I met Crystal for our interview at the Austin Biofeedback Center. Located in a health care district in north-central Austin, the Center was a pleasant, homey place that opened out onto a balcony overlooking a garden courtyard. I entered a comfortable waiting room and was escorted past therapy rooms full of computers, bio-medical electronics, and a relaxed, quiet hum of activity. In one of the therapy rooms, Crystal sat in a front of a computer screen while technician, Leslie Schriever "hooked her up" to an electroencephalograph.

In 1996, Crystal’s frequent, excruciating headaches finally drove her to her doctor for help. The remedies she tried on her own were not working. Then a 25 year old fashion design major at the University of Texas, she also had vision problems, unsettling hormonal changes, and saw an uncharacteristic drop in her grade point average.

Initial medical treatment did not faze the headaches. This led to rounds of tests, brain MRI’s (magnetic resonance imaging), and finally, the diagnosis of a brain tumor on her pituitary gland that was pressing on her optic nerve.

Crystal knew how dangerous her situation was. She could lose her eyesight or even die. She recalls, "I was more worried about my family than myself...but I thought, ‘I’ve never been skydiving,’ not that I ever wanted to before, but now I may not ever get to."

Surgical removal of the tumor was successful but post-operative recovery brought only a continuation of the constant, severe pain. When she was well enough to take medications, her doctors prescribed them to control the pain but Crystal soon discovered that it took increasingly larger doses to make "even a dent" in the pain. She was caught in a spiraling drug-rebound cycle. Her body’s response to each dose of medication was a more intense level of pain which required an even higher dose of medication.

Her life was becoming more and more difficult. She had to drop out of school. Crystal explained, "I couldn’t go anywhere without my medication. I was always in pain. I couldn’t do things. I was afraid... of pain. I lost a year of my life."

She spent months in a haze of pain and medication. Then, desperate to break the medication’s hold on her, she entered a detox/rehab center and was successfully treated for the rebound addiction. Crystal filed a lawsuit against the drug manufacturer whose product, advertised as non-addictive, had jeopardized her recovery. She ultimately won the lawsuit but she was still no closer to ending her struggle with pain.

Unable to turn to medication for relief, Crystal began to search for alternatives. Based on the results of her search, her doctor prescribed a different approach to pain control that was reported to show a high rate of success. Finally, this proved to be the turning point.

With her doctor’s support, Crystal’s health insurance company authorized a program of psychophysiological self-regulation training (commonly referred to as "biofeedback therapy"), a high-tech solution to a broad-range of medical problems.

Far from an outdated misconception that sees biofeedback as just another relaxation technique, Crystal found herself involved in a sophisticated therapeutic training protocol through which she actually learned to control the specific somatic (physiological) causes of her pain with her own physical and mental efforts.

According to Lynda Kirk, MA, LPC, a national authority on the clinical applications of biofeedback and a practicing biofeedback therapist, "There are two keys to why biofeedback training works so successfully in cases like Crystal’s and in a variety of other medical and behavioral applications as well. "

The first is that more and more medical research and years of clinical experience tell us that the mind, the brain and the physical body always operate as one inseparable unit. If you can positively impact the mind in specific ways, then specific, predictable changes in the body will follow.

Conversely, if you can positively impact the body or brain in specific ways, then specific and predictable changes in the mind and thought processes will follow. "The second key to biofeedback’s success," Kirk continues, "is almost forty years of research that continues to be substantiated, which shows that individuals can, with training, learn to physically and mentally control their own internal processes with a high degree of precision, even processes formerly thought to be just autonomic [controlled automatically by internal systems rather than by conscious choice]."

On her initial examination, using an electromyograph to measure baseline levels of muscle tension, Crystal’s biofeedback therapist discovered massive structural bracing patterns in her face, neck and upper-body. These ingrained habitual bracing patterns probably developed over time in response to the intense pain of her earlier headaches but were now themselves causing chronic inflammation of the tissues which led to more severe headaches and other painful symptoms as well.

