| I met Crystal
for our interview at the Austin Biofeedback
Center. Located in a health care district in
north-central Austin, the Center was a pleasant,
homey place that opened out onto a balcony overlooking
a garden courtyard. I entered a comfortable
waiting room and was escorted past therapy rooms
full of computers, bio-medical electronics,
and a relaxed, quiet hum of activity. In one
of the therapy rooms, Crystal sat in a front
of a computer screen while technician, Leslie
Schriever "hooked her up" to an electroencephalograph.
In 1996, Crystal's frequent,
excruciating headaches finally drove her to
her doctor for help. The remedies she tried
on her own were not working. Then a 25 year
old fashion design major at the University of
Texas, she also had vision problems, unsettling
hormonal changes, and saw an uncharacteristic
drop in her grade point average.
Initial medical treatment
did not faze the headaches. This led to rounds
of tests, brain MRI's (magnetic resonance imaging),
and finally, the diagnosis of a brain tumor
on her pituitary gland that was pressing on
her optic nerve.
Crystal knew how dangerous
her situation was. She could lose her eyesight
or even die. She recalls, "I was more worried
about my family than myself...but I thought,
'I've never been skydiving,' not that I ever
wanted to before, but now I may not ever get
to."
Surgical removal of the tumor
was successful but post-operative recovery brought
only a continuation of the constant, severe
pain. When she was well enough to take medications,
her doctors prescribed them to control the pain
but Crystal soon discovered that it took increasingly
larger doses to make "even a dent" in the pain.
She was caught in a spiraling drug-rebound cycle.
Her body's response to each dose of medication
was a more intense level of pain which required
an even higher dose of medication.
Her life was becoming more
and more difficult. She had to drop out of school.
Crystal explained, "I couldn't go anywhere without
my medication. I was always in pain. I couldn't
do things. I was afraid... of pain. I lost a
year of my life."
She spent months in a haze
of pain and medication. Then, desperate to break
the medication's hold on her, she entered a
detox/rehab center and was successfully treated
for the rebound addiction. Crystal filed a lawsuit
against the drug manufacturer whose product,
advertised as non-addictive, had jeopardized
her recovery. She ultimately won the lawsuit
but she was still no closer to ending her struggle
with pain.
Unable to turn to medication
for relief, Crystal began to search for alternatives.
Based on the results of her search, her doctor
prescribed a different approach to pain control
that was reported to show a high rate of success.
Finally, this proved to be the turning point.
With her doctor's support,
Crystal's health insurance company authorized
a program of psychophysiological self-regulation
training (commonly referred to as "biofeedback
therapy"), a high-tech solution to a broad-range
of medical problems.
Far from an outdated misconception
that sees biofeedback as just another relaxation
technique, Crystal found herself involved in
a sophisticated therapeutic training protocol
through which she actually learned to control
the specific somatic (physiological) causes
of her pain with her own physical and mental
efforts.
According to Lynda Kirk, MA,
LPC, a national authority on the clinical applications
of biofeedback and a practicing biofeedback
therapist, "There are two keys to why biofeedback
training works so successfully in cases like
Crystal's and in a variety of other medical
and behavioral applications as well. "
The first is that more and
more medical research and years of clinical
experience tell us that the mind, the brain
and the physical body always operate as one
inseparable unit. If you can positively impact
the mind in specific ways, then specific, predictable
changes in the body will follow.
Conversely, if you can positively
impact the body or brain in specific ways, then
specific and predictable changes in the mind
and thought processes will follow. "The second
key to biofeedback's success," Kirk continues,
"is almost forty years of research that continues
to be substantiated, which shows that individuals
can, with training, learn to physically and
mentally control their own internal processes
with a high degree of precision, even processes
formerly thought to be just autonomic [controlled
automatically by internal systems rather than
by conscious choice]."
On her initial examination,
using an electromyograph to measure baseline
levels of muscle tension, Crystal's biofeedback
therapist discovered massive structural bracing
patterns in her face, neck and upper-body. These
ingrained habitual bracing patterns probably
developed over time in response to the intense
pain of her earlier headaches but were now themselves
causing chronic inflammation of the tissues
which led to more severe headaches and other
painful symptoms as well.
