5-3.5 Hz, that is nothing to be nervous about. There is no excluded zone here. There is no such thing anymore as a good frequency or a bad frequency. It all depends on the response of the individual to the particular challenge. It is time, therefore, to bed down the hysteria about reinforcing within the ostensibly forbidden zones at low EEG frequencies.

Order does still prevail within this generally more permissive regime of dynamic protocol development. We have found our own way toward an ordered process by which training can be progressively refined. This is embodied in the Clinical Decision Tree, which is available on EEG shop (www.eegshop.com) and is updated a few times a year. It is likely, however, that any of the conventional protocol starting points can lead to a similar strategy of successive optimization. Once the frequency neighborhood is identified where the particular client can most usefully train, then that also defines the frequency neighborhood for complementary protocols. The only thing we are tempted to generalize about is that the approach works more strongly with bipolar rather than with referential placements. We don’t actually have a lot of recent comparative data on this, as we abandoned referential placement long ago after satisfying ourselves on this count. It also makes sense in terms of our model of the underlying mechanism.

An Update on NeuroCarePro

If the argument is made that the above dynamic approach to protocol optimization surpasses both QEEG-based approaches and the standard protocols in terms of refinement, finesse, comprehensiveness, universality, and speed of response, how might it compare with NeuroCarePro? I just had another opportunity to experience the NeuroCarePro with Alan Bachers in Cleveland. On this occasion, I got to look at the bilateral display of all the bands throughout the session. This suits my own worldview, in that I believe training improves as the visual displays or other feedback tracks the actual EEG data more closely and gives the brain more information to key on.

I could see directly where my EEG was banging against the stops in the different bands. But this needs to be a relatively rare occurrence or else the training becomes too off-putting and burdensome as auditory feedback is constantly interrupted. By watching the bilateral display throughout the process, one gets to see the ebb and flow, and the variability of the data, as it unfolds. The information density to the client is thereby vastly enriched. One imagines that the brain gets the “gestalt” of what is going on, and relates that to the turbulence inside. More information in that enterprise is actually better. The details may or may not matter. I focused in on the undulating signals and wished for a calming of the seas.

Whatever it is that the NCP post-analysis is actually keying on, a respectable change in the parameters appeared to be indicated for my efforts in a pre-post comparison. Joked Bachers: “If I did not have contrary evidence, I might have thought this to be the EEG of someone in a coma.” Calming of the seas indeed. I previously reported on an NCP session that took me to low arousal and affected my sleep that night. There was no repetition on this occasion, quite possibly because the session was conducted mid-day. The effect of the NCP is calming and stabilizing, and as such the objectives are quite similar to our own narrowly targeted approach. I therefore see the two approaches as very complementary. The effect of the NCP is typically gradual and cumulative, whereas the effect of our reward-based training can be dramatic early on as optimization proceeds.

One other difference is that we are able to move the person deliberately in arousal level, whereas the NCP default setting does not offer that kind of steering. Yet another difference is that the early effect of our approach tends to promote buy-in by the client even well before the training is optimized. Even if we end up heading in the wrong direction initially, the person is put on notice that the process is non-trivial and not innocuous. The NCP is also not unique in offering the kind of information that I found so useful to train on. It should be recalled that Chuck Davis’ original ROSHI relied on the bilateral spectral display on the Amiga for reinforcement, augmented by optical or magnetic stimulation derived from bilaterally correlated EEG signals. At the time his was probably the most advanced neurofeedback system available, and the dominant emerging themes in neurofeedback today were already implemented there. Both ROSHI and NCP distinguish themselves by being minimally prescriptive, whereas our own approach can be thought of as maximally constrained. There should be much merit in combining the two, and if the prescriptive approach ever poses too much of a clinical challenge at the outset of training, one can always fall back upon a non-prescriptive strategy for moving forward.

The technique of neurofeedback lends itself to accommodating different perspectives by a process of absorption and generalization. This will in the end override any impulse by one or another of the entrepreneurs individually—or perhaps of the professions generally—to establish and fortify boundaries; to define and carve out procedural turf; and to elevate certain narrow perspectives as definitive for the field. Every attempt within the discipline of neurofeedback to define “right belief” narrowly in terms of a particular prescription for training has been found inadequate to the complexity we confront. Mastery lies in our capacity for adaptation to particular clinical challenges, irrespective of whether we deploy prescriptive or non-prescriptive modalities of neurofeedback.

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