Treating Trauma with Neurofeedback:

Another Tool For Your Toolbox

Theresa Hubbard, MS, LMFTMOAMFT Annual Conference

April 25, 2015

Not a Ph.D. And I do not consider myself an expert in anything. Just a very curious person. I love to learn and experience new things, both personally and professionally. I am married to Charlie, a CPA who is currently completing his PhD in Cultural Anthropology, and 4 children, ranging from 7 to 20 years.

In private practice in Liberty, Missouri and Shawnee, Kansas. President of the GKC Chapter of MOAMFT. Owner of The Journey Home, a retreat center north of Kansas City.

Work with a variety of clients. Focus is on all levels and types of trauma.

Utilizing EMDR for 10 years, and Hypnotherapy for 5 years. Each of these have shown incredible results.

For some clients I have noticed that they don’t “quite” achieve the level of peace that they desire. These clients had childhoods where they experienced varying levels of trauma and neglect.

Neurofeedback kept coming into my awareness over the last several years. And as I learned more about Stephen Porges, Ph.D’s work on the Polyvagal Theory I became aware of Bessel van der Kolk (The Body Keeps The Score), MD and Sebern Fisher, MA (Neurofeedback in the Treatment of Developmental Trauma).

I began reaching out to various providers who provide neurofeedback in the Kansas City area to learn more about their practice, who they treat, their equipment and training.

Neurofeedback Versus Biofeedback

•Biofeedback – Umbrella Term•Neurofeedback – A Type of Biofeedback

Definition of Biofeedback

• A technique you can use to learn to control your body's functions, such as your heart rate. With biofeedback, you're connected to electrical sensors that help you receive information (feedback) about your body (bio). This feedback helps you focus on making subtle changes in your body, such as relaxing certain muscles, to achieve the results you want, such as reducing pain. • In essence, biofeedback gives you the power to use your thoughts to

control your body, often to help with a health condition or physical performance. Biofeedback is often used as a relaxation technique.

Uses for Biofeedback

Is used to help manage many physical and mental health issues, including: • Anxiety or stress • Asthma • Chemotherapy side effects • Chronic pain • Constipation • High blood pressure • Incontinence • Irritable bowel syndrome • Raynaud's disease

Why It Is Appealing

• It's noninvasive. • It may reduce or eliminate the need for medications. • It may be a treatment alternative for those who can't tolerate

medications. • It may be an option when medications haven't worked well. • It may be an alternative to medications for some conditions during

pregnancy. • It helps people take charge of their health.

Definition of Neurofeedback And How It Works• Neurofeedback is a technology-based learning technique that

provides real-time information about your own EEG activity. Through this type of brain training, a person can alter his or her own brainwave characteristics by challenging the brain to learn to reorganize and by conditioning the brain to function better. The EEG Biofeedback technique is a process in which subtle brainwave information is amplified and shown back to the trainee in the form of a computer game. The object of the training is to re-educate the brain to make voluntary changes via computerized graphic displays and auditory signals that encourage a change in mental state and thus challenge the brain to function more effectively.

Videos• What is Neurofeedback?• https://www.youtube.com/watch?v=t6XeCwFQrCA

• Regaining Control: Neurofeedback and PTSD• https://www.youtube.com/watch?v=M5UE69o99lo

• What is Neurotherapy, How it Works, and Why, explained by Dr. Jolene Ross of Advanced Neurotherapy• https://www.youtube.com/watch?v=BruxEhRW_cg

• Neurofeedback and ADHD: A mom with a VERY out of control boy• https://

www.youtube.com/watch?v=8uRFRkfBlTs&feature=em-share_video_user

Why People Use Neurofeedback-There is clinical evidence and/or clinical reports on the effectiveness of Neurofeedback for the following disorders seen in children and teens, as well as adults.

