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- Peak Performance Training
There are many people for whom good brain function is critical, but the objective has largely been achieved through conventional means. The concert pianist trains brain function through the tireless practice of his craft. Tiger Woods continues to hone his skills with great diligence. But what does the diplomat do who has to function in critical negotiations after changing six time zones? What does the surgeon do when he is roused out of deep sleep for emergency surgery at three in the morning? What does the aging commercial pilot do when he confronts his re-qualification test in the simulator?
We are at a threshold now where the training discipline of a sports competitor or the rehearsal discipline of a performance artist has become relevant to anyone who is dependent on good mental function. Actually, the burden is not nearly so great as in sports or the arts. After an initial series of Neurofeedback sessions, people can usually maintain with only rare booster sessions, possibly as few as one per year.
If one's challenges arrive on a schedule, one can prepare with remote training. A professional golfer can plan to do a session prior to a tournament. A singer can compose herself prior to a performance with a calming Neurofeedback session. The traveling diplomat can help to reset the circadian clock with a strategy that includes Neurofeedback. The pilot booked on long-distance flights can ease the strain of time zone shifts with Neurofeedback. The graduate student petrified before his oral exams can prepare with a few sessions of training.
- Panic Disorder (Panic Anxiety)
Panic events are not just a more extreme form of anxiety. They represent a distinct state, a kind of paroxysm of the autonomic nervous system. It is highly alarming to experience, although the risk of death is exceedingly small. In our Neurofeedback perspective, we tend to lump panic disorder with seizures. Our objective must be simply to stabilize the brain so that it does not trip over into a panic attack. It turns out that this is usually not difficult to do. The remedy almost seems trivial in comparison with the immensity of the experience of panic.
Training the brain toward stability is what Neurofeedback / EEG Biofeedback does well. On the other hand, medications do not handle this well, by and large. Medications of necessity target one or another aspect of our regulatory function, whereas it is the overall function that needs to be addressed.
"Parkinson's is a real disease. How can Neurofeedback help?" This is not an unreasonable question, and the answer to this question reveals a lot about what Neurofeedback is actually about. The organization of movement involves the orchestration of many parts of our neuronal network. Each of these parts is in turn subject to regulation by other parts of the network. In Parkinson's we are dealing with a highly localized neuronal loss in one branch of the network. Remediation for us lies in training the brain generally so that other regulatory pathways are strengthened in compensation.
The brain actually does a lot of this on its own. It is known, for example, that by the time symptoms arise in Parkinson's the person has probably already lost the use of some 75% of the neurons in the substantia nigra. So a mere 25% was sufficient to yield smooth and controlled willed movements. When even further neuronal loss occurs, is all hope lost? Apparently not. Of course one now also has available techniques such as Deep Brain Stimulation to override the misbehaving neuronal activity. But we can also work more naturalistically by coaxing the neuronal networks into better regulation despite the localized deficit. Neurofeedback could be tried before Deep Brain Stimulation is considered. One might, for example, be able to postpone brain surgery for a number of years, and just that delay should constitute a significant saving.
- Pediatric Bipolar Disorder
Pediatric and Early Adolescent Bipolar Disorder (PEA-BD) is just in the process of coming into focus. The diagnosis of childhood bipolar disorder used to be so extremely rare that it was not even listed in the Diagnostic Statistical Manual of psychiatry. Its increasing prevalence parallels that of autism, asthma, the ADHD spectrum, and childhood depression to indicate that mental health indices are declining for a significant fraction of our youngsters.
The prominent clinical features of pediatric bipolar are rapid mood swings, labile mood, high irritability, rage behavior that is difficult to abort, episodic euphoria, and grandiosity. The presentation may be very different from the classic manic-depressive pattern of adulthood.
