Can Increasing the Daily Amount of Neurofeedback Training Improve the Clinical Outcome and Other Case Histories?
The following case histories may have useful implications for neurofeedback because they imply possible clinical effectiveness with immune disorders, anorexia, and obsessive, compulsive disorders. In addition the neurofeedback timing strategies used suggest that the length, frequency and total number of sessions may be as important in achieving best neurotherapy results as titration is in the administration of medications.
A Dangerous Obsession
He had reached an advanced stage of anorexia. As a 54 year old construction worker, he was normally 6′ and a well muscled 155 lbs. At the beginning of therapy he was 118 lbs., eyes sunken, somewhat manic, claiming his diet of mostly lettuce was making him high and filling him with energy. He was almost completely isolated as his behavior had destroyed his marriage and alienated him from his friends. He had not worked for five years at his trade as he was on disability. He was almost broke even though he earned between sixty and one hundred thousand per year when he was working. He was obsessed with a well known cult which had counseled him to distance himself from his family, and against seeking therapeutic help. He had invested over $200,000.00, virtually his life savings, in the cults system of “therapy and enlightenment.”
He discussed the possibility of suicide on several occasions in the beginning and was experiencing many stress related disorders including sleeplessness, irritability, hyperactivity, intense loneliness, and much obsessive/compulsive symptomology including going over and over often unimportant details. He fluctuated between overtly aggressive, hyper behavior as he tried to convert people to his ideas, and passively aggressive behavior when individuals attempted to establish relationship with him. A strong concern at the beginning of therapy was that irreversible organ damage might have already occurred because of his complexion, gaunt, haunted appearance and the obviously massive loss of muscle tissue, even though he continued to exercise vigorously (as is the case with many anorexics). Biofeedback therapy was for him a desperate last resort.
Within three weeks of beginning neurofeedback training (adjunctive to counseling) his demeanor had changed remarkably, he had begun to gain weight and he entered enthusiastically into the life rebuilding process. He began sleeping better, felt much calmer and more optimistic, less lonely and isolated. He began to form new relationships and he was opening up and talking to people in ways that were impossible before. He wanted to report on his “Love Stories”. An interesting example follows: He would go to playgrounds and sit and watch children play. This made him feel so happy at times that he would weep. This appears to be healthy abreactive phenomena happening hours or days after actual neurofeedback training. People he met or had known before seemed to be easier to be with. He saw that he had changed and was giving others the chance to be affectionate and not blocking them with his rigidity, restlessness and passive aggression. He began to eat a more balanced diet and gained weight reaching 150 lbs. within the first year.
Although he had studied “meditation” extensively, he almost never did it because he felt it was boring and a waste of time. It was suggested that he forget about meditation as he knew it and just do the EEG work. After the first week he had learned enough to do his version of the “EEG work” without hooking up. He said that now instead of forcing himself to meditate he looks for opportunities to sit and simply make his alpha. He reports surprising benefits like those he had hoped to receive from meditation are flowing from these alpha sessions. He realizes now that what he had thought was meditation was not, because he was merely sitting still and straining to concentrate, which is why it was boring, unpleasant and flat.
He has since obtained his own EEG home trainer and continues a remarkable transformation of life style. Interestingly, at first he didn’t realize how important the EEG work was. Like many clients he discounted the neurotherapy and looked for other things to attribute his improvement to. This is common and frustrating for NFB practitioners. During the neurofeedback training he constantly wanted to talk. Instead, he was encouraged to train first and discuss later. The results spoke for themselves.
About nineteen months after he began neurofeedback therapy, he looked quite fit for his 56 years, his complexion was good and his personality, even his voice seemed remarkably changed. He was working full time and furthering his education pursuant to changing his profession. A follow up revealed that at age 60 he was continuing to work (maybe too hard) and he reports that he has solved his economic problems; and the combination of his working and investing will generate a considerable net worth within a relatively short time. He is engaged and intends to marry this year. He continues in the construction business and is unusually fit for his age. He believes neurofeedback and the counseling that accompanied it is responsible for saving and assisting him in transforming the quality of his life.
A Cancer Case
She was a seventy seven year old woman with a diagnosis of multiple myeloma (bone cancer) and intestinal cancer. Her oncologist estimated that she would live between four months to one year. She was being treated by first rate doctors at Swedish hospital in Seattle, which is probably one of the best hospitals in the US. Doctors developed a treatment plan including a resection, a relatively small amount of radiation, and a mild form of chemotherapy in order to make her more comfortable.
