The Use of Flexyx Treatment Modality

alchemy in actionThe Use of Flexyx Treatment Modality

with Patients with Multiple Brain and Spinal Cord Injuries

 

                                          

Presented at the Winter Brain Conference, Miami, February 2001 (v.3)

Stephen Larsen, Ph.D.

The following includes a position paper, historical and clinical notes pertaining to the use of Flexyx with TBI and spinal injury, our own replication of Ochs’ clinical findings, and some theoretical speculation on how and why this method is so effective with this category of injury. My hope is that this paper will help pave the way for a more complete experimental study of the subject using larger populations, randomized selection and double-blinds. I also hope that it will stimulate other clinicians to keep careful records of their work with traumatized and head injured people, as well as developing ever more subtle observation, diagnostic and therapeutic skills.

The Position: Multiple traumas can cause functional as well as structural damage to the nervous system, occasioning both specific and general deficits that accumulate, and often do not improve on their own. The symptoms include memory problems, cognitive confusion and cloudiness, restricted sensorium, mood instability, sleep disturbances, motor and coordination problems, and generalized and specific pain syndromes.

An EEG based stimulation program (Flexyx) can help to break up both acute and entrenched functional rigidity of the nervous system–and hence of the cluster of associated problems that accumulated with each trauma. The process restores flexibility to the nervous system, and hence revitalizes functioning. For clinical as well as research purposes problems and improvements are rated on a CNS questionnaire, a subjective rating scale. We also use detailed clinical interviews. Improvement usually takes place across a variety of symptom dimensions that can not always be predicted in advance; nonetheless, the cumulative improvement is unmistakable, and usually affects most dimensions of the client’s functioning. Work with developmentally disabled children (diagnosed as pervasively developmentally delayed, autistic, or cerebral palsy) has shown that as the children improve they accelerate through the predictable normal stages more rapidly, achieving missed developmental milestones.

The support for the position is drawn from our clinical experiences with closed head and spinal cord injury at our main office in New Paltz, NY, and satellite office in New York City, amounting to over fifty patients with known previous brain or spinal cord injury usually considered in the “mild” category, though still exerting pervasive negative effects on their functioning and quality of life. (Interestingly enough, some patients who originally told us they didn’t know of any injuries, recovered memories during treatment. They had been too injured to notice how injured they were. Many, who had initially mentioned only a few head injuries, as they “cleared up,” remembered more.) None of the patients was hospitalized or in a coma at or up to the time of treatment, nor were any quadri or hemiplegic, though some arrived in wheelchairs or on crutches, having lost a lot of their mobility due to the accidents.

While we recognize two types of trauma: “hard” (physical); and “soft” (psychological) both of which causally affect CNS functioning, most of our cases involve known multiple “hard” traumas involving concussion, or spinal injury or both; or combined “hard and soft” trauma, as in wartime PTSD, extreme domestic abuse involving physical and psychological components, and accidents in which friends or family are hurt or killed along with the patient’s being injured. The latter of course represent both physical and emotional injuries. All of the patients we surveyed had at least one or more “hard” and in some cases multiple “soft” traumas as in “anaclitic” deprivation in infants, or ongoing patterns of familial abuse: physical, sexual or emotional.

We begin by a summary of the history of FNS treatment particularly with brain and spinal cord injury, then move to our own experiences of helping people with multiple traumas. Several case histories are then presented in more depth, to show specific aspects of how the therapy works, limitations are overcome, and clients move forward in new ways. Permission has been obtained from clients to use their information and results.

A Background and History of FNS Treatment
with TBI, Closed Head and Spinal Cord Injury:

According to the Centers for Disease Control, 260,000 people a year are hospitalized with a traumatic brain injury, and the annual costs of combined forms of care is $37 billion in direct and indirect costs. Multiple injuries are not atypical, because after the first TBI the risk of a second injury is three times greater than for normals, and after a second injury a third is eight times greater.<1> Like it or not, our wounds (the Greek trauma means “wound”), particularly to these most vital parts of our anatomy, the brain and spinal cord, seem to multiply themselves. <2>

While the diagnostic power of modern medicine is unprecedented, with first x-rays, then MRI’s, CAT and PET scans, these reveal mainly the physical structure of the brain and nervous system. They are good for identifying lesions, and the locations of strokes aneurisms, and tumors. But neuroscience is now becoming aware that there are also functional disruptions after trauma, usually not visible in the screenings just mentioned. Here we need dynamic MRI’s, or QEEG’s, that measure the way that the brain performs or fails to perform. And here neuropsychological testing reveals the much more subtle cognitive sequellae of injury: the aphasias and dyslexias, agnosias, amusias and dyscalculias that result from certain types of injury, as well as other instabilities in cognitive functioning.

Neuroscience has in fact learned an enormous amount about the brain through systematic comparisons of brain damage to changes in personality (as in the famous case of Phineas Gage, whose behavior altered radically after a steel tamping rod was blown through his frontal lobes, or the observations of personality changes after frontal lobotomies.) But we are here making a case for a treatment that effects both gross, and excedingly fine levels of processing, involving all the subtleties of cognitive, affective, and even spiritual dimensions that make us truly human. Because of the immediacy of some people’s response to FNS treatment, as well as the equally well-established nervous-system stabilizing effects of Neurofeedback generally, we know that this treatment addresses the functional aspects of trauma. Because of its slower, but equally documented effect on longer term endogenous or familially-based problems, we believe structural changes also are facilitated, possibly through the restoration of function.)

Lastly, and most importantly, we have the injured person’s own subjective reports. But these are regarded with suspicion by the scientific community, for a number of reasons: 1) (most simply) This is “ideographic data,” a sample of one. 2) People are often unreliable in self-appraisals, especially where emotions are involved, and when people have been injured, they’re emotional. Psychiatry since the time of Freud has been aware of the role of reality-distorting psychological mechanisms in people. 3) In some cases people use imputed psychological or neurological damage to win legal settlements or to establish disability (and here there can be no doubt that a few malingerers have cast doubt on a much larger group of sincere sufferers.) Lastly, “subjectivism” is the very demon of untrustworthiness human hat science endeavors to exorcise by its rituals of observation and measurement.

Nonetheless there is remarkable agreement in the subjective sequellae of injury. In case after case of TBI and spinal injury we hear of acute chronic pain, muscle spasms, mood swings, explosive disorders. Sleep is often disturbed and the world seems removed or muffled. Then there are cognitive impairments that people know they have, but don’t know how to, or have lost the ability to, explain. They know things are “not right,” but feel helpless to improve them. (It is amazing how subtle some people can be in their self-appraisals, even in the midst of impairment, showing that proprioceptive, or self-discriminatory systems are intact.)

While the doctors quibble over diagnosis from a complex-seeming, but actually crude list of literal terms and descriptions, the sufferer lives in a chaotic world which just doesn’t “feel right.” While managed care, lawyers and courts stand in the role of arbiters of what is real or not, the individual in question lives in quiet desperation in the only world he or she knows–the subjective one, which now seems grotesquely distorted, and almost impossible to communicate about. (Despite the mantle of authority worn by these tribunals, here we must invoke civil rights; the rights of the psyche, of the soul, to its own ultimate “diagnosis” or sense of what is truly right or not in its own domain. Ultimately, no one else can know, and the closest approximation we can even imagine is the discerning but empathic human witness, the clinician or therapist.)

Naturally physicians look to their own tools to attempt to heal these problems: Medicines for the most part; or surgery, as in neurosurgery; or procedures like electroconvulsive therapies, that were annexed by medicine as part of its own armamentarium.<3> The legendary collusion of doctors and the pharmaceutical companies began, the latter promising to give the former the most powerful chemical tools science could develop, if the doctors would in turn give them a sanction like that bestowed by priests, for their medicines. The partnership has spawned a multi-billion dollar trade in pharmaceuticals that offer to address problems from physical pain to psychological angst. But the world has now witnessed the limitations of these medicines: side effects, waning efficacy over time–necessitating changes to other medications, and the endlessness and cost of the procedure. There are medications to control the side-effects of other medications, sometimes prescribed in “layers”.. The humanistic psychologist Abraham Maslow summed it up: If the only tool you have is a hammer, everything begins to look like a nail!”

Here we should observe that a fundamental dichotomy exists where disorders of the nervous system are involved. The CNS is “electrochemical” in functioning, by all agreement. That is to say, we can measure the activity of the brain in microvolts at the scalp. The neurons are like little wires, with their “action potentials,” sweeping down the long axon from cell body to end-fibers. But neurons are also chemical in function, bathed in nutrients, and with solutions of ionized sodium and potassium passing back and forth across permeable membranes. They are especially “chemical,” however, in the synapses, the spaces between the neurons. These are filled with organic compounds called “neurotransmitters,” that resemble and in some cases are indistinguishable from the hormones of the endocrine system, such as epinenphrine or adrenaline.

It is in these shadowed synapses that modern psychopharmacology plies its tawdry trade. Agonists, like characters in Greek drama, imitate the neurotransmitters, gaining admittance to receptor sites by wearing mimetic chemical masks. So “speed” in its variety of forms has an adrenaline or epinephrine-like effect on the nervous system. Or antagonists block the chemical gateway, causing tranquilizing effects for an overly self-stimulated nervous system. The more subtle, modern “designer drugs” such as Prozac (fluoxetine) keep serotonin, one of the body’s own neurotransmitters more active and available. (Hence they are called SSRI’s, serononin-re-uptake-inhibitors).

There can be no question that psychotropic medicines are powerful and effective in many cases. But the practice often dissolves into an odd witches brew, with medicines to compensate for the side effects of others. And one cannot always predict how a drug will act on this particular person, because no matter how many randomized large-population have been done, they show only what the drugs do in a generic sense, not how they act uniquely on different constitutions.

In a case that is probably not atypical, a boy of about eleven was seen at our center, who, after he was placed on an SSRI, developed an impulse-control disorder that had him skateboarding dangerously through traffic, engaging in shoplifting and baldfaced lying. As soon as he was taken off the SSRI, his wild behaviors subsided. In another case, a woman of about thirty five who had been sexually abused for many years by a relative, had terrible anxiety attacks, but could not get to the memories. When she went on Prozac, suddenly the “unconscious” mind seemed to empty out. The memories crowded to the fore in an eidetic review for her, and she relived the abuse almost completely in the space of about three months. Therapeutically, this was a very good event, but the literature on Prozac does not mention anything of the kind.

The drugs also are known for “wearing out their welcome,” which is that after a certain amount of time of use they are less effective, or require, “switching” prescriptions. The theory is that agonists and antagonists, which use the same chemical receptor sites as the body’s own neurotransmitters, modify or destroy the sites (because of structural differences on the molecular level), so they no longer respond so well to the body’s own neurohormones, as happens with amphetamine users and adrenalin, and opiate users and beta-endorphins. Even the SSRI’s which use the body’s own neurotransmitter, serotonin, seem to eventually lead to fatigue after a while of use. Here the theory would say that the serotonin became “worn-out” by not being “uptaken” or recharged, as would happen in the natural course of things (advocates of the more natural approach to depression management claim that Hypericum (St. John’s Wort) and SAM-e do not “wear out their welcome in the same way.)

The alternatives to the medical approach are the still neglected “functional” or energy approaches to dealing with trauma. These, broadly could include psychotherapy–in all its myriad inflections–which aims to help the problem by talking, emoting, or gaining insight; or physical, cognitive, or occupational therapies that aim at restoring function, to energy therapies such as acupuncture, Qi Gong, bioenergetics, Reiki or Applied Kinesiology, all of which have been shown to help in the aftermath of trauma. Our special interest in this paper, however, is the field called “Biofeedback,” and particularly that branch of it called “Neurofeedback” or “Neurotherapy.”<4>
Traditional biofeedback uses a volitional or operant-like process in which the subject is asked to “do something,”<5> that is, to produce a specific outcome without knowing quite “how” it was done. Nonetheless, a change in a graph, videogame or tone, or a vibration against the skin, acts as a reinforcement, and a new behavior is learned. People using biofeedback could learn to relax tense muscles, lower their blood pressure, overcome urinary incontinence, avert headaches by deep muscular relaxation or even control autonomically mediated problems like spastic colon or migraine (vascular) headaches by “warming” their hands. During the nineteen sixties and seventies people explored what would happen if instead of muscle tension or hand temperature, the feedback was of one’s brainwaves.
The very existence of brainwaves was only discovered in 1924 by Hans Berger. He called the first Rhythm that he was able to record with his primitve “string galvanometer,” “Alpha” after the Greek Letter (8-12Hz). It was that range now so familiar to EEG specialists that dominates many people’s mental activity, particularly when they are cognitively “idling”. The next range to be discovered he called “Beta” (12Hz and greater in those days.) Later Delta 0-4 Hz, associated with trauma, deep sleep, or coma, and Theta (4-8Hz) usually signalling profound reverie, emotional recall, or hypnotic trance, were identified.<6>

In the beginning, EEG was just used by doctors for the most basic kinds of diagnostic work–as a convenient way to establish clinical or brain death (the waves stopped), or epilepsy (the waves went tidal.) Berger died in 1941, disappointed that the medical world had been so slow to make use of his astonishing discovery.<7>

Even during World War II, W. Grey Walter was exploring devices for measuring brainwaves in all the frequency ranges (1943).<8> And Gibbs and Knott were studying the growth and development of EEG through the life cycle (1949).<9>

By the 1970’s Barbara Brown had begun the tortuous but necessary process of showing that–mirable dictu–brainwave ranges corresponded to subjective states. <10> (Most conventional neuroscientists originally doubted that there could be any cconnection.) Joe Kamiya’s work in the 1960’s had already hinted that subjects could identify brainwave states, and thus, perhaps, learn to prolong them, altering the way their nervous systems functioned. Basmajian’s remarkable premonitory work with muscle cells showed that people could learn to control units as small as a neuron–without knowing how they did it.. Kasematsu and Harai showed EEG differences in beginning versus experienced Zen Buddhist meditators, and differences in “habituation,” (ignoring a repeated stimulus) between Zen and Yoga meditators. The clinical implications were immediately explored and found useful. The early “Alpha” enthusiasm began when it was found that an abundance of this particular rhythm (usually thought of as 8-12Hz) produced in certain areas of the brain, was equated with a state of well-being.

