Dr. Erik Peper is an internationally known expert on biofeedback (applied psychophysiology), holistic health and stress management. Since 1976 he has taught at San Francisco State University where he was instrumental in establishing the Institute for Holistic Health Studies, the first holistic health program at a public university in the United States. Dr. Peper is President of the Biofeedback Foundation of Europe and past President of the Association for Applied Psychophysiology and Biofeedback (AAPB). He holds Senior Fellow (Biofeedback) certification from the Biofeedback Certification International Alliance (BCIA) and was the behavioral scientist (sport psychologist) for the United States Rhythmic Gymnastic team in the early 1980’s. Dr. Peper lectures and teaches frequently through-out the world and has a biofeedback practice at BiofeedbackHealth in Berkeley, CA.
This is part 1 of a 3 part interview with Dr. Peper that discusses what is bio and neurofeedback? How these tools are utilized to enhance sport performance, age appropriateness, technological advancements and simple products available for consumers.
Examiner: You are an expert in the field of biofeedback and also work with neurofeedback. What events captured your interest to bring you into this field of study?
EP: There are a number of events that captured my interest. One there was an opportunity to study with some remarkable people who weren’t athletes but studied pain control. In 1971 I studied an interesting person who voluntarily put a skewer through his cheeks and through the sides of his body and reported zero pain.
Examiner: You studied this?
EP: Yes, here was a person that took a skewer and we made the skewers by taking bicycle spokes, sharpened and sterilized them. The first thing he did at the lab, this was at NYU, he dropped the sterilized spokes onto the floor took his dirty shoes, which he had been walking around with outside and he sterilized the spokes in his own terms by taking his dirty shoes and rolling over these at that time sterilized spokes. Once the spokes were really messed up with all these outside germs then he began his skill demonstration.
Examiner: This person took a skewer and poked it through his cheek?
EP: Through one cheek and out the other and also another one through one side of his body through the flesh and out the other side.
Examiner: This person did this for the sake of doing it?
EP: He did it more for the concept you can have voluntary control. I had heard about this skill initially through the New York Academy of Sciences where the discussion was can you have voluntary control? This was the era where people did not even believe you could warm your hands with voluntary control, through the use of imagery. This idea was very much in dispute at the time. Through the years I’ve known other people who could do this discipline. Recently, at San Francisco State, a 62 year old Japanese yogi, Mr. Kawakami with thirty seven years of experience practicing various forms of yoga demonstrated this discipline. Mr. Kawakami, pushed unsterilized skewers through his tongue. Sitting calmly with skewers in his tongue and throat, he showed no signs of discomfort; rather he radiated peace. Removal of the skewers left neither open wound nor bleeding.
Examiner: Why did he choose to demonstrate this discipline?
EP: A major reason people with this type of mind control do this is often for themselves to point out they’ve learned these meditation techniques, and feel they need to prove it to themselves. and second reason yogi Kawakami wanted to do this was to demonstrate to his students that the limits of their beliefs are the limits of their experience. If you have other beliefs you may have other outcomes. (Yogi Kawakami is founder and chief executive director of own school of yoga and the Institute for Research of Subconscious Psychology in Fukuoka and Tokyo, Japan).
Examiner: These people have conditioned themselves for this particular exercise.
EP: They have learned how to control their attention. Any good sports performance is where you are able in most cases to control your attention and not have negative thoughts or distracting thoughts. Historically athletes went to a sport psychologist when they were performing poorly. That is still often the case, but the field has shifted to how can you use these concepts of Sport Psychology to optimize performance? A slightly different way of thinking. When you look at the word “motor rehearsal” that’s the use of imagery and if you talk with top athletes as a rule they generically say, “When I am in competition, it’s 95% mental control.” If athletes are standing in a line with their competitors in most cases at the top level of sport all the athletes can win. In most competitive sports there isn’t that much unique difference and so the key is how is the athlete thinking? If you think of psyching out in sports where the athlete could basically win but somehow gives up. We came up with a series of strategies to try and shift that.
