In a clinic in Woodland Hills, California, a woman pastes an electrode through thinning hair onto a man’s scalp.  She’s done this thousands of times over the years and easily finds the spot just behind the top ridge on the right side of his head called “P4”.  The tiny, tiny signal – one of a trillion sparks of life that this brain generates every second – travels through a thin wire into her computer.

This man fought in Bosnia 10 years ago and since his return home, he has had all the classic symptoms of Post Traumatic Stress Disorder.  He has not slept more than two hours at a time. He has panic attacks at the grocery store and nightmares every night.  He is anxious and depressed.  His marriage is falling apart.   The VA has put him on many different medications and although he’s done all the approved therapies, everything from individual counseling to group therapy to EMDR, he is still a mess, jumpy even in this quiet room at every footstep that passes on the other side of the closed door.

Because of this clinic’s veteran’s program that offers free brain training, or Neurofeedback, to veterans, he gets to interact with his own EEG, a neurological form of shadow boxing, to shift his state.  After 30 sessions, his nightmares are gone.  He can sleep through the night without medication.  He is cracking jokes in the session and smiling.  He is better.  And all of this change has occurred without one conversation about what happened in Bosnia, about the content of his nightmares, or even about his childhood.

“Oftentimes, clients come to me and they’ve had too much trauma to even deal with it.  They are stuck and cannot resolve it or work through it.  Many psychologists put clients on meds to manage their states so they can just do the therapy.  I mean, if you’re crying all the time or hysterical or not sleeping, you can’t really do the heavy lifting that is required to heal a trauma.  With Neurofeedback, you can manage state without meds and their side effects.  And just as often, when they are more functional, they just feel better and a large percentage of the problem is gone.  Does that not count?  For the client, it doesn’t really matter.  We are concerned with positive outcomes and we see that with Neurofeedback,” says this veteran’s clinician and pioneer in the field, Sue Othmer.

The goal of this article is to expose the reader to an entirely new paradigm for understanding and treating psychological problems. It will deconstruct the Neurofeedback clinician’s process of translating emotional pain into functional problems.  It will also look at why focusing on state, not story, is a critical difference and how this tool, by teaching the brain to shift states, can assist people in permanently healing emotional suffering.

In its simplest definition, neurofeedback is “exercise” for the brain and when you hear clinicians talk about their work, they sound like coaches.  They are making the brain stronger, more flexible, more resilient… all the qualities of an Olympic athlete.  But there’s no sweating involved or tears, just driving spaceships with your brainwaves.

In the game, Inner Tube, for example, a spaceship flies through a tunnel.  When your brain is in a functional state, the spaceship speeds along.  When the brain tenses up or spaces out, the spaceship stops.  Lots of new clients, especially kids, ask, “Am I controlling this with my thoughts?  If I think, ‘go, spaceship!’ will it go?”  It’s a very Buddhist practice in that any trying usually makes the game stop.  This is why babies are easily able to do it and high stress, controlling CEO’s struggle at first.

Instead of thoughts, it’s the electrical activity of the brain that’s fueling this spaceship. The exercise occurs when the spaceship stops and the brain needs to figure out how to shift its activity – or state – to make it go again. Over the course of a half-hour session, the brain will shift states over a thousand times which leads to a change in physiology.  By the end of a session, the client can feel relaxed and alert, regardless of how scattered, anxious, or downtrodden he began the session.  Not only do chatty brains become quiet, there is often a noticeable relaxing of tense shoulders and even drops in blood pressure.

Today, there are many different types of systems available but most of the technology is similar. Whether any of this technology works, though, for its most common use – ADD – or for the repercussions of debilitating emotional trauma – hinges on the protocols.  Where do you put the electrodes and at what reward frequency? 

In the early days of neurofeedback there was only one protocol.  The electrode was pasted on top of the head at a site called, “CZ”, what a yogi would call the 7^th chakra, and that site was always trained at 12- 15Hz.  Now, there are 20 common sites all over the scalp and the rewards vary from .001Hz to 42Hz.  The combinations are endless.

20 years ago, Sue Othmer was one of the first to move the electrode off CZ and train different sites at different frequencies.  Now, she is known for being one of the only clinicians still experimenting and what she uses are the Delta frequencies, training the majority of her clients below .01Hz. What results from this is a deep, deep calming that happens within minutes of sitting down and being hooked up.

Neuroscientists are still uncertain as to exactly why training at such low frequencies can make a difference but new research is pointing towards a connection between these specific frequencies and the brain’s ability to regulate one’s basic, core functions.