Then there was Elmer and Alyce Green’s intriguing work on Theta and altered states–the lower frequency waves often precipitated religious or creative experiences. Barry Sterman’s pioneering studies showed how training up the “sensory-motor rhythm,” (12-15Hz, occurring on the “sensory-motor” strip, centrally located on the cerebral cortex, could actually be used to evert epileptic seizures. The study began with cats, and then showed clinical efficacy with humans. A brilliant graduate student, Joel Lubar, took the process a step further by adapting SMR to help children with ADD (Attention Deficit Disorder, and ADHD, with hyperactivity component.)

It is also important to note Peniston and Kulkowsky’s groundbreaking work using the Alpha-Theta protocol for PTSD and its associated drug and alcohol syndromes, particularly in Vets, along with Matthew Kelly’s comparable work with alcoholic Native Americans. Margaret Ayers showed high rates of improvements with brain-injured people. Siegfried and Susan Othmer, during the late eighties and ninetees were pioneering development of Beta protocols for learning disabilities and behavior disorders. The field was exploding with possibilities, rich in clinical findings and short on formal research.

Dr. Len Ochs, a Ph.D. psychologist, was trained in traditional biofeedback and neurofeedback or neurotherapy (which utilizes signals directly from the brain or nervous system), and, during the seventies and eighties, worked with many early researchers and clinicians. Like many of his peers, he was looking for ways to improve on psychotherapy, especially for those patients who had a history of trauma, endogenous depression or bi-polarity or high anxiety, such as that manifested in panic attacks, phobias, obsessive-compulsive disorders, and dissociative identity disorders.

We know that psychotherapy can help with these situations but often falls short of affecting the more physiologically mediated ones, including bi and uni polar affective disorders, schizophrenia, alcoholism. Biofeedback was already showing promise in these areas.Ochs encountered the quandary experienced by many beginning in the field: Should he specialize in the approaches that reward the lower frequencies (theta or alpha/theta, 4-8Hz), and thus induce deep states of reverie as in the Green’s work, or recall of traumatic memories (as in Peniston’s work with Vietnam vets) or head for the “high-ground,” SMR (12-15) or beta (15-18), which are used, respectively to calm and balance, and to stimulate intellectual activity for “underarousal problems” like depression or ADD–as in the Lubar or Othmer protocols. Both seem effective in their own ways. Both have their adherents. Both have their “ideal” training ranges, such as Michael Tansey’s legendary 14Hz, which seems to facilitate recall of traumatic memories without the “abreaction” or catharsis that sometimes happens with the lower frequency (theta) types of recall.

Ochs credits the work of Marion Diamond, W. Grey Walter, and Harold L Russell for influencing him along the path of developing EEG-driven stimulation in the early 90’s. He claims that he himself began with a prejudice against the light and sound technology that existed, which were basically EEG entrainment devices, and hence “drive” the brainwaves to frequencies they would not have gone to in the natural course of things. (There seems to be an attraction or pull, followed by “mode-locking” to the stimulation frequency. The brain has been coerced, through a process closer to physics than psychology.)

Nonetheless, there had been some interesting reports that ramping up and down through different frequencies stimulated the brain, a kind of workout; an idea with applications for the elderly, as well as for inattentive learners, who could be given daily “workouts” on machines that would take them up and down through the ranges, and thus increase the strength and flexibility of the brain.

Russell and Carter’s studies had showed improvements in performance, IQ and behavior with children who received photic stimulation. In addition there were a few real “miracle stories” from experimentation with these light and sound EEG-driving devices. People with serious problems that had been there for a long time, suddenly experienced relief, or even cure.

In 1992 Ochs put together a J&J I-330 EEG and a Light-Sound device from Synetic Systems, and wrote the software to connect the two systems. The first EEG Entrainment Feedback (EEF) was born, using light-emitting diodes (LED’s) inside a pair of sunglasses, and sound through earphones. Ochs soon realized that the light was far more effective than the sound, the visual pathways being three times as extensive in the brain, and so the visual stimulation would reach more areas of cortex. And so he dropped the sound component; using only the dark glasses with built-in LED’s, that became his early trademark.

“I found it much more visually beautiful than the traditional sound and light stimulation,” Ochs wrote in Megabrain Report in 1994<11>, “It seemed more alive and responsive to my brain waves than was the fixed-frequency or pre-programmed slowly ramping stimulation I had tried.” (At that time many people were using the light and sound machines with their “ramped progressions” up and down the brainwave frequencies for aesthetic appreciation and “altered states,” as well as for therapeutic stimulation.)

But there was more to it than that. Working with early TBI and PTSD patients, Ochs noticed that they were very sensitive to the “live” treatment, where the light followed their own brainwaves, and that the flashing lights made them uncomfortable right then and there, as he applied the stimulation. It was as if, highly irritable or sensitive individuals were being given a dose of themselves–their own brainwaves in a slightly different form–and it was intolerable! The red lights that were initially used (because they were available) seemed irritating to the sensitive clients. New glasses were requested by Ochs, to be built with gentler green lights. Also he was asking for the intensity and bandwidth of the lights to be able to be turned up or down.

Ochs was to find the aid to psychotherapy he had been looking for. The EEF brought up symptoms, intensifying them, including memories related to trauma. Early in the process of development, he noted of one Vietnam Vet he worked with, “Over a span of two weeks of daily EEG-driven LS (stimulation) sessions, tears would show over the man’s cheeks; he felt thermal hallucinations (“It’s hot as Nam–whoops its gone–‘) He experienced auditory hallucinations (‘I hear the choppers.’)”<12> After the course of treatment, twenty years of rages (explosive personality disorder) had abated, and the patient had a higher frustration tolerance. His marriage and family life improved. Ochs noted that this man had already received 40 conventional EEG biofeedback treatments without much improvement, before the two week intensive of EEF which brought about the far more dramatic relief.

Ochs developed an early “desensitization” protocol similar to the ones used in behavior therapy for the treatment of phobias. Increase the intensity of the lights and the duration of the session until the person could not tolerate them more; then back off, then stimulate still more, until the patients’ sensitivity seemed less acute. Those he could “desensitize” seemed to improve. But, he noted that if he wished the patients to continue improving after they were desensitized, he then had to lower the light stimulation markedly.

During this period, two dominant insights were to emerge that would characterize Ochs’ thinking throughout. The first was that of varying the feedback frequency in exact response to the brainwaves by introducing offsets, and the second, the clinical criterion of the “comfort” of the patient.

“If the patient looked uncomfortable or sounded uncomfortable, I reversed the polarity of the leading frequency, ie. alternating between slightly faster and slightly slower than the dominant brain wave frequency.”

With one woman with major depression and severe anxiety problems, as well as pain, he noted that if he used an offset that was lower than the dominant brainwave frequency the woman complained of increased discomfort in one of her symptom areas. When he used a positive offset, her discomfort abated. “Non-verbal signs of over-stimulation” he noted in his 1994 paper, included “tightening of the chest, restriction of chest motility, lifting or rounding of the shoulders, flexion of the neck, or tightening of the jaw. There were verbal expressions as well, ranging from ‘too bright’ to ‘too much flicker’ to ‘too much red,’ to cries and grunts of discomfort.”

A colleague, psychophysiologist Jon Cowan, suggested to Ochs that he was really doing something like “disentrainment” rather than “entrainment”. The flashing light or light and sound devices “entrain” because the brain tends to follow any rhythmically pulsing stimulus–the reason epileptics should avoid discos with flashing lights. Now where the entrainment is generated by the brainwaves themselves (at 0 offset), the process might actually amplify brainwaves, creating an instability condition, and maybe even seizures. Using an offset however, decreased the amplitudes. Because the brainwaves tried to follow something that was close to, but actually different from itself. Ochs reasoned that whereas the entrainment process could be dangerous for people with seizure disorders, the disentrainment model might break up incipient seizure activity, as well as areas locked up in the wrong kind of synchrony or “coherence.”

It was around this time that Ochs read James Gleick, Chaos: The Making of a New Science, which had a major effect on him. Gleick pointed out that entrainment or mode-locking bodes to decrease freedom and bind the system. In neurotherapy terms it would amplify the patient’s pathology, whereas disentrainment would break down the locked up or stuck patterns, opening functioning to new alternatives. “A locking in to a single mode can be enslavement, preventing a system from adapting to change…”

Ochs began to experiment primarily with “offset” protocols, later even eliminating the “0” setting from the equipment, because of the danger of “entrainment” adversely affecting epileptics, or even people with tics or subclinical seizure-like disorders). Offsets could be varied anywhere from minus 1-5 Hz (large negative offesets are not used, because to disentrain 4Hz delta at -4 offset gives you 0.) On the positive side, however, the offsets go to plus 20. (If the person’s dominant brainwave frequency were pulsing at 10Hz and we had a plus 1 offset, the signal would come back at 11Hz, if plus five at 15Hz, plus twenty at 30Hz, and so on.) Ochs noticed that whether plus or minus offsets were used the procedure tended to lower the existing amplitude, because the brain would try to follow the new offset, and jump out of its existing pattern. (We assume that the existing pattern is less than desireable, since the person is suffering from symptoms of CNS dysregulation).The protocol seemed, in fact, to be the method “par-excellence” for “bumping people out of their parking places,” and breaking up dysfunction quickly. The name was changed to EDF (EEG Disentrainment Feedback). A new machine, called the I-400, was built by J&J to work with the new “pentium” computers. It featured a pair of the traditional red glasses for the more robust, and a pair of green glasses for the more sensitive patients.

It was while working with patients referred by Neuropsychiatrist Herbert Gross of Los Angeles, a specialist in head injuries, that Ochs noticed he had to lower and lower the intensity of the light he used, and that “no intensity allowed for the comfort of these highly sensitive patients.” (Those with the most head-injuries). He had seen the grosser manifestations of sensitive patient’s responses right at the moment of treatment, with grunts, cries or body language. Now Ochs began to question more probingly, and observe the consequences of treatment over the 24 hours following the treatment–and then over the course of the week until the next one. The two most obvious signs were that the patients were “tired” or exhausted, sleepy on the one hand, or “wired” on the other–hyperactive children became more “hyper.” Along with either condition could come a definite “irritability”. Small things seem overwhelming; noises and lights cause adverse reactions. It was noticed that patients experiencing “overdose” never seemed to develop new problems, just a re-presentation, and maybe momentary intensification of old symptoms.

A third sign of “overdose” later brought forward was that the symptoms under treatment showed no therapeutically positive movement. The stimulation was “locking-up” the recovery process instead of facilitating it. Ochs began to find lower and lower doses that were less taxing for the patient, but still effective. At first he tried different offsets, such as +5 +10 +15 or even +20, and found that certain ones seemed to work better for certain patients. In general it was thought that the larger, hence “further away” offsets were less stimulating, but there was no uniform rule or principle.

In response to a suggestion by an early EDF practitioner, Dieter Dauber of California, Ochs began placing opaque barriers such as manila-folder cardboard or folded plastic or electrical tape between the LED’s and the eyes. Soon he was using six layers of plastic, then fifteen, then thirty layers of plastic for the most sensitive patients. Naturally these maneuvers would drastically reduce stimulation; but the question came up as to whether there was any stimulation at all. Still, to Ochs’ astonishment, and that of the early practitioners who were using his protocols, the treatments still seemed to produce a substantial therapeutic effect. The watchword of EDF practitioners became “Less is more”. In all these maneuvers, the goal was the clinical comfort of the patient. They should be free of discomfort during the session, and hopefully during the 24 hours following the treatment. If the treatment stayed within these bounds the positive effects tended to accumulate.

