Neurofeedback training and PTSD

Neurofeedback training can be effective with Post Traumatic Stress Disorder (PTSD) by allowing the client to calm the "fear network" which, due to the trauma, freezes the rational brain and the prefrontal cortex in particular. The prefrontal cortex holds the areas responsible for speech processing. This constitutes a problem for clinicians attempting to use "talking cures" to help the client - these memories become literally unavailable for processing.

 PTSD is associated with but not exclusive to combat situations

PTSD is associated with but not exclusive to combat situations

There is also research that suggests that PTSD compromises the default mode network. The default mode network (DMN) is a network of interacting brain regions that is active when a person is not focused on the outside world.

We know that PTSD is not experienced just by persons in war zones; it can arise whenever stress is not correctly processed.  Situations such as motor vehicle accidents, rape and other traumatic events can lead to PTSD.

An organism's response to threat is normally fight, flight or freeze. When fight or flight is not activated the last option is enabled - immobility. Trauma that is not resolved has been described as a "frozen residue of energy that has not been resolved and discharged -- trapped in the nervous system"

The brain's natural plasticity allows it to adapt to the stress but the result is what we label as PTSD.

We know that the autonomic nervous system has two parts the sympathetic and paraympathetic pathways. The sympathetic nervous system should only be activated in times of stress with balance then achieved as soon as possible via the parasympathetic system. Unfortunately in PTSD humans suffer from chronic activation of the sympathetic nervous system. Traumatised people tend to be hyper-vigilant and unable to relax.

Where neurofeeback training fits in

 Neurofeedback training screen of a NeXus system allows easy identification of frequency band energy levels and selection of feeback thresholds

Neurofeedback training screen of a NeXus system allows easy identification of frequency band energy levels and selection of feeback thresholds

Neurofeedack training could be described as as a learning modality - a type of biofeedback that facilitates changes in brain wave patterns, cerebral blood flow and neurotransmitter balance to useful effect.  Clients experiencing neurofeedback are presented with representations (feedback) of their own subconscious brainwave patterns and encouraged to change them to patterns which are judged to be "optimal".  The client receives audio-visual feedback which is intended to encourage the achievement of the desired optimal state. There is no effort of struggle involved and much of the learning takes place at the subconscious level.

The goal of neurofeedback training is primarily stress reduction and relaxation via non-invasive means. Neurofeedback targets the hyper-arousal component of PTSD that tends to prevent sleep without drugs. Historically the type of neurofeedback used was so called Alpha-Theta (AT) training.

This training is so-called as it uses feeback to encourage reinforcement in the amount of energy in the Alpha and Theta bands.  AT training has been found effective for cocaine abuse, alcholism, stress disorders and chronic PTSD. This training appears to open a window to access traumatic memories that allows then to released and processed without re-traumatising the individual.  Although CBT, eye movement desensitisation reprogramming and drug therapies are considered effective treatments for PTSD, they are more costly than neurofeedback in total resource commitments.

Related materials

M Shim, C-H Im, and S-H Lee (2017)
Disrupted cortical brain network in post-traumatic stress disorder patients: a resting-state electroencephalographic study
Transl Psychiatry. 2017 Sep; 7(9): e1231.

Judith K. Daniels, PhD, Paul Frewen, PhD, Margaret C. McKinnon, PhD, and Ruth A. Lanius, MD, PhD
Default mode alterations in posttraumatic stress disorder related to early-life trauma: a developmental perspective
J Psychiatry Neurosci. 2011 Jan; 36(1): 56–59.doi:  10.1503/jpn.100050