| Bioenergy Feedback and Energy Cardiology: A
    Challenge for Integrative Medicine Gary E. R. Schwartz, Ph.D. and Linda G. S Russek, Ph.D. University of Arizona Science and society are facing a great challenge. On the one hand, we are facing
    tremendous dangers --- to the health and well being of our environment, our bodies and
    minds, our institutions, and our spirit. On the other hand, we have been given a
    tremendous opportunity --- to re-envision health and well being at all these levels so as
    to evolve into a responsible and caring species.  The birth and evolution of biofeedback and neurotherapy can be viewed as a prototype of
    how basic and applied science is attempting to address this challenge. Modern technology,
    designed and implemented with wisdom and compassion, is being used to help re-educate the
    brain to foster health and wellness. The Journal of Neurotherapy, for example, was
    created to foster the development of basic science and clinical knowledge in brain
    self-regulation and to communicate this knowledge to scientists and practitioners (and in
    the process, to policy makers and the public). We believe that neurotherapy, when viewed from the perspective of bioenergy feedback,
    has the potential to become a prototype connecting conventional and alternative medicine.
    On the one hand, its concepts are based on generally accepted principles and knowledge in
    modern biophysics, neuroscience and psychology. On the other hand, its applications
    involve intentionality, states of consciousness, and powers of mind that go beyond simple
    mechanistic, uni-directional, cause-effect models of how the brain and mind function. When
    modern concepts of energy and information are systematically integrated with traditional
    concepts and methods of neurotherapy, the potential for neurotherapy to serve as a
    prototype connecting conventional and alternative medicine is substantially increased. The purpose of this chapter (an expanded version of Schwartz and Russek, 1996) is to
    consider a challenging development that we believe can have important implications for
    neurotherapy in the future. This development involves the integration of modern concepts
    of systems theory with modern concepts of energy and information (Russek and Schwartz,
    1994, 1996; Schwartz and Russek,1997a). Because of space limitations, the present
    discussion is necessarily abbreviated. However, as should become clear below, the
    implications of this integration, though far reaching and controversial, can be confirmed
    or disconfirmed in future basic and clinical research. Feedback, Systems Theory, and Energy The foundation of neurotherapy is the concept of feedback. Feedback is a fundamental
    concept of systems theory. Systems theory, including general systems theory (von
    Bertalanffy, 1968) and general living systems theory (Miller, 1978), was developed as a
    conceptual tool to organize and integrate knowledge within and across disciplines, from
    the physical and biological sciences to the behavioral and social sciences (Schwartz,
    1982; 1984; 1987;1989).  The "heart" of systems theory, so to speak, is the notion of dynamic
    interaction. When two or more components are connected in a system, the components do not
    simply "act" upon each other, they "interact" with each other.
    Feedback loops therefore have complex, often non-linear, emergent effects. Complexity
    theory (e.g. Flood, 1988) and chaos theory (e.g. Cambel, 1993) are current examples
    reflecting the evolution of our understanding of this fundamental principle.  Paraphrasing Miller (1978), living systems can be defined as dynamic organizations
    of intelligent information expressed in energy and matter (Russek and Schwartz, 1996).
    Energy is defined as the capacity to do work. Organized energy is informational energy.
    Hence, when we speak, for example, of the heart generating electromagnetic energy, we are
    also speaking of information (generated by the heart and the brain) that is carried by the
    energy that affects matter.  Energy is one of the most mundane yet mysterious concepts in modern physics. Though the
    measurement of energy may be defined precisely, its interpretation is abstract and is
    difficult to comprehend (even by seasoned physicists).  Becker and Selden (1988) illustrate this point beautifully: 
      
        "Electromagnetism can be discussed in two ways---in terms of fields and in terms
        of radiation. A field is "something" that exists in space around an object that
        produces it. We know theres a field around a permanent magnet because it can make an
        iron particle jump through space to the magnet. Obviously theres an invisible entity
        that exerts a force on the iron, but as to just what it consists of dont ask!
        No one knows. A different but analogous something an electric fieldextends
        outward from electrically charged objects." We believe that this difficulty of interpretation may be one reason why the concept of
    energy has yet to make its way into the mainstream of modern medicine and psychology.
