by Rob Kall
Copyright 1995, R. Kall
An introduction to a panel at the 1995 Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, organized and chaired by Rob Kall, with Carol Schneider, James Hardt and Stanley Krippner
I organized this panel for highly political reasons. I and many longtime supporters of this organization have become seriously concerned about recent efforts to medicalize biofeedback at the cost of depreciating and trivializing the value and benefits biofeedback offers to humanity and to individuals.
I believe that Biofeedback is not an innately medical process. Rather than being a remedial treatment passively performed on the patient, which fits into the reductionist medical model, biofeedback is an active, self-responsible, behavioral/learning holistic process. It is based on teaching the individual to optimize his or her mind body functioning. Ultimately, biofeedback can be distilled down to the idea of learning to increase or decrease, inhibit or disinhibit some physiological activity.
Ralph Waldo Emerson, a transcendentalist of the turn of the 19th century wrote one of my favorite quotations:
"A man is like a bit of Labrador spar, which has no lustre as you turn it in your hand until you come to a particular angle; then it shows deep and beautiful colors. There is no adaptation or universal applicability in men, but each has his special Talent, and the mastery of Successful men consists in adroitly keeping themselves where and when that turn shall be oftenest to be practiced." Ralph Waldo Emerson
Biofeedback teaches people to turn their strengths to the angles which show them best, and help people to discover the parts of themselves which are the best. And that is not a medical process.
If you teach someone to change adipose tissue levels or muscle mass via diet or exercise you are not engaging in a medical procedure. You are teaching health optimizing behaviors.
If a coach teaches an athlete to move more efficiently and effectively, so the muscles work better kinesiologically, it's not a medical procedure.
If a consultant for a fortune 500 company determines a musculoskeletally better ergonomic design for a work station, which reduces risk of carpal tunnel syndrome or back pain, it's not a medical procedure.
If a corporate optimal performance consultant evaluates an executive's psychophysiological response profile to identifypatterns which can be improved upon to enhance performance, that is not a medical procedure. It's a fine-tuning process, a form of training in psychophysiological grooming.
I'll repeat my assertion that all biofeedback can be characterized as training to move an individual to a different position on the overlapping continua of either activation-de-activation or inhibition-disinhibition.
At last month's (1995) Key West EEG meeting, Hershel Toomim sketched out the beginning of a new theory to explain why it takes 30 to 60 sessions for neurofeedback to produce significant results with ADD. He proposed, based on PET scan and scalp thermal monitoring, that neurofeedback trains for increases in blood flow to the areas being trained, and that the long term effect of this is growth of microcapillaries, leading to increased vascularization of that area of the brain.
This is an exciting concept which one of our most esteemed pioneers in neurofeedback has suggested could easily be conclusively verified with animal research. But is this increased vascularization training a medical process? I say, not any more than pumping iron produces new muscular tissue or yogic stretching produces changes in connective tissue.
It's simply a learning and growth process. A stretching and challenging of the individual such as is experienced in the Flow state.
Yet there has been a powerful impetus over the last decade or so for biofeedback to be fully recognized as a medical procedure-- to be treated as a medical treatment. The reasons are fairly obvious.
The primary means for earning income as a health care provider is to perform procedures accepted by the dominant medical paradigm-- having received the blessing of the sacred Bishops chanting scriptures from the ICD-9 code book and the cardinals of the state workmen's comp boards.
In Medieval Spain, the Jews, to escape the dark punishment of the Spanish inquisition, masqueraded as Marano's, pretending to be Christians, hiding their true religion to save their lives.
In a sense, that's what many people in biofeedback have resorted to doing. And to some degree, that's been okay, inasmuch as it has enabled those providers to make biofeedback more accessible to people who would have otherwise been unable to benefit from it.
But I come to you today to propose that the medicalization of biofeedback has gone too far. There is a higher vision in the life change philosophy which can and should accompany effective biofeedback training. That vision has been dwarfed, clipped, bound, and gagged in an effort to avoid offending the double blindism preaching ayatollahs of reductionist medical scripture.
And considering they represent the trillion dollar empire which last year conquered the US congress and President-- they are fearful powers to be reckoned with. Although the power brokers and protectors of the medical empire are cold-blooded, money and power driven, dinosaurs, there are warm hearted health care providers within the medical profession, many good doctors who are able see the full biofeedback self awareness and voluntary self regulation model as more than just muscle re- education, relaxation and incontinence training. They are able to see their patients as complex individuals who consist of systems within systems rather than simple lesions or illness foci.
