November 27, 2023 by Dr. Sal Barba, PhD., BCIA-BCNAs I have hinted at in the previous blogs on this website, largely, human suffering comes from destructive emotions and thoughts. It appears that the brain does not make clear distinctions between thought and emotion. Every region in the brain has been found to participate in the generation of emotions that are connected to cognition. The circuitry for cognition and emotion are intricately connected. Therefore, when we study the mind, we are brought right into the internal space of psycho-emotional states, and through the introspective process our brain lights up in numerous neuro-networks and pathways.
We are vulnerable to unwholesome states of mind, and the mind also has the potential to cultivate wholesome states of mind. One of the challenges with Western Psychology is the separation of emotion and cognition. Western thought, in general, doesn't particularly put emphasis upon understanding the nature of thought and emotion, or making the time to study and learn about what the relationship is between a felt sense, and cognition. This may have something to do with going back to the Enlightenment period, and perhaps further back to Aquinas, when there was an enormous priority focused upon reason and intelligence. However, the Contemplative approach in psychotherapy and neurotherapy, as a science and as a practice do not conflict in the perspectives they have upon the environment; they both have differing approaches in their attempts to arrive at the same end: seeking the truth and liberating others from suffering by studying what is happening internally in a moment of suffering. Therefore, both ways of seeking the truth can expand our knowledge, experience and understanding. For example, Contemplative Buddhism and Christian Contemplative practices are rich in their histories of inner science and have been of practical interest to many researchers studying cognition and neuroscience. Thus, offering significant contributions to their understanding, and to those of us who have integrated brain-based approaches into the context of neurotherapy.
I recall many years ago when his Holiness the Dalai Lama came to Seattle to talk, and to participate in the Science of Mind Conferences. He stated, "The more we pursue material improvement, ignoring the contentment that comes with inner growth, the faster ethical values will disappear from our communities. Then we will all experience unhappiness in the long run, for when there is no place for justice and honesty in people's hearts, the weak are the first to suffer. And the resentments resulting from such inequity ultimately affect everyone adversely." (2002.)
There is no doubt that scientific and technological innovations have helped to make our lives better, but the impact technology and science have on our lives, our spirituality, our mental health has an even greater responsibility in reminding us of our humanity. This point is particularly important to our younger generations, whom are already being negatively impacted by technology, alienating them from each other, and from their natural environment. Therefore, we must continue to take responsibility in our communities, academic institutions, and family systems to balance scientific and material progress with a greater sense of responsibility that comes along with encouraging and supporting introspective development into social action. That is, we must support and encourage skill development and understanding, on a fundamental level, engaging in the exploration of how destructive thoughts and emotions can chisel away at the human heart, mind and soul, and to learn how to navigate and counter this potentially dangerous trajectory in our collective nature. Furthermore, to meet this challenge, we require more competent clinicians and funding to provide more services to our communities. Our current level of mental health care is already overloaded without enough mental health providers to meet the demand of need. In fact, many clinicians have a long wait list, and often don't have time to return potential client inquiries.
From the perspective of the Contemplative approach and of the science of the brain and mind, emotional states become a perplexing challenge in that these are brain responses that have, in part contribute to and shape the human mind, and presumably have performed a crucial role in our human survival. Currently, destructive emotions threaten our individual lives, our families, the communities that we live in, as well as our collective fate. The good news is that there is a growing sense of lassitude, where human beings collectively by and large are becoming completely tired of all of the violence, homelessness, lack of safety in our neighborhoods and academic institutions concomitant to the lack of action taken against these forms of suffering from our city councils to our state government and national government.
It is this kind of emotion that makes us have a strong desire to get out of our suffering by recognizing the source of our suffering. From this realization and acceptance comes the attitude of what is referred to as "emergence," which means to experience an arising aspiration for the freedom from our suffering! From a Contemplative perspective, emotions can also guide us to experience greater internal space that allows internal room for peace of mind, and what I refer to as a non-neurotic sense of silence, joy and serenity.
