neurofeedback and related procedures used to deal with ADD, Closed Head Injury, Addictions, or for alertness, focus

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By Patricia Norris and Steve Fahrion

Beta EEG Brainwave Biofeedback
This procedure uses computerized visual and/or auditory feedback to provide the individual with information about the presence of brainwaves within the beta range (nominally 13-20 Hz). For example, we often represent the amplitude of beta activity with a circle that gets larger as the size of the beta increases, together with a tone that represents these changes. Using this feedback, an individual can typically begin to make changes in brainwave activity readily easily, and in doing so, to make changes in associated behavior (focused attention).

Alpha-Theta Biofeedback EEG Training: EEG biofeedback is a procedure in which brainwaves are measured and turned into sounds or visual displays that inform the individual when particular brainwaves are present. For example, a low-pitched tone may indicate the presence of theta brainwaves (4-8 Hz or cycles/second). A higher pitched tone may indicate the presence of alpha brainwaves (8-13 Hz). Using these indications, the individual can learn through trial-and-error to increase the presence of these brainwaves in order to enhance relaxed, pleasurable states. Such states tend to enhance creative imagery and reverie as opposed to logical, linear thought processes.

Theta EEG Brainwave Biofeedback:
This procedure uses computerized visual and/or auditory feedback to provide the individual with information about the presence of brainwaves within the theta range (4-8 Hz). Increased theta activity is usually associated with states of reverie that have been known to the creative people of all time. For example, when Thomas Edison had a problem to solve, he would often attempt to "fall asleep" at his desk with ball bearings clutched in each hand. Just as he was about to "drop off," the ball bearings would fall to the floor activating him, and he would often return from the drowsy state with an image of the problem solution. Theta occurs in abundance in that delicious state just on the verge of sleep that most of us a familiar with. It is often difficult to recapture the images that occur in association with theta as we move to normal waking consciousness, yet it can be useful to develop this skill.

Delta EEG Brainwave Biofeedback:
This procedure uses computerized visual and/or auditory feedback to provide the individual with information about the presence of brainwaves within the delta range (nominally 2-4 Hz). While delta waves are observed below 2 Hz, those in that range are usually greatly enhanced by body movement and are best regarded as an artifact of motion rather than as an index of deep brain relaxation and unfocused attention. Delta occurs naturally for most individuals in the first stage of deep (Stage IV) sleep before the first dream period of the night. It's absence during this time is associated with suppression of growth hormone, as in chronic fatigue syndrome. Growth hormone is necessary to repair the connective tissue in order to prevent aches and pains.

Delta is also seen after a head injury or other insult to the brain (e.g., after a migraine headache). Suppressing delta activity through Delta Brainwave Biofeedback results in an alert brain and supports improved focus of attention.

Neurofeedback Therapy for Alertness and Focused Attention:
This treatment procedure utilizes other elements noted in this article including Beta EEG Biofeedback (Enhancement), Theta and Delta EEG Biofeedback (Suppression) and Attentional Challenge.

Attentional Challenge
While not yet commonly used by treaters working with ADD, we use attentional challenge in the later phases of treatment to aid generalization of learned skills to the classroom or other distracting environment. In attentional challenge, the treater tells the trainee, "No matter what I do, don't pay any attention to me: stay focused on the training task." The treater then engages in a series of distracting maneuvers during the training process. Challenge periods alternate with regular training periods until the trainee can do as well or better under challenge than without it.

Attention Deficit (ADD) and Closed Head Injury

Conventional Treatment
These are often poorly diagnosed problems. ADD is now considered to affect approximately 3% of children, especially males, and to continue into adulthood with some 60-70% of those afflicted. ADD may include hyperactive behavior or not. It is often relatively ineffectively treated with addictive medications, and often returns when the medications are stopped. Despite acknowledged problems with medication treatment of the disorder, a strong lobby exists among certain groups of professionals who support these solutions and who disparage new treatment approaches

Closed Head Injury may result from head trauma even when the skull is not fractured and the individual does not lose consciousness. It may result from birth injuries, falls, accidents, and the like. Cognitive Rehabilitation, reducing situational demands through structure, and self-medication through the use of stimulants or marijuana are common responses to such problems.

Neurofeedback Therapy
The basic problem in ADD/ADHD is that there is a relative surplus of slow-wave activity, and a relative absence of fast-wave activity. When fast rhythms are absent in the frontal (executive) areas of the brain, expression of emotions is not inhibited in the normal way, and the individual may operate in impulsive, emotional, and daydreamy ways, rather than with focused attention. Other conditions that may reduce frontal inhibition of emotions even in those without ADD problems include drugs of abuse, low blood sugar, lack of sleep, and emotional experiences.

