Two studies aim to bring funding and attention to neurofeedback in the treatment of PTSD

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“Almost half the nation’s children have experienced at least one or more types of serious childhood trauma, according to a new survey on adverse childhood experiences by the National Survey of Children’s Health (NSCH). This translates into an estimated 34,825,978 children nationwide, say the researchers who analyzed the survey data. Jane Ellen Stevens, ACEsTooHigh.com

Research from the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study) shows that people who suffer early childhood neglect and abuse get sick more often throughout their lives and with more serious illnesses than the average population. They also become addicted at much higher rates and are far more likely to attempt and commit suicide. As a result of all of these factors, as a cohort, people who have experienced an overwhelming amount of abuse and neglect as children will die 20 years ahead of their peers.

According to the CDC, “Childhood experiences, both positive and negative, have a tremendous impact on future violence, victimization and perpetration, and lifelong health and opportunity. As such, early experiences are an important public health issue.” The CDC and Kaiser Permanente launched the first study on this topic from 1995 to 1997, as part of an effort to better understand how childhood abuse and neglect affect later-life health and well-being.

There are numerous treatments available to those who have suffered trauma. However, PTSD, and particularly developmental trauma often leads to chronic, treatment-resistant psychological and physical conditions that ruin lives and strain communities.

Abuse and neglect in childhood lead to disorganized brains that are typically overrun by the limbic eruptions of fear, shame and rage. Medications and talk therapy have not yielded much help. In fact across the board, mental health statistics are worse in the last 30 years — after the introduction of psychotropic medications, according to Tom Insel, director of the National Institute of Mental Health.

Neurofeedback offers a new approach to regulating the brain and, in turn, to quieting the minds of those so injured in early childhood.

To understand what a neurofeedback session looks like, take a moment to watch this video. The black and white portion of the video is footage shot when the boy was eight years old for a documentary on untreatable children. The color part of the video is shot when he is 11 and has had 80 neurofeedback sessions. Before he started neurofeedback, this youngster was going to be locked up in juvenile detention after multiple police calls to his home and arrests for assault. We don’t know what led to this boy’s profound disregulation and aggression, but we do see what happens when he trains his brain.

A study led by Dr. Bessel van der Kolk and published in PLOS in December 2016 — A Randomized Control Study of Neurofeedback for Chronic PTSD — is the first randomized clinical trial on neurofeedback with a specific focus on chronic, treatment-resistant PTSD. van der Kolk is a world-renowned trauma researcher who has devoted his career to a search for effective treatment for this population. He has researched Prozac, EMDR, and yoga and discusses all of these, as well as neurofeedback, in his New York Times science best-seller, The Body Keeps the Score. In the randomized clinical trial of neurofeedback that he led in 2016, he demonstrates a 40% increase in executive function after 24 sessions of neurofeedback, which translates to increased capacity to modulate emotions, better cognitive function, and better judgment. All of these results have profound implications for the treatment-resistant trauma population and, given its size and the interwoven role that trauma plays in public policy, for society at large.

The team at van der Kolk’s Trauma Center in Brookline, MA focused on those who were suffering chronic PTSD, excluding those with histories of brain injury and substance abuse, to explore the impact of the treatment and the cost of implementing it.

The study notes: “The equipment […] cost less than $10,000. If further research confirms the results from our study, neurofeedback has the potential of becoming widely available in community settings since it can be economically administered by well-trained technicians in small offices and clinics.”

In her book, Neurofeedback in the Treatment of Developmental Trauma, psychotherapist and neurofeedback practitioner Sebern Fisher supports this claim, concluding that neurofeedback is an ideal therapeutic modality for therapists to use in their private practices as well as in schools, prisons, halfway houses, and shelters. Mental health practitioners can learn how to implement neurofeedback, typically in a four day intensive, which they follow-up with mentoring. The regulatory benefits to the brain allow the patient to begin the heavy lifting of other therapeutic modalities, or as is the case for many children, not to require them at all.

van der Kolk’s study fills a vital research niche. These are “the untreatable patients”, meaning those who receive only limited benefit from the treatments more widely available today. They fill our shelters, our hospitals and our prisons. Neurofeedback practitioners and patients who have experienced its benefits have been clamoring for a randomized clinical trial (the holy grail for proof of effectiveness for a treatment modality) that would stand up to the detractors of neurofeedback and to the dominant paradigm of psychopharmacology.

In a section titled “Future Directions”, the van der Kolk study points out that:

“Clarifying to what degree NF induced psychological changes are correlated with specific changes in neural activity will be a complex scientific challenge akin to correlating the clinical effects of various psychiatric medications with specific neurochemical changes in the brain.”

The study again places its seminal findings within the larger narrative of mental health research:

“In an emerging new framework mental disorders are considered to be driven, at least in part, by abnormalities in underlying neural circuits [55]. A concerted effort is currently underway to map these networks, the so-called ‘human connectome project’ [56,57].”

There was a second groundbreaking neurofeedback study published in 2016. This one was led by Dr. Ruth Lanius. In it she shows that the brains of people who have endured these histories profile differently than the brains of people who have not. Their amygdalas (the fear center of the brain) are hyper-connected to threat detection centers in the lower regions of the brain. These patients who present with dissociation are wired for threat and therefore they see threat where a healthy person would not. In the Lanius study, one session of neurofeedback showed changes in connectivity in 80% of subjects. Their amygdalas now showed beginning connectivity to the pre-frontal cortex. The prefrontal cortex is “command central” in healthy people.

Both the van der Kolk and Lanius studies are landmarks in the field of trauma. Put simply: the van der Kolk study shows that neurofeedback works for trauma patients where other treatments have failed, and the Lanius study shows how neurofeedback makes changes in the traumatized brain. These studies may well change the way we understand the impacts of early childhood trauma and how to treat them.

For a deeper understanding of how neurofeedback and psychotherapy are integrated to treat abuse and neglect, take a look at Sebern Fisher’s book, Neurofeedback in the Treatment of Developmental Trauma and visit http://www.sebernfisher.com/seberns-bookshelf/ to see vetted books written by other leading experts in this specific subset of the trauma research field.

Fig0401 Neuro FdBk

“After four months of neurofeedback, 10-year-old boy’s drawings of his family reflect increasing neurological development, developing sense of self.” –Sebern Fisher, from Neurofeedback in the Treatment of Developmental Trauma

3 responses

  1. I am a CASA. I recently secured Neurofeedback treatment from an experienced PhD for my CASA youth. It has been incredibly helpful to her. It has been rapid. She is a compliant, try-hard kid who was still suicidal and dark after three or four years of CBT. NF changed the whole situation in 8 sessions. A whole new lease on life.

    Liked by 1 person

  2. Marvelous to see the application of the compelling reinforcement value of interactive computer programs that require frontal cortices attention to complete the task. This teaches the ability of the frontal cortices to dominate the emotional responses of the limbic complex. I use similar techniques with adult substance abusers by positing for them the concept of sub personalities (observable states of the ego,ego states) from Eric Berne, Games People Play (1964) which can be affect free and as one builds and strengthens the affect free ego state one finds the need to self medicate lessened. An obvious oversimplification as the periods where trauma created the neural disruption are addressed as well with strategies to deal with the trauma are introduced.

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  3. Pingback: Two studies aim to bring funding and attention to neurofeedback in the treatment of PTSD • SJS

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