How does neurofeedback help to heal from trauma? People who suffer from trauma have a range of symptoms including anxiety, depression, hypervigilence, flashbacks, emotional reactivity, sleep disturbances, etc. From a neurofeedback perspective we can understand that all of these symptoms are disturbances in the resting state of the brain, otherwise known as the “default mode network.” Neurofeedback helps by teaching the whole brain to be in a good resting state so the whole system (body/mind) can calm down.
The Othmer method of neurofeedback treats trauma in two stages. The first stage addresses physiological regulation of the body through Infra Low Frequency Training. The second stage is working with deeper states and processing with a training called Alpha Theta. It is important that enough time is spent on stabilization before addressing deeper states as the body needs to feel safe enough to process the held memories of trauma.
First Stage: Infra Low Frequency Training
After doing an extensive 2 hour intake assessment to understand each person’s nervous system, we come up with a plan for training over a period of 20 sessions to start. In the first stage of treatment, the brain is trained at a frequency of .1 or lower. This is done by watching a video screen of a movie or game for a duration of 30-40 minutes with sensors of the head that pick up electrical activity of the brain. A sophisticated computer program takes that information and feedbacks information through changes in the signal from the monitor, giving your brain the information it needs to track a very low frequency.
Each person’s brain has an optimal low frequency that lets them feel calm and focused. In the first few sessions of ILF training we find that optimum frequency through a process called optimization. Through the 20 sessions we add training sites in the brain to address different symptoms of trauma. This is a gradual and collaborative process and requires a lot of attention to tracking how one feels during and in between sessions. It requires a lot of commitment and patience for both therapist and client as it takes time to get the protocol just right for each person. The overall result is a much more calm and regulated nervous system.
Second Stage: Alpha Theta Training
The first stage of ILF training can take more than the initial 20 sessions. Each person is very different and the progress in treatment can depend a lot on the nature and severity of the trauma; other compounding factors such as diet and substance use; and whether people are integrating neurofeedback treatment with traditional talk therapy to address the experience of trauma and recovery. All of these factors will impact on the progress of neurofeedback.
Once we know that the nervous system is regulated enough that people can feel relatively calm and resilient we can consider adding deep state training. By this time people feel they have more energy, can sleep through the night, recover more easily from life stressors, and feel more present and engaged in their lives.
Alpha theta training trains the brain in a very different way from ILF training. In this training the eyes are closed and we are induced into a deep relaxed state, usually in an inclined position with blankets to keep one comfortable. Alpha theta works with deeper parts of the brain (brainstem) by releasing cortical control. With the eyes closed our brains can go into an alpha and theta stage which means there is a dominance of these frequencies in the whole brain. Alpha waves are 8-13 Hz and are dominant when we are in an awake and relaxed state. Theta waves are slower (4-7 Hz) and are present before the very slow delta waves of sleep. In a theta state the brain produces more images and memories that can be processed.
Alpha theta training is often done with an induction to guide people into an internally focused, relaxed state. We may start with a short guided meditation to relax the body and mind and to settle into the training. It can also be helpful to set an intention or affirmation to help release traumatic memories and learned habits, and start to integrate new ways of being. This part of the practice can be very helpful in planting the seed for change that can happen through alpha theta training.
Alpha Theta training may be introduced before 20 sessions of ILF or after. Once people are introduced to this training they can choose whether they integrate it with ILF or shift into only doing Alpha Theta training.
Third Stage: Integration
The third stage of treatment for trauma is one that should be addressed through the whole process but becomes more important as the nervous system is regulated. This is the stage of integration and processing the meaning of trauma and recovery. While neurofeedback takes away the necessity of only using talk therapy for the recovery of trauma, it is still important to integrate psychotherapy in order to understand what it means to live without trauma. Often people experience a lot of grief for the years that they have suffered and how much they lost through this experience. They may also start to have a very different sense of self that can be very disorienting. All of these issues can be addressed through talk therapy.
Neurofeedback is not meant to be a stand alone treatment for trauma but one very powerful tool that can enhance and support the different treatments that support recovery of the whole person in body, mind and spirit.
Why is it so difficult to slow down, calm the busy mind and relax the body? This is one of the most common problems I hear about in my practice and for most of us the answer has to do with our addiction to busy lifestyles and constant engagement of our minds. The pace of our lives may be difficult to change but there are practical tools to help train the brain to slow down when needed.
One tool that I recommend and practice myself is the practice of Yoga Nidra, a guided meditation that promotes a deep state of relaxation. Research shows that a 30 minute practice of Yoga Nidra can equal 2 hours of restorative sleep and it is a relatively simple practice to learn. It just takes a commitment to making the time in one’s day.