Using feedback from the electromyograph,
electroencephalograph, and coaching from her
biofeedback therapist, Crystal began to learn
to consciously control and release the structural
bracing and the high levels of mental arousal
(common with chronic pain), that were responsible
for her painful symptoms. Her symptoms became
less severe and less frequent. She was able
to develop new habits and her upper body was
no longer constantly braced in anticipation
of physical pain that was no longer there.
According to Kirk, "The missing
piece that biofeedback instruments provide a
patient like Crystal is the highly specific,
detailed information (feedback) about their
own internal processes that individuals need
in order to learn conscious control over those
processes.
"Extra information
is not necessary for some things, like learning
a fine motor skill with your hands," Kirk explains.
"For example, learning to write, use a keyboard,
or draw is accomplished by "feedback" from your
eyes and sense of touch. You can see or feel
when your finger movements are right or wrong
by the results they produce. Constantly correcting
and refining your movements over a period of
time using this feedback from your eyes and
your sense of touch, develops mastery of the
desired skill."
Unfortunately, these same
five senses we ordinarily rely on to write or
draw do not provide us adequate information
to learn to control processes going on inside
our bodies. If we were to suffer from high blood
pressure, for example, we may have some vague
or general sense of what high blood pressure
feels like in our body but we do not have any
direct awareness of what specific events or
conditions are occurring in our cardiovascular
system, muscles, or brain that are directly
related to the high blood pressure we experience.
According to Kirk, "Biofeedback
instruments such as the electromyograph, the
plethysmogragh and others can provide this information
to patients in great detail, in real-time, as
the events are occurring in their bodies. Through
the marriage of biofeedback instruments with
high-powered, modern computers and software,
this technical information is translated and
presented to them almost instantaneously, in
a user-friendly and understandable format. "
With guidance from a biofeedback
therapist patients can use this information
in the same way they would use feedback from
their eyes and sense of touch to learn to use
a computer keyboard. They can begin to cause
specific functional changes to occur in their
cardiovascular systems that make their blood
pressure go down and with practice, they can
become highly skilled and confident with these
abilities. Then, when they experience life events
that in the past may have made their blood pressure
skyrocket, like rush-hour traffic for example,
they can use their new skills while they drive,
and in a matter of seconds their blood pressure
is at a relaxed healthy level and they are on
down the road without missing a beat."
Whether an individual's problem
is high blood pressure, chronic bladder problems,
closed head injury, acid reflux, or chronic
pain and headaches like Crystal's; biofeedback
can provide the "missing" information that leads
to successful self-regulation and relief.
Crystal is almost finished
with her biofeedback therapy now. She is excited
about school again, back in class, and will
graduate this Spring, "I'm able to produce more,
do more... I'm really looking forward to my
last semester."
Crystal now goes for months
without headaches and when they do occur she
knows how to stop them. She is enjoying life
again. Crystal explains that after biofeedback
therapy, "I was outside, just sitting there
looking around thinking, 'So this is what real
life is like, life without pain.'"
As a final note to Crystal's
story: when I originally called her to schedule
our interview, she wanted to make sure we would
be through by noon. "I'm going skydiving this
afternoon!" she said.
Many of the conditions or
symptoms biofeedback therapy is used for are
characteristically physiological in nature like
Crystal's. Others are not so easily defined
but include a sometimes bewildering mix of characteristics
that are both behavioral and physiological at
the same time.
Laura (not her real name)
is a bright, precocious eleven year-old. She
has a house-full of pets, writes wonderful poetry,
takes guitar lessons, and her daddy is teaching
her to shoot skeet.
Laura learns quickly and easily
but last year problems at school became serious.
She was not turning in assignments. Often her
work was lost or misplaced. "I couldn't concentrate,"
Laura said. She was so distractible, that staying
focused long enough for her to finish her homework
was an exhausting, frustrating process for both
Laura and her mother.
Concerned for her daughter's
well-being, Laura's mother sought medical help
for Laura's problems. Her doctor diagnosed Laura's
condition as attention deficit disorder (ADD)
and prescribed the drug Ritalin to control the
problem.
According to Laura's mother,
Ritalin proved to be an unsatisfactory and ineffective
treatment, so Laura, her mother and her doctor
decided on a course of EEG biofeedback (neurofeedback)
as an alternative to the medication. At her
doctor's request, Laura's health insurance provider
agreed to pay for the biofeedback therapy.
