ALPHA-THETA NEUROTHERAPY AS A MULTI-LEVEL MATRIX OF INTERVENTION
Nancy E. White,
Ph.D. and Karinn Martin, M.S.W.
The
Enhancement Institute Houston, Texas
ABSTRACT
Alpha-Theta Neurotherapy, has been found in clinical practice, as in the
original work of Elmer and Alyce Green and further developed by Eugene
Peniston and described in his original research, to reduce or eliminate
alcoholic craving while simultaneously addressing mental, emotional,
physical and, at times, spiritual dimensions of alcoholism and surrounding
issues. The Peniston protocol of Alpha-Theta Neurotherapy is treated as a
multilevel matrix by addressing multiple diagnoses of affective disorders,
anxiety, post traumatic stress disorders, personality disorders and some
somatic complaints while simultaneously addressing the chemistry of
addiction.
The methodology of the Peniston protocol involves pre and post treatment
testing using the Minnesota Multiphasic Personality Inventory (MMPI-2) and
the Millon Clinical Multiaxial Inventory II (MCMI-II), thermofeedback
training to attune autogenic responses, the development and use of imagery
with respect to both the process and the desired outcome, and a prescribed
regimen of EEG Neurofeedback using specific neurological training sites. The
patient is encouraged to practice a post treatment regimen of regular
meditation with imagery of desired outcome along with periodic "booster"
sessions if indicated. One year of periodic follow-up is advocated to
monitor the progress of the patient.
The previous high recidivism rates of alcoholics with multiple diagnoses (comorbidity)
may stem from failure to adequately address underlying psychological
disorders in the treatment process. The Peniston protocol facilitates the
release of deep unconscious material while the patient is in a predominant
theta brainwave state. While the etiology of comorbidity is unknown, it
could be related to neurochemical imbalances that may either precede,
succeed or coincide with alcoholism. One of the reasons for the Peniston
protocol's success may be related to this possibility, since both alcoholism
and emotional conditions may be considered in terms of neurochemical
transactions. Use of prescription drugs to alleviate symptoms, while
necessary in certain cases, may be ineffective and contraindicated in other
cases and could be double-edged: it may lead back to the dependence on the
drug of choice and/or create conflict with programs demanding abstinence.
Four case studies from the files of The Neurotherapy Center are presented as
examples of the presenting problems and their degree of resolution. The
authors then present the theories of Colin Wilson (Chronic Trauma),
Stanislav Grof (COEX Systems), Bruce Perry (effects of prolonged "alarm
reactions"), Rossi and Cheek (state-dependent learning and memory) expanded
by Cowan, and Alyce and Elmer Green (Beyond Biofeedback), among others, to
help rationalize the exceptional effectiveness of the Peniston protocol in
treating multiple disorders with accompanying addiction. A final discussion
expands these ideas and brings in the experiences of actual patients, noting
the "letting go" that accompanies access to slow brainwave states,
ultimately allowing entry into a nonlocal reality (outside of linear space
and time). Within this nonlocal reality, one's awareness of self becomes
distinct from the conscious ego and one may experience "inner guidance" by
means of which, frequently in a dream or "vision," one may release
unconscious material, heal psychic wounds and subsequently experience a
change in one's phenomenal world. The authors see the ability to promote
these outcomes, and the power of the protocol, in effect, as resting in
training the patient to enter and hold a deep slow brainwave state
simultaneously with intention of a desired outcome. Implied is the
possibility that cogent intent, held in the slow brainwave state, can
produce shifts in neurochemistry.
INTRODUCTION AND BACKGROUND
In March of 1989, when Eugene Peniston's and Paul Kulkosky's research was
published in Medical Psychotherapy, it may have heralded a major shift in
the future course of therapy for addictions. Their research amplified the
prior work of Elmer and Alyce Green, Dale Walters, Margaret Ayers, Barbara
Brown, Joe Kamiya, Les Fehmi, Tom Budzynski and others over the past twenty
plus years. The Peniston Protocol created a multilevel matrix approach which
could simultaneously treat the multiple diagnoses of affective disorders,
anxiety, post traumatic stress disorders, personality disorders, some
somatic complaints and addiction (Peniston, 1989, 1990, 1991) comprising the
horizontal axis with the unconscious, the physical, emotional, mental,
spiritual and transpersonal forming the vertical axis. Computerized EEG
feedback, a therapeutic relationship and the imagery of desired outcome,
interfaced technology with compassionate personal contact. This protocol
worked concurrently on overlapping addictions and the underlying
psychological state.
Figure 1. The Peniston Protocol creates a multilevel matrix of intervention
with its horizontal axis of diagnoses & presenting problems & its vertical
axis of levels of the Self & Self connected to All That Is.
The April, 1991 issue of Men's Health magazine commented on a study reported
in the Journal of the American Medical Association
"Why do many alcohol or drug addicts repeatedly sober up, only to relapse?
They may be suffering from underlying preexisting mental illness, including
manic-depressive and anxiety disorders, depression and schizophrenia.
"A recent study conducted by the Federal Alcohol, Drug Abuse and Mental
Health Administration and published in the Journal of the American Medical
Association (JAMA) points up the futility of repeatedly detoxifying addicts
without addressing their mental problems. Researchers also find that
psychological treatment is useless while a mentally ill person is abusing
drugs or alcohol. The answer appears to be tackling the symptom and the
underlying cause simultaneously."
As many as 30% of all individuals treated for chemical dependency and 50% of
all individuals treated for psychiatric/psychological disturbances may be
suffering from both a chemical problem and mental illness (Continuum, 1993).
JAMA states that among those with an alcohol disorder the lifetime
prevalence of at least one other mental disorder was 70%. The highest
comorbidity rates are for affective, anxiety, and antisocial personality
disorders (Regier, 1990).
Dual diagnosis patients are difficult to treat and have high recidivism
rates according to an article by Wolpe, Gorton, Serota, and Sanford in
Hospital and Community Psychiatry, January, 1993. Levy and Mann reported in
the Journal of Substance Abuse Treatment in 1988: "Dually diagnosed patients
have problems beyond alcoholism that complicate recidivism; problems in
regulating thought, affect, and behavior; poor self-esteem; and low
frustration tolerance among others" (Continuum, 1993).
From a scientific perspective, the etiologic mechanisms underlying these
high rates of comorbidity remain undiscovered. Common neurotransmitter
systems have been identified for some mental and addictive disorders. For
example, dopamine system dysfunction has long been considered a factor in
certain forms of mental illness and dopamine-mediated psychological reward
and reinforcement functions have been demonstrated more recently to be
related to substance abuse (Ritz, 1987). The system for producing and
distributing serotonin also has been critical to the understanding and
treatment of affective disorders (Goodwin, 1973), and decreased serotonin
metabolite levels have been found in the more aggressive and impulsive
population of young male alcoholics (Ballenger, 1979). Evidence also
suggests that certain mental disorders such as affective and anxiety
disorders may precede the development of substance abuse problems, although
there is increasing argument that certain mental disorders are actually the
result rather than the cause of substance abuse disorders (Schuckit, 1988).
It is difficult to ascertain which came first, the addiction or the mental
illness, or were they born hand in hand through some imbalance in the
neurochemistry (Blum, 1991) and/or core trauma?
It is not uncommon for addicts to present depressive symptoms prior to
addiction and, if not that, they may have feelings of worthlessness and
guilt about what they have created out of their chronic addiction. The
recovering addict is often anxious. Suicidal ideation, especially in the
addict detoxing from cocaine, is also encountered. Recovering individuals
often report that they feel worse than they did when they were using. Their
behavior is still addictive with the major change being that they are no
longer using their drug of choice. Often they exhibit personality disorders.
