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By Wes Sime, Ph.D., M.P.H
., Thomas W. Allen, Ed.D., and Catalina Fazzano,
Ph.D. Draft submitted for publication, Biofeedback,
2000
Sport psychologists and peak
achievement trainers are continuously seeking
cutting edge methods of achieving the most expedient
route to confidence, trust in one's ability,
appropriate focus, composure and explosive power
with graceful, efficient movement patterns.
This is characteristic of almost all high level
performance including team and individual sports,
as well as aesthetic performances in music,
dance, artistry, etc. All are rewarded when
graceful, yet powerful movements can be performed
with seemingly effortless composure.
While stress management is
an essential foundation of effective performance
in sport, the applications of traditional biofeedback
(EMG, Temp, EDR) have been limited and perhaps
most useful for demonstration of stress and
tension outcomes. It has been only moderately
useful in shaping the performance behavior toward
excellence, primarily because of the obtrusiveness
of equipment and sensors. Along came neurofeedback,
with the sophistication of 10-20 lead placement,
complicated filters, multiple channel display,
exotic feedback display and QEEG. It, too, is
intrusive and seemingly not well suited for
performance applications. However, neurofeedback
has the advantage of measuring and displaying
a signal that is directly related to the visualization
a performer may conduct in preparation for stage
or competition. Thus conducting a session in
a quiescent setting is still relevant if the
client can make the mental rehearsal as vivid
as possible. It is even more relevant to the
performer if the apparatus is portable and can
be utilized in the backstage or sidelines of
competition wherein all the stimuli and distractions
are realistic for the client to struggle with
and hopefully overcome.
While we admire our colleagues
who have access to (and the skills to use) the
most sophisticated neurofeedback equipment available
and while we occasionally refer clients to them
for more sophisticated clinical assessment and
treatment (when symptoms indicate it is needed)
we have opted to use less complicated, more
user friendly equipment and protocols. These
are also more likely to be portable and somewhat
more acceptable to our athlete clients who are
cautious and reluctant to be examined too closely.
We are using neurofeedback from the Peak Achievement
Trainer developed by Jon Cowan. Our case examples
feature performance training in diving, golf,
equestrian (jumping) and music, with a minor
focus on ADD/HD.
Case Study #1: The diver had
missed his opening a dive from the platform
and landed "splat" on the surface of the water.
The result was a fracture of the transverse
process of one of his thoracic vertebra. In
effect he had figuratively "broken his back".
As the months of recovery went by he became
increasingly frustrated that he was getting
behind his teammates while unable to practice
in the pool. Historically he reported using
imagery in his diving routinely, thus when offered
a chance to enhance the quality and intensity
of his visualization process, he eagerly accepted.
In weekly sessions, the diver alternated between
watching video of his previous healthy diving
with several 10 minute bouts of neurofeedback
on the Peak Achievement Trainer. In the first
opportunity to compete after two months of training
had begun, the diver won a major competition.
While this could be a spurious
outcome, the coach's critique was most meaningful.
He said, "I don't know what you were doing with
all that brain stuff, but it is literally unheard
of in the world of diving to have an athlete
come off a major injury with minimal preparation
time in the water and win a meet like this.
Before his injury, this kid could do well in
8 out of 10 dives, but now he is a 'diver',
i.e., he makes something positive out of all
10 opportunities."
Later in the season with minimal
follow-up training, this diver won the Big Twelve
Championship. Then again in the Spring of 2000
at a critical time for preparation in the NCAA
Championships, the diver was inadvertently deprived
of booster sessions as he faced more intense
competition and anxiety. His performance faltered
and he reported in debriefing that he was simply
not able to replicate the intense imagery that
had accounted for previous success. As a result
he missed the cuts for the Olympic trials.
In this single case, quasi-experimental
A-B-A design, it appeared that initiation of
neurofeedback training followed by withdrawal
thereof was related to the patterns of success
and failure for a performer coming off a very
serious injury and rehabilitation. Furthermore
the coach's report that the diver's performance
after neurofeedback training superseded that
which the diver had ever achieved pre-injury
seems to substantiate our enthusiasm for this
application of peak achievement training with
athletes.
