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Original Content at
https://www.futurehealth.org/articles/FLEXIBILITY-AND-APPROPRIAT-by-tom-collura-090808-526.html

February 19, 2010

FLEXIBILITY AND APPROPRIATENESS -AN UNDERPINNING WE CAN ALL AGREE UPON

By tom collura

Flexibility and appropriateness of brain function are put into context, and show up at the core of many applications of neurofeedback. It is not so much an issue of "too much" or "too little" as it is one of the brain having the ability to be flexible and appropriate, to access brain states that are suited to the task or situation.

::::::::

As the field of neurofeedback

continues to evolve

and change, we continue

to seek metaphors or guiding

principles that can

bring workers together.

We are faced with many

concepts that are intrinsically

separatist or devisive,

as they force us to choose

one side or the other.

These include clinical vs.

nonclinical approaches,

the "to Q or not to Q" controversy,

debates regarding

reward contingencies

or philosophies, use of

adjunct techniques,

"should we use games,"

and other issues. We

seek unifying principles

that will allow practitioners

to meet on common

ground, and to build upon

jointly, rather than to take

sides across.

One of these principles is

that of "flexibility and appropriateness,"

which to

me permeates not only the

nuts and bolts practice of

neurofeedback, but also

our approach to the field,

as well as conduct both

inside and outside the professional

arena. In the

context of EEG training,

this paradigm provides an

approach to rationalizing

protocols and clinical

methods, as well as conducting

sessions, managing

trainees, and interacting

with trainees' family,

professional, and support

persons. In the broader

sense, it can inform our

interactions with other factions

in the community,

professionals, clients, educators,

the press, and so

on.

At its core, the concept of

flexibility and appropriateness,

when applied to the

brain, simply means that

the brain needs to be flexible,

and that there are appropriate

brain states and

behaviors, for appropriate

circumstances. It is a simple

issue of fitting the

brain's mode of operation

to the current demands, to

reduce stress, improve

productivity, and, ultimately,

to relieve suffering.

This is neither a medical

nor a nonmedical approach,

it is a "medicalneutral"

approach. It provides

a way of looking at

normal function in a dynamical

way, and a way of

looking at any non-optimal

functioning as something

that can be improved

upon. At an extreme, inflexible

or inappropriate

brain states may appear in

the DSM-IIIR, but such a

designation is not fundamental

to how we approach

improving brain

function. A great many

maladies and disorders

can be fit into this conceptual

framework, in that the

brain may be inflexible,

and stuck in a particular

way of working, leading to

chronic disfunction and

maladjustment. Similarly,

if the brain is flexible but is

unable to achieve appropriate

states at desired

times (math class, meetings,

etc), then again there

is the potential for a negative

outcome. The primary

challenge of neurofeedback

is to teach the brain

the proper flexibility, and to

allow it to learn to suit appropriate

states to appropriate

circumstances, and

then allow the brain to take

over, doing what it does

best, automatically.

One example I give is to

look at a typical athlete, for

example a basketball

player. We do not train a

basketball player to run

around the court with their

hand up in the air at all

times, because the basket

is up there, and the hand

will need to be there some

time. This is clearly not a

productive approach.

However, there are those

who look upon neurofeedback

training as doing just

that, pushing the brain into

the "good" brainwaves,

and pushing the "bad"ones

down. Rather than appreciating

the dynamics and

importance of changing

brain states, some trainers

view the neurofeedback as

a way to mold or bend the

brain back into a "good"

shape, as if it were made

of clay.

What is being provided is

guided exploration. It is

paradoxical but true that,

when control and guidance

are provided, then exploration

can proceed to yield

results. When a system is

running "open loop," then it

may traverse many possible

modes, but there is no

insight regarding what the

modes mean, or even that

they exist.

When appropriate feedback

is provided, the system

can identify its modes,

and thereby gain some

decision-making power

over these options.

 

The issue is not so much

that of "rewarding" or

"punishing" specific states,

as it is of allowing the system

to know that these

states exist, and thereby

providing the simple power

of decision, hence control.

These considerations

apply equally well over a

broad range of designated

"disorders" or "conditions",

and their typical interventions.