Yoga Nidra and the Brain
Yoga Nidra works at the level of our brain waves by decreasing high beta frequencies (busy mind), increasing in alpha frequencies (relaxed state), and then guiding to a deeper dream like state with increased theta frequencies.
An interesting study in Copenhagen demonstrated this shift in brain wave activity by looking at the electrical activity of participants with an EEG during a Yoga Nidra practice. They found that the whole brain was in a relaxed state, similar to sleep for the duration of the meditation, and there was an increase of theta activity (11%) while the alpha activity did not decrease significantly (2%). This shows that the meditative state of Yoga Nidra is different from sleep in that the brain is still conscious and alert while allowing for a slowing down of thoughts and increase in images of a dream like state. It is in the space that rest and restoration can happen at the level of the whole nervous system.
Healing for Mental Health
Yoga Nidra comes from an ancient Tantric practice of yoga and has been adapted more recently for modern times and for mental health conditions such as anxiety, depression and trauma. One of the reasons that Yoga Nidra is effective for mental health problems such as trauma is that is promotes long term changes in the brain through neuroplasticity, the brain's ability to establish new synaptic connections and set new neural pathways for healing and self regulation. Research on Yoga Nidra fro trauma, for example, has shown a significant decrease in symptoms of PTSD including reduced rage, anxiety and emotional reactivity. A 2014 study with veterans 2014 published in the International Journal of Yoga Therapy “showed significant decreases in negative thoughts of self-blame and depression." Richard Miller, the creator of iRest, has adapted Yoga Nidra for PTSD and has conducted research with combat veterans, homeless people, domestic violence survivors, and other traumatized populations with very good results.
How does it work?
Yoga Nidra is essentially 10 practices in one. There is a sequence of steps that guides one from the busy mind state to a deeper and deeper state of relaxation. All of the steps may be practiced or just a few, depending on how much time one has to practice. These 10 steps are adapted from Richard Miller’s modern version of Yoga Nidra.
Step 1: Initial Relaxation
In this step we prepare for Yoga Nidra by lying down in a comfortable position in a room with little distractions. This is traditionally done in savasana or corpse pose with legs and arms extended, eyes closed and a blanket to keep the body warm. We take some time to settle the body and mind and shift to an inner awareness by letting the body be supported and relaxed.
Step 2: Setting of Intention for this Practice
In Yoga Nidra we make an intentional shift to acknowledge that we are doing this practice for the next 30 minutes and reflect on the attitude we are taking towards ourselves and this practice. We let everything else go, as best we can, and take a stance to welcome our experience as it comes and let the teacher’s words become our own words that guide us to a deeper state.
Step 3: Sankalpa or Heartfelt Desire
We now move beyond setting the intention for this particular practice and reflect on our heartfelt desire for our lives. This is very personal and is expressed in present moment language. Some examples of a sankalpa are “I am at peace”, “I am healthy in my body and mind”, “I have caring relationships in my life.”
Step 4: Finding an Inner Resource
This step is very important for people who suffer from anxiety and trauma and may feel unsettled and unsafe by paying attention to their inner experience. The inner resource can be a place, person, or image of something that evokes a feeling of safety and comfort in one’s life. We hold this image to evoke the feeling of safety and know that we can come back to this place at any time.
Step 5: Body Rotation
The mind is now guided to the specific sensations in throughout the whole body. This can be done fairly quickly so the mind has to keep moving attention to the direct sensations as they occur and is less easily distracted by random thoughts.
Step 6: Breath Awareness
The focus of attention now becomes the breath and the physical sensations of breathing. This can be done by counting the breath cycles backwards to help maintain focus of the mind.
Step 7: Opposites – Feelings, Emotions, Beliefs
This step moves beyond this direct physical experience to incorporate particular sensations (cold/hot, heavy/light), emotions (happy/sad, hurt/loving), and deep seated beliefs (I am worthy/unworthy) and how they are held in the body. We pay attention to opposites, moving from one to the other and then holding both.
Step 8: Joy – Visualization
The next layer of our experience to explore is the bliss state. In Richard Miller’s iRest practice he invites a feeling of pleasure, joy, or love. One may also be guided to particular images and visualization that can evoke deeper feelings of well-being.
Step 9: Witnessing – Observe Yourself
As we come towards the end of the practice we let go of any particular focus and just observe the self as a witness. We become aware of the part of self that can just observe the self and all the experiences that emerge in the present moment.
Step 10: Integration
The last step is to slowly emerge from the deep inner experience and return to a waking state. We set an intention to integrate Yoga Nidra into our daily lives and be more alert and relaxed in our waking state.
Here is a guided Yoga Nidra practice to try. It is recommended to try this practice on a regular basis to help the brain and body integrate the state of deep relaxation over time.
24 minute Yoga Nidra practice
For an introduction to Richard Miller's iRest practice try out these guided meditations: