Theoretical Implications of Neurofeedback Integrating Bowen Theory Andrea Maloney-Schara, LCSWA 11/4/97 Simple statements often conceal a great deal of complexity. The notion that the brain learns from experience is one such statement. The brain develops the internal connections by fitting with the external world. Learning then can be defined as the struggle to make sense of human interactions. The efforts to integrate feeling and thinking, or values and impulses, are what gives each person their own unique self. Reflecting on much of life's experience, furthers one's goal and thereby enables humans to escape a deterministic world. PET scans, MRI and EEG look at evidence that the brain does reflect the nature of relationship sensitivity, physical and emotional challenges and eons of evolution. For the EEG one arena, sleep states; have been very well documented. Eventually waking states of conscious will be as well investigated. As in many areas of medicine much has been learned from symptoms. Diseases have taught us about the functioning of the different parts of the brain. Neither of the brain's two information systems, chemical nor electrical has a one to one correspondence with functional states in the human. Rather the state of the body reflects the overall adaptation that any individual has made. Certain areas bind anxiety, and no one area can reflect a life history. An EEG may give us more insight into the overall way that feelings and thinking have been integrated and how we pay attention. In 1929, Hans Berger measured the brain's electrical activity. The activity was recorded in the form of line waves and now these same waves can be fed back to the brain as information. EEG Neurofeedback is a relatively new discipline that enables us to understand how the brain functions and also promotes the brain's ability to learn from observing itself. Neurofeedback has been documented to be useful for serious symptoms. People have been able to function after sever head trauma. Epileptics have been taught to reduce the severity and numbers of seizures. Headaches, and other types of physical pain, have been reduced. In addition to physical symptoms, emotional and physical symptoms, such as ADD, have been reported to decrease by Lubar, Tansy and others. There are a wide number of manufactures of equipment and most have reported positive results in working with various symptom groups. Bowen Theory can go beyond symptoms to look at the relationship's system and promote a larger systems view of EEG and the role of learning in an emotional system. Symptom reduction may simply be the evidence needed to show that EEG has merit. In the future EEG may in fact be a window to open the door to a broader systems perspective on the way in which relationship energy impacts of functioning. Bowen Theory points to the fact that an individual function as a part of an emotional system. The fact that anxiety can be spread from one individual to another testifies to the increasing interest in self-regulation and self help. Individuals realize that anxiety is part of being alive in a relationship's system and that altering the tendency to absorb others anxiety for the pleasure of being in positive relationships with another is often not worth the price that will be paid The thesis would be that relationship's systems organize the interplay of physical and emotional energy so that individuals within that system can live and work in some degree of harmony. The EEG is a tool, which can momentarily promote an increase in functioning in one individual. The relationship system will adjust. The individual must be strong enough to manage the resistance to change within the system. If this can be accomplished over time then other people who are emotionally linked will also be able to do better. The family as an emotional system maintains certain patter of relationships, which then reinforce broad patterns of brain wave activity. At the most basic level EEG neurofeedback teaches motor skills and mental flexibility. Individuals can learn a variety of focused states plus enhance the ability to reflect on the consequences of particular thinking patterns. The training teaches the individual to enhance or inhibit certain brain wave patterns. Learning occurs through feedback which rewards increased self-control. The brain waves are seen as waves or as bars or graphs on a computer. Sensory feedback teaches the brain faster than the conscious mind can learn. Just watching and noticing how what one thinks or does effects the feedback this type of leaning appears to remain after one session. Leaning in this case may mean that the individual has less pain or more energy. The individual who has a positive mental/physical experience may be learning to pay attention at multiple levels of awareness. For example, the thalamus may have received new messages and the basic rhythm of the system may be altered. New peptides may be produced. New information will be circulating. No one has the necessary evidence, the blood work, gene testing, pet scans, etc. to say for sure just what systems are changed by the EEG experience. Over time the individual has a greater ability to change automatic reactions to stimulus in the relationship system. For many people just this experience is