Laura received her therapy
at the Austin Biofeedback Center, where her
brain was found to produce a high-level of slow
frequency brainwaves accompanied by low levels
of fast frequency brainwaves, in a pattern that
is typical of individuals with ADD.
Biofeedback therapy is both
painless and noninvasive. According to Laura,
"I was nervous at first, and I thought it felt
kind of weird having them clip the things on
my ears but it was fun!"
Her twice-a-week training
sessions began with the placement of delicate
wire sensors, with drops of conductive gel,
on her scalp and ears. The sensors were attached
to an electroencephalograph (EEG) that "read"
and interpreted the electrical activity of her
brain and then fed this information into a fast
computer.
Software in the computer translated
the brain activity into pictures and sound that
Laura could use to train her own brain to produce
the higher levels of fast waves and lower levels
of slow waves that are exhibited in a more focused
brain. Some of the software even produced video
games that Laura learned to play with her own
brainwave patterns through the EEG instead of
using a joystick.
According to Lynda Kirk, "A
recent program on The Learning Channel outlined
how this advanced technology is also being used
by U.S. Air Force researchers to develop control
systems for very, very fast aircraft, where
flight controls are linked directly to the pilot's
head through EEG contacts in his helmet. With
this direct link to the pilot's brain, the elapsed
time between his decision to act and the control
system's response would be almost instantaneous."
Guided by the brainwave training
on the computer, and with coaching and encouragement
from her biofeedback therapist, Laura began
to make progress. As her brainwave patterns
became more normalized and flexible, her organizational
problems at home and at school began to disappear.
Now, several months later,
Laura reports that she has made straight A's
in the last two grading periods with no missing
homework. "I've been able to keep my locker
clean and my desk clean..." Laura smiles.
"...Which is a miracle!" her
mother interjects.
Even better, according to
Laura, "Another problem was that I would have
a ton of homework and we never had any time
for activities. Now I get a lot of [homework]
done in school... I'm a lot happier because
it's made things easier for me."
Laura's mom is happy too,
"It has really helped all our lives - a lot!...It
has really made a difference in my life. I don't
have to constantly sit down with her and make
sure she is doing her homework anymore!"
Whether individuals turn
to biofeedback for help with medical problems,
or like Laura, for help overcoming difficulties
they experience in developing their talents
and human potential, biofeedback therapy relies
on, and works in tandem with the medical and
other healthcare communities.
James Reeves, M.D. has been
practicing medicine in central Texas for thirty-six
years. A respected, board-certified urologist,
Dr. Reeves has, for nearly twenty years, actively
included biofeedback as a part of the comprehensive
care options he can call on to treat his patients.
According to Dr. Reeves, urology
is an extremely complex field especially concerning
bladder dysfunction: "Initially it involves
extensive testing...to determine whether or
not surgery is necessary or whether biofeedback
can help [the patient avoid surgery]." Medication
is usually used from the first day to get symptoms
under control while the doctor searches for
the most appropriate long-term solution. Long-term
solutions may include medications, biofeedback,
surgery, or different combinations of these
and other therapies.
Sometimes problems can be
dealt with quickly and effectively with medication.
Sometimes there are injuries or structural defects
that only surgery can correct. "Where biofeedback
comes in," Dr. Reeves says, "is when there are
no structural defects but the system just doesn't
work right."
"Biofeedback therapy proves
successful for many cases of urinary incontinence
and chronic bladder problems." he continues,
"In some cases, surgery may turn out to be necessary
but a less invasive approach would be desirable.
In these cases, biofeedback may be tried first
to see if surgery can be avoided, and it often
can be."
Dr. Reeves recalled an elderly
patient whose symptoms all pointed to the potential
need for prostate surgery, but extensive testing
"did not clearly indicate structural problems."
He suspected that, "The patient's blockage was
not caused by internal tissue impeding the flow
but by [associated] muscles that were not working."
He referred the patient to
the Austin biofeedback Center for muscle retraining
and soon received a call from the patient saying
that the retraining had been successful. Dr.
Reeves summed up, "Biofeedback's role and value,
in a nut shell, is that it uses the body's own
ability to heal itself."
Medical problems, like the
urological problems above, may often include
elements of mind and emotion and well as the
body.
