Tuesday, June 27, 2006

Photo of me, author of this blog

Neurofeedback improves physical balance, incontinence, and swallowing

Margaret Ayers developed a neurofeedback protocol that improves physical balance, incontinence, and swallowing. In a recent article*, Cory Hammond, PhD, presented case histories of clients he helped with these issues. This protocol holds potential promise for work with the elderly, stroke and head injury patients, primary nocturnal enuresis, and in peak performance training where balance is important, such as gymnastics.

One case presented was a 45 year old woman who spent 98% of her time in a wheelchair following a stroke. She had almost no movement in her left leg. Her balance was very compromised and she relied heavily on her cane to move awkwardly on her feet. She also had urinary incontinence, having “accidents” 4-5 times a day. After a total of 50 sessions the patient was spending 95% of her time out of her wheelchair and taking ½-1 mile walks daily. Her incontinence was virtually non-existent. The author noted how most patients begin to show improvement within 2-3 sessions, and other clinicians using this protocol report similar findings. One 19 year old college student with a lifelong bedwetting responded in 3 neurofeedback sessions.

I own and use the Neuropathways EEG unit developed my Margaret Ayers that was used in this journal article. I first learned of this particular protocol at the Neuropathways annual conference in 2002.

*Journal of Neurotherapy, Vol. 9(1) 2005, Neurofeedback to improve physical balance, incontinence, and swallowing, Hammond, C., University of Utah, School of Medicine, Physical Medicine & Rehabilitation.

EMDR treats PTSD quickly

I was first trained in EMDR 1990 and later taught EMDR at the California Graduate Institute in Los Angeles. EMDR, or eye movement desensitization and reprocessing, is a new, nontraditional, short-term therapy for treating posttraumatic stress syndrome. It involves assisting the client move their eyes back and forth while focusing on the negative experience. I have found it tremendously useful for adult onset PTSD, and have helped clients come to a complete resolution of trauma from car accidents, motorcycle accidents, being held up at gunpoint, victim of a rape attempt, physical assault, and witnessing a murder. It works fast and few individuals require more than 6 sessions for complete recovery. You can read up in great detail at http://www.emdr.com/q&a.htm.

Neurotoxicity and its removal

Attending professional conferences, I keep hearing of the impact of environmental toxins on human health, particularly on the brain. At last year’s ISNR conference, I learned that a 45 day use of Metagenics UltraClear eliminates 90% of the symptoms of fibromylagia. I was intrigued and did some research on the product and on neurotoxins in general. I had heard the name Metagenics several times as being the premier company for medical foods.

I personally tried the 30 day detoxification program and noticed an improvement in my overall health by the second week. The data is quite clear. More and more pollutants are being released in the environment every year. Pesticides, endocrine disrupters such as PCB, toxic metals, food additives, preservatives, and drugs overload the liver and contribute to a build up of toxins in the human system. Each year over 9 billion pounds of chemicals are being released into the air, water, and land in this country alone. It is not a question if we are carrying a burden of these toxins, but rather, how much and to what extent they affect our health. Neurological toxicity affects cognition, mood, and overall mental functioning.

Metagenics UltraClear is a powered formula that you drink daily. There is a gradual removal of certain food groups and in the middle of the detoxification, you are eating steamed vegetables and brown rice. Gradually, each food group is reintroduced into your diet.

Depending on the toxins your body is carrying, results could range from mild to dramatic. It is quite possible that your emotional problems, low energy, headaches, digestive problems, mental focus and memory, joint problems, throat problems, skin problems, PMS, hot flashes, chronic pain, and even weight issues are related to toxicity in your body.

Metagenics products are only available through participating Metagenics healthcare practitioners. If you want to enroll in a 30 or 45 day detoxification program, send me an email or call me.

Monday, June 26, 2006

Altered states training and the unconscious mind

In the past year, I have added altered states training (low frequency) to compliment high frequency training. Basically, high frequency training is done from the middle of the head forward. Low frequency is exclusively done on the back of the head. High frequency is working on stabilizing the physiology of the brain by reducing amplitude and variability. Low frequency is focusing on the psychological unconscious by increasing amplitude of the frequencies that are already present.

Low frequency training is also called alpha theta training or altered states training. It takes an additional 20 to 25 sessions. I find that if a person stabilizes their brain with a few high frequency training sessions first, then that person responds to altered states training much faster. I have had some clients who follow this sequence notice results in 5 sessions, and it can be dramatic. It’s similar to hypnosis in that the client and I create a script for what they want to focus on. Often the script is on the type of person they want to become. It’s about creating a conscious evolution of oneself. They may want to improve their creativity, be calm in all situations, be able to talk openly to their family, lose their anger, start their own business, or be more outgoing.

I place the sensors over the parietal lobe and have them close their eyes. I spend the first 5-10 minutes going over the imagery they are to consciously focus on. I then turn the feedback on and leave the room. The tones guide them into the elusive alpha theta state. This state of consciousness is experienced as being in between the awake and the asleep. It’s a twilight state. Normally you fall asleep if left on your own. The tones you hear coming from the computer holds you in that normally fleeting state of conscious.

It has all the benefits of hypnosis because you’re re-programming your subconscious mind, but with the added feature that hypnosis can’t get to. Is it clears out the traumatic experiences that have put on the brakes on your ability to progress. Everyone has outdated negative, life limiting beliefs. They reside in the unconscious and usually you don’t even know what they are. The brain operates as if these beliefs are still true.

Alpha-theta training is most commonly used for alcoholism and post traumatic stress disorder. In 1989 Eugene Peniston published his now famous study using alpha theta training to treat chronic alcoholics in an inpatient setting. He achieved an 80% rate of recovery. These were men from a VA hospital who were also Vietnam vets. They were reporting that not only did they stopped drinking, but they stopped obsessing about the war. Also, many negative aspects of their personality cleared up. That led to another study of just working with PTSD. They found the same thing happened. The PTSD went away. The rough edges of personality mellowed. Several MMPI scores moved to within normal limits.