All these refined clinical distinctions don't matter so much when it comes to Neurofeedback / EEG Biofeedback. The clinical features point to a pervasive pattern of disregulation in which the brain is unable to maintain state. From our perspective the remedy is straight-forward. It is to train the brain toward greater stability. So the various symptoms may not even require targeted approaches. It may be largely sufficient to target the underlying instability. Whatever remains in terms of symptoms can then be more specifically targeted.
The concern about diagnostic distinctions is indeed important in the psychiatric realm because pediatric bipolar disorder is often swept up in the more common ADHD diagnosis. The problem is that the typical medical remedies for ADHD may be entirely inappropriate for childhood bipolar disorder and may even make things worse. None of this presents a comparable challenge to Neurofeedback. If the child presents with symptoms of nervous system instability of any kind, then the appropriate training approach is adopted.
We have in fact been very pleased with our results with childhood bipolar disorder. Many of these children present a considerable challenge to their families. Parents may even be fearful of what they children may do, or how they will grow up. With Neurofeedback / EEG Biofeedback, the trajectory of these children can typically be turned around quickly. Longer-term training is often needed, but once the child is better regulated the parents can continue the training at home under clinical supervision.
Even perfectionism can be driven to extremes that are troublesome. This can be seen as part of an obsessive behavior pattern or it can come out of an anxiety/depression state. Brain training can be used to back the person off to a more controlled and less driven state of being.
A famous opera singer once said, "I sing for free. I get paid for my fear." Now a certain amount of performance anxiety is probably a good thing that helps performers function at the top of their abilities. But anything beyond that optimum level of activation gets to be costly to the person and detrimental to the performance. Neurofeedback / EEG Biofeedback training can actually put the person in control where such control might otherwise be lost. And the awareness of biofeedback methods allows a person to control his own state in the moment merely by focusing on one's interior state in general, and on the breath in particular. Merely bringing awareness to how we are relating to the world, to how we are paying attention to it in that instant, can effect a normalization of arousal level. The implications of this are huge, and the methods are straight-forward, so it is surprising that this is not a part of every performer's formal education already.
- Pervasive Developmental Delay
We have seen substantial improvements in function in children labeled with the diagnosis of pervasive developmental delay. There may well be organic causation here, as in the autism spectrum, but functional recovery may well be in prospect nevertheless. The level of deficit turns out not to be a good predictor of what is possible with strategies of remediation such as Neurofeedback. Benefits are anticipated across the whole range of regulation governed by the central nervous system, including level of cognitive functioning, emotional regulation, sleep regulation, autonomic nervous system regulation, sensory excitability, and motor function. (See also Mental Retardation; Autism)
It may be best to illustrate what is possible with an actual case history. The following report was issued by the therapist as the training was still ongoing: This was a case of a four-year-old whose mother had been given a vaccination while she was pregnant. The girl had been tested with an IQ score in low 40s. The status before training: She is in a wheel chair; she is nonverbal, with no notable mobility; she does not cross midline with objects; she does not actively participate in any of her therapies of OT, PT, and speech; she does not show emotions or preferences; she often sleeps twelve hours at night and takes naps during the day; finally, she has infrequent but debilitating seizures.
After 58 sessions she is a "new girl," actively participating in all therapies; mimicking sounds; holding her own bottle initially, and now having graduated to a cup with a lid. She moves herself from place to place in her wheelchair. She has definite opinions, and has had no seizures since starting Neurofeedback. The mother proclaims that the child is now part of the family.
Phobias must be very deeply rooted in our biology. We may have phobias about spiders and snakes, but we tend not to have them about electricity and guns, which are the greater risks in our modern lives. Phobias can get established through traumatizing events in our individual histories, and perhaps most are traceable to such events. The phenomenon is tied to our basic fear response, which is so deeply rooted that it can defy rationality. A perfectly rational scientist can still be plagued by a fear of heights that turns knees to butter. Neurofeedback can be helpful here in restoring a more stable nervous system, even to the point of banishing phobias. If the Neurofeedback / EEG Biofeedback is not sufficient on its own, it can be combined with specific desensitization strategies, possibly with the aid of virtual reality systems.
