NEURAL DISSONANCE PROFILE BASED ON GUIDED IMAGERY AND BIOFEEDBACK THAT SERVES AS FOCUS FOR CHANGE

Russel N. Cassel, D.ED.
Cassel Psychology Center
Head Disease Risk Factor Clinic
1362 Santa Cruz Court Chula Vista, California 91910

Brian R. Costello, Ph.D.
Cassel Research Centre
101 Beleura Hill Road, Mornington, Victoria Australia 3931

By use of "Guided Imagery" a neural dissonance profile is developed that serves as the basis for planning change or therapy in the health delivery process. Based on "need theory" principles, emotional scars from earlier crisis states, or areas of ungratified needs harbor feelings of discontent or displeasure, and when conscious deliberations deal with such areas, physical changes take place that can be assessed rather accurately through the use of biofeedback instruments (Festinger, 1957; and Cassel, 1986).

Cassel Tri-Bi-Sensor

The Cassel Tri-Bi-Sensor is designed with an interface board for a PC XT microcomputer. It contains three different biofeedback instruments, and the provision to read the data from a fourth one directly into the computer:

I. GSR -- Galvanic Skin Response -- emotional temper.
II. EMG -- Electromyograph -tension of skeletal muscles.
III. TEM - Peripheral Temperature - finger temperature - (presence of sympathetic pattern - fight or flight).
IV. PUL -- Pulse Rate -- present stress load of individual (fourth instrument).

T-Score Like Scale

The computer program, written in Quick Basic, converts the data from each of the four instruments to a common T-score like scale ranging from 20 to 80, with a median of 50. This makes all scores for each of the four instruments have a common range, and with high scores always ranging in an upward direction. Thus, the greater the bodily function, the higher the score being depicted.

The physical functions being assessed by the four biofeedback instruments represent important considerations that bear directly on one's present state of wellness, i.e., GSR - emotions, EMG - muscle tension, TEM "fight or flight pattern", and PUL - stress load for the moment of time. All of these are directly related to one's mental health, and serve as a critical basis for change in health delivery, where such malfunctions are present. DISPROF is designed to determine not only the degree of malfunctioning, but also the specific areas involved. In planning for change with guidance (for future), or therapy (for some past emotional scars), each of these neural scores serves as an effective basis for planning change (Cacioppo and Tassinary, 1990; Taylor, 1990).

The use of "Guided Imagery" to create a "Neural Dissonance Profile" (DISPROF) is a program developed at the CASSEL PSYCH CENTER over the past decade for use in planning one's "ego-ideal" or plans for change (therapy for past and guidance for future). It makes use of the Cassel Tri-Bi-Sensor with the four different modalities (GSR, EMG, TEM, and PUL) being assessed simultaneously, and to depict bodily changes taking place (Green and Green, 1979; Horney, 1945).

Creating Psychological State

Following a "beep" on the computer monitor, a short statement appears at the bottom of the screen for exactly 12 seconds of time (Is your home warm and friendly?), and the subject is instructed to discuss each statement with self, and as if talking to another, but in silence and in secret, just as if answering the question being posed. It is this interaction with one's self that serves to forge a "psychological state", and based squarely on dominant brain action. When such a state is structured internally, a corresponding change takes place in the body, and the four biofeedback instruments depict four of such important changes. Further enhancement of that involvement is fostered by depicting immediately upon the screen, above the statement being displayed, those changes; so the individual may observe impact of present deliberations. The "G" representing emotions, "T" the sympathetic pattern involvement, "P" the stress load, and "E" presence of skeletal muscle tension.

Control Inhibiting agents

The theory embraces the notion that impact is directly related to valence and nature of thrust incited, and where neutralizing imbibing elements (coffee, cigarettes, alcohol, etc.) are prohibited for at least one hour immediately preceding performance. It is important that the thrust being assessed by the biofeedback instruments be from the coincident psychological state created, and not from chemical elements or drugs that serve to provide false leads. This, to be sure, is no less important than a "fast free diet for past 12 hours", in relation to cholesterol assessments. Areas of Life Space

It is not only important to know which of the neural measurements is active within individual being assessed, but also to know the area of one's life space associated with such functioning. The 12 areas utilized in DISPROF parallel one's developmental history. There are six questions provided for each of the 12 areas. The first three deal with symbolic associates; while the last three deal with one's personal interactions, i.e., for example, "home" deals with the concept (Is your home broken by death or divorce?"), while "family" deals with the people in the home ("Did your mother hug you as a child?"):

1. Home and family.
2. Religion and inner-development
3. Affiliation and social.
4. Law and security.
5. School and learning.
6. Romance and Psychosexual.
7. Sports and risk taking.
8. Health and safety.
9. Travel and relaxation.
10. Aesthetic and beauty.
11. Money and productivity.
12. Survival and pollution.

