Neurofeedback: The First Fifty Years
by Siegfried Othmer | February 5th, 2020
This weighty book of 500 pages has just reached us, and the editors deserve our gratitude and appreciation. Their labor has been a service to the field: Jim Evans, Mary Blair Dellinger, and the late Harold Russell. No neurofeedback denier could read this book and remain resolute in his convictions. As it has evolved over the decades, the field is too diverse and multi-fold to have emerged out of mere imaginings into a grand delusion. This is not to deny, however, that grand delusions have also been a motive force. And the disagreements among us have always played a much greater role than whatever beliefs we shared.
It is also notable that our field has brought together a greater variety of health professionals in common enterprise than any other. Neurofeedback has no natural home in any one healthcare discipline; rather, it will come to underpin them all. A major revolution in health care impends, and it will be driven by the self-regulation technologies, most prominently the neuromodulation disciplines.
The person who first envisioned this future most clearly was Barbara Brown, and sadly her chapter is the most glaring omission from this book. Barbara Brown was the prime mover in organizing the first meeting of what later became the AAPB (in 1969). In the mid-seventies it was her advocacy that brought peripheral biofeedback and EEG biofeedback to the attention of millions through her popular writings. Her name was most closely associated with alpha-band training, and in 1974 she edited a book on alpha-band research that covered more than 1000 formal studies on that subject.
The sudden popularity of alpha-band training unleashed a backlash from the unreconstructed professions, a development for which Barbara Brown was then also blamed. This became a near-death experience for the biofeedback community, and for that reason she is not fondly remembered by many of the old-timers.
Overlooked in this collective trauma memory is the fact that Barbara Brown had really been making the case for biofeedback in general in the book that first brought her to notoriety, New Mind, New Body: Biofeedback, New Directions for the Mind, with Foreword by Hugh Downs (Harper and Row, 1974).
“Not until biofeedback has Western thought entertained the notion that the insights and awareness achieved by explorations of the self by the self may provide a far more solid base for ensuring mental health than can be achieved by all of the Westernized psychologic, psychiatric techniques combined.”
“If we are to relieve anxiety, tension, and headache, we may do well to listen to the voices within. If the skin and the heart [read GSR and HRV] seem to be able to respond to pure mentation, if they signal conflict in our social ideas, if they detect down to the least significant event in our functional milieu, is it not reasonable to listen?”
“In biofeedback the mind and body use information about internal and external events in a remarkably efficient and effective way to change both internal processes and the relationship between the perceived world and the self.”
Hers was a grand and inclusive vision. It hints at gestalt concepts and foreshadows modern dynamical systems theory. Brown continues:
“This information is not discrete, nor is it isolated; it is, rather, information about fluid relationships and dynamic functions that is understood and utilized as an organized, meaningful, holistic pattern.”
“Both the psyche and the body are in a state of continual flux—to change one element in it means that its entire sphere of interactions and relationships must also be changed in relative and suitable proportion.’
“It is most parsimonious (as body processes are) to conceptualize the process of such complex changes in terms of patterns.”
Barbara Brown took a dim view of operant conditioning, which set her at odds with Barry Sterman, with whom she shared research quarters on the Sepulveda Veterans Administration Hospital grounds.
“Operant conditioning may be a highly limited version of biofeedback.”
In this she shared the views of the contemporaneous Nobel Prize-winning ethologists Konrad Lorenz and Nikolaas Tinbergen:
Ethology was a “reaction against a tendency…in psychology to concentrate on a few phenomena observed in a handful of species, which were kept in impoverished environments, to formulate theories claimed to be general, and to proceed deductively by testing these theories experimentally.” (N. Tinbergen)
“Nearly a century of Western experimental psychology has been concentrated on theories of learning appropriate to rote, mechanical, almost automatic ‘learning.’”
“With respect to the everyday necessity to learn new bits of behavior, Pavlovian conditioned learning has little to offer.”
—Barbara Brown
The operant conditioning model set neurofeedback apart from the rest of the biofeedback field, and left it to the tender mercies of existentially deprived left-brained reductionists who have strait-jacketed the field ever since.
“The physiologist is no ordinary man. He is a learned man, a man possessed and absorbed by a scientific idea. He does not hear the animals’ cries of pain. He is blind to the blood that flows. He sees nothing but his idea, and organisms which conceal from him the secrets he is resolved to discover.” —–Claude Bernard (Note 1)
“The fact that autonomic functions, such as heart rate, can be brought under control is probably of no importance whatsoever. All that means is that we have a new way to continue our studies.” –Eminent research authority speaking to a gathering of scientists.
Fortunately, that was not the end of the story. If ethology is understood as the biological study of behavior, then the emergence of infra-low frequency neurofeedback (ILF NF) has proceeded by way of an “ethology of brain behavior.”
ILF NF had to be discovered empirically. It could not have emerged out of a laboratory in an American university under the constraints of an NIMH-funded study. The discernment of patterns emerges out of observational science. So ILF NF had to be discovered by an ethologist, by someone who would allow hypotheses to be formulated out of long-term accumulations of clinical experience. These are then progressively confirmed or disconfirmed in the same manner.
The same thing happened in biofeedback. Driven by the operative ‘theoretical’ model of seeking ‘homeostasis,’ the American approach to heart rate variability training was to train variability down. Russian researchers, on the other hand, proceeded by observational science and found that good heart function depended on robust variability.