One way of treating this problem of dual diagnosis, or perhaps multiple
diagnosis, has been to give the patient drugs. The presence of medication
can interfere with the treatment of addiction. Addicts may have come in with
the desire to get off drugs and not to use anymore, but use the prescribed
medication as an excuse to sabotage their treatment. Perhaps pleased to not
have to go chemical free, the addict could assume that since the doctor
prescribed medication that the doctor must agree that he or she can't live
chemically free in order to function. Any regularly prescribed medication
could lead to this thinking process. So, addicts may rationalize that, since
they can't live chemically free, they may as well take their drug of choice
rather than the prescribed chemical (Reilly, 1989; Sweben, 1993).
There are considerations concerning medication in another direction as well.
Compliance with an aftercare program is strongly associated with improved
outcomes, lowering the recidivism rate. A strong support system is an
important factor (in recovery), yet many twelve step groups such as A.A.
(Alcoholics Anonymous), C.A. (Cocaine Anonymous) and N.A. (Narcotics
Anonymous) view the use of even essential psychotropic medications as
"using" or not remaining substance-free. This leads to conflict with sponsor
and/or group support and possibly damaging compliance with the prescribed
drug regimen. Many times these patients simply return to the former
situation, which often leads to a return of their addiction and
mental/emotional symptoms. (Continuum, 1993; Erickson, 1991).
We are not speaking against medication; sometimes it proves to be the best
way of handling the multiple diagnosis problem. If there is an effective way
to promote what appears to be more permanent healing and recovery without
medication, however, we would prefer it.
TREATMENT METHODOLOGY
At The Neurotherapy Center we have found that the Peniston Protocol of
Alpha/Theta neurofeedback has allowed us to affect addictive craving
directly and to simultaneously address physical, emotional, mental and,
sometimes, spiritual levels of the disease. Since emotional problems, as
well as addictive craving, may ultimately be explainable in terms of
neurochemical transactions, by extrapolation we can speculate that the
protocol works to alter the nature of some of these transactions in a
lasting way; but this has yet to be proven. Even though the exact mechanisms
by which this breakthrough protocol works are not yet known, the method is
producing a high level of positive clinical results. For example, a recent
survey of several of the leading practioners using Alpha-Theta Neurotherapy
estimates that the success rate of outpatient treatment is in the range of
60 to 70%, while the inpatient success rate is in the range of 70 to 80%
(Walters,1994). We wish to present a method of treating with this
multileveled matrix of healing and to offer actual case studies as examples
of achievable outcomes. Later in the Chapter we offer some ideas, based on
some leading theories, as to what may make the Peniston protocol so
effective.
Our treatment incorporates the protocol developed by Peniston (1989, 1990,
1991), with allowances made for our outpatient clinical setting, and is
developed in the following paragraphs. The outpatient model we have
developed leaves the Peniston protocol virtually intact. Imagery, while
following the guidelines of the protocol, may be directed more to a
patient's specific needs and presenting problems. A minimum of four
treatments per week is indicated, scheduled to recognize to the extent
possible the demands of the patient's outside life. Severe cases may receive
two treatments per day, with a minimum three-hour interim between
treatments, up to four days a week. The accelerated pace may continue just
for the first several weeks of treatment or may last the entire time.
Adjunctive treatment may be called for in certain cases, such as individual
psychotherapy and/or CES treatments. When we treat an addict from another
city we help them find living arrangements conducive to sobriety - often a
halfway house that understands our program - and assist them in joining a
support group, either one of our own or another. We also conduct random drug
and alcohol testing on addicts during the course of treatment.
Intake and Assessment
The initial phase of assessment utilizes the Peniston procedures which
involve:
1. Pre-treatment psychological testing: Patients complete The Minnesota
Multiphasic Personality Inventory-2 (MMPI-2) and The Millon Clinical
Multiaxial Inventory II (Millon II) prior to beginning the treatment.
2. Medical history
3. Addiction history
4. Neurological conditions including any head trauma history
5. Personal history
(with emphasis on any mental, emotional or physical trauma, particularly in
childhood)
6. Needs and goals of the patient assessed
7. Explanation of the program
8. Patient commitment to the program
Pre-Treatment
Patients complete the MMPI-2 and the Millon II and fill out a personal,
medical and addiction history, a neurological checklist and completes a
quantative EEG prior to beginning treatment. We then meet with the patient
to review the outcome of these assessments. At this time an overview of the
EEG brainwave training is explained. The needs and goals of the patient are
assessed and any mental, emotional or physical traumas of childhood are
discussed.
Thermofeedback Training
The Peniston protocol begins with four to six thirty-minute sessions of
thermal biofeedback-assisted autogenic training. The subject is instructed
to sit in an Alpha chair (manufactured by Sensory Environment Engineers) and
to relax with eyes closed. These chairs are used to accelerate/heighten the
patient's auditory stimuli and create a feeling of environmental security.
The Alpha chair is a cushioned egg-shaped chair with strategically placed
speakers wrapping their sounds around the occupant. A temperature sensor is
attached to the middle finger of the subject's dominant hand, collecting
data received by a J&J I-330 instrument. Autogenic phrases are presented to
the patient by way of an audio tape. Individuals who are auditorily
non-responsive are assisted in creating effective visualizations for
themselves instead. The patient is taught deep rhythmic breathing techniques
to induce relaxation of the body and to quiet the mind. A training criterion
of warming the hands to between 94 and 96 degrees Fahrenheit is established.
Imagery Development
Following the thermal training but prior to the brainwave training, one
session is devoted to the clarification of the patient's goals and imagery
is constructed to represent the patient's desired outcome. An alcohol
rejection scene is developed relevant to the patient's previous drinking
behavior (Peniston, 1989; Fahrion, 1992). The patient is shown a picture of
delta, theta, alpha, and beta brainwaves with an explanation of the state of
consciousness that predominance of each of these brainwaves represents. Next
he or she is instructed to visualize initially increasing the amplitude of
their alpha brainwaves and is told that at some point during the feedback
sessions that the alpha amplitude will usually begin to recede and the theta
amplitude will rise. The exception to this instruction would be the patient
who initially has very high alpha amplitude, in which case the alpha audio
feedback will be turned off and they will be instructed to visualize
increasing the amplitude of the theta brainwaves from the beginning of the
feedback sessions. The next task includes the visualization of one's
hypothalamus gland in the center of the brain and requesting that it
optimally balance the production of neurotransmitters. The patient is then
assisted to create an image of his/her ideal self as he/she wants to be,
handling in a positive way the important personality and social issues in
his or her life. Next the patient is told, "Let yourself sink down to a
state just before sleep without going to sleep." The final step is a
directive to the subconscious stating, "Please bring to me anything out of
my past that I may need to see or experience for my healing," and then,
lastly, giving the simple command of "DO IT!"
Neurofeedback Therapy
The patient is then given 24 to 26 sessions of alpha-theta EEG feedback, a
total of 30 sessions overall although additional sessions may be indicated
for some individuals. The most common schedule is four sessions of brainwave
training per week with a duration of 45 minutes to an hour each which
incorporates 30 minutes of active feedback. The patient is instructed to
differentiate the alpha and the theta audio feedback tones. The patient sits
in a semi-darkened room, in a comfortable reclined chair with the eyes
closed and is generally left alone during the active feedback period. The
clinician remains nearby in order to make any threshold changes (explained
further below) that might become necessary, or to handle any problems. The
process of the patient is not interrupted during the feedback session but
with a few patients who were inclined to go to sleep, the clinician was
available to lightly tap them on the arm to bring them back from sleep. The
clinician might suggest that the patient incorporate, "Tell your unconscious
mind to keep you awake during the session."
