The Peniston Neurofeedback Protocol is an intervention tested and proven effective with veterans and PTSD at the VA hospital system. This article details the elements of it.
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IntroductionAlcoholism is a disease that afflicts at least 12 million Americans. It
leads to approximately 250,000 premature deaths a year, disrupts the
lives of some 45 million family members and costs an estimated $120
billion a year in medical bills, property damage and lost time and
productivity.
In recent years, a major breakthrough in the treatment of
alcoholism and chemical dependency has been consistently demonstrated
by a number of researchers, including (but not limited to) Saxby and
Peniston (1995), Anderson (1994), Sonder and Sonder (1994), White
(1994), Cowan (1993), Patterson (1993), Peniston, Marrinan, Deming and
Kulkosky (1993), Schneider, Elbert, Heimann, Welker, Stetter, Mattes,
Birbaumer and Mann (1993), Byers (1992), Fahrion, Walters, Coyne and
Allen (1992), and Peniston and Kulkosky (1990, 1989).
The essence of this treatment involves a non-invasive,
non-pharmacological outpatient program combining EEG brain wave
biofeedback (called neurotherapy), highly specific imagery of brain
structures, neurotransmitters and brain wave patterns, positive
personalized visualizations, cognitive re-scripting and intensive
cognitive-behavior therapy. This program, commonly referred to as the
Peniston Protocol, is administered 3-5 days per week over a 7-12 week
period for a total of 35-40 sessions.
Success Rates and Cost-Effectiveness
In sharp contrast to traditional inpatient, outpatient and 12-step
treatment programs, which yield maximum success rates of 30-40%, the
long-term (3 year) abstinence rates for severe alcoholics receiving the
Peniston Protocol consistently reach 80%. Moreover, significant
positive, measurable and durable personality changes have consistently
accompanied these startling results.
Further, these dramatic results appear to be deliverable at a very
reasonable cost (e.g., $4,000 - $6,000 total), particularly in
comparison to the extremely high cost of traditional inpatient
treatment programs (e.g., $2,500 - $9,000 per week, depending on
complexity of diagnosis and whether or not detoxification is included).
Background and Rationale
As it functions, the brain produces minute electrical signals on its
surface called brain waves. Brain waves constantly change as the brain
handles the business of dealing with itself and its environment. For
over fifty years, this electroencephalographic (EEG) activity has been
used for neuroanalysis (e.g., diagnosis of brain disease or injury).
With the advent of fast computers, researchers are now able to
quantitatively analyze the frequency and amplitude of brain waves
(QEEG) to form complex topographic "maps" of the EEG's power and
frequency distribution for more accurate and effective diagnoses. They
found that abnormal behavior often corresponded to abnormal brain wave
patterns and distributions.
Conclusive research indicates that certain types of abnormal brain
functioning can be corrected by learning to operantly condition the
brain's electrical activity. This conditioning is accomplished by
visual and/or audio feedback of the moment-to-moment activity of the
EEG. This visual/audio EEG feedback is used by the patient to learn to
increase or decrease the power and/or percentage of selected brain wave
frequencies This conditioning or training is called neurotherapy.
Neurotherapy is proving to be medically effective because it
facilitates positive neurochemical, personality and behavioral changes
in relatively short periods of time (weeks vs. months or even years).
Moreover, it is cost- effective because it avoids the high expenses
associated with surgery, drugs or long- term inpatient or outpatient
therapy.
It is also widely accepted among researchers and clinicians that
patterns of surface EEG activity reflect the activity of deeper brain
structures and patterns of brain neurochemistry. For example, those
brain neurotransmitters, opioids, neurohormones and neuropeptides
associated with reward and internal feelings of well-being are
influenced directly (and thus fluctuate widely) according to changes in
cortical EEG patterns. Equally important, alcohol cravings and
uncontrollable alcohol ingestion are now strongly associated with both
deficiencies and/or abnormalities in certain brain neurochemicals
(e.g., serotonin; opioid peptides including beta endorphin and
enkephalin; norepinephrine; dopamine; and GABA) and poorly developed
low frequency EEG rhythms (e.g., alpha and theta) (Blum, 1991).