She was trained in neurofeedback on a CapScan for two 1-hour alpha-theta sessions per day for ten days and after that she continued on her own using her “internal instrumentation”. Approximately three months later we checked her “calibration” to see if the two hour per day practice of her “Alpha Meditation” without equipment was delivering the same amplitude and per cent time of alpha and theta as when she was working with the equipment. She was right on the money, producing about 35 UV of alpha approximately 80% of the time. She then received six to ten 1-hour booster sessions per year for several years. She has been retested several times and clearly demonstrates that she is maintaining, even increasing her ability to produce alpha without the feedback equipment. She also loves the attention and the assurance that she is on track.
Frankly, when we began the neurotherapy it was not because we thought it might have a beneficial effect on her immune system. Actually, it was in order to deeply relax her central nervous system and to assist her in getting a handle on mind states that would enable her to deal with the distress of dying. We hoped she would develop her meditation skills to a level which would help her reduce her pain and her need for mind numbing medications, thereby allowing her to enjoy her large family more and to enter the final stage of life with as much mindfulness as possible. One of the inspirations that led to this strategy is the work of John Cabot – Zinn with end stage cancer and chronic pain patients in Boston.
She says the training has helped her handle the drugs and the pain better, and indeed her children have been comforted and inspired by her amazingly cheerful, wise, clear headed and compassionate behavior in the face of her illness. In fact, they report that she seems happier and more mentally alert than she has been in some years. However, as of this writing this case has taken an exceptional turn. She was able to make a trip to the East Coast fifteen months after the diagnosis. Twenty four months after her diagnosis her oncologist stated that he had never seen this type of cancer become so inactive and relatively pain free in a patient who was by that time 79 years old. He avoided using the term remission.
At the time of the diagnosis the patient was mostly confined to a wheel chair. Four years later she was walking up and down stairs and using a cane. She is cheerful and seems remarkably grateful for her relatively good health and active life. She makes at least two air trips a year to stay with her children and her oncologist officially declared her cancer in remission. He said he had not seen this happen before in a patient of her age (at that time almost 81). A follow up indicates she is still in remission (at 85 years old). I have read that there have been less than fifty documented cases of remission of multiple myeloma in the United States in this century.
Another neuro-immune anomaly?
Following is another case history from one of the biggest rehabilitation hospitals in the US. A female meningenoma patient developed a pea-sized tumor which gradually grew to the size of a grape and then a plum. She underwent brain surgery and began rehabilitation because of neurological problems caused by the surgery. After several years the tumor reappeared and progressed to about the size of a plum again. She underwent another surgery. A number of years later the process repeated itself. The period of the three operations covered about fifteen years.
Sadly, the tumor reappeared for the fourth time and grew again to about the size of a grape and the patient was sent to the neurofeedback therapists at the hospital so that they could do the standard Traumatic Brain Injury protocol with her. They were hoping to improve her social skills and ability to initiate an action. The NFB therapists primarily employed a high frequency (beta) strategy with theta inhibit over the frontal lobes. They also did about three months of beta training over the site of the tumor. When they sent her for her pre op exam the neurologist was amazed to see that the tumor growth had apparently stopped.
This brought great relief because both the neurologist and the surgeon did not believe she would survive another operation; and if she did survive it they were sure she would be severely neurologically impaired. The neurologist said that they would look at her again in a year. Her family was euphoric because they had feared the worst. As of this writing she is stable and her next exam should be in about six months. So far, so good.
The trouble started when her mother began inquiring into what had been done this time that might have caused a better outcome. When she found out that the only thing different was the NFB she speculated that the NFB might be causing changes that had slowed the tumor growth and that continued NFB might even reduce tumor size. Naturally, she petitioned the neurologist and neurosurgeon to continue NFB with the patient. The neurologist asked the NFB therapist to do a literature search to see if anything like this had been reported and when it was clear that it had not he said that the whole idea was too absurd and in any case it was too experimental so he ordered NFB therapy terminated.
The mother was furious but unable to persuade them to change their minds. The neuro surgeon would not even return the therapist’s phone calls. There was so much resistance by the administration (neurologist and neurosurgeon) that the NFB therapists felt their jobs were in jeopardy. In fact, because of this episode and other similar conflicts, the neuropsychologist who set up and ran the entire NFB operation (at considerable profit to the hospital) has left and established a private practice nearby. There was apparently tremendous anger over the idea that the NFB therapists had suggested that NFB might have contributed to the stabilization of (or in any way effected) the tumor growth. To emphasize their point all tumor patients at the hospital are prohibited from NFB regardless of the reason (i.e., relaxation, education, rehabilitation, cognitive dysfunction, stroke, etc.). The mother is trying to find a way to continue NFB. It will be interesting to see what happens to the tumor and the patient from here on out.
Ray’s Story
“As a concerned parent, I have spent 33 years trying many kinds of therapy for my brain damaged daughter, Laura. I seem to have finally found something that’s helping her mental development. For the first time, I’m seeing real progress. A process called EEG Biofeedback Training seems to be normalizing her brainwaves to the point where she’s becoming teachable. This process appears to be a major breakthrough and it could portend a whole new ball game in educating certain types of mentally handicapped individuals. While I’m still not a total believer, it looks very promising.