First of all, an item of disclosure: the writer of this article is of the male persuasion. That's actually ok, because the topic is really going to be about the brain. Ironically, the old docs who decades ago just dismissed PMS as being "all in your head" were correct in a manner of speaking after all. PMS turns out to be entirely a matter of brain function-as opposed to being a matter of hormonal regulation, for example, or an issue around our biological plumbing. The good news is that it is also almost entirely remediable. No woman needs to suffer through disabling PMS symptoms. We have never met anyone who could not be significantly helped.
Here's the story. A full listing of PMS symptoms includes a huge variety of symptoms that woman is heir to. The condition is very heterogeneous. In fact, the only thing that is at all predictable about it is the 'periodicity' of the occurrence of symptoms. It does not appear to be any one condition at all, but many. If one accepts that basic reality as a point of departure, then the following emerges. When our central nervous system is not well-regulated, then under the additive stress of enormous and rapid hormonal shifts the body may become symptomatic in a variety of ways that touch upon a number of basic regulatory systems.
First of all, there can be an adverse impact on the regulation of arousal: alertness, vigilance, sleep-wake cycle, energy level, etc. Secondly, there can be impacts on mood regulation, and on the anxiety-depression continuum. Thirdly, there can be impacts on attentional function and cognitive function. Fourth, there can be negative impacts on the body's regulation of its internal functions through the autonomic nervous system. This is where changes in pain sensation come in, along with any tendency toward hot flashes in menopause.
Finally, there can be a negative impact on overall stability of brain function. So if the person has any kind of propensity toward seizures, migraines, panic, rage, or anger, then these vulnerabilities are just more likely to find expression when the hormonal shifts are most extreme.
Now for the remedy: The remediation of PMS symptoms is almost entirely a matter of training the brain toward greater stability and better function. This does nothing more than raise the threshold for symptom expression, but that is enough. Of course the nervous system has to be in a position to support the change with adequate nutrition and decent life habits, but by and large nearly all affected women may anticipate profound relief from their PMS and even menopausal symptoms with a series of brain-training or Neurofeedback sessions.
Typically results are achieved within the scope of a month if training is conducted at a pace of at least three sessions per week. Completion of training for ordinary cases may be anticipated within twenty or so sessions. Realistically, PMS is almost never an issue by itself, so we see it in the context of other symptoms that bring people through our door. And we usually ask people to expect that a generalized strategy toward self-regulation may take from twenty to forty sessions. Within such a training sequence, PMS symptoms may well be among the early ones to respond.
When PMS is the specific issue for which clients are seeking out Neurofeedback, then that is likely to be at the more severe end of the clinical spectrum. In these cases, it is not just a matter of minor disregulations of brain function, but rather of more profound trauma history, involving either physical brain trauma or more likely psychological trauma, or more particularly gender-related trauma. Such a problematic history will not yield to a simple 20-session run of Neurofeedback sessions.
Neurofeedback will still be the remedy of choice, and a sequence of twenty sessions could already be very helpful, but the whole program will necessarily be more extended, and the Neurofeedback would be embedded in a more comprehensive program of care. Now this is also exceedingly good news, because those whose lives have become significantly diminished by pervasive PMS symptoms probably have no idea at all what degree of potential liberation is available to them. The grim and constricted life becomes a self-perpetuating expectation, and even the prospect of relief is greeted with great skepticism or derision. Or one fears being majorly disappointed.
In such cases, we don't want to have the "best" become the enemy of the "good." If the prospect of major change evokes incredulity, perhaps it is sufficient to just think of taking the first step toward improved self-regulation without even getting one's hopes up. Matters are taken up one step at a time. Can sleep be improved? That should happen quite early in training. Can anger episodes be obliterated? That should happen quite early on as well. In time one's horizon of expectations is raised, one success at a time.
