Hello Friends,
I was contacted by a former Neurofeedback client's Wife who recently lost her husband due to many complicated health issues all the while suffering from PTSD. Her now deceased husband was a Veteran who served 20 plus years in the Marines. During his decline in health he received a year of Neurofeedback. She feels so strongly that Neurofeedback gave her husband so much value during this tough time that allowed them to enjoy their last year together filled with spirit and joy, that she now wants to give back by offering the availability for a Veteran who suffers from PTSD who normally wouldn't have the resources to receive the training.
Please refer a Veteran who suffers from PTSD who would be willing to receive the training 3-4 sessions a week in my Vista Office for 10 to 12 weeks. We would like to document the Veterans experience along the way so that the story can be shared with the public to help let the community know more about Neurofeedback and its benefits. drrob@sportofmind.com
Article below is from Siegried Othmer on Neurofeedback and PTSD.
- Siegfried Othmer, Ph.D.
Chief Scientist, The EEG Institute and President, Homecoming for Veterans
For more information on Siegfried Othmer please visit http://www.drothmer.com/
Such a functional decline may be difficult to admit to, but see if the story does not ring true. (And hang in there, because we have good news).
It is common to hear of difficulty with sleep. There may be difficulty falling asleep, or perhaps frequent waking, with a difficulty to fall back asleep. Sleep may not be restful, and may even be punctuated by events that seem like nightmares. If these so-called nightmares take you back to known events in the war zone, they are really flashbacks, not nightmares at all. Only these flashbacks happen to occur at night.
There may be problems with stability of mood - sudden flare-ups of anger.
There may be a generally greater level of irritability than before.
There may be swings of anxiety and depression.
There may be problems with memory, and cognitive functioning may require more efforting.
Things that you may have known about yourself from before the war are now there in spades: Attention problems; learning difficulties; short-term memory problems; relationship issues. If there were tics before, these may be worse. If there was a smoking habit before, it is now even more entrenched. And if there was a problem with drug taking, that too may be worse. If you had headaches before you went off to war, these may now be much worse, or more frequent. There may be other kinds of pain that were not there before, or they are simply worse now than before.
There may also be differences in how you relate to others. Your loved ones may be aware that you are now more remote, less accessible, less warm. Or things go in the other direction, where you become much more emotional than you used to be. Your emotions might also swing from one end of the pendulum to the other, and you may not feel in control at either end.
And now for the good news:
All of the above issues lie in the domain of brain function. They do not indicate, most likely, a structural problem in the brain that we have no choice but to live with. Such a structural problem cannot be ruled out in our discussion, obviously, but it is in fact unlikely. On the other hand, they also do not indicate a problem of the "mind," just in case you are starting to harbor some doubts about your own sanity. And in the event that an organic brain problem exists, that may be no barrier to recovery either.
Let us illustrate:
We worked with a veteran of WWII who had not slept well since the war. In just a few training sessions, his sleep was back to what it had been when he was a teenager in the forties. The capacity of recovery was never lost in his brain. His functional recovery was substantial and comprehensive, covering many symptoms. It did take a lot of training sessions in this case (68), because after half a century this man's brain had a lot of entrenched bad habits. But the training was clearly worth it.
The brain training that we are talking about is now called Neurofeedback. It used to be called EEG biofeedback. We changed it for two reasons. The first is that people tend to confuse biofeedback with things like biorhythms, and various unconventional techniques are now called biofeedback even though they don't fit the classic description. The second reason is that most people have pigeon-holed biofeedback as just relaxation training, with techniques such as hand-warming and the training of proper breathing.
Now hand-warming should not be trivialized, because a lot can be accomplished even with such a simple technique. And relaxation training should not be trivialized, either, nor should training in proper breathing. But things have gone a lot farther than that. It has all been about giving the brain better capacity to function. By now we know how to train the brain directly, and that just has a lot more relevance to the issues we are confronting. Now we look at the EEG itself, where we see the brain in the act of regulating its own behavior. And we have simply learned to recognize when the brain is going off-line or out of control. Whenever that begins to happen, we cue the brain to behave differently. We may give it a cue in the direction we would like it to go, or we may simply alert it to the fact that it is becoming disregulated. This simple procedure then allows the brain gradually to relearn good behavior.
This technique was first employed in the management of seizure disorders. Now you may not regard your own situation as being quite that serious. But you might also think that if we can take care of something as challenging as seizures, perhaps your condition can be helped as well. The technique has been further used with attention and behavior problems of children. Again, you may say that that is not relevant to your situation. But getting the brain to pay good attention to its own stuff may indeed be the issue! Most of what the brain does is worry about itself. If we can "fix" the problems of attending to the outside world, perhaps we are also attending to the problems of the inner machinery, the one that manages our moods and emotions and our readiness to function.
