A Different Vision of Biofeedback, Self Regulation and Applied Psychophysiology first printed in the AAPB Biofeedback Magazine, Winter 98
Optimal Functioning 2003 Sixth Annual Meeting, Jan 26-27, 2003, Palm Springs, CA
Rob Kall, M.Ed.
211 N. Sycamore, Newtown, PA 18940, 215-504-1700 fax 215-860-5374
Can you imagine, given the same cost, that any client who would choose a doctor or health plan with the sole goal of getting rid of the immediate symptoms over a doctor or plan whose goal was to empower and help the client to raise up and maintain his or her optimal level of functioning at physical, mental, emotional and spiritual levels. Or that a patient would choose a doctor who only wanted to make the patient feel not bad, or be un-sick, rather than feeling great and optimally healthy.
I can. We are taught since birth by a trillion+ dollar illness system to be dependent upon "omnipotent," almost deified providers of "magical" cures. The idea of taking responsibility, time and expending effort to stay healthy is entirely absent from the conceptions of hundreds of millions of people in our world.
It is time to embrace, or should I say resurrect, a new, yet old idea-- that health care (not pathology and illness management) can be empowering and life enriching, ennobling and capable, perhaps even obliged to be optimizing for all life functions and activities.
Biofeedback started "breaking-the-ice" for releasing this idea to the world almost half a century ago. Biofeedback's earliest history started with an awe-inspiring example of how Applied Psychophysiology can optimize our human potential. John Basmajian showed that subjects could learn to control single cells in their spinal cord (Basmajian, 1977 ) Joe Kamiya showed that subjects could voluntarily control their brainwaves. (Kamiya 1962).
The then new concept of biofeedback produced profound changes in the world, making the term involuntary nervous system obsolete, spinning off the Society of Behavioral Medicine, the Holistic Medical Association, the International Society for the Study of Subtle Energies and Energy Medicine (ISSSEEM) and perhaps, also, the Association for Transpersonal Psychology.
The BIG idea of biofeedback captured the hearts and fancies of the world, and particularly Americans at about the same time that men began landing on the moon. The idea we could start controlling our bodies and our brainwaves suggested fantastic possibilities of what we could do with "inner space exploration," comparable with NASA's outer space program.
From it's inception, AAPB, then called the Biofeedback Research Society, was composed of a highly heterogeneous mix ranging from university scientists to physicians, psychologists, dentists, physical therapists, engineers and physicists to counselors, teachers, yogis, healers, visionaries and psychics. The history of the early days of biofeedback is filled with idealistic, yet practical visionaries who foresaw a new era in health care, education, human potential, inner consciousness exploration and a vast, unfolding world of possibilities for helping humanity make
use of tools which would produce a consciously produced evolutionary leap. After Basmajian and Kamiya, the next generation of pioneers-- Miller, Green, Budzynski, Brown, Hardt, Fehmi, Stoyva, Adler, to name a few, quickly saw ways to use biofeedback to chart new, shorter paths to higher consciousness, performance enhancement and achievement of some of the self-actualizing peak states described by Maslow.
Biofeedback's luster, like any over-hyped media phenomenon, could not last, and it fell to the scientists and applied practitioners to make true the promise of the new field. It didn't take long for research papers to come pouring out. In the 1970's, references to biofeedback in annual issues of Index Medicus grew from a few column inches to pages, mostly focusing on clinical uses, from headache to spinal cord rehab, alcoholism to hyperhydrosis, anxiety to
There was funding money for health related research, so that's where the researchers focused their efforts. And this made sense, if we were to be successful at getting the medical world to embrace the field of biofeedback.
Yet, in a way, this research effort was like the man who lost his contact lens on the street, who was looking for it under a street light. A fellow came by to help him and asked where it fell. The man pointed to a spot about 20 yards away in the darkness of an unlit section in the middle of the block. "Why are you looking here when it fell over there?" the helping stranger asked, incredulously. Because the light is better over here, the half sighted man replied.
This paper does not mean to suggest that this line of clinical research was not fruitful. It was phenomenally successful in identifying clinical populations who could benefit from biofeedback-aided self regulation training. And in recent years, new technologies have enabled clinicians to use greater precision and specificity to develop even more effective models, protocols and interventions. But I suggest this "search where the light (or funding) is better" idea because the idea of exploring less obvious approaches and applications of biofeedback to inner space exploration and the development of the "real estate" was for the most part, neglected at the expense of these more bread and butter clinical, reductionist, pathology oriented medical model directions.
Unfortunately, these reductionist clinical approaches settle for a much shorter vision of the promise and potential of biofeedback. And many of the visionaries who saw the larger potentials of biofeedback have departed from AAPB. When it comes to health care in general, the reductionist, pathology elimination based model is far less preferable when compared to an optimal functioning model.