Using feedback from the electromyograph, electroencephalograph, and coaching from her biofeedback therapist, Crystal began to learn to consciously control and release the structural bracing and the high levels of mental arousal (common with chronic pain), that were responsible for her painful symptoms. Her symptoms became less severe and less frequent. She was able to develop new habits and her upper body was no longer constantly braced in anticipation of physical pain that was no longer there.

According to Kirk, "The missing piece that biofeedback instruments provide a patient like Crystal is the highly specific, detailed information (feedback) about their own internal processes that individuals need in order to learn conscious control over those processes.

"Extra information is not necessary for some things, like learning a fine motor skill with your hands," Kirk explains. "For example, learning to write, use a keyboard, or draw is accomplished by "feedback" from your eyes and sense of touch. You can see or feel when your finger movements are right or wrong by the results they produce. Constantly correcting and refining your movements over a period of time using this feedback from your eyes and your sense of touch, develops mastery of the desired skill."

Unfortunately, these same five senses we ordinarily rely on to write or draw do not provide us adequate information to learn to control processes going on inside our bodies. If we were to suffer from high blood pressure, for example, we may have some vague or general sense of what high blood pressure feels like in our body but we do not have any direct awareness of what specific events or conditions are occurring in our cardiovascular system, muscles, or brain that are directly related to the high blood pressure we experience.

According to Kirk, "Biofeedback instruments such as the electromyograph, the plethysmogragh and others can provide this information to patients in great detail, in real-time, as the events are occurring in their bodies. Through the marriage of biofeedback instruments with high-powered, modern computers and software, this technical information is translated and presented to them almost instantaneously, in a user-friendly and understandable format. "

With guidance from a biofeedback therapist patients can use this information in the same way they would use feedback from their eyes and sense of touch to learn to use a computer keyboard. They can begin to cause specific functional changes to occur in their cardiovascular systems that make their blood pressure go down and with practice, they can become highly skilled and confident with these abilities. Then, when they experience life events that in the past may have made their blood pressure skyrocket, like rush-hour traffic for example, they can use their new skills while they drive, and in a matter of seconds their blood pressure is at a relaxed healthy level and they are on down the road without missing a beat."

Whether an individual’s problem is high blood pressure, chronic bladder problems, closed head injury, acid reflux, or chronic pain and headaches like Crystal’s; biofeedback can provide the "missing" information that leads to successful self-regulation and relief.

Crystal is almost finished with her biofeedback therapy now. She is excited about school again, back in class, and will graduate this Spring, "I’m able to produce more, do more... I’m really looking forward to my last semester."

Crystal now goes for months without headaches and when they do occur she knows how to stop them. She is enjoying life again. Crystal explains that after biofeedback therapy, "I was outside, just sitting there looking around thinking, ‘So this is what real life is like, life without pain.’"

As a final note to Crystal’s story: when I originally called her to schedule our interview, she wanted to make sure we would be through by noon. "I’m going skydiving this afternoon!" she said.

Many of the conditions or symptoms biofeedback therapy is used for are characteristically physiological in nature like Crystal’s. Others are not so easily defined but include a sometimes bewildering mix of characteristics that are both behavioral and physiological at the same time.

Laura (not her real name) is a bright, precocious eleven year-old. She has a house-full of pets, writes wonderful poetry, takes guitar lessons, and her daddy is teaching her to shoot skeet.

Laura learns quickly and easily but last year problems at school became serious. She was not turning in assignments. Often her work was lost or misplaced. "I couldn’t concentrate," Laura said. She was so distractible, that staying focused long enough for her to finish her homework was an exhausting, frustrating process for both Laura and her mother.

Concerned for her daughter’s well-being, Laura’s mother sought medical help for Laura’s problems. Her doctor diagnosed Laura’s condition as attention deficit disorder (ADD) and prescribed the drug Ritalin to control the problem.

According to Laura’s mother, Ritalin proved to be an unsatisfactory and ineffective treatment, so Laura, her mother and her doctor decided on a course of EEG biofeedback (neurofeedback) as an alternative to the medication. At her doctor’s request, Laura’s health insurance provider agreed to pay for the biofeedback therapy.