The most reliable and methodical way he found to diminish “dose” was to shorten the time of stimulation. Soon treatment lengths were reduced from minutes to mere seconds of treatment per site. Each client was evaluated as the treatment progressed, using CNS questionnaires and clinical interviews and observations of behavior. Ochs continued to find great individual variability between patients, making diagnostic acumen crucial for the treatment process–the setting of the protocol and of the levels of feedback stimulation.

Ochs confirmed with dozens of cases that, where the treatment did not overtax the patients’ resources, they showed not only the greatest rate of improvement, but the results lasted. He developed a computer scoring method, using Word and Excel spreadsheets, that measured each site for activity and reactivity, using amplitude and standard deviation respectively for these measures. He created graphs and maps of the cortex using 19 sites of the International 10-20 system, with two extra (FPZ and OZ), thus creating cortical mapping procedures analagous to a QEEG, but measured one site at a time sequentially; and usually with a little stimulation added to the mapping, to see how the brain responded. Once the map was completed, treatment now moved along a “site sort,” going from those sites with least amplitudes and standard deviations, a few sites at a time, to those with the highest amplitudes and sudden rises and falls of energy in a graded sequence; averaging as few as one or two up to about six sites per treatment, depending on the sensitivity of the client.

Eventually Ochs was to find that sites that had originally looked like “bad boys” on the original map (high amplitude and spiky standard deviations) looked milder and tamer by the time he reached them, after painstakingly proceding through the site sort. Somewhere in the development process the treatment acronym shifted from EDF to EDS (EEG driven stimulation, and then finally to its current name: FNS (Flexyx Neurotherapy System.)

Traditional EEG biofeedback had already proven itself helpful with head injuries, (Ayers, Othmer et al.) but from the beginning, EEG driven stimulation (referred to hereinafter as FNS) seemed to produce effects that were immediate and unmistakable. Without lengthy training protocols, people were recovering all kinds of functioning which had been lost in the aftermath of injury, and really getting better. Mood, energy, flexibility (the watchword of Flexyx), cognitive clarity all were seen to improve. One of the most surprising improvements is “ability to learn from experience,” one of the queries used on the CNS Questionnaire. Sometimes people get caught in “redoubling their effort when they’ve forgotten their aim.” The treatment seemed to help people become more pragmatic as well as flexible.

Ochs’ protocol came to differ from almost all other biofeedback treatments because it included mandatory visits to all 21 sites on the map, and then around the site sort again, maybe two or three times, using these tiny stimulations with lights, or Radio Frequency impulses, until the amplitudes, and the whole cortical complexion, changed enough to warrant a new map. In this regard, Ochs came to believe that FNS offers a far more thorough stimulation of the cerebral cortex than traditional biofeedback, which only relies upon a couple of, as he says, “canonically approved” sites (C3, C4 and 01 and 02). This has begun gradually to change, as conventional biofeedback clinicians find training at other sites to be equally effective, or more effective for certain kinds of problems; a problem discussed at a recent Futurehealth conference (2001.)

Ochs kept upgrading his equipment, and in 1998 introduced the C2, built by J&J, with a far more effective and precise registry of brain waves, and two-channel capability, so that more areas of the brain could be accessed in a single treatment, and interaction between specific areas of the brain be monitored. He introduced new glasses whose emissions were in micro-lumens, barely registerable by the eye, and which included a switch, so there could be a mode of treatment without light, for the ultrasensitives. But because of the precision of the C2, the effects still seemed more powerful than the I-400, the old system. Ater a second generation of glasses, with the lowest possible lights (The technicians at the manufacturing plant accusing Ochs of being crazy, for wanting to have the stimulation so low it couldn’t possibly have any effect, he noticed that some sensitive people were getting overdosed, based on the criteria mentioned above (tired, wired or no progress). The glasses were moved out inches or even feet from the face, and still there seemed to be some effect for the sensitives.

Finally Flexyx would bring the equipment to the Lawrence Livermore National Laboratory for a series of tests as to what stimulus was really reaching the patient. With the I-400, there were no measurable emissions other than the light of the glasses. But with the C-2, it was discovered that there were radio-frequency emissions–emerging from the EEG processor, and also the wires and leads to the head and in and out of the computer, acting as antennae. These emissions had not been controlled for in building the equipment, because they were deemed to be far too small to have any effect whatsoever. (It has been controversial whether emissions in this portion of the electromagnetic spectrum have any effect on humans at all, even though we know that they are passing through our bodies, for many hours of each day, from TV and radio stations, CB’s, etc .) In the case of the C-2, the emissions were thousands of times weaker than those of cell-phones or walkie-talkies, for example; residing in the “nanowatt” range. Nonetheless, the clinical reports indicated that something significant and beneficial was indeed happening to patients’ nervous systems.

Lest at this point the reader think that we surely are talking “placebo,” or even something as far fetched as ESP “entrainment” effects–of the belief system of the therapist on the patient–or even unconscious misperception or manipulation of the data by myself or other clinicians, let us recount an event happened, that affected both the Flexyx office and a number of the treatment facilities.

From time to time Ochs would develop new versions or “upgrades” of his software programming for running the computers and conducting clinical sessions, sending out updates with new capabilities. On one of these a programmer had inadvertently made a mistake, and instead of the EEG following the patient’s brainwaves at the prearranged offset, it stimulated them only at 4Hz, a fixed frequency between the Delta and Theta ranges. ( An unwitting double-blind study had begun, with neither the subjects nor the experimenter knowing what was going on.)

Within days, reports were coming in to Ochs that were very different than the varied, but usually positive ones he was used to getting. People were regressing, complaining of headaches, depression, pain returning, sleep disturbances and many other things, all negative. Our office was one of the afflicted ones, and patient after patient was giving us negative reports that went directly against the grain of what we had been receiving and thus expecting. Finally, while one patient was hooked up, I pulled the black tape off the LED’s and observed the ominous 4Hz flashing, not the varied, pulsing dance of an alive signal we had been used to. It was a scary moment.

Flexyx was called, and we learned how many people had been experiencing the same thing. The source of the error was discovered. In short order, a new installation was prepared by the Flexyx home office, we apologized to some of our patients with considerable chagrin; and went on with the usual course of treatment. Once again the patients reported a steady rate of improvement, and we were back on track.

Another factor makes it doubtful that placebo effects could explain all of our results: that changes are relatively long-lasting (unlike placebo). And the improvement sometimes follows a unique and idiosyncratic course of recovery that the patient him or herself wouldn’t have predicted. (The steady progress of the spectrum of improvement is only elicited by the clinician’s thoughtful questioning and unbiased recording of “worse” along with “better”.)

Once the effectiveness and penetrating power of the radio frequency emissions were learned about, standard RFI filtering devices were added to all leads coming into and out of the EEG. This seemed again to make a few seconds of treatment tolerable even to the ultra-sensitive. Glasses with LED’s were generally not used any more except for the extremely robust patient, and still with RFI filters on the leads to the glasses. It is hardly necessary to note that now especially, in this most recent development of FNS, the subject has no conscious registry of the feedback; it does its work “sub-consciously,” or subliminally. (Some might wonder if that does not diminish its effectiveness, but the reverse seems actually to be true. The biofeedback delivered subliminally seems to do its work on those preverbal, affective and arousal dimensions that we are never normally aware of, but nonetheless represent adjustments and accomodations of the organism to information that is made available to it, and may also represent subcortical learning.)

It is also important to note that traditional biofeedback has suffered from lack of double-blind studies, in some measure because human subjects quickly figure out if they actually have no control over a feedback signal. (When they notice they have no control, paradoxically, they realize they are in the “control” group!) The undetectibility of the FNS treatment, along with its effectiveness, makes it eminently suitable for both single and double-blind studies. The only way people would know whether they had or had not received treatment would be in how they felt in the few days and the week following treatment.<13> (Clinicians may do their own informal study as the client sits quietly, but self-observantly with eyes closed (the only instructions). In your programming screen put in one second of stimulation out of sixty seconds of non-stimulation. Vary the location of the 1 sec stim so the client has no idea when it’s coming. As the program runs, watch the client out of one corner of your eye, and the screen with the other–with raw EEG and/or bandpass analysis. You will often see minute body language or even audible responses in many clients, and at the same time an immediate dip or spike in response to the one second of stim–and which is not present in all those other moments of non-stim. Furthermore the effect of the stim can be tracked over the whole sixty seconds or portion of that time after the stim. (There can be no placebo effect where the subject has no knowledge of the moment–or even the nature of–the stimulus.)

Ochs is notable as an innovator in many respects, but especially in his astuteness as a clinician–tracking the modulation of many symptoms resulting from his therapeutic procedures, but always with an eye to the overall health and functionality of the patient. He was able to identify a constellation of symptoms, that when present in one form or another, point to a pervasive underlying CNS dysregulation. His theory seems broadly in agreement with the Othmer hypothesis that only three basic diagnoses exist beneath the panoply of individual symptom pictures. These would be: 1} Underarousal, as in fatigue and depression; 2} Overarousal as in anxiety and panic and 3} Instability, as in the bipolar constitution, or extreme emotional lability. Ochs CNS Questionnaire focuses on:

1. Mood disturbance/ emotional lability/ depression or anxiety, irritability
2. Energy depletion, also sometimes described as chronic fatigue or fibromyalgia
3. Chronic Pain, localized or generalized
4. Sleep Disturbance–from sleep onset to nocturnal awakenings to daytime sleepiness
5. Cloudy Sensorium–the world seems inaccessible or far away, unresponsive to cues
6. Memory Problems, forgetfulness, short and long term disturbance
7. Cognitive Problems–clarity, focus, planning, sequencing, organizing
8. Problems Initiating Behavior–and pursuing to completion

The Flexyx approach identifies all of the above dimensions not only as symptoms of an underlying CNS dysregulation, but as potential measures which will indicate the degree of the healing process. As mentioned above, Ochs observed that if there were an exacerbation of symptoms during treatment, it would be along the lines of familiar symptomatology. Whatever was constellated was something recognizeable to the patient from his/her history. No new symptoms appeared as a result of the procedure. The neurotherapy seemed to evoke, and then resolve, knots or impasses in the nervous system–and thus in the psyche. If there were an aggravation (along the lines of what happens in homeopathy, where the patient gets “a
little worse” before getting better) within twenty-four hours the clients usually reported the opposite–an upswing of energy, relief from pain, etc.<14>

Nonetheless Ochs held to his criterion: The neurotherapist should try to cause the least discomfort possible at every stage of the treatment process. It was this strict clinical discipline that caused Ochs to develop his special protocols for the head injured.

“The medical establishment,” he writes, and to a certain extent the psychological establishment, have taken a “bully-exercise, gain-through pain” approach to rehabilitation, which I, too, almost began to apply to FNS work, until I saw that the opposite was the only approach that worked. It has turned out the more sensitivity is favored, and the treatment made as gentle as possible in ways I couldnt even begin to imagine, the neuronal strength of the patients has been supported, and recovery follows far more often than not.”<15>

Five Years of Treating TBI and Spinal Injury at Stone Mountain Center

In 1996 I retired as a psychology professor in the SUNY System. For more than 25 years I had taught a “psychology of consciousness” program and run a biofeedback lab for students, where they were able to have “hands-on” experience of EMG (muscle), GSR (skin conductivity) and temp training (for vascular relaxation) and EEG (states of consciousness. The students kept records of their protocols and results, and a “psychological journal” as well. They recorded lowering their blood pressure, overcoming anxiety attacks, improving dream recall and becoming more sensitive to themselves (proprioception.) It was immensely rewarding work, but in my mid-fifties I decided I wanted to spend more time at home, and in clinical practice and writing.

I set up a full-service biofeedback center with therapeutic capabilities in all of the above areas. Soon we began to offer primarily Neurofeedback services. I began taking intensive trainings with American Biotech and the Othmers, and going to neurofeedback conferences. That year I also met Dr. Len Ochs, and was immediately struck by his approach. (It resembled the thinking of Edward C. Whitmont, M.D., an outstanding high-potency homeopath and Jungian Analyst with whom I trained for many years.) Ochs also gave some inspirational demonstrations–working with some very severe little autistic children. This began an intensive period of training in the Flexyx method, and later that same year, our center was licensed to become Flexyx providers.

Since then we have been able to replicate most of Ochs’ clinical findings at our Center in New Paltz, New York (and satellite office in New York City). We have worked with children with autism, Asperger’s syndrome, and some–as young as 18 months–with cerebral palsy. In addition, we see lots of older children with ADD/ADHD and conduct and antisocial disorders. Our clientele also includes a spectrum of adult clients, from Vietnam vets, to Workmen’s Comp cases, from industrial accidents, to dysfunctional family issues, including physical, sexual and emotional abuse, to ambulatory schizophrenics, to middle class people with anxiety and substance-abuse problems. We offer psychotherapy and counseling as well as biofeedback, and have a skilled MD medical director who is an accomplished psychopharmacologist. Recently he has increasingly specialized in herbal, natural and nutritional approaches.