Shortly after Laura’s birth, she was diagnosed as having cerebral palsy and brain damage. Physical rehabilitation specialists helped her learn to walk. She learned to run by herself. Speech therapists helped her learn to talk. Now she talks too well, or rather too much. With lots of help from some marvelous doctors and therapists plus her great spirit, she gradually overcame many of her physical disabilities. Today her physical development is far ahead of her mental development. Since modern medicine hasn’t yet learned how to stimulate brain growth or jump-start neurons, I looked for an alternative.
I found EEG Biofeedback Training. It’s fairly new, hence its use is relatively uncommon. NASA uses it to train pilots and astronauts. Psychologists are beginning to use it to treat ADHD. Within the past several months it has enabled her to reduce her distractibility about 80%. It seems to have jump-started her cognitive processes, perhaps her neurons. I think “jump-start” is an appropriate metaphor since it implies a threshold.
Now Laura is planning and organizing her time, reading more and more each day and even reading script. She understands years and months fairly well, weeks and days not as well. She is beginning to understand the hour hand of a clock. The minute hand and the concept of minute is still too abstract for her. Several people have remarked that her self-esteem and self-confidence appear to have improved this past year. Although her distractibility is way down, her ability to concentrate is still poor in many areas. It’s premature to go into detail, but it appears that certain of the scores on the neuropsychological tests that comprise what’s known as IQ may well have improved. Naturally, my own bias must be considered.
One Year Later: Today, her clinician and I looked with amazement at the graphical performance summary of one of her recent sessions. He said to me, “These brainwave characteristics are no longer any different from yours or mine.” More important to me is the fact that her ADHD symptoms are gone! And without the use of any medication! Her EEG Biofeedback Training worked!
Laura’s distractibility is no longer a problem. Her attention span is now normal and she can concentrate quite adequately. She has become more composed, responsible, and self-reliant. She prepares her lunch before going to bed, awakens between five and six a.m. and goes to work eagerly and happily each day.
Laura is no longer “caught up in herself” but is increasingly aware and thoughtful of others, more comfortable in social situations, and more at ease with strangers. Her delightful personality promises to serve her well in her continuing social/behavioral development. Although she is still exuberant and enthusiastic much of the time, significantly, her hyperactivity is gone. With ADD/ADHD no longer a limiting factor, it has become possible for me to observe other neurological factors taking on more prominent roles. These were previously not apparent, having been masked by her hyperactivity. While she still has a long way to go, Laura now behaves more like a 33 year old than she did several months ago.”
Last month Ray called me and told me that Laura’s therapists had decided that she could now live on her own. Laura now works for two companies and is considered a well-liked and valuable employee.
The Inner Game
Although stories such as this are common, neurofeedback has more to offer than just remediation of existing disorders. Utilizing this technology to improve healthy people is another possibility that neurofeedback has opened us to. The following account offers insight into changes that are occurring as we attempt to improve the performance of a PGA golf professional utilizing this technology. Only in this instance we are using alpha training in conjunction with methods employed in The Process.
“I cannot begin to explain to others how much better my lifestyle has become. Not only has it tremendously improved my mental skills and outlook relative to my golf, but also my everyday dealings with business and personal family life as well. As you know, but others may not, I am a golf professional with a very strong entrepreneurial and corporate background. My initial intentions were to enhance my focus and concentration during tournament golf. In a very short period of time not only did we accomplish this, but also improved other areas necessary to achieve and maintain peak performance. My scores have dropped considerably and my overall demeanor has improved tremendously.
We were able to enhance my ability to utilize my intuitive skills more instinctively and to be able to control my EMG during the most crucial moments. This not only allowed me to be calm during anxious moments but also to recover from trouble in a quick and calm fashion. It has taught me to understand more about my ability and myself, and at the same time how not to get in the way of myself.
As well, my personal life has always been good, but now it’s even better. It’s opened my eyes to things that we take for granted and has brought my family even closer together by better communication. We were able to increase my stamina along with greater mental and physical conditioning. My overall experience has been phenomenal and I continue to look forward as we progress further into the future.”
Another golf professional writes: “I am writing to thank you for your help when I came to you seeking advice regarding what could be done to reduce levels of anger and stress surrounding my golf game. As a professional golfer I subject myself to a great deal of performance pressure. My standards are very high and I can anger easily when I feel I am not achieving those high standards.
Your program of neurofeedback training has been instrumental in reducing the levels of anxiety and frustration I experience on the golf course. The neurofeedback work is especially effective in helping me find a calm state of mind where I can relax and focus my energies more efficiently. It has been a revelation to discover just how much a state of relaxation can enhance one’s overall enjoyment and consequently, one’s levels of performance.”