I took that information and thought, why don’t we just apply this to everyone? Theoretically, every person has had some trauma during their lifetime. Therefore, just about anyone could benefit. Everybody wants to move forward in life and resolve their stuck points. You want to move towards something, but you get to a certain level and then you stop yourself. While a person may have some awareness of what stops them, the real reason is buried in the unconscious. There is the fear that if you get too close to achieving your goal, you’ll get rejected, ridiculed, yelled at, abandoned, hurt, etc. It’s pure fear. It has to do with early memories, early belief systems, and early trauma. The great thing about altered states training is that it’s very generic. You don’t have to consciously know what it is that is holding you back. The brain, while idling in 6-9 cycles per second, just clears it up. I have a person focus on what they want to move toward and visualize that. With this type of training, the brain increases the motivation (approach) and decreases the fear (avoidance).

Thomas Edison had his own version of this method. When he would get stuck on a problem, after hours of focusing on it, he would go to his office for a “power nap”. He would recline in his chair with metal ball bearings in the palm of both hands. Below his dangling hands on the floor were two metal pie pans. He got as close to sleep as he possibly could without actually falling asleep. If he did, the ball bearings would drop and make a loud clang noise, waking him up. He would drift into the twilight state until the solution to the problem arose spontaneously, then jump up and go back to work. It was low tech biofeedback at its finest.

Several of my clients “graduated” to altered states training after they completed 20 sessions of high frequency training. These individuals have been making significant changes in their life. It’s exciting to watch. It often goes way beyond what psychotherapy offers and with greater depth.

Neurofeedback and epilepsy

I found three recent articles on the use of neurofeedback and seizure disorder. Neuropathways EEG unit patented by Margaret Ayers has shown excellent results with reducing or eliminating seizures. I have been using this unit for 5 years.

Clinical Electroencephalography, 2000 Jan;31(1):45-55, Sterman, MB, Department of Neurobiology, School of Medicine, UCLA.

This is an extensive neurophysiological literature review that documents both immediate and sustained functional changes that are consistent with elevation of seizure thresholds using neurofeedback. An assessment of over 25 years of peer-reviewed research demonstrates impressive EEG and clinical results were achieved with the most difficult subset of seizure patients.

Expert Review of Neurotherapeutics, February 2006, Vol. 6, No. 2, Pages 247-257, Egner T & Sterman MB, Functional MRI Research Center, Columbia University, Neurological Institute.

The treatment of epilepsy through operant conditioning of the sensorimotor rhythm electroencephalogram has a 35-year history. The clinical benefits derived from this neurofeedback training protocol, particularly in patients that are nonresponsive to pharmacotherapy, have been documented in many independent laboratories. Recent advances in computer technology have resulted in the availability of relatively inexpensive high-quality equipment for the application of neurofeedback therapy, thus presenting a viable and promising treatment alternative to the interested clinician.

Child Adolesc Psychiatr Clin N Am. 2005 Jan;14(1):163-76, viii., Walker JE & Kozlowske GP, Neurotherapy Center of Dallas.

With electroencephalographic (EEG) biofeedback (or neurofeedback), it is possible to train the brain to de-emphasize rhythms that lead to generation and propagation of seizure and emphasize rhythms that make seizures less likely to occur. With recent improvements in quantitative EEG measurement and improved neurofeedback protocols, it has become possible in clinical practice to eliminate seizures or reduce the amount of medication required to control them. In this article, the history of neurofeedback for epilepsy is presented followed by discussions of the relevant neurophysiology of epilepsy. A model of how neurofeedback might raise the seizure threshold is then presented. Clinical experience using a quantitative EEG-guided approach is described, including a representative case study.

Saturday, June 24, 2006

How watching a DVD can change your brain

Imagine you’re sitting in a comfortable chair watching a DVD movie, perhaps a romantic comedy, a travel show, or a documentary. Now, imagine you have 5 wires attached to your head that you barely even notice. The wires are connected to a computer and you are looking at the monitor enjoying the show. You are wearing a special pair of glasses that have 4 LED colored lights around the edges of each one. The lights are flickering gently, and it does not interfere with the movie. You notice that the movie is starting and stopping periodically, but its not all that annoying since you were told at the start this would be happening. After a while you realize you are totally engrossed in the film, even more so than if you were watching it in a theater. Time goes by fast, and before you know it, 30 minutes have elapsed and the session has ended.

You feel relaxed, mellow, calm. Nothing dramatic exactly, but it’s a good feeling. Its subtle, but something inside feels different. Its hard to put words to it. Your brain just got trained to reduce amplitude power and amplitude variability. Sounds technical, but the movie was stopping every time your brain had a surge of amplitude.

Just like ocean waves, brain waves have different heights. When the brain waves being measured gets too high in power, it shuts the movie off. Since the brain will work for entertainment, it strives to find a way to keep the moving going. The only way it can do that consistently is to keep the amplitude low. As the oscillation lessens, so does the variability.

Other neurofeedback systems typically use repetitive tones or simple repeating graphics. Many of my clients in the past found these boring, and they would often get drowsy. While it did work, I imaged a software that could provide entertaining feedback. That software is Bioexplorer. Since converting the feedback to primarily DVD movies, my clients have found it to be enjoyable and engaging. What better way to train your brain than to sit back, relax, and watch a movie?

Ken stops smoking pot

Ken, a man in his 30’s, had attention deficit disorder since childhood and was going through a long spell of feeling depressed. He would wake up unhappy and smoke marijuana to feel better. His wife complained about this, but he refused to stop. After he saw his wife improve in neurofeedback, he agreed to receive some training himself.

After 23 sessions he said, “At first, I didn’t know if it would be able to help me at all. After the first few sessions my overall attitude and outlook on life got better. My willingness to try new things and my motivation improved. It’s really helped me in many areas. The marijuana craving began to subside more and more after that point. It’s hard to explain, but it feels like my mind is on the right track. I’m a lot more alert. I’m a lot happier waking up in the morning. I’ve tried to quit smoking pot and drugs in the past and have had no luck whatsoever. People at work have actually noticed that I’m taking a little bit more time with things. It seems like I’m more together.”

His wife added, “He’s able to cope a lot better with situations. He’s an artist and he’s been a lot more motivated on his art. He is having a lot more creative energy. He’s calmer and easier to talk to. He listens more before he makes a judgment. I always thought that we were happy, but it seems like now we’re just so much happier. We’re able to talk through things a lot more than we used to. He’s just calm in general.”

