The Domestication of Neurofeedback

by Siegfried Othmer | September 28th, 2018

At the fall meeting of the Northeast Regional Biofeedback Society (NRBS), Roger deBeus will report on the status of a ‘multi-site double-blind randomized clinical trial of neurofeedback for ADHD,’ a study that was actually funded by the NIH. We look forward to seeing the results. The study involves quite a cast of characters: Eugene Arnold, psychiatrist and authority on ADHD who has been in emeritus status for years already at Ohio State University; Keith Conners, author of the Conners CPT and one of the original critics who hounded Dan Chartier early on for doing neurofeedback; Larry Hirshberg, who tried to use our old protocols in a study of PTSD; Vince Monastra, who undertook the largest-ever study of NF for ADHD; Joel Lubar, and of course Roger deBeus, who conducted an earlier attempt at a blinded study (one that is not fondly remembered).

This ‘science-done-by-committee’ project leaves me of two minds. On the one hand, if the study is ‘successful’ in its own terms, then it will indeed change the debate in neurofeedback. It will put the critics on the back-foot. But when the sun rises again the following day, it will be discovered that not much has changed—except for the kind of arguments to be raised against neurofeedback: it is too expensive; it takes too much time; the results are too meager; and who knows whether they last. It is safe to say that it will be difficult to argue against any of that–on the basis of the findings.

The study will have accomplished a long-term goal in the field—acceptance within the frame of the medical model. Neurofeedback as a fixed ‘procedure,’ effectively electronic Ritalin. If the study garners attention, neurofeedback may come to be seen narrowly through the lens of the protocol that demonstrated validity. It will in a sense be put in a cage—a mental cage that will have been enlarged just enough to include this protocol. Neurofeedback will have become domesticated. By virtue of the acceptance of the ‘double-blind’ design as a discriminant, everything that has not passed through that gate will be placed in a kind of provisional or second-class status. The gate-keepers will be empowered to flog everything that has not met that particular standard.

The irony is that the prime movers within the field—Sterman and Lubar and others—have been most fervent in their desire to achieve this objective of meeting medical research standards—when in fact that would only lead to putting gate-keepers in charge who rightly see neurofeedback as a threat to the status quo in which they themselves are heavily invested. This project of getting one protocol past the goalposts has put the research agenda onto a narrow-gauge track for many years already. The attempt to cleanse the technique of any placebo contaminant has impoverished the training experience, and protocol innovation has been inhibited.

Consider that Ohio State has been at this game for a decade or so, and is only now coming forth with its first reportable study. The entire development of Infra-Low Frequency Neurofeedback fits within that same time frame. ILF Neurofeedback has by now benefited between a quarter and a half a million people around the world, at the hands of thousands of clinicians who had all been doing something else before they found their way to here. The ILF NF has clearly empowered them, or they wouldn’t continue to do it. There you have the real answer: It actually works in the real world of paying clients, and it works better than whatever they were doing before.

By now we are in a position to say to the world, “We are not doing standard neurofeedback. What we are involved in is quite something else. What we are doing cannot be done by an ‘operant conditioning procedure.’ It cannot be reduced to a formula. It cannot be done blind. It cannot be turned over to robots. It cannot be done without a knowledgeable clinician involved. The procedure is not “manualizable”–except in the more general sense of the Protocol Guide. Our approach is not bound within the framework of standard diagnostic categories. It is not even dysfunction-focused.

What we are about is the liberation of the brain from its own accumulated dysfunctions through the simple expedient of allowing the brain to witness its own function in real time. This empowers the brain in its essential task of regulating its own activities, which can be understood as the brain’s essential skill. The entire project is a matter of skill-building, one in which the brain itself is in charge of the particulars.

The kind of organic neurofeedback that we are doing can only reach acceptance through the bottom-up process that we are engaged in. It cannot conform to standard research designs. We get there by outcome studies that cannot be matched in terms of results by anyone else using any other method at the present time–either qualitatively or quantitatively. The case keeps building as the method continues to be refined.

Along the way, every member of the practitioner network can help the cause by faithfully doing the QIKtest to document progress, and by doing symptom tracking for the record whenever appropriate. It’s the results that count. For these, please see the next newsletter.

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