The Status of biofeedback in Israel. Arnon Rolnick, Phd. Zahava Lawntal Msw.

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1 The Status of biofeedback in Israel Arnon Rolnick, Phd. Zahava Lawntal Msw. Israeli Association for Applied Psychophysiology and Biofeedback The way Biofeedback develops or fails to develop in certain countries might reveal some aspects about the meta-psychology of Biofeedback and shed some light on how biofeedback is conceptualized and understood in different cultures. This article will describe the status of biofeedback and applied psychophysiology in Israel, and will try to identify the facilitating and inhibiting factors in its growth. While psychology and medicine are very well developed in Israel, It took much more time for Biofeedback to earn its status within the public and the scientific community. The history of biofeedback in Israel goes back to the early seventies when an effort was made to treat post traumatic soldiers who were wounded in the Yom Kippur War. In 1983 the Israeli Biofeedback society was established. But it was dormant for several years. In the past three years we witnessed a very active period for our Association. The association now numbers 56 dues paying professionals, who are involved in the regular activities of the association. Proportionally to the Israeli population, This amount of active members is quite impressive when compared to the USA. In order to map the type of problems treated with biofeedback in Israel a survey was conducted between the members of the association. They were given a list of problems (Taken from the AAPB form for directory listing) and were asked to note 5 areas from which they accept referrals. Table 1 presents the results of this survey. Table 1 percent of professionals who accept referrals in various types of problems. Type of problems % of professionals

2 referrals accepting Anxiety disorder 80 Behavioral control work 30 Bruxism 20 educational applications 30 Pain 60 psychotherapy 40 sleep disorders 40 speech disorders 10 Sports Applications 20 Stress Management 50 Urinary Incontinence 5 stress disorder 95 Physical Therapy 10 Childhood disorders 30 As can be seen from table 1 the main field is stress and anxiety disorder. This will be discussed later on..../. Figure 1 presents the distributions of the professions in the Israeli Association. As can be seen from figure 1, the largest part of the association comprises of psychologists and Medical doctors..../. Another indicator of the status of biofeedback is related to its usage in Major Institutions. Table 2 Present the information on this topic. Table 2 Major institute who use Biofeedback in Israel Institute Field Type of Activity Dept of Psychology Medical psychology R Tel - Aviv University Technion Sleep Lab. - Sleep problems R & A

3 Dept. of Psychology - Stress related Problems R Wingate Institute - Sport applications R & A Natania Ichilov Hospital - Psychiatric Problems R & A Tel - Aviv Brull Mental Health Clinic Psychiatric Application R & A Ramat Chen - Tel-Aviv Shalvata Psychiatric Hospital - Psychiatric Problems R Hod Hasharon Sheaba General Hospital - Psychiatric Problems R & A Tel Hashomer Soroka General Hospital - R & A Bear Sheva Meir General Hospita Neurological problems A Belinson Children Hospital Psychiatric Problems A National Institute For Brain Neuro-Psychological R damage Rehabilitation Applications Levinshtein Rehabilitation Neuro-Psychological A Hospital - Ranana Applications Naval Medical Institute - Stress related problems R & A Medical Corps Stress - related problems A Israel Defense Forces Rambam Hospital - Gynecology and Pain Clinic R Kibbutz Movement Child and Medical Psychology Family Clinics A

4 Ilan Mental health Clinic - Childhood Disorders A Jerusalem Community health Center Neurological Disorders A Jerusalem Note: A - applied activities R - Research and experimental activities Summary and discussion As described above biofeedback was not very well known in Israel until recently, but it has attracted interest in the last years. We believe that the main inhibiting factor was a cultural and sociological one which is related to the Jewish tradition and culture. Stein et al. (1978) Argues that biofeedback is a product of the American society " The conceptualization of biofeedback is rooted in core feature of American cultural ethos... of immediacy with its search for rapid instant and disposable solutions". It can be argued that the Jewish tradition does not accept "quick" and "simple" solutions and therefore a tended to use analytical or dynamic theories. Zuk (1978) has demonstrated that the Jewish culture is more inclined to family therapy than other ethnic groups. It is our impression that some of the reluctance regarding biofeedback is related to a set of beliefs regarding mental health. Recently the first author has shown the possible combination of biofeedback with psychodynamic therapy. We believe this integrative approach can reduce the reluctance of the traditional therapists to use biofeedback as an additional tool. How can we then explain the rapid growth of biofeedback in recent years? We believe that the main reasons are the following: A) An Increasing interest in stress and stress management technique. Israeli people are in constant state of alertness due to possible terrorist attacks. It is for this reason that the study of stress has become a major field in Israel. The Gulf war was a very vivid example of stress and at that time there was high interest in stress management technique. Since biofeedback is a very useful method in stress reduction it is clear that more and more professionals were interested in Biofeedback. B) There is greater awarness of the possible damage and side effects of many drugs. Biofeedback as a "natural" method is attractive to many people who search for "alternative" remedies.

5 C) As in many European countries, medical and psychological treatments were for many years governed by public medicine There was only one medical insurance and very few private practices. Recently Israel has faced major change and the tendency to use private practices has increased significantly. The biofeedback clinician certainly enjoys this revolution. In summary we are very optimistic regarding the future growth of biofeedback in Israel. If clinicians will be flexible enough to combine it with their regular practice as an additional and valuable tool and not as a separate "pseudo-therapy", then we can be sure that it will be used safely and professionally.