Serenity and silence do not prevent us from being active. They are different from passivity or indifference. Instead, they allow us to have greater compassion and awareness, and equanimity. It is with equanimity that our compassion for others is not mixed with an underlying attachment of self-interest. Therefore, with the additional support of the contemplative therapeutic process integrated with neurotherapy, the contemplative practitioner can hold in his or her presence, the client's suffering within an inquiring open and compassionate way. It is this even-mindedness that can counteract and neutralize an unwholesome state of mind by bringing a self-accepting attitude into the introspective process. Through this work, an attitude of curiosity, inquiry, patience and discernment can mindfully exam one's symptoms in depth without trying to get rid of them. Through this awakening attitude a person can find deeper understanding, insight and wisdom from the way their mind and body carries what lies beneath the symptoms they live with.
I will continue to write more blogs regarding the contemplative approach integrated with neurotherapy. Until then, I would suggest reading Tara Brach's book, Radical Acceptance, The Psychology of Awakening by John Welwood, New Seeds of Contemplation, by Thomas Merton, The Eloquence of Silence, by Thomas Moore, Experiencing and the Creation of Meaning, by Eugene T. Gendlin.
November 24, 2023 by Dr. Sal Barba, PhD., BCIA-BCNThere are basically 7 types of Neurofeedback for the treatment of various disorders:
- Frequency/power neurofeedback: This method often includes the use of 2 to 4 scalp surface electrodes, known as “surface neurofeedback”. This is also referred to as "traditional neurofeedback," which is what many clinicians, and lay people use, and can be purchased or rented for office or home use. It is used to change the amplitude or speed of specific brain waves, in particular brain locations to treat ADHD, anxiety, and insomnia. The following are some of the more known standardized surface training neurofeedback software systems.
- Slow cortical potential neurofeedback (SCP-NF) improves the direction of slow cortical potentials to treat ADHD, epilepsy, and migraines (Christiansen, Reh, Schmidt, & Rief, 2014).
- Low-energy neurofeedback system (LENS) delivers a weak electromagnetic signal to change the patient’s brain waves while they are motionless with their eyes closed (Zandi-Mehran, Firoozabadi, & Rostami, 2014). This type of neurofeedback has been used to treat traumatic brain injury, ADHD, insomnia, fibromyalgia, restless legs syndrome, anxiety, depression, and anger.
- Hem Encephalographic (HEG) neurofeedback provides feedback on cerebral blood flow to treat migraine (Dias, Van Deusen, Oda, & Bonfim, 2012).
- Live Z-score neurofeedback is used to treat insomnia. It introduces the continuous comparison of variables of brain electrical activity to a systematic database to provide continuous feedback (Collura, Guan, Tarrant, Bailey, & Starr, 2010).
- Low-resolution electromagnetic tomography (LORE-TA) involves the use of 19 electrodes to monitor phase, power, and coherence (Pascual-Marqui, Michel, & Lehmann, 1994). This neurofeedback technique is used to treat addictions, depression, and obsessive-compulsive disorder.
- Functional magnetic resonance imaging (fMRI) is the most recent type of neurofeedback to regulate brain activity based on the activity feedback from deep subcortical areas of the brain (Hurt, Arnold, & Lofthouse, 2014; Lévesque, Beauregard, & Mensour, 2006a).
Traditional Neurofeedback involves direct attention to stimuli during a 45-60 minute session. Typical results are achieved in an average of 30-40 or more sessions. In Direct Neurofeedback, no sustained attention to stimuli is required. The majority of traditional or standardized neurofeedback devices are limited to the influence of the cortical surface. They are very useful and can be effective. Although, they can't address the subcortical regions of the brain. SW LORETA Neurofeedback, which is a Z Score multi-channel training system , and uses a full cap to target both the cortical and subcortical areas of the brain simultaneously, utilizing a highly customized protocol design to address the specific challenges assessed during an initial interview, and based upon a QEEG! Generally, SW LORETA training does not require more than 20 to 30 sessions, sometimes less training sessions depending upon whether those challenges are chronic. The best outcome from the use of SW LORETA training is when it is integrated with various modalities of psychotherapy and active imagination methods.