In a one hour intake interview, I meet with the prospective client and go over extensive paperwork they have already filled out on their personal backgrounds, including detailed medical and psychological questions. They take the CNS questionnaire, as a way of helping to evaluate their appropriateness for FNS treatment. An informative conversation is conducted about the benefits and limitations of neurotherapy, and they are invited to question us as completely as we question them about how we work and what to expect.

If they decide to go ahead with treatment, they are given literature informing them about the process, and an FNS consent form to read and sign. (Clients are advised, but never coerced, to consider having psychotherapy at the same time as the FNS treatment, for what may “come up” during treatment. If they are already in therapy, we ask them to convey our regards to their therapist, and an offer to work interactively in any way that might be productive for the client. FNS seems to accelerate movement in therapy, including stimulating dreaming and dream recall.)

Five areas of functioning are selected in which the client wishes to have improvement. If time permits, an “Intro,” “Duration” or “Offset” protocol might be run, which all involve observation of how well the brain responds to four single-second bursts of stimulation at one site; usually FP (in the center of the forehead). Each burst is separated by a minute of observation and recording of the EEG. In the next session a cortical map will be made of the 21 sites. (In the intermediate model, each site was observed and recorded for four seconds, along with one second of stim. For the most sensitive clients we would have to break the map into several sessions because the overall procedure (21 sec) of stim would be far too much for them. Now there is a no-stim map available, so that most clients can be mapped in one session.)

When the initial diagnostics have been run, we will set the protocol for this particular patient. This includes setting the number of seconds of stimulation (developed from the Duration procedure), the “ideal” offset to lower the amplitudes of the brainwaves (developed from the Offset procedure). The cortical map tells us about what sequence to follow, and where potentially tender areas of the cortex might be (those come at the end, and are often “soothed” by the process of getting there. (Subsequent visits to the same site often show a quieter and less reactive–the standard deviation measure–picture).

In the beginning of the treatment there is often a “honeymoon” phase in which the client may feel miraculously better. In some cases this is actually permanent, justifying the “expect miracles!” slogan some neurotherapists have in their offices. Like a well-chosen high potency homeopathic remedy, FNS can work magic. In these cases we could say the vital and self-healing forces were all available in the person. Their main problem was functional rather than structural, only their functioning was a little out of tune. Our treatment tweaked the system back into its own innate pattern. But more usually, there is a blissful period, then a gradual sliding back in symptoms over the week or two till the next treatment. As treatments accumulate, the effect seems to last longer, and the treatments may be spread farther apart. The ultimate goal is for the client to be restored enough, finally, to need no more treatment.

As clients heal, their fatigue abates, they sleep better, mood swings stabilize, pain diminishes, cognition and clarity improve. The underaroused pick up the pace, and the overaroused slow down. The instability patterns stabilize, although not always immediately.

Patients who had a healthy and vital lifestyle prior to their injuries not only recover more easily, Ochs says, but are strongly motivated to get well, will act assertively to get to their appointments, and participate in the healing process. Those with chronic problems, or problems overlayed on each other, or replicating family problems one or more generations back yield much more slowly and must be “chipped away at”. Our findings here are firmly in agreement on Ochs’ general approach to prognosis. (The longer you’ve had the problem, and if your parents and family members have it or something like it, the longer the treatment is going to be.)

The truly astonishing thing is that people who have been “given up on” by traditional medical science, or have endured years of oppressive medical regimens, multiple medications, electroconvulsive (“shock”) treatments even, can indeed be helped. Though there is not the volitional effort of other biofeedback methods, there is still a sense of “having done it oneself” or at least actively participated in the curing process. (The therapist can help in this process. The advantages and disadvantages of the neurotherapist and the psychotherapist being being the same person has been addressed recently by Sebern Fisher.<16>)

Psychotherapy and Neurotherapy:

Early in my private practice as a psychotherapist, during the mid 1970’s, I began to work with a woman with a high school education who was a deparment store clerk. Violet had agoraphobia, terrible anxiety and continuous sleep disturbance, as well as stomach problems, but she remained adamant about not wanting medication, which had once made her terribly sick. All through her youth, her mother had filled her with anxiety-producing stories about abductions and men taking sexual advantage of women. She had never left Ulster county in her thirty-five years of life. After an unsuccesful marriage that lasted only six months she went to work for the department store, and lived at home with two elderly parents (one of whom was the neurotic mother). Over four years of psychotherapy I had helped her feel validated and supported, and gain insight into her situation. But the psychotherapy did not do much to alleviate the terrible anxiety that plagued this patient, making her seem rigid and shaky, always on the edge of panic, frightened at her own shadow These things seemed just to have been taken into her nature with her mother’s milk (and in fact it did not seem unreasonable to assume that the mother had been tense and anxious while Violet was still in the womb.) Some insights helped her in her relations with co-workers, and her ability to set boundaries with the very needy parents, but still the biting anxiety persisted. Bioenergetic exercises proved mildly effective, but it was not until I did EMG biofeedback, coupled with autogenic training for relaxation, that she began to sleep better, and could function a little less rigidly.

But still the pervasive anxiety dogged her. Then I hooked her up to an Autogenics EEG I brought over from my college office, where it was used to expose students to brainwave training. I tried a simple alpha protocol, because her main occipital production was in HiBeta (22-28 Hz). Within only a few sessions her anxious hypervigilance began to wane, as she learned to produce more alpha.

Her family and parents were actually a little bit scared at the transformation that began in Violet. She became more outspoken and assertive (less “wallflower”-like). At the annual family Thanksgiving football game she not only participated, which she had never done, she executed a decisive tackle on her brother-in-law, a robust man who was sufficiently astonished as he went down, and then laughed uproariously. Soon she began dating and having an affair with a romantic fellow who picked her up from work in a sports car. She moved out of her parents home and got her own apartment (nearby, so she could visit them, while keeping her independence.) Eventually she was able to visit New York City–which she had never done in thirty-five years–travel to other states, and even take a Carribean cruise with her sister. As we were concluding our therapy she was practicing for her driver’s license (just the idea would have had her in tremors in her pre-treatment condition…).

This case and a few others, including a woman with an explosive personality disorder and hyperirritability, who had been helped in less than ten sessions at my college lab, helped me glimpse the possibility of a synergy between psychotherapy and neurotherapy, and see neurotherapy accomplish some things that psychotherapy couldn’t.

One of our earliest patients at Stone Mountain, in 1996, after we began with the Flexyx equipment, was a Vietnam Vet about whom we have written elsewhere.<17> After the war he was injured in an industrial accident–a thirty foot fall to a concrete floor that shattered his heel and broke his spine in several places. Though he was on about a dozen painkillers and antidepressants, Peter he had been in excruciating pain for nine years before he came to our center. He had become a local legend.

After nine years of pain Peter had finally decided to do himself in with a shotgun. His desperate wife called the police. When they arrived, Peter ran out the back door of the trailer into the woods, where he easily eluded police. Finally deciding it was pointless, he decided to give himself up. But he asked the officers not to restrain him because of his wartime experience. At first the police seemed to be honoring Peter’s request, but then pounced on him, which was a bad idea! So in short order there were five or six policemen in the emergency room along with Peter, and the event made the papers, once more bringing the precarious fate of Vietnam Vets home to the local community..

When Peter came to see us, a few months after that event, he arrived on crutches, driven by his wife (and wearing his green beret). Within two months of twice-weekly treatments, the foot and spinal pain had abated, and he was walking with a cane. Within three months, he was able to drive himself the twelve miles to the therapy center, and travel places alone. His mood swings had also stabilized. He dug in more deeply to the process of psychotherapy and let out some of his pain. His marriage came out of crisis.

Soon Peter was walking unassisted, and thinking of a more active lifestyle, maybe some part time work, after a decade of total disability. Even his stolid neurologist allowed himself a little bit of awe.

Another early case that was that of a very athletic rock climbing guide who had fallen and fractured his lumbar spine, simultaneously losing the use of, and feeling in, his legs. He had to be catheterized in order to urinate. Jim was told he would never walk again. Needless to say, his marital situation was blighted by the sexual impotence.

Early sessions stabilized his mood swings and eased the awful depression that accompanied his loss of personal power and mobility. On the thirteenth session, he jumped in the chair visibly as the stimulation was applied. “What was that?” Jim Giorgi, one of my staff members, and I, who were both in the room, asked. “I felt like a bolt shot up my spine!” said the client, “like electricity or energy.” That week, feeling began to come back into his legs. By two more treatments (1 per week) he was getting the sensation that he had to urinate, and in a few more sessions he began to re-develop urinary and bowel control.

This client’s sexuality recovered a little more slowly, but it did finally come along–unfortunately not in time to save the marriage. On his last day of treatment, however, (under twenty sessions) this man was able to walk down the hall and into the session unassisted. Last summer, three years after the treatment had ended, I asked him to guide me and a half-dozen youth at risk on a rock climb. He hiked the half-mile or so into the cliff with a heavy pack, climbed up to fix ropes, rappelled all over the rock, and guided the young people expertly. Jim had recovered about three-quarters of his original prowess.

On more than one occasion we have seen knots or spasms in the body come to the surface, intensify and then disappear. A woman in her thirties with (congenital) cerebral palsy had a spasm which she experienced as a tight painful knot in her thigh that never diminished. She had tried muscle relaxers, massage, Feldenkrais, all to no avail. After the seventh FNS treatment, she was riding a bus somewhere in New England, when the pain of the spasm began to intensify. She felt terrified, alone on a trip, handicapped, and with this awful pain. Fortunately, after a while it subsided a little, and to her astonishment, shifted its location. Over the next few days it intensified and shifted several times, and then was gone totally. That was over twelve months before the time of this writing and the problem has not returned. She credits the FNS with relieving her of a pain she carried for over thirty years.

Neurologists have tended to pooh-pooh these kind of results, claiming they must have been due to placebo or suggestion, or are “not really possible,” as one told me. (So I told him I would order my client immediately to begin catheterizing himself again, and get back on those crutches.) But all one has to do is talk to the clients to verify the reality of these stories (some have been kind enough to be videotaped).

Below I present a couple of case histories in more depth, to illustrate certain features of FNS treatment for head injuries.

The Case of Sharon.

When I first met Sharon about twelve years ago, she was a returning adult student in her late twenties at the community college where I taught. After her first semester of psychology, I thought, “This is the most highly motivated, most ADD adult student I have ever had. Intelligent and clearly of a good heart, she lost all the assignments, had to be given them again, forgot term papers, showed up at the wrong time for the final, etc. And yet she seemed very motivated–a paradox.

What I did not know then, was that Sharon had had three terrible head injuries before that time. In the first, just after high school, at age 17 she had been mugged with a baseball bat while walking through through a “safe” part of San Francisco. She had been unconscious for a while, found by strangers, and taken to the hospital where she was deemed to have a concussion.

Sharon wasn’t “quite herself” after that, and noticed her daily skills and her ability “to keep track of things” had gone haywire. A couple of years later, there was an auto accident where she was a passanger and her head smashed into the windshield. After that Sharon was riding a bicycle when hit by a car from behind. Bystanders were certain she must have been killed, so bad was the accident. She sustained a number fractures and injured her head and spinal cord again. All these accidents had predated her time at the Community College.

We remember that according to the CDC, head inujured people are three times more likely to have a second head injury than the average person, and eight times more likely to have a third. After that, it gets exponential. Unfortunately Sharon was now to have a fourth head injury, the one that eventuated in her coming to us for clinical treatment. And this was the one that seemed to put her “over the line” in some way. It was the only one in which she had had some measure of control. She was driving on a winding country road, and either dozed off or spaced out, for the next thing she knew her car was rolling over and over through the fields and woods. Though she ended up hanging in her seat belts, she hit her head on the roof during the pinwheeling. When she finally got out of the straps she wandered off through the dark November woods without the vaguest idea of where she was going, or even who she was.

A terrible time began for Sharon then. She was separated from her husband, and trying to raise a ten year old boy by herself. She had had a succesful massage practice with a good clientele and many friends. Within months she had lost it all. She could not keep track of appointments, disappointing many of her clients and friends. Even the most ordinary coping skills seemed to have gotten lost; and she ended up penniless and on total disability, SSI.

Sharon had been in that condition for a couple of years when she tried to return to school. She still had an incomplete on record from me for her biofeedback lab journal, and asked if she could complete it. I had already retired from the college to focus on my private practice and writing projects. I told her, yes, but that she would have to turn in the missing journal, or come and see me for biofeedback and recreate the journal. I told her it would be the longest “incomplete” I had ever turned into a grade (ten years). She decided to come.

Sharon’s map showed areas of frontal Delta and very high occipital Alpha consistent with some head and spinal cord injuries. The amplitudes were in the 20-40mv range, and with high standard deviations, implying instability. In making the maps in those days there were four seconds of observation with one second of stimulation–the evoked potential–built in. As we hit F4 (right frontal region) she cried aloud as the one second of stim. came on. “What’s the matter?” I asked. “I’m hanging upside down in my seat belt! I’ve just hit my head.” She was reliving her most recent accident, of which she had had no conscious memory.

