Report on the BSC Conference
by Siegfried Othmer | January 4th, 2007
It was my hope that the Biofeedback Society of California Annual Conference would offer a favorable climate for the cross-fertilization between peripheral and EEG biofeedback that now badly needs to occur. In actual fact, the rather large program made for considerable fragmentation and splintering of the audience, as nearly everyone gravitated to their own traditional priorities. Tribalism won out again, an opportunity lost. Sue and I were almost the only ones who actually addressed the main topic of evidence-based practice, but nevertheless our audience was mainly neurofeedback people.
The program did, however, offer some real gems that have broad implications for healthcare. Robert Gorter, MD, who is both Associate Professor at the UCSF School of Medicine and head of oncology research at a Berlin hospital, talked of new perspectives in cancer research. Gorter is also involved with anthroposophical medicine in Europe, which attempts to practice more naturalistically and comprehensively. The thrust in cancer research is toward strategies of immunomodulation, with cancer largely seen as an immune deficiency condition. Our immune systems are conducting a perpetual campaign against tumor formation. That is the steady state. When that process fails, boosting the immune system should be invoked as a remedy.
With this philosophy, what has emerged in Europe is an emphasis on hyperthermia as a standard approach in cancer care. Fever therapy originated when it was observed back in 1876 that cancer patients who also had infected wounds paradoxically did better with their cancers. Fever therapy then became commonplace until mustard gas treatment was introduced as a chemotherapeutic agent during WWII. Now it is being reintroduced. A mere 1.5 degree increase in body temperature doubles the efficiency of the immune system, according to Gorter. The modern twist is that electromagnetic fields are used to raise body temperature, which also has some selectivity for tumors.
The tie-in to body temperature can be seen in other ways as well. Apparently some 96% of cancer patients have reduced core body temperature as well as a disturbed circadian rhythm (which is indexed by excursions in body temperature). Gorter asserted that cold body parts–hands, feet, back, etc. constitute the first known sign of cancer susceptibility.
A second issue is the maturation of the immune system during childhood. Anthroposophical medicine has hewed to the traditional view that exposure to the common childhood diseases is actually beneficial. Measles or chickenpox cropping up in a Swiss Rudolf Steiner (Waldorf) school is the occasion for a party at the house of the affected child. There is less resort to antibiotics (52% incidence versus 90% among other Swiss children), and less reliance on immunizations against the routine childhood illnesses (18% versus 93%). Over 60% of the Waldorf children had had measles, versus only 0.5% of those conventionally schooled.
The existence of these disparate communities of children made possible a formal study, which showed that the Waldorf kids had fewer illnesses related to immune system immaturity than the more sheltered kids. The study was even published in Lancet. As Gorter put it, the experience of high fevers in childhood may be a precondition for a robust immune system in adulthood.
According to Gorter the most common drug used in Central Europe at this time for the treatment of cancer is mistletoe. It is now being used in conjunction with hyperthermia to strengthen natural killer cell function. I suspect that much of this was news to most of the people in the room, just as it was to me. The particular message for biofeedback therapists is that perhaps some more attention should be paid to proper thermoregulation in our clients. Cold feet may be more than a matter of discomfort.
Martin Rossman, MD, spoke on guided imagery. Rossman is co-founder of the Academy for Guided Imagery, and he has co-authored a book on the topic with Andrew Weil (Self-Healing with Guided Imagery). Rossman asserted that “It may be a matter of self-image that prevents people from caring for themselves in a healthy way.” His own view of the human body when he graduated from medical school was that of a ‘walking time bomb.’ Said one of his patients: “I’ve had heart disease for fifteen years, and this is the first time that it has occurred to me that this is my heart.”
Imagery is a part of all communication with a patient about their condition. But when visualization is emphasized in its own right, it may represent a most efficient entry into a state that is so fruitful because it is respectful, non-judgmental, open-ended, and relatively content-free. This may be the powerful point of entry for healthy caring for the self. Whereas imagery may reflect the outside world, it always surfaces the internal world.
Imagery represents one of the two principal information-coding languages. The one is sequential, and the other simultaneous. Imagery is intuitive, symbolic, synthetic, integrating. It is information-dense, richly affective, immersive, and physiologically active. “There is the part of the brain by which you define yourself, and the rest can be thought of as a four-billion-year-old healer….” (400M years is more like it, but we won’t quibble about a mere order of magnitude.) Imagery leads naturally from a re-appraisal of the relationship to self to an openness to the ‘Inner Healer.’
My own first reaction was to make the connection with our Alpha-Theta work. Alpha-Theta training can also be thought of as a means by which we disengage the sequential process of information-coding. What is left is imagery, and we give it free reign. It is difficult now to put oneself back in the earlier frame of mind where we were told (and we accepted and also taught…) “beware of alpha training–it’s been discredited, you know.” “Beware of abreactions.” “Don’t do it with children.”