In a fit of physics envy, the nascent field of neurofeedback latched onto the QEEG to illuminate the path to good feedback. This placed the clinician even more firmly in the saddle, and rendered the client’s experience even more irrelevant than was already the case in protocol-based training. What did the QEEG do for us? It squeezed the variability out of the measures, because variability was equated with uncertainty in the conclusions that could be drawn. Just as in the case of HRV, this has been a monumental blunder—because of what it has caused us to neglect.
It is in Infra-Low Frequency Neurofeedback (ILF NF) that we may finally see the culmination of Barbara Brown’s vision, and at another level, the conceptual re-unification of biofeedback and neurofeedback:
“The customary view was to control behavior…..by external control devices and procedures.”
“The new biofeedback was escaping the strictures of classical thought; control was in the head, no longer in the hands of the experimenter.”
ILF NF takes us to the top of the regulatory hierarchy, the glial and the neural networks. Within the domain of neuroregulation, however, it takes us to the bottom of the hierarchy, our core regulatory function, to which we don’t readily relate at the conscious level. Core regulatory function–autonomic arousal and balance, as well as central arousal–is also the principal domain of biofeedback. So here we are seeing a convergence of objectives. Further, ILF NF was developed in the same manner in which GSR and Temp and Alpha synchrony training and the Menninger Protocol first matured, with observations at a global, organismic level rather than that of subsystems. We relate to this information experientially, viscerally.
There is one major distinction to be made, however: Barbara Brown argued mightily for including the mind in the project of enhancing self-regulation. In peripheral biofeedback, conscious engagement with the process is essential.
“In the cold, impersonal laboratory of the biomedical scientist it has taken a long time for the mind to recognize the importance of the mind.”
“Talking about the mind will set the field of medicine back fifty years.”
—–MD’s comment at a medical conference, 1980 (Note 2)“…there were no concepts of possible voluntary control—such as we have over our hundreds of muscles—and this psychic, now scientifically proven power of the will moved unseen through the psychologic experiments like a many-fingered Beelzebub plaguing the researchers.” –Barbara Brown
In ILF NF we have to take the mind out again. Conscious engagement with the physiological measure, the signal being tracked, is rather pointless. The signal is meaningful, and thus of interest, only to the brain that is producing it. The signal is being experienced rather than merely being observed, and the experiencing entity is first and foremost the brain itself, and only secondarily the client—by virtue of the brain’s engagement with the signal over time.
Readers might wonder what is intended with the concept of the brain as the experiencing entity. It simply means that the cerebrum is where the contextual relevance of the proffered signal is discerned and a response is engendered. To that proposition there is no reasonable alternative. We have arrived at a learning process that is entirely understandable in brain terms. This is ‘endogenous neuromodulation’ in its essence—the brain engaging with its own regulatory processes without external guidance, and without supervision by the faculties of consciousness. The brain assumes ownership of the signal, if you will, and the process effectively becomes internalized.
Finally, it must be observed that the essence of ILF NF, namely endogenous neuromodulation, has been an element of our approach since the very beginning of work with our new instrument, the NeuroCybernetics, in 1987. At that point, the operant conditioning aspects of the protocol were still paramount in our considerations. All the while, however, the brain was getting more out of the signal than we realized…. Over all these years, it has been the brain itself that directed our efforts. But it took an ethologist to take notice of what was really happening…. Barbara Brown would have loved it.
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Note 1. One is reminded of the dictum of Sir Francis Bacon, generally recognized as the first empirical scientist: “We shall torture the secrets out of nature.”
At this point, one cannot fail to recall the person considered to be the Dean of psychophysiology researchers in our field, the late Neal Miller. He directed the critical experiment that was to settle the issue as to whether the self-regulatory response of autonomic function was mediated by the voluntary motor system. After all, the thought that the mind, and the will, could influence autonomic (read automatic) function was beyond the pale.
The training of heart rate was to be attempted in curarized rats. The reward was electrical stimulus to the hypothalamic pleasure center. Here’s what Barbara Brown had to say about it: Picture the scene: “…a limp-as-a-rag white rat stretched out on a little pad, all of his muscles paralyzed, unable to move, unable even to breathe without the help of respirator forcing the exchange of air in his lungs.” The circumstances were hardly propitious to discern the subtleties of a self-regulatory response.
Here’s how Edward Taub paints the scene: “There it is, lying on a table in an alien and clearly hostile environment. It suddenly has been totally paralyzed and now cannot move a muscle, nor can it breathe on its own. A cone is placed over its face and a gaseous mixture is forced in and out of its lungs. The rat would, of course, have to be completely terrified.” And yet success was proclaimed, against all expectations.
The fact that the experiment succeeded hardly compensates for the absurdity of the situation. Subsequent replication failed, and because so much had been staked on the outcome, the future of the biofeedback enterprise was threatened. With the results of the original research thus called into question, the researcher Leo DiCara, who had already moved on, committed suicide. That only heightened suspicions further…
Note 2. The role of the mind in healthcare is of course recognized–and reified–in the concept of the placebo. But the placebo is seen—much like Barbara Brown’s Beelzebub—as a confound in medicine. It is the principal adversary that needs to be bested in pharmacology research. Rarely is the mind seen as an ally, as a healing force in its own right, in the medical armamentarium.