Biofeedback -- the Ultimate Self-Help Discipline
Siegfried Othmer, Ph.D. and Caroline Grierson, RN, BCIAC.

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History of EEG Biofeedback
EEG biofeedback had a curious beginning. After all, no one in the Western scientific tradition would think it likely that one might actually be able to train people’s brain waves! The early findings were therefore somewhat serendipitous, and even accidental. There were actually two independent beginnings, for the two divisions in the field which exist to this day. EEG biofeedback got its start with the study of the famous "alpha" rhythm, the rhythmic signal at about 10 cycles per second (called Hertz) which appears in our visual cortex when our eyes are closed and the visual system isn’t very busy. This rhythm can be seen as the idling rhythm of the visual system.
On a separate research track, the idling rhythm of the motor system (called the Sensorimotor Rhythm, or SMR) was investigated in cats. These two lines of research led to very different approaches to EEG feedback, addressing different conditions and employed by different disciplines. It is interesting to review the history briefly.

The History of Alpha Training
The so-called alpha rhythm was the first feature identified by Hans Berger in the late twenties. Berger was interested in consciousness, and in how it might be measured. The work was immediately controversial, and controversy seems to have dogged this field ever since. Decades later, Joe Kamiya, then at the University of Chicago, was also interested in studying consciousness with the help of the alpha rhythm. He asked the question, can a person be aware of his or her own alpha rhythm, and if so, what is that awareness? He successfully trained a subject—by simple reward—to discern when an alpha rhythm, or rhythmic spindle, was present in his visual cortex. Over a period of time, the person became 100% accurate. The serendipitous aspect of this work is that Kamiya never found another subject who was nearly that good in all his subsequent work. Later in his research, Kamiya succeeded in training people to increase their alpha activity. This was the first case in the Western world of EEG biofeedback training.

Subjects found the training to be very relaxing and comforting. In some instances, the experience even opened the door to spiritual transformation. The sciences were not prepared to deal with such unruly and subjective phenomena, so it was not long before this line of investigation fell into disrepute. The fact that all this was happening in the psychedelic age of the sixties did not help. EEG feedback quickly captured the public fancy, aided by enthusiastic public lectures by people like Barbara Brown. Sober left-brained scientists were aghast. The hard scientific data were meager at this point, and the whole matter became unsuitable for serious scientific discourse at the universities, with work only continuing among certain independent research groups. The most famous of these was the one at the Menninger Foundation, which included Elmer Green, Alyce Green, Dale Walters, Steve Fahrion and Pat Norris. Other researchers and clinicians who persisted in this line of work included Jim Hardt, Tom Mulholland, Les Fehmi, Adam Crane, and the late Chuck Stroebel.

It was recognized that what became known as alpha training was really a way of quieting the mind. By virtue of the connection between a quiet mind and a quiet body, this was also a way of achieving what came to be called "behavioral stillness." In a larger sense, the training was a way of achieving and extending voluntary control over one’s own mental and body states. With an increasing propensity toward revved, left-brained mental activity in the Western world, the respite afforded by the alpha training was a treasured antidote. The few remaining stalwart practitioners learned that the alpha training could be extremely helpful to those who were undone by the demands of Western life and manifesting anxiety disorders, pain syndromes, sleep disorders, and various other reactions to chronic stress.

In 1989, Peniston and Kulkosky reported a stunning research result in which stage 4 alcoholism (with a long-term history of treatment failure) was essentially fully remediated in some Viet Nam veterans by a treatment program which included alpha training as a primary component. This result was so incredible that initially it was given essentially no credence by the scientific community. What is most striking is the fact that these early results have held up in follow-up over the subsequent ten years, which takes us up to the present. The work has also been replicated in a number of other studies, and has been extended to other drugs of choice. Together, these results are giving rise to a reappraisal of alpha training, now called alpha-theta training because of the inclusion of even lower frequencies in the reward, namely the theta region of frequencies (4-8 Hertz).

It has become clear that this work is best seen as a treatment for post-traumatic stress disorder (PTSD), which was sustaining the addiction in these particular Viet Nam veterans. But the word treatment is inappropriate. The person undergoing the feedback is the only active agent in everything that happens in biofeedback! There really is no treatment here. Rather, what is accomplished is that the person is guided to a comfortable, comforting state of his body-mind in which true healing—the healing of psychic wounds—can take place. The biofeedback training simply aids in movement toward that healing opportunity.

The History of Sensorimotor Rhythm Training
In the mid-sixties Barry Sterman of UCLA was also studying brain-behavior relationships. He observed the EEG of cats that were trained to withhold a response under certain conditions. What he found was a brain rhythm of somewhat higher frequency than the alpha rhythm, one that was associated with motor stillness. He called it the sensorimotor rhythm (SMR), and it turned out to be the idling rhythm of the motor system. After training the cats toward motor stillness and observing SMR spindles, he turned matters around and decided to reward the cats for making more SMR spindles, and observed the resulting behavior. Not surprisingly, the cats became motorically still. What was surprising is that it turned out to be easier to train the cats to change their EEG (and thus their behavior) than it was to train them to change their behavior directly. Here was the second instance of EEG biofeedback training. It was also a case of training the brain toward behavioral stillness, or, in a larger sense, control in general.

Fortuitously, Sterman was given the task by NASA to study the effects of a toxic substance called monomethylhydrazine (MMH), a rocket fuel that was used in the Apollo program and was believed to be causing astronauts to suffer cognitive deficits in space when exposed to small amounts of the substance. At higher dosages, the stuff was known to cause seizures and even death. Sterman studied the effects of MMH on his cats, and found to his amazement that some cats showed a much higher threshold for seizures. These fortunate cats turned out to be the ones that had been previously trained to make more of the SMR rhythm! Thus a new field was born.

Sterman subsequently demonstrated seizure reduction in human epileptics with the EEG training, and a new therapeutic approach was launched. Lubar, Tansey and others successfully employed the same technique with hyperactive and learning-disabled children. Others extended these findings to minor traumatic brain injury and a host of other conditions. Results were variously reported for anxiety and depression, PMS and migraines, sleep disorders and chronic pain syndromes, even autism and cerebral palsy! What could possibly account for such a broad reach of such a simple technique?