Future Directions

The history of self-regulation of brain waves (neurofeedback) has had some wavelike characteristics itself. As noted earlier, the field rose rapidly in popularity and peaked in the early 1970s, followed by the trough of the late 1970s to mid-1980s. Now its popularity is rapidly rising, with no sign of cresting. This section includes speculation on whether NF's popularity will continue to rise until cresting and persisting at a level reflecting its true value or whether it will again crash (temporarily or permanently).

The scenario of steady growth and continuing popularity is likely if there are continuing reports of successful clinical use backed by credible research findings, favorable media coverage, and increasing acceptance by insurance carriers and managed care groups. A ''crest and crash'' scenario is likely if controlled research findings unfavorable to NF are published in prestigious journals and publicized in popular media outlets. Related to this, there is considerable concern among NF practitioners that laboratory research on NF will be so controlled as to be ''sterile'' in nature and preclude the positive results commonly reported by clinicians. Practitioners often state that it is the total treatment situation that yields positive results, i.e., client-therapist rapport, ongoing adjustment of electrode placement, as well as the EEG feature being trained. Many also fear that there will be bias in the large-scale, federally funded research being called for by some NF critics because researchers may be major stakeholders in the present health care system (e.g., drug companies, physicians) who stand to profit from continuation of the status quo. Relatedly, NF advocates often report a reflexive, negative response when the topic is mentioned to members of some other professions. Responses appear to range from skepticism to derision and often include automatic dismissal of claims of NF efficacy. Whether this situation stems from perceived threats to the health care status quo, perception of NF claims as incredible, lingering memories of early 1970s association of biofeedback with ''flower children,'' and/or perceived lack of data to support claims, it impedes professional development of the field. Such attitudes by leading professionals in related fields and in university training programs need to be modified if the field of NF is to attract bright, young persons who could help insure its future development.

EEG biofeedback as a treatment method seemingly has ''risen from the ashes'' under the new title NF and is rapidly growing in popularity as a sole or adjunct treatment for an increasingly large number of disorders, many of which have been resistant to more traditional therapies. Whereas there are reports of near-miraculous results with minimal or no side effects, NF practitioners often express dismay that their results are dismissed by mainstream medicine, psychology, and education rather than embraced as evidence that treating abnormalities of the electrical aspects of the electrochemical functioning of the brain can be at least as effective as treating chemical imbalances. Considering the rapidly increasing scientific evidence for neural plasticity, central nervous system influence on immune system function, and a rhythmic basis for much transfer of information within the brain (time-binding theory), it does not seem unreasonable to expect that modification of aspects of central nervous system rhythms could have profound effects on health and learning rates. However, before becoming overly eager about the unique value of NF, advocates should consider that several other alternative medicine fields (e.g., chiropractic, nutrition) claim major and near-miraculous treatment successes for an equally wide range of disorders. Some of these, such as music therapy, also may be modifying basic central nervous system rhythms through entrainment or other means. If NF is to maintain its current popularity and grow in acceptance by other professions, it must be demonstrated through well-designed, nonbiased research to be not only an efficient treatment but a unique one that offers advantages beyond those of other available treatments.

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Biofeedback Mastery

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