Whether the training

variable is amplitude,

asymmetry, coherence, or

any other derived parameter,

overall, the brain is

asked to explore the dimensional

possibilities of

the feedback signal, and to

learn to develop the flexibility

to enter and exit

those conditions, and to

recognize when conditions

are being met. Whether

the result is a change in

designated symptoms,

general focus, overall activation,

mood, or other

neuropsychological variables,

the basic mechanism

behind neurofeedback

training remains one

of providing sufficient neuronal

flexibility to produce

desired states, at appropriate

times.

Another value of the F&A

point of view is that it helps

to understand the connection

between the

"relaxation" training that is

purportedly being provided

through neurofeedback,

and the overarching benefits

such as improvements

in concentration, performance,

creativity, and so on.

When we view the entire

brain/mind process as one

of dynamical changes and

adaptations to demands of

input and processing, the

importance of flexibility

and appropriateness to

function and performance

becomes clear. It is not so

much a case of whether a

brain is "good" or "bad," or

whether it is well suited to

a particular task. It is more

a matter of any particular

brain being "in the right

place" and "at the right

time" so that the best outcome

is forthcoming. It is

interesting to note that

even the greatest poets or

physicists or musicians still

have the same basic machinery

as the rest of us.

Their limbs, bodies, and

brains are not qualitatively

different from anyone

else's in any fundamental

way. But when a physicist

sits in front of a problem,

there is simply that extra

taking of time, of relaxing

certain judgements and

plans, and of allowing their

brain to take in the information,

in a manner that is

appropriate to the task.

The question has been

asked, "Is this good for

ADD", or "Will this help

with my depression?".

Specific answers are available

to these questions.

However, an overarching

answer is "This is good for

anyone". That is, we

should not specifically care

whether a trainee presents

with any particular constellation

of parameters. The

primary assumption is that

the use of neurofeedback

can be beneficial and of

value, and that the protocols

and methods will be

adapted to a full range of

issues, of which clinical

presentation is but one.

Beyond the realm of practicing

and interpreting neurofeedback

work, we can

further apply these concepts

in our interactions

with professionals, clients,

educators, the general

public, and other groups.

It is evident that the applicability

of neurofeedback

extends well beyond the

naive concept of

"relaxation training" as it

has been historically understood.

We must look

toward considerable work,

research, publication, and

clinical studies, before the

full acceptance of neurofeedback

in all of its potential,

will be realized. Our

ability to exercise flexibility

and appropriateness in all

such interactions will be

key to the gradual, but certain,

acceptance of the

field in a form well beyond

what it is today.



Submitters Bio:
Dr. Collura has over 30 years experience as a biomedical engineer and neurophysiologist.  He has conducted clinical research and development and system design, in the areas of evoked potentials, microelectronics, human factors, EEG mapping for epilepsy surgery, and neurofeedback.  His graduate work focused on the real-time measurement of visual and auditory evoked potentials, and relationships with selective attention in a vigilance task.  He then spent 8 years with AT&T Bell Laboratories as a technical staff member and supervisor in the areas of integrated circuit technology, computer graphics, networking, and man/machine interfaces.  He then served from 1988 to 1996 on the Staff of the Department of Neurology, Cleveland Clinic Foundation, where he conducted research and development in EEG mapping for epilepsy surgery, long-term EEG monitoring, and DC brain potentials.  As a consultant to industry, he has designed software and hardware for computerized tomography, automated radiometry, and automated imaging.  Since 1995, he has been founder and president of BrainMaster Technologies, Inc.  He has published over 100 peer-reviewed journal articles, book chapters, abstracts, and papers.  He has 2 patents and 3 patents pending, all in the areas of neurofeedback, electrode technology, and evoked potential methods and systems.  His current interests focus on research and development of automated neurofeedback systems, evoked potential neurofeedback, and low-cost quantitative EEG.  He is a licensed Professional Engineer in Ohio and Illinois, is a past board member of the International Society for Neuronal Regulation (ISNR), and is president-elect of the Neurofeedback Division of the Association for Applied Psychophysiology and Biofeedback (AAPB).

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