Every time you see someone for biofeedback you have the opportunity to effortlessly go beyond helping them to eliminate their symptoms or chief complaint. You can help them grow and add the biofeedback metaphor to their lives so they learn to fine tune their physiology and optimize their performance mentally, physically emotionally and spiritually.
I've purposely put a religious slant on the medical model because it is a paradigm which is illogically embraced by its holders to the exclusion of viable alternate approaches to health. Yet I do not believe there is anything religious about teaching and preaching the gospel of biofeedback, just as William James taught the Gospel of Relaxation in his book Talks to Teachers.
Borrowing from Les Fehmi, can you imagine using biofeedback to teach self awareness, self control and self discipline to inner city children at risk for becoming drop-outs or criminals? or for convicted felons and probationers. Look at Jeremy & Yael Langford's work with students on an Israeli Kibbutz.... at Al Bermea's work with violent teen offenders, and Stacy Schafer's and Donna King's work with court appointed parolees and probationers.
Can you imagine training executive and government personnel, and celebrity artists to function more creatively and effectively, with reduced risk of succombing to stress and its effects not only on health, headache or pain, but also on energy, enthusiasm, alertness, attention and joy? The pentagon, fortune 500 companies and professional and amateur sports teams have.
Can you imagine teaching kids to pay better attention before they develop problems or before they are identified as gifted, so they can begin even earlier in to life to be more fully enabled to reach their full academic potential?
Can you imagine biofeedback in churches, synagogues, mosques and temples, helping people to let go and open themselves to states of consciousness associated with increased spirituality and awareness of the sacred in their everyday life?
Can you you picture athletes using computerized telemetric force and movement biofeedback or kinesiologic surface EMG biofeedback comparing their movement with temporal templates of ideal patterns pre-recorded by professional athletes, trainers or programs which create them. I presented on a non-computerized wearable analog ski biofeedback device 14 years ago at the 1981 Colorado Springs Biofeedback Society of America Annual meeting. You could listen to the sound of your skiing. Now multimedia, virtual reality feedback promises to enable us to use feedback to enhance almost any behavior, movement or physiological function in ways so subtle and sophisticated it won't feel like biofeedback at all. It will be more like edutainment.
Can you imagine applied psychophysiological rejuvenative , cosmetic facelifts for outside and inside? Try a zygomaticus EMG placement and some simple pumping smile iron exercises to see how easy it is to produce a better looking face.
Imagine a suite of multimedia, semi automated biofeedback training stations, with a collection of these kinds of personal growth and enhancement programs, which could be easily operated by a trained, certified person. The cost of this kind of biofeedback will drop by 90 to 95% from an estimated $1500 to $8000 down to $80 to $500 if the utilization is great enough. Will that hurt the medicalized biofeedback practice of the clinical psychologist, physical therapist or other health care providers? On the contrary, the massive increase in exposure to biofeedback and the screening process this approach will enable should produce considerably more people who are identified as not responding to the initial standard training. The same technician/trainer can, along with the expert system software, be trained to observe adverse reactions, such as autogenic abreactions or development of awareness of painful memories. These non-medical biofeedback trainees will become candidates for psychophysiological, psychotherapeutic and physiotherapeutic therapies.
Wouldn't it be nice to have biofeedback a routine part of the educational curriculum and preventive health maintenance. The idea of referring patients who need medical biofeedback treatment might become far more likely, perhaps even obvious to primary care providers and insurers.
Perhaps the most important aspect of non-medical, human potential biofeedback is what it does for you. When you start teaching people to feel good and function at their best you feel better-- more energized, enthusiastic, satisfied. You are helping healthy normal people to feel and function better.
Let's take just a moment to put this into practice. Use the skills you learned with biofeedback to regulate your mind/body/emotions. First quiet your self, with eyes closed. Now, access a memory of a past positive experience, when you reached a peak of performance, of feeling good ...
So, what can you do now? The next time you see a patient, take another look and see not a lump of pathology but the glow of a rich human being who can shine brightly with your help. Even if the person comes in for incontinence training, you can help to empower the person with the biofeedback human potential paradigm of bringing out the best, rather than merely getting rid of the unwanted. Your work will be just about the same. The difference is the vision you share with your client.
It is not necessary to give up this vision while working within the archaic, yet hopefully rapidly evolving and changing medical model. My three panelists will help you to think about new ways to conceptualize the ideas of health, healing and human potential. Each one will introduce his or herself. Thank you