Clinically, her protocols are some of the most effective for addressing emotional issues, which is ironic because her focus is purely on her client’s physiology, not his psychology.   She says, “As a neurofeedback clinician, I’m focused on state, not story, and I’m curious how the person is at war with his own physiology.  Is there a problem sleeping, calming down, is he constantly fighting his own anger, distractions, etc.?  If so, I can work with that and once we clean up the physiology, he will function better and emotional issues clear up.”

Everyone’s protocol is highly individualized and the key to discovering the optimal protocol for a client is the age-old art of listening. Many clients come to neurofeedback after having tried everything so they are usually well versed in their traumas.  The clinician must be like a bloodhound, following a trail of clues hidden in stories to get beneath it all to the core problems.  If a client suffers from nightmares, the question is not, “What happened in the dream?” but “Was it more or less intense than before, are you having more or fewer than you used to?”

“When someone says ‘I rage,’” says Sue Othmer, “there are different functional aspects of that which are completely unrelated to the story of the rage.  Are you trying to stop but cannot?  Is there remorse afterwards or does the person feel justified?  Is it releasing pent up energy and therefore rewarding on some level to the client?  The different ways rage can manifest gives me clues to where I should put the electrodes…Psychological diagnoses are tricky because they don’t lend themselves to specific solutions.  Tuberculosis is a real thing, a disease with a singular treatment but PTSD?  Each person may need a different protocol.  I focus on the symptoms and I break them down into categories that relate to the different lobes of the brain and then I “train” those parts of the brain.” 

A well-trained cortex is an enormous part of wellness but is it the whole story?  If I raise my resiliency, for example, and am now less reactive to my mother’s comments about my weight, does that mean I no longer believe she judges me or has that belief just been put to sleep?  Does it matter?

Jaclyn Gisburne is a Neurofeedback clinician that works in Colorado and she believes that it is necessary to go below the cortex to truly clean up the trauma that we re-enact when we’re triggered.  She has developed neurofeedback protocols that incorporate the work of trauma experts like Dr. Robert Scaer and Dr. Allan Schore.  For her, making someone more functional is valuable but it isn’t until the trauma is fully reconciled at the level of the central nervous system that true transformation and wellness occurs.

She has discovered that what is most effective for this outcome is using the high frequencies of gamma.  When she trains brains – usually in the occipital lobes – she believes she can gain direct access to the cerebellum and the amygdala and at 36+Hz, her clients usually have some kind of aha! moment.  Old memories surface often with all the old feelings, which she believes is the trauma moving into the cortex from the deeper brain regions so that it can be acknowledged then fully released. 

For her it began with an article in Science Magazine about how emotional and physical pain both reside in the same part of the brain, the anterior cingulate.  This is the thin strip between the hemispheres at the front of the brain.  This set her off on a search to discover protocols that would address physical pain that has an emotional source like arthritis and fibromyalgia.  Consistently, she would find that traumatic memories would surface and then pain and inflammation would diminish.  Issues as severe as rheumatoid arthritis would clear up in 4 – 8 sessions.

A third protocol approach is alpha synchrony training developed by Neurofeedback pioneer, Les Fehmi, a clinician in Princeton, NJ.  Alpha training usually occurs around 10Hz and can be done all over the head.  This frequency is typically associated with calm, relaxed focus or a flow state.  According to Les Fehmi, most of his clients’ mental health problems like anxiety, depression, and panic attacks are related to the fact that they have forgotten how to relax physiologically.  Since they are often unaware of their own chronic stress that runs in the background and may be decades old, they are unable to shift from a chronically activated “fight or flight or freeze” response to a calm state on their own.   He believes neurofeedback is one of the fastest and most effective ways to help the brain rediscover that lost state.  With repetition, the client can then access this on her own.  Physiological calm, versus a psychological one, is a key difference and where brain training excels. It is ironic that it is our technological lifestyle that creates chronic stress and now it seems technology offers a new, more powerful cure.

No matter what protocol, with repetition, neurofeedback teaches the brain self-regulation.  This can result in less reactivity, increased functionality and also brings us into the present moment. Many talk therapists say that once they begin using it, the talking stops.  Amanda Armstrong, a clinical psychologist for over 20 years who has been doing Neurofeedback for the last ten years says, “It’s like waving a magic wand and multiple problems disappear.”

Our nervous system’s ability to be resilient is supposed to be learned in the first years of life, by a mother or caregiver who calms us when we’re upset.  When we don’t learn to self-soothe, Neurofeedback can be seen as “reparenting” not us but our nervous systems at any age.  In the language of psychotherapy, neurofeedback can be seen as a new way to heal all of the wounded inner children who hide deep in our limbic brains.

