Autogenics serves as a do it yourself approach to health care. It has been referred to as "BODY FORTRAN" suggesting that one may program self just as one does a computer. The technique developed in Germany uses a step-wise process in fostering self control of own neural functions.

A technique developed initially in Germany in the early 1920's by Schulz, and later modified by Wolfgang Luthe (1964) a student and earlier co-worker. It has been variously referred to as:

1. Autogenics
2. Autogenic Feedback Training, and
3. Body FORTRAN.

The technique borrows heavily from Eastern philosophy involving the traditional meditation, but with considerable scientific rigor added (Schultz, and Luthe, 1969; Luthe, 1964; and Horney, 1942). Six different hierarchical steps are involved in effective autogenics. Each of the stages must be reasonably well accomplished before going to the next higher one (Cassel 1985; and Cassel and Sumintardja, 1983). The use of biofeedback to increase autogenic effectiveness is a rather new innovation introduced by Cassel; as the usual Autogenic Feedback Formula (AFI) is typically the means to achieve success. The AFI formula is also used by Cassel, but only after reasonable success has been demonstrated in self control of the first five stages by use of biofeedback.

1. Passive volition (stress load reduction).
2. Striated muscle relaxation.
3. Emotional (visceral) control.
4. Autonomic (sympathetic) control.
5. Level of consciousness (brain laterality).
6. Guided imagery (creating psychological states).

Unusual Successful Uses
It has been the most effective intervention strategy in health care for a wide variety of illnesses. Some of the unusual success stories reported where autogenics served as the major strategy are as follows:

1. Increasing and decreasing thyroidn for persons with hyper and hypo active thyroid glands, respectively (Luthe, 1964).
2. Unquestioned recovery of youth with brain tumor (Porter and Norris, 1985).
3. Effective treatment of air sickness for astronauts in space - more effective than drugs (Cowings, 1990).
4. Canadian program that decreases body age and increases zest for life (Imrie and Imrie, 1989).
5. Effective treatment of pain (Shealy, 1976).
6. Mental health therapeutic uses (Horney, 1942).

Transpersonal Psychology

Autogenics is based on the use of Transpersonal Psychology where the individual alone is responsible for own health care and treatment (Cassel 1990). In severe cases of health problems, professional health care personnel are utilized, to be sure. But even in such extreme cases, it is the patient who is provided choices or alternatives and who makes the final decisions. Typically, in the more severe cases multiple opinions are sought from medical specialists with detailed descriptions of risks and likely outcomes provided the individual. In addition, more often than not, research literature is given where the individual may seek first-hand knowledge about promise for success of the choices being deliberated. Always, in the final analysis it is the individual who elects the choice; not the physician. This, of course, is in direct opposition to traditional health care where the physician is expected to heal the sick and to make choices in relation to all health services.

Framingham Study

In 1948 a study was initiated in Framingham, Massachusetts where we first learned about Type-A personality and its relation to coronary heart disease (CHD) (Cassel, 1986b). When the lives of persons from some 20 different tribes in Africa were examined, few or no incidents of heart disease were observed. When members of those same tribes migrated to our Western culture, similar incidents of heart disease emerged among them as with our typical population. It was clear that life style was the culprit, and many of the problems noted could be eliminated or minimized, i.e., tobacco, alcohol, overweight, lack of exercise, exaggerated use of negative diet, too little use of positive diet, too little sunlight (vitamin D), among others. Each of these were well within the potential for change by the individual and "risk factor" science along with primary health prevention practices had become a reality (Cassel 1987b). Repeated medical research seeking to identify indicators of pending CHD were in agreement that there was malfunctioning in visceral activity. Clearly it involves an absence of harmony in one's neural functioning, and autogenic feedback training proved to be the most important single intervention strategy to deal with the problem (Imrie and Imrie, 1989).

Neural Functioning Harmony

From the Framingham studies we have learned that higher levels of wellness can be attained for all individuals, and that one seldom, if ever, achieves full potential. Wellness no longer is associated with the presence of pathology alone, but means "fitness" in relation to human productivity, i.e., work, learning, human relations, etc. Clearly, fitness has to do with one's neural functioning, where five secondary vital signs are involved (Cacioppo and Tassinary, 1990):

1. Stress load reduction (pulse).
2. Tension of striated muscles.
3. Emotional control of visceral activity.
4. Personal control of sympathetic syndrome.
5. Establish varied levels of consciousness.