Some Neurofeedback software systems are passive meaning the client just closes their eyes and listens to tones or lights or both. These programs may be AVE systems: Audio Visual Entrainment Training devices. Audio-Visual Entrainment (AVE) is a technique that uses pulses of light and sound at specific frequencies to gently and safely guide the brain into various brainwave patterns. By altering your brainwave frequencies, you can boost your mood, improve sleep patterns, sharpen your mind, and increase relaxation levels, all with the simple push of a button! You can google MindAlive Inc. to inquire further about these devices and their cost.
The Brain lobes descriptions below provide the reader with a nice outline of the locations and their functions. This chart was borrowed from John Demos--(Getting Started With Neurofeedback, Demos, 2005). LH: Left Hemisphere. RH: Right Hemisphere. The areas below are based upon the 10-20 International site location map. Even numbers are located on the right hemisphere, odd numbers are located on the left hemisphere, and letter sites without numbers attached to them are along the midline of the scalp. Two to four channel neurofeedback software can target the scalp to address various surface areas on the scalp. These sites, or locations target the symptoms that might be the focus and protocol design to use for any given training session.
Sites
Functions
Considerations
Parietal lobes
Pz, P3, P4
LH: Problem solving, math, complex grammar, attention, association
RH: Spatial awareness, Geometry
Dyscalculia sense of direction learning disorders
Frontal lobes
FP1, FP2, FPZ, FZ, F3, F4, F7, F8: Frontal regions of the scalp. These address:
LH: Working memory, concentration, Executive planning, positive emotions.
RH: Episodic memory, social awareness Frontal poles: attention judgment
LH: Depression
RH: Anxiety, fear, executive planning, poor executive functioning
Temporal lobes
T3, T4, T5, T6
LH: Word recognition, reading, language, memory
RH: Object recognition, music, social cues
Facial recognition
Anger, rage, dyslexia, long-term memory, closed head injury
Occipital lobes
OZ, O1, O2
Visual learning, reading, parietal- temporal-occipital functions
Learning disorders
Sensorimotor cortex
CZ, C3, C4
LH: Attention, mental processing, RH: Calmness, emotion, Empathy Combined: Fine motor skills, manual dexterity, sensory and motor integration and processing
Paralysis (stroke), seizure disorder, poor handwriting, ADHD symptoms
Cingulate gyrus
FPZ, FZ, CZ, PZ, OZ
Mental flexibility, cooperation, attention, motivation, morals
Obsessions, compulsions, tics, perfectionism, worry, ADHD symptoms, OCD & OCD spectrum
Broca’s area
F7, T3
Verbal expression
Dyslexia, poor spelling, poor reading
Left hemisphere
All odd numbered sites
Logical sequencing, detail oriented, language abilities, word retrieval, fluency, reading, math, science, problem solving, verbal memory
Depression (underactivation)
Right hemisphere
All even numbered sites
Episodic memory encoding, social awareness, eye contact, music, humor, empathy, spatial awareness, art, insight, intuition, non-verbal memory, seeing the whole picture
Anxiety (overactivation)
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Abbreviations: LH, Left hemisphere, RH: Right hemisphere, AHHD: Attention deficit hyperactivity disorder, OCD: Obsessive compulsive disorder.
Alpha/theta is indicative of awareness and sleep. Alpha/theta training is another neurofeedback approach that can be used once the brain has been stabilized through neurofeedback training. A/T training is one of the most popular neurofeedback trainings for stress reduction (Gruzelier, 2009; Raymond, Varney, Parkinson, & Gruzelier, 2005). Furthermore, this training approach is helpful for deep levels of depression, addiction, anxiety while it increases creativity, relaxation, musical performance, and promotes healing from trauma reactions. The electrodes are usually located on O1, O2, CZ and PZ. Alpha/theta frequency range is 7–8.5 Hz with the typical value of 7.8 Hz. This training approach is implemented through the eyes-closed condition that increases the ratio of theta to alpha waves while using auditory feedback (Demos, 2005; Egner & Gruzelier, 2003; Thompson & Thompson, 2003).
