Letters

Biofeedback now!

Just a few years ago the Monitor published an article on "Easing ADHD without meds." I looked in vain for a single reference to biofeedback in that article. As a clinician who for over 30 years has incorporated biofeedback in my practice, both in the VA system and in community hospitals, I was heartened to see it on the cover of the March Monitor: "Biofeedback: An underappreciated tool that holds growing promise," but disheartened by some of the comments in it. While the article should be lauded for its general encouragement about biofeedback, I also observed some old and discredited caveats. Specifically, that these "therapies are highly susceptible to placebo effects." That demonstrates a misunderstanding of both biofeedback and the placebo effect. Neurofeedback training/learning has been demonstrated with rats, cats and monkeys, presumably with no knowledge of what was expected. There is an unfortunate and even damaging discrepancy between the scientific assumptions of biofeedback practitioners and researchers. For years biofeedback clinicians have heard about the need for "sham feedback groups" and other research techniques that treat biofeedback like the now discredited "ghost in the machine." A short look at other research would reveal that low-resolution tomographic (LORETA) neurofeedback is in fact quite capable of localizing activity in the brain. After 40 years of hearing endlessly about the need for "more robust studies" (and now for expensive fMRI machines), the operative word for biofeedback clinicians is neither "if" nor "when," but rather "now!"

David Wakely, PhD
Fitchburg, Wisconsin

In her "President's Column" in the March Monitor, Susan McDaniel, PhD, addressed the much-needed issue of defining leadership as a collaborative process rather than a hierarchical one. She wrote about a group of military family physicians who concluded that they valued mission over control: "They wanted their patients to have the best possible outcome and would yield to anyone, independent of rank or discipline, who might help that happen."

I would hope that that group of "anyone" would include the advocate and/or caregiver of the patient. Too often overlooked are parents and caregivers who can often have a body of information from their day-to-day contact with the patient that can be important to reaching that "best possible outcome."

Harriet Heath, PhD
Winter Harbor, Maine