• Attention Deficit Disorder (ADD)• Attention Deficit Hyperactivity Disorder (A

DHD)• Anxiety• Autism• Chronic Illness• Chronic Pain• Concussion• Depression• Epilepsy

• Headaches/Migraines• Learning Difficulties• Lyme Disease• Parkinson’s Disease (PD)• Peak Mental Performance• Post Concussion Syndrome (PCS)• Post Traumatic Stress Disorder• Sleeping Problems• Stroke /Aneurysm • Traumatic Brain Injury (TBI)

Subcategories of Neurofeedback• Traditional neurofeedback-This is based on operant condition and help retrain the

brainwave to optimal level. Methods include Othmer’s low frequency; Paul Swingle Method; Kurt Thornton Gamma Coherence, Nancy White’s alpha/theta training and Robert Thatcher Zscore training.• Z-score training• LENS (Low Energy Neurofeedback System)-This system developed by Len Ochs is based

on restructuring the stuck patterns in the brain and to promote a balance flexible state.• Low frequency training• Loretta training• pEMF training• pRoshi-This is a light machine used to disrupt inefficient patterns in the brain. The

lights flash at a constantly varying speed, helping the brain to “get out of the rut” of current dysfunctional patterns. Infrared light as a healing modality. The infrared light is used to calm the nervous system, reduce spasm and spasticity, relieve pain and reduce inflammation.

Subcategories of Neurofeedback (con’t)• NeurOptimal-This system allows the body to engage its own restorative systems so as to return to a

balanced, homeostasis state. Specific amplitude and frequency changes can be measured for the purpose of guiding the brain so that it can function more effectively. NeuroField was designed to strengthen the body and promote healthy, balanced states.

• CES (cranial electrotherapy stimulation and self-controlled energy neuro adaptive regulation (Scenar)-This system produces tiny “microcurrents” which are thought to stimulate the areas of the brain responsible for neurotransmitter and hormone production. Thus, this method is another us to bring regulation to the brain.

• HEG (Hemoencephalography)-This measures the blood flow in the brain and gives feedback to encourage blood flow to the targeted regions. This was specifically designed for helping with migraine headaches and depression.

• HRV (Heart Rate Variability): This measures the heart to brain communication to help regulate and bring balance to the autonomic nervous system and limbic system.

• BAUD (Bio-Acoustical Utilization Device): BAUD is device that creates sonic waves that coincide with brain frequencies measured by an electroencephalogram (EEG). By integrating the BAUD as a stimulant with other therapies, such as Neurotherapy or music therapy, the individual can better grasp the significance of regulating their brain waves as well as other psychophysiological dimensions, such as relaxation and indices of mood.

• AVS (Audio/Visual Stimulation): Through light and sound in coordination together, this machine that is used to bring balance and regulation to the brain.

Levels of Brainwaves• Currently there are seven unique frequencies, bandwidths and specific states or

characteristics with each bandwidth.• Delta 1-4Hz: This is seen in sleep, repairing of the brain, intuition, emotional

radar, trauma and unconscious thought.• Theta 4-8 Hz: This is present in sub-conscious thought, insight, meditative and

creative.• Alpha 8-12 Hz: This is the neutral, peaceful, relaxed state that is the gate that

allows flow from restorative sleep to alertness.• Low Beta (SMR) 12-15 Hz: This is seen in mental alertness, physical relaxation.• Beta 15-21 Hz: This is being present, sustained attention, thinking, focusing, and

conscious thought.• High Beta 21-32 Hz: This is hyper-vigilance, hyper-alertness, extreme anxiety,

and PTSD.• Gamma 33-64 Hz: This is integrative thinking, creativity, learning, and the “ah”.

Basic Aspects of Functioning Effected

•Attention•Focus•Organization

Four Lobes of the Cerebral Cortex

Definition of Neuroplasticity• In 2010, a study provided some evidence of neuroplastic

changes occurring after brainwave training. Half an hour of voluntary control of brain rhythms led in this study to a lasting shift in cortical excitability and intracortical function. The authors observed that the cortical response to transcranial magnetic stimulation (TMS) was significantly enhanced after neurofeedback, persisted for at least 20 minutes, and was correlated with an EEG time-course indicative of activity-dependent plasticity.