Although some people react negatively to the thought of their brains interfacing with a computer, it is not a cold process.  The clinical relationship is still strong and important and early pioneers in the field like Bill Scott believe that the rapport between client and clinician is critical for this treatment to work.  Someone – a person – still needs to hold space for the client. But unlike a traditional talk therapy session, this technological agent of state shifts refuses to accept projections or transference, and is incapable of becoming a mommy figure.

Training the brain allows the client access to new, more functional states.  Native American cultures have always understood the power of shifting states.  Shamans have been doing it for centuries.  For them, shifting states offered a path to new information, feelings, and behaviors.  Now, anyone can journey to new states of consciousness and instead of ayahuasca, you can get there by hooking yourself up to your laptop.

Although it’s been around for about 30 years, it’s still the crazy uncle in the mental health family.  Critics claim there is not enough research or that the research is not the right kind.  But some of the numbers are shocking.  One of the classic studies in the field was done ten years ago in Los Angeles, California at a highly respected rehab facility called Cri-Help.  Out of 120 people doing conventional treatments for substance abuse like 12 Steps work and talk therapy, half also did Neurofeedback.  18 months after treatment, 72% of the neurofeedback group was still sober versus 35% of the control group.  The statistics are breathtaking but what’s even more interesting is that it went quietly by the wayside.  Less than 20 centers out of the thousands in this country have it or even know about it.

The majority of research to date documents Neurofeedback’s efficacy in addressing problems like seizures, autism, ADD, and migraines, but SHIFTING STATES looks at this tool’s ability to heal emotional issues like anxiety, depression, post traumatic stress disorder, and attachment issues.  Through interviews with neuroscientists, readers will learn about the changes that take place in the brain during treatment.  Primarily, though, this book is about people, both the leading clinicians in the field who are able to create unprecedented emotional healing in their clients quickly and without processing stories.  And the people whose lives are permanently changed by their experiences of being “hooked up”.

There is the bipolar teenager who spent the majority of his life on medications that left him 45 pounds overweight and still rageful.  After only 4 sessions he said, “I don’t feel angry anymore.”  There’s also the ex-heroin addict who had been struggling with depression her entire life; a person who spent years beating herself up for not being able to handle the basics of living.  After doing neurofeedback, her mood brightened and everything from going to the grocery store to cleaning her kitchen got easier.  In her words, “a weight was lifted”.  What was most exhilarating, though, was that she could stop judging herself, realizing it wasn’t her but her brain…and all of this after one session.  The skeptics will be heard from as well and in some cases hooked up to see how their experiences differ from their judgments.

Clinicians come from a variety of fields.  There are talk therapists, doctors, nurses, even acupuncturists.  Any mental health professional can add this to his or her tool belt.  What they all have in common, though, is a deep desire to find new and more effective treatments to help their clients.  Judy Abrams is an acupuncturist and neurofeedback clinician and she shares a common desire, “I was constantly searching for ways to treat what seemed like people’s most important issues – anxiety, depression, emotional problems, ADHD, problems with children’s behaviors, and all of those are problems that can be addressed very effectively with neurofeedback, and that’s the most important thing for me, to help people in their daily lives.”

At this moment in time, advances in neuroscience and technology have come together in a new and powerful way. As little as 8 years ago, a neurofeedback system would run in the tens of thousands of dollars.  Now, you can be up and running for as little as 5 thousand dollars.  As a result, this treatment is spreading rapidly across America, Europe and Asia.  Currently, there are upwards of 15,000 practicing clinicians around the world and it is estimated that the field is growing at a rate of 20-30% a year.  Like most of the alternative health field, the majority of these clinicians are paid out of pocket which means that people are spending approximately one billion dollars a year to train their brains.  Every month, courses are being offered across America, in Europe and even in Asia.  The American Psychological Association recognizes it and offers CE’s to their members who do the training course.  The Food and Drug Administration has approved the main systems being used clinically today.  Even Nintendo makes a “smart” game for its DS system called “Brain Training: How Old Is Your Brain?” bringing a questionable version of neurofeedback into people’s homes.

With more widespread acceptance of this tool, will there be new hope for the hundreds of thousands of veterans returning from Iraq with PTSD?  What about for the millions of us just trying to get through our day, bogged down and burnt out from anxiety, depression or other mental health issues?  And finally, what about the approximately 50% of Americans who are medicated at incredible expense and often with dangerous side effects?

How can Neurofeedback remove so many problems that we’ve spent decades believing were endemic to personality in sometimes only 20 sessions?   Have we been going about it all wrong?  Is it possible to fix our feelings without talking about any of it?  Inside the neurofeedback clinic, it is possible and it happens every day.