enough to make a significant functional change possibly. In fact it is the ability of one individual to be able to maintain a separate self, and not react to the clues or demands from the larger emotional system, also begins the process of differentiation. Symptom reduction however is not differentiation. The point here is that this type of learning has to do with increased knowledge about self in the relationship system rather than just the reduction of a symptom. Perhaps a couple of case examples will make this point. Consider one family, where the individual, Mr. D. had been the focus of family anxiety during his teen-age years and early adulthood. As an oldest son he blamed himself for his problem, cocaine addiction. After seeing his three generational family history he began to recognize the impact of the family disturbances. The early deaths in the war, and the pressure that put on his mother growing up without a father, the emotional cut off from both sides of the family, and finally his mother's early marriage to his father when she became pregnant. The father was also an oldest son who had come from a religious family with high expectations. The father had gone into business for himself, lost money and eventually left his wife and three children. The client had over fifty session of EEG feedback during a year and a half. This case illustrates that as anxiety increases people are less able to manage relationships and become emotionally blind to the interpersonal pressure that one person is putting on another and that this occurs over the generations. By looking at the spectrum of brain wave activity it was evident that this individual could not produce alpha waves. He lacked that ability to relax without taking drugs. The EEG reading would give one some idea of the anxiety in the family without even doing a family diagram. The family diagram shows the relationship areas where this individual had to manage himself due to his automatic reactivity. By reflecting on the early years he could experience, in the form of dream fragments, some of this early reactivity. By further reflecting on how he wanted to act in relationship to important others, the past experience became less intense. During the training he learned to focus on keeping his body calm while allowing his mind to wander. Having experienced a new level of physiological integration with these old memories, the individual was able to make a positive move toward his father and stepmother. This seemed to unbalance the relationship with his mother. Very soon after this Mr. D became engaged, his mother became closer to the new girl friend and her relationship with her own boyfriend turned sour. The son then helped his mother manage to talk to her boy friend about his increased drinking. Eventually the boyfriend went for treatment and within a year both the mother and the son married. The system stabilized and a new level of emotional contact has been established. The second family concerns were focused on a 13-year-old son. This son was diagnosed with ADD and had been seen by a psychiatrist since that age of seven. He had taken drugs for the ADD which appeared to have stunted his growth. When he came in for therapy he still had a light attitude. Since he was the youngest son he did not have to take everything too seriously. Mr. B. was able to escape from some of the family worry by being smart. He loved science but he did not enjoy reading or writing. In terms of the family history his mother's younger brother had died of cancer the year that this young man was born. The mother automatically had a great deal of concern about her sons functioning. In addition the boy's type of intelligence was not appreciated or reward in a classroom. He would win prizes in science but teachers could not understand what he wrote. He had a difficult time sitting still in school. At eight years old he was diagnosed as ADD. The parents were not interested in coming into counseling for their own issues. They were willing to come in as a function of the son being symptomatic. This is an example of a difficult situation. If you consider that the family has difficulty knowing how to pay attention, then it makes sense to treat the family. Theoretically there can be a number of different approaches to his type of an issue. I have taken the position that I will work with this type of a family system and see if some flexibility can develop by having a dialogue with the child and at least one interested and motivated family member. In this case the son came in for treatment for a year and a half with his father. The father became interested in the treatment and did it for himself. He was also able to encourage the child's interest in reading by allowing his to read science fiction books and discussing the outcomes. The son was able to learn physiological self-control and to improve his grades and to increase his IQ significantly. When the mother finally decided that she also needed to look at the broader family relationships she selected another therapist. This is also part of the price one can pay for increased functioning by a family member. In both of these cases individuals who were willing to learn how to alter patterns of brain wave activity had fewer symptoms. In addition this approach