Neurofeedback

The First Fifty Years

James R. Evans, Mary Blair Dellinger, Harold L. Russell, James R. Evans, Mary Blair Dellinger, Harold L. Russell

• Publisher: Academic Press
• Year: 2019
• ISBN:
  9780128176603
• Topic: Biological Sciences
• Subtopic: Neuroscience
• Index: Biological Sciences

Neurofeedback: The First Fifty Years features broadly recognized pioneers in the field sharing their views and contributions on the history of neurofeedback. With some of the pioneers of neurofeedback already passed on or aging, this book brings together the monumental contributions of renowned researchers and practitioners in an unprecedented, comprehensive volume. With the rapid and exciting advances in this dynamic field, this information is critical for neuroscientists, neurologists, neurophysiologists, cognitive and developmental psychologists and other practitioners, providing a clear presentation of the frontiers of this exciting and medically important area of physiology.

• Contains chapters that are individually authored by pioneers or well-known persons presently active in the neurofeedback field
• Provides personal and historical perspectives regarding important past and present developments and future needs
• Enables each author to discuss his or her unique contributions to the field
• Includes chapters noting the contributions of deceased neurofeedback pioneers

Chapter 1

Some call me the father of clinical neurofeedback

Joe Kamiya University of California, Berkley, San Francisco, CA, United States

My first contact with the EEG occurred when I was a new instructor in the Department of Psychology at the University of Chicago. My office was near the sleep laboratory of Professor Nathaniel Kleitman of the Department of Physiology at the University. He was just retiring from a distinguished research career and kindly allowed me to use his laboratory for my own research. He asked William Dement, then a medical student and an assistant of Professor Kleitman, to teach me about the EEG. Dement was very helpful, showing me the attachment of scalp electrodes, how to prepare the equipment for the inked-pen tracings of each EEG recording site, and to identify the tracings in terms of the different stages of the sleep-wake cycle and dreaming activity. I started studying the various physiological indicators of sleep and dreaming, with the EEG and eye movements being among the most interesting.

As I watched the EEG's fluctuations emerge on the continuously moving graph paper during all-night recording sessions, I became interested in another aspect of the EEG in the awake subjects. I noticed the irregularly repeated alternations of the occipital EEG alpha rhythm with a lower voltage mixed frequency pattern in awake subjects who sat quietly with eyes closed. I also observed the occurrence of alpha activity in the occipital region of awake subjects.

My Department of Psychology at the time (the mid 50's) was among the most important ones to follow the traditions of B.F. Skinner in the use of a kind of training called operant discrimination training. Howard F. Hunt, who became chairman following James G. Miller, helped shape my thinking in the following way: I wondered whether people might learn to discriminate their own state of EEG, as to whether they were in alpha or non-alpha, using discrimination training. Might the difference between the presence of alpha rhythm activity and its absence be associated with a difference in some subjective experience, state of mind, feeling, mood, or other mental quality?

With the help of a small grant from NIMH, I began experimenting to see.

Choosing college students who had clear trains of alpha about one-third to one-half of the time, they were told: “This will be an experiment to see if you can learn the difference in feel between two different brain wave patterns as they appear in your EEG tracings.” I had them sit alone with eyes closed in a darkened room. The EEG equipment was in a separate room, so the subject would have no audible feedback from the recording equipment as to whether the alpha rhythm was present. I proceeded to run trials three or four times a minute. The training sessions were run for approximately 1 h with a 5-min break at 30 min. I instructed them to sit quietly, listening for a single ding of a bell that I would ring about two or three times each minute. Outside the subject's room I watched the subject's EEG emerging on the paper trace. I decided to designate the presence of alpha state A and the absence of Alpha, state B. About half the time I would ring the bell when they were showing EEG pattern A, and the other times when they were showing EEG pattern B. Each ding of the bell would be a prompt for them to report their guess as to whether they were showing pattern A or B, and I would immediately indicate if their guess was right or wrong; “A” was correct for alpha present, and “B” was correct for alpha absent.