When I think of peak performance one skill for athletes is mental rehearsal, how can you show athletes how to use their brains in a sense to improve their performance, and how can you teach them to recover quickly during and after performances? I learned this in a sense not from sports initially but around 1971 I worked with a well known Opera singer who was singing at the Met. After a performance the performer would be excited which is normal. The performer would go out for a late dinner around 11pm and having another performance the next day there wasn’t enough recovery time. The question became how do you recover more quickly? This is a theme in sports regardless of where you are, what happens, whether you win or lose, you need to be able to shift back.
One of the uses of bio and neurofeedback are for recovery and regeneration both on the cognitive side, letting go of whatever happened and the physical side getting your body to recover. It involves learning to let go of muscle tension and breathing slower.
Examiner: The terms biofeedback and neurofeedback can seem a bit mysterious for some people. Please define the terms in simple form.
EP: Let me start by saying feedback is just immediate information usually about what is going on. When someone plays basketball and they take the ball and are trying to shoot it through the hoop. They receive immediate visual feedback. If they miss the target they keep adjusting, by throwing higher, lower, sideways etc. They may get coached by people who have other hints and eventually they get it right and make it in the hoop. They keep doing this until they become better at the skill. That is what feedback is.
Biofeedback is monitoring what happens in the body and displays it back on a device. The person then can either use that information or not. A classic example of biofeedback is if a person goes to a doctor and they take his blood pressure and the machine reads back that the person has high blood pressure. If the doctor just writes down “high blood pressure” then it’s just information for the doctor. If the doctor on the other hand tells the person to sit quietly and take a couple breaths. Now the blood pressure is taken again and the persons blood pressure drops. The person can see that they did something that affects the blood pressure. Biofeedback is really ongoing measurements of some process in the body where the person can see changes, or that there aren’t changes. Hopefully as in this example with information the person can try new things to affect their blood pressure. Different biofeedback systems can monitor, heart rate, sweatiness, muscle tension, brain wave activity.
Example: In class I have my students perform an exercise where they are instructed to relax, let their arms hang and bend forward to touch their toes. I ask them if they are relaxed and most students say “yes.” But if you are observing them from the side you will notice many students are slightly lifting their heads. They don’t notice they are doing this. We then place electrodes on their necks while they are standing. There will be a little bit of tension on their neck because the neck muscles have to hold their head’s up. I have them hang forward and touch their toes again, the muscle tension in their neck should be close to zero, little muscle activity, however ten out of eleven healthly students will register significant muscle tension in their neck when they are saying they are relaxed. All we do now is add an auditory sound which is the biofeedback and I tell the students when they are doing the exercise that if they are relaxed there will be no auditory sound when they are bending forward. What typically occurs is that the student will life their head many times and each time they will trigger the auditory tone which gives them information that they are tensing their neck muscles. But the average student can learn to shift and do this correctly with about five minute of practice, even without prior training.
Often people are unaware of tension patterns in their body and that makes sense because they are interacting in the world. They are not focusing on what is happening within their bodies.
Examiner: They have an external focus.
EP: Correct. What biofeedback does is make the unaware aware. The undocumented documented. One of the early pieces we observed in biofeedback is that people are highly unaware of what they are doing. They aren’t aware they are shifting position or shaking. They don’t observe their internal language where they may be using lots of buts, and negatives.
Examiner: How is neurofeedback different?
EP: Neurofeedback is a subset or specialization in the field of feedback where you only record from different areas of the skull. Historically there wasn’t a separation between the two practices. A practitioner would do muscle feedback, heart rate feedback, temperature feedback and brain feedback. In 1995 the field separated. The neurofeedback scientists record with different electrodes on the head and look at these patterns. From my perspective the two, bio and neurofeedback are not really apart. Neurofeedback is a specialization. However the brain and body are one. Changes in the body affect your brain. Changes in your brain affect your body.
Next week, Dr. Peper discusses effectiveness of biofeedback for young athletes.