Laura received her therapy at the Austin Biofeedback Center, where her brain was found to produce a high-level of slow frequency brainwaves accompanied by low levels of fast frequency brainwaves, in a pattern that is typical of individuals with ADD.

Biofeedback therapy is both painless and noninvasive. According to Laura, "I was nervous at first, and I thought it felt kind of weird having them clip the things on my ears but it was fun!"

Her twice-a-week training sessions began with the placement of delicate wire sensors, with drops of conductive gel, on her scalp and ears. The sensors were attached to an electroencephalograph (EEG) that "read" and interpreted the electrical activity of her brain and then fed this information into a fast computer.

Software in the computer translated the brain activity into pictures and sound that Laura could use to train her own brain to produce the higher levels of fast waves and lower levels of slow waves that are exhibited in a more focused brain. Some of the software even produced video games that Laura learned to play with her own brainwave patterns through the EEG instead of using a joystick.

According to Lynda Kirk, "A recent program on The Learning Channel outlined how this advanced technology is also being used by U.S. Air Force researchers to develop control systems for very, very fast aircraft, where flight controls are linked directly to the pilot’s head through EEG contacts in his helmet. With this direct link to the pilot’s brain, the elapsed time between his decision to act and the control system’s response would be almost instantaneous."

Guided by the brainwave training on the computer, and with coaching and encouragement from her biofeedback therapist, Laura began to make progress. As her brainwave patterns became more normalized and flexible, her organizational problems at home and at school began to disappear.

Now, several months later, Laura reports that she has made straight A’s in the last two grading periods with no missing homework. "I’ve been able to keep my locker clean and my desk clean..." Laura smiles.

"...Which is a miracle!" her mother interjects.

Even better, according to Laura, "Another problem was that I would have a ton of homework and we never had any time for activities. Now I get a lot of [homework] done in school... I’m a lot happier because it’s made things easier for me."

Laura’s mom is happy too, "It has really helped all our lives - a lot!...It has really made a difference in my life. I don’t have to constantly sit down with her and make sure she is doing her homework anymore!"

Whether individuals turn to biofeedback for help with medical problems, or like Laura, for help overcoming difficulties they experience in developing their talents and human potential, biofeedback therapy relies on, and works in tandem with the medical and other healthcare communities.

James Reeves, M.D. has been practicing medicine in central Texas for thirty-six years. A respected, board-certified urologist, Dr. Reeves has, for nearly twenty years, actively included biofeedback as a part of the comprehensive care options he can call on to treat his patients.

According to Dr. Reeves, urology is an extremely complex field especially concerning bladder dysfunction: "Initially it involves extensive testing...to determine whether or not surgery is necessary or whether biofeedback can help [the patient avoid surgery]." Medication is usually used from the first day to get symptoms under control while the doctor searches for the most appropriate long-term solution. Long-term solutions may include medications, biofeedback, surgery, or different combinations of these and other therapies.

Sometimes problems can be dealt with quickly and effectively with medication. Sometimes there are injuries or structural defects that only surgery can correct. "Where biofeedback comes in," Dr. Reeves says, "is when there are no structural defects but the system just doesn’t work right."

"Biofeedback therapy proves successful for many cases of urinary incontinence and chronic bladder problems." he continues, "In some cases, surgery may turn out to be necessary but a less invasive approach would be desirable. In these cases, biofeedback may be tried first to see if surgery can be avoided, and it often can be."

Dr. Reeves recalled an elderly patient whose symptoms all pointed to the potential need for prostate surgery, but extensive testing "did not clearly indicate structural problems." He suspected that, "The patient’s blockage was not caused by internal tissue impeding the flow but by [associated] muscles that were not working."

He referred the patient to the Austin biofeedback Center for muscle retraining and soon received a call from the patient saying that the retraining had been successful. Dr. Reeves summed up, "Biofeedback’s role and value, in a nut shell, is that it uses the body’s own ability to heal itself."

Medical problems, like the urological problems above, may often include elements of mind and emotion and well as the body.

