Year-End Newsletter

by Siegfried Othmer | December 29th, 2005

At the office we received our Christmas present just a day or two after Christmas. It was the arrival from our Swiss development partners of a new amplifier, with built in impedance checking, for EEG and peripheral measures. It was immediately placed into operation in our office. Peripheral measures to follow. EEG Support has been offering the impedance meter for those already equipped with amplifiers. Many people thought it pricey, not realizing perhaps that it required even more complexity than is normally furnished in EEG amps. For new purchasers, the combination of impedance checking and EEG amplification makes for a more attractive overall package.

The first operational interface is with the BioExplorer software, which already runs the new games, InnerTube and Particle Editor. The next interface will hopefully be with the BrainMaster software, which now also runs the new games. This would be in line with existing trends within the field toward increasing inter-compatibility and the emergence of specialized development niches. BioExplorer currently interfaces with a variety of hardware. NeuroCarePro interfaces with Thought Tech’s Procomp and the Nexis. NeuroCyberbenetics has utilized the Thought Tech amp for many years, and before that Biofeedback Systems.

With respect to peripheral measures, conversations are ongoing with Hershel Toomim about an interface to his nIR HEG. EEG Support will also be offering the more common temperature and GSR sensing capability, as well as providing for pIR HEG. The new amplifier will be exhibited at the Winter Brain Conference in Palm Springs.

Projections for the New Year

This brings us then to the larger topic of what we may expect over the coming year. On the EEG frontier, we will see a more general movement toward two-channel training. This will certainly be our thrust, and the software offerings will increasingly accommodate those particular requirements. With the BioExplorer, this is largely a do-it-yourself kind of exercise. The requisite modules are largely in place, including a beautiful Lissajous display, and a gorgeous 3-D display of the compressed spectral array. With the BrainMaster, a new module for the calculation of net reward signals is in the offing, which will give the developer much more effective “plasticity” in the design of feedback on a multiplicity of variables. The payoff should be noticed progressively over the course of the year, as we achieve burn-in of the new games and of the new software features. The BrainMaster also offers a visually pleasing compressed spectral array. The design is very different from what is seen on the BioExplorer. Whereas the latter typically smoothes the signal in the time domain, while retaining high frequency resolution, the BrainMaster software smoothes the signal in the frequency domain and offers high time resolution. Seeing both gives one very different impressions of the same signal.

The Thought Technology Infiniti will soon offer a new iteration of the software that will accommodate our needs. The Lissajous loop will be included for a lively two-channel display, and the automatic thresholding will be more agile. An interface to the new Particle Editor and InnerTube will be provided as well. An EEG-only system is available with the Procomp II at very competitive pricing, with the software bundled with the amplifier at no additional cost.

The second major thrust we foresee is a more determined move in the direction of incorporating the peripheral measures among neurofeedback practitioners. This yields the advantage back to the traditional strong players in the biofeedback field, manufacturers such as Thought Tech and J&J Engineering, as well as newcomers offering a full spectrum of capabilities, such as MindMedia, with the Nexus.

Mostly this refers to the traditional measures of temperature, galvanic skin response, heart rate, and respiration. But it now also includes the infrared measures of cortical activation, although advocates would like for these to be lumped with neurofeedback rather than biofeedback. I don’t have a dog in that fight, but it seems cleaner to me to link the term neurofeedback to modalities that appeal to the bioelectrical domain directly, rather than indirectly through metabolic measures. Finally, this may include tracking of “end-tidal” CO2 levels in the breath.

Finally, we will increasingly see clinicians move in the direction of more comprehensive offerings in their clinics. Five minutes of HEG training before neurofeedback might prime the pump nicely for many clients. Then for the rest of the session, HEG measures can simply be monitored passively just to assure that things remain on track. Similarly, a ROSHI session before standard neurofeedback need not take a clinician’s full attention, and can likewise prime the pump. Yet others will adopt Len Ochs’ LENS system for the ultimate in EEG-driven stimulation for their most challenging clients. Or clinicians may have anxious clients spend some time in the waiting room with an Alpha-Stim before settling in for neurofeedback.

The theme of becoming a more versatile practitioner is also relevant beyond the realm of neurofeedback/biofeedback. Increasingly we are finding both the need and the opportunity to knit up with like-minded mainstream practitioners who cover other bases that need covering. By like-minded I am referring to a state of homelessness within the medical edifice, and an appreciation of the multi-dimensional aspect and spectrum character of our most intractable conditions. Local informal networks are building in which our clients’ needs for other complementary modalities can be attended to with our continued support and involvement. The ball is not being dropped so much in the handoff to other professionals. The groundwork is surely being laid here for something that will substantially complement the “standard medical model” in applications to disorders of disregulation, to chronic medical conditions, to the problems of aging, and to “lifestyle-mediated” dysfunction.

