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Neurofeedback / EEG Biofeedback can be very helpful in staving off the full impact of degenerative conditions such as dementia. We need to be somewhat charitable here. Beyond certain ages, none of us are still working with a full deck. Neuronal loss proceeds apace. It is a natural process of attrition, and the normal response is actually to have our brains become somewhat faster and more efficient. When neuronal loss is larger than normal, or when other factors intrude on normal neuronal function, we are still able to train the brain to make better use of the resources that remain available. Again, we are not talking of cure here, but rather of functional adaptation. The objective of maintenance or improvement of cognitive function in dementia can be pursued at many levels, ranging from commercially available home use devices to targeted Neurofeedback under clinical supervision. (See also Age-Related Cognitive Decline)
Depression is in fact a complex disorder that finds various expressions in our clinical populations. We have seen depression increase in incidence for over a century, to the point where it is becoming the single largest cause of loss of productive life years around the world. Depression does not have the visibility that cancer and heart disease have in our culture, but it has an impact that is comparably devastating. And Prozac is not the answer.
From our own necessarily limited perspective, depression is to be seen as yet another "Disorder of Disregulation." We can train the brain to pull itself out of depression and to maintain itself in a better state of dynamic equilibrium. This finesses the issue of whether the nervous system is the cause of the problem or the victim. A boot-strapping technique is available to abort the depressive episode in many if not most of those who are depressed. This finding is particularly dramatic in those who exhibit the kinds of depression that are most difficult to treat: agitated depression and suicidality.
People who have a history of suicidality often fall into that pattern quite suddenly, and even unprovoked. It may not even make sense given their life circumstances. It is therefore to be seen as principally a problem of brain organization. The proper Neurofeedback technique can in many such cases pull people out of suicidal thinking just as rapidly as they fell into it, often in a single 45-minute session. Over time, the brain is trained toward stability, and then a recurrence is no longer expected. If a recurrence does happen, the remedy lies close at hand. Suicide is a problem of the brain, not of the mind, in the most intractable cases.
The above will seem like a startling revelation to most readers, but in fact no one should be surprised. After all, the gold standard in the treatment of severe depression remains shock therapy, in which a single treatment is expected to "reset" the system so that depression no longer manifests. In the perspective of Neurofeedback, shock therapy is just monumental overkill. A gentle technique such as ours can just as effectively coax the brain toward a more functional state. At a minimum, the gentle technique should be tried before the brain is put into an artificial seizure. Significantly, shock therapy does not involve pharmacology. So it has already offered evidence to the effect that anti-depressants are not essential to the resolution of depression.
Case Report:
The following are excerpts from an article by Dan Dinello, published in the Chicago Tribune November 11, 2007:
After 20 years of anti-depressant drugs and therapy, Lisa Ferguson still struggled with anxiety, poor sleep and panic attacks. Then she met a doctor who suggested Neurofeedback. Ferguson gave it a month, saw improvement and stuck with it.
"My sleep is incredibly better," she said. "I can function during the day without ruminating, without worrying. It's been wonderful."
"The objective is to normalize brain waves," said Dr. Kyle R. Bonesteel, assistant professor of neurology at Loyola University Medical Center and director of Neurohealth Associates. It was Bonesteel who suggested treatment to Ferguson.
Information coming soon...
Diabetes is one of the few conditions where the health picture is getting worse rather than better in the US. In fact, if all the pieces of the picture are pulled together, diabetes may be the third-largest cause of death in the country, competing with stroke. Much of this is entirely avoidable. It turns out that the health risk of obesity is largely traceable to the association between obesity and diabetes.
We must distinguish here between Type I and Type II diabetes, although Neurofeedback is relevant to both. Type II diabetes is to be seen in the perspective of Neurofeedback as primarily a disregulation of blood glucose level. This is not intended to disadvantage other perspectives; it just happens to be the one that is relevant to what we do. In training the brain to self-regulate better, we observe that other regulatory functions unfold more smoothly as well. One that is clearly affected as well is blood glucose regulation.
We have seen numerous instances in which dietary management of incipient Type II diabetes at some point was no longer sufficient, and insulin supplementation was recommended. If Neurofeedback was undertaken at that point, insulin supplementation could usually be avoided.
We have seen other instances in which clients exhibited a hypoglycemic pattern in a glucola challenge, and with Neurofeedback training the swings in glucose level could be attenuated. Such known precursors of Type II diabetes could therefore be normalized well before they became a medical issue. Obviously all such self-regulation strategies benefit from support of a sound nutritional strategy, and all of them can equally well be sabotaged with reckless inattention to lifestyle and dietary issues.
Type I diabetics can likewise benefit from improvement in the body's self-regulatory status. The combination of sound diet and sound lifestyle with brain training can eventuate in better-controlled blood glucose level. It can even result in reduced insulin requirements. The tighter regulation of blood glucose levels will no doubt have later payoff with respect to the degenerative aspects of diabetes in its advanced stages.