Liz, 49, is a vivacious, energetic woman with a fast-paced career as an independent advertising and copyrighting consultant. In her high energy, high stress profession, Liz says deadlines and demanding clients are the rule, "It’s what I like to do and I enjoy it but it does get pretty stressful."

The last thing Liz needed, with her demanding job, was a major health problem but two years ago in January she had to have major surgery. A tumor was removed successfully but she was left with serious problems in her urinary tract.

"I went through months and months of repeated urinary infections... eight or nine months trying to regulate this in some way to get back to normal." Medications did not work, Liz reported, "Finally [after] extensive, extensive testing my urologist said that my choices were either biofeedback therapy or surgery and that he strongly recommended that we not do surgery unless we have to." She was ready to try anything.

Last year, with Christmas approaching, Liz was in the midst of an extremely stressful period in her life. The urinary problems, back pain, stresses at work and with her clients, all occurring in the middle of the holiday season, left her feeling extremely overwhelmed and depressed.

It was in this context that Liz began her biofeedback therapy. "I did not realize then," Liz remembered, "that the other problems were going to get treated simultaneously [with the urinary infections]." Biofeedback showed her how everything in her life was so interconnected. "The stress, the health problems," according to Liz, "[these] all needed to be brought back into alignment."

The first thing to disappear was her back pain. Then, with electromyographic biofeedback therapy and continued guidance from her biofeedback therapist, the urinary tract infections went away. "[After the training], I went from January to the end of November with never an infection. I had had them every two to three months the year before," Liz said, "It was all because of this - the biofeedback therapy."

Even with her back pain and infections gone, Liz was still feeling overwhelmed and depressed but she did not know why. Her biofeedback therapist continued the training, teaching her how to control the effects stress was having on her body, mind and emotions. "With the techniques she taught me, I got to feeling so much better, I haven’t felt stressful all year...I was able to come out of my depression. I’ve got thousands of things on my desk but I’m just fine!" Liz exclaimed, "Being aware that the techniques she taught me are available to me, empowers me, and I use them!"

It is Christmas time again but now, Liz says, "Last year I was overwhelmed all the time. This year, getting ready for Christmas - everything - I do not feel overwhelmed. There is nothing else I can credit this to but the [biofeedback] treatment." She continues, "I have to say this. The bladder problems ended up being a sidelight. Hey! - That got fixed - Great! But everything else that got fixed is so much more important to me. "My emotions - everything. I’m able to be much more productive because of it. It’s been a revelation to me. Biofeedback therapy has changed my life...It has given me a tool that I can use to regulate everything that happens to me in my life and to put myself in control of it rather than it controlling me!"

The important role biofeedback can play in solving emotional issues is no clearer to anyone than to Anna Gonzalez-Sorensen, Ph.D. Dr. Sorensen, a clinical psychologist formerly on the faculty of Colorado State University, has maintained a busy practice in Austin for the last fifteen years.

Dr. Sorensen and her husband, Don M. Sorensen, LMSW, ACP, are co-founders of Austin Counseling and Psychological Services. The couple also teams up to present the popular relationship workshop series, "Getting The Love You Want".

According to Dr. Sorensen, the emotional issues clients are dealing with generally include related physical symptoms. "I often refer [clients] for biofeedback... I’m dealing with the emotional aspects. If my clients can get help with the physical aspects, then it makes it easier to do the emotional work they need to do." For clients to learn the connection between their emotions and their bodies is very important, according to Dr. Sorensen. "If they can learn about reading their bodies... getting feedback from their bodies, it makes it easier to work with the grief, or the anger, or whatever is coming up for them around the physical issues. Headaches, migraines, high blood pressure, and so on - I check for these physical issues when I do the [client’s] intake form."

Many times, these physical problems are the body’s response to emotional issues. After appropriate medical work-ups when necessary, biofeedback is often the most effective physiological way to support the client’s psychological treatment.

"Another big area where biofeedback is very important is in treating ADD and ADHD," Dr. Sorensen says. "Not only children but adults with these problems can certainly benefit [from biofeedback therapy].