appeared to lead to improved functioning by other family members. Is there an analogy between the growing brain and relationship system? Let us consider the journey of a single neuron in the brain and how that neuron functions. First it must learn to recognize and coordinate action with literally billions of other neurons. Each newborn neuron starts firing at the moment of its conception. The embryo moves the neurons in the brain fire. Electrical current, generated by the neuron's firing, launches the biochemical system. Ten to the billion neurons send electronic messages down the often long gangling axons to the dendrite branches. When neurons communicate, synaptic messengers release and retrieve chemical signals. Neurons form clusters of cells. The brain stem and the limbic areas operate out of complex but primitive values. These systems regulate body functions, mating, care of the young and defending the territory. The thalamocortical system evolved to receive signals from the interior sensory system and to give signals to voluntary muscles. The cerebral cortex is adapted to constructs maps which can be refined but which categorize perceptions with space and time. The feedback from the cortex can strengthen deeper structures in the brain and vice versa. However these deeper structures have habitual firing patterns, which take time to influence. Overall each individual has the constraints of a biological being and the freedom afforded by a unique neuronal wiring system that must be constantly reinforced by experience. Neurons are constantly changing. No matter how genetically similar people are, for example identical twins, no two brains are wired the same. Experience is a constant modifier of our genetic expression. Neurons, like individuals in a family, tend to communicate with those who are functionally similar. In both systems new communication occurs when the brain or the individual is challenged. When old patterns are no longer adaptive both humans and animals experiment to find new mental pictures that can offer some way to meet the challenges. Complex feedback loops in the brain enrich old ideas with new images. These images are created by neuronal connections, representing new pathways in the brain, notes Sir John Eccles. The building of neuronal connections creates memory stores in the hippocampus and in the cerebral cortex. The reinforcing of behaviors then builds memory, which is stored as neural maps. These maps can be reinforced and inhibited that gives the individual a sense of value. Family members adapt to changes, in any important part of the relationship system, just as change in one part of the brain influences the other areas. Both the family and the brain have feedback loops that will reinforce the ongoing possibilities for both stability and learning. Perhaps it is in the coordination between the individuals and the larger system that adaptation occurs. It would be in the given and take that the possibilities for freedom exist. One of the differences between neurons and humans is that humans project ideas and feelings onto others and even onto things. Humans do not like to admit that they are projecting their interior universe onto the outer world. It is difficult to imagine that the brain is capable of constructing the entire outside universe. A few billion neurons fire, perhaps randomly, and a vivid, seemingly real world is constructed. Dreams usually seem real to the dreamer. A similar construction of reality takes place through the coordination of the five senses. The test is the fit between our construction and the outside world that each of us encounters. We assume that there is an outside world, that the brain is not just sitting on a shelf, constructing a private universe. Science, aware of the subjective difficulty, asks that investigators claim personal responsibility for what is observed. There is a methodology designed to validate observations. Continued validation by the scientific community is necessary for a theoretical hypothesis to become an accepted fact. The first discovery made by a researcher often forces that individual to stand alone. Slowly new ideas are accepted. There is a similar emotional process in a family. Tensions rise when one individual begins to think or behave differently. Instead of being able to stand alone, an immature person will try to convince others about the right way to be. There is little ability to separate what "I" think from what "you" believe. Undue influence in science and in families creates distortions of reality and interpersonal stress. Conflict, stress and anxiety can interfere with learning. Fear conditioning is common in the human and in other species. There is an increased tendency toward tunnel vision with heightened sensitivity and reactivity, leading to physical and emotional symptoms. It is possible for individuals to learn to recognize and dampen reactivity. It is slow learning, as it takes time and discipline to learn new responses to old sensitivities and fears. Biofeedback is one way to enable individuals to decrease reactivity. Machines give feedback when the body responds toward achieving a selected goal. The feedback allows the individual to associate a state of mind with a result. Reinforced learning strengthens the mind/body