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.