Dr. Sorensen recalled, "I had a family come to me for counseling." The family was in turmoil and it was apparent to Dr. Sorensen that the behavior of one of the children, a twelve year-old, was at the root of the problem. On examination, she found that, "The child was defiant, he wouldn’t do his homework. It was a battle and it was clear that he had ADHD... I referred him for neurofeedback. In a few weeks, the mother reported to me that the child told her, ‘Mom, I can follow along in class now. I never could before!’"

"In another similar story," Dr. Sorensen said, "[after neurofeedback] another child said to me, ‘I read a whole chapter for the first time in my life!’"

"A lot of adults don’t know that they actually have ADD. Their inability to focus or concentrate - they label it anything else." Dr. Sorensen continued, "Then I do a case history and I find that when they were in school they exhibited a classic ADD profile. As adults they have learned to compensate but they still have problems.

"For people [with ADD/ADHD] who are good candidates for it, neurofeedback can be miraculous. If a client is willing to make the effort that it takes, it is very effective. I have clients who have thanked me over and over again for referring them for neurofeedback."

According to research findings, individuals with attention deficit disorders consistently score higher than national norms both in intelligence and in creative abilities. More and more, adults with ADD are turning to biofeedback to overcome the problems they have focusing and concentrating, that have suppressed their natural advantages in intelligence and creativity.

Removing limitations that block intelligence and creativity, while increasing mental flexibility, can be a definite career advantage. Many individuals, however, seek out the advantages biofeedback can offer, simply for the marked improvement in quality of life that it can bring.

Jeff, 42, is now a successful executive in the R&D department of a well-known high-tech manufacturing company. Originally from El Paso, Jeff has lived in central Texas since 1985. He is interested in sports and enjoys auctions and collecting antiques.

In the early nineties, events led him to search for serious life changes. As Jeff put it, "I recognized that life wasn’t very much fun for me." He wasn’t as happy as he thought he should be and exhibited some of the signs of clinical depression. He had problems with stress and was being treated for a bleeding ulcer. "I started on this journey to unravel what that was all about," he continued. "I got into counseling and some other things and the psychologist I was seeing suggested that I might have attention deficit disorder (ADD)." Jeff was referred to a doctor whose diagnosis concluded that he actually had ADHD (attention deficit, hyperactivity disorder) instead of ADD.

"I immediately started on a program of heavy medications," he said, "and took them for several years. I guess they helped me somewhat [to] ‘do’ my daily life...but I eventually came to a point where I just didn’t want to be on these medications for the rest of my life."

When first told what his diagnosis was, Jeff searched for information about his disorders on the internet. There, he discovered that a process called neurofeedback could be an effective, drug-free alternative for overcoming problems like his. His doctor was skeptical, but when Jeff later decided he wanted to try to get off the medication, he recalled, "I finally decided to pursue that and just give it a shot... I decided to embark on [a course of] neurofeedback treatment and [that decision] just changed my whole life!"

He was referred to the Austin Biofeedback Center where a comprehensive brainwave evaluation called a quantitative EEG, or qEEG, indicated possible lingering effects from a childhood closed-head injury. According to Lynda Kirk, "Jeff’s qEEG was forwarded for analysis by the Thatcher Database. Dr. Robert Thatcher’s normative database and discriminant analysis with qEEG is used by the Veteran’s Affairs Administration and the Department of Defense as an evaluative component of their standard of care in head injury cases." An appropriate therapeutic protocol was formulated, based on both the qEEG analysis and Jeff’s medical diagnosis, and his EEG biofeedback training began.

"I started with the ‘beta’ work [fast brainwave training]," Jeff recalled, and that eventually got me off the drugs completely. It got to the point where the amphetamines [that were prescribed to keep me focused] were actually making me high so I knew [it was working]!" His dosage was reduced and ultimately eliminated. "It happened pretty quickly, really." he said.

Initially somewhat skeptical himself, Jeff noted that, "It took me awhile to fully believe that I could sit and watch [a neurofeedback computer screen] for forty minutes and actually have something change in my brain. It was absolutely the most amazing experience to walk in [for a neurofeedback session] feeling one way and to walk out forty minutes later feeling completely different.

