In World War I a German psychiatrist named Hans Berger was almost killed by a runaway piece of machinery during a military operation. Hundreds of miles away at that moment, Berger’s sister knew for sure that her brother’s life was in danger. How could this be possible? Berger decided to probe the mystery. This research would one day provide new hope for trauma survivors.
Using a primitive string galvanometer (an instrument to detect and measure electric currents) attached to the scalp, he began measuring the oscillatory brain waves (repetitive neural activity in the central nervous system) that could be identified through the scalp and skull. He named the waves alpha (the conscious and relaxed brain’s normal electrical activity), beta (faster frequency related to mental effort and thinking, including anxiety), delta (the slowest frequency found in sleep, as well as injury or deep depression), and theta (the gateway connecting the conscious and subconscious minds).
Berger’s curiosity launched a new therapeutic field. Neurofeedback (NFB), a type of biofeedback, provides real-time expression of electroencephalography (EEG)—the tracking and recording of brain waves—to display brain activity and teach self-regulation. Knowing that your beta waves are overactive, for example, you can use NFB to train them down while training up your alpha waves.
“The results were clear: The EEG and fMRI network activities (plus subjects’ self-reported changes in calmness) qualified NFB’s ability to modify aspects of the brain involved in emotional processing. This proves that crucial brain networks involved in moderating emotion and cognition in PTSD can be recalibrated through NFB.” Up until about 1990, the primary use of the EEG was to detect seizures and their likelihood, traumatic brain injury (TBI), and clinical death. There was no system that could match certain brain waves to clinical syndromes like anxiety or depression. That changed with the rapid evolution of computers and new technology for mapping brain waves on large numbers of people to determine what patterns are normal. As computer processors advanced in capability, researchers refined their work. Not only could they detect epilepsy, for example, but they could also localize and determine the severity of a TBI and even pinpoint exactly what kind of ADD or ADHD a child had via quantitative electroencephalography (qEEG), which correlates EEG data with associated behavior.
How does neurofeedback work?
In 2009 I attended the annual Trauma Conference in Boston, hosted by Bessel van der Kolk, the father of modern theory about treatment for post-traumatic stress disorder (PTSD). The major focus of the conference was the idea of using NFB to help reduce PTSD symptoms. I spoke with several of the neuroscientists, asking each of them the same question: “Can NFB heal PTSD?” They explained that NFB helps retrain the brain by creating long-term change at the synapses, which can reduce and even eliminate certain symptoms. Usually NFB is used in conjunction with other clinical therapeutic approaches. Stephen Larsen, Ph.D., author of The Neurofeedback Solution: How to Treat Autism, ADHD, Anxiety, Brain Injury, Stroke, PTSD and More (Healing Arts Press), explains: “Neurofeedback is in a unique position, right between physiology and psychology…. It can accomplish the same kind of up-regulation and down-regulation of the CNS [central nervous system] that pharmacology prides itself on being the only agent of—and it does this without flooding the entire CNS with chemical agents.”
After the conference I was curious to see NFB in action, so I went to the Center for Brain Training in Jupiter, Florida. In a demonstration, the subject had several wires attached to his scalp and was seated in front of a computer monitor that displayed a game of Pac Man. The goal was for the subject to use his brain to manipulate the icon around the screen.
Of course, this was no ordinary video game. Based on real-time EEG feedback, the computer program altered itself to force the subject to use his brain in ways that increased or decreased specific types of brain waves. At the heart of NFB procedures is the goal of training the brain to be intentional in how it controls its activity; this is how it learns to self-regulate. Using video or sound for positive or negative feedback based on brain activity, NFB allows subjects to actively engage in their brain function rather than be at its mercy.
Using neurofeedback to treat PTSD
In the five years since I attended the Trauma Conference, use of NFB for PTSD has evolved in step with the continued development of the field of neuroplasticity, which illuminates the potential for brain change in neural networks. A significant aspect of this focuses on harnessing the power of attention. For many PTSD survivors, connectivity in the salience (active attention focused outside the self) and default (the brain at wakeful rest unfocused on the outside world) systems can be altered. The anterior cingulate, for example—the part of the brain that enables you to switch your attention from one object to another—can lose functionality, leaving the brain unable to switch attention at will. This can cause survivors to experience many negative effects, including obsessive-compulsive thinking or hyperarousal, the act of noticing threat even when none exists.
Recent NFB research results, released in 2013 from a study at the University of Western Ontario, conclusively indicate that neurofeedback offers ways to train the brain that support its ability to choose where it places its focus of attention. The research, achieved by studying 21 survivors with PTSD related to childhood abuse, used functional magnetic resonance imaging (fMRI) in conjunction with EEG to assess whether neurofeedback could help adjust emotional processing in PTSD. Patients’ resting-state brain activity was captured just prior to and again after a 30-minute NFB session. The results were clear: The EEG and fMRI network activities (plus subjects’ self-reported changes in calmness) qualified NFB’s ability to modify aspects of the brain involved in emotional processing.
This proves that crucial brain networks involved in moderating emotion and cognition in PTSD can be recalibrated through NFB.
Scientifically, of course, this news is a big win in the fields of PTSD treatment and NFB, as the results suggest even more concretely that not only can the brain change but we can choose how it changes and then bring about those changes ourselves through specific repetitive actions. But I’m not a science geek. When I hear this kind of news, I don’t think of synapses or neurons, the possibilities of imaging apparatus, or the exultation of scientists who worked hard to develop a successful experiment. I think of the 21 subjects who went from feeling out of control in their own minds and bodies to recognizing there is a way for them to reclaim the bits and pieces of themselves that trauma stole away. I think of the suffering of every PTSD survivor worldwide and how many are overmedicated or die from accidental overdoses.
The research results are exciting, as they point to a noninvasive, nonchemical, nontraumatic way of bringing peace and healing to those who are deeply suffering. One day we might heal millions of people, and I want to high-five the researchers and all the NFB practitioners who help survivors transform dysfunctional neural networks into new and more highly functional minds.