Dissonance Profile

A "Dissonance Profile" is provided by the computer containing two separate parts (pages) following the assessment:
(1) The first and main portion has to do with strengths and weaknesses as depicted by the neural measurements of the four biofeedback instrument readings (GSR, EMG, TEM, and PUL). A T-Score like scale is used for profile ranging from 20 to 80, with a median score of 50. All four biofeedback scores are comparable. The depiction is by use of bar graphs. The neural profile for this part is contained on the first page of the profile sheets.

(2) The interacting statements that appear at the bottom of the screen, and which the subject is asked to answer with self in secret, are structured differently. The First one is always positive (Is your home warm and friendly?), the second is neutral (Do you like your home?), and third is negative (Is your home broken by death or divorce?). The second page of profile depicts the relation of positive and negative responses, so critical in determining the most effective approach to therapy (the positive and neutral are included together, and they are averaged), i.e., where the positive forces are most numerous, rational/reasoning may be most effective, etc.. The neural profile for this portion is contained on the second sheet, and it is from this portion of profile that critical clusters are determined that serve as the basis for change processes in health delivery (Horney, 1945).

Brain Laterality

The "guided imagery" theory is based on brain laterality, and where use of dominant brain is made to create a psychological state that impacts on nondominant brain areas to reflect emotional scars that might be hidden from past crisis states. Psychological states do not emerge by themselves, the individual causes them to emerge, and the corresponding changes in the body are captured and projected on the screen. Motivated by seeing changes in relation to own silent, but real deliberations, a psychological state becomes the more magnified. When an individual sees such changes the personal involvement becomes more intense, i.e., as being depicted by tile "G's", 44 7 )p PS ' "T's", and "E's" on the screen before them. It is this mystery within individual being depicted by accurate assessment instruments representing the roots of our being, where today is tomorrow in health care. DISPROF is a portion of the "TypeA Proneness Assessment Program (TYPEAP)", which uses 23 critical coronary heart disease risk factors to estimate coronary age of individual. The total program is entitled "Defensive Living", and promises improved quality of life and an increased life span for effective participants (Levy, 1985; Cassel, 1986a).

Validity Data

There are two aspects of interpretation involved in the use of the Neural Dissonance Profile:

First is the neural dissonance profile, where a bar graph depicts each of the four biofeedback indices for the 12 different areas of the life space. It represents an "intracomparison" where there is no reference to a norm group, and where strengths and weaknesses are in relation to own self. Second is the sum of positive (positive and neutral averages), and negative statements used in creating the various psychological states. It is this portion of the profile that is used for planning the primary change or intervention technique that is pertinent to the specific general malfunctioning of the person involved. To treat emotions when muscle tension is the culprit; or stress load when control of sympathetic pattern is the problem, would be counter productive to effective change, or promise for such change.

Factor Validity

A principal components factor analysis was computed on the critical neural measurements from part 2 of the Neural Dissonance Profile, and which involved 9 different scores: (1) GSRPOS (the positive GSR), (2) EMGPOS, (3) TEMPOS, (4) PULPOS, (5) GSRNEG (the negative GSR), (6) EMGNEG, (7) TEMNEG, (8) PULNEG, and (9) INIGSR (the initial GSR before interaction). In addition, three related variables were added: (10) AGE, (11) SEX (1 = F, and 2 = M),, and (12) MRSTAT (marriage status, 1= unmarried, and 2=married). The scores rotated by varimax process are displayed in Table 1.

This is precisely the same data from which the later 7 clusters were abstracted for use as intervention technique bases, and as depicted in Table 2. It included 111 individuals, 96 presently involved in psychological treatment, and 15 typical individuals (all from the Australian Centre).
It is of interest to note from Table 2 that Factor 1 is a "bipolar" factor, depicting that when persons are in the sympathetic pattern the pulse rate tends to increase and be higher (this is in agreement with research that shows a significant correlation between pulse rate and diastolic pressure). Further, the only factor related to age is marriage status (MRSTAT). The single factor related to sex is emotions (GSR), and where males tend to have higher GSR (emotional scores).

