The Biofeedback Umbrella by Connie Dent, Ph. D.

Recently I reviewed a 1994 edition of a Clinical Psychology text that is to be revised for a new edition coming out this year. The authors' position in the 1994 edition declared "that there is not enough evidence at this point to conclude that biofeedback is a clinically useful technique." I frankly told the authors that this view was antiquated, uninformed and would be a detriment to future adoptions of their text if left unchanged in the new edition. I pointed out that a colleague of mine and I have developed two courses in Health Psychology which emphasize biofeedback, and we cannot accommodate all the students who are clamoring to get into these courses. In the first course students are introduced to biofeedback machines which include several different electromyograms, a variety of electroencephalographic modalities, different instruments for measuring temperature (in the extremities), blood pressure measures, and to a plethysmograph. In the second course they are also introduced to a capnometer which feeds back to a subject the O2/CO2 ratio of their exhaled breath. The emphasis of this latter course, however, is on research using one of the biofeedback modalities.

As one pursues the variety of treatment possibilities for which each of the biofeedback techniques can currently be considered efficacious, it becomes apparent that specialization will soon become a "must." Just as physical medicine has had to do, biofeedback practitioners will have to select an area in which to specialize. Already neurotherapists, like neurologists did before them, have formed their own society, publication, etc. Those who look into the capabilities of the electromyogram realize that this biofeedback approach can be used not only in the treatment of various disorders that require muscle tension reduction but in rehabilitation that requires muscle tension enhancement and more recently in the prevention of muscle disorders through dynamic EMG thrusts that emphasize "ergonomics."

Above and beyond treatment applicability, the biofeedback umbrella will surely cover and enhance research efforts . Psychologists and others involved in human subject research have often found it difficult to quantify the behavior aspects of their investigation. My students and I are finding that biofeedback measures can give the researcher clean, objective measures of psychological variables that usually constitute the dependent variable in their experiments. An example will sustain this point.

A graduate student and I were interested in determining if the gender of a pursuer influence the magnitude of the fear response in the person pursued. Male and female subjects listened to a guided imagery tape wherein their car stalled on a dark, lonely country road, and they began walking toward a distant light in search of help. As they did this, footsteps sounded behind them and as the footsteps got closer, they felt compelled to turn around and determine who was there. All Subjects did this; individually with eyes closed in a dark room and each was hooked up to a biofeedback machine which measured their electrodermal response (EDR).

In half the cases, the person behind them was a male and in the other half the pursuer was a female. In male-pursuer cases the EDR which as rising during the guided imagery continued to rise. In the female pursuer scenario the rising EDR always leveled off upon learning it was a female and in most cases actually began to drop down. The difference in fear response depending on pursuer-gender was significant at the .001 level!! Each subject was also queried about how they felt upon learning who was following them. Their subjective reports matched their quantified EDR measure except in one case. This case underscores the value of biofeedback as a variable measure. A male subject related with noticeable bravado that when he turned and saw a man behind him, it didn't scare him at all. However, the EDR told a different story. Unbeknownst to him it continued to climb without surcease, thus underscoring the value of this kind of measure when dealing with human subjects.

In sum, though the future of biofeedback in alleviating unhealthy conditions for humans is just shedding its "swaddling clothes," it is already showing its capabilities for giant steps. However, just as important as its treatment future is biofeedback's value to researchers. It is a quantifier of subject variable that in human research has often been most difficult for investigators to achieve. The biofeedback umbrella is indeed a large one, but we can all find a place under it.

Spotlight: Dr. Frank Echenhoffer

Combining Western and Eastern, scientific and spiritual principles, yin and yang; this is the vision of Dr. Frank Echenhofer. True to his premise that there are commonalties in both the empirical and spiritual methods of investigation, Dr. Eichenhofer seeks out areas of similarity. At his office in Cheltenham, I first viewed a picture of a Tibetan Buddhist dakini (goddess) and then a Rossetti portrait of a mesmerizing woman. "Do you see the similarities", he asked. Both inspired, and both seems to represent an ideal beyond mere surface beauty. But one was "eastern" and the other "western". Dr. Echenhofer explained that he and others are working to constellate a broader western psychology that can incorporate certain "eastern" spiritual practices and truths. But, rather than use "eastern" images, concepts, and words, it will be "western" in flavor and be based on western spiritual tradition. We then spoke of meditation and empiricism. Dr. Echenhofer explained that both deal with repeated observations to arrive at truth. The scientific method is not the enemy of spiritual truth; the enemy of truth is spiritual dogma and rigidity. And what of biofeedback. It is often heralded as a means of connecting mind and body. Biofeedback involves working with fragmentation and with subtle physiological realities. As a past president of the Pennsylvania Biofeedback Society, Dr. Echenhofer expressed his thoughts and feelings about our organization. He commented, "Really good people are drawn to biofeedback...and the potential for biofeedback is enormous." He encourages all of us not to lose contact with what excited us initially about biofeedback in these times when the market place is so hard.