Liz, 49, is a vivacious,
energetic woman with a fast-paced career as
an independent advertising and copyrighting
consultant. In her high energy, high stress
profession, Liz says deadlines and demanding
clients are the rule, "It's what I like to do
and I enjoy it but it does get pretty stressful."
The last thing Liz needed,
with her demanding job, was a major health problem
but two years ago in January she had to have
major surgery. A tumor was removed successfully
but she was left with serious problems in her
urinary tract.
"I went through months and
months of repeated urinary infections... eight
or nine months trying to regulate this in some
way to get back to normal." Medications did
not work, Liz reported, "Finally [after] extensive,
extensive testing my urologist said that my
choices were either biofeedback therapy or surgery
and that he strongly recommended that we not
do surgery unless we have to." She was ready
to try anything.
Last year, with Christmas
approaching, Liz was in the midst of an extremely
stressful period in her life. The urinary problems,
back pain, stresses at work and with her clients,
all occurring in the middle of the holiday season,
left her feeling extremely overwhelmed and depressed.
It was in this context that
Liz began her biofeedback therapy. "I did not
realize then," Liz remembered, "that the other
problems were going to get treated simultaneously
[with the urinary infections]." Biofeedback
showed her how everything in her life was so
interconnected. "The stress, the health problems,"
according to Liz, "[these] all needed to be
brought back into alignment."
The first thing to disappear
was her back pain. Then, with electromyographic
biofeedback therapy and continued guidance from
her biofeedback therapist, the urinary tract
infections went away. "[After the training],
I went from January to the end of November with
never an infection. I had had them every two
to three months the year before," Liz said,
"It was all because of this - the biofeedback
therapy."
Even with her back pain and
infections gone, Liz was still feeling overwhelmed
and depressed but she did not know why. Her
biofeedback therapist continued the training,
teaching her how to control the effects stress
was having on her body, mind and emotions. "With
the techniques she taught me, I got to feeling
so much better, I haven't felt stressful all
year...I was able to come out of my depression.
I've got thousands of things on my desk but
I'm just fine!" Liz exclaimed, "Being aware
that the techniques she taught me are available
to me, empowers me, and I use them!"
It is Christmas time again
but now, Liz says, "Last year I was overwhelmed
all the time. This year, getting ready for Christmas
- everything - I do not feel overwhelmed. There
is nothing else I can credit this to but the
[biofeedback] treatment." She continues, "I
have to say this. The bladder problems ended
up being a sidelight. Hey! - That got fixed
- Great! But everything else that got fixed
is so much more important to me. "My emotions
- everything. I'm able to be much more productive
because of it. It's been a revelation to me.
Biofeedback therapy has changed my life...It
has given me a tool that I can use to regulate
everything that happens to me in my life and
to put myself in control of it rather than it
controlling me!"
The important role biofeedback
can play in solving emotional issues is no clearer
to anyone than to Anna Gonzalez-Sorensen, Ph.D.
Dr. Sorensen, a clinical psychologist formerly
on the faculty of Colorado State University,
has maintained a busy practice in Austin for
the last fifteen years.
Dr. Sorensen and her husband,
Don M. Sorensen, LMSW, ACP, are co-founders
of Austin Counseling and Psychological Services.
The couple also teams up to present the popular
relationship workshop series, "Getting The Love
You Want".
According to Dr. Sorensen,
the emotional issues clients are dealing with
generally include related physical symptoms.
"I often refer [clients] for biofeedback...
I'm dealing with the emotional aspects. If my
clients can get help with the physical aspects,
then it makes it easier to do the emotional
work they need to do." For clients to learn
the connection between their emotions and their
bodies is very important, according to Dr. Sorensen.
"If they can learn about reading their bodies...
getting feedback from their bodies, it makes
it easier to work with the grief, or the anger,
or whatever is coming up for them around the
physical issues. Headaches, migraines, high
blood pressure, and so on - I check for these
physical issues when I do the [client's] intake
form."
Many times, these physical
problems are the body's response to emotional
issues. After appropriate medical work-ups when
necessary, biofeedback is often the most effective
physiological way to support the client's psychological
treatment.
"Another big area where biofeedback
is very important is in treating ADD and ADHD,"
Dr. Sorensen says. "Not only children but adults
with these problems can certainly benefit [from
biofeedback therapy].