- Dissociative Identity Disorder
Known commonly as Multiple Personality Disorder, we are dealing here with the establishment of separate personalities, perhaps even unknown to each other, on the same cortical real estate. This occurs as a result of early childhood trauma, and resolution of the condition ultimately involves a re-organization of the trauma history. But that is the end of the story, not the beginning. A person thus traumatized in childhood is carrying forward a lot of baggage that can be helped with Neurofeedback. We therefore nibble away at the problem of disregulation in various ways, and strengthen the person's capacities for self-regulation. In the course of this process the person's awareness may well expand to the point where it begins to include the different personalities. Where does health ultimately lie in this process? Is there a definitive goal of therapy? The Neurofeedback is non-prescriptive. We provide the training brain opportunities. We don't prescribe where the person takes those opportunities.
A principal component of the work offers the opportunity to revisit the early traumas in a benign way that avoids re-traumatization. This may lead to a healthy reframing of the issues for the person. Whether that ultimately leads to a re-unification of the personality is another matter. We observe that clients come for better mental health. Multiples don't come to us with the objective of unification, and we respect that.
In some ways the very existence of multiple personality illustrates the centrality of the role of brain organization in the bio-electrical domain. After all, the different personalities all function in the same brain with the same neurochemistry. What does it tell us about the importance of the kind of brain organization we are talking about that one alter may be an insulin-dependent diabetic whereas the others are not; that one alter may need to wear glasses whereas the others do not; and that one alter may be an alcohol abuser whereas the host is a teetotaler? Nothing could better illustrate the broad impact on our whole physiology of the particulars of brain functional organization than the DID client.
Remarkably, Down Syndrome children have been able to recover function quite nicely with very simple Neurofeedback training tools. The initial work in this area was done by a psychiatrist in Turkey, and was reported at a European scientific conference on Neurofeedback. In some respects, academic skills performance became indistinguishable from that of normal peers. The initial study was performed with a limited number of sessions and, as stated above, with only the most straight-forward of training approaches.
Significantly, all of the children in the study were able to progress significantly with the training. One can only assume that further gains are to be had with more extended training and with more targeted protocols.
- Drug Addiction and Alcohol Dependence
The problem of drug addiction and of alcohol dependence in our society is alarming. It is involved in nearly half of the female juvenile justice population and a third among males. It is a dominant factor in automotive fatalities and in domestic disputes. There is a genetic component that makes this more of an issue with some ethnic groups than others.
Addiction is a brain-based problem, and it demands a brain-based solution. The will is over-rated when it comes to the addicted brain. Fortunately, a new era opened up at the outset of the "Decade of the Brain" with the publication in 1989 of Eugene Peniston's epoch-making study of Viet Nam Veteran alcoholics. This breakthrough study on the application of Neurofeedback to alcoholism was performed essentially independently by Eugene Peniston, staff psychologist at Fort Lyons Veterans Administration Hospital in Colorado, and Paul Kulkosky, a physiologist. The treatment outcome for alcohol addiction treatment for Viet Nam veteran pilots was abysmal at the time. Veterans were simply cycling periodically through the treatment program, only to resume their prior habits soon after.
Peniston had personally experienced biofeedback and Neurofeedback at the Menninger Clinic where an early research group in EEG biofeedback was continuing its work. The group was aware of the benefits of EEG biofeedback for alcoholism, but that was not their research interest.
Peniston took the Menninger method back with him to Fort Lyons where he undertook a controlled study. The results were striking. Every veteran who did the Neurofeedback (ten out of ten) no longer abused alcohol after the training, whereas everyone in the control group, which received the regular in-patient treatment, continued the pattern of addiction after release. There was no reason for them to do otherwise. The contrast could not have been more dramatic. If anything the results were too good to be believed, so critics simply didn't believe them! Nobody wants to be taken for a fool.
There were a number of small-scale replications subsequently which supported Peniston's findings. But all involved small numbers of clients, and they did not provide for controls. Years later, our own research group participated in a replication of this work, and it included a variety of drugs of choice simply because at that time it was difficult to recruit a lot of alcoholics. Other drugs were more popular. The result was fortuitous: outcome was in no way dependent on the drug of preference, whether we were talking about heroin or crack cocaine or methamphetamine or alcohol.
This means that we may be witnessing here an underlying commonality in the problem of addiction that is independent of the drug of choice. It may also indicate that the remedy for drug addiction and alcoholism is not to be found in biology alone, but must involve the psyche as well. What may be needed here is not a cure in the usual sense, but a more comprehensive healing, and Neurofeedback may be making that possible.
