Neurofeedback: If It Can Help PTSD Veterans, Why Not Addicts, Alcoholics and Those With Sleep Disorder?
A long history of treatment of substance abuse with EEG failed to lead to mass acceptance. That may change based on success with Post Traumatic Stressed-Out vets.
To be a person with Post Traumatic Stress Disorder (PTSD), is to have a section of your brain disabled by an invisible injury in which you keep reliving the dark side of your emotional past while seeking desperately to find your way back to a life and normality you once knew. It can be pain beyond belief.
PTSD as a mental health condition affects an estimated 7.7 million Americans, according to the National Institute of Health. The military is particularly hard hit. According to the U.S. Department of Veterans Affairs, PTSD affects 31% of Vietnam veterans, 10% of Desert Storm veterans, 11% of Afghanistan veterans and 20% of Iraqi veterans.
Less well known is that an astonishing 52% of men with PTSD are diagnosed as alcoholics and 34% suffer from drug addiction. Of the women diagnosed with PTSD, 28% experience alcoholism and 27% drug addiction.
The larger substance abuse and alcohol dependent community – 25% of Americans – will recognize core symptoms of PTSD. These can include sleep problems, irritability, aggression, uncontrollable rage, physical pain, dependency, tinnitus, jumpiness, loss of interest or an increased feeling of isolation.
Among the treatment modalities creating some fresh buzz and attracting more research and treatment funds is neurofeedback, a process by which computerized brain data is fed back in sensory form to patients. (It is also known as EEG biofeedback, or NFT for neurofeedback training.)
During a session electrodes are attached at selected points to a client's scalp and the information on brain activity is reported to the individual within a fraction of a second through visual, auditory and tactile stimulation. In essence, the brain witnesses its own activity and, seemingly miraculously, alters its own patterns toward a more stable state. As the brain waves shift moment to moment, the patients gain awareness of their own bodily responses, become able to track sensations and feelings, and then learn to use these sensations as therapeutic tools for healing.
Neurofeedback has a decades-long history in alcohol and drug treatment, often with some notable positive results. Even so, it has not been mainstreamed for a variety of reasons, including treatment prejudices and lack of serious funding for peer-reviewed studies. Other factors are the variety of forms and techniques that can give different results with different populations, and the reality that proper training as a practitioner can be extensive.
A shift may be coming. Among the leaders now in testing and expanding neurofeedback as a treatment mode is EEG Institute in Woodland Hills, California, whose findings treating PTSD might clearly overlap into more support for EEG for substance abuse. It was just a few years ago that the Institute began treating PTSD-suffering veterans because of the poor track record of standard therapy and pharmacology.
Alongside its regular treatment center, the EEG Institute also runs the non-profit Homecoming For Veterans and has facilitated neurofeedback treatment centers at several military bases around the country. Homecoming provides this cutting-edge treatment to veterans at no cost to the vets and as part of a nationwide program.
Dr. Siegfried Othmer, its director, spent decades perfecting the style of neurofeedback treatment at the EEG Institute. Othmer argues that the conceptual underpinning of EEG treatment was a shift out of an incorrect understanding of PTSD. "We are finding that PTSD is a physiological condition that has psychological consequences. That gets people thinking mistakenly that it should be treated in a psychological domain. But that's largely ineffective because you don't talk people out of trauma. We can rescue people with this treatment just by dealing with the physiology.”
"The brain wants to work from a resting state,” Othmer explains. “The problem with PTSD is that those who suffer from it can no longer access that state because they're feeling perpetually agitated, and because of that, their nervous system never calms down and this is what disrupts their entire life. By using neurofeedback, we basically allow the brain to find its way back by giving it information. Once that person experiences that for a while, then that person can live comfortably."
Othmer believes that all military personnel should be able to benefit from similar treatment. Toward this end, his facility donated all the equipment used at another Homecoming for Veterans program - at the Salvation Army Bell Shelter in Bell, CA, which provides housing primarily to the homeless. The Bell Homecoming program began last April and recently expanded operations from two to four days a week utilizing volunteer neurofeedback technicians backed by a staff managerial hiring. Based on the early success, the shelter is also ramping up to soon treat substance abusers with EEG.
Paul Wager, clinical director at the Bell Shelter, told The Fix that several veterans in the PTSD pilot program have already transitioned out of the shelter and into their own apartments. Some now have jobs and are functioning independently. "We're very excited to have been able to expand the program,” Wager said. "We need more studies done on this to give empirical validation to this treatment because for those of us using it, it's so obvious that it works."
According to Wager, sleep disorders and anxiety are the most prevalent symptoms of PTSD. With treatment the symptoms decline and the patients become calmer and more stable.