This site can be seen as a little “bullseye” or hot spot in the delta range on map#1. (This constituted the focal area of her main frontal problem, and we see that after about seven months of treatment, and map#2 it has has completely disappeared.)

Sharon proved, unlike many multiply head-injured patients, to be very robust and able to tolerate higher levels of treatment, so in twice-weekly early sessions we were really able to accomplish quite a bit. Slower to yield, however was the high amplitude alpha, which seems to originate occipitally as would be expected, but proliferates over the parietal and into the central and frontal areas. This may show a familial ADD–which her son also has–but in these high amplitudes and dysregulated may be indicative of spinal cord injury. Indeed, indeed when treatment began Sharon had been in extreme pain, localized in the neck and shoulders.

Several times, to the astonisment of both Sharon and myself, as we treated one of her sites, with just a few seconds of stimulation, her neck would “adjust itself” with a little clicking sound, as if an invisible chiropractor were in attendance, and then she would “feel much better”, sometimes averting incipient headaches.

One of the first areas to regulate itself with Sharon was improved sleeping. Before her circadian cycle seemed all “messed up”. Now it was also “readjusting itself. Her mood improved and she no longer felt suicidal; her energy began to come back.

Friends noticed the difference and said things to her. She found she was able to remember more and more things. She was able to pull an “A” in one of her college courses.

Sharon had always had abilities some people would describe as “paranormal”. She would see or know things before they would happen. As a masseuse, she could zero right in to a problem area, and then tell the patient accurate information about the psychic wound or problem associated with it. When she was at her worst, these faculties turned bad. She felt “spells” were being put on her, and was suspicious of people. She had several encounters with entities that felt to her like evil spirits. She could hear other’s thoughts, but they would be jumbled, or intrusive, or malevolent.

With the FNS treatment, Sharon’s psychic abilities “settled down” and became more sedate–and more accurate, she felt, again. Her dreams became less turbulent, and now seemed to include wisdom or guidance dreams. She made good progress in both psychotherapy and as a valued member of a dream group led by the author. She accompanied a tour to Guatemala to work with shamans and indigenous healers, and at times showed abilities rivalling or eclipsing those of the shamans. Without speaking Spanish, she did some independent travelling, and seemed to get along well.

This past year, she was able to help her son, who has learning disabilities, to improve his scores in college classes, and do research papers. She feels her cognitive abilities, short term memory, and focus, all are better.

“There is a room,” she said in a videotaped interview, “where people who have had head injuries go. The real world seems very remote and unreal. When you meet someone else who has been there, you recognize them. I am so glad I’m not in that room anymore!”

The Case of Manny

Manny came to us in his forties, with a heartbreaking story, but not so atypical among the multiply head-injured. He came from a Catskills blue-collar, lumberjack family that encouraged a rough and tumble lifestyle, mostly in and out of the local taverns. His father was a “good ole boy” with what would now be considered a severe drinking problem, an explosive temper and a heavy hand. Even the police gave him a wide berth.

His elder son, Manny’s older brother, fit the mold. At age nineteen (Manny was sixteen) the brother had been drinking heavily and was driving about ninety miles an hour when the car hurtled off the road and crashed. As so often happens, the drunk and floppy driver was virtually unhurt, while his younger brother’s smashed into the windshield. But Manny’s feet were trapped in the wreckage; he broke both ankles and legs and other bones throughout the body. It took the “jaws of life” to get him out. Manny’s life ground to a halt, as he had known it, at sixteen years of age, and he became an invalid.

Three years later the seizures were to begin. They were regular as clockwork, and came on about once a month: Grand Mal., They lasted about three to five minutes, but in the aftermath, Manny would be confused, incoherent, dyscoordinated, and moody, which could last for several hours or several days. Dilantin, Felbutol, Zyprexa, and SSRI’s were all tried, and in various combinations, without appreciable benefit. But–the patient felt, dumbing and numbing side effects.

Now each month Manny could count on falling down a flight of stairs, breaking most of his limbs, fingers, toes, ribs, in the seizures and their aftermath. The head injuries began to multiply. The condition was so severe that in 1998 his doctor recommended neurosurgery. And so 2/3 of Manny’s right temporal lobe, wherein they believed lay the foci for the seizures, was removed. But the seizures did not stop.

He was on his way down to New York City for a one-month checkup, post-surgery, when his brother in law, who was driving, was in an accident, and Manny’s head again hit a windshield. Now the seizures became more serious. After the post-operative trauma “post-ictal psychosis” was diagnosed, in which it is recognized that for a little while after the seizures the person is “out of their minds,” literally uncontrollable. But really, it was a little more like a “post-ictal delirium”. His wife, a strong woman, was really unable to control his more violent movements without getting hurt, and their grown son, who lived nearby would race over, and see if he could control his father’s dangerous lunges toward windows, stairways or roadways. It was a precarious and awful situation, compounded by the fact that the family lived on the second story–“the only apartment they could afford”.

When we first saw Manny in January of 2000, his quality of life revolved around the seizures. It was awful to see him the day after, sometimes with broken fingers and toes, and in pain. He had become sober a number of years before, and converted to Christianity, which he felt had saved him in many ways. But he still needed marijuana in fairly large daily doses to keep the pain, anxiety and depression away. And his temper, like that of older brother and father, at times seemed uncontrollable, adversely affecting his marriage. He was on total SSI disability, and he told us with a serious face that his dreaming seemed to have totally stopped, some years before.

On the positive side, Manny had worked on himself; completing a two year college degree, maintaining sobriety and, after a midlife conversion to Catholicism, participation in parish activities. But on the negative side, hell was vying with heaven in Manny’s psyche. His attitude was good, but his nervous system seemed uncontrollable.

Within the first few months of FNS treatment, sleep regularized and mood stabilization improved. In psychotherapy and marriage counseling sessions I was able to help him interpret the outbreaks of anger as subclinical seizures–such was their intensity, and his total inability to get out of them, sometimes for several days. His wife was helped to see that they weren’t really directed “at her” but were emotional events over which Manny really had little control. They began slowly, though unmistakably, to improve.

Around eight sessions into the treatment Manny came in radiant. He had remembered his first dream in years.

After several months of treatment, the seizures were still present, but began to be erratic. He had a period of nearly fifty days without; and then two came about a couple of weeks apart. He and his wife both noticed that the intensity of both the seizure activity itself, and the “post-ictal psychosis” had lessened. A couple of times we saw him on the day of, or the day after the seizure, and he looked and acted pretty good. He seemed less oppressed by them. His marijuana consumption began to decrease, effortlessly, as it were. He was remembering more dreams. The marriage was improving.

The antidepressant SSRI’s were discontinued at the patient’s request. The doctors changed the medication twice, and finally agreed to take off the Resperidol for the post-ictal psychosis; leaving only two medications (Dilantin, 100mg and Moban 25 mg he was now on, and a “trileptal” as needed. (No more meds to control other meds).

This past August 2 (2000) was Manny’s last seizure, and it broke the mold. Heretofore all seizures had taken place in sleep in the wee hours of the morning. On Monday afternoon he lay down for a nap. About 2 pm his wife saw his eyes fluttering, and thought a seizure was happening. It was mild, lasting a couple of minutes, and there was no post-ictal problem. About 5 pm there was a second one. Manny was a little more confused and bit the tip of his tongue, but he was not aggressive, and he stayed on the couch. At 8:30 came the third and last. He wanted to talk but couldn’t. Dilantin, 500mg was given, which seemed to do nothing.

That night he soaked himself with sweat in his sleep, something that had often followed fevers. He had anxious “jamais-vous” experiences (he didn’t feel “like himself). The seizure was followed by a couple of days of restlessness and poor sleep, but then he began to feel better, his energy level was improving. The doctor took him off Dilantin and put him on a new drug, Kephra.

Two weeks after the seizure, an enormously traumatic event happened when some close friends’ teenage son shot himself. The family, and the community were devastated, but Manny played a very supportive role, finally organizing a community benefit, at which thousands of dollars were raised for the family. We continued treating twice weekly with neurotherapy during this time, though the psychotherapy was focussing on the tragedy.

Noticing that Manny was yawning after neurofeedback sessions (tiredness being a sign of overdose) we stopped using glasses with LED’s, and used only the radio frequency stimulation. Immediately he seemed to respond with increased energy and clarity. Now he was getting up early and doing volunteer work for the church and friends. All during the Fall he remained seizure-free, and his mood and cognition improved radically.

In January 2001 we were able to celebrate that Manny was seizure-free for six months. (The longest time ever, since the accident.) I was able to record his own words about how he was feeling on this occasion.

“The FNS has given me a brand new positive attitude and the motivation to do something positive with my life.

I can now step outside of my situation and make decisions based on what I see. Now I have more emotional distance from a situation. My interpersonal relationships have improved a lot. Before I was depressed at the situation I was in, couldn’t see past my troubles. I have a larger perspective. I’m more concerned with other people’s feelings.

I have improved my chess scores to the point of feeling almost “unbeatable;” maybe I’m winning 75% of the time. I can think and plan three or four moves ahead.” (Manny played weekly chess sessions with the priest of his parish throughout treatment, and his success or failure became an interesting barometer of how he was doing in treatment. Recently he observed that the priest has a temper problem “and probably could use some biofeedback.”)

“I carry around a positive attitude most of the time. You know, brother, its much better to give love than try to demand it. It comes back anyway, always. I am seizure free six months; my positive attitude has me jazzed; I feel like `Mike’ again.”

As twelve months of treatment have now passed, Manny still comes religiously to neurotherapy, once a week. We have occasional psychotherapy sessions. He still remembers his dreams. When issues come up with his wife, he tries different strategies to resolve them. He acknowledges: “She’s stubborn, but how else could she have put up with me for twenty-five years.”

This month, with the blessings of his neurologist, Manny will open and lead a community support group for people with seizure disorders, sponsored by our local hospital and head-trauma center.

The Case of Leslie.

Cerebral Palsy is usually present at birth or discernible in the earliest months of life, and is usually believed to result from unknown genetic or perinatal events that damage CNS functioning. We are presenting it in this context because we believe both the patient’s symptoms and her response to treatment is not essentially different from TBI or spinal injury.

We don’t know much about Leslie’s mother, or the conditions of her conception, but what we do know is that as soon as Leslie was born, she was given up for adoption. Her adopted parents thought they were getting a normal child, and then when Leslie’s developmental delays became apparent, they weren’t sure they wanted to keep her. They did end up keeping her; but never, she feels, understood her, or really tried to take cognizance of her handicap, or who she was striving to be, in spite of it. In an unfortunate way, the adoptive family became embarassed about having a handicapped child. Leslie feels this then set the tone for how others treated her.

Growing up in this atmosphere, Leslie, like many people with impairments in conventional skills, would often feel she knew so much inside that she couldn’t say. She could understand much about people by reading their body language and intentions, but couldn’t communicate the nuances of what she was feeling. She had difficulty walking and talking, and coordinating activities. But she insisted she was “college material,” and struggling against obstacles most of us might buckle under, achieved first her bachelor’s degree, and then a masters degree in special education. She did years of Feldenkrais work to minimize her physical and speech difficulties.

Leslie was able to drive herself to our center, and walk, with some awkwardness, accross the parking lot and up the stairs into the building. She was able to give a very clear and compelling anamnesis, or history of her problem, and detail the steps she had taken to correct it. She described herself as almost sleepless, with restless nights and fatigued days, struggling to do her job as a data-entry clerk for an insurance firm. Her cognitive cloudiness had her slow to learn procedures, and perceptual-coordination problems slowed her down at sorting and filing tasks. She was constantly asking co-workers for assistance in running the different computer programs. She made noticeable mistakes, something she felt was impermissible in the competitive environment she worked in.

There were excruciating pains from muscle spasms, particularly one in her thigh (as earlier described). She was depressed (in a way that included some suicical ideation) and suffered anxiety and panic attacks at work.

Leslie’s map showed a normal-enough looking adult brain except for both frontal lobes that were characterized by giant spikes of delta frequency activity. We began to move through the site sort–leading up to those wicked-looking frontal areas.

Two symptoms were rather quick to yield, even at the 1x/week frequency we decided on. One was the muscle spasm mentioned above. Another was the sleeplessness. After the second treatment using the site sort, she described getting a good night’s sleep the night of the treatment. The next week had her enjoying two nights, the following week three nights, and so on in a predictable pattern, taking about seven weeks, at the end of which, when I asked her how she was sleeping, in the normal routine interview before treatment, she said “There is no night in which I do not sleep well!” and gave me a radiant smile.

Depression also yielded week by week, and the anxiety of feeling like an outcast or “defective person” diminished. She noticed she was getting much faster at the paper-sorting and filing tasks, and was asking fewer procedural questions of her co-workers. She could get in and out of the car better. A friend commented on her gait seeming smoother.