This vision entails using biofeedback as a coaching tool-- combined with technologies -- to expand awareness of bodily processes beyond what our ordinary senses provide, so we can increase our voluntary self-regulation of the mind-body functions measured.
We teach and empower people to exert control of and greater responsibility for their mental, physical, emotional and spiritual functioning
It is important to realize that this teaching can and should go far past elimination of un-desired symptoms and pathologies. The most honorable way to work is to give the tools and procedures you use a chance to do all the good they can do with the amount of energy you commit to the job.
In the medical illness/pathology model, most "treatments" only have the potential to eliminate a problem-- infection, tumor, chemical imbalance, etc. Biofeedback, unlike most clinical interventions, can be used this way, but in virtually every case, it is possible, with a simple change in client orientation, to begin a learning process which can lead far beyond symptom elimination toward health and function optimization and maintenance. It costs no more and arguably takes less effort and is more pleasant to teach clients to feel good and function better rather than teaching which settles for symptom elimination.
In some ways, the disempowered use of biofeedback solely for symptom elimination is similar to Seligman's learned helplessness model-- in which subjects only go so far because that's what they learn feels safe, even if they could enjoy much more space and freedom. (Seligman, 1991)
Although the clinical, pathology elimination model seems to encourage this approach, it seems almost unethical, and at least, less than ideal to use a weaker version of tool when the stonger one could be just as easily employed to do greater good.
Politically, biofeedback is at a crossroads in its evolution. For at least the past 23 years, BF practitioners have become more included in and dependant upon the medical insurance model.
The question, "Can biofeedback help?" (or help with less risk of harm or side-effects) has increasingly been replaced by "Is it reimburseable?" And the vision of biofeedback's potential to help humanity has eroded to a vision of an ancillary, alternate treatment only considered appropriate when provided by specialists licensed in diagnostics and treating pathology.
A Sampling of Optimal Functioning Applications Outside the Clinical Realm
Consider another vision. At an exclusive Swiss private school, bio- and neuro-feeedback for enhancing student functioning-- mental alertness, attention, creativity, self-awareness and self-discipline-- is being offered as an additional benefit for the children of the wealthy parents. (AAPB members are training the teaching staff at the school). A not-that-different program of neurofeedback is now included in the Yonkers school district. These are at the cutting edge of the health revolution, building skills to help people reach their potential in education, health and emotional and mental well being.
Dan Chartier (Chartier, 1997) reported on the use of neurofeedback to enhance golfer's performance. Other biofeedback trainers have worked with ice figure skaters, marksmen, hockey players, gymnasts, runners at all levels, often at the elite olympic level. (Private conversations with Erik Peper, Vietta Sue Wilson, Stu Donaldson, Tom Budzynski, Daniel Landers.)
Elmer and Alyce Green envisioned biofeedback as a tool for making the skills of yogis, which require years, available in much shorter time. They were also founders of the Society for Transpersonal Psychology and included biofeedback in their vision of a science of the transcendent self. More recently, Elmer Green has spoken of theta training as a form of "instrumental Vipassana"-- a path which enables one to connect with the planetary consciousness, somewhat akin to Jung's concept.
Steve Fahrion has described a non clinical use of SMR training: "I've been finding a lot of benefit from training people to increase of SMR levels. The effect of it is to enhance the meditative aspect of be here now, to be fully present with whatever is happening in the moment, without judging and evaluating. The feeling is one of immersion in the experience. The importance of this is all of the pleasure experiences of life are the timeless moments in life are based on
this experience. It opens up a gateaway to reconnecting- to the mind of the child-- to the oneness of the moment. You don't have a barrier between yourself and it. Like the flow experience."
Jim Hardt, an early EEG BF researcher called his organization the Biocybernaut Institute, alluding to inner space exploration. He eventually worked with elite military troops and a wide range of others in a unique intensive alpha immersion approach he has developed over the last twenty plus years.
Anna Wise, a colleague of Britain's Max Cade, explored bilateral brain wave frequency patterns for over 20 years. By studying the EEG patterns of yogis, top level corporate executives and others who had achieved different kinds of success, she developed a model for training people to produce the "awakened mind" and the "high performance mind."
Lawrence Klein, of Thought Technology, Vietta Sue Wilson, Jack Sandweiss, Wes Sime, Tom Budzynski, Dan Landers, Erik Peper, myself, and others, in the seventies and eighties, developed numerous approaches to enhancing athletic performance. Some involved reducing stress. Others involved timing of physiology (like Dan Landers' teaching Olympic athletes to shoot rifles between heartbeats, (Landers 1985) and my audio template training-- using pressure sensors in ski boots to transduce weight shifting into sound pitch changes which skiers could learn to imitate (Kall, 1980.) Gideon Ariel, a former Israeli Olympian, devised sophisticated biomechanical transduction systems which enable himt o create detailed 3-D stick figures showing movement vectors for key body points over time. This precision enables trainers to feed back exactly the changes in position and timing necessary for performance enhancement in athletic or work related movement.(Ariel, 1985) More recently brain training is being used by Richard Patten and Dan
Chartier to enhance golf and other athletic performance.
