Easing Pain With Mind Over Matter : Medicine: Designed for adults, controversial biofeedback is now being used on young patients.

Never mind the electrodes taped to the little girl’s shoulders.

Or the two red sensors stuck to her left index finger and palm. Or the band of black elastic around her waist.

Instead, in a basement room at Children’s Hospital of Orange County, 6-year-old Cory Barger stared at a video monitor that showed her muscle tension, perspiration, and breathing as bright, geometric designs.

“Keep your shoulders quiet, Cory. Relax,” technician Barbara Farber advised. And Cory let her shoulders fall. She took a breath. On the screen, blocks of pink, yellow and green turned to dazzling blue. “Wow,” Cory said softly.

The solemn-faced girl in the red Minnie Mouse dress was practicing a relaxation technique called biofeedback that she uses often to control pain.

In remission from leukemia, Cory must have spinal taps every six weeks. But until she learned biofeedback, the needle jabs were agonizing. Each time, five nurses--or sometimes, four nurses and Cory’s mother--had to hold down the often screaming 40-pound girl.

But since she began biofeedback last November, Cory has walked calmly to the spinal punctures, positioned herself on the table, and held her body still, concentrating on relaxing. “It makes my pokes not hurt too much,” she explained.

Introduced in the late 1960s and still controversial, biofeedback is mental training that lets people gain control over involuntary bodily functions.

By wearing electronic sensors that “feed back” data on temperature, respiration or muscle tension to a biofeedback video monitor, patients discover ways of relaxing.

When an electrode is wrapped around a finger, for instance, the video screen will display the patient’s temperature, sometimes as a wavering line. But by experimenting with ways of easing tension--breathing deeply, for instance, or imagining a quiet walk on the beach--a patient can gradually learn to make the temperature line rise. And slowly he has learned a simple method of relaxing--that of warming his hands.

Again, when an electrode is placed on a patient’s shoulders, bright colors on the biofeedback monitor may indicate that the patient’s shoulder muscles are tense. But by studying the monitor and trying to change the colors on the screen to ones that indicate relaxation, a patient can learn how to ease the tension.

Though the high-tech procedure was designed for adults, across the nation many psychologists and pediatricians now use biofeedback with children, a few as young as 2.

Not only does it help youngsters like Cory who need frequent, painful medical procedures but also, doctors at Children’s Hospital and many other pediatric hospitals say, it can help treat a long list of disorders--from anxiety, migraine headaches and fiercely itching eczema to arthritis, attention deficit disorder, and a neurological syndrome called Raynaud’s Disease.

In addition, Children’s Hospital psychologist Frank Carden said, his staff uses biofeedback to “re-train” children with asthma and cystic fibrosis--improving their lung function by showing them how to breathe using the diaphragm, not the chest. A recent Children’s Hospital study of 26 cystic fibrosis patients, ages 10 to 41, showed that those whose breathing was “re-trained” with biofeedback improved lung function by 38% to 100% and would probably show long-term benefits, including fewer respiratory infections.

The list of uses for biofeedback goes on.

At the Hargitt Elementary School in Norwalk, counselor Micki East, uses biofeedback sensors and a computer game called “Stack Attack” to show first-through-seventh graders how their bodies react to stress.

In Tulsa, Okla., psychologist William Finley has created a patented biofeedback device to stop bed-wetting. And in Florida, at the University of Miami Medical Center, doctors use biofeedback to teach brain-damaged children and adults to move paralyzed limbs. With sensors attached to immobile arms or legs, patients try to move while the monitor shows if the muscle has received a signal from the brain.

Explained Dr. Bernard Brucker, a co-director of the Miami Project to Cure Paralysis: “We’re teaching people to be more efficient at using cells of the brain.”

For all the enthusiasm, some doctors remain deeply skeptical about biofeedback, some suggesting that it is a modern form of snake oil. Many more are cautious, suggesting it may work for a few psychosomatic ailments but that most of the time, simple relaxation techniques may work just as well.

“It’s of unproven scientific validity overall,” said Ira Lott, chairman of pediatrics at UC Irvine School of Medicine.” In rare instances, biofeedback may help, “but I would not recommend it as a prophylactic treatment in general.”

Childrens Hospital in Los Angeles rarely uses it, said its head of behavioral sciences, psychologist Michael Dolgin.

“A lot of people feel you can get just as good results with other techniques like hypnosis,” he said. Still, some of Dolgin’s private patients, especially youngsters with headaches, learn biofeedback. The technique teaches children to dilate blood vessels and ease their pain, said Dolgin, who believes it can give them a sense of mastery over their bodies.

One of the most negative reports on biofeedback came in 1987 when a committee of the National Research Council in Washington said there was no proof that it could relieve stress.

That finding still appears correct, said several committee members, including USC psychology professor Gerald Davison. He acknowledged that biofeedback research with paralyzed patients appears promising but said he still doubted many other claims made for the technique, which he described as “impressive gimmickry.”

