A History of Neurofeedback
In the late 1960’s Dr. Barry Sterman of UCLA and the Veteran’s Administration Hospital in Sepulveda,
California was conducting sleep research. The focus of the research was to evaluate neurological activity
associated with sleep and sleep onset. The means to assess the activity was electroencephalography (EEG). EEG is
a technology by which the electrical activity generated by brain cells is monitored. When a brain cell or neuron
"fires", it produces a change in the electrical field within and around the brain cell. This change in
electrical field can be observed by placing electrodes on the scalp to detect the activity and amplifying the
minute signals generated by the neurons. The rate at which a neuron fires is called the frequency and this is
usually measured in hertz, times per second. By observing the EEG the frequency and patterns of activity of the
neurons of the cortex, the outer layer of the brain, can be determined.
 While observing the brain activity
of the laboratory animals, in this instance cats, Sterman and his colleagues noticed an interesting EEG pattern.
A recurrent burst of activity at a frequency of approximately 14 hertz appeared to be associated with reduction
of muscle tension in the cats. The researchers labeled this activity sensorimotor rhythm (SMR) because it was
observed to occur on an area of the brain called the sensorimotor cortex.
They were intrigued by this observation and sought to determine if there would be an increase in this
activity if the cats were given a reward each time the pattern was produced. Each time the SMR activity was
noted in a cat’s EEG the cat was immediately given a small amount of milk and chicken broth. In a short period
of time the cats were generating an abundance of the activity and the research group noted that this was one of
the first occasions that brain activity was trained in a direct manner.
Shortly after the completion of the sleep study Sterman’s research group was contacted by a colleague and
invited to participate in some research for NASA. NASA officials reported that exposure to a particular rocket
fuel, monomethyl hydrazine, appeared to be producing severe consequences including headache, nausea,
hyperventilation, hallucinations, and seizures. NASA employed Dr. Sterman and his group to evaluate the toxicity
of the rocket fuel. The research group began exposing the laboratory population, again cats, to increasing
amounts of hydrazine. The typical response pattern of the cats was a sequence of vomiting, vocalizing,
hyperventilation, salivating, seizures, and death. However, one group of cats exhibited an unusual pattern in
that they appeared to suppress the seizure activity at dosage levels well beyond that tolerated by all of the
other cats. The discrepancy between the response patterns was perplexing until review of the cat’s laboratory
history revealed that the cats that were resistant to onset of seizures were those that had been trained in the
sleep study. The researchers hypothesized that the training the cats received had made their brains more
resilient. The group repeated the study with other animal populations and then decided to explore applications
with human populations.
Noting the benefit specific to seizure activity Sterman and his group began by recruiting a population of
individuals experiencing epileptic seizures that were not manageable with medication. This group was, by
definition, the most severely impaired as most of them experienced seizures consistently and had no means to
effectively control frequency or severity. Sterman’s group used a training process based upon the procedure
utilized with the cats and other animal populations. At the conclusion of the study was observed that 60% of the
treatment group responded positively to the training. The researchers reported that within this responding group
an average of 60% reduction in seizure activity was observed. The range of seizure reduction was between
20-100%. And more significantly, the reduction in seizures was observed to endure for most of the group. The
first study derived from this research (Sterman & Friar, 1972) and is part of over 160 papers published by Dr.
Sterman investigating the brain’s capacity to learn new, more beneficial patterns of response through
neurofeedback.
Dr. Joel Lubar of the University of Tennessee had become interested in Sterman’s work after he replicated the
results of Sterman’s epilepsy study. After obtaining a grant he was able to join Sterman’s research team. Lubar
had already studied hyperactivity and attention issues extensively and through his experience with Sterman was
hopeful there was potential benefit for this population. He noted that many of the participants in the epilepsy
study reported a reduction in feelings of physical restlessness and associated hyperactive behavior. As a
consequence of this observation Dr. Lubar decided to evaluate the benefits of neurofeedback with a population
exhibiting hyperactivity. His first research on hyperactivity (Lubar & Shouse, 1976) was only the start of his
extensive contributions to the research literature.
While Sterman, Lubar and associates concentrated on training within the SMR frequency range (12-15 Hz),
another group of individuals were exploring applications of training at lower frequency ranges known as Alpha &
Theta. Alpha is a frequency range (8-11 hertz) that is most evident in the human brain during periods of
unfocussed relaxation. Imagine reclining in a favorite chair after a nice meal. The feeling of well being
experienced at that time is associated with the brain operating within the alpha frequency range. Theta activity
(4-7 hertz) is experienced each time a person falls asleep. As the brain quiets and slows activity the person
reaches a stage of consciousness during which he/she is unaware of external surroundings but is not asleep.
Alyce and Elmer Green were researchers at Menninger Foundation in the early seventies. The anecdotes of many
famous artists and scientists regarding moments of profound insight and creativity had convinced the Greens that
the lower frequencies of brain activity were associated with these bursts of creativity. They developed
biofeedback apparatus to enhance the production of this activity, particularly in the theta range. They began
working with a wide range of individuals in largely uncontrolled studies to confirm their hypothesis.
During one of their theta training sessions at Menninger’s a psychologist, Dr. Eugene Penniston, experienced
a flash of insight and contemplated the idea of using alpha/theta (A/T) training to enhance the efficacy of
treatment of substance abuse and addiction. Dr. Penniston worked at the VA medical center in Fort Lyon,
Colorado. He was intimately familiar with the failure of traditional forms of substance treatment. Dr. Penniston
found an interested colleague, a physiological psychologist, Dr. Paul Kulkosky, and the two designed a study to
incorporate A/T into a traditional treatment model. Their first study (Penniston & Kulkosky, 1989) used three
groups of ten participants, two of those groups being severe alcoholics with repeated inpatient
hospitalizations. One of the alcoholic treatment groups received traditional substance abuse treatment and
another received traditional treatment plus A/T training. Thirteen-month posttreatment follow-up revealed that
two of the ten in the traditional treatment group had remained abstinent. Eight of the ten in the traditional
plus A/T group had maintained abstinence for the thirteen months. An informal four-year follow-up of this group
done by the Menninger Foundation reported that the eight individuals had maintained sobriety.
Penniston has followed his research with exploration into applications of A/T for posttraumatic stress
associated with combat. Others have explored A/T treatment for Bulimia Nervosa and Multiple Personality
Disorder.
The current increase in public awareness and clinical use of neurofeedback is largely attributable to
Siegfried and Sue Othmer. Their son presented with intermittent periods of violent rage due to temporal lobe
epilepsy. The symptoms were not effectively managed with medications. After observing the dramatic benefit to
their son from neurofeedback the Othmers began their efforts to make this treatment more accessible. They spent
four years developing computerized instrumentation and opened their first clinical office in 1989. Soon
thereafter they began to offer training courses to mental health professionals in further efforts to make
treatment increasingly available. They have trained in excess of 3000 clinicians and there are over 300
affiliate offices, including Midwest Neurofitness, worldwide. Their organization, EEG Spectrum, continues to
engage in ongoing research, training, and advocacy for the technique.
From this brief synopsis of the early history of neurofeedback one begins to grasp the potential significance
of this treatment and simultaneously struggles to understand how such a promising technique has remained
virtually without recognition. For a more detailed presentation of this fascinating story read A Symphony in
the Brain by Jim Robbins. |