Rita no longer feels stuck in her life

Rita, a woman in her 50’s, stopped drinking two years ago after many years of alcoholism. She had been on anti-depressants for 6 years and already had years of talk therapy that didn’t seem to help. Her life seemed to be going nowhere. She felt stuck in her life, was negative, unhappy, and felt she had no hope for future. She felt angry most of the time, held grudges, and felt bored with life. She had lost her sex drive and had bouts of unreasonable jealousy when her husband talked or looked at other women.

After 22 sessions of neurofeedback she reported, “It took awhile for me to really see the change, although I felt good after the first training. After a few sessions, all of a sudden I realized something was different. I got calmer. I felt less frantic about things. The same things come up as they did 2 years ago, but they don’t bother me. I’m not as stuck. In the past I’d have a thought that would send me off the deep end. Now I can rationalize it and can think about it. I feel like I’ve really improved. I find myself trying to hold a grudge, but I let go of it. Before I would stay in it and hold it forever.

Jealously with my husband used to be a big problem. The fact that its gone I think is amazing. He still talks to women, but it doesn’t bother me any more. I used to be bored a lot. What I learned was that boredom was often just not liking to be with myself. Now I don’t mind being alone. When I find myself bored, I just do something now.

I’m not stuck. When I’m having a bad day, I say well, this is going to pass. I can get out of the same rut. Before, I felt there was no hope for my future. Now, I feel like there’s a lot of hope. I think it’s just a matter of getting through the stuff that you’ve got to go through, and always look to the future and say, well I can do this in the future. The day after a session, I’m almost giddy. That goes away, but it tells me something’s going on. What I like about this is there’s no drugs.”

Rita never liked the idea of taking anti-depressant medications and wanted to get off. As a result of her depression lifting from neurofeedback, she consulted with her physician and tapered off and eventually stopped taking her medications. One year later she has held the gains and remains off anti-depressants.

Sally deals with chronic pain, anxiety, and depression

Sally came to see me for chronic pain, anxiety, and depression. A woman in her 40’s, she was on Prozac, and had received 17 years of mental health treatment.

After 13 sessions of neurofeedback she reported, “I have had six surgeries on my hands and arms. I was in constant severe pain. I couldn’t do much of anything. My pain overwhelmed me. I would get dizzy, nauseous and throw up. My body would shake. I would get depressed and anxious and have diarrhea. I didn’t have the coping skills to handle the physical and emotional pain that I was going through.

Once I started neurofeedback, there was nothing but improvement. I was noticing differences within a few days. My overall demeanor got better. Now, my pain is noticeable, but it’s not overwhelming my life. I know when I’m in a pain cycle, but I don’t get nauseous or dizzy or shaky. I think all the mental aspects of the pain are pretty much gone. I’m not irritable anymore because of the pain. My physical pain is something that I live with on a daily basis and accept.

There was an unexpected change in my PMS as well. For 2 weeks every month I was emotional, irritable, and cranky. I was not a nice person. That’s all dissipated. I don’t even really notice it any more. It’s basically gone. Since we weren’t predominantly treating that problem, I think the neurofeedback was actually treating pain throughout my body in general.
I stopped taking Prozac after 15 years. I’m taking less Vicodin. It seems like I don’t depend on pain killers as much any more.

I had 17 years of talk therapy and I feel that neurofeedback is more progressive. I used to feel I had to talk to others about my problems, but now I don’t feel this urge. It’s an extremely big change for me as I did that for 17 years. Now, I don’t get any gratification talking about my pain problems or things in my life that are stressful. I don’t want to. I don’t need to, and it’s a pretty good feeling. I just don’t have this need to do talk therapy any more with friends or professionals really.

On the advise of my psychiatrist I went through biofeedback for my irritable bowel 7 years ago for about 6 months. I’ve gone into deep breathing and stress management and all that kind of stuff. This program is more profound, 100 times better. This seems to be the only thing that seems to have really worked. It changed my life.”

Mike recovers from anxiety and depression

Mike’s anxiety and depression finally became so severe he was unable to work and took a medical leave of absence. He had a long history of emotional problems, having high anxiety since age 10. He was diagnosed with obsessive compulsive disorder at age 17. He had been in psychiatric treatment for the last 5 years and had tried many medications, including Luvox, Prozac, Xanax, and Effexor. His parents paid for a SPECT scan from Dr. Amen and high activity in the prefrontal cortex was found.

Now at age 22 he was falling apart. Every night from 5pm to midnight he was plagued with anxious thoughts that he could not get rid of. The only thing that helped was drinking alcohol and smoking marijuana. These he did every day to excess. He had irrational fears of being away from home. He was severely depressed, had self-doubt, mental fatigue, social anxiety, insomnia, and a short attention span. He was unassertive and compulsively overspent, leaving him broke all the time. His parents were at their limit in supporting him. He said, “I feel trapped inside my head. I think about everything too much.”

After 20 sessions of neurofeedback, he was 90% improved in all areas that concerned him. He commented, “I feel more comfortable in my skin. I am back to work and making friends. I don’t feel like I have to drink. If I do drink I can stop at will. I have no desire to smoke pot. I have little or no anxiety and my depression is totally gone. Of all the therapy I’ve had or the prescription drugs I’ve taken, this EEG biofeedback has been far and away the most helpful thing I’ve tried. I feel entirely different than my former self.”

Thursday, June 22, 2006

My informed consent form for neurofeedback

My office conducts EEG brainwave biofeedback, also known as neurofeedback. Depending on your situation and needs, a 2 Channel EEG Assessment may be recommended. This is performed with the intent of collecting data on sum amplitude, asymmetry, imbalances, dominant brain wave frequency, theta/beta ratio, and alpha peak frequency. Conducting this evaluation may help the practitioner customize sensor placement, frequency targets, and reward patterns.

Sensors are placed on the scalp, amplified, and sent into computer software that displays brainwaves on a screen. Brainwaves occur at various frequencies. Some are fast and some are very slow. The EEG bands are called delta, theta, alpha, and beta.

