April 9, 2003

Report on AAPB

Author: Siegfried Othmer

There’s nothing like starting off a conference by giving an eight-hour lecture, and expending all one’s energy up front. It was only on the morning of the lecture that I discovered the AAPB literature had featured mine as an introductory workshop rather than an intermediate/advanced one. I had intended this as an intensive presentation of our model to those who were already doing neurofeedback and weren’t about to sit still for our introductory course. The AAPB promotional material must have carried the day, as the room was full of neurofeedback novices.

What to do? I quickly changed over to my Introductory course, but the appetite had been whetted by all the viewgraphs that I had handed out on protocols. People wanted that covered as well. So it was quite a ride for attendees as we waded through lots of material.

The overall tenor of the conference revealed a continuing migration from the starchiness of old. The crowd was also smaller, and more friendly. Conference planners arranged for the meetings to take place in smaller rooms, so the audience did not get lost as it once did in the cavernous halls of the Cincinnati Conference Center. And the podiums were not so frightfully elevated that one felt intimidated by the speakers.

We hear that attendance was over 400. That’s down from about 1400 in San Diego in 1989, and from about 700 in frigid Cincinnati a few years ago. But one must consider that the biofeedback constituency is now much more split than before. The surface EMG group is split off. The Menninger group/Elmer Green left to start the subtle energy group (ISSEEM), which has an annual meeting. The SNR attracts over 300 attendees, as does the Winter Brain Conference, and the EEG Spectrum CIC attracted over 200. Most of the attendees go to only one of these conferences a year. Biofeedback has also moved into other communities. For example, much of the incontinence work is done by PTs and nurses who don’t generally attend AAPB Conferences.

So the field has not shrunk at all, as might be indicated by those attendance figures. In fact, it has grown considerably. However, the economics of conference attendance has changed over the years. Back in 1989 there was a lot of attendance by university-affiliated professionals who had their way to the conference paid. Less of that is happening today. And then there is the whole reimbursement issue for biofeedback and for psychotherapy in an age of managed care. One psychologist related that in Ohio there has been a sixty percent decline in the number of practicing psychologists over the past ten years. The reimbursement climate is clearly getting tougher for practitioners.

To the program: Adam Clarke had come over from Australia to give a presentation on ADHD subtypes. His typology was a lot simpler than that of Chabot and Serfontain. Clarke lumps frontal and pre-frontal placements together, lumps all the placements on the central strip together, and lumps all the parietal/occipital sites together. He asserts that this classification works for the vast majority of ADHD kids. This partitioning really struck me because it matches up with an emerging picture around the way we now train with inter-hemispheric placements. What has mystified us to date is why the optimum training frequencies fit into certain patterns. As it happens, these patterns line up with the regions Clarke has defined.

The central strip exhibits one characteristic training frequency (for both C3-C4 and T3-T4). The frontal region is characterized by another (there is at most a small difference between optimum training frequencies at Fp1-Fp2 versus F3-F4, and no systematic difference). Finally, the parietal/occipital region is characterized by yet another characteristic training frequency. And whereas the optimum training frequencies can be all over the map for any of these clusters over many subjects, in almost every case they retain a predictable mathematical relationship to each other in any given subject. Even more remarkably, these differences are in terms of frequency offsets rather than ratios. At least that’s the way we have treated them to date. Clarke has been invited to present at the SNR meeting this fall, and he has agreed to come, SARS willing.

At the Neurofeedback Division meeting, John Gruzelier presented excerpts from his 8-hour seminar at the Udine, Italy, meeting of the ISNR. Professor Gruzelier is the editor of the highly regarded International Journal of Psychophysiology (since 1984). He established the psychophysiology lab at Imperial College, London, in 1977. His main interests have been psychosis in general (and schizophrenia in particular), QEEG, laterality issues, hypnosis, and immune function. John mainly presented results of the work with the music students. Briefly, if you will recall, the results were that alpha-theta training was the only element of a multi-faceted experimental design that showed significant results in terms of enhancing the musical performance of students at the Conservatoire of Music at Imperial College. This music program is thought to be the British equivalent to our Juilliard School. The evaluation of musical performance was done blindly by famous musicians who had no connection to the school.

John related a number of anecdotes---of how the music school faculty was initially opposed to the study (“You’re not laying hands on our students---anxiety is part of genius!”); and of how they ended up mandating alpha/theta training as a constituent of their normal music program after the results were in. He also recalled that he had himself listened to the tapes, and found that in some cases the singers were so different pre to post that he did not even recognize what tapes belonged together. The total number of alpha/theta training sessions per subject: ten! The results are in fact on the edge of being unbelievable.

John also recalled what hooked him into this work originally. After hearing Sue at a workshop at one of the Winter Brain Conferences, he came to our training course in New Orleans a year later. Jet-lagged and a day late, he could barely stay awake for Sue’s lectures. The next day he got to experience SMR-beta training, and it did not touch him at all. However, his subsequent alpha-theta session he called “a million bucks.” “John, you’re smiling,” someone said afterwards. John already had an interest in hypnosis. It was this personal experience that convinced him to pursue the research more than the literature extant on alpha/theta. We went over to teach our course at Imperial College a year later, and all of John’s graduate students were in attendance. EEG Spectrum donated a set of instrumentation for his graduate students, and then another. An American in England---and a competitive swimmer, not a musician---inspired the study, and the Leverhulme Trust in London funded it. It was in fact the largest project they had ever funded. The program was off and running. The year was 1999. In retrospect, perhaps it is no surprise that it was the alpha-theta component that ultimately proved its mettle in the music program.

The room was full, the hour was late. Eventually, John simply had to stop lecturing. But not before telling the audience, “This is potentially the most important of all the things that I have done.” And “I’m on a roll in London trying to introduce neurofeedback.” His new interest: the implications of the theta rhythm for consciousness. There is also an obvious case for the extension of our work to musicians generally. Some 24% admit to stage fright, and for 16% it is severe. Some 27% admit to using beta blockers, and actual use is estimated at 70%.

John gave me a copy of his CD of the presentation, and I will be posting relevant portions of that on the Bulletin Board. The next day his graduate student, Tobias Egner, presented on other portions of the EEG neurofeedback work at Imperial College. Unfortunately the time of his talk was changed at the last minute, so I missed it. Tobias kindly gave me a copy of his presentation as well, and it will also go up on the Bulletin Board. Basically, he confirmed the specificity of the SMR/beta protocol, but the particulars of the predictions were not confirmed.