The technique has also been used for treating addictions. This is in fact where the story gets very close to home, because this work was first performed in a VA Hospital in Fort Lyon, CO. There a psychologist named Eugene Peniston was working for years with intractable alcoholic veterans. These were all highly functional people before Nam, and now could not stop drinking. One treatment program after another failed them. Obviously their alcoholism was a symptom of Post-Traumatic Stress Disorder (PTSD). But that term did not exist yet at the time of the Vietnam War and for years thereafter. PTSD was not described as such until the eighties.
In his first controlled study Peniston found that adding Neurofeedback to the mix gave him 100% success in treatment. This was stunning, because the controls in that study, who received only the standard VA treatment program, all remained alcohol-dependent. The contrast could not have been greater, and these folks have now been sober for more than ten years (one has since succumbed to cirrhosis of the liver). Putting all the early studies together we obtained about 85% recovery in in-patient settings, about 75% in out-patient programs.
One of the criticisms leveled at Peniston after the first publication of his neurofeedback work is that he had not so much demonstrated a cure for alcoholism as that he had shown recovery from PTSD. Peniston thought, if that's the worst that could be said about his work, he would take that criticism! A remedy for PTSD in less than forty contact hours, where everything else had already failed? Not bad. In Peniston's studies, relief from PTSD symptoms and recovery from alcohol dependency was jointly observed. Of course this was not the worst judgment rendered against Peniston's work. Many still thought the results were too good to be true, and the method of achieving them entirely too unconventional.
As documented in published research, we now know how to remediate PTSD and drug addiction, and attention problems, and mood problems, and sleep problems, and pain syndromes such as migraine. Migraine is a particular success story. Just a few years ago a study was published that demonstrated some 95% recovery from migraine using biofeedback. (This was published in the Journal of Neurotherapy in 2005. The author was psychologist Jeff Carmen). The study covered 100 subjects. This is a level of success that was previously unheard of even in the field of biofeedback. This level of success is currently being matched with EEG Neurofeedback.
If neurofeedback is so wonderful, you might ask, why is it you have not heard of it? The big reason is that neurofeedback is not a drug! So it is not written about in the medical journals. Biofeedback and neurofeedback fall more into the domain of psychology. And thousands of psychologists are using biofeedback, including neurofeedback. But it is still taking a while to catch on. That's the nature of any major breakthrough in the health field. It takes time for a revolution in thinking to take hold.
Testing is conventionally done ahead of time to test your vigilance and attentional skills. This tells us how to adjust the training for your brain. From that time forward, we take into account how you react to the training: alertness, pain, moods, how well you sleep, etc. Then we retest after training some twenty to forty sessions, and compare to the earlier benchmark. EEG measurements may also be made. Training is usually done in twenty-session blocks until resolution of symptoms is obtained. It is our estimate that 85% of veterans should reach their training goals in forty sessions or less. Meeting training goals means recovery of function to at least 85% of pre-war functioning. (In our greatest success story so far, a Vietnam veterans reduced his PTSD symptoms by over 90% in only eighteen sessions.) Since this is a brain-training procedure rather than merely a program of recovery, we expect that many veterans will end up functioning better than they ever have before.
The second aspect of the work addresses the more psychological aspects of the war-time experience. You may also have come away with visual memories that you wish you had never had. There may have been periods of intense fear, or of a sudden confrontation with death, or perhaps you experienced the death of members of your unit. Our bodies are geared toward registering life-threatening events in perpetuity. At the biological level, that educates the fear response. At the psychological level, we register these as traumas. In the trauma experience, these two realms become intimately coupled. When these events are re-awakened in the brain, they are often fully re-experienced. It is therefore a matter of training the brain so that these events become part of your normal memory, recallable at any time but not having you in their grip.
The second kind of training takes your brain to a benign state of inward orientation. If a traumatized individual enters such states, the traumatic memories are quite likely to surface. But they can be well managed in this state, so the body learns to accommodate these memories without upset. The entire relationship to your past will be altered. The memories are by no means erased. They just lose the power over the rest of your life. If this kind of training is indicated for you, then the first kind of training above will not be enough by itself. Most likely, some symptoms or other will just crop up again later unless the second kind of training is undertaken also, or an equivalent alternative is pursued. This second approach may be referred to variously as "deep-state" training, or "alpha-theta" training, again referring to EEG frequencies.
And what about those cases in which there has been real injury to the brain? We have worked with a great variety of cases of traumatic brain injury over the years. The existence of an organic locus of injury tends to focus the attention there, and also has the effect of lowering our expectations for recovery. The good news, however, is that most of the consequences of traumatic brain injury are not directly traceable to that organic injuryhowever, is that most of the consequences of traumatic brain injury are not directly traceable to that organic injury, or to the locus of that injury. They are in fact the usual symptoms seen in many head injured folks, regardless of whether there is organic structural injury, and irrespective of where it is. These are the symptoms of head pain, first of all, plus mood disregulation, anxiety and depression, effort fatigue, energy level, vision problems, planning and executive function deficits, memory problems, motor control deficits, and problems with working memory and cognitive function. This general quality of brain injury symptoms has been known since German soldiers were studied after they came back from WWI.