While there are a number of good computerized EEG systems on the market, we
have been using the CapScan Prism Five (CapScan Corporation) to monitor the
EEG and provide harmonic auditory feedback. The feedback is presented from
the left occiput (Green, 1977, Peniston, 1989). Three active, user defined,
bandpass filters are set at theta (4-8 Hz), alpha (8-13 Hz) and beta (13-26
Hz). Auditory feedback is provided for alpha and theta independently when
brainwave frequency exceeds thresholds. A concurrent bar graph is shown on
the screen during the patient's alpha-theta training experience. At the end
of each session, a statistical analysis and graph is produced of the mean
amplitudes of theta, alpha and beta and is reviewed with the patient.
Earlobes, forehead and scalp are cleansed with alcohol and rubbed with Omni
Prep and White Signa Cream used to reduce electrode resistance prior to
applying the monopolar electrodes. Electrodes are then placed on FP1, FP2,
O1, O2 (International 10-20 placement, Jasper, 1958) and a ground electrode
placed midway between FP1 and FP2 and reference electrodes placed on both
earlobes. The electrodes are held in place by velcro and a headband.
Electrode impedance is checked before recording begins and electrodes are
reapplied accordingly for an impedance of less than 5,000 ohms. Thresholds
for alpha and theta are set in order to provide feedback, triggered if the
occipital (O1) alpha or theta go above these preset thresholds. Thresholds
are adjusted appropriately throughout treatment maintaining approximately
70% feedback. The initial increase of alpha amplitude seems to enable the
subject to release physical and mental tension, whereby a deeper, or theta,
state of mind surfaces. As the alpha state deepens, the individual lets go
of the waking ego state, thus evoking the "window" to the subconscious as
theta becomes dominant.
The desired ratio of theta amplitude over alpha amplitude is 2:1. While most
alcoholics have low amplitude alpha, we have found that some exhibit high
amplitude alpha initially. In these cases, since the original software had
no capacity to set an inhibit or to support ratio training, the alpha
feedback was eliminated or set above the patient's average amplitude in
order to avoid reinforcing excessive alpha production. When the patient
begins to produce a predominance of theta brainwaves, a "crossover" occurs
(theta at a higher amplitude than alpha). Once crossovers begin to occur
regularly, perceptual and behavioral shifts become evident, cravings
diminish or disappear and abreactions related to repressed subconscious
material emerge. These abreactions seem to emerge naturally in approximately
40 to 60% of the patients with no coaxing from the clinician except the
previously stated suggestion, "Please bring me anything of my past that I
may need to see or experience for my healing."
At the beginning of the session, as the electrodes are being placed on the
patient's head, any relevant issues are processed that may have come up
since the last brainwave training session. At the end of the session, the
clinician is available to process any abreactions or experiences that the
patient had during the session. The clinician listens, not interpreting but
allowing the patient to find their own insights. (As a general rule, the
patient is not interrupted during the feedback.) The patient is then asked
to fill out a post treatment session form which inquires as to their
experience during the session. This writing seems to assist the patient in
returning to normal waking consciousness (beta dominant) and helps them to
integrate whatever experience they had during the session. It also provides
a record for them and us to follow their progress.
POST TREATMENT PROGRAM
The patient is administered a second MMPI-2 and Millon-II post treatment to
determine levels of change. The changes are noted and discussed with the
patient. The post treatment interview involves the review of the patient's
preset goals, assessment of changes in the person's attitude, behavior and
perceptions and recommendations for the future. Such recommendations may
include extension of treatment, periodic "boosters", twelve step groups, and
the continued practice of entering the slow-wave (theta) state with the
intention of a desired outcome. Follow up phone calls are made at 3, 6 and
12 month intervals.
CASE STUDIES
This multi-modal neurotherapeutic approach seems to address the many
dimensions of the individual who, while in treatment for addictions, often
exhibits multiple mood disorders, personality disorders and/or somatization
disorders. We have found this EEG brainwave training to facilitate the
simultaneous integration of the patient's mental, emotional, physical and,
at times, spiritual dimensions. The far reaching effects of this treatment
are more easily appreciated by examining case studies.
Case Study 1 - B.K.
We have found that nearly all our patients that are treatment resistant
and/or high risk present with multiple diagnoses. B.K. is a good example.
She was a 43 year old female referred to us by her A.A. sponsor. The sponsor
reported to me that this woman had been sober for about two years until she
had slipped about two months prior. She was active in AA but was craving
alcohol and the sponsor said she had done all she knew to do and hoped that
we could help.
When she came in for her first appointment it was obvious that she would be
a difficult, if not impossible, case for more traditional psychotherapy. She
had an eating disorder and was obese; she was experiencing frequent panic
attacks; she was self mutilating, depressed and often had suicidal ideation.
She also had migraine headaches. The most difficult aspect of her case was
that she was emotionally phobic. She was unable to express any feelings and
would panic, become immobilized, dissociate or leave and get drunk when
pressed to face any situation that was emotional. She came from an alcoholic
family. Her sister is an alcoholic; her mother, a nurse, died of alcoholism;
her father, a doctor, now senile, is also an alcoholic. Her mother's brother
froze to death on the porch at age 19 when he came home drunk and his family
would not let him in the house. She knows that her father's father was
alcoholic and believes that her mother's father may have been an alcoholic
also. Our assumption is that there is a genetic component to her alcoholism.
(See figure 2.)
Figure 2. Genogram depicting the multigenerational family of B.K.
Her initial testing with the MMPI-2 revealed an anxiety disorder or
dysthymic disorder within a schizoid personality. Both of the diagnoses fit
our clinical impression of her. Her testing also showed a possible
schizophrenic disorder. The results of the testing with the Millon II
revealed her as quite elevated on borderline personality, compulsive and
dependent scales, all of which also fit our impression of her.
She agreed to treatment using Neurotherapy. After the sixth session, she
experienced abreactions during the session and was having auditory
hallucinations but desired to continue with the feedback sessions. She began
having flashbacks and on the fifteenth session she experienced a flashback
and realized that she had been sexually abused in the crib, presumably by
her father. She recognized this as the probable core of her lifelong
problems (Ross, 1989; Grof, 1985; Perry, 1992). She experienced many
flashbacks of incest and physical abuse by her alcoholic mother and father.
She had lived her life as a victim (her own and others'), yet when she had
the flashback of the crib abuse, her adult self appeared in the room and
said in a booming voice, "How dare you!" This was a "Resource Self" that had
not appeared in her life before.
Using the Neurotherapy, we have found that this phenomenon of the Resource
Self occurs with many female cases who have experienced sexual abuse. The
adult self will enter the flashback and say "How dare you!" or "Don't you
ever do that again!" and rescue the child. An inner resource is reclaimed.
The patient is never fully the victim again. This has been a spontaneous
occurrence emerging from some part of the self and not programmed by us.
B.K. completed the treatment with a total of 30 sessions. She was retested
(See figure 3). The MMPI-2 showed no clinical diagnosis on Axis I and
personality disorder NOS on Axis II. There was a major drop in the
depression scale from 81 to 53. She was no longer suicidal. She showed the
same shifts on the Millon II with the dysthymia scale dropping from 102 to
34. Borderline dropped from 86 to 70, which also fit our impression of her.
Perhaps most noteworthy was her pre Millon II score of 71 on the schizoid
scale denoting her unwillingness to process any emotional content. Her post
score of 00 on this scale suggested that she could be emotionally available
for further therapeutic treatment. The elevation of histrionic on the post
treatment Millon II, may be perceived as a positive developmental step also
suggesting she was now not so blocked to her emotions. She was still
slightly high in psychopathic deviance on the MMPI-2 scale. We often see
this scale remaining slightly high after EEG feedback training which could
be related to creativity and independence. She came in for five booster
sessions during the first year when she felt stressed and sensed that she
was losing some of her inner peace and connection to herself.