Biofeedback advocates counter angrily that the NRC study was uninformed, misleading and misstated the research.

Overall, the medical establishment has been quick to find fault with the technique, noted a biofeedback pioneer Judith Green.

“The sad story is we (biofeedback practitioners) don’t get a lot of referrals” from doctors, said the Greeley, Colo., psychologist. “When a child shows up at the pediatrician’s with a migraine, they think drugs. Or hyperactivity? They think Ritalin. . . . But I think doctors are becoming more educated, more interested in mind-body therapies.”

Cory’s mother Barbara Burns said she might not have believed the claims about biofeedback either--if she hadn’t seen it help her daughter.

After Cory was diagnosed with leukemia in April, 1987--immediately enduring three or four bone marrow aspirations that first week--Burns said she started searching desperately for some sort of pain management for her little girl.

“Our vet manages pain” with Cory’s pony, Burns said. Before he gives the pony a shot, he loops a 10-inch chain around the animal’s lip, twists it tightly “and the pony falls asleep.”

“I thought, my God, if you can do that for horses they ought to be able to find a place on a human being” that would still the pain, Burns said. “But (the doctors) didn’t have any suggestions.”

So, for two years the situation didn’t change. About every 12 weeks, Cory would have a spinal and each time, she would scream and have to be held down.

For a while, “they used to sedate her . . . a very painful poke in the leg and sometimes a poke in the hip to numb the area,” Burns said. “But these would hurt so much.” And sometimes the sedation, a form of “twilight sleep,” would make Cory “wild.”

Burns said she decided to join nurses in holding her flailing, screaming daughter during the five-minute-long puncture when she discovered, after one procedure, that Cory bore fingernail scratches from being pinned down. At 4 1/2, Cory “made the decision that she didn’t want to take the sedatives anymore,” said Burns. “So the doctors suggested, ‘Let’s try and see if we could reason with her.’ Still, it took quite a few people to hold her and she screamed and it was awful.”

But it was not until October, 1989, that she learned by accident, at the Orange County Children’s Hospital parent support meeting, that the psychology department offered biofeedback.

At the time, 4 1/2-year-old Cory was the hospital’s youngest biofeedback student.

But Burns was hopeful. Cory was eager to find a way to block the pain. Also the hospital’s biofeedback programs--some displaying charts and colorful shapes, one depicting a small man climbing a mountain as the child’s tension rose--seemed tailored toward kids, Burns said. And “Cory’s pretty video-literate”--good at video games like Nintendo. “I thought this would be right up her alley.”

And it was. After just two half-hour sessions with the biofeedback equipment, Cory had learned relaxation techniques, said Frank Carden, the hospital’s director of health psychology. (Each session costs $65, and insurance companies typically pay for the treatment.)

In November when she had her next puncture, “she was a little stressed,” her mother admitted. But instead of nurses holding her, Cory rested quietly on the procedure table.

“There was just one little scream. And it was over.” Burns said.

How does Cory do biofeedback? Meeting with a reporter at her family’s rustic home in Riverside’s orange groves, the little girl--a typical 6-year old--made it clear that she would prefer to discuss her gray pony Moki, her Little Mermaid watch or her two toy ponies, Miss Sparkle and Miss Dawn, rather than biofeedback.

Still, with her mother’s prompting, Cory talked a little. Practicing biofeedback, she said, batting large brown eyes, “is just like you’re trying to go to sleep.”

By now, Cory has biofeedback down to a science, she and her mother said. About a week before each spinal tap, Cory visits the Orange County hospital for a half-hour refresher class in front of the video monitor.

And on the day of the needle stick, Burns stays by Cory’s side, holding her hand, and coaching her on biofeedback techniques.

While Cory waits for the puncture, she and Burns also discuss an elaborate fantasy that they narrate together. In this waking dream, a stallion named Black Beauty gallops through the forest, carrying young Cory to a safe place--beyond pain.

“I just remember when I’m getting my pokes, I think about riding Black Beauty through the woods. And it’s cool in the woods. And we go through the trees,” Cory said.

Added Burns, “And when the poke is going to come, we think about a jump. And when it hurts a little, I say, ‘Breathe!’ And it works.”

Both Cory and Burns say they are delighted to have found biofeedback. Cory has even used it occasionally outside the hospital. Once, on the roller coaster at Castle Park in Riverside, they were both scared, Burns said, but Cory stayed calm, working her way through her terror by breathing deeply, relaxing her shoulders, practicing biofeedback.

Overall, Burns said, her only concern about biofeedback was that Cory didn’t learn about this sooner.

“I don’t know why this is such a well-kept secret.” Burns said.

Whether it would work for children much younger than Cory, Burns said she didn’t know. “But it’s worth trying for Pete’s sakes. These little guys--they don’t know what’s happening to them” and biofeedback could give them something to do, give them some control over their pain,” Burns said.