These symptoms are largely the rogue's gallery already referred to as being responsive to Neurofeedback. We can help here just about as well as in cases where no locus of injury has been identified. This again is due to the fact that the entirety of the neural networks involved in neuro-regulation have been altered in their function. It's not just about the place that was injured in the brain.
We see the effects of this in the EEG in most cases. The EEG will exhibit sudden changes even when you are sitting in a chair resting. That documents the brain's propensity to be unstable. And that for us represents a target for training through feedback. We also divide the EEG into its various frequencies, each of which has its own functional implications. Training some of these frequencies can be seen by analogy to putting the brain on a stair stepper. This is nothing more than an exercise. We push the brain (through feedback); it pushes back. We push it again; it pushes back again. Eventually this strengthens the brain's internal machinery of regulation.
And if all of this doesn't work? In the worst case, we will have wasted your time and some trips to the office. But if we cannot help you that will be obvious fairly early in the training. We usually expect to see some direct benefit of the training even after the first few sessions. If that is not the case, we are not inclined to stretch out the process and waste people's time. (It is prudent to issue this kind of disclaimer, since we can never know what the next case may bring. But in our experience we have been able to help every veteran to the point where they were grateful for the changes they were seeing.) The clinician may have some other alternatives to discuss with you, which you may want to consider. There are in fact quite a few different ways in which the brain can be coaxed or coached to behave better. Usually clinicians handle only one or two of these, but some have all the hardware options under one roof. Each of these options has at least one website attached to it, so you can check them all out.
And now we have a remedy that lies entirely in your own hands: Just Train Your Brain.
Night terrors (unremembered; can't be awakened out of the state)
Apparent nightmares
Unrestful sleep
Seizures that were not there before
Irritability
Rages
Mood swings
Emotional numbing and withdrawal
Increased use of licit and illicit drugs
Anxiety and Depression phenomena
Worsening of symptoms of asthma, allergies, tics
Cognitive deficits
Short-term memory deficits
Slowness of thought
Heightened visual or auditory sensitivity
Racing thoughts
Blanking out; spacing out
Exaggerated Startle Response
Inability to plan activities
Increased migraine incidence; worsened migraine severity
Increased pain syndromes
Tremors; poor motor control
Dizziness or vertigo
This sober appraisal appears in an article by Scott Shane of the New York Times. About one soldier in six is reporting anxiety, depression, or symptoms of Post-Traumatic Stress Disorder. With a total number of soldiers having served in Iraq or Afghanistan now numbering about one million, perhaps as many as 100,000 soldiers will require long-term mental health care. However, post-traumatic stress disorder may not surface until months after the return from combat duty and many soldiers or veterans are too proud to admit that they might have mental issues so they try to deal with it themselves. This delay can worsen the symptoms and make the recovery period even longer.
One platoon leader in Iraq, a Mr. Rieckoff, said that he never encountered a combat stress control unit while in Iraq. This suggests that the Armed Forces are not taking mental health concerns seriously, since much is known about how combat stress can be dealt with before the accumulation of unrelieved stress ultimately causes the soldier to burn through his resources.
Neurofeedback is essentially the only available remedy for the lingering symptoms of traumatic brain injury. And it is a remedy because the deficits in TBI lie largely in the functional realm. Blast injury, concussion, or whiplash may not leave much obvious physical evidence of injury, but the loss of function may be considerable. And it may well linger over the long term. Much of this functional loss can be recovered quickly, which is to say within twenty to forty brain training sessions. Research has shown that MTBI symptom recovery by an average of 85% with respect to pre-injury levels of function within an average of about 30 training sessions. Newer methods promise even better and faster results. A trainee should know within four to six sessions that he is being significantly helped. Most likely, he will know it after only one training session.
Ongoing research is finding subtle organic injury within the brain even for blast exposure where none had been expected. The good news is that these findings helped to put blast injury on the agenda as a problem that needed to be acknowledged. Perversely, however, it also increased skepticism as to the remedies that might be brought to bear. The answer, however, is already in hand: it is neurofeedback. Good brain function is possible even in the face of distributed small-scale lesions within the brain. And even if brain function cannot be fully recovered, successful brain training for a good quality of life is still in prospect.
Many of the self-regulation skills that the veteran will learn during this training will be useful over the rest of life. Eventually all this will be taught to every school child. But first things first.
- Siegfried Othmer, Ph.D.
Chief Scientist, The EEG Institute and President, Homecoming for Veterans
For more information on Siegfried Othmer please visit http://www.drothmer.com/