Criticisms of Neurofeedback

• How do we know that the additional focused attention of the therapist does not account for the improvement• Most practitioners are not adequately trained• It isn’t the equipment that works, it is the mental exercises that the

we are asking them to do• The person is actually just maturing• It’s a placebo• There is actually something else going on that we don’t understand• It is expensive• Opponents will not claim it is harmful, because that would conclude

that it could be helpful as well.

Contact Information and Follow Up

•Please feel free to contact me if you have questions about neurofeedback. I will do my best to answer, and/or point you to additional resources.• theresa@theresahubbard.com

Performance Enhancement Research• Sherlin, L., Larson, N.C., Sherlin, R.M. (2012). Developing a Performance Brain Training Approach for Baseball: A Process Analysis with Descriptive Data.

Journal of Applied Psychophysiology and Biofeedback. (DOI) 10.1007/s10484-012-9205-2.• Larson, N.C., Sherlin, L.H., Talley, C. & Gervais, M. (2012).

Integrative Approach to High Performance Evaluation and Training: Illustrative Data of a Professional Boxer. Journal of Neurotherapy.• Sherlin, L., Arns, M., Lubar, J., Heinrich, H., Kerson, C., Strehl, U., & Sterman, M. B. (2011). Neurofeedback

and basic learning theory: Implications for research and practice. Journal of Neurotherapy, 15(4), 292-304.• Gruzelier, J. H. (2013). EEG-neurofeedback for optimising performance. I: A review of cognitive and affective outcome in healthy participants.

Neuroscience and Biobehavioral Reviews. doi:10.1016/j.neubiorev.2013.09.015.• Arns, M., Kleinnijenhuis, M., Fallahpour, K., & Breteler, R. (2008). Golf performance enhancement and real-life neurofeedback

training using personalized event-locked EEG profiles. Journal of Neurotherapy, 11, 11-18.• Babiloni, C., Del Percio, C., Icaboni, M., Infarinato, F., Lizio, R., Marzano, N., Gallamini, M. & Eusebi, F. (2008).

Golf putt outcomes are predicted by sensorimotor cerebral EEG rhythms. The Journal of Physiology, 586, 131-139.• Gruzelier, J., Egner, T., & Vernon, D. (2006). Validating the efficacy of neurofeedback for optimising performance. Prog Brain Res, 159, 421-31.

doi:10.1016/S0079-6123(06)59027-2.• Vernon, D.J. (2005). Can neurofeedback training enhance performance? An evaluation of the evidence with implications for future research. Applied

Psychophysiology and Biofeedback, 30, 347 - 364.• D.M. Landers, S.J. Petruzzello, W. Salazar, D.J. Crews, K.A. Kubitz, T.L. Gannon, M. Han. (1991). The influence of electrocortical

biofeedback on performance in pre-elite archers. Medicine of Science Sports Exercise, 23, 123–129.• Gruzelier, J. H. (2013). EEG-neurofeedback for optimising performance. II: Creativity, the performing arts and ecological validity. Neuroscience and

Biobehavioral Reviews. doi:10.1016/j.neubiorev.2013.11.004.• Sherlin, L., Gervais, M., Talley, C., & Walshe, A. (2011). Comprehensive sport performance program. Biofeedback, 29(3), 119-122.

Additional Information• http://www.peakachievement.com/articles/Neurofeedback_for_Training_Childrens_Attention.htm

• http://www.eeger.com/Training/Pre-reading-1.pdf

• http://www.eeger.com/Training/Pre-reading-2.pdf

• http://www.eeger.com/Training/Pre-reading-3.pdf

• http://www.drleakelley.com/neurofeedback.htm

• http://drjulialewis.com/services/eeg-analysis/

• http://www.sebernfisher.com/faq/

• http://www.isnr.net/neurofeedback-info/info-articles-books-dvds.cfm

• http://www.brainbalancecenters.com/understanding-the-issues/research/

• http://neurosculptinginstitute.com/tag/neuroplasticity/•

http://m.theaustralian.com.au/news/features/the-healing-mind-how-neurofeedback-is-treating-trauma/story-e6frg8h6-1227000221084?nk=4ae73a1fcd9c9b993fabec43b721c1de