Then came the cognitive breakthrough that took our breath away, because of its soul-restorative implications for the developmentally disabled or head injured. She had been requested to “visualize something” by someone who did not know how handicapped she truly was. Heretofore it would have been out of the question for her. She had not been able to form pictures in her mind. Suddenly something opened, and she found herself visualizing.

While visiting a friend, Leslie suddenly did something her friend’s little girl had been asking her to do for a long time: help her put together a picture puzzle. “Before, I never could do that,” she said, “It was very embarassing. Now I found I could imagine where the pieces went, how they’d look turned around, and what the overall picture might look like. She was beaming: “I can compete in puzzles with a four-year old!”

In a recent on-job shakeup, Leslie was able to protect her position. When she thought she was being treated unfairly she followed through with assertive action. She was able to point out to her employers that her work record stood on its own merits; she had, recently especially, done three to four times the work that her “normal” peers had done, and her accuracy was higher. Most impressive was her fearless determination to stand up for herself and confront the demon of discrimination that had dogged her since childhood.

Theoretical Considerations:

(Though the following ideas are broadly generalized from work with the Flexyx system, they are not necessarily those of Dr. Len Ochs; and I take full responsibility for their speculative side.)

When the brain is multiply traumatized, layers of protective mechanisms become involved around the injured area that cause functional disturbances which are far more pervasive than the physical injury itself. Not only the functioning of neurons, but neurotransmitters and glial cells are implicated, the relationship between the cortex and subcortical dynamisms, and the complex layering of the cortex itself.

The subcortical nuclei that create brainwaves are spread throughout the thalamus, limbic and brainstem structures. Their main business is to distribute signals and propogate waveforms. The main business of the cortex is to choreograph it’s activities based on those wavefronts that spread through it’s circuits. (Millions of little nanosecond, microwatt events add up to the “brainwaves” whose electrical potentials are able to reach the surface of the scalp–having penetrated the cerebral membranes, the cerebrospinal fluid, the bony skull and oily scalp–finally to be measured in millivolts and Hertz by our sensors.) It is where the cortex is weakened that these rhythms break through most strongly–from somsewhere in the thalamus, directly, as it were, to our sensors. We see high amplitude, low frequency Delta and Theta, and even Alpha, as visible on the FNS maps.

These are the sites of cortical “permeability,” where in the simplest terms, our higher order functioning cannot control the lower. Emotions break through and sweep all reason aside. Obsessive thoughts rise up and cannot be controlled. Mood fluctuates as if a madman were driving the hypothalamus like a “bumper car”, and appetite, sleep, body temperature are all affected. Primordial fantasies, hard to control impulses, what Freud called “primary process” thinking overwhelms the symbolic cortical “secondary process.” This is why when Ochs stimulated some of the cortical sites on his more sensitive subjects they made cries of discomfort. We also have also observed people gasp, turn white, have auditory hallucinations, grimace. On the other hand more energetically-available clients may experience a burst of energy, an insight, or even a transpersonal experience, at a particular site. (Some, especially teenagers, experience “nothing”. This may be a proprioceptive insensitivity, the expectation that nothing real is going to happen, or both.)

On the day this piece is being written, we treated a Japanese woman from an abusive and alcoholic background, who suffered from major depression. Tomiko’s story serendipitously illustrates some of the principles under discussion. Her depression/abuse showed up in the map as high and spiky right frontal delta. But there was also an unusual dysregulated left temporal (T3) Delta of 25 Mv. She proved to be very sensitive. The first pass through the site sort found the patient often in tears, or doses of depression as we visited each site. Nonetheless she resolved to continue, because she generally felt better after the sessions (the immediacy of her feeling worse also passed quickly, a sign of gaining flexibility. She wanted us to go on. In fact all of her clinical measures, as elicited in the weekly reports, were improving rapidly: depression, sleep disturbance, anxiety, cognitive cloudiness.

Today we were at about ten sessions, finishing the second pass through the site sort, and visiting the wicked T3, as the second site. I sat across the room, taking notes, while a clinician in training ran the session. As we ran the site we both were watching the screen. We looked at each other in astonishment. “Did you see what I saw?” The spectrum analysis showed a beautiful undulating landscape with no amplitude over 4 microvolts, including delta. I checked the map again, and verified her amplitudes. In those two circuits of the site sort her amplitudes had dropped 20 Mv. The “tiger” had become a “pussycat.”

Having finished with the worst site, protocol usually dictates beginning the site sort again, thus going to the “best” (the one with lowest combined amplitude and standard deviation–shown by a blue section on top of the bar graph) . Oddly enough this was T4, the corresponding temporal site on the right hemisphere to her “worst”. To our astonishment, as we applied the 1 sec. of stimulation, tears streamed down Tomiko’s face and it became immediately apparent she was trying (very hard, being Japanese) to control much deeper emotions trying to surge up. “What is this?” I thought, “best is worst and worst is best? What gives?”

When she spoke, hesitantly, everyone in the room fell silent. “It was a good thing, not a bad thing,” she said, and tried to render in English, her second language, words for an experience of rapture. Tomiko had had, as best we could understand, some deep insights about the nature of existence and the part she had to play in this life.

This is not the only time this has happened, and it seems transpersonal experiences and mystical insights need also to be included in the positive category of our “symptoms.” On the one hand it seems demeaning to refer to them as “symptoms, ” but they do often seem to cap periods of improvement. Maybe the absence of mystical experiences should be listed as a symptom to be cured in the overall process of healing. And we can only conjecture what relationship the neurological quieting and balancing had to the mystical experience.

The amplitudes of all frequencies are lowered when the cortex recovers its integrity and elasticity. This is the effect we are looking for. The “miracle stories” show re-settings, probably in the purely functional and frequency domains. It is as if things were intact but just needed a “reset.” (The existence of these miracle cures illustrates how cortical descending neural pathways also probably re-set the “pacemakers” in the subcortical nuclei. In fact, in true feedback, all aspects of the feedback loop are re-adjusted as a new “gestalt” of functioning emerges.)

In the great majority of the cases, however, longer term physiological process may be involved, as the brain tries to restore damaged tissue, grow new processes, and deliver the required neurotransmitters to the right areas or synapses. This takes a healthy nutritive environment, and repeated stimulations at intervals, to achieve. The nervous system is, in effect, being asked to rebuild itself. Here interactive systems theory could be enormously helpful in understanding how self-regulation propogates itself through our many functional subsystems, from the cortex to subcortical pacemakers, to arousal and metabolic “switches” in the brain stem, to neurochemical pathways and the synapse-building effects of glia, to the regulation of endocrine and cardiovascular systems, branches of the autonomic nervous system and mesenteric complex (and thus stomach, bowel and urinary disorders.) All these systems are interlocking with each other, so changing one means accomodations in all.

We know that that the glial cells outnumber ordinary neurons by a factor of ten to one. Originally thought by neuroscience to be just “scaffolding” to support and nourish the neurons, we now know that a class of main glial cells called “astrocytes,” are involved in the formation of new synapses, and which are obviously implicated in the ability to learn from experience. “Our results show absolutely clearly that environmental signals can have a profound effect on how many synapses neurons can have,” says Prof. Ben Barres of Stanford.<18>

But in injuries, neuroanatomists have found a condition called “gliosis” where the glial cells may overreact to an injury, “causing neurons to form too many synapses and thus triggering the overfiring that means an epileptic seizure.” The hyperhelpful glial cells could thus not only cause seizures, but any subclinical seizure activity, including tics, panic attacks or explosive disorders, or hyperactivity. This would be the “overstimulation” condition of Ochs and the Othmers. But the glial cells could also be involved in the opposite: defense mechanisms, the glia surrounding and trying to protect the neurons from toxins, or viral attacks or trauma by a kind of shield; or in the third condition, the glia overstimulating them into exhaustion, like we see in chronic fatigue, or bipolar states where hyperexcitability vies with exhausted depression in an endlessly repeated cycle.

It is also clear that the abundance and availability of neurotransmitters are involved in the process of cortical repair, and the the role of the adrenergic, serotonergic and cholinergic pathways and hormones are involved in all the intimate aspects of arousal, motivation and emotion and cognition, along with dopamine. The sleeper in this process is GABA,<19> whose role as a cortical inhibitor has been underappreciated. But as the inhibitory and self-regulatory aspects of cortical functioning are more understood, we will probably find precisely how this neurotransmitter helps us maintain that much-vaunted “higher-order functioning,” and the “self-control” most human beings like to be proud of.

Neuroscience has also measured the glucocorticoids in people under stress. These substances inhibit neural proliferation and repair, working counter to serotonin and its analogues–which increase neurogenesis. People with depression have lighter and diminished hippocampal structures, particularly the dentate gyrus and the CA3 cell fields. Yvette Sheline and her colleagues at Washington University in St. Louis have detected smaller hippocampal volumes in older chronically depressed women. (Another neuroscientist, Premal Shah, at Royal Edinburgh Hospital reported smaller hippocampal volumes in chronically depressed patients, but when they measured those of people who had recovered from depression the volumes were comparable to normals.<20>

SSRI’s such as Prozac (fluoxetine) or fenfluramine often take three and more weeks to “uptake” and also are supposed to be withdrawn from slowly. An explanation has been put forth by Ronald Duman of Yale that fluoxetine increases neural cell proliferation in the dentate gyrus area in rats. FNS may work in an analagous way, though their are no quantitative neurobiological studies as of yet. (An interesting one might be randomly to select people with chronic depression. Give one group placebo, one fluoxetine or another SSRI, and a third group would receive FNS. The study would use depression rating scales, QEEG’s, but also MRI’s and other measures of hippocampal weight and density, as well as inspecting the dentate gyrus and 5-HT1a receptors.

(To this effect, as a clinical aside, if we are asking the nervous system to rebuild and regenerate itself, making new glial and neural tissue, and to synthesize neurotransmitter substances, it most be adequately nourished. The clinician should at least make sure that the subject has colloidal trace minerals, B-complex vitamins, and probably Omega fatty acids. Proteins and amino acids are also helpful in synthesizing neuropeptides.)

Other studies have shown lighter or withered frontal lobes in those children (and later adults) who have suffered from Reactive Attachment Disorder or other anaclitic deprivation in the early weeks and months especially of life. This is a part of the general “failure to thrive” syndrome, and again implies that people in this category (sometimes regarded as sociopaths, or cruel and inhuman children who shoot their classmates), have actual neural deficiencies which need to be restored through treatment. A thorough nutritional progam, combined with EEG biofeedback for stimulation and flexibility can help to redress the imbalances in both the nutritional and the neurological domains. Here also psychotherapy can be more effective if these other imbalances are already redressed.

All of the brainwave ranges may be found in any given EEG; and bandpass filters help us select out the percentage of Delta, Theta, Alpha and SMR, low and hi Beta. The key to succesful CNS functioning for human beings seems to be flexibility of functioning, so that the level of arousal and engagement, as reflected in the appropriate brainwave range, is brought into play in a particular activity or situation. This is the flexible brain.

Its opposite is the recruitment or entrainment phenomena, at its most powerful in seizure activity, but certainly present in any low frequency activity, where millions of neurons sway in the rhythm of the neural tides. It is also present in “coherence,” where the same frequency occurs throughout an area or “carpet” of the cortex. The key threshold seems to be about 5mv, above which recruitment and dysfunction are far more likely, and below which, autonomy and flexibility are more likely to reign in the brain. (In Flexyx, the bar-graph, or 3d representation, the white bar representing the “dominant frequency,” the range of greatest amplitudes, is a measure of this flexibility. If it goes no higher than Alpha, or stays stuck in Delta/Theta, there is a problem; energy for higher order or abstract thinking is simply not available.)

In the flexibile brain, however, the dominant frequency bar runs up and down the scales like a pianist practicing arpeggios; the energy is free to go where it will, and that means the person is in the state Taoists call wu wei, or Zen practitioners shikan taza, complete, unpremeditated, dynamic presence in the moment. (Mihalyi Czizemihalyi has called it “flow,” Les Fehmi, “Open Focus”.) It seems to be the best state for biofeedback, as well as life; a relaxed, open state in which the brain is both centered yet open to any experience, in which there are no walled off enclaves (nor ghettoes of the mind). Every part of the brain is potentially open to the other parts, but not in a coercive or obsessive way. In this state the hemispheres can dance with each other, the right giving color and feeling tone to the words and logic of the left. The flexible brain can bring forward old experience, while staying open to the new and unexpected. It can concentrate intensely, or kick back and dream of the creative unknown.
To summarize the previous ideas: When the cerebral cortex, the “roof brain” and site of our voluntary, and “higher order” functioning is weakened, peripheral and sensory stimuli can literally overwhelm it. William James’ “buzzing blooming confusion” may then take over.
Intelligence and discrimination go down, the person lives a muddled existence in a world that seems so remote or clouded as to be scarcely real. The person may seem to outsiders as if asleep or in a strange kind of trance. But a brain that appears to be torpid and lacking in energy,
as suggested, may actually be exhausted from overstimulation, or neurologically shut down by helpful glial cells.
Dr. Ochs’ approach takes everything back to the resilience of the cerebral cortex, and its ability selectively to inhibit subcortical impulses (indispensible to all tasks of discrimination or discernment). In his approach, as in traditional Neurofeedback, high amplitude low frequency Delta and Theta waves in a waking EEG indicate damage, depression, fatigue. But there are also the higher range problems. In Ochs’ system high amplitude Alpha, especially frontal, is indicative not of bliss, but of anxiety, attention deficit, and cloudiness. (We would add to that a spiky Alpha that seems to carry acute chronic pain, whether found frontally, temporally or occipitally.) The same can be true of SMR (the range right above Alpha) and Beta, and especially hi Beta (that is not skin/muscle artifact.) Dysregulation in the upper ranges can in fact feature excruiciating forms of anxiety, up to the intense hypervigilance, irritability and the anger-proneness of hi-beta that we see in so many PTSD profiles, along with the slow wave activity. (Sometimes the hi-beta may seem a dense, ragged scrolling on the outline of the delta tsunami, as it were , as if representing a desperate, futile attempts of the will, or conscious mind, to control the great slow waves rolling inexorably out of the “unconscious” loaded with psychoemotional freight.) It is an open question how much talk therapies can touch any of these neurologically entrenched problems (we “understand,” but we still freak out).

