Treatable Conditions
The following conditions can be treated with Neurofeedback therapy:
Anxiety (see also Panic Disorder & Worry)
This topic deserves a longer discussion, but in this brief summary let it just be said that the most common application of EEG Biofeedback field is the treatment of anxiety disorders. There are any number of ways in which a person’s physiology can be trained to function in a calmer fashion at lower levels of physiological arousal or state of agitation. A lot of the work with anxious people involves teaching them the ways in which they can help their own condition with conscious influence on their own physiology.
A simple change in breathing strategy, meditation, relaxation techniques, or simply improving coping strategies are all ways of leading to the adoption of new habits by the body/mind which can profoundly improve health.
EEG Biofeedback can help as well. Gently the brain is trained to operate out of a calmer place. Initially this may take the anxious person out of his or her historical comfort zone. Even if this is actually a zone of discomfort, it is still what the person is accustomed to.
So it is important to train people toward calmer states while keeping them within their comfort zones. The training is therefore highly individualized, and that is the breakthrough that EEG Biofeedback has made possible. We encounter three classes of anxiety:
Each of these requires a different approach in training; for instance, the more severe condition may have its roots back in the early childhood history of the sufferer, and that also has implications for what is to be done. The less severe cases of anxiety are meanwhile readily amenable to EEG Biofeedback training.
The benefit of resolving anxiety conditions are not just to be seen narrowly with respect to anxiety per se, but will influence the person’s entire quality of life, for example how the person pays attention, deals with personal relationships, performs under pressure, etc. If underlying arousal/anxiety is reduced performance will improve in many different areas.
Depression is in fact a complex disorder that finds various expressions in clinical populations. Depression has increased in incidence for over a century, to the point where it is becoming the single largest cause of loss of productive life years in the western world. Depression does not have the visibility that cancer and heart disease have in our culture, but it has an impact that is comparably devastating. And Prozac is not the answer.
From a brain perspective, depression is to be seen as yet another "Disorder of regulation". With EEG biofeedback it is possible to train the brain to pull itself out of depression and maintain itself in a better state of dynamic equilibrium.
People who have a history of depression often fall into that pattern quite suddenly, and sometimes unprovoked. It may not even make sense given their life circumstances. It is therefore to be seen as principally a problem of brain organization. The proper EEG Biofeedback technique can in many such cases pull people out of mild or moderate depression thinking just as rapidly as they fell into it. Over time, the brain is trained toward stability, and then a recurrence is no longer expected. If a recurrence does happen, the remedy lies close at hand. In other words mild depression can be a problem of the brain, not of the mind.
The above will seem like a startling revelation to most readers, but in fact no one should be surprised. After all, a frequently used medical treatment for severe depression remains shock therapy, in which a single treatment is expected to “reset” the system so that depression no longer manifests. In the perspective of EEG Biofeedback, shock therapy is just monumental overkill. A gentle technique can just as effectively coax the brain toward a more functional state.
Migraine (see also Headaches)
For quite a number of years now it has been found that biofeedback techniques are one of the best available remedies for migraines. This is well documented in the published literature that has accumulated over the years. The problem has been in getting the story out to those who need it. After all, the first point of contact of a migraineur is with his or her GP, not with a biofeedback practitioner. And the medical world is going to prefer its own set of remedies first, namely medication.
However, one of the problems was that traditional biofeedback techniques weren’t all that much better than the medications at the outset. Often the medications gave people a kind of quick honeymoon period with their migraines, whereas biofeedback techniques had to be learned over time. Eventually, however, the medications tend to accumulate their own sets of problems; they may no longer work so well, and they may cause rebound headaches. Medication strategies thus can become complicated. Over that same timeframe, the biofeedback path increasingly shines. By the time three years have elapsed from the outset of therapy, biofeedback is distinctly superior to the medication-only route.
Of course it’s not really an either-or situation. If biofeedback strategies are learned, then the medications can simply play a more minor backup role so that over-medication effects can be avoided. So biofeedback strategies are available for any migraine sufferer, irrespective of whether they are fond of their medications.
Over recent years we have seen EEG Biofeedback strategies constantly refined to address the problem of migraines. In the case of EEG Biofeedback, the technique turned out to be very similar to the one that has been found optimal for seizure disorder as well. We have here a powerful technique for using the brain’s own resources for stabilizing itself. The success rate of the new technique is extremely good. Not only that, this success has been achieved with some of the most difficult migraine patients.