memory. Neurofeedback rewards an individual for learning to relax by reinforcing particular brain wave patterns. Specific patterns are associated with health and mental flexibility. Stimulation of the brain through focused attention is thought to enhance blood flow and neuronal dendrite growth. Neurofeedback provides a method of learning to enter various mind/brain states to influence the body. A more organized brain wave pattern produces a calmer body. A calmer person can automatically influence perception and manage self in relationship systems. Learning to relax can alter responses to both physical sensations, pain, or to patterns of thinking. The brain's electrical activity has been studied for years. (Byers 1996) There are four main patterns, which have been described in the literature. There are four patterns: beta, (12-32 Hz.) Usually an eyes open, focused, alert state. Alpha, (8-12 Hz) is a more relaxed, eyes closed, state. Theta, (4-8 Hz.), is a deeper, dream like state characterized by slower brain wave activity. Lastly delta, (0.5-4) is the state associated with sleep and often with pathological slowing of the brain. Each state shows different dominant brain wave patterns or states of electrical activity in the brain. Each person's brain fires in unique but stable patterns, disturbed slightly by challenges. Challenges or learning can alter the brain wave patterns in the brain. This alteration produces different chemicals and a different state for the individual. Murray Bowen, M.D., wrote about two forces. One force, perhaps the weaker, to be an individual and stand alone when necessary, and the opposite force togetherness, the urge to go along with the group. Individuals are constrained by the constant feedback from important relationship systems. Usually this force is out of awareness. Two forces can also be described in the EEG patterns in the brain. One force can be seen as a habitual pattern that the brain returns to after any challenge. New patterns often arise as a result of willful events. It can be as simple as defining a new goal. New directions create marked changes in the firing patterns within the brain. This can lead to new levels of functional adaptation. It is often only during a challenge that the new brain wave patterns can be seen. (Deitz, 97). It has been known for years that there are indicators, like warm hands, or a slower pulse, which indicate control of physiology. These signals are communicated to the individual so that self-control is maintained over the direction of physiological change. The same process occurs in Neurofeedback. A series of audio or visual rewards reinforced the brain for positive performance. The results of EEG feedback have demonstrated measurable improvements in cognitive performance and in behavior (Byers, 1996). Specific goals can be achieved by increasing or decreasing specific amplitudes. Any assigned task simply creates accurate feedback to maximize performance. Tasks are associated with increases in EEG stimulation in specific areas of the brain. This is similar to physical exercise. As there is an increase in blood flow and eventual dendrite growth, the communication between different regions of the brain increases. Communication promotes rapid adjustments or even recognition of new information. Improved communication between functional areas of the brain arises from these new pathways, which then promote new behaviors. Research data notes changes in the brain's functioning as measured by changes in EEG frequency activity. The amount of glucose present, the rate of oxygen metabolism, and the specific areas where there is an increase in cerebral blood flow can be seen and tracked. It appears that learning takes place as a function of more flexible patterns existing within the brain. Breathing, physical and mental exercises can also result in tuning the brain for performance. Historically the idea to use Neurofeedback to promote learning came about in the early 1060's. Elmer Green and a dedicated team of researchers at the Menninger Clinic were among the first. They noted the dominant brain wave patterns of individuals who had become masters at meditation and at healing. They had very high levels of alpha/theta production. People then tried to become like the masters. This did not gain wide acceptance. The feedback was slow, and without the aid of computers there was little ability to learn from the slow feedback signal. The signal arrived too late to be useful. With the advent of the faster computer, electrical signals are delivered to the individual almost as soon as the waves' form. Due to the real-time nature of the feedback individuals are quickly guided into deeper states of relaxation or of concentration. In the 1970's Joel Lubar, Ph.D., began to document increases in cognitive and behavioral functioning for children who were unable to concentrate on tasks. These changes occurred following 40 to 60 feedback sessions. (Lubar, 1995; Tansey, 1993). This long-term training resulted in significant cognitive and behavioral gains. Eugene Peniston, Ph.D. (Peniston, E.G. & Kulkosky, P.J., 1989, March/April) reported significant long-term gains while treating alcoholics with EEG feedback. He saw patients who were hospitalized. They had sessions twice a day