Cluster Analysis
It is this position of the profile that is used for purposes of planning change in relation to guidance or therapy for individuals involved. Seven characteristic patterns are clearly evident, even by a causal examination of the data:

I. TYPICAL PATTERN -- all score within mid-range of profile generally between 40 to 60 on TScore like scale.
II. SYMPATHETIC PATTERN -exceedingly high scores on TEM -- person in "Fight or flight pattern" -- exhaustion usually evident.
III. STRESS PATTERN -- exceedingly high PUL -- where pulse rate suggests high diastolic blood pressure.
IV. TENSION PATTERN -- high EMG pattern, and where there is continuous need for motivation and rest.
V. EMOTIONAL PATTERN -where there is at least moderately high GSR, often accompanied with other marginal high indices.
VI. TENSION/SYMPATHETIC PATTERN -- high EMG and low TEM -- where anxiety, frustration and depression are evident.
VII. TENSION/STRESS PATTERN -- high EMG and high PUL -- tension and exhaustion evident.

Typical Individuals
Characteristically, the typical individuals cover maybe as much as from 80 to 90 percent of the general population. Thus, when we refer to 7 clinical patterns on the DISPROF profile, we are referring to the 20 percent or less of the population that are characterized by psychosomatic health problems for 6 of the 7 cluster areas shown. The well individuals were included to show their relation to other six patterns.

Clinical Types
For the 20 percent of the population that constitute the atypical individuals, the 6 remaining clinical types or patterns on DISPROF distribute as follows (The 6 clusters depicted here are based on the statistical analysis of data for the 111 individuals involved. Prior to the statistical analysis, two separate clinicians placed the records in the 7 cluster groups simply based on personal observation of records. There was less than a 10 percent error from that obtained, and as displayed here:

I. TYPICAL PATTERN (not included in percentages below)
II. SYMPATHETIC PATTERN -- 0.4%
III. STRESS PATTERN -- 23.4%
IV.TENSION PATTERN -- 4.2%
V. EMOTIONAL PATTERN -- 12.7%
VI. TENSION/SYMPATHETIC PATTERN --9.5%
VII. TENSION/STRESS PATTERN -- 9.5%

Validation of Seven Clusters
A cluster analysis was accomplished using 111 records of which 15 were for typical individuals, and 96 were for subjects presently undergoing treatment for psychosomatic problems. By use of the "K-Means Clustering" approach (assumption that no hierarchical structure was evident), the data above was abstracted. The data for cluster I, Typical Individuals is contained in Table 2. Similar data was obtained for each of the other 6 clusters obtained.

Functional Use of Clusters
After it has been ascertained that the basic general problem has to do with one of the 6 atypical clusters, the basic thrust for change must focus on the problem indicated, i.e., if it happens to be VII. TENSION/STRESS PATTERN, for example, it is obvious that some approach to fostering relaxation training is in order. To APPLY any other approach would be expected to be "counter-productive". In the field of therapy or guidance, this is where today is tomorrow; for now there is a clear depiction of need in the life of an individual, and where the focus for change must be made, if it is to be effective.

Functional Use of Dissonance Profile
For this portion of the dissonance profile, a clinical approach is in order and where the strong and weak areas are considered as complements to each other. For example, if SCHOOL AND LEARNING are low, and MONEY AND PRODUCTIVITY are high, the need for a job and the earning of money is evidenced.

Discerning Validity
For the 111 subjects involved in this study a "step-wise multiple linear regression" was accomplished against three different dependent variables:

1. SEX (Male= 2, Female= 1),
2. AGE (to nearest six months), and
3. MRSTAT (Married=2, and Not married = 1).
4. INIGSR (Initial GSR).

There is no statistically significant correlation with age, so age was not a valid discerning variable. There is a statistically significant multiple R with SEX = .309 (.05 level or better), so SEX is a valid discerning variable. There is also a significant multiple R with INIGSR (R =.583); so it too is a valid discerning variable. The multiple R's for GSRNEG (NEGATIVE gsr) and MRSTAT (marriage status) were not statistically significant; so they are not valid discerning variables between persons in therapy and the members not in therapy.

References
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Cassel, R.N. (1986a). Examining the early roots of heart disease. College Student Journal, 20(1), 2-7.

Cassel, R.N. (1986b). 'The use of guided imagery to create a neural dissonance profile (DISPROP'). College. Student Journal, 21(3),106-213.

Festinger, L. (1957). A 'Theory of Cognitive Dissonance. Stanford, California: Stanford University Press.

Green, E., and Green, A. (1979). Beyond Biofeedback. New York: Dell Publishing Company.

Homey, Y., (1945). Our Inner Conflicts. New York:W.W. Norton.

Levy, J. (1985). Right brain, left brain: Fact and fiction. Psychology Today, 19(5), 38-44.

Taylor, S.E. (1990). Health Psychology -'The science and the field. American Psychologist, 45 (1), 4050.