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From electric eels to batteries to home-based direct neurofeedback!

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Were you aware that electric fish, like the eel and catfish, were utilized for healing, including physical health ailments such as headaches and epilepsy, as well as for mental health challenges such as melancholia and hysteria? They also provided the inspiration for the invention of the first battery in 1800. Transcranial electrical stimulation has a long history rooted in ancient practices and modern scientific advances for therapeutic purposes. Now, with continued advances in technology and a growing understanding of the neuroplasticity of the brain, are we on the verge of a new in-home healing revolution using electricity?

I have been providing direct neurofeedback in my office to clients challenged by many symptoms, such as hyperreactivity, impulsivity, mental fog, panic attacks, and procrastination, for over 5 years now. This treatment has been offering long-term results to often elusive symptom relief without prescription medication. The results have been so heart-warming when clients experience and report positive changes in their lives in a relatively short period of time. Unfortunately, this treatment is not as readily available as medications and often times, not covered by insurance.

Early use of brain stimulation techniques included neurosurgeons mapping brain areas during surgery, which started in the early 20th century and continues today. Then, in the 1970s, research into electrical stimulation as a treatment tool began in earnest with the development of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). In 1985, the first TMS device was developed (by Anthony Barker and colleagues) for use in research and therapeutic environments. Unfortunately, during this same time period, advances were also being made in pharmaceuticals for psychiatric disorders, which took away the attention from electrical therapy research.

The good news is, in 1998, researchers seeking more effective and targeted treatments with fewer side effects than pharmaceutical medications ignited a resurgence in electrical brain stimulation. New brain imaging techniques and stimulation methods brought tDCS to the forefront again, allowing research to focus on treating both neurological and psychiatric disorders. However, initially such tools were big and heavy and located primarily in research medical facilities due to the high cost of the equipment, making access to such care challenging.

As both TMS and tDCS gained increased recognition as effective treatments for conditions such as anxiety, depression, attention-deficit disorder and chronic pain, progress continued to improve computer processing capabilities, reducing the size and cost of such tools. At this point, private practitioners (such as me) were able to afford to purchase the equipment and offer this non-invasive treatment on a broader basis. Current research continues to expand by exploring tDCS in healthy individuals to enhance cognitive and neurological functioning, thus paving the way for this technology to be even more widely accessible.

So, similar to the history of electric cars, transcranial electrical stimulation (AKA direct neurofeedback) is back and here to stay. Perhaps one of the last remaining questions might be: Can this technology be deployed in our homes remotely? Well, a recent research study seems to support this potential inevitability.

If you are interested in reading more, click below:

Will Neurofeedback Be Available at Home?

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

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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:

Neurofeedback and Virtual Reality for PTSD

Can two decades of research be wrong about the benefits of direct neurofeedback for neuropsychiatric disorders?

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I don’t think so!

With the growing awareness around complex trauma and the corresponding increase in mental health challenges, such as anxiety, depression, and addiction, it is mission critical that the healthcare system take off the blinders and drop the belief that prescription medications are the first line of attack to address such challenges. Most health care insurance will now cover acupuncture and chiropractic services, which are considered complimentary and alternative medicine (CAM) practices, in addition to more traditional, conventional medical services for what ails the body. However, they seem more reluctant to turn to CAM when addressing what ails the mind. After twenty years of research, direct neurofeedback or transcranial direct current stimulation has been shown to relieve the symptoms of many neuropsychiatric disorders.

The mind is the different levels of consciousness that arises from the brain, the main organ of our neurological or nervous system in the human body. Therefore, the mind works through the organ of the brain to think, feel and decide what action to take or not. So when we are challenged by our mental health, we can work with the mind and/or the brain. Traditionally, medications were prescribed for the brain while psychotherapy was prescribed for the mind. But what if someone is not responding to the medications or doesn’t want to take medications at all? How can we then work with the brain directly, while also working with the mind? That’s where direct neurofeedback comes in.