After the completion of the Neurotherapy program, she had no craving for
alcohol and was able to face her emotions. She then went through our PAIRS
program which is an intense 120 hour group program extending over four to
five months, attended by couples and singles. The focus is predominantly on
the relationship with one's self. It is a very emotional experience and our
belief is that she could not have gone through this if she had not completed
the EEG feedback training.
She was called for follow up and after three years she is still doing very
well. We recently saw her at a lecture and she came up to speak to us. She
looked wonderful. She was still overweight but was no longer bingeing on
food and she has remained sober. She has a good relationship with her
husband and is doing well on her job. She thanked us again and said, "I owe
it all to you."
Case Study 2 - M.M.
An interesting 35 year old male (M.M.) came in for therapy in December of
1990. He was a bright, attractive professional. During the course of the
first meeting, he remarked that he smoked marijuana every day. He was told
that if he wanted his therapy to be effective he would have to stop. He
commented that he couldn't and spoke of his inpatient experience two years
prior. He had gotten high the afternoon he got out of treatment.
Figure 3. Pre/Post testing graphs of the MMPI-2 (top) and the Millon II of
B.K.
He had begun drinking at age 13 and drank to get drunk every weekend. He
began smoking marijuana at age 14. By age 15, he had a goal to try every
psychoactive substance at least once and studied the Physician's Desk
Reference (PDR) to be sure he didn't miss anything. He had had uppers,
downers, heroin, amphetamines, LSD, cocaine, quaaludes, and so on. As far as
he knows, he accomplished his goal with the exception of the drug "ecstasy."
He would go to Mexico to buy drugs to sell and would test them by shooting a
small amount in his vein and could quickly tell the quality by the taste in
his mouth. If it was good, he would buy it. By age 22 until he began his
treatment, he had had drugs and/or alcohol almost daily.
When M.M. left his inpatient treatment and immediately relapsed, he realized
he could not stay off drugs and so he concocted his own therapy which
consisted of heavy doses of $320 per ounce marijuana every day. Nothing else
would suffice. Every other weekend he would take crack cocaine for several
days until his body would collapse. This was the state he was in when he
came in for therapy. He was depressed. His wife had put him out of their
house and he was living alone in an apartment.
There were multiple addictions throughout several generations of his family.
He had had a difficult childhood with a controlling, demanding father who
beat him and a depressed mother who felt helpless in her situation with her
husband.
Fig. 4. Genogram depicting the multigenerational family of M.M.
He smoked his last joint the day after Christmas on December 26, 1990. He
then came in for the Neurotherapy which he completed in early March of 1991.
Upon completion, he had no craving. Both his MMPI-2 and his Millon II show
remarkable changes. On the pre Millon II, narcissistic, antisocial,
aggressive/sadistic and borderline conditions are almost off the scale. The
improvement can be seen in the post test which fits our clinical impression
of him. His dysthymia scale went from 82 to 11 on the Millon II and
depression scale went from 72 to 47 on the MMPI-2.
Figure 5a. Pre/Post testing graph of the MMPI-2 of M.M.
He moved back in with his wife and his children and is successful in his
professional practice. He is active in an AA program. On his one year follow
up, he reported that he had had the best Christmas he had ever experienced.
His parents and sister had come to visit and had brought him a gold key
chain to celebrate his year of sobriety.
At eighteen months, he was in a highly stressful situation and relapsed for
several days. He immediately came in for six boosters and left feeling good.
(It has been our experience that patients completing the Neurotherapy
program, should they relapse, are more likely to quickly return for boosters
and continue abstinence.) It has now been more than four years since his
original treatment and, except for his brief relapse, he is doing well and
experiences no craving.
Figure 5b. Pre/Post testing graph of the Millon II of M.M.
Case Study 3 - K.H.
The next study is K.H., a 28 year old female. She came in for individual
therapy subsequent to a suicide attempt. She and her husband were both drunk
and she attempted to jump out of the car moving at 55 mph on a freeway. When
she sobered up, she was frightened of her behavior and was aware she needed
help. Her diagnosis included alcoholism, PTSD (post traumatic stress
disorder), dissociative disorder, depression and she was experiencing
frequent and severe panic attacks. She had an abusive relationship with her
alcoholic husband.
When she came in, she was told that she must stop drinking. She looked with
dismay and said, "I don't think I could stand the pain of my life without
alcohol." She was encouraged to try the Neurotherapy treatment which, in her
desperation, she agreed to do.
Upon examination of her genogram, it was obvious she was from a
multigenerationally addicted family. K.H. realized she had been an active
alcoholic since her father began giving her beer when she was one and
one/half years old. Her childhood had been very difficult. She was neglected
and was even sent home from school as being dirty. Her alcoholic father had
died when she was seven. Her mother remarried a friend of her brother's who
subsequently sexually molested her.
At age twelve, she was raped by a friend of her brother's. She became
pregnant and had an abortion. She was also sexually abused by this brother.
During this period of her life she began seriously abusing alcohol. She was
gang raped her first year of high school. She spoke of herself as "a piece
of sh*t."
Figure 6. Genogram depicting the multigenerational family of K.H.
Depressed, suicidal and craving alcohol, she began the Neurotherapy program.
After two weeks, she was amazed she had been able to go without alcohol. She
did not remember having gone a day without alcohol in many years. She had
one beer several weeks after starting the Neurotherapy program but felt so
sick the next day that she said she did not think she would ever have
another drink. (This was probably the "bone sick flu" that Eugene Peniston
speaks of and will be discussed later.)
During the program, she had many flashbacks. At one point she saw the face
of her rapist just in front of her. In this deep theta state, without the
resistance of the waking ego, her adult resourse self was able to facilitate
rapid integration of these past traumas and began to feel much better about
herself. She is no longer suicidal or depressed and has had one minor panic
attack in the three years since treatment. Her PTSD (post traumatic stress
disorder) seems to be resolved. She still has the problem of an alcoholic
husband, does not live in a supportive environment and has refused to go to
AA, but has managed to maintain her own sobriety. She has enrolled in
graduate school and plans to get her masters degree and teach science to
high school students. She is enthusiastic and thinks her life experience
will help her to have more compassion and understanding for her future
students. Her self esteem has risen considerably and she has commented that,
even though she loves her husband, she knows she will have to divorce him
when she completes graduate school. She plans to move away from this city
and stated that she thinks too much of herself to live in the environment
with a drunken husband for the rest of her life. This was a long way from
her earlier self-deprecating definition of herself as "a piece of sh*t."
She has now been sober for three years. She has no craving and no desire to
drink. Her dysthymia scale on the Millon II dropped from 79 to 24. This is a
scale where we see major drops with most of our patients. Borderline
personality dropped from 76 to 62. We often see improvements in the
borderline scale after treatment, which generally fits our clinical
observations. Her post treatment Millon II shows improvement but the
self-defeating and passive-aggressive scales are still quite high.
Her MMPI-2 shows considerable change. On the pre treatment test seven of the
ten scales were elevated. In the post treatment test, she is within normal
limits and is only slightly elevated on the paranoia scale. Again, the
depression scale dropped from 72 to 58. Her ego mastery went from 74 to 49.
She comes in for individual therapy sporadically and is continuing to feel
better about herself and her life.