    Systems theory reminds us that what we measure is the functioning of systems.
    Energy and force are concepts we invent to make sense of the observation that
    iron particles do, in fact, jump through space to a permanent magnet, and we use this
    observation to explain how, for example, the heart can be observed to contract when an
    electromagnet is placed near the chest (Ragan, Wang, and Eisenberg, 1995). The Dynamical Energy Systems Approach and Energy Cardiology We have recently derived five general hypotheses from systems theory, applied them to
    the concept of energy (termed the dynamical energy systems approach), and then
    specifically applied them to the heart as a prototypic energy generating system (termed
    energy cardiology) (Russek and Schwartz, 1996). Table 1 illustrates five dynamical energy
    systems hypotheses and their application to energy cardiology.  --------------------------------------------------------------------------------------------------------- Insert Table 1 about here --------------------------------------------------------------------------------------------------------- The five dynamical energy systems hypotheses can be applied to any organ system or
    combination of organ systems. In Russek and Schwartz (1996), the focus was on the heart,
    which can be viewed as a generator of a broad spectra of types and frequencies of energies
    occurring over time. We could as well have focused on the brain, typically taken to be the
    prime generator of bodily processes. However, we wanted to show the new insights that can
    be derived from a dynamical energy systems approach to the body. For the purpose of this
    paper, we will focus our discussion on one component of cardiac energy ---electromagnetic
    energy measured by the ECG.  TABLE 1 Five Dynamical energy Systems Hypotheses and Their Expression in  Energy Cardiology  DYNAMICAL ENERGY SYSTEMS ENERGY CARDIOLOGY HYPOTHESES HYPOTHESES  1. Systems are expressions of 1. The heart is a dynamical organized energy and emit energy. energy generating system. 2. Energy activates and 2. Energy from the heart may regulates systems interactively. regulate organs and cells throughout the body  interactively. 3. Different energies (types and 3. The heart generates patterns frequencies)are emitted of energy. The cardiac simultaneously, including energy pattern at the quantum level. includes electrical, magnetic sound, pressure, temperature. and electrostatic energies. 4. Energy is transmitted between systems 4. Cardiac energy patterns  dynamically and interactively. may have interactive effects interpersonally and environmentally as well as  intrapersonally. 5. Levels of consciousness may 5. Levels of consciousness may modulate patterns of energy in modulate cardiac energy  health and illness, and patterns in health conversely, patterns of energy and illness, and conversely, may modulate levels of cardiac energy patterns consciousness. may modulate levels of consciousness. This table lists two parallel sets of hypotheses. The first set - the dynamical energy
    systems hypotheses - is drawn from general systems theory, and conceived in terms of
    energy. The second set - the energy cardiology hypotheses - applies the first set to
    biological systems, as illustrated by the heart and cardiovascular system. The hypotheses,
    necessarily abbreviated here for the sake of space, are organized from the least to the
    most controversial (see Russek and Schwartz, 1994; 1996). When the biophysical consequences of organized energy are considered, far reaching
    implications for the role of the heart in health and healing emerge. For example, since
    the electromagnetic energy from the heart literally reaches every cell within the body,
    the heart (in concert with the brain) may be the major organizer and integrator of
    coordinated cellular functioning in the body. Moreover, since electromagnetic energy and
    information from the heart is not contained within the skin (it leaves the body roughly at
    the speed of light), cardiac energy patterns may interact between people (even at a
    distance). It is possible that cardiac energy patterns communicated between people may be
    involved in both conventional and alternative therapies. A central mystery in modern biology is how a system that contains literally trillions
    of highly specialized cells can ever function as an organized whole. The metaphor of a
    symphonic orchestra is useful here. If the body was thought to be an orchestra containing
    trillions of separate instruments, from "piccolos" (generating high frequency
    patterns) to "tuba's" (generating low frequency patterns), how could these
    individual instruments ever play their unique melodies as a symphonic whole? The need for
    a "conductor" becomes self-evident. We believe that the heart may serve a