Delta brainwaves (1-4cps) are the slowest frequencies and have the highest amplitude. We normally find these when we are asleep and they originate in the brain stem. If they are too abundant in the waking state, it is often a sign of head injury.

Theta (4-9cps) brainwaves are characteristic on the twilight state of consciousness between wakefulness and sleep. Thoughts are loose and random. Originating in the hippocampus, too much of it in the waking state is associated with poor attention and distractibility.

Alpha brainwaves (8-13cps) are abundant when we have our eyes close and are relaxed. It represents the brain shifting into idling gear. Alpha should predominate in the back of the head, with less and less showing up on the EEG the closer we get to the frontal lobes. Too much alpha in the waking state in the frontal lobe, especially in the left frontal is associated with depression.

Beta brainwaves (15-21cps) are associated with being alert, focused and attentive. It should be the dominant frequency when performing tasks. Too much of it in the right frontal lobe is associated with anxiety. Too much of it in the back of the head is associated with insomnia.

All brainwaves are present in every person’s brain every hour of the day. It’s the percentage of the total and the ratios that make a difference in states of consciousness. As an example, when very high frequency of beta is dominant, we typically experience anxiety and tension.

Once training goals have been determined, the practitioner will place 4-5 sensors on the head. You will be asked to put a special pair of glasses on, the color depending on the nature of your presenting issue. You will then be given feedback that is designed to train the brain towards a balance. The feedback may be in the form of a DVD movie, CD music, audio tones, or a computer animation. These training sessions are designed to teach your brain to gradually change your brainwave pattern. Each person will have different goals. Some will focus on downtraining certain amplitude frequencies while others will uptrain. Its similar to going to a gym to exercise. The brain gets a workout. The outcome is a brain with greater resiliency and flexibility. Neurofeedback training usually requires 20-25 high frequency trainings of about 45 minutes in length. Some people need up to 50 sessions.

Low frequency training (also known as alpha-theta or altered states training) has a different goal than high frequency. This type of training increases low frequencies in the back of the head for the purpose of improving psychological or emotional functioning. Alpha-theta training usually requires 20-24 sessions of about 45-60 minutes in length each.

Neurofeedback has been shown to help a variety of conditions. Attention deficit/hyperactivity disorder (ADD/ADHD) respond well to this approach. Research has indicated that not only do the presenting symptoms improve (80%), IQ scores increase ranging from 10-23 points. Chronic alcoholics tend to have lower levels of alpha and theta waves. Neurofeedback training can achieve up to 80% success in creating long term abstinence. Using alpha-theta training, studies have shown that people who have Posttraumatic Stress Disorder (PTSD) have significant reductions in symptoms as well as a reduction in medication. Neurofeedback has been found to be helpful with all kinds of epilepsy, on average producing a 70% reduction in seizures.

Neurofeedback training has also demonstrated usefulness in reducing symptoms of anxiety, depression, head injuries and strokes, chronic fatigue syndrome, fibromyalgia, sleep disorders, Tourette's, obsessive-compulsive disorder, imbalance, incontinence, and PMS. Neurofeedback is also being used in peak performance training for athletes, executives, and musicians.

Only rarely have significant side effects from neurofeedback training been noted. However, occasionally someone may feel tired, spacey, anxious, experience a headache, have difficulty falling asleep, or feel agitated or irritable. Many of these feelings pass within a short time of a training session. If they do not, you should inform Dr. Staso in your next session of any negative side effects so that a modification can be made in the training protocol.

While neurofeedback has been demonstrated to produce beneficial and lasting change, some people may show little, if any response. This could be from having too much damage to the brain or from having an undiagnosed medical condition.

Despite all the research in the area of neurofeedback, it must be regarded as experimental given the absence of large, carefully controlled studies. I encourage clients to have 10-20 sessions to evaluate progress. It is the client’s personal responsibility to monitor subjective effects of training and to continue training as long as they see benefit.

You should be aware that many insurance companies, and even some professionals who are not aware of the latest published research and may regard all EEG neurofeedback as experimental. Some insurance companies still insist on defining all biofeedback as experimental and may not reimburse for these services.

If you are taking prescription medication, it is important to remain in close communication with your physician. In many cases, the need for some or all of these medications may decrease after a series of neurofeedback sessions. In some cases, a person will experience increased side effects of the medications unless they reduce the dosage. I advise you stay in contact with your prescribing physician and not make any changes without seeking medical advice.

Vicke Quinlyn’s interview with me part 1

Vicke Quinlyn interviewed me last year and I thought some readers might be interested in what we spoke of.

VQ: How did you get interested in neurofeedback?

DS: In 1983 I heard of Margaret Ayers in Beverly Hills doing neurofeedback. I knew nothing of it despite having written my doctoral dissertation on biofeedback. I had been referred a case of a 23 year old man who had injured his head while hang gliding. Immediately following the accident he began acting erratic. He had poor insight, was very impulsive, started abusing drugs, and was unable to work. He was dysfunctional in so many ways. Over the next 6 years he was hospitalized 6 times for psychiatric disturbances and was given a variety of diagnoses. Nobody knew what to do with him as neither medication nor psychotherapy helped. I finally referred him to Margaret Ayers for neurofeedback and he improved dramatically. He got off all medications. He returned to work in the family business. He got a girlfriend. He was never hospitalized again. Virtually all of his psychopathology disappeared. This led to my referring clients to Margaret Ayers for neurofeedback for the next 17 years. I saw the results and became a believer in the work. I posted details of this case on my website www.neurofeedback-sb.com.

VQ: When did you start practicing neurofeedback?

DS: I bought my first unit in 1990 after I took a 3 day seminar in the Peniston-Kulkosky alpha-theta training for alcoholism at the Menninger Clinic in Topeka, Kansas. The unit was rather crude, was limited to uptraining only two frequency bands, but worked just fine. I used it for a few years, but I had difficulty convincing clients to see me five times per week, which was the procedure at the time. In February 2001 I purchased the Neuropathways unit, the one Margaret Ayers holds a patent on. It was dramatically more powerful and more versatile that the one built by the Menninger Clinic. I began to use it for head injury, ADD, depression, and anxiety. Since then I have acquired a NeuroCarePro, a Roshi II+ with Bioexplorer software, a Neurointegrator with Bioexplorer software, and the Roshi II with the Amiga. I have lots of equipment.