In Sweden, Bo Von Scheele, reports, "we are working on conditioning (according to state dependent theory) performance behavior (in sport so far) to optimal state of respiratory parameters including SaO2, ETCO2, microdialysis of glukose, lactate, ..and some more parameters."
And there is an incredible amount of training of trainers and athletes happening, focusing on peak performance, offered by Anna Wise, Adam Crane, Linda Mason, Lexicor, Valdeane Brown, Siegfried Othmer and Dennis Campbell, Michael Hutchison, James Hardt and Richard Patten. Others in the field include Jack Sandweiss, Lawrence Klein, Frank Echenhoffer, Chuck Stroebel, Stu Donaldson-- to name a few.
Adam Crane calls the field "Performance / Life Enhancement (PLE)" training. He suggests that it can be more time demanding than the clinical He says, "One of the critical keys to success in this field is a training program that stands on its own with or without NFB. Being forced to walk the talk is an uncomfortable blessing of infinite potential." and " PLE
transcends the limitations of managed care and attracts trend setters thereby feeding the clinical practice at the same time." It is important, that in approaching this new way of conceiving biofeedback, that we open our minds to new ways of conceiving themarketing, economics and means of delivering services too.
About ten years ago I began teaching courses at AAPB on the Happiness Response and Positive Experience or Emotional Self Regulation training, based on arousal reduction biofeedback, EMG smile biofeedback, self regulation and cognitive behavioral approaches. My vision is a model of healthiness care which is based on a positive approach. While we certainly will need to keep our pathology oriented diagnostics and assessments, it is worth exploring how
much useful information we can get by looking at people from a positive perspective-- identifying strengths, resources, skills, etc. Can we build a paradigm based on growth, strengths and asset enhancement rather than diagnosing and eliminating negatives?
So... another dimension of this resurgence in interest in optimal functioning is the development and use of assessment tools for evaluating individuals potentials and needs.
Dennis Campbell says, 'Performance measurement or determining "fitness for duty" is an exciting new field, which has produced a number of computerized, self-scoring tests which can be used for evaluation and baselining of performance, protocol selection and progress measurement. The most important feature of these tests is that they are PERFORMANCE TESTS rather than purely diagnostic in nature, and therefore much more appropriate for use with moderate to high functioning subjects than many of the tests normally used by clinical practitioners'
The combination of these kinds of tools and approaches offers a huge range of possible techniques and interventions for a host of applications.
In the last year alone, the interest in peak performance and other dimensions of optimal functioning training and coaching has soared.
The goal of this article has been to get readers to consider alternate ways to conceive the use of biofeedback from a more positive perspective. In the continuation of this article, details of specific applications and protocols will be discussed, including athletic, mental functioning, creativity, academic, consciousness exploration, self actualization and positive experience skill building strategies.
Ariel, Gideon B., Biofeedback and Biomechanics in Athletic Training, chapter in Biofeedback and
Sports Science, by Sandweiss & Wolf, New York City, Plenum Press, 1985
Basmajian, J.V. Learned control of single motor units. In Biofeedback: Theory and Research,
edited by G.E. Schwartz and J. Beatty, Academic Press, NY 1977
Chartier, D. 1997, Peak Performance EEG Training and the Game of Golf, 1997 Winter
Conference on Brain Function/EEG, Modification & Training: Advanced Meeting Colloquium
Kall, Rob. Athletic Template Feedback To Enhance Performance, Poster Session Biofeedback Society
of America Annual Meeting 1980
Kamiya, Joe. Conditioned descrimination of the EEG alpha rhythm in humans. Paper presented at the
Western Psychological Association, San Francisco, 1962
Landers, D. M., Wang, M.Q., & Courtet, P. Peripheral narrowing among experienced and inexperienced rifle shooters under low- and high- stress conditions. Research Quarterly for Exercise and Sport, 1985
Seligman, M., Learned Optimsm, 1991, Alfred A. Knopf, Inc, NYC
What Really Matters; Searching for Wisdom in America, Tony Schwartz, NY, NY Bantam, 1995
The High Performance Mind; Mastering Brainwaves for Insight, Healing and Creativity, Anna Wise,
New York, G.P. Putnam's Sons, 1995
FLOW; The Psychology of Optimal Experience, Mihaly, Csikszentmihalyi, New York, Harper and Row
MegaBrain Power, Michael Hutchison, Hyperion, NY, 1994
Beyond Biofeedback: Elmer & Alyce Green out of print, but available through Elmer Green.
Biofeedback and Sports Science, J. Sandweiss & S. Wolf, NYC, Plenum, 1985
Altered States of Consciousness, Charles T. Tart, , Garden City, NY, Anchor Books, 1969