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Remediating PTSD with neurofeedback

 

5th Annual Winter Conference on Brain Function/EEG, Modification & Training: Advanced Meeting Colloquium Feb 21-25,1997 Palm Springs CA, Organized by Rob Kall

Abstract & Workshop (tapes of both available)

CITATION For Bill Scott: The following abstract is an exemplary example of how a clinician researcher can share data and techniques in detail, in writing.  Rob Kall, Meeting organizer
                                              ABSTRACT
Ending The War Within;Remediating PTSD with neurofeedback.
William  Scott
EEG Spectrum 16100 Ventura Blvd Suite #3  Tarzana CA 91436
818-884-2882 Fax 818-713-0248
*  How It Works
We begin with bipolar uptraining C3-Fpz beta (15-18Hz), C4-Pz SMR (12-15Hz) and Theta (4-7Hz) suppression, with the Susan Othmer protocol for ADD.  Use this protocol to normalize the T.O.V.A. or if it's already normal, administer 10 sessions.    Preferably we'll administer 10 thirty minute sessions, twice per day in five consecutive days.  There appears to be a significant dosage effect doing sessions twice daily.  People that have completed the above protocol seem quite advanced when they start their alpha / theta feedback compared to those that haven't.  Their ego strength improves, their heightened cognitive functioning better enables them to process unconscious imagery, and they experience cross overs in their first sessions. 
We then administer alpha theta sessions twice daily, thirty minutes each for a total of 30 sessions.  All 30 alpha theta sessions are done with their eyes closed. We call alpha (8-12Hz),  theta (5-8Hz)  and we suppress 2-5Hz.  The 2-5Hz suppression seems to prevent the painful abreactions and sleep.  We've replaced 4-7Hz theta with the 5-8Hz band because people recall their experiences with heightened clarity, don't feel as spaced out afterwards, don't experience heaviness after sessions, and have more of the witness state experiences.  We reward alpha between 60% to 80% and theta between 30% to 60%.  We suppress the 2-5Hz activity from 10 to 20 percent.  Our main objective is to maintain within these parameters while adjusting thresholds as little as possible.  We don't adjust to deviations from their general trend.  We get to know patients EEG patterns and set the thresholds in anticipation of them.  For example, patients with unresolved PTSD start out with excessive alpha during their first 5 to 10 minutes and then it drops by a factor of 2 to 5 and remains at this lowered level.   We would set the thresholds in anticipation of this drop or gradually change the threshold as it begins to attenuate so the client continues to hear the same amount of feedback as their EEG normalizes.  People with PTSD usually drop their average level of alpha after 30 sessions.  The heightened levels of alpha in their initials sessions has a strong correlation with the suppression of unconscious material.  As it drops so does the amount of intrusive thoughts, night terrors, and flash backs.
*  The Retraumatization to Resolution Process
To best understand this process, lets contrast the more familiar talk therapy with neurotherapy.  When people with untreated PTSD talk about the trauma, or experience anything that restimulates it, they are retraumatized.  The trauma seems to have been erroneously stored in the present memory locations and their brains don't differentiate restimulation from reoccurrence.  The reason talk therapy lacks effectiveness with this population is because patients can't talk about it without reexperiancing it.   Many patients, on an almost unconscious level, eventually pretend they're over it to avoid being traumatized and  just decide to go on with life attempting to avoid restimulation.  Many overworked therapists are traumatized by hearing rarely spoken acts of cruelty and are also inclined to share their client's manipulation that they are better.  
Neurotherapy's appeal to this population lies in the lack of  an expectation for   them  to talk about it.  The therapist  just monitors the number of occurrence of symptoms, sets thresholds, reads the client's guided visualizations prior to their 30 minutes of feedback, and teaches the client to interpret their experiences.   During sessions, with their unconscious properly seeded with the visualizations, they experience whatever they need to erode these symptoms.  Their unconscious knows the exact strength of their ego and never overloads it.  At times it is stretched and they may fear going over the edge but they can't.  I've done thousands of sessions and haven't questioned this possibility since about my 100th.  I've also talked with dozens of practitioners and have yet to hear of someone needing hospitalization.
After patients have a few key sessions, the retraumitization to resolution process begins.   Clients have experiences of dark holes or spaces they had been avoiding and they enter in or look through them, usually to find themselves in a  place of consciousness where they observe the past traumatic events from a non first person perspective.  In this way, they observe and process without  re-experiancing.   Their unconscious,  for the first time, stores the experience(s) as past events.  After these sessions, they learn a way to be restimulated without being traumatized. 
Now in these previously retraumatizing situations, they still have a conditioned response where they find themselves preparing with for the full shock, but it doesn't happen.   In the initial stages of this process, in anticipation of trauma they do experience stress.  But now as restimulation occurs, it acts to continue to resolve the conditioned stress response.  They go into what I call an adventure mode where they seek out restimulation.  They often rent violent videos, engage in war stories, and become very verbal after the feedback portion of their sessions.  So to easily sum this phase up, talk therapy says, "Talk about it and you'll feel better." and neurotherapy says, "Feel better and you'll talk about it."
*The Therapist's / Technician's Influence
In alpha theta neurofeedback, patient's enter into very open and sensitive states of consciousness.  If their therapist caries excessive anxiety, the patient absorbs it or prevents themself from going into an open state of consciousness.  If a therapist feels inadequate or frustrated because a client's EEG isn't doing what is expected, chances are it won't.  It's also important to recognize that if a therapist or the patient's conscious mind could have alleviated their symptoms, it would have by now.
Patient's usually look to their therapist for safety when they have had a particularly moving session.  If their therapist is uncentered, uncertain, and questioning the safety of the process, the patient will likely shut down and avoid going into the necessary deep levels of consciousness.
Background:  William Scott has been using alpha theta neurofeedback in combination with traditional 12 step chemical dependency treatment for the past 4 years. William and Dr. Eugene Peniston have the worlds largest study of alpha theta neurofeedback pending with the Journal of Clinical Psychology, involving 24 Native American with alcoholism.   He is currently supervising a controlled 150 subject study of neurofeedback on addictions in North Hollywood CA USA. 

Workshop # WFF2  1997 
APPLICATIONS OF ALPHA / THETA NEUROFEEDBACK IN CLINICAL PRACTICE
Bill Scott
Topics will include:
TYPICAL CLIENT PROGRESSION: We'll examine, behaviorally, cognitively, and psychometrically, how clients typically react over the course of 30 alpha theta sessions.  
POPULATION REACTIONS: We'll discuss common reactions of chemically dependent, anxious, and depressed populations.  Questions answered will be:   How do we know when it's working How to create an environment for crossover What can we do if it's not working    What makes the changes permanent Why people don't have psychotic breaks that require hospitalization
CLINICIAN'S INFLUENCE: You'll learn:   How much therapists see in client's EEG Differences in therapeutic bonding How direct unfiltered communication between therapist affects the process How to stay out of the way of a client's growth How much therapist's influence client progress Trouble-shooting ineffectiveness
NEW BAND-WIDTHS AND THEIR EFFECTS: This topic gives practitioners an understanding of frequency effects on consciousness and emotions.  It suggests what to reward and inhibit for different pathologies. 
DEMONSTRATION: We'll observe a condensed explanation of the process in an initial session You'll witness a streamlined guided visualization (with explanation) We'll review a post session graph and how to process the session

 

 
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