Niels Birbaumer: Paralysis, scoliosis and learning: a tribute to my friend Neal Miller

During the early seventies we read the first time about a curare experiment: completely paralyzed rats were able to learn in an operant learning situation to control different aspects of the physiology. These reports which later turned out to be unreplicable electrified us because they opened the door for learning treatment of medical diseases. I decided to meet the hero behind these experiments in person and travelled to New York and visited Neal in his lab at the Rockefeller University at 1st Avenue. I vividly recall this first formal meeting of a young researcher and behavior therapist from Vienna with one of the most famous psychologists of all times. It was a very friendly and warm encounter from the beginning. Neal  recalled his experience with psychoanalysis in Vienna during the early thirties and the simultaneous rise of the Nazi movement, antisemitism and all the other political illnesses which plague Vienna and Austria until today (I returned my Austrian passport after the Neo-Nazi party of Haider was accepted in the government during the 90ties). This first meeting with Neal was probably around 1972 or 1973. He showed me the lab and I saw different experimental set-ups for research on motivation (hunger and thirst), but nothing of the curare experiments. He told me that he couldn’t show the experiments to me on that day because the responsible graduate student wasn’t there. On the same day I met Barry Dworkin, at that time also a graduate student, who explained to me that they had some problems with the replication of the curare experiments and introduced me to another problem, namely the biofeedback treatment of scoliosis and kyphosis. Barry and I became lifelong friends since that day and published many papers on scoliosis and baroreceptor physiology and blood pressure learning over the years. It was Barry Dworkin who tried to replicate the curare experiments over many decades without success, but discovering many other new effects of learning, particularly classical conditioning on nerve firing. It was Barry Dworkin who in the late 80ties wrote the famous paper where he tried to explain the lack of replication and pointed out that “experimenter effects” may have caused the early success of these experiments. After several visits in these early days at Rockefeller and the beginning of an international cooperative project on the behavioral treatment of scoliosis and kyphosis which was later published in PNAS, Neal and Barry visited my laboratory at Tübingen and we organized a big international meeting on biofeedback and operant treatment of disease on the occasion of the 500th birthday of Tübingen University at a romantic medieval castle near Tübingen. The papers of this conference were published in a book edited by Birbaumer and Kimmel (Biofeedback and Self-Regulation, Hillsdale, NJ: Lawrence Erlbaum Ass. 1979). The fact that Neal’s name became associated so strongly with the failure of replication of the curare experiments and the lack of replicability of many biofeedback studies in general is very unfortunate because Neal’s work, particularly his book on psychotherapy is the foundation and the beginning of behavior therapy and experimentally based psychotherapy in general, now dominating psychological and psychiatric treatment all over the world. Neal’s motivation to write that book and to build an experimentally oriented psychotherapy was driven by his appalling experience with psychoanalysis and the psychoanalysts in Vienna: he started a self-analysis with Ferenci or one of the students of Ferenci during this year in Vienna and experienced the pseudo-logic and mystical drive concept as a trainee himself. Neal was one of the psychologically most healthy persons I ever met in my life and that was probably the basis of his sensitivity to the pathologizing theory and practice of psychoanalysis. Only a healthy mind can create such an intellectual wealth and scholarly productivity as the work of Neal Miller.
Below I cite the papers Neal Miller, Barry Dworkin and myself wrote or edited:

Birbaumer, N. & Kimmel, H. (Eds.) (1979). Biofeedback and Self-Regulation.  Hillsdale, NJ: Lawrence Erlbaum Ass.

Birbaumer, N., Cevey, B., Dworkin, B. & Miller, N.E. (1984). Biofeedback in der Orthopädie [Biofeedback in orthopaedics].  Forschung. Mitteilungen der DFG.

Dworkin, B., Miller, N.E., Dworkin, S., Birbaumer, N. , Brines, M., Jonas, S., Schwentker, E. & Graham, J. (1985). Behavioral method for the treatment of idiopathic scoliosis.  Proceedings of the National Academy of Science, USA, 82, 2493-2497.

Birbaumer, N., Dworkin, B., Elbert, T. & Rockstroh, B. (1987). Stimulation der Barorezeptoren erhöht die Schmerzschwelle bei Bluthochdruck [Stimulation of baroreceptors raises pain threshold in hypertensives]. In: Nutzinger u.a. (Eds.): Herzphobie [Heart phobia]. Ferdinand Enke Verlag,  pp. 92-102.

Larbig, W., Lutzenberger, W., Birbaumer, N., Rockstroh, B. & Dworkin, B. (1987). Barorezeptorenstimulation und Antinozizeption. Experimentelle Labor­unter­suchungen zum lernpsychologischen Entstehungsmodell der Hype­r­tonie [The stimulation of baroreceptors and antinociception. Experimental studies in the laboratory concerning the behavioral ideology of hypertension]. In: F. Lamprecht (Ed): Spezialisierung und Integration in Psychosomatik und Psychotherapie [Spezialisation and integration in psychosomatic medicine]. Heidelberg: Springer, 319-324.

Rockstroh, B., Dworkin, B., Lutzenberger, W., Larbig, W., Ernst, M., Elbert, T. & Birbaumer, N. (1988). The influence of baroreceptor activation on pain perception.  In: Elbert, T., Langosch, W., Steptoe, A., Vaitl, D. (Eds.): Behavioral Medicine of Cardiovascular Disorders, John Wiley & Sons,  49-60.

Rau, H., Schweizer, R., Zhuang, P., Pauli, P., Brody, S., Larbig, W., Heinle, H., Müller, M., Elbert, T., Dworkin, B. & Birbaumer, N. (1993). Cigarette smoking, blood lipids, and baroreceptor-modulated nociception. Psychopharma­cology, 110, 337-341.

Birbaumer, N., Flor, H., Cevey, B., Dworkin, B. & Miller, N.E. (1994). Behavioral treatment of scoliosis and kyphosis. Journal of Psychosomatic Research, 38, 6, 623-628.

Dworkin, B.R., Elbert, T., Rau, H., Birbaumer, N., Pauli, P., Droste, C. & Brunia, C.H.M. (1994). Central effects of baroreceptor activation in humans: Attenuation of skeletal reflexes and pain perception. Proceedings of the National Academy of Science, 91, 6329-6333.

Elbert, T., Dworkin, B.R., Rau, H., Pauli, P., Birbaumer, N., Droste, C. & Brunia, C.H.M. (1994). Sensory effects of baroreceptor activation and perceived stress together predict long-term blood pressure elevations. International Journal of Behavioral Medicine, 1(3), 215-228.