" Not only his medications, but his symptoms also began to disappear and over time, were eliminated as well. "It absolutely changed my life," Jeff stated, "It’s been one of the greatest things that has ever happened to me.

"Since then, [finishing his therapy], I don’t do depression anymore! If I do ever get upset or depressed, it is short-lived. It’s just not a part of my life anymore."

Jeff sees other fundamental changes in his life now. "I used to have a problem with anger... This was one of the things that caused me to seek some change. I was the kind of person who stuffed my emotions and it was eating me up on the inside physically," he remembered, "I had a bleeding ulcer and nearly bled to death. [Now,] I don’t react angrily anymore, or not very much, and when I do, I get over it real quick. I credit the neurofeedback more than anything else for making it possible for me to do that."

"I’ve also got a new-found appreciation for life." Jeff stated, "I mean, I can stop and take a look at a ladybug and just have a good time doing it, whereas before, I might not have even seen the ladybug, or the flower, or whatever, because I was so ‘balled-up’ in all these emotional issues all the time. All that just stopped at some point in the therapy. So when I say it changed my life, it did. They say life begins at forty; well it began at forty-one for me because that was when I finished my neurofeedback."

According to another former patient of the Austin Biofeedback Center, she was not the only one who received benefits from her biofeedback therapy.

Anna, 42, is a cheerful bundle of energy wearing colorful surgical scrubs. She is the office manager for a busy veterinary clinic. "The loves of my life are animals!" she says, "I have three dogs and four kitties." For fun, Anna and her husband like to listen to music and to travel around on their Harley Davidson motorcycle. "We like to get out and about and do things."

Several months ago, Anna came to biofeedback with a long history of bad migraines. "I’ve had them off and on since I was thirteen years old... especially during stressful periods in my life," she recalled, When I came in [for biofeedback] I had had a headache [continuously] for several months."

Her doctor thought that the headache was caused by a combination of stress and hormone problems. "I couldn’t get rid of it... it wouldn’t go away. I had tried drugs, and drugs, and drugs," The medication helped a little, she continued, "but you know, with drugs you’re just treating the symptoms and not getting to the root of the problem anyway."

She went back to her neurologist who then suggested that she try biofeedback. She had other stress-related health problems too, such as irritable bowel syndrome, and a sleep disorder. Although she did not know much about it, she had heard that biofeedback could help these kinds of problems so Anna said, "Sure!"

Anna reported, "So, I went in [for biofeedback therapy] and I started getting relief from my very first session. That made a believer out of me!"

Anna continued on a comprehensive program of biofeedback and cognitive therapy with her biofeedback therapist to help her get control of both the headaches and the stresses in her life. She overcame her other symptoms as well. "The biofeedback therapist was a wonderful person who taught me so much," she said, "I use what she taught me almost every day."

Every now and then, Anna will still get a headache but she attributes that to forgetting to use the skills she has learned. Then all it takes is remembering what to do and the headache is under control.

Anna considers herself an intense, high-strung person who used to make her headaches worse by getting mad easily, especially when others, at work or at home, did not meet her expectations. She was even harder on herself. She said, "I just take a different perspective now... and I deal with [problems] the right way, so it all works out... I’m so much better now.

"Before the biofeedback I was a mess... My husband and I fought all the time, I cried all the time. It was a nightmare. My head hurt so bad I didn’t want to go anywhere, I didn’t want to do anything.

"Going through this training - it saved my marriage. Its made me a happy, pretty well-adjusted person. My mental health is better. My physical health is better. I know that now, I can make myself feel better! I can control it myself and that’s the most wonderful thing about it!

"Now I feel like, when I have a headache or almost anything, I can make myself better. I can do it by myself! It takes a few minutes to stop, think, and actually do it. I can actually do it!"

Anna concludes, "It’s been one of the best things that’s ever happened to me. I’m happier, my husband is happier, my boss is happier, the guys I work with are happier. There’s no doubt about it!"