Case Study #2: Much of what
is most dear to us in sport psychology is based
on self-report. Athletes report what they experienced
during their best performances and we seek to
further improve performances based on those
characteristics. Unfortunately, some case self-reports
are unreliable, thus we seek technology and
methodologies that afford us a window into the
minds of athletes as they perform. Having observed
that when skilled readers read or experienced
meditators meditated, the concentration line
on the Peak Achievement Trainer went down (indicating
a reduction in the "idling rhythms"--0.5 to
40 Hz. at AFz) we monitored a number of recreational
golfers and local pros with the Peak Achievement
Trainer while they took some 33 putts of 6,
10, and 20-feet.
The output of the Trainer
was (in virtually every case) ordered in such
a way that it was meaningfully related to the
degree of accuracy of the putts. Surprisingly,
EMG artifact was not a problem, as the movement
of the club by the golfer had no discernible
effect on the EEG record.
Of course, putting is a multi-factorial
event. Across players the various elements of
process pull different weights. Sometimes concentration
is a major player; at other times it is eclipsed
by other factors. Sometimes concentration is
more crucial during the planning of a shot;
sometimes at the preparation to take it; and
sometimes concentration is most important at
the point of action.
Most players appear to utilize
variations from a general pattern. There are
significant valleys in the Peak Achievement
Training EEG record (indicating heightened concentration)
during period 1 (planning). That is, players
concentrate for a moment on the nature of the
shot. Then they relax for a few seconds before
bearing down again as they prepare, accessing
the (visual or kinesthetic) template for the
shot they believe they need. Finally they take
a last short break before turning up concentration
levels once more right before the backswing.
For one dedicated recreational
golfer, concentration appeared to play a major
role in how true to the target the surface of
his putter head was as he struck the ball. Thus,
the mean AllBand score at the moment of contact
was significantly lower at contact for the 7
putts that were on target than it was for the
18 putts that were not (t=3.655; p=.001).
Case Study #3: On the other
hand, for an experienced instructor, the "preparation
phase" was critical. How close his 20-ft. putts
were to the target was well-predicted by the
level of concentration he achieved, i.e., how
low the AllBand score went during the second
phase of the putting process (r=0.69, p = .003).
Case Study #4: For another
veteran 2-handicap player, it was the first
stage or "planning phase" that was most telling.
The greater the level of concentration during
pre-shot routine and the lower it was as he
struck the ball, the better outcome of the putt.
More specifically, we measured "putting error",
the number of inches the ball ends up from the
cup after the putt. Putting error correlated
r = 0.63 (p =.009) with the delta (difference
between level of concentration during preparation
from that recorded when the ball was struck).
However, in one trial his performance slipped
dramatically when he was asked to formulate
what he was thinking about during the putt.
Not surprisingly, his concentration was disturbed
and he "choked" dramatically during the contemplation
of a narrative for his thoughts.
Case Study #5: Ironically,
performance for one novice golfer actually improved
under the "thinking" conditions described above.
In this case, a very well-ordered picture of
the relationship between the PAT measure of
concentration and putting performance was observed,
i.e., the better he concentrated, the worse
he putted. For this individual, there was an
inverse correlation between concentration and
putting error r= -0.637 (p=.014). As an after
thought in one of those trials, it was suggested
that he focus only on the stroke. Giving up
his usual concern with a host of other variables
and attending only to "the feel of the stroke"
this inexperienced golfer produced his best
putt and his highest level of concentration.
In summary, while matching
this EEG index of concentration with levels
of performance in putting, the Peak Achievement
Trainer's "concentration line" behaved just
as one would expect a valid measure of attention
to behave. Thus it appears that optimal level
of concentration at various phases of performance
may differ dramatically among participants,
and across different cognitive strategies.