Figure 7. Pre/Post testing of the MMPI-2 (top) and the Millon II of K.H.
Case Study 4 - M.B.
This attractive 30 year old female (M.B.) had been referred to our office
three years prior. Her life was quite dysfunctional but she came for only
three appointments in 1988 and then we did not see her again until she
appeared in March of 1991. Her life was in shambles. She was depressed and
suicidal and she had recently attempted to overdose on sleeping pills. She
had smoked marijuana daily for six years along with frequent use of alcohol.
As her mother had been, she was addicted to prescription drugs, particularly
speed. She had had a recent automobile accident and was in a state of
anxiety. She was acting out sexually and had three abortions that year. She
had a panic disorder, dissociative disorder and PTSD. She had a bipolar
disorder, her depression was interspersed with mania. She had a
dysfunctional relationship with her fiance, which was close to breaking up.
She had rage attacks which, among other things, were contributing to the
destruction of the relationship. This was the impetus that brought her back
to therapy. She was highly intelligent, yet unable either to focus mentally
or to concentrate and she had had to drop out of law school. She was having
as much difficulty physically as she was emotionally. She had gained weight,
was chronically fatigued and had asthma, allergies and anemia. She had a
sleep disorder, hypoglycemia, and dizziness. She was taking diet pills in an
attempt to lose the weight she had gained.
Her parents divorced when M.B. was three months old. Her father, a lawyer,
was wild and irresponsible and she was raised by her paternal grandparents
in a home that was chaotic and dysfunctional. Her mother, that she remembers
having seen only once after the divorce, later died of an overdose of
heroin.
Figure 8. Genogram depicting multigenerational family of M.B.
M.B. was quickly able to raise the temperature of her hand to 95 degrees and
to maintain it at that level. She moved to the EEG training by the third
session. Her imagery was simple. She imagined herself at the beach as "calm,
natural, stronger, rejuvenated, and with a broader perspective of life." She
then imagined her work and relationship as "calm, thinking before
responding, and expressing feelings appropriately." She then imagined a drug
rejection scene and ended with seeing herself as she wished to be. During
the training, while in the theta state, she had flashbacks to her chaotic
childhood and experienced her crying and terror. Much of this was
experienced in the "witness" state of consciousness. Due to the issue of
childhood sexual abuse, she requested a change to a female therapist after
which she was able to process her abreactions more effectively.
She had a total of 30 sessions, two of thermal biofeedback and 28 sessions
of EEG training with alpha/theta feedback. This was over a period of
approximately eight weeks. She has since married her fiance, a medical
student who was very skeptical of the treatment, but who now thinks it was a
miracle. She has gone back to law school and additionally is conducting her
own international business. She has no craving for drugs or alcohol.
In a six month follow up, M.B.'s comments were, "Being able to enter a
deeper state has helped me in a variety of areas. I have lost thirty pounds
and have a desire to get back to running. I was previously so lethargic. I
am clearer thinking and feel so much more mentally focused. I have a
healthier personality. My depression is gone. If I begin to feel down, I get
myself relaxed and I handle the situation well. I use the visualization. I
can take rejection better (a previous problem for her) and I accept it. I am
physically healthier than I have ever been in my life. Previously, I wasn't
taking care of my life." She is no longer on any medications.
Figure 9a. Pre/Post testing results of the MMPI-2 of M.B.
Figure 9b. Pre/post testing results of the Millon II of M.B.
THE POWER OF THE PROTOCOL
Thermal Biofeedback - Self Mastery
It is our belief that the Peniston protocol in its entirety is the power of
this therapy. In our clinical setting, we are delighted with our outcome and
do not wish to break the protocol into pieces for examination but recognize
that for purposes of research it may be advantageous to attain further
information about its many aspects. To examine the parts of the protocol and
the power of each, we look first at the thermal biofeedback with autogenic
training which leads one to experience a sense of self mastery of an aspect
of the autonomic nervous system that heretofore most believe is out of
conscious control. It reduces stress and readies the body/mind system to go
to the deeper levels in preparation for the "theta state of consciousness"
and, in the field of biofeedback, it has long been recognized that this self
mastery brought with it feelings of personal empowerment. We are preparing
the proper psychophysiological environment where awakening can occur (Wuttke,
1992).
Educating and Programming the Conscious and the Subconscious
Next we visually educate our patients with the nature of brainwaves and
relative states of consciousness as a preparation for the desired
performance of the conscious and the subconscious mind.
Showing our patients a model of the brain, we explain in layman's terms the
neurotransmitter system and the optimum balance of this system and believe
that this offers them a program and a picture for the subconscious mind to
follow. We co-create with the patient an alcohol rejection scene or other
appropriate rejection scene and end with seeing oneself as one wishes to be.
"Programming the unconscious" (Green & Green, 1986) was explored in the late
1960's by Dr. Elmer Green, who revealed that he had modified an approach to
changing life patterns that he had excerpted from the ancient Yoga sutras:
Hold the image of change firmly in mind as you quiet down both physiology
and thought processes, and then release it without attachment (Cowan,1993).
With this aspect of the protocol we agree with Jon Cowan who states, "From
the viewpoint of learning and memory, the repetition of intentional images
or visualizations is quite different from a series of guided imagery
experiences. It is much more likely to reinforce learning and produce the
overlearning of the particular response that is important in creating
personal change." Dr. Deepak Chopra (1993), author and endocrinologist,
tells us that imagery creates intention and intention automatically seeks
fulfillment.
Altered State - The Nonlocal Reality
We believe that the imagery is very important but that the strength of this
therapy lies within one's ability to enter and be held in a deeply altered
state with intention of desired outcome. We live in a world that rewards the
state of consciousness that we will refer to as the "beta state." It is
predominately narrowly focused, rational, linear, more interested in "doing"
than "being," and productive, but, due to the narrow focus, is limited in
its perceptions of reality. It gains its wisdom and insight predominately
from the five senses. It is a world of objects. Sole reliance on this method
of brain function inherently activates the ego self (adapted self) with its
fears, anxious thoughts, need to be in control and "hold on." We rock
between pleasure and pain. Even when we are in the pleasure, we fear the
loss of the pleasure, putting us back into the pain. The state of
consciousness where the brainwave pattern is predominately low alpha and
theta is more openly focused and attention is divided among multiple objects
(Fritz & Fehmi, 1982). As we move the predominant brainwave frequency into
the lower realms, there is a surrender or "letting go" of control. We move
into an emptiness of space where we are conscious and aware but not aware of
being aware until we return to the thinking mode. It is here that we
encounter the nonlocal reality where we transcend ordinary space and time as
we know it, a world behind the scenes that is beyond the world of objects
and persons.
In the "normal" or usual state of consciousness, in both our internal
perception and our external perception, we experience ourselves as existing
within the boundaries of our physical body and are confined by the usual
spatial and temporal boundaries. We vividly experience our present situation
and our immediate environment. We recall past events and anticipate the
future. In the training with feedback tones of a computerized EEG, as the
patient obtains deep alpha and theta states, there appears to be a
disidentification with the ego self which includes the physical body. "After
several minutes of a lot of alpha and theta I began to feel quite
disassociated from the sound, as though out there was all the activity, and
my brain was completely passive. With this feeling came the disassociation
with my body..." states J.H. in Beyond Biofeedback (Green & Green, 1977).
Subjects consistently experience a sense of ego-lessness, a "pure being
state." They have no consciousness of a body or their life "drama". They
frequently experience a sense of being "pure energy." Light and colors are
experienced by some, contributing to a profound sense of well-being and
inner peace. One woman experienced gold and purple swirling in the center of
her forehead bringing with it a feeling of joy and ecstasy.