When people calm and balance the CNS, their experience is less turbulent; the very issues that used to drive them “over the wall” now seem less fraught with emotion or urgency. They are still there, but they’re far less overwhelming. (Now might be a really good time for insight and talk therapies.) As one client said, a large, strong man with crippling agoraphobia, panic and depression, who paid for and participated in a whole “mindfulness” and meditation program based on the work of John Kabat Zinn, “It was like trying to knock down this hard solid wall with a feather” (when he would try to “still his mind” and calm down).

A few sessions into the neurotherapy this client experienced a couple of days utterly without panic or depression for the first time since his accident. “Now I could use some of that mindfulness training!” he said wistfully. ( Trying to sit in lotus posture while your liferaft is being tossed mercilessly on an angry sea is twice as hard.)

In Flexyx theory, any range with over 5Mv of activity is considered problematical, and the goal is never to train up any ranges whatever; but only train down, in order to steal the energy out of recruitment, coherence, the “crowd behavior of neurons.” Humans in large collectives are known for being stupid as well as dangerous, and it is an old truism that the crowd is only as intelligent as its least intelligent member (as in your average lynch mob). So, it seems, neurons are dangerous or “stupid” in certain kinds of collectives.

When appearing in waking behaviors, large amounts of Theta seem associated with trance states and dissociation. One of our clients is a ten year old girl who has periodic headaches and hears voices. Working cooperatively with her neurologist we arranged for an MRI to be done–to rule out tumors or lesions of any kind. Nothing of this sort was found. But in the girl’s map, Theta is pervasive, and sometimes spikes over the 25mv level in frontal and central areas. Her mother complained that, though very intelligent, she is a “space cadet,” and often has to be accosted forcibly to get her attention. Several months of treatment have improved her mood, helped her pay attention in school, and decreased the intensity and duration of the headaches. But the voices she hears have yet to yield to treatment. Fortunately they are not hostile or menacing, as some patients have experienced. The girl’s mother wonders if they are not a harbinger of a clairvoyant (and clairaudient) streak that seems to run in her family, and should not be “trained away” any more than she would want to medicate them away. I empathized with her point of view, and told her that out of all neurofeedback treatments, the FNS would be less likely to “train away” an innate faculty, because it does not emphasize one brain range over another. It seeks to make them all available by making none of them the unilateral ruler.

Beta is often associated with concentration and problem solving on the good side, and used actively for intellect-stimulating protocols. But dominant high amplitude Beta and hi-Beta in the Flexyx approach can be associated with hypervigilance, manic or compulsive thinking, sleeplessness and with several people, who showed spikes of over 20mv, a kind of toxic anxiety that permeated everything they did. These people are just “not happy in their skins.”

Beta, it seems, is not meant to be pervasive or coherent; it is best found as isolated little pockets of activity here and there, as the brain multiprocesses information or thinks through complex problems with verbal and spatial, emotional, social or philosophical aspects. For most higher order functioning, we do not wish for crowd behavior among neurons, but more individual or small-group expression. These groups should be cooperative, but not coercive, intelligently interactive systems.

To take our metaphor a little further, in an example that Ochs developed, imagine that the brain is analagous to is a large and stupid crowd of fanatics of some kind, that you wish to break up in the city square. (They are the real reason the whole place is paralyzed.)

In most crowds there are “instigators,” who have a purpose in mind, and are very intent on pursuing it. There are also “collaborators,” whom the former have recruited, but thse are really just “yes men.” Then there are the “bystanders,” who are actually indifferent to all this nonsense, but are just going along for the ride.

To achieve your purpose skillfully, you will first try to disperse the bystanders, who didn’t really like those fanatics in the first place, and would just like to go back to what they were doing before the ruckus started. They don’t resist very much. Then you take on the collaborators. They’re a little more stubborn, so you show them how they’re being used by the instigators, and wean them away. Finally, when you take on the instigators (those hot spots, foci, or core of trauma) they’re all alone. They try to recruit their old cronies, the collaborators, or the bystanders, but those guys are already otherwise employed. They yell out to the other instigators accross the courtyard, but instigators really only like to instigate, not follow anyone else. Eventually they just lose their steam and go about their business. (Yes, even they will have to get haircuts and useful employment!) The brain has become more like a well-functioning democracy that is open to input from all its members, who in turn, become happy and productive participants.

It’s here that we digress momentarily into the politics of neurotherapy, for it is surely clear that flexible brains lead to open minds, and the reverse is also true. When we have trauma, all our mental “fundamentalists” come to the fore: “That will never happen to me again!” “I can never trust men again in this lifetime.” “When I go out, I get hurt (the agoraphobic).” And so, on and on. Some of the reactions to trauma are worse–and more functionally pervasive–than the trauma itself ever could be. When they are multiple, they form layers, involved with fears, flinchings, protections, numbings, compensations, and the whole inventory of Freud’s defense mechanisms: projection, repression, reaction formation, denial, etc. Here too are Jung’s “complexes,” knots of feeling, defense mechanisms, overcompensations.

Some levels of the complex are conceptual and verbal; these can sometimes be reached by skillful psychotherapy. But there are also levels that are more like conditioned reflexes, that don’t respond so well to psychotherapy. Here operant conditioning and the use of extinction and desensitization techniques can help extend the reach of therapy; but sometimes the classical conditioning inherent in the problem is more fundamental than the operant conditioning we use to try to overcome it. And there may be even more elemental levels, where genetic intelligence lies, and where our ancestors meet modern life through and in us.

It is this neurochemical level that psychotropic treatments try to effect, using drugs to adapt our inherited temperament to the challenges and vicissitudes of modern life. (Hans Selye’s work woke the world to how we humans meet the contemporary world with archaic nervous systems geared to fight or flight. All the excesses of compensation we call “stress” are the outcome, and are characterized by the overarousal and underarousal, as well as instability states we have been discussing.)

In our experience, FNS neurotherapy does in fact work on all these levels, and that is one key to its uncanny effectiveness. Especially because its effect is subliminal or unconscious, it goes right down to the immediacy of the neural, and maybe even the cellular levels of response. Unlike what Ochs calls “the bully approaches” or medicine’s “heroic” treatments, we do not attempt to disperse the crowds with tear gas or tanks (which usually only makes things much worse than they were, and triggers a revolution.) Instead we lower the levels, so that we see little or no gross effect from our stimulation. In this way, like the “ninja” of neurotherapy, FNS sneaks right past the inner defenses that guard coherence and neural crowd behavior. The preverbal instigators of insecurity, anxiety and depression actually seem to respond to this delicate tweaking, like an Aikido move that requires very little energy, but utilizes the opponents own energy to take the advantage.

The FNS approach can be analogized to all self-rectifying systems. Jim Hardt has shared with me that he has ethical issues with brainwave entrainment devices that coerce or force the brainwaves. I couldn’t with him agree more. But Ochs’ system is not really coercive, in any sense I can figure out. Neither the clinician nor the client sets a reward or inhibit protocol. The brain is given back itself, slightly altered, nothing less and nothing more. FNS beautifully bypassses everybody’s ego, and in fact the whole voluntary system. The subject’s only instructions are to sit quietly and observe what happens; they are not to “try” to do anything. It is biofeedback taken to its elemental form, the Tao of Neurotherapy. The language of the presentation is not verbal, nor imagistic, it is uninfluenced by culture or social learning. It is yourself greeting yourself in the domain of frequency, of pure pulse and waveform geometry.

We remember that Ochs originally envisioned a “desensitization,” process, as in behavior therapy; somehow to force the brain to lower its rigid defenses against what it feels is overwhelming suffering. In this mode the cortex is “locked up” by the defensive process itself. Clients were to be exposed to increasing levels of light stimulation, beginning with masked and ending with unmasked LED’s, first green and then red (known to be highly irritating) lights. During this process, people were not infrequently overdosed, to which they responded by being “tired or wired,” or more symptomatic with their usual problems. Ochs noted that once people had passed through the entire ordeal, if they were to continue to make progress, the settings had to be lowered radically. Thus he paved the way for what are now considered “state of the art” FNS protocols, which skip the desensitization and stay, throughout the process, within the bounds of the client’s comfort.Why? It just works better!.

Sometimes FNS seems able to release old trauma, or complexes, without exhaustive abreaction or deep emotional work. Ken Tachiki has pointed out that “recall with affect,” or catharsis, that characterizes Theta work is only one way among many Neurofeedback approaches to healing buried trauma. In traditional Alpha/Theta protocols, two brainwaves are combined–the theory being that Alpha soothes the intensity of the (Theta) eidetic recall of trauma. Michael Tansey has also proposed that 14 Hz facilitates recall of trauma without affect, or with only a greatly reduced affect, and yet is a clinically effective release.

Len Ochs has offered that FNS represents a mini-retraumatization, especially when the client experiences a return or exacerbation of symptoms, or is overwhelmed with exhaustion or irritability. But current prudence says it should be held to as “mini” or even “micro” an event as possible. Afterward some time must be allowed to elapse for the system to reset itself, usually at a higher level. (Some early “bully-exercise” versions of FNS treated people every day. Now it is usually a maximum of two three times per week.)

From repeated treatments, separated by temporal intervals, the area that before was locked off is “chipped away” at; defenses are gradually eliminated, information and function open up, and the brain begins to function in that area better again. Perhaps even positive potentials, that lay blanketed by the area of dysfunction are now released, as in the times we have seen creative insights or mystical experiences.

It takes a really gentle stimulus to sneak under the brain’s defenses against things that overwhelm it. That is why “less is more.” A tiny simulacrum of the brain’s own signature nudges us out of our “parking place,” and then again and again, and so on. It is that glimpse of your face in a dewdrop, a totally preverbal and energetic confrontation with what you are doing, or probably more accurately, how you are doing it. As the Delphic Oracle is know to have said over two thousand years ago, “That which wounds shall also heal.” Socrates took up the refrain with “Know thyself.” Paracelsus in the sixteenth and Hahnemann in the nineteenth century echoed the principle: Similia similibus curantur, “like cures like.” Jung and Assagioli talked about “the self-liberating power of the introverted mind.” The perennial power of this homeopathic principle shows it to be a fundamental archetype of existence. Included in it is how to extract wisdom from one’s own symptoms, and how to turn our life predicaments into stages of a wisdom journey.

I have seen FNS fail to provide relief for people with certain disorders. These include certain aspects of paranoid schizophrenia, and paranoia, character disorders (though Ochs claims good success with some patients in this category, our experience has been mixed). We have also seen bipolar and endogenously depressed clients who showed very little improvement. The bipolar clients have in some cases seemed better in almost all symptom dimensions, but still that sneaky manic episode jumps in there, or they go rocketing down, without warning, into a steep depression. Often these are clients who have had acute chronic conditions for years, and the FNS will shorten the time of their attack, or mitigate it somewhat, but still it persists. (In other cases, even more unstable-looking affective disorders have stabilized in response to treatment., so it is hard for the clinician to have an accurate prognosis in these cases.)

One case of Tourettes compounded on Cerebral Palsy was seemingly intractable. The young woman (mid-twenties) continued to have awful public episodes where she obscenely berated her family. The treatment, even a couple of seconds a week, seemed to make her worse. Because this woman was inarticulate (except for the Tourettes) she could not report back to us what she was feeling, and we may have been overdosing her all along–hence her failure to make progress. We do know that after we would stop treatments she would have a period of improvement and then gradually grow worse again.

Adult ADD is a combination of a neurological disorder and a lifestyle or habit pattern. The older the child, the harder it is change the habits, and this is especially true for adults. There are very high Alpha patterns that run in congenitally ADD families and seem virtually unbudgable, although Mary Lee Esty, a respected FNS practitioner, feels that 2 EEG protocols gradually bring that stubborn Alpha down.

