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.
Rachael Frankford, MSW, RSW is a clinical social worker in private practice. This blog is to share musings on mental health and about the intersection of mindfulness, neuroscience, and psychotherapy.