Figure 10. In the "beta state" of consciousness we rock between pleasure and
pain. As we lower the brainwave frequency, there is a letting go and
surrender in the "alpha state" moving into the "Void" or deep "theta state."
Dr. Larry Dossey (1993), speaking about the nonlocal reality, refers to this
void that is encountered in the deep theta state as follows: "Paradoxically,
this void becomes the fullness that gives rise to everything in the visible,
phenomenal world. Modern physics seems to echo this vision. For example, in
devices called cloud chambers, we can easily see subatomic particles
appearing out of the void and disappearing back into it - the mysterious
transformation of energy into visible matter and matter into invisible
energy. Science, therefore, clearly shows us that the void, whatever else it
may be, is not nothing."
Several of our patients have experienced the sensation of being "out of
their body." There is, distinctly, a double recollection of two bodies. One
is sitting in the chair with eyes closed in a deep state of consciousness
hearing the tones of the machine as it rewards the attainment of the preset
thresholds of alpha and theta. The "other" self is floating on the ceiling
observing the self in the chair. With this state comes inner peace and the
awareness that one is not solely his or her body bringing with it the
appreciation that one is more than one's body.
It is not unusual for some patients to experience an "inner guidance." This
takes many forms, on a continuum from deep insight to the sense of another
being or animal appearing to them. One middle aged professional man, who had
not had any prior experience of the transpersonal realm, experienced a guide
that he referred to as his "Higher Power" which appeared in different
guises. Initially his guide appeared as a hawk and then as a snake.
Frequently, the guide appeared as a native American who told him he was his
great, great, great grandfather (who was known to have been an American
Indian). The hawk took him on his wings and soared out into the cosmos. From
there, the hawk pointed out the earth to him and then the pinpoint that was
his home. He explained to him the insignificance of his local reality in
comparison to the vastness of the cosmos. No sooner than he had absorbed
this idea, he was quickly propelled to the earth where he was taken to the
microcosm world of the earthworm. It was then explained to him the
significance and importance of all things. Truth is often found in paradox.
This same man had had a difficult relationship with his father for most of
his life. They were not close and he didn't understand his father and his
coldness. During the session, he was taken back before his birth and back in
time where he was shown the conditions of his father's childhood and the
conditions of his father's relationship with his father (the patient's
grandfather). He returned to normal waking consciousness with a new
understanding and compassion for his father. Stanislav Grof (1985) tells us,
"Sometimes the regression appears to go even further and the individual has
a convinced feeling of reliving memories from the lives of his or her
ancestors, or even drawing on the racial and collective unconscious." Elmer
Green (1977) describes theta training as a path to access planetary
consciousness.
One female patient was taken by an angel to her father's deathbed where she
was able to heal old wounds and say several things she had not been able to
say to him when he was living. She returned with a deeper sense of inner
peace. For those who experience an "inner guidance," they express a major
shift in perception about their lives and environment.
A recurrent phenomena observed by many patients and our staff is the dynamic
interconnections between the individual's inner experiences during the
neurotherapy and changes in their phenomenal world. It has not been unusual
to find that as our patients change during this therapy that other family
members change, often without contact as in the case of one woman who had
come from out of town and lived with her son during the duration of the
therapy. She and her husband had had a very difficult and dysfunctional
relationship and, even though she was in her sixties, she was contemplating
divorce at the time of her arrival at our office. When she returned to her
home, she found that her husband had experienced a positive personality
shift. This had seemed to occur simultaneously with her neurotherapy and did
not appear to be solely in response to her on the level of the five senses.
Again Grof (1985) speaks of change in others congruent with the changes in
the individual during the therapy sessions and happening quite independently
and not explained in terms of conventional linear understanding of
causality. The persons involved may be hundreds or thousands of miles away
at the time with no physical communication between the persons involved. For
explanation we could turn again to physics and a famous mathematical
formula, known as Bell's theorem (1964) that holds that the reality of the
universe must be nonlocal; in other words, all objects and events in the
cosmos are inter-connected with one another and respond to one another's
changes of state (Sheldrake, 1981, 1988; Herbert, 1985; Chopra, 1989).
Witness Consciousness
While in the "theta" state, the subject frequently connects with the
"Witness Consciousness." The subject appears to be transported into a
suspended, objective state wherein he/she experiences an observing self.
"With training you eventually develop the ability to consciously observe and
witness internal and external stimuli, without judging or thinking" (Wuttke,
1992). A verse from an ancient Indian Upanishad describes this beautifully:
"A man is like two doves sitting in a cherry tree. One bird is eating of the
fruit while the other silently looks on." The bird who is the silent witness
stands for that deep silence in everyone, which appears to be nothing at all
when in reality it is the origin of intelligence (Chopra, 1989). This
dimension of self is able to experience and perceive a "bigger picture" of
the original trauma. This state of mind enables the patient to perceive from
a larger domain and experience less judgment and more acceptance. This
capacity to elevate beyond the pain of the original trauma allows the person
to release and discharge the prior unexpressed emotional pain. There seems
to be carryover when the patient returns to "normal" waking consciousness.
One lives more in a state of acceptance of what is rather than how one
wishes it to be, more able to "let go" of unwanted thoughts and feelings.
Resource Self
The "Resource Self" seems to be another aspect of the "Witness
Consciousness" although there is a different quality to the experience.
Whereas the "Witness Consciousness" could be defined more as an "Observing
Self" that watches with interest and without judgment, the "Resource Self"
is experienced as the personal adult self available to the child being
abused in the abreactive flashback situation and becomes "her" champion and
rescuer as in the case of B.K. In essence, the individual incorporates the
"inner parent" for reparenting/rescripting his/her life.
Inner Healer
This deeply altered state of consciousness that we term the "theta" state
may also produce an "Inner Healer" that targets somatic issues, strengthens
the immune system and, otherwise, physically energizes the subject. M.W. was
referred to us for brainwave training by a psychiatrist who had prescribed a
regimen including Prozac and Activan. At the beginning of the program,
pre-testing with our psychometric instruments indicated a probable
schizophrenic disorder or an anxiety disorder in a paranoid personality. He
had dropped out of college and was on total disability for Epstein Barr
Virus. Presenting symptoms included severe anxiety attacks, depression,
sleeplessness, low energy levels, and cognitive impairment. After the
Neurotherapy program, post-testing revealed the patient to be within normal
limits: there was no clinical diagnosis. He returned to college and his
academic performance had returned to normal, depression and anxiety symptoms
had vanished, the symptoms of Epstein Barr Virus had disappeared and there
was a marked positive change in interactions with family and friends. The
attending psychiatrist discontinued all medications.
Further, as relating to addiction, Chopra (1989) states, "Meditation may be
a powerful therapeutic tool, allowing the body to get unstuck from the
disease. Meditation researchers caught on to this potential in the late
1960's when they discovered that many college-age meditators who used
alcohol, cigarettes, and recreational drugs spontaneously quit their habit
within a few months of beginning to meditate. We can call this getting
unstuck from an old level of consciousness. In terms of neuropeptides, it
may be that the meditation freed up certain receptor sites by offering
molecules that were more satisfying than alcohol, nicotine, or
marijuana....We are no longer in doubt about the fact that invisible wisps
of thought and emotions alter the fundamental chemistry of every cell." This
may be the neurochemical shift that creates the "bone sick flu" that
Peniston speaks of. When many patients have been thoroughly trained in this
protocol, if they relapse, they experience bone, joint and muscle aches and
sometimes fever, with the symptoms resolving spontaneously in about two days
(Cowan, 1993). The body seems to reject the drug or alcohol substance as
toxic.
