When Adam got off the bus after school, he knew what to expect. By
the time he walked through the kitchen door, his head had begun to
throb and his stomach was churning. Objects were surrounded with a
sickish aura of light and he saw jagged patterns whenever he shifted
his eyes. Despite his nausea, he took two Tylenol and made it to his
bedroom. Lights off, head under the covers, Adam waited for his mom to
come home from work. He knew he wouldn't do any homework today. But he
was too sick to care or to worry about his plummeting grades. He
didn't even think about the appointment next week with the
psychologist to start biofeedback.
Migraine headaches are extremely common among children, as well as
adults. Nobody knows why, but young and middle-aged women are
especially susceptible. The usual medical "remedy" is
high-powered pain killers and vasoconstricting drugs that treat the
final pathway of the disorder: pressure from blood vessels in the head
that have suddenly relaxed, thus expanding and pushing against
sensitive tissue. Persons with migraines tend to be chronically tense,
but ironically it is when they finally relax that the migraine
strikes. This is why migraines often happen on Friday afternoon, when
the person is able to relax after a week at work or school.
Little known to the general run of physicians, even to
neurologists, there are other ways to treat migraine. Among the most
successful are self-control strategies using biofeedback.
Biofeedback simply means giving the individual information about
his or her physiological states and allowing him or her to learn to
control them. In one way, we can see biofeedback as a way to gain
conscious control over one's physiology: mind over matter. But, in a
deeper sense, biofeedback is also a way to tune into one's body's
wisdom, turn off the mind, and allow the brain to self-regulate. This
mind-body unity is achieved when the conscious mind is in a state of
focused relaxation -- quiet but highly alert. It is like the state of
"flow" that successful athletes sometimes feel when they
"just know" the putt will go into the hole or the fly will
land six inches in front of the trout's nose.
A New York psychologist, Jeff Carmen, has specialized in treating
migraines with biofeedback for many years. He began with a group of
procedures that have proven successful in many research studies. These
are ways of learning consciously to relax, to turn off the
"fight-or-flight" side of the autonomic nervous system (ANS),
the so-called "sympathetic" branch. This allows the other
side, the relaxed "parasympathetic" arm of the ANS to be
dominant. Sympathetic overarousal has a number of effects, all
deleterious: cold hands, fast heart rate, fast shallow breathing,
muscle tension, and sweat gland overactivity. Classical biofeedback
for migraine involves learning to warm the hands, reduce sweating,
slow down breathing, and lower muscle tension. There are separate
instruments that measure each of these, and information is presented
to the client on a computer screen. By watching the display, these
physiological processes become normalized. In addition to biofeedback
in the office, home practice is essential. Two twenty-minute periods
of daily practice, and numerous short periods of a few seconds at a
time are required.
About four years ago, Dr. Carmen invented a new biofeedback
procedure, which he has found to be faster and to offer even greater
migraine control, with less need for home practice. This involves
learning to control the temperature, and hence the blood flow and
metabolism, of the prefrontal areas of the brain, the location of the
so-called "executive" functions of self-control, memory, and
attention. A sensor is placed on the forehead that looks deeply into
the brain by measuring far infrared temperature. These rays pass
directly through the skull and can be seen by the optical sensor. It
is similar to the new heat-imaging techniques police use to look
through the walls of houses in search of marijuana grow lights. Dr.
Carmen uses movies on a VCR as the feedback signal: when the head
temperature rises, the movie comes on; when temperature drops, the
movie pauses. Most people are able to learn to control their
temperature within a very few sessions. The results over the years
have been striking: about 80-90% of clients report significant
improvement in migraine frequency or intensity, and over half have no
migraines at all following the treatment.
Dr. Carmen has presented his results over the past three years at
the Society for Neuronal Regulation. Other physicians and health
practitioners are now using his system with good results. Our clinic
has used his devices for the past three years, and our experience
agrees with Dr. Carmen's. In a particularly successful case, a
ten-year -old boy ("Adam" of the first paragraph) who used
to have weekly severe migraines has had almost none in the past two
years, and the two or three he has had have been of markedly lower
intensity.
The best news is that in most cases the brain temperature
biofeedback is quite fast, often giving relief from headaches in as
little as 2-5 sessions. Because the technique is new, however, it has
to be regarded still as experimental. The older processes of finger
temperature biofeedback, breathing, etc. are much better established.
We use both approaches in our clinic. But in all forms of biofeedback
a similar mental attitude is important.
Jeff Carmen has a picture of Yoda, from Star Wars, on his
wall to illustrate the correct attitude. Yoda stands with his arm
extended, a peaceful but focused look upon his face as he invites the
"force" to lift Luke Skywalker's space ship out of the
swamp. It is obvious from the look on Yoda's face that he has no
headache, that he is relaxed but deeply aware. Without forcing things,
or getting anxious about it, the frontal areas of his brain are in
charge and are fully cooperating with his whole body and mind, as well
as the forces of the universe outside. That is the state that
biofeedback, like meditation, yoga, and the martial arts teaches. When
it is applied to control a migraine-or ADD, anxiety, and even
epilepsy-wonderful results can follow.
With his wife Elaine Molchanov, a Jungian analyst, Al Collins,
Ph.D., practices in the Alaska Neuro/Therapy Center in Anchorage.
The office is located at 615 E. 82nd Street, Suite 102. Call 344-3338.