    fundamental synchronizing function since its energy and information reaches every cell
    within the body (including the brain). Using this metaphor, the heart becomes the
    "conductor", and the brain provides the "score." The energy to do this need not be strong. Consider: very tiny electromagnetic
    signals have been shown to influence cellular functioning (reviewed in Becker, 1990 and in
    many articles in the journal, Bioelectromagnetism). Moreover, serious scientists
    are entertaining the possibility that biological cells can "rectify and signal
    average" weak electric fields through "stochastic resonance" (see Astumian,
    Weaver, and Adair, 1995). Though space precludes reviewing this research here, it is
    important to note that these new findings and models indicate that bioelectromagnetic
    effects often show an inverted U shaped function --- weak signals can produce
    resonance whereas strong signals may not. Of course, all systems have boundaries that protect them from external matter and
    energy, and therefore information as well. As Miller (1978) writes, "an important
    function of boundary processes is fending off matter-energy excess stresses." Since
    the human body contains trillions of highly specialized cells designed to perform specific
    tasks, it makes sense that cells should not be excessively regulated by the heart (or any
    other organ or cell). It is conceivable that cells of the body (including the brain) have
    mechanisms that prevent them from being over-controlled by the heart (or any other energy
    generating system).  However, depending upon the state of the cell at a given moment, it may be more or less
    sensitive to the energy generated by the heart. A dynamical energy systems approach to
    heart-cell interactions requires that we consider each cell as a semi-independent unit (in
    effect, a subsystem) that responds dynamically and interactively with other
    semi-independent units, including the heart and, as we propose in Hypothesis 5,
    consciousness. Energy and Heart / Brain Relationships Of all the organs within the body, the heart is preeminent in terms of the centrality
    of its location, the richness of its connections to all the cells within the body, and
    particularly relevant here, the intensity of its energy transmission. This energy aspect
    of the heart does not receive much attention. But just as the heart not only pumps
    patterns of biochemical nutrients to every cell within the body through the circulation,
    it also "pumps" patterns of energy and information to every cell within the body
    through the circulation as well.  For example, it is well known that the electrical potential generated by the heart,
    identified by the electrocardiogram, can be recorded from any site on the body
    because of "volume conduction", a mechanism that is well known in physics and
    biology and is not, in and of itself, controversial (Malmivuo and Plonsey, 1995).  A natural example of volume conduction is the simultaneous recording of fetus and
    mother cardiac electrical fields (potentials) from the same pair of ECG electrodes placed
    on the abdomen (Wakai, Wang, and Martin, 1994). For the first nine months of life, the
    developing fetus is literally "bathed" in cardiac energy generated by the
    mother, and the mother, in turn, is similarly bathed in the emerging cardiac energy of the
    developing fetus. Historically, the mother's electrocardiagram has been considered to be
    an annoying recording "artifact" that seriously confounds the measurement of the
    fetus's electrocardiogram rather than reflecting the actual "sharing" of cardiac
    energy and information that may have, heretofore, unrecognized yet important biophysical
    consequences for the fetus, the mother, and the mother-fetus relationship. It turns out that of all the internal organs, the heart is by far the largest generator
    of magnetic energy. Superconducting quantum interference devices that measure magnetic
    fields outside the body have shown that the heart generates over 50,000 femtoteslas (a
    measure of intensity of magnetic field), compared to less than 10 femtoteslas recorded
    from the brain (Clarke, 1994), which makes the heart's magnetic field 5,000 times greater
    than the brain's. For this reason, when researchers try to record the magnetic field of
    the brain (the magnetoencephalogram) they discover that it is "contaminated" by
    the magnetic field of the heart (the magnetocardiogram). The magnetic field of the heart
    travels through the brain and mixes with the brain's magnetic field.  As is well known in radio and television transmission, information can be transmitted
    on top of waves of energy (i.e. carrier waves) that also have specific timing functions.
