How to Enhance Trauma Recovery

How to Enhance Trauma Recovery

Peg Shippert, MA, LPC Trauma Therapist
August 09, 2016

For this post, I want to discuss something that has been getting a lot of attention in the trauma therapy community lately, but which I’ve found difficult to understand: Neurofeedback. In my quest to better understand neurofeedback, I spoke to a few different neurofeedback providers, did some internet research, and tried some treatments myself.

Why Neurofeedback?

Interest in the use of neurofeedback to treat trauma has in recent years largely because of the efforts of Bessel van der Kolk, an internationally acclaimed clinician, researcher, and teacher on the subject of post traumatic stress. Van der Kolk said in a recent interview at that one of the biggest changes in his thinking in the past couple of years has been due to his exposure to neurofeedback. "Learning how to interpret quantitative EEG's helped me to visualize better how the brain processes information, and how disorganized the brain becomes in response to trauma. What made it necessary to look for other, non- interpersonally based therapies was the realization, followed by research, that dramatically illustrated how being traumatized may interfere with the ability to engage with other human beings to feel curious, open and alive."

A recent pilot study authored by Mark Gapen, van der Kolk and others found that neurofeedback significantly reduced PTSD symptoms and increased emotion regulation in multiply-traumatized individuals with treatment-resistant PTSD. A follow up study has now collected additional data that is currently being analyzed. I know I'm not the only trauma therapist who eagerly awaits the results of this study.

My Information Sources

My first introduction to neurofeedback was in the form of a brain map created by Betsy Carr at Aspen Neurofeedback in Longmont, CO. Later I experienced neurofeedback using the non-traditional NeurOptimal® system, combined with canio-sacral release provided by Joy Om of Boulder, CO. Finally, I had a conversation with the team at Interactive Brain Analysis (IBA), about neurofeedback and the other biofeedback treatments they provide.

What is Neurofeedback?

Neurofeedback is a type of biofeedback, so let’s start by defining biofeedback. Biofeedback is interaction with a type of measurement from sensors attached to the skin. Biofeedback is used to make a person aware of certain processes in their physical body that they are not normally aware of, like brain wave activity, breathing patterns, heart rate, temperature, muscle tension, or sweat gland activity. The person receives real-time information about those processes, which creates an opportunity to learn to adjust them for more healthy functioning.

Neurofeedback is a type of biofeedback that measures brain waves and trains self-regulation of brain function. In a conventional neurofeedback session, brain waves are measured using an Electroencephalograph (EEG). The clinician places electrodes on specific locations on the scalp, to passively measure brain waves. If you’re a science nerd like me, you may be interested to know that the EEG measures voltage fluctuations resulting from ionic current within the neurons of the brain. But the important thing is that the measured brain waves can then be compared to desired brainwaves. Some kind of signal is given to the person about how their measured brainwaves compare to the desired brainwaves. That’s the feedback. The person’s brain can then figure out how to adjust to make brain waves that more closely resemble the desired pattern.

What is it good for?

There are many conditions that biofeedback in general, and neurofeedback in particular, can be good for: ADD, learning disabilities, head injury, anxiety, depression, chronic pain, sleep disorders, tinnitus, high blood pressure, stress responses, obsessive compulsive disorder. Because psychological trauma can be a huge piece of the picture in many of these conditions, it can have a profound effect on brainwave patterns.

As Joy Om explained it, neurofeedback supports the entire central nervous system in becoming more efficient, resilient and flexible, bringing it into present-time awareness (as opposed to caught up in the past or future). Joy told me that most of her clients report feeling more relaxed, less anxious, less emotional reactive, more mentally clear, and less prone to addictive behaviors after neurofeedback. She also offered that coupling this with gentle, hands-on cranio-sacral release techniques helps to integrate the new neural patterns learned through neurofeedback into the rest of the body’s physical and energy systems.

Different Types of Neurofeedback

One thing that I discovered pretty quickly after starting to research neurofeedback is that there are different types of neurofeedback. This is where things got confusing for me.

Traditional Neurofeedback

In traditional neurofeedback, the first step is an initial “brain map”, which is made by placing many electrodes around the scalp to measure different types of brain waves. Once the brain map is made, the resulting brain wave patterns are analyzed and interpreted, and compared to reported symptoms. From this, a plan is made for how your brain waves will be trained to change. The interpretation of the initial brain map and development of a brain training plan requires considerable expertise. During the subsequent training sessions, the client’s brain waves are measured while they engage in an activity like playing a video game, or watching a movie. When the brain wave patterns match the desired patterns, the video game character or movie continues as desired. When they don't match the desired patterns, the game character or movie stop. The brain then figures out how to change the various brain waves into the desired pattern, to get the game or movie going again.

NeurOptimal® Neurofeedback

In my internet research, I noticed that many providers in the Boulder area use an alternative neurofeedback approach developed by NeurOptimal®. The NeurOptimal® system does not require a brain map and does not diagnose symptoms or train toward pre-determined goals. Instead, it measures the stability and flexibility over time of brain waves. Feedback is provided via sounds accompanying music. When the system detects that the brain waves have becomes less optimally stable than they just were, feedback is provided to the brain as a click or scratch sound in the music. This feedback creates an opportunity for the brain to adapt itself in response thus, retraining itself.

There are many other forms of neurofeedback, which are beyond the scope of this post. An interesting article to read if you would like more information is What is Neurofeedback by Diane Roberts Stoler.

My Experience and Conclusions

I found Joy’s combination of NeurOptimal® neurofeedback with craniosacral therapy very comforting, releasing. I came out of that session feeling relaxed, and . . . held. At first I tried to understand a pattern for the clicks I heard with the music, but I couldn’t ever relate them to anything I noticed in my thoughts or feelings or my general mental state. After a while I stopped trying to figure it out; Joy said that many people nap during it. So obviously it’s not a conscious type of feedback but speaks directly to the Central Nervous System - or the unconscious mind where patterns and habits reside and calls on the brain’s natural self- healing capacities. But the session was very, very soothing, and I felt exceptionally calm and grounded for the rest of that day.

I understand that the NeurOptimal® system compares the current signal with the signal taken just before it, while traditional neurofeedback compares the current signal with a desired signal based on the initial brain mapping so it tend to ‘push’ the brain in a certain direction rather than let it respond naturally to the information it receives.

I would gladly go back for more work with Joy Om, and I would definitely consider renting her system for more sessions at home which makes it very affordable to do.

How Long Does it Take?

I asked the different providers I met with how many sessions are needed to experience results. They all agree that there seems to be a noticeable shift in most people somewhere between 10 to 20 sessions. For people with severe symptoms, everyone agreed that more sessions than that may very well be needed.

How Much Does This Cost?

As of the writing of this article, a half hour introductory session at IBA is $25. The initial brain mapping starts at $400 if you pay with cash or credit and don’t need a written report. Subsequent neurofeedback brain training sessions are $100 each if you pay with cash or credit.

Joy Om offers neurofeedback sessions combined with cranio-sacral therapy for $120. She is also covered as an out-of-network provider by some insurance policies (auto). Another option is to rent a NeurOptimal® system from Joy to take home for a week for $200 (for 5 sessions). This is possible because NeurOptimal® is simple to set up and does not require any clinical expertise to operate. If you did seven sessions per week, you could accomplish 15 sessions for only $600 this way.

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