for one month. They learned to warm their hands and to create a realistic scene in which they said "no" to the continued use of alcohol. Initially Dr. Peniston reported that ten of twelve patients had remained symptom-free for three years. There was a general disbelief in the scientific and biofeedback community but time has allowed others to replicate the findings. One theoretical explanation has been based on a hypothesized link between deep states of relaxation, increased brain blood flow and memory formation which might allow for a significant behavioral change in an individual with a serious drinking problem. Long term research, effective with stroke and coma patients, done by Margaret Ayres, has shown that inhibiting spikes and slow brain wave activity can reduce serious symptoms. The brain seems to recalibrate after certain types of trauma, with just a little bit of information delivered through a digital EEG. There will be many years of research needed to verify and standardize procedures. Overall, there is substantial evidence that specific neurons are very responsive to stimulation and that increased inhibition or stimulation directly affects neuronal pathways. The question arises if Neurofeedback fine-tunes the more focused or relaxed mental states; can more changes be produced through the addition of mental suggestion? Sound stimulation can promote EEG changes without challenging physical laws. The auditory track passes directly into the RAS, reticular activating system, of the brain. The RAS is a nerve net, which coordinates sensory information and alerts the cortex. A sound stimulus can enable the brain to over ride other inputs such as pain or negative thoughts. Over time the mind and the body are less reactive. Yet this does not explain how a non-material suggestion, such as goal setting, effects a physical property, like the electrical firing of the brain? Are we programming our bodies and our minds with non-material thoughts? There is a great deal of evidence to say that mental preparation is an important factor in altering behavior. Yet the mind is a non-material thing. The energy associated with thoughts cannot be measured. It is subjective. Once one accepts that the mind and body influence one another then the relationship between these two domains' matters to us all. This is an important question since much time is spent in reflection. How has one managed the day? What will the plan for tomorrow be? If the brain reacts to thoughts, then negative information may be blocked out or distorted to fit with preconceived ideas. Can reactive messages from the body boss the brain? Many researchers take this possibility into account. For example, in the Peniston protocol, the client is asked to imagine, in minute detail, a scene whereby the client tells friends in a familiar setting that he is changing his drink of choice to root beer. Relaxing first and then imagining what one will do appears to alter the setting on the thalamus. The thalamus is the boss. It sends messages to the rest of the brain. All stimuli except smell are sent through the thalamus. There are numerous examples of self-hypnosis and sensitivity training that use mental suggestion as a profound tool for learning. Yet no one has proven that the mind can effect the brain. John Eccles is one person who has long been intrigued by the mechanism that may unite the split between the immaterial mind and the material brain/body. In his book, "How the Self Controls Its Brain," he formulates a hypothesis of the mind that does not break the conservation laws of physics. The thesis, briefly stated, appears to be that mental events are not identical with the brain's electrical events, but are associated with the activity of certain types of dendrites. Mental thoughts, reinforced by intentions and attention, could be linked to the mind/brain by way of the sensory system. Mental or actual experiences would be habitually and reciprocally link to certain types of dendrites, which he then calls dendrons. Tiny synaptic openings in the dendrites would occur as a result of the laws of quantum mechanics. As long as energy is exchanged in small enough quanta, no physical law is broken. Energy can be borrowed and replaced immediately. The mental processes have enough energy to produce a quantum, enough to stimulate a physical opening. The mind-set of an individual appears to lead the way for long-term behavioral change. The untrained mind cannot command the body to relax. Therefore, sensory feedback is often used to appeal to the brain. Sound quickly guides the brain/body. The brain responds while the mind is back in the past, chattering. A consistent amount of accurate feedback is needed to form stable new patterns within the brain. (Budzynski, 1996.) Once the EEG is altered and the body is relaxed, then the everyday chattering of the mind quiets and the mind then has room for new possibilities. The mind may consider possibilities, but the body, in a hyper-vigilant state, would not be flexible enough to tolerate change. Hyper-vigilant states are often out of awareness. A relaxed body and mind can lead to an increase in the ability to reflect, problem solve and change. Relaxation and EEG training have been associated with decreases in physical symptoms such as muscle