One clinician doing this kind of work asked her clients at the outset of Neurofeedback about their expectations for an outcome. She would ask them: "What level of symptom relief would cause you to regard your Neurofeedback training as a success?" After a year or two she looked over her records, and she found that the clients' expectations had been matched or exceeded in 98% of the cases. And all of that happened with nothing but the competence embodied in their own nervous systems. Nothing was actually "done" to them. The only thing that had occurred was the learning of improved state regulation. And nowhere has our clinical success over the years been greater than in the case of PMS and migraines.
Siegfried Othmer, Ph.D.
August 2006
Polydipsia is seen in association with Tourette Syndrome, and from our Neurofeedback perspective responds to the same training that we do for TS.
The mental confusion, cognitive dysfunction, sensory disturbances, pain, emotional upheaval, and sleep disruption that characterize post-concussion syndrome can be significantly helped during the recovery phase by Neurofeedback / EEG Biofeedback. Much of the "injury" here lies in the functional domain. That is to say, we are most likely not dealing here with neuronal loss, but rather with functional disorganization. This is evident from the observation of the natural recovery process. When spontaneous recovery occurs, it often does so on a fairly rapid timescale. That precludes substantial organic injury as an explanation of the deficits.
If the deficits lie in the functional domain, then it might be possible to accelerate the normal processes of recovery. That is what we find to be true with Neurofeedback. The same arguments apply to whiplash injury (q.v.).
- Post Traumatic Stress Disorder (PTSD)
Neurofeedback / EEG Biofeedback can be very helpful for Post Traumatic Stress Disorder (PTSD). This has been known now for over fifteen years, but the word has not yet spread widely. In fact, the label PTSD is not much older than that. It was first so identified in a Viet Nam War veteran. And it was in Viet Nam War veterans that the remedy was proven out.
It is difficult to cover a complex topic such as this in brief. Why should Neurofeedback be helpful for this condition? To understand recovery we have to understand the condition being targeted, on the one hand, and to have an objective for recovery, on the other. What is the essential deficit here, and what does it mean to heal?
SPECT Scans of Individual with PTSD |
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The narrative goes as follows: A life-threatening traumatizing event, or a sequence of such events, evokes our core emergency response system. One aspect of that response system is for our memory to be heightened for the event. The traumatic event is recorded like blotter paper. But what is remembered is of course our experience of the event, and that experience also includes our response to the crisis. So the body-mind remembers a unitary experience that merges the external sensory inputs with the internal responses. In subsequent recall of the event, it is this unitary experience that re-emerges.
The job of therapy is to allow the person the possibility of recall without the re-experience. Calming the physiology and taming the fear response is the first order of business. In Neurofeedback this is accomplished in a two-stage process. The one just focuses on training down the raw fear response and on training toward physiological stability. The second takes the person to a benign place in his own mind where traumas can be re-accessed without triggering the physiological response. The original memory is literally being reprogrammed in a process reminiscent of physical therapy.
The result is that the traumatic memory assumes its rightful place as a biographical, historical memory like all the others. The memory will have been defanged, so to speak. It no longer has the person in its grip.
This is the full and complete remedy for PTSD. We are not looking for amnesia for the original event. The person can function normally (in this respect) from that time forward. Successful training also deals with the nocturnal flashbacks that are inappropriately labeled nightmares.
Neurofeedback & PTSD - Watch Video
Related Newsletter Articles:
Anxiety and PTSD Research
Psoriasis is one of a number of medical conditions where a strong immune system involvement has been demonstrated. Such a biological chain of causation can still leave room for the observation that Neurofeedback may be helpful in the management of the condition. Neurofeedback can help to moderate the activity of the immune system and thus lead to a reduction in symptom severity.
We are aware of only one case of ptosis in which Neurofeedback was tried. Botox was already being used. Yet the person responded to Neurofeedback in a mere fifteen minutes. So perhaps ptosis should be considered as one of the many movement disorders for which Neurofeedback should be considered.
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