Non-medical Biofeedback by Rob Kall,
Copyright 1995, R. Kall
3171 Rail Ave. Trevose PA 19053
compuserve #74354,654
an introduction to a panel at the 195 Annual Meeting of the Association for
Applied Psychophysiology and BIofeedback,  organized and chaired by Rob
Kall, with Carol Schneider, James  Hardt and Stanley Krippner


I organized this panel for highly political reasons. I and many longtime
supporters of this organization have become seriously concerned about
recent efforts to medicalize biofeedback at the cost of depreciating and
trivializing the value and benefits biofeedback offers to humanity and to
individuals. I believe that Biofeedback is not an innately medical process.
Rather than being a remedial treatment passively performed on  the patient,

which fits into the reductionist medical model, biofeedback is an active,
self-responsible, behavioral/learning holistic process. It is based on
teaching the individual to optimize his or her mind body functioning.

     Ultimately, biofeedback can be distilled down to the idea of learning
to increase or decrease, inhibit or disinhibit some physiological activity.

Ralph Waldo Emerson, a transcendentalist of the turn of the last century
wrote one of my favorite quotations:

"A man is like a bit of Labrador spar, which has no
lustre as you turn it in your hand until you come to a
particular angle; then it shows deep and beautiful
colors. There is no adaptation or universal
applicability in men, but each has his special Talent,
and the mastery of Successful men consists in adroitly
keeping themselves where and when that turn shall be
oftenest to be practiced."
          Ralph Waldo Emerson

Biofeedback teaches people to turn their strengths
to the angles which show them best, and help people
to discover the parts of themselves which are the
best. And that is not a medical process.
     If you teach someone to change adipose tissue
levels or muscle mass via diet or exercise you are
not engaging in a medical procedure. You are teaching
health optimizing behaviors. If a coach teaches an
athlete to move more efficiently and effectively, so
the muscles work better kinesiologically, it's not a
medical procedure. If a consultant for a fortune 500
company determines a musculoskeletally better
ergonomic design for a work station, which reduces
risk of carpal tunnel syndrome or back pain, it's not
a medical procedure. If a corporate optimal
performance consultant evaluates an executive's
psychophysiological response profile to identify
patterns which can be improved upon to enhance
performance, that is not a medical procedure. It's a
fine-tuning process, a form of training in
psychophysiological grooming.
     I'll repeat my assertion that all biofeedback can
be characterized as training to move an individual to
a different position on the overlapping continua of
either activation-de-activation or inhibition-disinhibition.


     At last month's Key West EEG meeting, Hershel
Toomim sketched out the beginning of a new theory
to explain why it takes 30 to 60 sessions for
neurofeedback to produce significant results with
ADD. He proposed, based on PET scan and scalp
thermal monitoring, that neurofeedback trains for
increases in blood flow to the areas being trained,
and that the long term effect of this is growth of
microcapilaries, leading to increased vascularization of
that area of the brain. This is an exciting concept
which one of our most esteemed pioneers in
neurofeedback has suggested could easily be
conclusively verified with animal research. But is this
increased vascularization training a medical process?
Not any more than pumping iron produces new
muscular tissue or yogic stretching produces changes
in connective tissue.
IT's simply a learning and growth process. A stretching
and challenging of the individual such as is
experienced in the Flow state.
     Yet there has been a powerful impetus over the
last decade or so for biofeedback to be fully
recognized as a medical procedure-- to be treated
as a medical treatment. THe reasons are fairly obvious.
The primary means for earning income as a health care
provider is to perform procedures accepted by the
dominant medical paradigm-- having received the
blessing of the sacred Bishops chanting scriptures
from the ICD-9 code book and the cardinals of the
state workmen's comp boards.

In Medieval Spain, the Jews, to escape the dark
punishment of the spanish inquisition, masqueraded as
Marano's, hiding their true religion to save their lives.
In a sense, that's what many people in biofeedback
have resorted to doing. And to some degree, that's
been okay, inasmuch as it has enabled those
providers to make biofeedback more accessible to
people who would have otherwise been unable to
benefit from it.
     But I come to you today to propose that the
medicalization of biofeedback has gone too far. There
is a higher vision in the life change philosophy which
can and should accompany effective biofeedback
training. That vision has been dwarfed, clipped,
bound, and gagged in an effort to avoid offending the
double blindism preaching ayatollahs of reductionist
medical scripture.
     And considering they represent the trillion dollar
empire which last year conquered the US congress
and President-- they are fearful powers to be
reckoned with. Although the power brokers and
protectors of the medical empire are cold-blooded,
money and power driven, dinosaurs, there are warm
hearted health care providers within the medical
profession,  many good doctors who are able see
the full biofeedback self awareness and voluntary self
regulation model as more than just muscle re-
education, relaxation and incontinence training. They
are able to see their patients as complex individuals
who consist of systems within systems rather than
simple lesions or illness foci.
     Every time you see someone for biofeedback you
have the opportunity to effortlessly go beyond
helping them to eliminate their symptoms or chief
complaint. You can help them grow and add the
biofeedback metaphor to their lives so they learn to
fine tune their phsyiology and optimize their
performance mentally, physically emotionally and
spirituallly.
      I've purposely put a religious slant on the
medical model because it is a paradigm which is
illogically embraced by its holders to the exclusion of
viable alternate approaches to health. Yet I do not
believe there is anything religious about  teaching and
preaching the gospel of biofeedback, just as William
James taught the Gospel of Relaxation in his book
Talks to Teachers.

