Neurofeedback (eBook)

WHAT IS NEUROFEEDBACK?

When I caught the neurofeedback bug I was about to become a laboratory assistant in the pharmaceutical industry. I was just completing my degree in neurobiology and was looking through the most recent studies on migraine in preparation for my diploma thesis. I was particularly interested in the question as to how the brain manages to regulate and control its excitability and the extent to which excitation develops and spreads. One of the greatest challenges of the nervous system is to fine-tune stimulating and inhibiting impulses – we might think of this as stepping on the gas or putting on the brakes – so that we are able to do what we have to do in the best possible way. If this doesn’t go well, a number of very different of symptoms can result, migraine being just one example among many.

With all my neurobiological knowledge about the structure of the brain and the important role of neurotransmitters, my initial impulse was to look for the solution in chemical substances – i.e. active pharmacological ingredients that might be able to help the brain to better manage its excitation levels. However, in the course of my searches I came across the idea of neurofeedback and I was immediately electrified. It was claimed that patients could use devices to train themselves to better regulate their brains, and that by so doing they could learn to create a healthy balance in the excitability of their nervous system and thus prevent attacks of migraine or epilepsy. If that is possible, I thought, what else might the brain be able to learn to do with if it was supported by the right feedback signals? I couldn’t wait to find out more about this! From then on I was infected by enthusiasm for neurofeedback, and, as it turned out, it was quite a serious infection. Today I am still in the thrall of this kind of therapy – in fact my fascination grows from day to day.

That all happened a good 20 years ago, and the world was quite different then. Those were the early days of the internet, for example, and nobody could envisage how radically that was going to change our lives. In those days, the genome was viewed as an immutable template for all our bodily functions, whereas today we know that genes are not simply something that we possess, but that they can be switched on and off depending on the environmental conditions the organism has to contend with. Moreover, the fact that the brain has the capacity to develop was not so widely known. The dogma at that time was that adults cannot form new nerve cells and it was therefore thought that after a certain age it is impossible to make any decisive changes to the way the brain is organized. I’m sure you know the saying “You can’t teach an old dog new tricks.” Nothing could be further from the truth.

In fact the brain can be modified well into old age. This capacity is known as neuroplasticity. We can see how pronounced it is if we look at stroke patients. The more they exercise the more likely it is that the tasks previously performed by the damaged areas of the brain will be taken over by other areas. Some experiments conducted by the American neurophysiologist Paul Bach-Y-Rita, a pioneer in research into neuroplasticity, are also most impressive. He managed to render sensory impressions experienceable in new ways. For example, he created apparatuses that transform pictures taken by a camera into electrical impulses and transfer them to a metal plate so that they can be perceived by blind people by means of their tongues. The harder blind people practice, the better they can “see” again. Their brain learns to turn the signals they have felt into pictures.

Today we know that in the same way that muscles get stronger if we use them a lot and place demands on them, the brain can also expand its capacities through exercising. It always adjusts to what the situation demands. But it is also lazy and tries to do what it has to do with the minimum of effort. In other words, it loves routine and likes best to follow well-worn paths – even if these are rather rocky. However, if it has to do something differently from before it has to be coaxed out of its complacency. One of the most powerful ways to do this is to evoke curiosity, enthusiasm and fun – i.e. states in which we are relaxed, but at the same time cheerful and outward-looking. If we had a kind of rev counter for the brain on our heads it would show that it is in these states that it is at an optimal level of excitation, with the revs being neither too low nor too high.

On a bell-shaped curve that I like to draw for my clients, this state is represented by the plateau at the top of the arc. This is where people are particularly productive because this is the arousal level that provides them with the most possible ways to act and react and will even make them capable of trying out completely new strategies. Thus it becomes more likely that the brain will find a way to reach a desired goal. And “goal” here can also mean quite ordinary things like making friendly contact with someone, concentrating on a task and enjoying performing it or simply sitting in the sunshine enjoying having an ice-cream and taking real pleasure in it.

However, with many disorders of brain function the problem is precisely that people who are affected by them do not, or no longer, achieve this optimal level of activation, or only far too rarely. And this is where neurofeedback comes in. The training helps the brain to learn how it can more easily get out of states in which the revs are too high or too low and access the relaxed and open state at the top of the curve in the graph. This is a necessary requirement if the nervous system is to be able to structure itself differently, continue to develop and perhaps even continue to mature. However, this process takes place not so much during the practical therapy sessions as in the clients’ normal daily lives. Being able to maintain an optimal level of neural arousal more frequently and for longer periods of time broadens the perception of clients’ perception and also how they feel. They can try out new behaviors which will lead them to experience things differently from the way they did before. A child with ADHD, whose lack of impulse control used to get them into trouble everywhere, may experience for the very first time how they can join in with a group of children playing and feel accepted by the others on this happy afternoon. Pleasant experiences like this consolidate the new strategies, and nothing else is required. The brain structures itself anew through what it experiences.

I continue to be delighted by the fact that all of this can be achieved by a form of treatment that is so easy and effortless for the clients – they simply watch films or play on the computer. I am particularly pleased about how easy it is because many of them (and their families as well!) have had to struggle so much in the past.

I must also thank my doctoral supervisor Professor Wolfgang Hanke of the University of Hohenheim for enabling me to work with this wonderful method. At a time when feedback was still regarded as somewhat suspect, he was open-minded about my new passion and allowed me to pursue my own path in this direction. I am also particularly grateful to Sue and Siegfried Othmer in the USA, who developed the ILF neurofeedback that I work with. In my view, in the majority of cases it is this very modern branch of the neurofeedback method that gets the best results.

Many people are skeptical when they see the long list of indications for which neurofeedback claims to be effective (see Appendix). In fact you might easily get the impression that this method should be advertised as a cure-all. However, it is easy to explain why it can have such a positive effect on so many conditions. They all have one important thing in common – arousal in the nervous system is not regulated as well as it should be. Sometimes that is the underlying cause of the problem – as is almost always the case with migraine – and sometimes it is just part of the problem. With chronic back pain, for example, neurofeedback can help if the pain is triggered or exacerbated by excessive tension. However, if the root of the problem is structural damage, such as a fractured vertebra, brain training will usually be unsuccessful. It is also important to be aware that neurofeedback is often just one part of more comprehensive treatment and that it needs to be supplemented with coaching, psychotherapy, family counseling, massage or movement training.

And actually it is not neurofeedback that I am so passionate about anyway, but the brain – this infinitely fascinating organ that can deal with paradoxical demands simultaneously and allow us humans not only to experience the world passively but also even to create something completely new. The Othmers’ way of viewing the brain has left its mark on me most. For them there is never anything wrong with it or anything that needs repair, nothing needs to be stimulated or blocked by medication. They are convinced that most dysfunctions are merely a sign that the nervous system lacks practice in this one particular area and that targeted training exercises can help it to acquire the capacities that it is missing. And that is how I see it too – and my clients would support me in this view again and again. It is always immensely satisfying to see how someone can liberate themselves from the restrictions of their illness by their own efforts and can begin to lead a more fulfilled life.

I hope this book will give many people with such conditions some useful suggestions...