Here comprehensive treatment packages that include FNS with mindfulness training or personal coaching would probably seem to have the best results. We do know that patients who work on themselves in ways outside the Neurotherapy sessions often improve the fastest, and hold their gains. Like anything else, FNS works best when integrated holistically into life.

Postscript:
Opening a Dialogue Between Conventional Neurofeedback and FNS;
and Further Dialogues with the New Energy Psychologies and Transpersonal Psychology

Ochs believes, and I join him in this, that much of conventional neurofeedback may work, not just because the client is now able to “stay in C3 beta,” or has been soothed by C4 SMR. Perhaps even more importantly, the brain has been gently stimulated by its own efforts, and stretched and widened its area of flexibility. It has learned to step out of its own intrinsic lockup. (If I can get from here to there, maybe I can go anywhere!)

If this is true, then I suggest that neurotherapists of whatever approach and protocol, look at their lengths and intensities of feedback, and consider the possibilities of overdose: (Wired, tired, or failure to improve.) We all can learn to work within the bounds of comfort of the patient, and maximize the abilities of our complex interactive systems to readjust their physical, chemical and energetic dynamics. In this way neurofeedback can be even more “holistic” than it already is, that is, more mindful, not just of outcomes, and of applying protocols, but of the actual internal self-modifications of the human health-maintenance systems in response to our manipulations. The individuality and unique sensitivites of each patient argue that there can be no one “standard protocol,” where “one size fits all.” The settings and durations must be modified to pace the client’s ability to make use of them.

Much could be accomplished through a dialogue between conventional Neurofeedback and FNS. I recommend such an ongoing dialogue at AAPB, Futurehealth and SSNR meetings. There are a number of fascinating issues to be addressed by panels:

1. Do we train up amplitudes, or train them down?

2. What do protocols that both reward and inhibit accomplish?

3. How does FNS compare with conventional neurofeedback for specific problems?
(use QEEG as possible measure on controlled trials with matched populations?)

4. What of preceding conventional NF protocols with FNS to “till the soil” for the NF training? (We believe, as does Ochs that FNS is a perfect preamble, and especially good for young autistics and CP children, or people in a trance, because no conscious instructions are given.)

5. What are “bad alpha” and “good alpha”? (Anxiety or mindless rapture?)

6. Examine the role of overdose in each mode. (NF and FNS)

7. How does each mode address optimal performance?

8. Can FNS help when conventional protocols get “stuck” (and vice versa)?

It would obviously be helpful, in this regard, to have contributions from practitioners who have practiced both kinds of neurotherapy, and I would warmly invite them to this dialogue, and to present papers of their own. Also sometimes both kinds of practice take place in the same office, and there would be interesting observations on how that works.

Another useful synergy that could be imagined would be of neurotherapy with the “energy psychologies.” Neurotherapy is, in fact an energy psychology; and there should be much to learn back and forth accross these disciplines, separate only because they originated with different interest groups, and because they have not yet discovered their oneness. In some cases in our experience, severely depressed patients(with endogenous features and family history) improved only with the addition of energy therapies–Qi Gong and meditation–to biofeedback. We also know that healthful diet, exercise, regular sleep, and social exchange work synergistically with these treatments, and neurotherapists should be mindful of their presence in people’s lives. We ourselves routinely recommend meditation, massage, yoga Feldenkrais work, martial arts, even trapeze work for anxiety problems (desensitization with a touch of high drama). We regard the introduction of these things into people’s lives as a positive development, and Clients who do these things seem to improve more rapidly.

Furthermore, Biofeedback overlaps naturally with the consciousness disciplines. People who practice the one are often attracted to the other. Many neurotherapists, in particular, study meditation, meditate, and encourage their clients to do so as well. Since the early days, and the work of Kamiya, Elmer and Alyce Green, and Kasematsu and Hirai, people with these exciting new electronic devices have rushed to study yogis and Zen masters, and have indeed confirmed that the machines verify what the masters say about themselves. Even Tibetan “psychic heat” (gTummo) masters have had their (rectal and other) temperatures taken, and found to be geniunely producing extraordinary heat.<21>

While the field is controversial, early enthusiasts argued that biofeedback could give analogues of the classical rapture and enlightenment experiences of meditators and yogis, and deliver results much faster. Critics said that the two phenomena were not comparable, and that machine-facilitated satoris were no satoris at all! However my own experience has been that, before biofeedback, I still had to work awfully hard, when first sitting down to meditate, each time, to stop the “roof chatter” of a hyperactive mind. (I also had had a serious head injury thirty years ago.)

After over a hundred FNS sessions on myself, I noticed a drastic lowering of this mental activity, and an almost immediate “settling” when sitting down to meditate. My mind now feel quieter most of the time. One morning recently I began to hear an old and familiar kind of “frantic music” and activity in my mind. It took me a while to remember I had just had a fairly strong treatment. I lowered the settings at my next weekly FNS session, and immediately noticed a quieting of the mind.

Some questions that could be addressed in a dialogue between neurotherapy and energy psychologies are:

1. How do the International 10-20 sites relate to acupuncture meridians and points?


2. How does “chi” or “prana” relate to the microvolt electrical activity measured in
EEG?
3. How do Tai chi, Qi gong, Feldenkrais, affect the EEG, and how can the states work interactively?
4. How many practitioners of ordinary NFB and FNS have witnessed energy changes as a result of their biofeedback?
5. How many have seen transpersonal or spiritual experiences, even satoris, and under what conditions? How does the FNS flexibility criterion relate, if at all?
6. How about more studies and clinical observations on synergies between the energy disciplines and neurofeedback? (Including places where people in traditional disciplines were helped in impasses in their practice by neurofeedback, as a Zen monk said of his work with Hardt.<22>) What about some contemporary single-blind studies on meditators comparing a with/neurotherapy condition to a without (using an extra hour of meditation weekly as a control).
7. How many clinicians use dreams in their work?

In relation to criterion (7) above, we will share a story. A young woman with anxiety had responded very well to the “lights” (EDS) in the early days, when we still used glasses with red LED’s. Then she “plateaud.” (Overdose). One day she came in for her treatment with a funny little smile on her face, and told us a dream. In the dream she was in a car and the driver did not stop for a flashing red light, and a policeman had to come out and arrest him. She looked at us, we looked at her, and immediately cut the stimulation in half (a usual type of “cutting down” when you suspect the thresholds are too high). Immediately her rate of improvement resumed.

The process had commented on itself, here through a dream (or “autosymbolic” event, as Herbert Silberer called the products of the imaginal realm). It is a process analagous to Carl Jung’s “self-liberating power of the introverted mind,” perhaps pointing to the underlying reason why meditation is so helpful for so many people: We get an intensified simulacrum of our own mind, and it immediately quiets itself, because agitation and noise are so uncomfortable. Here the “feedback” loop includes whether the therapist is open to a message transmitted through a dream. If the therapist doesn’t believe that the unconscious psyche is intelligent or might have a useful comment, the “feedback” loop is broken.

Other clients have noticed their arguments with a significant other increased from FNS treatments. However the explosions triggered a coming to terms with some issues that had long slumbered in denial. In the ensuing arguments, and their aftermath, the client came to feel, much more authenticity was present. New limits were set in the relationship, emotional feedback restored, and things settled down again. Though we continued to give the client stimulating treatments, the explosions had stopped. (They weren’t needed any more to restore the balance of an intelligent self-rectifying system.) The authors are in preparation on a piece on human relationships as biofeedback systems.

In conclusion, then, it is evident that in the Flexyx approach to Neurotherapy, a new branch of a new body/mind technology has been developing. Both the phenomenon itself, and its implications, are truly inspiring. People who have become numb from the traumas of life can indeed be helped. And ordinary people, in what Jean Houston calls “the cultural trance,” can be freed and awakened. The energy psychologies and Transpersonal Psychology imply that there is more at work here than simple circuitry. Profound possibilities are emerging in personal flexibility and clarity, as well as spiritual awareness and openness. It may be that the journey we are on is far grander than we orignally allowed ourselves to believe, and that the universe expands with our ability to perceive it clearly .

NOTES

1. The TBI Homepage, For Survivers and Caregivers, The National Brain Injury Association at 105 Alfred Street Alexandria VA 22314; tel 703-236-6000; tbichat.org/injury2.htm.

2. Clearly a cloudy sensorium, depression, aphasias and agnosias can make a person more “accident prone,” but there seem to be other as yet unaccounted variables in these histories of multiple traumas, that make people susceptible to many accidents, even ones out of their own control. (One patient, after the sudden death of her daughter began to have auto accidents–four in two years. In one, a car coming the other way veered straight into her causing the collision, and in another she was hit from behind at 40mph while sitting at a traffic stoplight in an open area. Naturally it is helpful if these patients can also be helped with psychodynamic or insight-oriented therapies.)

3. ECT is really an attempt to change function by running fairly large crude electrical currents through the brain. The aim is to erase the energy blackboard totally and starting from scratch, so it really does belongs to the electrical and energy domains of the nervous system–as biofeedback does. But in modern ECT practice a medical doctor must be present to administer the drugs that soften the horrifying onset of the current for some people, and prevent the convulsions (widely believed to be the real curative agency) from being so hard as to break bones or cause other damage.)

4. See Barbara Brown, New Mind, New Body, and Stress and the Art of Biofeedback; or Elmer and Alyce Green, Beyond Biofeedback.

5. At a recent neurotherapy (Futurehealth `01 Miami). conference a number of presenters, including Karl Pribram, Richard Williams, Valdeane Brown, and Len Ochs called into question the issue of “will” and ego in the process of neurofeedback, agreeing that probably the best processes happen when the will or ego “gets out of the way.” This unquestionably happens in Ochs process, because the feedback is too immediate to do anything about, and in a form–beats or pulses of light the conscious mind makes nothing of, but the brain makes of it!–It knows what to do.

6. See Biofeedback: Advances in Neurofeedback and Neurotherapy, Vol 28, No.3, Fall 2000. The issue is dedicated to Hans Berger (1873-1941).

7. See also my piece entitled “The Soul and The Abyss of Nature” on Emanuel Swedenborg’s (1688-1772) premonitory studies on brain anatomy and the existence of brainwaves in the seventeenth century. In Emanuel Swedenborg: A Continuing Vision, New York: The Swedenborg Foundation, 1988.

8. W. G. Walter (1943, June) An automatic low frequency analyser, Electronic Engineering, 9-13, and (1954, June) “The Electrical Activity of the Brain” in Scientific American, 54-63.

9. Gibbs, F.A. & Knott, J.R. (1949), “Growth of the Electrical Activity of the Cortex”, Electroencephalography and clinical Neurophysiology, I 223-229.

10. Brown, B.B., “Recognition of Aspects of Consciousness Through Association with EEG Alpha Activity Represented By a Light Signal,” Psychophysiology, 1970, 6:642; and “Awareness of EEG-subjective Activity Relationships Detected Within a Closed Feedback System,” Psychophysiology, 1971, 7:451.

11. Megabrain Report, Vol. 2, No. 3, Spring-Summer 1994.

12. Ibid., p.3.

13. Crane and Soutar write: “We have found that the majority of biofeedback clinicians and researchers are among the most responsible professional s in the entire healthcare system. Although the pressure to turn out more research is unrelenting, most newcomers are surprised to find out that there have already been thousands of studies (largely funded out of the pockets of the clinicians themselves). Yet the establishment continues to call for multi-million dollar, large scale, double-blind studies… In fact, double-blind studies might be impossible because the nature of the biofeedback instruments would probably cause all but the dumbest of patients to realize that something was amiss. Imagine flying an airplane (your body) upside down and straight toward a mountain with all of your senses intact but your instruments say you are right side up and there is no mountain there…that’s what trying to give false feedback is like.” Crane and Soutar, Mindfitness Training: Neurodfeedback and the Process. (New York, Writers Club, 2000)

14. Ibid., Ochs, “Thoughts…” p5.

15. Ochs, “Thoughts” p. 15

16. Paper presented at conference, FutureHealth 2001, Miami.

17. Stephen Larsen, “The Tao of Neuroscience: Len Ochs’ Magic Lights and the Realization of Cortical Flexibility,” February, 1998; Presentation at special session, FutureHealth, the Sixth Annual WinterBrain Conference, Palm Springs. The paper is posted on this website, among Articles (http://stonemountaincenter.com/site/?page_id=12).

18. “Wiring in the Brain,” January, 25wisiwyg://36http://www.cnn.com/2001/HEALTH/01/25/boosting.neurons.ap/index.html.

19. Gamma Amino Butyric Acid, an inhibitory neurotransmitter.

20. Jacobs, van Praag, and Gage, “Depression and the Birth and Death of Brain Cells” in American Scientist, Volume 88, July-August 2000. pp.340-345

21. Herbert Benson and Keith Wallace’s research team in 70’s and 80’s did a number of these experiments and also filmed the yogis performing.

22. Paper presented at Winter Brain Conference, FutureHealth 2001, Miami.