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What new non-drug approaches to treating PTSD are on the horizon?

My husband purchased a virtual reality headset a couple of years ago to enhance his workout routine. I thought whatever supports his efforts to maintain his health and increase his chances of a longer life, go for it! Two years later, he continues to use it, so I’m grateful it was not just another impulse purchase that sits on a shelf somewhere. His continued use of it reflects virtual reality’s potential staying power. What does any of this have to do with PTSD treatment?

One of the first-line evidence-based treatments for PTSD is prolonged exposure therapy. Prolonged exposure is a trauma-focused psychotherapy that supports people as they confront memories, feelings, and situations that they avoid since their trauma. The premise of this approach is to gradually teach them that their trauma-related memories and cues are no long dangerous in the present and don’t need to be avoided. One approach to prolonged exposure is imaginal exposure where the person revisits the traumatic memory in their imagination and recounts the event. This imaginal exposure causes the person a great deal of distress, promoting emotional engagement with the trauma memory. It is then followed by cognitive processing of the experience of revisiting their trauma. Although effective, might there be another approach that might reduce the level of distress by speeding up the psychophysiological habituation process through this approach?

That is the exact question that the VA attempted to answer in a recent research study. They wondered if they added repeated, bifrontal direct neurofeedback (AKA transcranial direct stimulation) to therapeutic exposure using virtual reality, would it reduce the symptoms of PTSD perhaps faster. The VA already recognized the significant potential of noninvasive brain stimulation as a novel treatment to reduce PTSD symptoms, specifically in the particularly difficult population of military veterans. They had conducted a prior pilot study that showed promising findings which prompted them to move forward with the gold standard of research, a double-blind randomized clinical trial. This RCT replicated the key findings of the pilot study, including significant improvements in self-reported PTSD symptoms, reductions in autonomic arousal, and improvements in their social functioning. They concluded that combining repeated direct neurofeedback with virtual reality is a promising strategy and highlights the innovative potential for these combined technologies.

If you are interested in reading the full research article, click below:

Can neurofeedback be a “Nudge” to a Stuck Nervous System Due to Early Life Stress?

Growing up in a single-mother household created a lot of stress and fear that stayed with me even as an adult.  Such a household dynamic brings a greater risk of poverty, which creates challenges in securing a safe place to live and putting food on the table on a consistent basis.  Fear in childhood from stressful experiences can change the trajectory of a person’s health over the entire life span if not addressed, specifically an elevated vulnerability to addiction in all of its forms.  Now, with the advent of the pandemic, we might need to add this to the long list of stressors that children struggle to adapt to as it might be years before the impact and lingering effects of the fear and isolation it has caused to be fully understood.  Is it possible that neurofeedback might be able to “nudge” the fearful nervous system back in the direction of health?

What we have learned about adverse childhood experiences and the traumatizing effects of such, is that talking about it may not be enough to move through the fear and calm the emotional centers of the brain.  More is needed and not everyone is willing to tolerate the side-effects of prescription medication, such as suicidal thoughts.  Therefore, research into alternative and complementary non-invasive, non-medication treatments, such as yoga and neurofeedback, has increased over the past couple of decades, with very promising results.

A recent review focused on neurofeedback to determine if it might help move the autonomic nervous system away from fear toward homeostatic equilibrium in people who experienced early life stress.  The researchers conclude that neurofeedback can increase the efficacy of other training protocols and more traditional talk therapy techniques.