Imagine a world with emotional numbness. A world where threats are perceived everywhere, and you have difficulty maintaining healthy relationships and stable emotional states, can’t concentrate, and can’t sleep. Your world is upside down, and there’s a disordered sense of self-perception, hyperawareness, and reactivity to stress.
If you’re one of the 8 million people in the United States living with PTSD (ADAA), you can imagine this world all too well because it’s your day-to-day life. At times, it may seem hopeless and life futile, but exciting headway has been made in therapy in the form of neurofeedback, a non-invasive form of biofeedback training that can physically change the landscape of a PTSD brain. And with such headway being made, more places like Mindful Ways to Wellness, here in St. Petersburg, FL, are popping up and offering such services - providing hope for those that suffer from the disorder.
The Disorder: PTSD
PTSD is a mental health condition that stands for Post-Traumatic Stress Disorder. With it, your whole ability to emotionally function and live in a healthy state will be altered. PTSD begins with trauma, recently experienced or from childhood, and affects the physical structure of the
brain. The trauma could be a life threat or bodily harm to yourself or a loved one (Greenberg, 2018). Neuroscience indicates that the area of the brain in charge of threat detection and response and emotion regulation is malfunctioning in those with PTSD. Thankfully, however, the brain knows how to recover itself from PTSD, and neurofeedback is a therapeutic tool used to help show it how (Psychology Today).
The Therapy: Neurofeedback
Neurofeedback is a form of non-invasive biofeedback that is unique in its ability to show your brain its problems through direct feedback, allowing your brain to fix itself and alter its own activity. It’s all happening in real-time, and it’s a proven way to help your brain function in a healthier state. The direct feedback to the brain comes from a computer-based program that is monitoring the client’s brainwave activity, sending the brain sound or visual signals. The brain then interprets these signals to reorganize and restructure its own neural activity, and in the process, learns to function more optimally.
As a result, there is often an improvement in mental health disorders and a decrease in many neurological symptoms, making it a wonderful tool to use for those with PTSD (Psychology Today). To learn more about the type of neurofeedback system used at Mindful Ways to Wellness, visit our neurofeedback page.
What’s going on in the PTSD Brain
The main difference between those with PTSD and those who do not have the disorder is that those with PTSD have a hyperawareness and reaction to perceived stress, while also having trouble regulating and de-escalating anxiety and anger. The hyperactivity takes place in the amygdala, and the difficulty with anxiety and anger regulation takes place in the medial PFC, or prefrontal cortex (Greenberg, 2018).
The amygdala is the part of the brain responsible for detecting environmental threats, activating the “fight or flight” response and sympathetic nervous system, and storing new memories or emotions related to threats. The PFC is the region responsible for decision-making, attention and awareness regulation, conscious behavior, emotion regulation, fixing malfunctioning reactions, and attributing meaning and emotional impact to events (Greenberg, 2018).
When there is a perceived threat, the amygdala releases adrenaline,
norepinephrine, and glucose to ready the body to “fight” or “flee.” If the threat lingers, the amygdala sends signals to the hypothalamus and pituitary gland to release cortisol. Meanwhile, the medial part of the prefrontal cortex consciously takes in the threat and decides what to do. It either revs the body up more to fight or flee or calms the body down.
In studies, it has been shown that those with PTSD have increased activity in the amygdala and decreased activity in the medial PFC (Greenberg, 2018). So, we have the amygdala overreacting to potential threats, and the medial PFC unable to regulate that overreactive threat response. The consequences of such malfunctioning brain activity result in hyperarousal, reactive anger and impulsivity, an increase in fear and anger, and a decrease in positive emotionality - the symptoms of those that suffer from PTSD.
This is a major disruption to quality of life. When hyperarousal is experienced, the overactive amygdala is pumping too much norepinephrine into the bloodstream, while the PFC is unable to regulate that release. This leads to sleep disruption and wakefulness, being easily emotionally triggered by anything that relates to the original trauma, and always being on edge. People with PTSD are also more impulsive because of their reactive amygdala keeping them keyed up, ready to take action against a threat. This means they are unable to effectively control their anger and impulsive behaviors when triggered (Greenberg, 2018).
Fortunately, this is not the end of the story for those living with PTSD; there is hope in the form of neurofeedback.
How Neurofeedback Can Change the PTSD Brain
Several studies (Gapen et al., 2016) have indicated that neurofeedback can show the brain how to recover from those brain differences caused by PTSD. The brain operates at different wavelengths, and these wavelengths change depending on what you’re doing and feeling. The slower alpha and theta brainwaves are more present during relaxation and meditative states. The higher frequency beta brainwaves are dominant during moments of hyper-alertness. Those with PTSD are continually living in a negative loop of that hyper-alert state. Neurofeedback helps tone that state down, training the brain to be more balanced and transitioning it to more of a theta and alpha relaxed state. This reduces the continuous state of anxiety that those with PTSD are trapped in.