Dr. Sorensen recalled, "I
had a family come to me for counseling." The
family was in turmoil and it was apparent to
Dr. Sorensen that the behavior of one of the
children, a twelve year-old, was at the root
of the problem. On examination, she found that,
"The child was defiant, he wouldn't do his homework.
It was a battle and it was clear that he had
ADHD... I referred him for neurofeedback. In
a few weeks, the mother reported to me that
the child told her, 'Mom, I can follow along
in class now. I never could before!'"
"In another similar story,"
Dr. Sorensen said, "[after neurofeedback] another
child said to me, 'I read a whole chapter for
the first time in my life!'"
"A lot of adults don't know
that they actually have ADD. Their inability
to focus or concentrate - they label it anything
else." Dr. Sorensen continued, "Then I do a
case history and I find that when they were
in school they exhibited a classic ADD profile.
As adults they have learned to compensate but
they still have problems.
"For people [with ADD/ADHD]
who are good candidates for it, neurofeedback
can be miraculous. If a client is willing to
make the effort that it takes, it is very effective.
I have clients who have thanked me over and
over again for referring them for neurofeedback."
According to research findings,
individuals with attention deficit disorders
consistently score higher than national norms
both in intelligence and in creative abilities.
More and more, adults with ADD are turning to
biofeedback to overcome the problems they have
focusing and concentrating, that have suppressed
their natural advantages in intelligence and
creativity.
Removing limitations that
block intelligence and creativity, while increasing
mental flexibility, can be a definite career
advantage. Many individuals, however, seek out
the advantages biofeedback can offer, simply
for the marked improvement in quality of life
that it can bring.
Jeff, 42, is now a successful
executive in the R&D department of a well-known
high-tech manufacturing company. Originally
from El Paso, Jeff has lived in central Texas
since 1985. He is interested in sports and enjoys
auctions and collecting antiques.
In the early nineties, events
led him to search for serious life changes.
As Jeff put it, "I recognized that life wasn't
very much fun for me." He wasn't as happy as
he thought he should be and exhibited some of
the signs of clinical depression. He had problems
with stress and was being treated for a bleeding
ulcer. "I started on this journey to unravel
what that was all about," he continued. "I got
into counseling and some other things and the
psychologist I was seeing suggested that I might
have attention deficit disorder (ADD)." Jeff
was referred to a doctor whose diagnosis concluded
that he actually had ADHD (attention deficit,
hyperactivity disorder) instead of ADD.
"I immediately started on
a program of heavy medications," he said, "and
took them for several years. I guess they helped
me somewhat [to] 'do' my daily life...but I
eventually came to a point where I just didn't
want to be on these medications for the rest
of my life."
When first told what his
diagnosis was, Jeff searched for information
about his disorders on the internet. There,
he discovered that a process called neurofeedback
could be an effective, drug-free alternative
for overcoming problems like his. His doctor
was skeptical, but when Jeff later decided he
wanted to try to get off the medication, he
recalled, "I finally decided to pursue that
and just give it a shot... I decided to embark
on [a course of] neurofeedback treatment and
[that decision] just changed my whole life!"
He was referred to the Austin
Biofeedback Center where a comprehensive brainwave
evaluation called a quantitative EEG, or qEEG,
indicated possible lingering effects from a
childhood closed-head injury. According to Lynda
Kirk, "Jeff's qEEG was forwarded for analysis
by the Thatcher Database. Dr. Robert Thatcher's
normative database and discriminant analysis
with qEEG is used by the Veteran's Affairs Administration
and the Department of Defense as an evaluative
component of their standard of care in head
injury cases." An appropriate therapeutic protocol
was formulated, based on both the qEEG analysis
and Jeff's medical diagnosis, and his EEG biofeedback
training began.
"I started with the 'beta'
work [fast brainwave training]," Jeff recalled,
and that eventually got me off the drugs completely.
It got to the point where the amphetamines [that
were prescribed to keep me focused] were actually
making me high so I knew [it was working]!"
His dosage was reduced and ultimately eliminated.
"It happened pretty quickly, really." he said.
Initially somewhat skeptical
himself, Jeff noted that, "It took me awhile
to fully believe that I could sit and watch
[a neurofeedback computer screen] for forty
minutes and actually have something change in
my brain. It was absolutely the most amazing
experience to walk in [for a neurofeedback session]
feeling one way and to walk out forty minutes
later feeling completely different.