The possibility exists that if we could create a structured meditation
program for a patient, that over a period of time we would see these deep
shifts in personality and behavior. We suspect that with the Neurotherapy we
are compressing time and, in less than two months, achieving the results
that adepts such as yogis experience after many years of meditating. It
would be interesting research to compare the neurotherapy with long term
meditation, although it might be difficult to control such a long term
program to insure validity.
This "Inner Healer" appears to be re-organizing the physiology during
immersion in the theta state. The body relaxes and lets go of resistances
during theta state of consciousness and, we hypothesize, then has the
opportunity to move toward homeostasis. Patients experiencing the following
syndromes and physical conditions, in addition to their presenting problems,
have reversed their conditions through the alpha-theta training: migraines,
chronic headaches, Epstein-Barr virus, Chronic Fatigue Syndrome, Vertigo (as
related to Meuniere's Disease), Angina, Hypertension, chronic pain, and TMJ
problems. As the case studies presented earlier have indicated, somatization
disorder is diminished. Chopra (1989) tells us that the body is fluid enough
to mirror any mental event. Dr. Candace Pert (1993), formerly Chief of the
Section on Brain Biochemistry at the National Institute of Mental Health,
refers to the entire mind-body system as a "network of information,"
shifting the emphasis away from the gross level of matter toward the subtler
level of knowledge. Pert prefers to use the term "bodymind." She theorizes
that the neuropeptides and the receptors of the body are the biochemical
correlates, the material manifestation, of emotions. Our body knows our
secrets and our sorrows and is a mirror of our emotions. As we release these
old patterns, the neurochemistry seems to change and our bodies heal and
change.
These expressions of the brain/mind system, the "Resource/Witness Self/Inner
Healer" consistently seems to produce a state of balance in the
psychological domain as well as in the physiological state. This internal
self-regulation process appears to address multiple systems of the beingness
simultaneously.
Patient - Therapist Relationship
Further, we believe that the self of the therapist is an important element
in the success of this powerful therapy. "The art of psychotherapy...
insists that what goes on inside the therapist, the artist, is crucial to
the whole enterprise," Bugental (1987) states. Others, such as Dr. Edgar
Wilson, have found brainwave synchrony between healer and patient at the
time of peak effectiveness (Cowan, 1993). Fahrion (1993) found that
interpersonal synchrony was highest during healing, especially in alpha
frequencies between left occipital areas of the practioner and the patient.
In a deeply altered state the patient seems to be more sensitized to the
environment and, we assume, to the energy and attitudes of the therapist. A
nonlocal connection seems to be formed, a rapport is created and trust of
the therapist seems crucial.
The quality of the relationship with the therapist and the "self" of the
therapist seems to be a significant component during the
abreaction/catharsis. The therapist's empathy and sensitivity to the
patient's emotional healing experience during the highly charged, vulnerable
experience of the theta state is important to create the atmosphere of trust
needed for the patient's willingness to "let go." Female subjects who have
been sexually abused consistently request a female therapist for support,
bonding and trust in order to move through the cathartic process.
The therapist's own level of personal evolvement in the psychological,
mental and spiritual domain and his or her trust of the process of the
healing that is taking place and lack of fear of the abreactions is sensed
by the patient and is an important component. In their inner healing
journey, the patient will not be able to face and heal what the therapist
fears. The patient is more likely to block or reject any spiritual or
transpersonal experience if they sense a lack of acceptance from their
therapist.
IN SEARCH OF COMMON DENOMINATORS
Explaining the remarkable personality shifts that we see in people who
experience thirty-plus sessions of alpha/theta training with EEG feedback
can only be conjecture at this point. Could there be common denominators,
threads that run through all these many symptoms and disorders?
State Contexts
An explanation for the wide-ranging power of this protocol might be found in
the realm of state-dependent learning and memory (Rossi & Cheek, 1988) or
state-context learning and retrieval (Cowan, 1993). The predominant waking
brainwave frequency of children under the age of six is in the four to eight
hertz range associated with theta in adults. As we mature, our average
brainwave frequencies get faster (Duffy, Iyer, & Surwillo, 1989). In
adulthood these lower frequency waves are usually associated with reverie
and hypnogogic imagery. They occur in the transitions from wakefulness to
sleep.
"The highly emotional experiences of early childhood, and the (often
mistaken) decisions which stem from them, are learned and stored as
modification of the slower background frequencies that were activated at
that time," Cowan (1993) states. The surfacing of memories from early
childhood during the theta training fits observations of "state-dependent
memory," i.e. that information learned while in one state of consciousness
is more difficult to access when in another state of consciousness. The
natural shift in dominant brainwave frequencies during maturation could
result in dysfunctional childhood learnings being preserved in the
unconscious (Beckwith, 1992). To gain access to most of these "state-bound"
memories, one has to be in the state in which they were created, i.e. theta.
Alpha-theta therapy induces a profound alteration in the state of
consciousness of the patient. As the subconscious appears to become more
accessible in this deeply altered state, traumatic memories of the past
often are released and the subconscious seems more readily amenable to
alteration or programming by new images. Dr. Thomas Budzynski, researcher
and clinician, found that theta was the ideal state for "rescripting" or "reimprinting"
the brain, eliminating destructive behaviors or attitudes that are a result
of "scripts" laid down in childhood (during times when the child is in a
theta state) and replacing them with positive scripts (Hutchison, 1992).
This is one of the few ways in which an adult can store new information in
the subconscious, which can be equated to state-contexts dominated by theta
and low alpha rhythms which have well learned but state dependent
connections to the limbic system and early emotional memories (Cowan, 1993).
Colin Ross
Following the theme of state-context dependent memory, we might consider
what Colin Ross (1989), an authority on Multiple Personality Disorder (MPD),
states about diagnoses of pathology. He writes that the DSM (Diagnostic and
Statistical Manual) should have a category for Chronic Trauma Disorder of
Childhood, Childhood Onset, with and without Multiple Personality Disorder.
It becomes a hierarchical diagnosis including multiple diagnoses, with the
most severely abused and dissociative persons developing MPD. Those who are
less severely traumatized or less gifted at dissociation, develop somatic
symptoms, personality disorders including borderline, panic disorders,
depression and addiction, exacerbated by any genetic predispositions (Blum,
1991). Using a metaphor from quantum mechanics, Colin Ross states that
chronic trauma disorder is a single field, with distinct regions. These
different regions are called affective disorder, eating disorder, substance
abuse, and so on. Numerous regions of the field can be activated
simultaneously in a given patient. These subregions can occur in different
combinations in different patients. From this point of view, could we
perhaps collapse our horizontal axis to a single diagnostic entity that we
term Chronic Trauma Disorder.
Figure 11. The Core Issue (Chronic Trauma Disorder), hiding in the
Unconscious, permeates all levels of the Self - Physical, Mental, Emotional
and Spiritual. Childhood trauma becomes the source out of which the multiple
symptoms and disorders flow.
Stanislav Grof
When our patients experience abreactions and flashbacks, we are encountering
their psychodynamic realm. The experiences belonging to this category are
associated with and derived from biographical material from the subject's
life, particularly from emotionally highly-relevant events, situations, and
circumstances. They are related to important memories, problems, and
unresolved conflicts from various periods of the individual's life since
early childhood. This can take the form of reliving memories of traumas that
were accessible in normal states of consciousness or can emerge from the
realms of the individual unconscious where the traumas have been repressed.
