Also, we need a valid and reliable real-time measure of coherence that has universal acceptance within our field. This will solve the problem of not knowing how many sessions to do unless one re-q's every 15-20 sessions, which often is not practical. Because of these and other issues, it is advisable to exercise caution when deciding to initiate coherence training and do so only under the supervision of someone who has experience and is aware of the uses and limitations of each of the qEEG databases.
With these recommendations in mind, once you initiate coherence training, you will likely experience the same thing I did - amazement. You will be surprised by the degree and rate of improvement, as well as a greater range in the disorders you will be able to treat. The world of Neurofeedback, for all of its political and economic problems, is a field in which we have become accustom to having many positive resultswhile utilizing very different approaches and techniques. One group encourages rewarding 40 Hz at Cz, another advises us to reward very low frequencies, and still another purports to achieve benefit from generally quieting and stabilizing all the frequencies available to the human EEG.
Rather than be confused by these various approaches one might attribute the basis of these improvements to the miracle that is the human brain. It would be evolutionarily supported that those brains able to take in information and adapt to either accommodate to, or assimilate new information would most likely survive to pass on their genes to the next generation. Neurophysiology studies in general, and specifically those emerging from within our field, indicate that our brains have retained their plasticity; and, given the right feedback, can improve impairments caused by various sources and thus improve functioning on many levels.
Where "windows of opportunity" were once thought to close, we now see that they do not close completely if given the correct type of feedback. Unstable brains benefit from Neurofeedback that emphasizes stability training, underactive brains benefit from Neurofeedback that activates higher frequencies and inhibits lower ones, over aroused, stuck or disconnected brains likewise benefit from applications of Neurofeedback.
Following the work of "Dr. Coherence", the late Joe Horvat, Ph.D., and Neurologist Jonathan Walker, M.D., I initiated coherence training in my office about 7 years ago. Starting first with dyslexic patients and after clearly indicating to them this was experimental, I got results that were incredible. Much like the results other clinicians were reporting, the ability to better comprehend, pay attention, and reading speed all improved.
Likewise I have often wondered why some kids with few qEEG amplitude disturbances would present with severe ADD symptoms. I
examined closely the fact that many of these kids had coherence
abnormalities apparent in their qEEG. When I attended to these
coherence problems and appliedcoherence training Neurofeedback training within this subgroup, I saw significant benefits coming on-line for them.
We know that over 70% of those diagnosed with ADD have at least one co-occurring condition which, in the past, we were unable to treat. Now, we can utilize the qEEG coherence maps to treat these other issues which often amount to disconnection (hyper or hypocoherence) syndromes. I have come to appreciate the fact that these individuals will typically show hyper or hypo coherence problems particularly in the frontal lobes. This serves to amplify their apparent level of ADD but careful diagnosis often defines a co-occurring central auditory processing problem, or an impulsivity problem whose etiology is the result of disconnection-type impairments. It has now become routine in my office, which specializes in ADD, Autism, and other developmental disorders to have two phases of treatment. The firstphase attends to the amplitude abnormalities and the second phase remediates coherence issues.
I want to share an exciting application of Neurofeedback I did with a
young man who, because of adult onset schizophrenia, had to drop out of
college at the beginning of his senior year. I did 5 serial qEEG's on
him and each time treated any significant disconnections which
NeuroGuide indicated. With each qEEG I received validation that the areas in which I did coherence training went from an abnormal standard deviation to a normal standard deviation. The patient had been going steadily up on Abilify and, with the Neurofeedback training, his psychiatrist was able to reduce his medication. He completed 535 sessions of Neurofeedback over one and one-half years doing treatment 3-6 times a week, he's now of the lowest dose or completely off Abilify, and he graduated from U.S.C. in May.
I am in the process of writing this up as a case study for publication. Although it will not get any serious consideration by academics, perhaps it will inspire others to take the work further. I was inspired attempt this application because new research was pointing to Schizophrenia as a problem rooted in the creation of disconnection patterns. Apparently, at least for this patient, I believe we stayed ahead of his encroaching Schizophrenia and with the Neurofeedback he became more and more competent and exhibited fewer symptoms.
I can only speculate as to his future, but we know that adult-onset Schizophrenia has a very poor prognosis and perhaps, in this case, the Neurofeedback was able to see him through a difficult period of vulnerability. Perhaps symptoms will return, and he will return to treatment. However, this remains a powerful example of how Neurofeedback can be a tool to remediate disorders rooted in disconnection abnormalities and may one day be a treatment for this pervasive debilitating disorder.
We remain at the beginning of the application of Neurofeedback to remediate disconnection syndromes. Fortunately for the field of Neurofeedback, these
have not been known to respond to medication.
Thus we have an opportunity to avoid the struggle that has consistently plagued useconomically and politically i.e., having a powerful, wealthy, and influential pharmaceutical industry who opposes any treatment that does not emphasize drug therapy. With many disorders having a disconnection syndrome as an essential element in the expression of impairment, we can continue to look to Neurofeedback as a new tool in the rehabilitation of disease - and a powerful one, at that.