tension, migraines or generalized pain. EEG feedbacks decrease the time needed to train more relaxed physiology. There are many possible goals one could have in mind when trying to alter EEG patterns. Each individual selects his or her goal. One goal might be to inhibit slow brain wave activity. The tasks associated, with this goal, often results in increasing the ability to concentrate and focus while keeping the body calm. The new experience serves as a marker for self-regulation. Just as one learns to ride a bike by allowing the body to self-correct, so too the feedback speaks more to the nonverbal brain than to the chattering mind. Over time, individuals become less preoccupied with the chattering mind and return to the experience of breathing and other physical clues, such as warm hands, that are associated with a more relaxed physiology. Over millions of years, what we call conscious experience evolved out of the brain's neocortex. It is this latest physical outgrowth in the evolution of the brain that accounts for and allows for sensory experience to guide behaviors. In recent experiments, Libet has shown that indeed conscious willing appears to occur about 200 ms before a movement actually takes place( Libet, 1990). The intention to carry out an activity appears to stimulate specific areas of the brain. In the future there will be expanded brain maps showing the specific areas of the brain that have more activity during different tasks. In the future it will be possible to inhibit or enhance neuronal functioning which is directly linked to performance. At this time there are only test model's of EEG equipment that can rule out muscle tension and give adequate feedback for learning during physical activity. Most of the learning now takes place in a lab, while looking at computer feedback or listening to feedback. All feedback is generated by the computer's response to mental activity. Measuring tasks, in a family or in a business, promotes self-awareness and often a positive sense of expectation. Each individual can be in charge of his or her research goals. In an organization the goals are often set as a cooperative decision between the individual and the supervisors, the board of directors or stockholders. If one decides to alter behavior for self then one needs no permission. Hopefully those who are willing to change self do so knowing that the relationship system will initially react negatively to any and all changes. One who is prepared for upheaval can manage self until a new functional level is achieved. Momentary allegiance to an outside authority produces only small blips of change that fade at the first sign of resistance. The primary difficulty that bosses, teachers and therapist encounters in trying to teach others are that others want to please and so no real effort for self goes into the change. The challenge is how to encourage individuals to think for self rather than do what the important other seems to demand or desire. Stimulation produces learning of some sort. Mental stimulation, (imagination, suggestions), physical stimulation, (sounds and visual colors or flashing lights), and of course significant relationship changes (family, friends, work), can result in the development of learning and new neuronal pathways. Learning take place when there are changes. These changes can occur in the brain chemistry or in the relationship system. In summary a new self-defined vision will produce new brain activity and therefore a new mind-body future. "Everyone may educate and regulate his imagination so as to come thereby into contact with spirits, and be taught by them. " Paracelsus, Philosophia sagax " The human is a mixture of feelings and objectivity. He has evolved a brain that enables him to know the differences between the two, if he is motivated to know the differences. The well differentiated person knows the difference, and each can be more fully appreciated when each is relatively free of the other. There is an advantage when the human can observe the automatic emotional process with his intellectual self." Murray Bowen (p. 368, Family Evaluation) References: Ayers, Margaret. (1987). Electroencephalic Neurofeedback and Closed Head Injury of 250 Individuals. National Head Injury Syllabus, Head Injury Frontiers, Page 380, 1987. Bowen, M. and Kerr, M. (1988). Family Evaluation. New York,: Norton Benson, H. (1975). The Relaxation Response. New York: Morrow. Budzynski, T.H. (1996). Brain Brightening: Can Neurofeedback Improve Cognitive Functioning? Biofeedback; Wheat Ridge, Colorado: Association for the Applied Psychophysiology and Biofeedback. Vol. 24, No. 2. Byers, A. (1996). The Byers Neurotherapy Reference Library. Wheat Ridge, Colorado: Association for the Applied Psychophysiology and Biofeedback. Eccles, J. C. (1994). How the Self Controls Its Brain, Springer, -Verlag, Berlin, Heidelberg. Edelman, Gerald, E. (1992). Bright Air, Brilliant Fire: On the Matter of the Mind. Basic Books. New York. Deitz, F. (1997) private communication. Green, E, & Green, A. ( 1977) Beyond Biofeedback. New York. Delta Libet, B. (1990) Cerebral processes that distinguish conscious experience from unconscious mental functions, Principles of Design and Operation of the Brain, edited by J.C. Eccles and O. D. Creutzfeld