Most subjects learned to make significant progress within one or two sessions. One remarkable subject made over 200 correct responses in a row. Intrigued, I kept running him beyond the normal session's time. When he finally made a wrong response and I said “wrong”, he was stunned. He told me he had deliberately made a wrong response, because he thought I was pulling his leg, just saying correct to whatever he said!

At first, he was unable to describe why he was so accurate, but as further training continued with him making perfectly correct judgments, he thought it seemed as though he was looking at something in his mind's eye when “B” was the correct answer, and “A” the correct answer when he was not so visually occupied. Others were unclear, stating simply “sometimes it feels like I should say A, and sometimes like I should say B”. During breaks in the training sessions they were encouraged to talk about what they had been trying. I think this helped them to code their successes and failures in their cognitive maps, helping them to recall from memory an essentially non-verbal task.

It was interesting to note that as subjects became more accurate in their judgements, they would seem to regularize their alternations from state A to State B. They would seem to begin to hold one particular pattern and then release it into the other pattern on their own, apparently to better judge which state they were holding at the time of the bell, so that they could be more accurate in their judgments. That is, they began to anticipate what they should say depending on what state of mind they had maintained at the time of the bell ding. This was interesting because my intention of training was not to train them to achieve control of their alterations of alpha and non-alpha, but merely to discern if there was any subjective difference between them. The subject who achieved the most accurate discrimination of alpha presence from its absence was able, without any further training, to produce at my command nearly continuous streams of alpha for several pages of records. The more accurate subjects were at discriminating alpha, the more adept they seemed to be at controlling it.

Clearly, learning to discriminate alpha from its absence seemed to contribute to the ability to control its presence. The apparent control unintentionally brought on by discrimination training led me to wonder if it would not be interesting to see if I could start with control training without any discrimination training at all. In 1956 I tried testing this idea by what I believe to be the first experiment to train the control of alpha abundance using feedback of alpha amplitude as an aid. With some circuitry including a voltage detector, I arranged a tone to be sounded in the subjects’ room whenever their alpha amplitude exceeded a threshold that I set. I asked the subjects to try whatever mental state that would work to increase the total duration of the tone. The tone would stop when the alpha rhythm disappeared. The subjects were now instructed to maintain the tone for as long as possible for a 5-min period, and then to prevent the tone from happening for the next 5-min period. A third 5-min period required them to increase the tone, and the fourth to decrease the tone. It was very clear that nearly all subjects could achieve some measure of control over whether they could produce alpha or non-alpha.

Initially, nearly all subjects showed a drop in alpha production that would last for a few moments. It seemed due to their attention to performing what was being asked of them. As expected, individuals previously trained in alpha discrimination learned more quickly to increase alpha than individuals who had not been so trained.

When asked to describe the difference in subjective quality between A and B, or tone on from tone off, even the most accurate performers did not have clear descriptions. This problem may suggest ways of mapping for each person the principal components underlying his or her judgments of the similarity of several EEG and other trained physiological variables to each other and to all the others. I would expect the wide individual differences in verbal descriptions could be greatly reduced. Your alpha is most likely not all that different from mine, given we are both of the same species.

The subjective reports of many subjects, after several sessions of training, began clearly to involve some kind of visual imagery as being the primary condition in which the alpha was not present. Some subjects were unable to achieve control, but they were a small minority, perhaps less than ten percent over 5 training sessions. The most successful subjects felt that the alpha state was more pleasant a state than the non-alpha state. The latter seemed to be more “busy”, and several subjects specifically identified visual imagery activity as useful for suppressing alpha. As for the subjective state of alpha, other than that it was a rather relaxed state, not much further was said. But one subject rather enjoyed putting himself in the alpha state. He asked at the end of his last training session if he could return for further training sessions so he could stay in an alpha state for as long as an entire session. In one of the first publications of this work, I mentioned this person's response. The result, unfortunately, was a widespread and oversimplified belief that alpha was a very pleasant state to be in-a thesis for which, as discussed above, there was limited subjective support. The cultural context of the 1960's contributed largely to that oversimplified response. There was much popular writing about the happiness that neurofeedback could magically bring, much to my regret.