Here for the first time there has been recognized the daily need for restoring harmony in one's neural functioning. Autogenics has repeatedly demonstrated effectiveness in the attainment of that goal. No longer is the goal the elimination of neural functioning, but rather full control and harmony in their uses. Effective goal striving and full achievement of individuals always involves a total neural functioning, with full stress load, almost complete tension of striated muscles, excessive emotions, etc., but always in harmony with each other and under full control and demand of the person involved.

Brain Waves

Brain wave patterns can be measured and analyzed by use of the electroencephalograph (EEG). Brain wave frequencies range from 0 to 30, and are classed into five separate groups, with a different subjective experience in each. It is, of course, clear that the neural functioning of individuals is significantly related to their brain waves:

1. Delta 0-2 Hz - deep sleep
2. Theta 3-6 Hz - twilight, or problem solving state
3. Alpha 7-12 Hz - meditative and day dreaming state
4. Sigma 13-14 HZ - non-attentive state, and
5. Beta 15-30 Hz - attentiveness state.

Brain wave frequencies occur at all five levels for any period of time, but often the predominant waves are in one or another of the categories. For some individuals the most important use of the EEG is to train one to have a preponderance of Alpha waves, and which correlate well with relaxation. Often, the training begins with the electromyograph (EMG), and then switches to the EEG for greater effectiveness. More recently, training has focused on the Theta predominance, and with the notion that creative endeavor is fostered better for some individuals in that state. Where learning and attentiveness problems are involved, there has been a tendency to train to suppress, rather than obtain predominance of the Alpha waves (Green and Green, 1977).

The various regions of the brain do not emit the same brain wave frequencies simultaneously. The brain waves are the product of electrochemical activity in the brain. The thalamus is believed to be the originator of brain waves, and the principal area of the brain utilized in relation to levels of consciousness is the occipital part at the very back of the skull. It is the visual projection area of the brain. There is no direct sensory process by which one can detect the presence of brain wave activity. What the individual senses and controls is a state of consciousness associated with particular categories of brain waves.

Use of Biofeedback

Each of the described autogenic stages is believed to represent a higher level of wellness in the form of a hierarchical scale. In order to advance from one level to a higher stage, it is necessary to achieve reasonable self-control on that level. In a sense, each lower stage is a requisite for the next succeeding level. When an individual has achieved mastery of all six levels in true concert fashion, the sesame to one's inner self becomes a reality (Horney, 1942). The more effective use of autogenics involves a step by step training process whereby appropriate biofeedback instruments are utilized to obtain self control before venturing to the next higher stage, i.e., EMG for skeletal muscles, temperature of finger (TEMP) for smooth muscles, galvanic skin conduction (GSR) for emotions, and EEG for levels of consciousness, etc. When, and only when, a reasonable degree of self control is demonstrated in each of the five basic areas, the autogenic feedback process is begun, and where the autogenic formulas (AFTS) developed by Luthe are utilized, and as a replacement for the biofeedback (Luthe, 1964).

Brain Mapping

By use of more recently developed computerized EEGS, both the amplitude of the electrical current generating the brain waves and the wave frequency are accounted for (Bonnet, 1989). Here from 18 to 60 EEG leads are placed on the skull, and patterns of electrical discharge are recorded by use of the square root of the discharge. While there is a general tendency in well functioning individuals for the lower brain wave frequencies to be associated with the higher amplitudes, it is clear, for example, that certain alpha waves may have twice the amplitude of still other alpha waves.

The first of the six steps in autogenics involves finding a quiet place where a minimum of distraction is present. After the technique is mastered, it can take place at a moments notice even in a crowded subway train, regardless of the distractions present. First you must remove tight clothing and other distracters that might interfere with the process. Initially it is better to have a dimly lighted room, and for the first half of the process soft quiet music sometimes helps to facilitate the action. Find a comfortable chair, and you are ready to begin a journey that should be a daily "must" for self regulation of own neural system just like the scrubbing of one's teeth. The first five of the six stages involves "passive volition" where attention to the task is minimized, and where a different approach to goal orientation must be learned. Here the structure of the situation causes the expected to happen, as opposed to the typical detailed planning of thrust for a related impact and specific goal attainment (Luthe, 1966; Koenig-Mill, 1986; Wallnofer, 1983; and Humphrey and Cassel, 1985).