Consequently, as Peniston and numerous other researchers have shown,
the normalization of alpha and theta EEG rhythms via neurotherapy
produces the same normalization of brain chemistry that is produced by
either alcohol ingestion or the external manipulation of the excitatory
and inhibitory processes that control these essential neurochemicals.
In other words, the increased feelings of reward and internal
well-being that occur from alcohol ingestion or other external
influences of brain neurochemistry are also produced by the
normalization of alpha and theta rhythms via neurotherapy.
Thus, the complex interrelationships among these variables appear to be
both at the root and the cure for severe alcohol cravings and
uncontrollable alcohol ingestion. Moreover, these interrelationships
and the normalization of the deficient factors within them via
neurotherapy certainly contribute to an understanding as to why the
Peniston Protocol produces such impressive results with this difficult
clinical population.
Breakdown of the Peniston Protocol
Although there is some variation among clinicians, the following is a
step- by-step breakdown of the most commonly used clinical procedures
within the Peniston Protocol:
(1) Intake interview, evaluation and personality/behavioral pre-testing
(e.g., MMPI II, MCMI II, Beck Depression Inventory, Beck Hopelessness
Scale and/or Sixteen Personality Factor Questionnaire).
(2) Brief pre-treatment QEEG topographic brain map.
(3) Five preliminary non-EEG biofeedback sessions (e.g. temperature, EMG, and/or skin conductance).
(4) Twenty-five to thirty alpha/theta neurotherapy sessions.
(5) Brief post-treatment QEEG topographic brain map.
(6) Discharge interview, evaluation and personality/behavioral
post-testing (e.g., MMPI II, MCMI II, Beck Depression Inventory, Beck
Hopelessness Scale and/or Sixteen Personality Factor Questionnaire).
Personality/Behavioral Improvements
In addition to long-term (3 year) abstinence rates of 80%, the Peniston
Protocol has consistently produced the following very healthy
personality changes:
(1) Significant decreases in scales labeled schizoid, avoidant,
passive- aggressive, schizotypal, borderline, paranoid, anxiety,
somatoform, dysthymia, alcohol abuse, psychotic thinking, depression,
psychotic depression, hypochondriasis, hysteria, schizophrenia, social
introversion and psychotic delusion.
(2) Significant increases in warmth, abstract thinking, stability,
conscientiousness, boldness, imaginativeness and self-control.
Thus, the Peniston Protocol consistently produces positive changes in
what many consider to be "hard wired" aspects of personality. These
dramatic personality changes enhance the patient's ability to cope
without substance abuse, significantly reducing the likelihood of
relapse.
Summary and Conclusion
Alcoholism is a debilitating and expensive disease that has responded
poorly to traditional inpatient, outpatient and 12-step treatment
programs (e.g., maximum 30-40% sustained abstinence). Researchers
Eugene Peniston and Paul Kulkosky, along with many others over the past
eight years, have consistently demonstrated that severe alcoholics
treated with EEG neurotherapy, imagery/visualization and
cognitive-behavior therapy (e.g., the Peniston Protocol) show startling
long-term (3 year) abstinence rates of 80%. Moreover, these extremely
positive results are consistently accompanied by dramatic, healthy
personality/behavioral changes that clearly contribute to reductions in
the likelihood of relapse.
The neurotherapeutic changes in alpha/theta EEG rhythms achieved by
these patients with the Peniston Protocol produce low, sustained levels
of the opioid peptide beta-endorphin, reflecting lower sustained levels
of arousal and stress. Moreover, the normalization of low frequency
cortical EEG rhythms (e.g., alpha & theta) apparently also produce
normalization of several other brain neurochemicals whose imbalances
are highly associated with severe alcohol cravings and uncontrolled
alcohol ingestion.