Most people who just have an occasional migraine will typically content themselves with a medication strategy. Those who come for EEG Biofeedback tend to be those who have suffered severely from migraine histories that have extended over decades. They are quite ready to be rescued from such a life, and they will accept the discipline—and the costs—of undertaking some twenty or more EEG Biofeedback training sessions.
For most migraineurs, a comprehensive remedy for their migraines is now available with the combination of EEG Biofeedback, attention to lifestyle issues and risk factors. And all the “natural” remedies can be supported by the medications if necessary.
One final note: among those with a long-term migraine history, it is likely that the migraines are just the “tip of the iceberg” of a more pervasive set of issues. In this introductory piece we have just focused narrowly on the migraine issue itself. The fact is that EEG Biofeedback represents a much more comprehensive strategy toward self-regulation that can also be of help with the other issues such as psychological trauma, etc., of which the migraine maybe just a signature.
One of the prominent applications of traditional biofeedback has been to the area of chronic pain. Most recently, it has been found that EEG Biofeedback can be helpful here as well. Results are coming out in which profound symptom relief can be obtained within a single session, although these gains are usually transient. Over time, clients can be trained to the point where these gains can be held onto permanently.
Chronic pain patients often exhibit a variety of problems, not only pain. But when pain is present, it rises to the top of our hierarchy of needs. Frequently among chronic pain patients there is a very high incidence of background anxiety. The correlation is so high that is seems as if the anxiety sets people up for chronic pain. For this reason it is never sufficient simply to address the pain, even if we did know how to do that systematically. One needs to also address the anxiety. That rarely happens in a medical setting where the attention is focused on medical remedies such as drugs, implants and blocks.
The importance of generalized anxiety in the history of chronic pain patients highlights for us the importance of the psychological realm. Pain is subject to regulation by the central nervous system, which it is possible to access to through EEG Biofeedback. With intervention improvements are made in the entire regulatory environment of the chronic pain sufferer, and with that the level of perceived pain improves as well. The point may be reached at which the pain may no longer bother the person even though, if asked, the pain may indeed still be present at some level.
Much of this is due to lifestyle issues that nibble away at the hours we should be spending asleep. The problem is actually bigger than that. Our lifestyles in the Western world also drives us toward living in brain-states that make it difficult for us to climb down later into restful, deep sleep. Much can be done for this state of affairs in the realm of self-care. However, when the brain has developed into bad habits over decades, the adoption of self-care remedies may only result in modest improvement and not sufficient to be sustained. EEG Biofeedback can give the brain a strong reminder of what it is like to sleep well. Once that is in place, sound health practices are easier to maintain. Even though excessive daytime sleepiness is not an issue that calls for emergency measures, the payoff for proper attention to this issue might well be huge in terms of quality of life and function.
Interestingly enough in using EEG Biofeedback for a variety of conditions, the quality of sleep is usually one of the first things to improve, and it does so quite irrespective of whether sleep was thought to be a problem.
The quality of sleep is an index to the quality of self-regulation, and the latter influences both waking states and sleep. Improved self-regulation is the objective of EEG Biofeedback and improved sleep is not only a consequence but also a measure of treatment success.
Headaches (see also Migraine)
It is mystifying why the efficacy of EEG Biofeedback for headaches is not widely recognized, because this has been the case for a very long time. The answer may simply be that over time headaches have become more and more a medical issue, and medical doctors tend to resort to their own methods, which in this case is medication. But if the medications worked well, why would we then still have so many headache sufferers in this country? The medical remedy is clearly not adequate.
So the good news: EEG Biofeedback is an excellent remedy for both what are called “tension” headaches and for migraines. In fact, treating migraines is not substantially more difficult, and it is not significantly less effective, than treating ordinary tension headaches. What this is really saying, of course, is that nearly every person is already carrying the remedy for his or her own headaches with themselves. Their nervous systems simply need to be trained toward better self-regulation.
Clinical success in dealing with headaches/migraines is greater for EEG Biofeedback than for almost all other conditions. Importantly it succeeds in people who have had debilitating history of headache/migraine, particularly if combined with attention to lifestyle issues and risk factors.
Nightmares are scary dreams. They must be distinguished both from night terrors and the nocturnal flashbacks of posttraumatic stress disorder, which are often referred to as nightmares inappropriately. Nightmares respond well to EEG Biofeedback training that is optimised to the person. In fact, nightmares are a signature of our having found the appropriate training procedure in those who have nightmares. And if nightmares arise during the course of EEG Biofeedback training, the procedure needs adjustment. Given the sensitivity of nightmares to EEG Biofeedback, they are among the first symptoms to respond to training, as are sleep difficulties in general.