VQ: Its common to find professionals like yourself having interests in science in their childhood. What experiences shaped your current interests?

DS: When I was 12 years old, I read a short article in the Encyclopedia on deep breathing as taught in the Eastern traditions. I was fascinated that such a simple process could produce such powerful results and was bewildered when I found that no adults I spoke to had the slightest knowledge of the subject. I taught myself how to control my breath and alter my state of consciousness. It proved valuable in playing sports as it improved my stamina and focus. It set the stage for my lifelong interest in self-regulation.

VQ: Did you major in psychology in college?

DS: I did major in psychology – good guess. I took every course available in the psychology department and carried a double minor in behavioral sciences and anthropology. I took my studies seriously and graduated with Great Distinction (3.96gpa). However, I was disappointed with my education. In the 1970’s courses in neuroscience lacked much substance. There was a basic lack of understanding of brain functioning at the time. I was disappointed that philosophy was the foundation of psychotherapy. As a college senior I envisioned a future where behavior change would come about far more rapidly and very differently than the 1970’s. I believed that once we knew more about the brain, psychologists would develop innovative strategies that were far different that what was being used at the time. I went on to earn my PhD in psychology. I never lost my interest in self-regulation and wrote my doctoral thesis on biofeedback.

VQ: Could you explain what biofeedback is?

DS: Biofeedback is the measurement of biological processes, amplifying them, and feeding it back to the body via the senses. As an example, one would have a difficult time guessing their hand temperature, but a special unit could tell you exactly, such as 78 degrees. By watching the gauge while its taped to the finger, a person can raise the temperature. This would normally be very difficult without the aid of visual or auditory feedback. Warming of the hands typically leaves a person feeling calm and relaxed as it reduces sympathetic nervous system activation and increases parasympathetic activity. In this state, the body is better able to allocate resources for repair and regeneration.

VQ: Is neurofeedback the same as biofeedback?

DS: The concepts are basically the same, only we are working with brainwaves. It’s sort of like the brain looking at itself in the mirror. Neurofeedback trains the brain to work more efficiently. When amplitudes are too high or the variation of the amplitude is too excessive, the brain is working too hard. Neurofeedback trains the brain to reduce the excessive power and stabilize the variations.

VQ: Do you still practice traditional psychotherapy?

DS: About half of my caseload is based on talk therapy. As you would expect, I often use technology to assist. While I use the traditional methods of cognitive behavior therapy, hypnosis, and EMDR, I often add audiovisual entrainment (AVE), electromedicine (Alpha-Stim SCS), and dietary supplements (5-HTP, OPC, etc.). These I have found to speed up results. I have specific protocols for cocaine, alcoholism, panic disorder, OCD, depression, and ADD.

Craig overcomes cocaine dependency

December 2005

If there ever was one to be called a modern-day miracle worker, it would be Dr. Dan Staso. I cannot praise him enough to fully express my satisfaction!

I’ve struggled with addictions most of my life. I began drinking around age 14 (I’m now almost 40.) Around age 20 I realized I had a problem. In my late 20’s I wanted to do something about it. I went through 3 different rehab programs, attended AA meetings, so on & so forth with limited success. Around age 35 I decided smoking cocaine would be a good idea. This was the worst mistake I ever made in my life. This stuff ripped me up, chewed me up, then spat me out and I still wanted more. How stupid is that? I could never figure that one out. I would have cravings for weeks at a time and be miserable fighting them off only to give into them “Just to get it over with.”

About four months ago I found Dr. Staso. Since then he has retrained my brain to where I can think things through and it makes sense to me. I still get cravings; in fact, sometimes I make one happen on purpose just so I can smash it instead of it smashing me. I’ve never felt more confident in being drug free. Things I couldn’t understand now make sense to me. I think for the first time in my life I’m using my brain for its original purpose.

I can never thank Dr. Staso enough for all he has done for me. I can now say with confidence “I am no longer a cocaine user!”

Cocaine addiction is treatable

Cocaine is a very addictive drug and can be one of the most difficult drugs to stop. Cravings tend to become stronger over time and all too often lead to addiction. I have been treating addictive disorders for 20 years and have put together a protocol that has a very high success rate. From 1986-1993 I specialized in teaching cocaine addicts how to deal with cravings and stop cold turkey. Cocaine just isn't a drug one tapers off. I now integrate these teachings into my neurofeedback program. Combined together, I find outcomes are even more effective.

On a conscious level a person needs to learn how to make the right choice when they have an urge to snort or smoke cocaine. They need to be educated about what the urge is and how cocaine has created an artificially induced biological drive. Each addict has to have a plan, one that is in the here and now. Talking about one's past never cured cocaine addiction, so all I focus on is what a person can do now. Later, it may be helpful to understand why a person started. The fact is, they're using today because their brain got addicted. It's as simple as that.

If a person is actively using and cannot stop for at least 2 weeks at a time before relapsing, I recommend they see me three times the first week. I provide information that can be used immediately to help the person deal with the cocaine urge. The urge will not go away by itself and must be faced directly. The client memorizes the plan and I make sure he or she understands how to apply it.

Then I recommend a series of high frequency neurofeedback trainings designed to calm down the hyperactive mind, reduce anxiety, and reduce depression. A person typically watches a DVD movie while training their brain. Then, I switch to low-frequency training, also known as altered states training, or alpha-theta training. My client is instructed to mentally rehearse situations where they will likely be at risk for relapse and mentally go through the choice making process as they were taught. With eyes closed they listen to certain tones that guide their brain waves into 6-9 cycles per second dominant pattern. It's a twilight state of consciousness. One is neither asleep nor awake. In this zone the non-conscious mind absorbs the new strategy and resolves old psychological traumas that may have caused the initial reason to use. Each session strengthens motivation and reduces the risk of relapse.

The total number of visits is typically 20-30. I designed it to be time limited. I have found that a recovered addict is just that, recovered. Some may want to attend a 12-step program, but most do not need it. I know this sounds radical as it is not the mainstream philosophy, but I only go by experience. My graduates rarely return to using cocaine.