In particular, we are enjoying cordial professional relationships now with the Amen Clinics (both here in Southern California and in McLean, Va), with Helen Irlen, with Lindamood-Bell, with Alan Shore and Daniel Siegel, with James Incorvaia of the Reiss-Davis Child Study Center, with Hyla Cass, and with Aleen Agranowitz of the Speech and Language Development Center. New connections have been established with the DAN docs for complementary services to our kids on the autistic spectrum, and with the docs of the American Academy of Pain Management. University connections continue to build, although more slowly than one might hope.

It may never be documented, but the real avenue for the progress of our field is through these kinds of informal networks where professionals are already engaged in similar personal journeys of defection from the strictures of prior training and of currently approved practice. Publications in the mainstream literature give some needed support to this enterprise, but it is largely moving forward under its own steam. Chances are that the formal publications would not have succeeded if the informal networks had not already prepared the ground.

A forecast

On the larger stage of our profession, we will probably continue to see a smoldering of the issues of entitlement with regard to neurofeedback. Who is entitled to do the work, and how will the mainline professions sort things out? We will be challenged to find the appropriate language that will allow us to be taken seriously, on the one hand, and not have NF defined as a medical procedure, on the other. As much as possible, it would be good for the individual practitioner to point to resources other than their own to make the case for what they do.

In marketing their services, clinicians must accomplish two diametrically opposed objectives. On the one hand, clinicians must be able to sell themselves as part of a large and respectable professional cadre that offers neurofeedback around the world, and on the other, they must make the case for their own particular uniqueness. On the one hand, we represent ourselves as being on the very frontier of healthcare, and on the other we are offering techniques that have had decades of seasoning in clinical practice. The longevity of the major techniques in our employ is considerably greater than almost all of the drugs our clients might be taking (outside of aspirin, Ritalin, and Dilantin).

Just to add to the challenge, the whole enterprise must not look like marketing at all. The very word makes many clinicians feel uncomfortable. A large part of the answer to the marketing challenge is to resort as much as possible to impersonal means of spreading the word. This is the role played by the EEG Directory ( for any neurofeedback clinician interested in boosting their visibility. Certified practitioners can also be listed on the BCIA directory.

We are seeing an increasing impact of our web presence when we survey how people find their way to our office. The value of such a presence is enhanced when it is known to represent the shared belief of a larger group. And there is benefit to the individual member to be associated with a larger group that acts as an attractant for the interested public. This is the well-known network effect talked about by Barabasi, namely the fact that it is always preferable to attach to network nodes that are already successful. The benefit is nonlinearly related to the number of participants, so as people join up they are also helping the success of the overall enterprise. Already there is probably no greater bargain to be had in the field than to be listed on the EEG Directory, and that cost/benefit ratio will only increase as more clinicians sign on, and begin to refer other people to the Directory.

In a number of locales, we are seeing the formation of local practitioner groups for collegial interaction and mutual support. These can be seen as the highly-interconnected local networks that are also predicted by network theory. At every level, we are seeing the emergence of new forms around neurofeedback: a new view of mental disorders; a new view toward remediation; newly emerging professional networks; new sources of clinical intelligence; and new scientific techniques for establishing our field.

Just today, Sue Othmer was doing neurofeedback with someone in Illinois. After the person hooked up her own electrodes, Sue took over the client’s computer via GoToMyPC and ran the BrainMaster software. All the communications with the client were just the same as if the client had been sitting in her office. We must acknowledge the significance of such milestones while the emerging capabilities are not yet commonplace.

How far away can we be from the world in which the computer that prompts you for your important phone call also summons you to your home neurofeedback session, monitors your breath and heart rate while you are doing e-mail, paces your breathing, and monitors your cardiac waveform for the occasional anomalies. How long will it be before we have data on the sleep quality of our clients from all-night monitoring piped back to our offices, all automatically scanned for the features of interest? How long before we get mobile EEG data on the bipolar children we send home with their harried parents? How long before we will be doing “immersive” neurofeedback with simultaneous appeal to visual, auditory, and somatosensory modalities all geared to the transmittal of physiologically relevant information?

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