"We oftentimes don't realize how truly important sleep patterns are,” Wager said. “Some of us may have a bad night's sleep but then we are able to resume normal sleep patterns. Some of these folks will tell you they haven't had a good night sleep without heavy medication for 10 or 15 years. Even on the medication they're not sleeping particularly well, so for them, it's like a revelation that they're able to sleep for six or seven hours a night."
The Bell Shelter also operates a 75-bed on-site drug and alcohol treatment center called The Wellness Center. (Overall the Shelter, which is capable of housing 350 people – the largest homeless shelter west of the Mississippi - currently houses about 200, most of whom are veterans.)
"Neurofeedback has been shown to be very effective in treating addiction," Wager says, citing evidence from treatment centers elsewhere. "Now with [our expansion into] more hours, we're going to educate our Wellness Center staff and see who wants to participate. We’re hoping to be able to open up this program to some non-veterans and people who are in our substance abuse program, to help them with their recovery process."
He added: "The typical relapse rate for substance abusers who enter treatment is about 78% within a year. That's a pretty high number. With some of the treatment facilities that are utilizing neurofeedback, that number drops to between 25% to 28% relapse rate."
WHO IT'S HELPING
Veteran Montana Nino, a former Marine now living at the Bell Shelter, reports that for a long time she couldn't figure out why she was so persistently angry and depressed - it wasn't like her. During her military service she suffered no serious physical trauma but after it she couldn't shake her negative feelings no matter what she did. Then she had eight neurofeedback sessions at Bell that, she says, are making a major difference.
"I've been in the program since January because I was suffering from depression and PTSD," Nino told The Fix. "Now I find myself thinking more positively, whereas I always used to think negatively, which is what led to my depression. Now I feel more alert. I wake up earlier. I'm getting stuff done instead of taking a nap."
Nino noted that before she entered the program, some of her PTSD reactions to events were over the top.
"I had an episode where someone came up from behind me and pinched me and I socked her in the gut. It was an instant reaction and I felt horrible and I really wanted to control that. Now I haven't had any of that in a while. I feel more calm and less anxious. There's been a lot of changes and I want to continue this for as long as I can."
Gerald Kraft, who served in Vietnam from 1972 to 1975, also reports serious earlier anger issues. He has undergone 35 neurofeedback sessions at Bell.
"This is helping me to stop, recognize and be able to think things out before I lose control,” Kraft said. “It's working good at keeping me calm. It's even brought me to a point where I'm finding the positive in everything and I'm always in a good mood instead of being angry and frustrated, and so I'm happy with it."
Veteran Cesar Rauda has also been in the program for a while. His major problem is tinnitus, or ringing in the ears. The noise can be continuous or intermittent and can vary in loudness. It can cause the sensation of hearing buzzing, hissing, chirping, whistling or other sounds, and can worsen at night due to low background noise. Rauda had sought help for it at the VA but doctors couldn't figure out the cause or cure.
"They couldn't help me but then I heard about this program," Rauda said. "Now it's gone in one ear and going away in the other. I also sleep better. It's helped me a lot because I'm more relaxed."
Therapist Carol Kelson, PhD, a neurofeedback professional who works at the Los Angeles-based company Advanced Neurofeedback, has been a volunteer at Bell since the start of the pilot program. She wrote her dissertation based on the Bell findings and will be presenting those at the 35th annual meeting of the Society of Behavioral Medicine in Philadelphia in April.
Kelson says she has seen first-hand the positive results of EEG treatment, including reversal or easing of negative cognition and moods, of hyper vigilance and of aggressive and destructive behavior.
"We started by doing a study of veterans who had PTSD symptoms and we had two groups, a group that was treated with neurofeedback and a group that was not treated with neurofeedback. We asked them the same questions weekly. We were tracking symptoms over time and we followed their results from before treatment, during treatment and then after 20 sessions. There was a huge result for those who were treated with neurofeedback. Everybody in the treatment group improved dramatically and those in the control group stayed the same or in some cases got worse.
“All those who were untreated in the study are now included in the program and are also doing better," Kelson said.
Ben Miller, another Advanced Neurofeedback professional, volunteered two days a week during the pilot program and is now spending four days a week treating the veterans. The program expansion, he notes, affords treatment opportunities to many veterans otherwise occupied with prior obligations such as attending classes or doctor and dentist visits.
"I think this is really going to help,” Miller said. “We've seen a huge difference in quality of life for most of the vets just by getting them more sleep. It's helping them become less irritable and they're more social and more efficient in their daily activities."
For more information about the program, visit the EEGInfo website.