Saturday, June 17, 2006

Alpha-theta training for alcoholism

This is a summary of the article

The Peniston-Kulkosky Brainwave Neurofeedback Therapeutic Protocol: The Future Psychotherapy for lcoholism/PTSD/Behavioral Medicine, by Eugene O. Peniston, Ed.D.

The full text can be found at http://www.aaets.org/arts/art47.htm

Electroencephalographic (EEG) biofeedback has been in use since the early 1970's for treatment of anxiety disorders and a variety of psychosomatic disorders. Alpha waves are smooth, high amplitude waves in frequency range of 9-13 Hertz (Hz). Alpha wave biofeedback was explored by some researchers, as a treatment adjunct for alcohol abuse. There were two theoretical rationales: first, investigators had reported that EEGs of alcoholics were "deficient in alpha rhythms and alcohol use induced more alpha wave activity. Clinicians speculated that alcoholics might drink less if they could be taught to produce more alpha waves. Secondly, many alcoholics and other drug abusers reported using alcohol or other drugs to relax.

Interest in the combination of alpha-theta training evolved from investigation of sleep and creativity. One earlier study found that, as individuals became drowsy, their brain waves commonly changed from high-amplitude alpha to low-amplitude theta. During the transition, some individuals experienced a hypnogogic state in which they had vivid visual imagery and auditory and visual hallucinations. Investigators studying creative individuals noted that when their subjects were in a state of "reverie," they produced increased amounts of 6-8.5 Hertz (Hz) activity. In an effort to facilitate production of the reverie state and hypnogogic imagery, the investigators developed an alpha-theta biofeedback system that provided information to the subject about both alpha and theta production. As memory for the content of images in the hypnogogic state is often poor, subjects were asked to verbalize the imagery. The investigators thought that the production of the alpha-theta twilight state "should prove to be a powerful technique for the study creativity enhancement in particular, and the hypnagogic state, in general." They suggested the possibility of using the alpha-theta state for psychotherapy.

Alpha brainwaves are smooth, high-voltage brainwaves in the frequency range of 9-13 Hertz. Some research suggests that alpha brainwaves are associated with a subjective state of relaxed alertness or tranquillity while other research suggests that alpha brainwaves are not associated with any particular subjective physiological state.

The theta rhythm state is defined as a dominance for 4-7 Hertz brainwaves. Transient elevation of theta occur during Zen meditation or while entering the early stages of sleep and are reported to be associated with vivid visualization, imagery and dream-like states.

In the late 1980's, the advances in digital processing technology gave clinicians and researchers biofeedback equipment that significantly improved the quality of EEG neurofeedback signal compared with that previously available using analog filters. The availability of high-speed desktop computers opened new possibilities for neurofeedback training and research. New neurofeedback equipment incorporated high-speed analog-to-digital converters and computers for data logging and the creation of data displays using fast-fourier transforms. In addition, some neurofeedback equipment could now automate data logging and session statistics.

It was during the late 1980s and early 1990's that Peniston and Kulkosky developed an innovative therapeutic EEG alpha-theta neurofeedback protocol for the treatment of alcoholism and prevention of its relapse. The Peniston/Kulkosky brainwave neurofeedback therapeutic protocol combined systematic desensitization, temperature biofeedback, guided imagery, constructed visualizations, rhythmic breathing, and autogenic training incorporating alpha-theta (3-7 Hz) brainwave neurofeedback therapy. Successful outcome results included a) increased alpha and theta brainwave production; b) normalized personality measures; c) prevention of increases in beta-endorphin levels; and d) prolonged prevention of relapse.

EEG alpha-theta brainwave neurofeedback therapy (Peniston/Kulkosky protocol) had also been employed in a clinical study using twenty male Vietnam combat veterans with a dual diagnosis of posttraumatic stress disorder and alcohol abuse. A follow-up study revealed that only 3 of the 20 experimental patients had relapsed to alcohol by 26 months after training.

In addition to the aforementioned clinical studies, the Peniston/Kulkosky protocol was employed in private group practice in the treatment of fourteen depressed alcoholic outpatients (8 males and 6 females). After training, subjects showed significant improvement on depression scores. At 21 months after training, only one subject was observed to relapse.

Other clinical studies using the alpha-theta brainwave neurofeedback therapy provide promising evidence for the effectiveness of the alpha-theta brainwave therapeutic protocol in: a) changing EEG scores and self-assessed depression; b) stabilizing serum beta-endorphin levels and; c) producing long-term prevention of alcohol relapse. Alpha-theta training also produced significant personality changes, reductions in the need for psychotropic medications, and some relapse prevention of PTSD symptoms. The recent 10 year follow-up clinical evaluation of the original Peniston/Kulkosky alpha-theta brainwave neurofeedback clinical study confirmed the long-term effectiveness of this therapeutic intervention. Such a success rate of a treatment modality has never before been achieved.

The Peniston/Kulkosky EEG alpha-theta neurofeedback protocol is being used by many practitioners to treat alcohol and other psychoactive substance disorders. Some alcohol treatment programs using the Peniston/Kulkosky EEG alpha-theta neurofeedback protocol as a primary treatment modality for alcohol addiction have demonstrated that intensive neurofeedback-based treatment has exerted a positive influence on a number of factors which contribute to alcohol intake including stress levels, depressive personality traits, beta endorphin output, resting levels of alpha and theta brainwaves, and prolonged abstinence.

Although psychopharmacological treatments for alcohol dependence are being investigated by many individual researchers and by NIDA's Medications Development Division, at present no psychopharmacological agents have been established as safe and effective for treatment of alcohol dependence.

It is suggested that neurofeedback therapy can become the future alternative choice of treatment for subgroups of addicts who are alienated by the religious overtones of traditional 12-step recovery programs. Moreover, such an intervention may prove to be more useful for treating depression, posttraumatic stress disorder, learning disabilities, attention deficit disorder (ADD), eating disorders and psychosomatic health problems. The alpha-theta protocol has been scientifically proven, for some disorders, to be a more efficient therapeutic intervention (when compared to traditional psychotherapy), and is more cost-effective over the long-term. Neurofeedback therapy works by assisting one's own mind-body connection to heal itself as opposed to relying on the use of medication.

