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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.
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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.
ÂThe 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.