With the growing understanding of the neuroplasticity of the brain, more noninvasive brain stimulation options have been explored. Neuroplasticity is the nervous system’s innate ability to reorganize itself towards health and balance in response to stimuli by creating new neural networks in the brain. This facilitates the neurons to regulate their responses to new situations. Direct neurofeedback communicates with the brain directly in its own natural electromagnetic language, gently stimulating the brain’s neuroplasticity, facilitating the interruption of the imbalances of the brain and supporting the development of a more balanced state. This approach trusts in the human body’s inborn ability to heal itself when the support structures are organic.

When someone has a history of complex trauma, the body and mind naturally adapt for survival, and symptoms of that adaption include, but are not limited to, panic attacks, obsessive-compulsive thoughts and behaviors, fibromalgia, self-harm behaviors, impulsivity, chronic fatigue, poor concentration and procrastination. The American Psychiatric Association produces a book, called the Diagnostic and Statistical Manual of Mental Disorders, creating labels for all of these normal human adaptations to a chronic hostile environment. The book might be more appropriately titled Human Trauma Responses. When the healthcare system wears this lens when offering healing modalities, it can begin to embrace person-centered care that involves personal choice, which trauma robs us of. Within choice of healing journeys, CAM options become more available when backed by decades of research. As a safe and affordable neuromodulation approach, direct neurofeedback has potential in many clinical uses.

If you would like to read more about this research:

Two Decades of Research on Direct Neurofeedback Supporting Mental Health

Might direct neurofeedback reduce impulsive behaviors?

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The symptom of impulsivity can be found listed under several mental/behavioral health diagnoses, including but not limited to intermittent explosive disorder, substance abuse, OCD, PTSD and binge eating disorder.  When the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5™) was published in 2013 and included binge eating disorder, I finally felt validated and, at the same time, gratitude for discovering yoga, which helped to reduce my anxiety and my out-of-control eating, especially in light of the fact that I didn’t want to start taking any prescription medications.

My relationship with food has been a long and winding road.  I have memories when I was 4 or 5 of sitting at my kitchen table by myself, long after everyone else finished eating and was allowed to move on, because I was not allowed to leave the table until I finished everything on my plate, including those horrible green vegetables.  I tried every trick in the book, including slipping some to the dog under the table and putting some in my mouth, wiping my mouth with a napkin and spitting what was in my mouth into the napkin.  I also hear my parents in my mind saying “Eat your food!  There are people starving in Africa” and thinking to myself “Great, send them my food!”.

From there, after my parents got divorced, food became scarce for most of my adolescence.  My parents’ divorce and subsequent relationship was very contentious, pushing me into the land of anxiety.  I began to worry about where my next meal would be coming from and if it would be enough.  The pattern that grew from there involved eating large amounts of food (even if I wasn’t hungry) when food was available and eating very quickly (to ensure I got enough before it disappeared).  I also have memories as a young adult where I would eat my meal very quickly and then eat what was left by others on their plates.

As time passed, my relationship with food changed when my weight began to increase.  At this point, I would not allow myself to eat anything until the end of the day, after I had taken care of everyone else’s needs on my list.  Only then, almost like a reward for completing my “To Do” list for others and my sense of self-restraint or control, would I allow myself the indulgence of fulfilling one of the most basic human needs.  What didn’t change at this point though, was the speed in which I ate and the amount of food I would eat!

I then ventured into the many ‘diets’ being promoted.  My weight began to yo-yo.  My life felt so out-of-control as did I!  It wasn’t until I discovered yoga that I found myself in a space to really confront this unhealthy relationship I had with food, facing the fears lying beneath my journey in the land of anxiety.  And even with the support of my yoga practice (and a boost from some hypnotherapy), it took me many more years to see food as simply a source of energy for my body, like gas or electric for a car.

So how excited was I when I read the recent promising research on using direct neurofeedback (i.e., transcranial direct current stimulation or tDCS) to reduce impulsive behaviors!  Although it is not exactly clear how it does so, a positive effect was found in 74 out of 92 research studies.  It warms my heart to learn that there is an alternative to prescription medications, something that specifically supports the brain’s innate ability to reorganize itself towards health, and does so relatively quickly.

If you would like to read a little more on this research, click on the box below:

Neurofeedback for Impulsivity