William follow up

June 16, 2006

I wanted to check in with you and tell you how things are working out for me. Well, that last session really did the trick. I've moved, and I lost all cravings for coke, meth, or anything except weed. I mean 0 cravings. As in, this is the first time they have even crossed my mind since the move. I also have quit smoking weed in the quantity I used to. I literally only smoke at night, 10 o'clock or later, and can go days without smoking. It doesn’t matter to me anymore. I got a job as a collections agent for a large contracting company. I work M-F 8-5 for pretty good money, and the company wants me to install their server and basically deploy andmaintain their network. Its a pretty big responsibility, but I'm very excited to do it.

I also start school soon, and the degree is all I focus on. I don't go out and party anymore. I go to work, then go home and (will be) studying. Its insane. I'm 45x percent more responsible than I was before, and I thought I was responsible before. I'm financially square, even making some money. My mind is clear. And once, I remember you said how a drug is a cheap high. This job and being down here has given me a more life high, and I'm pretty stoked to be doing what I'm doing. I just wanted to pass along the differences. I'm a 40 year old living in a 20 year old body. I really have grown up, and I'm satisfied being somebody who follows the rules and goes to bed on time. I know your treatment has made this change in me, because its almost as though my mind is clearer and sharper then it has ever been before. Imagine a fog over your perception of the world that has been lifted. I feel as if my eyes have been opened and I understand and rationalize much more. I feel healthy.

Thursday, June 15, 2006

William recovers from drug abuse

May 2006 When I walked into Dr. Dan Staso’s office one ordinary day in Ventura, I didn’t imagine that this treatment would alter my life with the magnitude that it did. I was a typical college drop-out from UCSB. I smoked marijuana everyday, as well as habitual use of cocaine, methamphetamine, oxy-cotton, and alcohol. I knew I was heading down a one way path, so I decided that seeking counseling was the best thing I could do.

Dr. Staso told me that his treatment was called neurofeedback. Neurofeedback is the study of brain waves and how different amplitudes of these waves direct behavior. The study has been around for over thirty years. Neurofeedback leaves typical western-medicine doctors sticking their nose up. Why? Neurofeedback is proven treatment for ADD, ADHD, OCD, chronic pain, as well as drug abuse, and it does it all without medication. How can this be? Well let’s take me for a typical example. I was a drug addict. (Well, according to Alcoholics Anonymous, we are always an addict, but let’s say that now that I no longer habitually use illegal drugs, I am no longer an addict.)

The human brain gives off four distinct waves; delta, alpha, beta, and theta.Apparently, when a person uses illicit substances, the brain generates a huge amount of alpha. When the drug has worn off, the alpha drops, and the body tries to keep the alpha waves higher, but it cannot produce the desired effect. So when the brain cannot keep the alpha where it wants, there is a craving. This is not different from anti-depressants. The body creates Serotonin, a substance that makes a person happy. When one is prescribed anti-depressant, synthesized serotonin is the “cure.” What happens is the body does not have to work so hard to create serotonin, so serotonin production stops. The actual amount of serotonin is higher in the body, but the body ceases to produce the desired amount. When the anti-depressant is ceased, the body cannot create enough serotonin, and so the patient drops into a higher depression, and has a craving. This is the same thing that cocaine and methamphetamine do to a user.

So what’s the solution? Harry Potter. That’s correct, no typo. Dr. Staso hooked me up to his mystery machine that monitors my EEG, or the different amplitudes of frequencies of alpha, beta, and theta waves coming from my brain. Then he plays a movie, in my case Harry Potter. He would set a certain threshold to decrease the excessive amplitude of my brain waves, and whenever it would pass that threshold, the movie would skip. The study of neurofeedback has found that the brain, if given a new set of guidelines, can adapt to the new set of guidelines. Without any conscious effort, I would start my 30 minute segment of Harry Potter with unintelligible skips and pauses, and end have a clear sailing movie. That threshold takes whatever amplitude your waves are at, and sets an according limit, so as to prevent spiking of the different frequencies, mostly the alpha peaks. The interesting thing is that neurofeedback has found that if the brain is presented with a more efficient schematic, it will adopt it. What does that mean? That means that the effects of my 30-minute session of alpha-control” are permanent.

So how does it make you feel? Well, on a typical Tuesday or Thursday, I would walk into Dr. Dan Staso’s office at 2 o’clock. By 2:15, I would be set up in the backroom. 2 electrodes were clamped on my earlobes, 2 behind my ears, at times 2 on the sides of my head, and a pair of glasses that rival Drew Carry’s on fashion sense but feature lights that blink around your eye. The purpose is to adjust your brain waves on the same phase as the computer. Not making sense?

Well, here is another way to explain it; have you ever tried to video tape a computer monitor? There is a significant amount of distortion that records until you adjust the computer monitor’s refresh rate to that of the camera. When the camera and computer monitor are in phase, the recorded video will have clear-reading computer monitors. Setting the refresh rate on the monitor is the exact same thing that these glasses do to your mind.

The room darkens and the movie starts. The focus that I had on these films is many times greater then any IMAX theater or movie theater I have ever been in. I would concentrate on the films and try to prevent the movie from skipping. The lights around my eyes made a flashing border around the movie picture. And I would watch. However, about 15 minutes into the movie, I would start to loose my thoughts of reality and of whom I was and what I was doing, and realize that the only thing that mattered was the movie. And strange as it sounds, my brain would numb. And then the next thing I would know, my session would be over and I groggily would pay and rush home to lie down for about fifteen minutes. I would emerge reborn, sober, and clear sighted. My ambition returned, and my desire for marijuana halted.

These sessions continued and I learned that the amplitude of the waves that we were controlling is recorded on a graph on the computer screen. When I started with Dr. Staso, my alpha amplitude was very high and would end low. However, now that we have finished the 20 sessions, the amplitude of my alpha starts and ends on the same level. I can even forcibly push my mind into the alpha-reduction state. If I feel out of focus or slightly off, I can put my mind in the state it was in with Harry Potter and can push down my alpha. I have trained my brain, to say the least, to learn to control the alpha.