When in search for a neurofeedback clinician, be certain that they are board certified, and inquire about what kind of neurofeedback software they use, as well as whether or not they administer QEEGs to assess whether your brain is presenting a hypo or hyper connectivity challenge, and to inform them on how to develop a customized protocol that will target your brain's specific issues. Ask them about their level of competency, how long have they been practicing, what kind of results do they obtain, what types of clinical issues are they comfortable in training and working with? What is their scope of practice? Are they knowledgeable about neuroscience, QEEGs, their own equipment, and do they use consultants when assessing various types of challenges a client is experiencing regarding their brain. Find out how long they have been practicing. After you have gathered your information, then contact ISNR or BCIA to ask them about what they know regarding that clinician, and what they can do to support you to understand the Neurofeedback training software that is being used by that clinician. It is important to find out whether a piece of equipment is FDA approved. Home training devices are becoming more popular. However, consider very seriously whether you want to work with an out of state clinician rather then a local Neurofeedback clinician, then find out what the State requirements are to work with an out-of-State clinician. Afterward, make certain to request a QEEG so that your clinician has a good understanding of what is happening with your brain, and how to design a protocol that will safely support neuro-regulation of your brain. If you work with an out of state clinic and clinician, be certain to locate a local clinician who is competent to provide you with a QEEG before you begin your training.
For more information regarding research papers, and what S LORETA and SW LORETA is google Applied Neuroscience Institute. They have marvelous free studies at the ANI website.
My next Blog will discuss what Neurodynamic Therapy is. This is a new model of how to integrate other modalities of psychotherapy, and active imagination to learn how to use advanced neurofeedback to shift states of mind from traumatized states to non-traumatized states of consciousness. This new model has positive implications for healing and resolving trauma. NDT was recently published as a chapter in, Introduction To Quantitative EEG and Neurofeedback, 3rd Edition (Chartier, Dellinger, Evans, Budzynski, 2023, Academic Press).
December 26, 2022 by Dr. Sal Barba, PhD., BCNSW LORETA (Sorted Weighted Low Resolution Electromagnetic Brain Tomography in real time 3-D) is a multi-channel-full cap advanced neurofeedback approach in helping individuals with a variety of cognitive, emotional, physiological and learning challenges. This training method helps to regulate networks in the brain and helps to enhance cognitive, emotional and physiological functioning. Research has shown neurofeedback to be effective in addressing a variety of clinical applications, including performance issues, learning challenges, attention deficits, autism, sleep, depression, anxiety, PTSD and addiction. Unlike standardized clinical grade cortical surface neurofeedback, SW LORETA training targets various neuro-networks in the brain addressing cortical and subcortical regions, such as in Parkinson's, and challenges related to balance, or other regions of the brain such as A-fantasia, or Alexithymia.
The individual observes real-time feedback of his brain functioning during Neurotherapy, which helps build awareness of inner states and make changes in a healthier, more balanced direction. Feedback is presented with the use of a computer, video animation or bar graphs, and a 19 channel sensor cap, which is administered on the scalp, in order to detect EEG activity - see image below. Upon successful analysis of a QEEG Brain Map, a customized protocol is designed, based upon the location and symptoms of the client.
Biofeedback training is a neurophysiological approach that can be integrated with neurofeedback by teaching skills such as relaxation and lowering arousal. Biofeedback sensors are worn to detect pulse rate, breathing, temperature or skin sweat. Biofeedback increases awareness of physiological states and is an effective regulation practice.
As a clinician practicing for forty years, I integrate contemplative practices during a training session, such as guiding the client to learn how to notice, attune to thoughts, feelings, attention, mood, breathing rhythm, and how to enhance skill during training to deepen awareness, self reflection, empathy, insight and integration of what is learned from session to session. Furthermore, the client learns to become an active participant in their training sessions by learning how to integrate visualization and imagination to benefit and experience positive change as they are engaged in a training session utilizing this advanced neuro-technology.
After 10 sessions of Advanced SW LORETA Neurofeedback Training with a client, depression, attention, anxiety and PTSD showed remarkable improvements in neuro-network regulation identified at the cortical and subcortical regions. A customized protocol was developed to target multiple areas of the brain that were simultaneously trained toward a successful outcome.
The Navistat image below shows the QEEG Baseline taken prior to developing the customized multi-channel protocol. The tenth session using the customized protocol shows remarkable regulation of network function (brain image on the left compared to the QEEG Baseline on the right). The key to successful neurofeedback outcome is to identify the right location and the right symptoms when providing advanced neurofeedback that addresses multiple neuro-network training.
