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.
Seeking to overcome fear of performance anxiety with Equestrian sports? (see case study #6 below).
While stress management is an essential foundation of effective performance in sport, the applications of traditional Neurofeedback 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.
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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. 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.. 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 Neurofeedback 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 Neurofeedback while they took some 33 putts of 6, 10, and 20-feet.
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.
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 Neurofeedback’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 Neurofeedback 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 NeuroFeedback 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 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.