    Further, different radio or television stations -- each a different frequency band --
    carry different kinds of information. It is conceivable that each of the various energies
    in the pattern of cardiac energy may contain different information. For example, frequency patterns in addition to the patterns comprising the
    electromagnetic activity of the heart can be carried and observed in the
    electrocardiogram, ranging from very low frequencies (.01 to 30 Hertz) to high frequencies
    (thousands of Hertz) --- "noise" that is "riding" on top of the
    electrocardiogram. In traditional cardiologic measurement, however, these additional
    patterns are deliberately "removed" and disregarded. Additional energy and information is routinely removed, for example, by careful
    electrode placement. If electrodes are placed on the chest across the heart (with an
    appropriate ground), the primary signal observed is the electrical activity arising
    from the heart. With this electrocardiogram electrode placement, the electrical activity
    of the brain, for example, which is also volume conducted throughout the cardiovascular
    system, is very small (because much of the EEG is subtracted using ECG leads) and is
    typically treated as "noise" to be ignored. Conversely, if electrodes are placed
    on the scalp across the brain (for example, scalp to linked ears), the primary signal observed
    is the electrical activity arising from the brain. With this electroencephalogram
    electrode placement, the electrical activity of the heart is relatively small (because
    much of the ECG is subtracted using EEG leads referenced to linked ears) and is typically
    treated as "noise" to be ignored.  However, if one electrode is placed on the scalp, and the other electrode is placed
    below the heart on the chest, what will be observed is the electrocardiogram combined
    with the electroencephalogram --- one will literally see brain waves riding, so to
    speak, on top of cardiac waves. With this scalp-chest (brain / heart) electrode placement,
    the true mixing of brain and cardiac electrical signals becomes self-evident.  Just as the blood contains a mixture of both molecules (for example, hormones)
    and cells (for example, red and white blood cells), it also contains a mixture of
    types (for example, electrical and thermal) and frequencies of energies. The dynamical
    energy systems approach encourages us to attempt to measure the wholistic (mixed) nature
    of multiple types and frequencies of energies within and between organs such as the heart
    and the brain.  Why is this worth doing? To discover what the "noise" is conveying. For
    example, the electromagnetic signal coming from the heart may be a carrier wave for
    additional information that is not only diagnostic of cardiac function and disease but
    also indicative of the functioning of other biological systems.   
 Simply stated, the ECG and the EEG mix with each other and travel to every organ and
    cell within the body (and by extension, beyond the body). When the heart is used as a
    "trigger", and EEG is averaged using event related potential procedures, the R
    spike of the ECG can be clearly observed in the EEG. Moreover, there is a clear
    topographic pattern of the ECG observed in the EEG.  To demonstrate this effect, Figure 1 (from Russek and Schwartz, 1994), displays   
 averaged cardiac synchronized energy patterns (CSEPs) recorded from 20 male subjects
    during a 2 minute eyes closed resting baseline. The data were collected as part of a 42
    year follow-up to the Harvard Mastery of Stress study (Funkenstein, King, and Drolette,
    1957; Russek et al, 1990). Nineteen channels of EEG (referenced to linked ears) and the
    ECG (arm to arm placement) were recorded at 128 Hz using a Lexicor Neurosearch 24 System.  Figure 1 displays the temporal window surrounding the R spike per se. Four samples
    preceding the peak and 6 samples after the peak are displayed. At 128 Hz, this represents
    an 85.94 millisecond window of time. One microvolt equals 13.21 units (obtained from the
    raw data files) as displayed in the figure. The average number of heartbeats in the 2
    minute baseline for the sample was 122.7 (SD = 21.2).  Cardiac synchronized energy patterns were obtained using special purpose software
    written to calculate averaged waveforms per trial per subject per site. Using the raw EEG
    and ECG data files, the program calculates averaged ECG and EEG waveforms synchronized
    either with the subjects own ECG (intrapersonal CSEPs - shown in Figure 1) or
    another persons ECG (interpersonal CSEPs). The program:  1. Detects the peak of each R spike (the largest peak that accompanies each ventricular depolarization). Various peak detection procedures and amplitudes can
    be used. 2. Selects a given number of samples (e.g. 30) preceding each R spike and a given
    number of samples (e.g. 90) following each R spike, and  3. Calculates averaged waveforms (and standard deviation waveforms) over the samples
    (e.g. 120) for a given trial. The program can select any number of R spikes, every other R
    spike, or create "pseudo" R spikes (to obtain control averages not synchronized
    with the ECG).  It can be seen that the R spike was largest in anterior sites (e.g. 01 and 02), was
    smaller in midline (PZ) then left and right sides (e.g. T5 and T6) in posterior sites, and
    was larger on the right side (e.g. F8) in anterior sites. There were individual
    differences in the amplitudes of the ECG observed in the EEG, and there was some variation
    in the topographic pattern between individuals.  Space precludes presenting and discussing the CSEPs obtained when a second
    persons heart was used as the trigger (see Russek and Schwartz, 1994). Though the
    magnitude of the effect was much smaller, the data suggest that interpersonal heart
    - brain registration may also be possible and be used as bioenergy feedback. Some Implications of Energy Cardiology and the Dynamic Energy Systems Approach for
    Neurotherapy and the Evolution of Bioenergy Feedback Traditionally, it has been assumed that the ECG is minimally present in the EEG.