The dramatic results obtained by Peniston and others, and replicated in our large-scale controlled study, invite the question about what may account for the high level of effectiveness while almost everything else fails so abysmally. The first thing to be said is that Neurofeedback doesn't just target the addiction narrowly. The objective is improved self-regulation in general, and with that we help with the conditions that sustain the addiction: anxiety and depression; cognitive deficits; poor emotional regulation; even attentional deficits. The training may even resolve the physiological dependency, so that craving for the drug subsides.
It must be said, however, that remediation of the addiction is not built entirely upon the relief from craving, because indeed many who abandon their addiction with Neurofeedback do so while the craving persists. Something else must be at work. There is a second stage to the Neurofeedback work in which the person is encouraged to move toward a more interior focus, a state of disengagement from the "real" world-both outer and inner-for the duration of the session. This is an opportunity for an encounter with the essential self, where the defenses are stripped away. This can be called "soul work." This is where the real healing takes place that allows the person to live more authentically, and to escape the hall of mirrors that is dependency. Addiction is simply no longer a part of such a rediscovered life.
Successful recovery, then, is actually a rediscovery of one's essential being. This must, of necessity, be a very private affair for which no therapist can have a road map. The therapist can guide, facilitate, and support the process, but ultimately this is a very personal journey. Given the fact that those caught in drug dependency will typically take this opportunity to abandon addiction when it is offered, we should perhaps alter our view that addiction merely represents a personal and moral failing. It may be a largely biological response to psychic trauma. Resolving the trauma allows the person to resume a drug-free life.
In our study, the inclusion of Neurofeedback in residential treatment tripled the favorable outcome in terms of relapse prevention over the best conventional treatment when looked at one year post-treatment. At three years, the ratio was even better.
It is estimated that for every dollar spent in addictions treatment, the society saves $7. This appears to be the case even with the simply abominable outcome statistics in conventional treatment. Multiply this by a factor of three and we see that the society is better off by $21 for every dollar spent in treatment when that treatment includes Neurofeedback. And the formerly addicted person is clearly better off as well. The implementation of Neurofeedback-augmented treatment programs should be a priority for our society.
A Hopeful Perspective on Addictions Treatment
Most of what is written about addictions comes from those who treat the condition. The result is commonly a very pessimistic picture. One of the more lamentable realities is that people are reluctant to seek the help that they need for this condition. And that state of affairs can exist for many years. The belief has been that people cannot bail out of addiction by themselves; on the other hand, they are unlikely to seek help until things are desperate. Treatment does not work, it is said, until the person is committed to change, and that is unlikely to occur until other alternatives are blocked.
Now all of this can be framed very differently. It is coming to be realized that the decision to seek help is a very powerful step in the recovery process already, perhaps even the most important single step. And of course that fateful step will likely be taken well before a therapist is in the loop. It is the first stage in a process of self-recovery. Perhaps the significance of this has been missed precisely because the therapist can in no wise take credit, and there is no way for the therapist to influence the process.
Perhaps the whole recovery process should be looked at as one of "self-recovery," one in which the therapist plays only a minor, albeit essential, role. By the time the person acknowledges the state of brokenness that leads to seeking help, the resources of self-recovery are indeed diminished, but they are still powerfully present. What if the entire focus were to shift from the drama of brokenness that the therapist finds so appealing to one of mastery? We'll pursue that thought in the following.
If indeed it takes ten years on average before someone seeks the help they need for an addictions issue, and if only a quarter of those affected show up at all, and if at best only a quarter of those in treatment are truly successful in shedding their addiction, then we can't really talk about having an effective treatment program. Among alcohol abusers whose lives are coming unglued, less than ten percent seek help, and no more than two percent are successful in any treatment program. The message is clear: What exists is irrelevant, as a practical matter, to nearly all candidates for drug and alcohol treatment in our society.
But we can look at the average eight to ten years before treatment is sought as a slow slide into progressive addiction. The brain learns addiction along the way. Can we bring influences to bear that help the brain unlearn addiction along the way, to counter the development of dependency? Indeed we can, and we call this the mastery model. Those who feel that they do not have a comfortable grip on their alcohol consumption can simply train their brains to compensate. They will likely still derive the usual pleasure from a drink, but one drink will not necessarily lead to another. With brain training, we are not sabotaged by our own brains. It is also possible, however, that they will give up alcohol altogether, and simply no longer feel drawn to it.
It is actually quite silly to think that we, using our brains, can rise above the physiological drive for the drug on which the brain has become dependent. If the brain wants the drug badly enough, it will have its way. We have depended on will power when we had nothing else. But now we do. We can train the brain to shed its own addictions. This allows us to adopt the model that addiction is fundamentally brain-based, and that we need a brain-based remedy. We have of course tried all kinds of drug-based remedies along the way, and the results have not been encouraging. But as we are beginning to understand how the brain actually functions, new recovery possibilities open up.