These memories can take the form of a variety of experiences that contain
unconscious material in the form of symbolic disguises, distortions and
metaphorical allusions, often presenting as hypnagogic imagery, imagery that
seems to spring into the mind from unconscious sources. This concept leads
us to the writings of Stanislav Grof (1976, 1980, 1985, 1988) and his work
with the National Institute of Mental Health in LSD psychotherapy, another
consciousness-altering type of therapy used in the 1950's and 1960's until
the drug was scheduled by the federal government. Grof offers the principle
of specific memory constellations, for which he has used the name COEX
systems (systems of condensed experience).
A COEX system can be defined as a specific constellation of memories from
different life periods of the individual. The memories belonging to a
particular COEX system have a similar basic theme or contain similar
elements, and are accompanied by a strong emotional charge of the same
quality. The deepest layers of this system are represented by vivid memories
of experiences from the period of birth, infancy and early childhood and
seems to represent a summation of the emotions belonging to all the
constituent memories of a particular kind. This is in basic agreement with
Freud's psychodynamic theory with the new element being the organizing
dynamic system. A given individual can have several COEX systems. The
psychodynamic level of the unconscious, and thus the role of the COEX
systems, is much less significant in individuals whose childhood was not
particularly traumatic (Grof, 1985), hence an explanation of why some of our
patients have strong life changing experiences of memories and abreactions
and others do not.
In a complicated interaction with the environment, these systems can
selectively influence the subject's perception of himself or herself and of
the world, his or her feelings and thoughts, and even somatic process. When
this core experience of the system is relived and integrated, the patient's
life can be transformed. In the case study of B.K., when, from a "witness
consciousness" (Wuttke, 1992) and in a deeply altered state, she relived the
memory of the crib abuse and was rescued by her adult Resource Self, she
collapsed a COEX system and altered her life and her perceptions of herself
in the world and her reaction to the world. This can also be said for the
experiences of K.H. and M.F. and many other of our patients.
Bruce Perry
The broad range of effectiveness of this type of therapy might lack
credibility if it were not for the fact that early childhood trauma exerts
such a wide range of psychological and physiological effects. Perry (1992)
states that prolonged "alarm reactions" induced by traumatic events during
infancy and childhood can result in altered development of the central
nervous system (CNS). He hypothesizes that with this altered development,
one would predict a host of abnormalities related to catecholamine
regulation of affect, anxiety, arousal/concentration, impulse control,
sleep, startle, and autonomic nervous system regulation, among others. He
further states that it is likely that the functional capabilities of the CNS
systems mediating stress in the adult are determined by the nature of the
'stress' experiences during the development of these systems, i.e., in utero,
during infancy and childhood.
Cowan (1993) states that it is hypothesized that many addicts use drugs not
just to feel good, but to forget that they feel badly. With this, we return
again to Colin Ross' suggested diagnosis of Chronic Trauma Disorder.
Frequently this "feeling badly" is residue of earlier trauma.
SUMMARY
Alpha-Theta Neurotherapy has made manifest what a research team, Elmer and
Alyce Green and Dale Walters, at The Menninger Foundation told us in the
1970's: i.e. causing the brain to generate theta activity daily over a
period of time seems to have enormous benefits, including boosting the
immune system, enhancing creativity, and triggering or facilitating
"Integrative experiences leading to feelings of psychological well-being"
(Green, 1974; Hutchison, 1992). The protocol seems to transcend the
patient's lack of motivation to change, incapacity to create internal visual
imagery or disbelief in the effectiveness of the treatment. Frequently the
patient's experience and results far exceed the goals targeted (in the
visual imagery). Entering this deeply altered alpha-theta brainwave state
seems to create a link to the subconscious where a wider scope or vision of
the "True Self" without its ego adaptations is contacted. Beyond overcoming
addiction, the treatment evokes in the patient shifts in behaviors,
attitudes, relationships, health, mental acuity, improved job performance
and creativity. When the rational mind enters the slower, more coherent,
brainwave range of theta and surrenders to the mind field (the subconscious
and the superconscious), the brain/mind system seems to be enabled to go
through a dramatic and profound reordering process much like that described
by Illya Prigogine as "escape to a higher order" (Dossey, 1982; Hutchison,
1992). The ego's defenses are bypassed and the patient may "observe" a past
traumatic event which may in some evoke a cathartic reaction. Other
patients, may remain an observer without any emotional response, while in
others change occurs without specific flashbacks of earlier trauma. A higher
functioning of the mind is accessed enabling the brain (the computer) to
open to the mind field (energy) and transcend the lower functions of the
brain (logic, memory, defenses), moving out of the realm of the conscious
reality to the realm of the transcendent. A dramatic personality
transformation frequently takes place as clinically observed and reported by
the patients and their families and documented by the pre and post testing
results of the MMPI-2 and the Millon II.
The positive balancing effect of this process seems to work despite the
severity or multiplicity of diagnoses making it a particularly advantageous
treatment for dual diagnoses with addictions and making it applicable to a
range of diagnostic conditions. On the physiological level, with the process
of "letting go," bracing of the autonomic and central nervous system is
reduced, apparently leading toward homeostasis. Further, with this "letting
go" there is less reactivity to the events of one's life. An external locus
of control is exchanged for an internal locus of control. The external self
becomes congruent with the validated internal reality.
To quote Ellen Saxby (1993):
"(this protocol)....is an invitation to connect with the ontological ground
of one's own being....I have begun to feel that the flight into the Self is
the most powerful and the most healing aspect of this work. I have come to
believe that the True Self exists or resides in negative space and that it
is in a sense "is not" or is "no thing" and what becomes established in
ordinary reality is the image of the self - the self image. In the shattered
and bruised mirrors that we have available to us, the image of the Self
becomes tattered and contorted. If our whole attachment of consciousness is
to the image, then the whole of our reality limps. Once we unglue ourselves
from that perception - that of the image - and have the experience that
actually a portion of the self always remains in the domain of unmanifest
reality and is no way tarnished or bruised because there is no mirror in the
realm of direct perception, then consciousness becomes freed up, as it were,
and has the potential to walk without a limp.
"While it is true that many things occur during the process of Alpha-Theta
training, I feel that this is perhaps the core piece that derives from the
very nature of the self and once having gained a glimpse of our primary
reality, the addiction to all of the processes that shore up the image have
the potential to simply fall away, being no longer needed. One can then
connect with the flow of truth from the deepest levels of reality and begin
to create the most wholesome and sweet form of homeostasis which can
potentially manifest itself in every aspect of our being, the physical as
well as the emotional and the mind. We can discover that, while anchored in
linear consciousness, by allowing this kind of emergence of awareness, we
can draw continually from inner realms of intelligence all sorts of
remarkable possibilities."
Multi Dimensional - "Beyond Biofeedback"
Many years ago, Elmer and Alyce Green (Green & Green, 1977) offered a
foundation for the power of this protocol in their book, Beyond Biofeedback,
and indeed we seem to be working in a realm that is "beyond biofeedback." As
we examine this intriguing therapy, it appears multi dimensional. We see its
effects on our patients at the personal levels of their being: the Physical,
the Emotional, and the Mental. We share in their experiences of their
Subconscious and its release of deeply repressed memories from their
forgotten past. We have admired the insights of their Superconscious, which
we relate to their spiritual and transpersonal selves. From the domain of
their spiritual selves, we find their "witness consciousness" or their
Silent Witnesses, their Resource Selves, and their Inner Healers. We revel
in our patients reports of their experiences with what they call their
Guides or their Higher Power. We are fascinated with the many different
forms of their transpersonal experiences as they experience the energies and
colors of pure beingness. We delight in their Healing!
Figure 12. From the original trauma this protocol moves the patient from the
imbalances and dysfunctions through the abreactions and insights to balance
and healing.
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