Problems in Biofeedback Training: An Experiential Analogy—Urination

PROBLEMS IN BIOFEEDBACK TRAINING: AN EXPERIENTIAL ANALOGY—URINATION ERIKPEPER, Ph.D.* The research literature on biofeedback training is filled with contradictions . Certain researchers and experimental settings appear to enhance learning in trainees, whereas other combinations appear to inhibit learning. Further, some researchers, educators, and clinicians suggest that biofeedback can be a useful tool for preventive medicine, since a person who can sense his body response can learn to change or modulate the patterns of his behavior [I]. Other researchers, especially those who have been unsuccessful in teaching voluntary control, believe that claims of any usefulness should be made extremely cautiously. Two examples of the many studies that could be cited are those of Love, Montgomery, and Moeller [2] and Sterman [3], who report that biofeedback training can be used to ameliorate a number of disorders such as hypertension and epilepsy. Conversely, other researchers report that biofeedback training does not ameliorate these conditions. An even more confused picture of visceral learning is presented in an article describing research on curarized rats [4], in which the same researchers could not successfully replicate their own studies. Researchers often discuss in detail the technical problems encountered in biofeedback research, such as the correct physiological feedback or unique combinations of lengths of training-trial periods. However, they usually ignore the subtle qualities of the experimental setting, such as smiles, smells, attitudes, and the comforts of the trainee's chair. The idiosyncratic behavior of the subject, trainer, or both is not well understood , and little attention is given to it. Usually, in experimental psychology , group behaviors are measured (mean, average); however, biofeedback learning is not group behavior but learning unique to an individual . The term "statistical average" in biofeedback training is as meaningless as the term "normal person" in clinical assessment. In discussing biofeedback learning, sometimes known as visceral learning or autonomic learning, no distinction is generally made between autonomic learning and striate muscle learning. Yet a number of *Albany Hospital, Albany, California 94706. 404 I Erik Peper · Biofeedback Training research programs are focused precisely around the question of to what extent those learning processes are the same or different [5, 6]. In many cases the major difference seems to be the type of reinforcer or the number of "conscious" learning trials. In muscular striate learning, the learning time involved and the necessity for attentiveness to the task is often underestimated. The intense practice necessary is easily demonstrated in the training of musicians or athletes. As a more ordinary example, consider the complicated process of learning to type. The fine finger movement and discrimination involved in typing takes an adult weeks to learn. However , this is only a variation of the child's process of learning to tie shoelaces, which takes months to learn. Tying shoes in turn is only a small advance over learning to hold a spoon to eat, which is a small advance over the grasping reflex present at birth. Whether or not the process in autonomic learning and striate muscle learning is different, both require a large number of learning trials. Many complicated striate muscular learning tasks are as unconscious as visceral learning in coordination, and often include autonomic processes . For example, in skiing there is a total coordination of balance, breath, blood flow, and timing of muscle movements, which allows the successful skier to experience the sensation of "floating over the slopes." It is no wonder that autonomic learning may take a long time. In trying to make this process conscious, we are having to make ourselves aware of sensations we have not noticed since infancy and have long learned to suppress. Moreover, some of the learning possible for a baby may no longer be possible for an adult; the adult slowly constricts his learning capabilities by the internal physical structure he creates in the process of development. Biofeedback learning cannot be described accurately, just as we cannot describe the process of getting out of a chair. Although language exists to describe our internal processes or our emotions (words like angry, afraid, friendly, etc.), the actual experience behind these words is uniquely different for each person. Each verbal label used to describe an emotion actually describes many components—think of the...