One such study clearly revealed this (Walker, 2009). Ten men and twenty-three women from ages 18-65 were diagnosed with PTSD, thus suffering tremendously from anxiety. All of them received neurofeedback. Before, after, and even one month after the training, the participants reported a significant reduction in anxiety after just 5-7 sessions. The study clearly indicated that the neurofeedback training was effective in increasing the relaxed alpha and theta brainwaves, while also reducing the overreactive and anxious beta brainwaves.
This one study stands among many others that have revealed neurofeedback training to be effective in helping people develop and strengthen self-regulation skills, which is the ability to control impulse reactions, especially under intense moments of arousal. Such a skill leads to emotional stability and can make a huge difference for those who suffer from PTSD.
How Neurofeedback Works and What to Expect
The key is repetition, because, as you go through sessions, your brain is relearning a more efficient way of working. On average, neurofeedback, or EEG (electroencephalogram) biofeedback therapy, takes place once a week for a total of about 20 sessions. Of course, everyone is different, and some need more sessions, while others need fewer (Psychology Today).
During a session, you sit comfortably in a chair while the clinician or therapist attaches sensors to your scalp. These sensors are connected to a computer EEG program that will read your brainwave activity and give back real-time information concerning the different brain frequencies. You will be watching graphics and/or listening to music while the computer is sending your brain and central nervous system feedback based on what it sees. This feedback is in the form of audio and visual signals that give your brain the chance to check itself and choose the most optimal pathway. Improvements in sleep, a decrease in stress, and greater mental clarity are some of the changes you might experience between sessions.
Rather than being viewed as a cure, neurofeedback is regarded as a way to regulate and retrain the brain to function at a healthier level. Through the repeated sessions, the neurofeedback program teaches the central nervous system to regulate brainwave frequencies that are considered dysfunctional - manifesting as symptoms that disrupt life. And as we just discussed previously, those with PTSD can experience some major life disruptors due to their trauma, but they are challenges that neurofeedback can indeed help with.
The Hopeful Solution
As you can see, there are distinct brain differences between those with PTSD and those without the disorder, and these differences manifest in ways that can dramatically impact a person’s quality of life. In cases where exposure therapy and psychotherapy treatment for patients with PTSD come up lacking, neurofeedback emerges with newfound hope. By understanding their physical brain differences, those with PTSD can see that their symptoms and struggles stem from a physiological issue, not any kind of personal failings. Since neurofeedback is brain-centered training that focuses on changing those physical differences, it can be an extremely effective route to healing for PTSD sufferers.
With education, neurofeedback therapy, and a community of support, it’s hopeful that those with PTSD can once again regain their pre-trauma quality of life. If you’re looking for such hope, places like Mindful Ways to Wellness in St. Petersburg, FL offer a path to that pre-trauma quality of life for those with PTSD. Click here to learn more about the various other benefits of neurofeedback and book your free consultation.
By Cathryn Fowler
Resources Cited
ADAA. (n.d.). Posttraumatic Stress Disorder (PTSD). Retrieved from https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd.
Gapen, M., Kolk, B. A. V. D., Hamlin, E., Hirshberg, L., Suvak, M., & Spinazzola, J. (2016). A Pilot Study of Neurofeedback for Chronic PTSD. Applied Psychophysiology and Biofeedback, 41(3), 251–261. doi: 10.1007/s10484-015-9326-5
Greenberg , M. (n.d.). How PTSD and Trauma Affect Your Brain Functioning. Retrieved from https://www.psychologytoday.com/us/blog/the-mindful-self-express/201809/how-ptsd-and-trauma-affect-your-brain-functioning.
Kolk, B. A. V. D., Hodgdon, H., Gapen, M., Musicaro, R., Suvak, M. K., Hamlin, E., & Spinazzola, J. (2016). A Randomized Controlled Study of Neurofeedback for Chronic PTSD. Plos One, 11(12). doi: 10.1371/journal.pone.0166752
Neurofeedback. (n.d.). Retrieved from https://www.psychologytoday.com/us/therapy-types/neurofeedback.
Walker, J. E. (2009). Anxiety Associated With Post Traumatic Stress Disorder—The Role of Quantitative Electroencephalograph in Diagnosis and in Guiding Neurofeedback Training to Remediate the Anxiety. Biofeedback, 37(2), 67–70. doi: 10.5298/1081-5937-37.2.67
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