Striated Muscle Control (Relaxation)

The second of the six, more or less, formal stages deals with self control of striated muscles and ability to relax. Too often the presence of tension with the striated muscles is designed to hide or shield one's feelings from painful emotional turmoil in the inner space. The use of the EMG to practice relaxation using carefully prepared audio tapes is recommended initially, and before trying autogenics. When one achieves success in such exercises, especially at the frontalis muscle level and where care is exercised to build conscious logic into the process to insure dominant brain involvement, autogenics is facilitated greatly. Autogenics is typically fostered by use of the "autogenic formula" where the individual talks self into process. For example, "My hands are heavy". If a simple "automatic formula" (AFI) fails, the use of "guided imagery" to facilitate is recommended, "Imagine a heavy weight is holding my hand down", etc. A fully relaxed skeletal muscle is one's guarantee that no tension or anxiety is present for that moment of time, and therefore will not impede the autogenic process. Where an individual is unable after repeated attempts to control the striated muscles (EMG), he/she may proceed to the next stage, but only to return for additional efforts at some later period. Reasonable control of one's striated muscles (being able to relax) is a necessary prerequisite for success in the use of autogenics.

Control of Emotions and Visceral

Because of the interrelationship of anxiety and muscle tension, it is sometimes advisable to work on stages 1 and 2 (striated muscles and emotions) alternately. The goal, to be sure, is not to eliminate emotions and visceral activity, but rather to order such use to be in harmony with the situation present. Full utilization on demand must always be a necessity. Before using the AFT for this stage it is recommended that the GSR be utilized in maybe 20 minute sessions where the individual seeks to allay anxiety and stress. When the AFI formula is utilized in this stage, again guided imagery may be employed, "Imagine that all is calm and peaceful and I have no worries". The guided imagery is always planned to be a positive force; as the negative type is typically counter productive in nature. It is essential that such practice sessions with biofeedback be scheduled so that person is not under pressure for other commitments.

Autonomic Function Control

In a constant environment, the temperature of one's fingers at waist level may fluctuate from maybe 65 to 95 degrees F. When fingers are cold under normal temperature conditions, it is largely because of restricted blood flow to the peripheral areas of the body. Blood flow through the arteries is controlled by smooth muscles, and which are under unconscious control. Brain laterality determines that the dominant brain has control over conscious areas, and the non-dominant brain over the nonconscious functioning. The automatic nervous system aligns two separate bodily functions with different halves of the brain: (1) parasympathetic, and (2) sympathetic. The first deals with the conscious functions and the second with the non-conscious ones. When the sympathetic pattern is triggered in emergency states the body is prepared for "fight or flight" or sometimes referred to as "to devour enemy" (It is like the turning-on of the after burner on a fighter airplane, and where the fluctuation of power is available to the pilot). Here digestion is inhibited, adrenalin or the opposite (norepinephrine) is released into blood stream to give vital energy for the emergency that is conscious or unconscious in nature. Often this state of emergency, where sympathetic syndrome is activated, is the residue from an earlier believed emergency state, and the individual has lost control for termination of the process. An example of such problem is typically associated with the Friday night college pep rally for planned weekend athletic games, and where athletes involved achieved full sympathetic syndrome that continues until game time, when they are already exhausted before playing. Cold fingers typically associated with the Type-A personality suggest a sympathetic pattern out of control for individual involved. Where this condition is present, the use of TEMP as a biofeedback practice is suggested to foster self control of the autonomic process. Here again the use of guided imagery is suggested, "Imagine my hands are heavy and warm", etc. Here again biofeedback exercises should be used until reasonable success has been achieved in the warming of one's hands.

Level of consciousness

It is here where "passive volition", a condition that is essential for effective autogenics becomes a reality. Because the dominant brain exercises veto power over the non-dominant brain, it is essential to bring one's level of consciousness to a lower level of attention; so that the non-dominant brain is able to exercise effective input. The EEG may be used for 20 minute training sessions until there is evidence that passive volition has become a reality. There is no direct sensory process by which one can detect the presence of a particular brain wave activity. What the individual senses and controls is a state of consciousness associated with particular categories of brain waves. When such control is in evidence, then and then only is one ready to exercise effective autogenic feedback training. It is of critical importance to note that there is not always a direct relationship between the amplitude of the brain wave in connection with the EEG functioning and the frequency as depicted by Alpha waves, 7 to 12 Kz. The older and traditional EEG equipment display a direct relationship, so the newer EEG equipment where the true Alpha or sometimes Theta state (3 to 7 Kz) is displayed regardless of amplitude present should be utilized.

