This is the first of a series of occasional articles on research findings in an important area of mind-body medicine. Some of the most important "breakthroughs" in the field of biofeedback have come not from one definitive study but from the accumulation of numerous studies over many years. Rather than focusing only on the latest published articles, we felt it important to place the field of biofeedback in its historical context.

Back in the 1960s when experimental psychologist Neal Miller first demonstrated that the autonomic nervous system could be trained to alter some bodily processes, it was thought biofeedback would change the world. Miller's discovery uprooted the prevailing paradigm, that the autonomic, or visceral, nervous system was basically "dumb" and beyond voluntary control. At the time, some scientists predicted that biofeedback eventually would allow patients to "take a fully active and direct role in literally learning not to be sick" (Dienstfrey, 1991).

Over the next three decades, some 3,000 articles and 100 books on biofeedback were published.

And although the research has not uncovered the kind of "unified field" originally hoped for, biofeedback has been shown to be an effective treatment for dozens of specific ailments. These include bronchial asthma, drug and alcohol abuse, anxiety, tension and migraine headaches, cardiac arrhythmias, essential hypertension, Raynaud's disease/syndrome, fecal and urinary incontinence, irritable bowel syndrome, muscle reeducation, hyperactivity and attention deficit disorder, epilepsy, menopausal hot flashes, chronic pain syndromes, and anticipatory nausea and vomiting associated with chemotherapy. While biofeedback has been used successfully to treat some psychological and mental disorders, it seems to work best with patients in which physiological processes are relevant (Futterman & Shapiro, 1986).

The most common forms of biofeedback today make use of instruments to "feed back" information about such bodily processes as muscle tension (EMG feedback), skin temperature (thermal feedback), brain waves (EEG feedback) and respiration. By watching the monitoring device, patients can adjust their thinking and other mental processes in order to control bodily processes. In some cases, subjects learn by trial and error what kind of thinking or behavior affects those processes. In other cases, subjects are taught specific methods, such as relaxation or imagery, which it is believed will have an impact on bodily functions.

One of the most exciting areas of biofeedback research today is the use of alpha-theta brainwave training. This therapy has proven effective in the treatment of various disorders, including chemical dependence, post-traumatic stress disorder, depression, anxiety, multiple personality, panic and eating disorders. Drs. Eugene Peniston and Paul Kulkosky's (1989, 1990, 1991) pioneering work showed that training chronic alcoholics to increase the lower-frequency alpha and theta brain waves, while controlling the higher frequency beta waves, resulted in significantly less depression, less craving for alcohol and less relapse. (The alpha brain wave has been associated with a tranquil, serene state, while the theta wave corresponds to a deeper meditative state.)

The researchers' treatment protocol includes 6-8 weeks of thermal biofeedback and autogenic training, followed by 30 sessions of evoked images of personal change and alpha-theta EEG biofeedback. The sessions are performed twice a day, five days a week.