Futurehealth WinterBrain Plenary presentation by Sebern Fisher.
Affect dictates our state. When states are rehearsed they become traits. States create self justifying narratives and we believe them. Worse yet, we actually think we are our traits. When neurofeedback addresses affect appropriately, it eases the grip of state. But neurofeedback also has the power to disregulate and promote negative states. This creates a hazard in training oneself. Given that states produce self-justifying narratives, how do we assess what we are doing? It is the conclusion of this presentation that any shift in state toward reactivity be considered compelling information that our training must change.
Psychotherapists and psychotherapy theorists from all schools of thought are coming to the consensus that affect regulation is the key to successful treatment outcome, and perhaps also, to successful living. Affect dictates our state and when states are rehearsed often enough they become reified as traits or aspects of personality. States create self justifying narratives which lead us to believe them. What's worse is that we actually think we are our traits. Not only do we believe that this is how we are, but we believe that this is who we are. When I hear a neurofeedback practitioner say "That is just the way I am", I can feel protest arising. If they believe that, I think to myself, then they don't yet understand the instrument in their hands or its potential. Neurofeedback challenges state by changing the frequency based arousal mechanisms that under gird it. If you successfully change the state often enough, you can change the trait that these states gave rise to in the first place. To borrow from the Buddhists, we are never who we are, and to borrow from a friend, "As long as we have a personality, we have a personality disorder." People change when their affect and their states and their traits change. They change fundamentally.
They don't, however, always change for the better. The same principles apply. Neurofeedback when it is done poorly promotes negative states and these states too drive compelling self-justifying narratives. As practitioners, we are, hopefully, watching for this in our patients to see what adjustments in protocol or approach we may need to make. How do we watch for it in ourselves? This problem with state presents a very real hazard in training oneself. We can not, clearly, be relied upon to be the sole or even the main source of feedback on our own states. In the worst possible scenario we can train ourselves into states of fear, anger and distrust. Given that states produce self-justifying narratives, we could end up in a situation in which we trust only our own affectively driven, state dependent, and faulty self perceptions.
Self training is an ethical imperative in our work. We must be training our brains to truly understand the mechanisms at play and the profound promise of neurofeedback. But we have this tricky confound, the confound of state, to deal with. I am proposing two simple protective strategies to escape the confound. We need to be engaged in this process with at least one trusted other, the more the better here, and privilege their feedback to us over our own and secondly, we must decide, a priori, that any shift toward reactivity, fear, anger, distrust, or failure of empathy is sufficient and compelling information that we must change the training. Effective neurofeedback training leads toward attachment, trust, openness and love. This is true not only for our patients. It is most importantly true for ourselves.
Sebern Fisher is a psychodynamic psychotherapist with a primary interest in the importance of secure attachment throughout the life span. She incorporated neurofeedback into her clinical practice in 1997. The effects of brain training that she has both experienced and witnessed have had significant impact on the way she now conceptualizes personality, self, psychopathology and even free will.
Emerging theory in all fields of psychotherapy is focused on the importance of affect regulation. After almost ten years of work with neurofeedback, Sebern has come to believe that the single most important contribution of neurofeedback is regulation of affect, and further, that the most important affect to regulate is fear. In pursuit of this, she discovered the site FPO2, "the gateway to the amygdala", in 1999, and uses it specifically to quiet fear and reactivity. She has fully integrated neurofeedback into her practice of psychotherapy, rarely now, providing one without the other. She works with people suffering from conditions as apparently diverse as PTSD, dyslexia, dissociative disorders, Asperger's, and attachment disorder.
Sebern was the Clinical Director of a residential treatment center for severely disturbed adolescents for fifteen years, where she implemented the first milieu DBT program in the US. She now maintains a private practice in Northampton, Massachusetts. She is an owner of EEG Spectrum International, and speaks nationally and internationally on neurofeedback, on the integration of neurofeedback and psychotherapy, and on attachment and neurofeedback.