It is important to realize that brain training does not just "fill in the potholes" in brain function. It doesn't just relieve the craving and the physiological dependency. It supports better brain function in some generality. And that means the person can have access to positive states of well-being for which drugs may have been sought at the outset. As addiction treatment specialists know, addiction is not merely a problem of the brain, it is also a kind of "suffering of the soul." But here again, we should not speak of brokenness, but rather of suffering. Through brain training, there is the prospect of positive outcome.
This is possible because brain training works at the body-mind nexus, our neuronal networks. It does not simply address our biology without also affecting our psychological states. Quite simply, successful brain training allows the "soul to sing." This is where you need a poet to describe what happens, not a scientist. But even as scientists we can observe as bystanders that recovery from addictions is nothing less than a process of transformation, one in which the person finds himself or herself. This has nothing to do any more with brokenness, with dopamine deficits, with methadone or naltrexone. This has much more to do with persons unfolding into their full humanity.
This is the path of mastery. At this point we should at least acknowledge the many people who have been successful in achieving mastery over their condition by the mere force of will. Some of them are so proud of their success that they will not take advantage of brain training. "I've gotten here by myself; I don't want you to make it easy for me now!" Mastery over their demons is perhaps the central story of their lives. One must genuinely honor and appreciate their achievement. Either way, however, we are talking about self-recovery. Some people can do this entirely on their own; most could use some help. In brain training, everything happens inside the skin. Nothing is added or taken away. We are simply building upon the brain's natural abilities.
Another significant observation is that the problem of alcohol intolerance in our society is not an isolated one. More than four out of ten males are affected at some point in their lives, and about two out of ten women. Those of Irish descent and native Americans have a particular genetic burden with regard to alcohol tolerance. These relationships testify to the fact that we have biological tendencies to deal with here rather than merely moral failings. In fact, the problem of alcohol dependency is worse for the higher socio-economic groups, and worse for white folks!
So the message is this: We are not dealing with broken people and we are not dealing with isolated cases. We have a huge, society-wide issue with tolerance to alcohol, and with the ready availability of drugs that can beguile our nervous systems into dependency. With the availability of brain-training, the answer then is obvious. At any time when one feels uncomfortable about alcohol or drug overuse, a course of brain training should be undertaken to begin to steer the other way.
This strategy is most effective early in the scheme of things, just when you begin to realize that your brain is making decisions for you that you don't necessarily approve of. It is best undertaken while you are still successful in school or job, while the marriage is still holding together, and while your financial affairs are still healthy. And if the drug or alcohol use is escalating because of a personal crisis, then that is all the more reason to undertake brain training to give yourself the best shot at mastering your challenges.
Finally, the above is applicable to any drug, legal or illegal, medical or recreational, that has a dependency risk. Thus, it is relevant to nicotine addiction as well as to dependency on sleep medications, anti-anxiety drugs, and prescription pain medications. For obvious reasons, we have put alcohol at the center of our considerations.
Dystonia is a term covering a variety of repetitive or spastic movement disorders. Neurofeedback can be helpful in ameliorating symptoms. This is usually accomplished with a sequence of training sessions, most of which can even be conducted at home after the best training routine is devised by the clinician. Over time, an occasional booster session may be required to maintain gains.
Dyslexia can be given a broad definition or a narrow one. The reality is that our brains may fall short in reading skills for a variety of reasons. The difficulty can be a very selective one in people who are otherwise quite competent mentally, or it can be part of a bigger picture. There may be problems in the visual integration of the parts with the whole, and there may be problems in integrating visual with auditory processing. There may even be problems relating to color vision that impact us even when we are looking at black and white text.
Since the dyslexia in a particular case may be traceable to a very specific problem, it may also demand a very specific remedy. (This is in contrast to most of what is being covered in this compilation, for which fairly general Neurofeedback techniques largely suffice.) And the first order of business is to determine whether Neurofeedback is needed at all.
It has been found that a little more than twenty percent of Caucasians deviate from the mainstream population in how they process color. The ratio of blue, red, and green cones differs from the normal. This makes for difficulties in the construction of the color spectrum. It also makes for difficulties in reading. This has come to be known as Irlen Syndrome, and much of dyslexia can be explained in terms of Irlen Syndrome alone. If it is present then the first order of business is to correct for it before anything else is done for the dyslexia.
It is possible that the presence of Irlen Syndrome has made the whole nervous system more sensitive and perhaps more disregulated. So even if Irlen Syndrome has been remediated (see www.Irlen.com), Neurofeedback may still be helpful. If the dyslexia did not involve Irlen Syndrome or else did not dissipate with the resolution of Irlen Syndrome, then Neurofeedback should be tried. A variety of specific protocols can be tried in turn to see if any of them affect the condition. Alternatively, a challenge test may be given in which the child's EEG is measured under a reading challenge. That can often point to new targets for training.
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