     Borrowing from Les Fehmi, can you imagine using
biofeedback to teach self awareness, self control and
self diiscipline to inner city children at risk for
becoming drop-outs or criminals? or for convicted
felons and probationers. Look at Jeremy & Yael
Langford's work with students on an Israeli Kibbutz....
at Al Bermea's work with violent teen offenders, and
Stacy Schafer's and Donna King's work  with court
appointed parolees and probationers.
     Can you imagine training executive and government
personnel, and celebrity artists to function more
creatively and effectively, with reduced risk of
succombing to stress and its effects not only on
health, headache or pain, but also on energy,
enthusiasm, alertness, attention and joy? The
pentagon, fortune 500 companies and professional
and amateur sports teams have.
     Can you imagine teaching kids to pay better
attention before they develop problems or before
they are identified as gifted, so they can begin even
earlier in to life to be more fully enabled to reach
their full academic potential.
     Can you imagine biofeedback in churches,
synagogues, mosques and temples, helping people to
let go and open themselves to states of
consciousness associated with increased spirituality
and awareness of the sacred in their everyday life.
     Can you you picture athletes using computerized
telemetric force and movement biofeedback or
kinesiologic surface EMG biofeedback comparing their
movement with temporal templates of ideal patterns
pre-recorded by professional athletes, trainers or
programswhich create them. I presented on a non-
computerized wearable analog ski biofeedback device
14 years ago at the 1981 COlorado SPrings
Biofeedback Society of America ANnual meeting. You
could listen to the sound of your skiing. Now
multimedia, virtual reality feedback promises to enable
us to use feedback to enhance almost any behavior,
movement or physiological funciton in ways so subtle
and sophisticated it won't feel like biofeedback at all.
It will be more like edutainment.
     Can you imagine applied psychophysiological
rejuvenative , cosmetic facelifts for outside and
inside. Try a zygomaticus EMG placement and some
simple pumping smile iron exercises to see how easy
it is to produce a better looking face.

     Imagine a suite of multimedia, semi automated
biofeedback training stations, with a collection of
these kinds of personal growth and enhancement
programs, which could be easily operated by a
trained, certified person. The cost of this kind of
biofeedback will drop by 90 to 95% from an
estimated $1500 to $8000 down to $80 to $500
if the utilization is great enough. Will that hurt the
medicalized biofeedback practice of the clinical
psychologist, physical therapist or other health care
providers? On the contrary, the massive increase in
exposure to biofeedback and the screening process
this approach will enable should produce
considerably more people who are identified as not
responding to the initial standard training. The same
technician/trainer can, along with the expert system
software, be trained to observe adverse reactions,
such as autogenic abreactions or development of
awareness of painful memories. These non-medical
biofeedback trainees will become candidates for
psychophysiological, psychotherapeutic and
physiotherapeutic therapies.

     Wouldn't it be nice to have biofeedback a routine
part of the educational curriculum and preventive
health maintenance. The idea of referring patients who
need medical biofeedback treatment might become far
more likely, perhaps even obvious to primary care
providers and insurers.
     Perhaps the most important aspect of non-
medical, human potential biofeedback is what it does
for you. WHen you start teaching people to feel good
and function at their best you feel better-- more
energized, enthusiastic, satisfied.  You are helping
healthy normal people to feel and function better.
     Let's take just a moment to put this into practice.
Use the skills you learned with biofeedback to
regulate your mind/body/emotions. First quiet your
self, with eyes closed. Now, access a memory of a
past positive experience, when you reached a peak
of performance, of feeling good, ...

So, what can you do now? The next time you see a
patient, take another look and see not a lump of
pathology but the glow of a rich human being who can
shine brightly with your help. Even if the person
comes in for incontinence training, you can help to
empower the person with the biofeedback human
potential paradigm of bringing out the best, rather
than merely getting rid of the unwanted. Your work will
be just about the same. The difference is the vision
you share with your client.
     It is not necessary to give up this vision while
working within the archaic, yet hopefully rapidly
evolving and changing medical model. My three
panelists will help you to think about new ways to
conceptualilze the ideas of health, healing and human
potential. Each one will introduce his or herself. THank
you