" Not only his medications,
but his symptoms also began to disappear and
over time, were eliminated as well. "It absolutely
changed my life," Jeff stated, "It's been one
of the greatest things that has ever happened
to me.
"Since then, [finishing his
therapy], I don't do depression anymore! If
I do ever get upset or depressed, it is short-lived.
It's just not a part of my life anymore."
Jeff sees other fundamental
changes in his life now. "I used to have a problem
with anger... This was one of the things that
caused me to seek some change. I was the kind
of person who stuffed my emotions and it was
eating me up on the inside physically," he remembered,
"I had a bleeding ulcer and nearly bled to death.
[Now,] I don't react angrily anymore, or not
very much, and when I do, I get over it real
quick. I credit the neurofeedback more than
anything else for making it possible for me
to do that."
"I've also got a new-found
appreciation for life." Jeff stated, "I mean,
I can stop and take a look at a ladybug and
just have a good time doing it, whereas before,
I might not have even seen the ladybug, or the
flower, or whatever, because I was so 'balled-up'
in all these emotional issues all the time.
All that just stopped at some point in the therapy.
So when I say it changed my life, it did. They
say life begins at forty; well it began at forty-one
for me because that was when I finished my neurofeedback."
According to another former
patient of the Austin Biofeedback Center, she
was not the only one who received benefits from
her biofeedback therapy.
Anna, 42, is a cheerful bundle
of energy wearing colorful surgical scrubs.
She is the office manager for a busy veterinary
clinic. "The loves of my life are animals!"
she says, "I have three dogs and four kitties."
For fun, Anna and her husband like to listen
to music and to travel around on their Harley
Davidson motorcycle. "We like to get out and
about and do things."
Several months ago, Anna came
to biofeedback with a long history of bad migraines.
"I've had them off and on since I was thirteen
years old... especially during stressful periods
in my life," she recalled, When I came in [for
biofeedback] I had had a headache [continuously]
for several months."
Her doctor thought that the
headache was caused by a combination of stress
and hormone problems. "I couldn't get rid of
it... it wouldn't go away. I had tried drugs,
and drugs, and drugs," The medication helped
a little, she continued, "but you know, with
drugs you're just treating the symptoms and
not getting to the root of the problem anyway."
She went back to her neurologist
who then suggested that she try biofeedback.
She had other stress-related health problems
too, such as irritable bowel syndrome, and a
sleep disorder. Although she did not know much
about it, she had heard that biofeedback could
help these kinds of problems so Anna said, "Sure!"
Anna reported, "So, I went
in [for biofeedback therapy] and I started getting
relief from my very first session. That made
a believer out of me!"
Anna continued on a comprehensive
program of biofeedback and cognitive therapy
with her biofeedback therapist to help her get
control of both the headaches and the stresses
in her life. She overcame her other symptoms
as well. "The biofeedback therapist was a wonderful
person who taught me so much," she said, "I
use what she taught me almost every day."
Every now and then, Anna
will still get a headache but she attributes
that to forgetting to use the skills she has
learned. Then all it takes is remembering what
to do and the headache is under control.
Anna considers herself an
intense, high-strung person who used to make
her headaches worse by getting mad easily, especially
when others, at work or at home, did not meet
her expectations. She was even harder on herself.
She said, "I just take a different perspective
now... and I deal with [problems] the right
way, so it all works out... I'm so much better
now.
"Before the biofeedback I
was a mess... My husband and I fought all the
time, I cried all the time. It was a nightmare.
My head hurt so bad I didn't want to go anywhere,
I didn't want to do anything.
"Going through this training
- it saved my marriage. Its made me a happy,
pretty well-adjusted person. My mental health
is better. My physical health is better. I know
that now, I can make myself feel better! I can
control it myself and that's the most wonderful
thing about it!
"Now I feel like, when I have
a headache or almost anything, I can make myself
better. I can do it by myself! It takes a few
minutes to stop, think, and actually do it.
I can actually do it!"
Anna concludes, "It's been
one of the best things that's ever happened
to me. I'm happier, my husband is happier, my
boss is happier, the guys I work with are happier.
There's no doubt about it!"
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