So what’s the difference? I failed to mention that before entering Dr. Staso’s office, I was in a deep depression. I had been kicked out of college, my father’s alcoholism was rampant, I failed to move 2 times previous to return to college, my friend passed away, etc. But now, my depression is gone. My drug use is gone. I won’t even consider cocaine ever again. My ambition has returned in full. I feel as I did before I even knew what the word marijuana is. I wake up feeling happier and more energetic. And I don’t sulk in my room by myself anymore. All of this without anti-depressants.

Monday, June 12, 2006

Linda experiences alpha-theta training #2

June 6, 2005

Today I had another session with Dr. Staso. It has been almost a month since I saw him. I am happy to report that I did well during this month. I thought maybe that meant my mind had nothing more to process in the neurofeedback sessions, but after today, I don't think that's the case. The session went similarly to the last one. I am trying to understand the exact state my brain is in during the session, because it is this weird in-between stage of not really being asleep, but not really awake. I again had several nightmare reactions, lots of twitching and lights flashing. It's kind of scary because it seems like my body and subconscious know what is going on, but my conscious brain is not quite sure what all the commotion is about. Even so, it's an enjoyable experience in a way that I just can't explain. I think maybe it's that I realize that whatever it is that is happening, it is helping me, and only good things are coming from it. I am in a really good mood.

Linda experiences alpha-theta training #1

May 9,2005

My last few neurofeedback sessions have been what Dr. Staso calls "Altered States Training", which is also known as "alpha-theta training". It is different from the other training sessions I have done. It is with eyes closed, and I am listening to different tones while focusing my thoughts on who I want to be. The experience is really interesting. I feel like I am fully conscious, but when my session ends, I realize that I wasn't really. It's like when you are dreaming, and you feel like you are awake and everything is really happening, but then you wake up and realize you were not awake. I'm not actually asleep during the sessions, even though it is a similar sensation. At the first altered states session, Dr. Staso told me to focus on who I want to be, but that at some point my mind would wander and that this was OK. So I thought about wanting to not be so uptight, to be more relaxed and patient, and a lot of other things. I focused on those thoughts as long as I could.

When my mind started to wander, the experience was very different from any of my previous sessions. What would happen is my mind would focus on one thing at a time, like not being so uptight. Then my mind would ask itself why I was so uptight. That question would repeat itself endlessly in my head until my mind resolved it. But it was how it resolved it that was odd to me. I didn't actually hear any answer to the question, but my whole body and mind would go into a state like I was having a nightmare. My body would start tensing up and twitching, and I would start to feel more and more stressed, and although I can't recall seeing any actual images, I had a sensation in my brain that lights were flashing. All of these sensations would get more and more intense until it peaked and then I would be very relaxed. Then my mind would go on to another question, and the whole process would repeat. Even though I would feel a lot of stress throughout the session, my body would let go of it and, by the end of the session, I was very relaxed. I felt really good. I felt like I had resolved a lot of things without my conscious brain really knowing what happened. Which is good, I think. If you can get over a trauma you don't remember without having to remember it, that's all the better.

This question/answer routine that my brain was doing went on during the first two sessions. Since then, when my mind wanders, it doesn't really ask any questions. I'm not as aware of what my mind is thinking about. It's a lot more dreamlike, but I still have the nightmare reactions several times during a session, so I think my mind is still processing things. I am noticing a lot of positive changes. I smile a lot more. People smile at me. I am patient, relaxed; basically, I am becoming the person I want to be. It's great.

Linda overcomes anxiety and panic

I have been seeing Dr. Staso for several months. I originally came to him because I was having panic attacks, but he has been helping me in so many other ways. The majority of the sessions have involved neurofeedback, which I have found to be extremely helpful for not only anxiety, but depression, PMS, and resolving past issues. Before my first appointment with Dr. Staso, I was really nervous about seeing a psychologist because I imagined it would mean talking about private issues with a stranger. Aside from the fact that I found Dr. Staso very easy to talk to, I never felt like he was invading my privacy. One of the reasons I feel I responded so well to neurofeedback is because it did not require me to discuss every detail of my life.

Before I started seeing Dr. Staso I was having panic attacks, which left me convinced I was going to die, which made me scared to be alone, which made me more anxious, so I had more panic attacks. I was in a vicious cycle, and although I had only been going through this for a few months, I felt like I could not remember a time when this wasn't happening, and I also felt it would never go away. Even when Dr. Staso promised me that anxiety disorder is treatable and I would be fine in a few months, I had a hard time believing him. The panic attacks did not go away immediately, but their severity and frequency did begin to diminish soon after I started therapy. I noticed other things I hadn't noticed before. I thought that this anxiety problem was just something that came out of nowhere in the last few months, but I realized that it had been something that had slowly been building up for most of my life. These last few years especially, I had been withdrawing from everyone, not speaking, feeling overwhelmed and worried and paranoid about everything. The worst part is that I didn't really notice this until I started coming out of it. I just thought that this was they way I was, that everybody gets unhappy and worried, that there was nothing I could do. But what I found is that I am not this way. I am a happy person who loves to help people and spend time with my friends and family, but I had a lot of issues that were not allowing me to be myself. My neurofeedback sessions have allowed me to free myself, and everyone has noticed.

One of the most surprising things neurofeedback has helped me with is PMS. I have always had bad PMS, from physical symptoms of cramping and bloating, to emotional symptoms of crying or being upset for no apparent reason. From the first cycle after I began treatment, I had no cramps, bloating, or mood swings. In the past, I would start with PMS for up to 10 days prior to getting my period. But since seeing Dr. Staso, I no longer experience any PMS symptoms. It is truly amazing. My husband has noticed also and is extremely grateful.

Neurofeedback has also helped me deal with life better. There are always problems to deal with, and I usually didn't handle things very well. I always imagined the worst and stressed needlessly. But in the neurofeedback sessions, I have also been working on allowing myself to be the person I want to be. I am able to keep my cool, feel relaxed, have more patience with my students, speak my mind, and I feel very focused and motivated in my schoolwork and research. As a grad student, this has been really helpful. The problems I was having with anxiety and my mental health in general had created a mental block when it came to my work. But once I started taking care of myself and improving my mental health, that block was lifted. I can now not only think of ideas, but have the motivation and self-confidence to carry them through.