    Moreover, it has been assumed that the ECG plays no role in the functioning of brain and
    mind. However, when the concept of energy is considered from a systems framework (the
    dynamic energy systems approach) and when predictions are applied to the heart (energy
    cardiology) and the brain (what might be termed energy neurology), novel ideas suggest
    themselves that are open to empirical investigation.  From a strictly "artifact" point of view, it may turn out that removing more
    of the ECG from the EEG (for example, by simultaneously measuring the ECG and developing
    on-line signal removal procedures) may improve the direct association between
    neurofeedback and underlying CNS functioning. This "simple" approach presumes
    that the ECG and the EEG do not interact energetically. However, if these energies
    are not "independent", but instead are "interdependent", then
    EEG feedback is to some extent ECG feedback, not only for "artifact"
    reasons, but for dynamical energy systems reasons as well! The idea that the brain itself functions as a dynamical energy system is consistent
    with the work of Becker and colleagues. Becker and colleagues have proposed that the
    nervous system carries direct (dc) electrical currents in addition to neural impulses
    (reviewed in Becker and Selden, 1988; Becker, 1990). This research has led Becker to
    propose what he calls the "dual nervous system," where direct currents travel in
    perineural cells parallel to the electrochemical responding of the neuron. He further
    proposes that the earth's magnetic field, via the magnetic organ of the pineal gland,
    influences both neural firing and direct electrical currents, which in turn regulate the
    senses and muscle movements (nerve impulses) and injury and repair (direct electrical
    currents).  An energy cardiology approach encourages us to entertain the possibility that future
    neurotherapy that combines EEG measurement with ECG measurement and trains patterns
    of brain / heart relationships may improve clinical efficacy in neurologic, cardiologic,
    and other conditions. EEG / ECG pattern training may find future applications in the
    treatment of dissociative and other psychiatric and psychosomatic conditions where the
    split between cognition and emotion is a salient clinical symptom. Is it possible that individual differences in the clinical efficacy of neurofeedback
    for attention deficit disorder, drug addiction, or depression, for example, may be related
    to individual differences in heart / brain synchrony (assessed through future EEG / ECG
    CSEP procedures)? Also, is it possible that a social psychophysiological analysis of the
    trainer / patient relationship may reveal interpersonal cardiac energy interactions that
    may facilitate learning and growth? Does the ECG of the trainer contribute to the EEG of
    the patient in some complex and potentially meaningful ways?  The "heart" of neurotherapy is bioenergy feedback ---the "heart" of
    bioenergy feedback is dynamic interaction. Modern advances in software using Windows
    based systems and protocols that can be standardized in multiple sites now makes it
    possible to collect ECG data along with the traditional EEG data. User friendly software
    systems can be written to make it possible to routinely measure (and give feedback for)
    cardiac and CNS synchronized energy patterns if future data warrants the development of
    this technology. Potential energetic interactions within and between individuals will never be
    discovered unless we entertain the possibility of energy hypotheses and we collect the
    kinds of data needed to evaluate these hypotheses. A dynamical energy systems approach to
    neurotherapy, though inherently complex and controversial, could propel neurotherapy into