Case Study #6: The use of
EEG biofeedback in equestrian sports has not
been reported previously. The client was a 13-year-old
female rider with six years of riding experience,
treated on a short-term crisis intervention
basis. She had been experiencing difficulty
completing the course which involved multiple
jumps over barriers in a timed event. In addition
she had experienced several falls and was intimidated
by a parent who was impatient and quite verbally
abusive.
This client was trained using
the Peak Achievement Trainer in two separate
sessions, each conducted at the competition
site and immediately prior to her getting on
her horse. The sessions consisted of training
in concentration followed by visualization of
the course while standing next to the show ring.
Emphasis was placed on planning for appropriate
spots where to narrow the focus of her concentration
during her time in the show ring. At the end
of the competition this rider was awarded a
third place ribbon, the first time she placed
all season. In a subsequent competition, the
following week, she obtained similar results
under more difficult circumstances in that the
competition took place in a ring where the rider
had previously experienced a bad fall the previous
year and where she had not been back since.
Following these brief, but intense training
sessions, she was able to ride without fear
and with continued success for the rest of the
season, undeterred by the trauma of previous
falls.
It is interesting to note
that clients seen primarily for either athletic
(or artistic) performance or for academic (ADD/HD)
symptoms have reported independently that their
training effects spill over to the corresponding
elements not specifically addressed in treatment.
Thus it is interesting to observe the case study
below.
Case Study #7. The client
was a 9-year-old male with a history of academic
and behavioral difficulties and a diagnosis
of AD/HD. He was failing academically and had
been lying to his parents about it. The mother
had been told by a neurologist that she should
resign herself to the fact that her son would
never be a brain surgeon.
The parents were opposed to
the use of Ritalin and were seeking an alternative
treatment. This child received 30 training sessions,
which included training with the PAT as well
as SMR and hand warming using the Biograph or
Multitrace. Additionally two screens were created
that would assist in lowering theta at Cz, with
an occasional attempt to increase beta at the
same site. The results were very positive.
After 12 sessions, his teacher
reported that he was finishing all his schoolwork,
and a normal TOVA was obtained after 16. At
the 27th session it was reported that his behavior
in the classroom was acceptable and that he
would remain on task. He had a normal Connors'
Rating Scale was returned from his school and
from his parents. At an 8 week follow up he
continued to do well, his grades were mostly
A's and B's.
The irony was that this young
child had simultaneously learned to read music
and to play several tunes on the piano while
he was undergoing the neurofeedback training.
Previously, at least three music teachers had
given up on trying to teach him to play the
piano.
Our conclusion is that the
essential contribution of neurofeedback, as
demonstrated with the Peak Achievement Trainer,
is to give the client the opportunity to become
more aware of the internal processes associated
with success versus failure. In effect, this
training enriches the discovery process for
novice as well as experienced performers.
_____________________________________________________________
All of the case studies cited
above were presented in October, 2000 at the
Association for the Advancement of Applied Sport
Psychology, held in Nashville, TN. _____________________________________________________________
Dr. Wes Sime is a Health
Psychologist and a Sport Psychologist. Only
recently has he taken an interest in neurofeedback
as it provides an adjunctive intervention for
his clients. Dr. Sime is Professor of Health
and Human Performance at the University of Nebraska
and has a small clinical practice. He also consults
with numerous teams and individual athletes
as well as doing some executive coaching.
Thomas W. Allen is an Associate
Professor of Education and a Licensed Psychologist
at Washington University in St. Louis. In recent
years he has become very interested in neurofeedback
as it relates to performance enhancement with
various sports including golf and basketball.
His research interest lies in finding the optimum
level of concentration associated with success
in any performance.
Dr. Catalina Fazzano is a
Licensed Psychologist who has been in private
practice for 20 years. She received her Ph.D.
degree in clinical psychology from the University
of Vermont, where she attended on a Fulbright
fellowship. She currently practices in Coral
Springs, Florida. Dr. Fazzano specializes in
the treatment of children and families.
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