In addition to its extremely high success rate for this difficult
clinical population, the Peniston Protocol appears to be very
cost-effective in comparison to traditional inpatient and outpatient
treatment programs.
REFERENCES
Anderson, B. (1994). Applications of biofeedback and neurotherapy in
private practice in the treatment of alcohol and chemical dependency.
Presentation delivered to the Advanced Brainwave Training Institute,
Number 5, Washburn University, Topeka, Kansas, February, 1994.
Blum, K. (1991) Alcohol and the Addictive Brain. New York: The Free Press.
Byers, A.P. (1992). The normalization of a personality through neurofeedback therapy. Subtle Energies, 3,1,1-17.
Cowan, J. (1993). Alpha-theta brainwave biofeedback: The many possible
theoretical reasons for its success. Biofeedback, 21, 2, 11-16.
Fahrion, S.L., Walters, E.D., Coyne, L., & Allen, T. (1992).
Alteration in EEG amplitude, personality factors and brain electrical
mapping after alpha- theta brainwave training: A controlled case study
of an alcoholic in recovery. Alcoholism: Clinical and Experimental
Research, 16, 3, 547-552.
Patterson, D.M. (1993) The secret of my success as a therapist:
Clinical procedures and success rates for the Peniston Protocol in the
treatment of alcoholism, chemical dependency and post-traumatic stress
disorder. Invited presentation delivered to the staff of the Mastery
Program, a subsidiary of Advanced Neuroscience Corporation, King of
Prussia, Pennsylvania, October, 1993.
Peniston, E.G., Marrinan, D.A., Deming, W.A., & Kulkosky, P.J.
(1993). EEG alpha-theta brainwave synchronization in Vietnam theater
veterans with combat- related post-traumatic stress disorder and
alcohol abuse. Advances in Medical Psychotherapy, 6, 37-50.
Peniston, E.G. & Kulkosky, P.J. (1990). Alcoholic personality and
alpha-theta brainwave training. Medical Psychotherapy, 3, 37-55.
Peniston, E.G. & Kulkosky, P.J. (1989). Alpha-theta brainwave
training and beta-endorphin levels in alcoholics. Alcoholism: Clinical
and Experimental Research, 13, 2, 271-277.
Saxby, E. & Peniston, E.G. (1995). Alpha-theta brainwave
neurofeedback training: An effective treatment for male and female
alcoholics with depressive symptoms. Journal of Clinical Psychology,
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Schneider, F., Elbert, T., Heimann, H., Welker, A., Stetter, F.,
Mattes, R., Birbaumer, N., & Mann, K. (1993). Self-regulation of
slow cortical potentials in psychiatric patients: Alcohol dependency.
Biofeedback and Self-Regulation, 18(1), 3-33.
Sonder, C. & Sonder, J. (1994) Alpha-theta brainwave training for
alcoholism, chemical dependency and post-traumatic stress disorder:
Success rates for the Peniston Protocol. Personal communications
regarding the Mastery Program, a subsidiary of Advanced Neuroscience
Corporation, Cherry Hill, New Jersey, January, 1994.
White, N. E. (1994). The Peniston Protocol as a multi-level
intervention: Theories of success of alpha-theta training. Panel
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of Applied Psychophysiology and Biofeedback entitled Alpha-Theta
Brainwave Biofeedback: The Multiple Explanations for its Clinical
Effectiveness, Atlanta, Georgia, March 7, 1994
Authors Bio:The late Dale Patterson Mr. Patterson was the Clinical/Executive Director of the Biofeedback & Alternative Medicine Centers, Inc. with New Jersey offices in Williamstown and Cherry Hill. He was certified by four national boards and had over 23 years experience in the field of biofeedback and neurotherapy (EEG biofeedback). He administered the Peniston Protocol for alcoholism (and other addictions), post-traumatic stress disorder and other selected disorders since 1991. He passed away in 2008