Clenching/Grinding Teeth (Bruxism)
Teeth clenching and teeth grinding are quite common, and they appear to be nothing more than a problem of disregulation of motor control, complete with a label. The brain can be trained toward better self-regulation, and the symptoms subside. This is even true for nocturnal bruxism, because indeed the brain is still in charge even while we are asleep. The EEG Biofeedback alters patterns of regulation, and these carry over into sleep.
Successful EEG Biofeedback may make it possible for the client even to leave the nocturnal mouth guard on the night table. Jaw aches and associated neck pain may be seen to disappear. If bad habits should happen to reassert themselves after some while, an occasional booster session can be helpful in restoring good regulation.
Insomnia (see also Sleep Disorders)
Common insomnia tends to fall into two categories: difficulty falling asleep and difficulty staying asleep through the night (or of falling asleep again after nocturnal waking). We distinguish between these because in some approaches they train somewhat differently. There is an association between the sleep-onset difficulty and anxiety, and between the sleep maintenance issue and depression. And just as we might train depression and anxiety somewhat differently, the same goes for the related sleep issues.
Good sleep is more than the absence of insomnia. The training of brain function gives one the possibility of achieving sound sleep even if one has not experienced it since perhaps infancy! This is one area where EEG Biofeedback diverges from medical remedies for insomnia. The medications do help one sleep, but by and large they extract a price. Over the long term there is the hazard of dependency, and over the short term there may also be a price to pay in terms of quality of sleep.
EEG Biofeedback, on the other hand, targets the basic self-regulatory function of the brain and has no side effects. Improvements in sleep quality are frequently one of the first things to improve with EEG Biofeedback. These improvements can be long-term especially if combined with attention to life-style factors, which may be contributing to the insomnia.
Sleep Disorders (see also Insomnia)
EEG Biofeedback is helpful for a variety of sleep disorders: difficulty with sleep onset; frequent waking; bed-wetting in childhood; restless leg syndrome; central and obstructive sleep apnea; teeth clenching; sleep walking and sleep talking; circadian rhythm disregulation (caused by jet lag or shift work).
The success of EEG Biofeedback on many sleep disorders is evidence that EEG Biofeedback targets very basic regulatory functions of the brain, such as the management of physiological arousal. The complex organization of our sleep takes us through a variety of states of arousal. Any deficiency in basic arousal regulation is therefore likely to show up in sleep. So any improvement we are able to achieve with EEG Biofeedback should show up readily in quality of sleep.
In essence sleep problems are an index to the quality of self-regulation generally. A particular sleep issue may not seem all that momentous in itself, but it is seen more as an indication of a more pervasive problem of the brain disregulation. it could therefore be the spur for further investigation into a course of action. The payoff for better sleep could indeed be multi-faceted.
Panic Disorder/Hyperventilation (see also Worry)
Panic events are not just a more extreme form of anxiety. They represent a distinct state, a kind of paroxysm of the autonomic nervous system. It is highly alarming to experience, although not serious. Witth EEG Biofeedback our objective is simply to stabilse the brain so that it does not trip over into a panic attack. It turns out that this is usually not difficult to do. The remedy almost seems trivial in comparison with the immensity of the experience of panic.
Training the brain toward stability is what EEG Biofeedback does well. On the other hand, medications do not handle this well, by and large. Medications of necessity target one or another aspect of our regulatory function, whereas it is the overall function that needs to be addressed.
Worry (see also Anxiety & Panic Disorder/Hyperventilation)
Worry is part of the anxiety spectrum, and from a brain prospective worry as is in the province largely of the left hemisphere. As a left hemisphere phenomenon, worry has more of a rational and cognitive dimension than right hemisphere anxiety, which has more to do with fear and dread. It also has more of a prospective or planning dimension, which is also the burden of the left hemisphere. It also has a “lexical” aspect, in that we are typically able to articulate worry and know what it is about. Worry is usually connected with an identifiable object. By contrast right hemisphere anxiety can be diffuse and generalized, a kind of pervasive and persistent state of oppressive and intolerable “Angst.” In any event, brain training with a left frontal or pre-frontal bias can be very helpful if worry is a persistent or pervasive problem. By extension, right hemisphere training is more appropriate for fear and for morbid dread.