Guided Imagery (one)

The sixth stage in the autogenic process involves 'guided imagery' where the individual plays a kind of 'imagery game' with self. The implementing of this stage often is used in the second and later stages in accordance with examples given. However, it becomes a principal mode of action when the 'hypothalamus/pituitary axis' is activated in the use of autogenics as an intervention strategy to produce change. Always, it involves the creation of an imaginary state psychologically and where corresponding physiological changes are expected to take place. It is the imaginary thrust that causes the planned change. Things do not simply happen by chance; rather we make them happen by design.

Ego Status and Ego Ideal

It is during this stage of autogenics that the functional use of the process becomes a reality. It is important, of course, that prior to this stage one's "ego-ideal" has been developed and in sufficient detail that there is meaningful direction for the use of autogenics. One can not have an effective ego ideal until a reliable ego-status has been established. That is to say that there must be a meaningful diagnoses of one's present conditions before one is ready to plan for effective change. The ego-ideal serves as a "blue print" for change, a kind of "road map" for action and desired change. After one has perfected the autogenic process, it may, of course, be utilized to establish harmony in the neural functioning, and which should be a daily requisite, no less important to one's wellness than the scrubbing of one's teeth. It is here where psychological states are created through guided imagery, and where the hypothalamus/pituitary axis is utilized. By creating psychological states that support the ego-ideal corresponding bodily changes occur that foster wellness at higher and higher levels of being (Cassel 1986a).

Body FORTRAN

This is where the process for change begins to function, and the individual seeks to program own body, much like the programming of a computer (Cassel, 1989). The "reticular formation' is the portion of one's brain that determines where and how all messages entering the brain are to be sent, i.e., verbal, chemical, electrical, visual etc.. It is contained in the "limbic system" which lies between the brain stem and the cortex. The three principal functioning units of the limbic system are:

1. Reticular formation.
2. Hypothalamus.
3. Pituitary gland.

The full limbic system is always involved in determining the nature and destination of messages entering the brain. Because of the interaction between the reticular formation and the other major elements (hypothalamus and pituitary gland), the body is already alerted to the message before it actually enters the other portions of the brain. If the hypothalamus, serving as the seat of emotions, alerts the pituitary gland that a crisis state is involved in connection with the entering message, the sympathetic pattern is already in full bloom to receive the incoming message. Digestion has already been stopped, adrenalin is being released into the blood to provide extra energy, and blood is rushed to vital organs to support the perceived situation, conscious or unconscious in nature. Just like in real computer programs, "garbage in, means garbage out". If the entering message is not in agreement with the real present situation, we have a false alert that is out of conscious control. Full wellness (fitness) can only be achieved when there is conscious control over this process. That is what autogenics seeks to accomplish as a necessary requisite for any other planned change.

Guided Imagery

Here the imagery and fantasy world of the individual becomes an integral part of the process. Through the use of "guided imagery" psychological states are created as if one were role playing as on the stage in a theater. Always the roles being played are of a positive nature, as negative imagery tends to be counter productive in nature. While it is true that guided imagery is suggested for the five initial stages for achieving self-control "My hands are heavy and warm," the new imagery is related to desired change in relation to health care or harmony in self regulation of one's neural system (Cassel 1987a).

Inhibiting Agents

All unnatural products used by an individual within maybe a 12 hour period must be considered to be counter productive in the effective use of autogenics. This, to be sure, includes cigarettes, tobacco, coffee, coke, and often medications being taken. Full effectiveness in the use of autogenics can only be promised when such other neutralizing agents are not present in one's system. In spite of the counter productiveness of such agents as cigarettes, coffee, coke, etc., the use of autogenics is suggested; maybe even as a vehicle to help curb such uses.

Termination Exercise

When one is ready to complete the use of autogenics there is a standard technique which is typically utilized. Four different modes are suggested for this accomplishment:

1. Briskly flaying of both arms.
2. Taking of a deep breath.
3. Opening of eyes.
4. Avoidance of trance like state.

Wellness and Fitness

In order to restore and maintain a high degree of wellness or fitness, autogenics is a necessary but not always a sufficient means or vehicle. Not unlike the evolutionary development in all other disciplines, the usual repertoire of the physician are sometimes indispensable. In addition, autogenics seeks to foster a state of fitness beyond that typically associated with traditional health care.

References

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