Using a digitizing EEG, it is possible to readily determine the ratio of theta/beta brainwave amplitudes, and to obtain an index of how well the individual is likely to be able to focus attention. Scientists and engineers and other who are highly skilled at focused attention have theta/beta ratios around "1.0". Similarly, it is possible to test for delta/beta ratios and to obtain an index of central nervous system alertness. Those who alert are usually more able to attend to and to remember events occuring in their presence. When theta/beta and delta/beta ratios exceed 3.5, the individual is likely to have difficulty maintaining focus of attention and alertness. The same equipment used to make these determinations can drive a feedback tone and help individuals alter theta/beta and delta/beta ratios and associated behaviours.

Addictive Disorders A new understanding of the biology of addiction has emerged in the past ten years.

Individuals with addictive problems often have inherited a deficiency in brain function--a relative absence of slow brainwaves--that limits their ability to experience satisfaction from everyday life events. The use of addictive substances then represents an attempt to self-medicate that is doomed to long-term failure as more and more of the substance is required to "feel good," or even feel OK.In contrast, a new treatment, Neurofeedback Therapy, is proving effective for these problems; it involves learning to correct for the inherited deficiency in slow EEG activity by increasing the presence of alpha and theta brainwave activity.

Neurofeedback Therapy for Addictions
This new treatment for addictive disorders actually uses two forms of biofeedback (noted below) to correct for the deficit in slow brainwave activity. Neurofeedback Therapy results in very low relapse rates compared to conventional treatment. This is, in part, due to the fact that it seems to function as a "mental antibuse." The treated individual who attempts to use addictive substances experiences flu-like symptoms over a couple of days. While this effect of treatment has not yet been explained it seems to be fairly consistent. After treatment, addictive substances also tend to lose their ability to instill a "high." These two effects of treatment together result in greatly reduced relapse behavior. The longest followed individuals are now seven years post-treatment, with none of the treated individuals currently engaged in substance abuse.

Attention Deficit (ADD) and Closed Head Injury

Conventional Treatment
These are often poorly diagnosed problems. ADD is now considered to affect approximately 3% of children, especially males, and to continue into adulthood with some 60-70% of those afflicted. ADD may include hyperactive behavior or not. It is often relatively ineffectively treated with addictive medications, and often returns when the medications are stopped. Despite acknowledged problems with medication treatment of the disorder, a strong lobby exists among certain groups of professionals who support these solutions and who disparage new treatment approaches

Closed Head Injury may result from head trauma even when the skull is not fractured and the individual does not lose consciousness. It may result from birth injuries, falls, accidents, and the like. Cognitive Rehabilitation, reducing situational demands through structure, and self-medication through the use of stimulants or marijuana are common responses to such problems.

Neurofeedback Therapy
The basic problem in ADD/ADHD is that there is a relative surplus of slow-wave activity, and a relative absence of fast-wave activity. When fast rhythms are absent in the frontal (executive) areas of the brain, expression of emotions is not inhibited in the normal way, and the individual may operate in impulsive, emotional, and daydreamy ways, rather than with focused attention. Other conditions that may reduce frontal inhibition of emotions even in those without ADD problems include drugs of abuse, low blood sugar, lack of sleep, and emotional experiences.

Using a digitizing EEG, it is possible to readily determine the ratio of theta/beta brainwave amplitudes, and to obtain an index of how well the individual is likely to be able to focus attention. Scientists and engineers and other who are highly skilled at focused attention have theta/beta ratios around "1.0". Similarly, it is possible to test for delta/beta ratios and to obtain an index of central nervous system alertness. Those who alert are usually more able to attend to and to remember events occuring in their presence. When theta/beta and delta/beta ratios exceed 3.5, the individual is likely to have difficulty maintaining focus of attention and alertness. The same equipment used to make these determinations can drive a feedback tone and help individuals alter theta/beta and delta/beta ratios and associated behaviours.

excerpted from The Life Sciences Institute of Mind-Body Health

Authors Bio:
Psychophysiologic psychotherapist Patricia Norris, Ph.D. is a past president of AAPB with over three decades of experience with psychophysiologic self-regulation. She has specialized in psychoneuroimmunology applications, emphasizing psychosynthesis, imagery and visualization procedures in her work.