Other researchers also began to explore this new field

While I was working at University of Chicago, Barry Sterman at UCLA was experimenting with operant conditioning of the sensory motor rhythm (SMR), first with cats, then applying what he was observing to his pioneering work with humans using SMR feedback for epileptic seizure disorders.

Elmer Green, who was in the engineering department at Chicago, came to a talk I gave on discrimination of EEG alpha. Later when he was at the Mayo Clinic, he began with his colleagues Alyce Green and Dale Walters to establish similar work in what they termed Voluntary Controls.

The following scientists were presenters at the first Biofeedback Research Society meeting in 1969 in Santa Monica, CA.:

1. • Tom Mulholland spoke of his early alpha studies with Eric Peper from the V.A. in Bedford, Massachusetts.
2. • Johann Stoyva spoke of developing early clinical biofeedback in collaboration with Tom Budzynski at the University of Colorado.
3. • Les Fehmi, then at UCLA, began learning how EEG alpha related to states of consciousness, later developing the Open Focus approach to mindfulness.
4. • Barbara Brown at the Los Angeles V.A. Hospital became, in 1969, the first president of the Biofeedback Research society.
5. • Leo DiCara spoke of using feedback techniques in experimental animals.
6. • And, I reported on EEG Alpha Biofeedback.
7. • John Basmajian described applying operant conditioning methods to EMG, predating others' work in EEG.

Other early contributors to the field

Notable EEG feedback researchers and cognitive scientists outside the US were Antoine Rémond from France and Niels Birbaumer from Germany.

Mention must also be made of E. Roy John, a wide-ranging neuroscientist, engineer and theoretician. Among his many contributions to our knowledge of the brain, he pioneered the early development of qEEG. As a fellow former University of Chicago researcher and valued friend, I always admired both the scope and depth of his views.

Looking back at the history of this field following these first experiments with the EEG, it was clear that many measures other than EEG alpha wave presence could be brought under control with the same methods used for alpha training. The development of biofeedback, as it came to be called, expanded its use for the control of such activity as the galvanic skin response, muscle tension, blood flow, stomach acid and motility, and other measures. The overwhelming thought among researchers, clinicians, and the public was that this method was primarily a useful clinical tool. Migraine headaches, persisting muscle pains, ADHD-ADD, anxiety, insomnia, epilepsy and other common disorders became candidates for treatment by biofeedback. The field has primarily been identified ever since for the treatment of clinical disorders. Other applications now focus on enhancing optimal performance, such as training professional athletes and Olympic contenders, or corporate executives to be more effective.

The field of neurofeedback has expanded and combined with new ways of looking at brain activity, with qEEG and LORETA, as well as fMRI. As computers have become vastly more powerful, and equipment and knowledge have become more sophisticated, the field has blossomed into some remarkably beneficial applications. They are too many to list here, but for two useful bibliographies: see one on neurofeedback compiled by Cynthia Kerson http://www.aped.training/s/NFB-Biblio-Aug-2016.pdf. This online publication is complete with abstracts. The 2017 ISNR bibliography is another useful recent reference.

Possible future directions

Reviewing the work done in the field, which is by now occupied by scores, if not thousands, of biofeedback-neurofeedback clinicians, my view is that there is a tendency to forget that training people to achieve discernment and control of a physiologic function might be an important basic research tool in the field of psychophysiology. This would be true regardless of whether there were any practical medical applications. The basic science of mind-brain and mind-body relations is a field where much serious mapping of the relations can be done, and it is hoped that a number of publications in the future will be devoted primarily to simply describing the relationships between mind and body functions. I regard Neurofeedback as a basic science tool that is sorely needed, and that should be pursued regardless of what practical applications it may have. It is through advancement of basic knowledge in this area that novel future applications can follow.

A change in scientific algorithms has been on the horizon for some time.

Johann Stoyva and I published in 1968 an article in the Psychological Review in which we examined the logic of indicators of dreaming sleep. The central concept of the article is that all indicators of private experience like dreaming, including the verbal reports of the dreamer, coordinated eye movements, accelerated heart rate, etc. are less than perfect individually, but together they converge in strong support of this ...