20 years with Neurofeedback

Author: Dr. Siegfried Othmer

Although I mentioned it last week, it is worthy of more reflection that March 5 was the twentieth anniversary of our son Brian’s first neurofeedback training session. Within a little more than a month thereafter, Sue and I had decided to contribute somehow to the development of this field. This happened not firstly because of Brian’s progress in the interim—the good news on that front were largely yet to come—but all of the other things we saw happening in Margaret Ayers’ office while we were waiting for Brian to finish his sessions. Here was a veritable breeding ground for enthusiasm about brain-training. No controlled studies needed. In Michael Tansey’s imagery, we were seeing crutches getting hung up on walls, figuratively speaking.

I continue to mention Brian’s history in our introductory training course, but I observe that the story changes over time as we continue to reflect on it, as our own understanding of neurofeedback deepens, and as we understand better the challenges that Brian was facing with his own brain. A continuing preoccupation on our part concerns the “worldview” that Brian was developing with regard to himself and to his relationship to the world, and how this changed over time.

Before seizure disorder was diagnosed, we had given Brian little quarter. That is to say, the governing model was that Brian needed control his behavior. In reality, of course, parenting was always a matter of “the art of the possible.” We knew Brian’s trigger points, and the household was always run in such a way his buttons wouldn’t be pushed. There was hardly ever a raised voice. When seizure disorder was diagnosed, he was finally able to differentiate to some extent between his volitional self and the disagreeable behaviors that sometimes happened as a result of the sub-clinical seizures. But that could never be the end of the matter because he was quite conscious during his rages, and I strongly suspect that his “feeling state” during his rages were quite consistent with his behavior at the moment. It is likely that the feeling was father to the act, just as in any other kind of rage that is not so neurologically driven. When one is angry, the world at that moment thoroughly deserves the anger.

So in the act of disagreeable behavior, I suspect that it would not be easy for Brian to be able to differentiate the self from the act. Hence there was a continuing sense of responsibility for these acts, but also a sense of moral failing that the diagnosis of seizure disorder did not assuage. From the vantage point of his more normal and moral self, Brian was mortified by his behavior, and thoroughly mystified by it. He was often in despair about himself, and there were times when he was even driven to punish himself. It is this ethical twilight that I wish to illuminate in this discussion.

We have finally come to know the classic pattern in which the abused in early childhood becomes the abuser in adulthood. This may cause us to moderate the harshness or absoluteness of our condemnation of the abuser, but all this is contingent on the status of victimhood of the abused. Having arrived at this model, we take care to preserve our imagery of the innocent victim. Newspapers tend to support this dichotomy of good and evil, and to put the setpieces in play appropriately. It is impossible anywhere to see Catholic priests as anything other than heinous perpetrators, and it is impossible to see their victims as anything other than victims. They were victims, of course, but they are now grown up, and it would be remarkable beyond likelihood that the cycle of the abused becoming the abusers were to be suddenly interrupted. And the perpetrators were that also, but they may in their early life also have been victims, which surely puts matters into a slightly different light.

In reality, matters are more complex. I recall the story of a majorly depressed person who came to us many years ago weighing some 400 pounds. During the course of neurofeedback training, she disclosed to Sue that she had been sexually abused as a child by her father. “I enjoyed it at the time, but it was child abuse nonetheless.” I recall Matt Fleischman chiding me during a break about reporting the case in this way. Not PC! But is it not likely that this may be the crucial element in her carrying forward a sense of moral culpability for an act she did not choose, and for which she should not be held responsible? Enjoying the experience made her a co-conspirator, a moral agent giving consent, in her own mind. But society does not deem 15-year-olds able to give consent, much less pre-teens.

By the same token, Brian had the burden of remembering that when he was beating somebody up, it seemed absolutely the right thing to do at the time. One cannot completely disown that, even if one has been given the excuse to blame the brain.

With that as prelude we come to the unfathomable story of the day, that of Dennis Rader, congregation president, dog catcher, and serial killer. In one of his early letters to police, he explained that when he wasn’t in the grip of the “monster,” he was a normal, everyday guy. “I come home [from a kill] and go about life like anyone else.” ( Los Angeles Times, March 6). “It seems senseless but we cannot help it….There is no help, no cure except death or being caught and put away.” (Daily News, March 6).

It helps to understand altered states, and to realize that the “monster” and the congregation president were not really the same person. “The Dennis I know is not the Dennis in the jumpsuit,” said a close acquaintance of 30 years. He is right; it’s not the same person. What poses a greater challenge to me is the question of who is the person that taunted the police for all these years; who is the ostensibly normal person that lived in awareness of the monster for all these years. I am speculating here, but I surmise that the person who taunted the police is no more the congregation president than he was the monster. There most likely had to be yet a third personality. And as for the congregation president living with the monster within, I suspect this points to an incredible capacity for compartmentalization that comes with the fracturing of the personality through early trauma.

Neurophysiologically, the marker for the kind of compartmentalization above may be abnormalities in coherence. But matters need not be that obvious. Deficits in connectivity may exist in specific neuronal networks that will leave no obvious trace on the surface EEG. But visible or not, challenging the neuronal networks into engagement through frequency-based neurofeedback may be most direct and effective way of undoing the long-term consequences of early trauma. And the lower the frequency, the easier it is to bring neuronal populations into the rhythmic dance. So in the neurofeedback perspective, the story of trauma recovery is not complete without reference to alpha-theta training.

The trauma model ultimately applies to Brian as well, in that the world was over the early years always somewhat incomprehensible to him, hence hostile and unpredictable. His was the experience of trauma even if it was not overtly visited upon him from the outside.

Dr. Siegfried Othmer