One of the studies that attempted to replicate Peniston used a sham procedure to parallel the full-bore alpha-theta training. Alas, the sham procedure led to comparably good results. Within the standard paradigm, one would have to conclude that the Peniston protocol was not validated. This would, of course, be a mistake. The reality is far more mundane. Any sham implementation that replicates the conditions under which the Peniston “procedure” takes place is likely to achieve the intended result as well. That is because the sufficient condition for the desired effect is that one disengages the sequential processing channel, assures the comfort and safety of the trainee, and eliminates distractions. Any conceivable sham procedure would have done that. It is routinely the experience of therapists who sit with their clients during the alpha-theta work that they enter these states as well. Sham training clearly works in this case–not as well as the design protocol, of course, but well enough to possibly confound a study with small ‘n.’
What the research in fact discredited was the assumption of specificity that was bound up with the whole study design. Lack of specificity, however, is not to be confused with lack of efficacy. Mere sensory deprivation is sufficient to mobilize this marvelous process. All that is required for the therapeutically productive journey of imagery to get underway is the provision of a protected environment devoid of distracting sensory input. It would be quite sufficient just to put the person in a float chamber, for example. Even the ancients new about this. Jesus did not spend thirty days in the desert just to get away from making furniture.
And just as the Indians aided their vision quests with a little psilocybin, research in the sixties found that only a smidgeon of LSD could accomplish significant improvement in addiction treatment outcome (about half the increment over standard treatment that we achieve with our full-bore A/T program can be achieved in one or two sessions with LSD). There are just so many ways to get there (in other words, forget the LSD…). All we have to do is give our body/mind the permission and the opportunity. Anything fancy that we do by way of rewarding alpha and theta amplitudes is just additive–handrails for the visionly handicapped. It is not essential. Even without the “specific benefit” of the alpha and theta reinforcements, the feedback helps to assure that the person stays awake for what happens. Beyond that, we probably accelerate the process for many people, and we deepen it for others.
A delightful surprise at the BSC Conference was a workshop by Gabor Mate, MD, of Canada. He spoke to the issue of the intimate connection of our emotional states with disease processes. As a case in point, the incidence of lung cancer among heavy smokers is highly predictable on the basis of prior emotional trauma. (The same is not true of other medical consequences of heavy smoking, such as emphysema.) The tie-in, presumably, is once again via the immune system. The more general theme was that one response to trauma is for the person to become self-effacing and accommodating–the selfless self. The defenses are demobilized thereby, and that carries over to the immune system as well.
This pattern can be observed in autoimmune diseases such as M/S and ALS (Amyotropic Lateral Sclerosis, Lou Gehrig’s disease). Just as one has the impression that cancer happens to the nicest people, the same is even more true of M/S and ALS. Mate related a vignette from an M/S conference at which he had just spoken. In a setting similar to our own, speaking to a small circle of participants, he encroached upon the personal space of an attendee to see at which point she would begin to raise objection. That point, however, was never reached. Eventually he stood on her feet, yet she did not push him away or raise objections. He then asked her, “What if I stood on your lap?” She answered calmly that she wouldn’t like it, but she still would not object because she remained interested in what he had to say.
At one center specializing in ALS diagnosis, the staff at intake had a little wager going on as to whether an incoming patient would end up with the diagnosis. They judged purely on the basis of how nice the person was. That criterion turned out to be highly predictive of who ended up with the diagnosis. The same is also reflected in the personal life of Lou Gehrig. He is still known for his record of consecutive games in which he appeared. At one point late in his career, X-rays done on his hands showed them to have been broken in seventeen different places. He must have played on numerous occasions with a broken hand without complaint.
Mate read from a number of obituaries of ALS people. The reporters there tell the same story again and again. Sure enough, a few weeks later the obituary of Stephen Haywood appeared in our paper. He died at age 37 of ALS after having participated in a variety of what might be called guerrilla research into the condition. Just before his death, he said: “I told my mom six months ago that if I could choose not to have this disease I couldn’t do it because I—I know what’s going to happen because of this [his participation in the research].” When he died, he gave two people the gift of his kidneys. Said his brother Jamie, “Stephen found a chance even in death to help others.”
Gabor Mate’s most recent book, “When the Body Says No,” is this week’s featured book. All of his three books are best sellers in Canada.
Finally I must comment on Cynthia Kerson’s presentation on combining peripheral biofeedback with neurofeedback. I just think this foreshadows where the entire field has to go. Neurofeedback has migrated from a concern with a very select set of conditions to which the biofeedback of the day was not thought be applicable: ADHD, seizures, traumatic brain injury and stroke. But it has metastasized into something that essentially covers all of the bases in the self-regulation domain. It has been known to us all along, however, that measures of peripheral physiology are capable of revealing subtle shifts of state that simply get lost in the natural variability of the EEG. With the refinement of neurofeedback to the point where such subtle shifts matter to us to guide the training, we should not be without such measures.
It is tempting, no doubt, to assume that such exquisite sensitivity also means that these would be excellent training vehicles, but that extrapolation remains questionable. The dual needs of improving efficiency in training while enhancing our awareness of what we are doing can only be met by drawing on the strengths of our respective disciplines. We have to break down the conceptual barrier that prevails between the two systems of thought. I wish that process could have moved even further along at this conference.