    the center of the scientific challenge of integrating conventional and alternative
    approaches to health and wellness (Schwartz and Russek, 1997b). References: Astumian, R.D., Weaver, J.C., and Adair, R.K. (1995). Rectification and signal averaging of weak electric fields by biological cells. Proceedings of the  National Academy of Sciences, 92, 3740-3743. Becker, R.O. (1990). Cross Currents. New York, NY: Jeremy P. Tarcher /  Perigee.  Becker, R.O., and Selden G.(1988). The Body Electric. New York, NY: Quill, William Morrow. Cambel, A.B. (1993). Applied Chaos Theory: A Paradigm for Complexity.  Boston, MA: Academic Press.  Clarke, J. (1994). SQUIDs. Scientific American. August, 46-53. Flood, R.L. (1988). Dealing with Complexity: An Introduction to the Theory and Application of Systems Science. New York, NY: Plenum. Funkenstein. D., King, S., and Drolette, M. (1957). Mastery of Stress.  Cambridge, MA:Harvard University Press.  Malmivuo, J., and Plonsey, R. (1995). Bioelectromagnetism. New York: Oxford University Press. Miller, J.G. (1978). Living Systems. New York, NY: McGraw-Hill.  Ragan, P.A., Wang, W., and Eisenberg, S.R.(1995). Magnetically induced currents in the canine heart: A finite Element Study. IEEE Transactions  on Biomedical Engineering, 42, 1110-1115. Russek, L.G., King, S.H., Russek, S.J., Russek, H.I. (1990). The Harvard Mastery of Stress Study 35-Year Follow-Up: Prognostic Significance of  Patterns of Psychophysiological Arousal and Adaptation. Psychosomatic  Medicine, 52, 271-285. Russek, L.G., and Schwartz, G.E. (1994). Interpersonal Heart-Brain Registration and the Perception of Parental Love: A 42 Year Follow-Up of the Harvard  Mastery of Stress Study. Subtle Energies, 5, 195-208. Russek, L.G., and Schwartz, G.E. (1996 in press). Energy Cardiology: A Dynamical Energy Systems Approach for Integrating Conventional and  Alternative Medicine. ADVANCES: The Journal of Mind-Body Medicine. Schwartz, G.E.(1982). Cardiovascular Psychophysiology: A Systems Perspective. In Cacioppo, J.T. and Petty, R. E. (Eds.).Perspectives in Cardiovascular Psychophysiology. New York, NY: Guilford Press. Schwartz, G.E. (1984). Psychobiology of Health: A New Synthesis. In Hammonds, B.L., and Scheirer, C. J. (Eds.). Psychology and Health: The Master Lecture Series Volume 3.. Washington, D.C.: American  Psychological Association.  Schwartz, G.E. (1987). Personality and the unification of Psychology and  Modern Physics: A systems Approach. In Aronoff, J., Robin, A.I., and  Zucker, R.A. (Eds.). The Emergence of Personality. New York: Springer. Schwartz, G.E.,(1989). Disregulation Theory and Psychosomatic Disease: A Systems Approach. In Cheren, S. (Ed.) Psychosomatic Medicine: Theory, Research and Practice. New York, NY: International University Press. Schwartz, G. E. and Russek, L.G. (1996). Neurotherapy and the heart: The challenge of  energy cardiology. Journal of Neurotherapy, 1(4):1-11. Schwartz, G. E. and Russek, L.G. (1997a). Dynamical energy systems and modern  physics: Fostering the science and spirit of complementary and alternative medicine. Alternative Therapies in Health and Medicine, 3,3:46-56. Schwartz, G.E. and Russek G. E.(1997b). The Challenge of One Medicine: Theories of  Health and Eight "World Hypotheses." Advances. 13 (3), 7-30. von Bertalanffy, L. (1968). General System Theory. New York, NY:Braziller.  Wakai, R.Tt, Wang, M., and Martinc C.B. (1994). Spatiotemporal properties of the fetal  magnetocardiogram. American Journal of Obstetrics and Gynecology. March,  770-776. Figure 1 Averaged EEG and ECG waveforms synchronized with the subjects  (n = 20) ECG   
 R spikes. The top two waveforms are FP1 and FP2, the next to the bottom
    two waves forms are O1 and O2, the bottom waveform is the subjects averaged
    ECG. The
    scale for the EEG waveforms is +70 to - 40, the ECG waveform is +2500 to -2000. One
    microvolt equals 13.21 units. |