How You Can Train
Your Brain to Help Reduce Stress
By Blaine Greteman, Ode.
Neurofeedback is an emerging method that relaxes, enhances
creativity and improves mental health.
As Vicki Wyatt attaches electrodes to my scalp with a generous
glop of slimy goo, I'll admit I'm a little skeptical about
the calming effects of the treatment I'm about to experience.
With newborn twins at home, I usually have enough slime in
my life and on my clothes to push anyone over the abyss.
But that, says Wyatt, is precisely why I could benefit from
neurofeedback, a therapeutic tool that advocates claim can
reshape our brains—and our lives.
To learn more about the procedure, I've come to The Wyatt
Clinic in downtown Oklahoma City. Just blocks from the memorial
that marks the site of the 1995 federal building bombing,
the location is aptly associated, in my mind, with both psychic
trauma and healing. This is a gentrifying but hardscrabble
neighborhood where Wyatt treats patients, from overstressed
professionals to addicts trying to get back on their feet.
Wyatt has been a therapist for 22 years, with a research
background at the University of Oklahoma Health Sciences
Center, but she has only recently embraced neurofeedback
as part of her treatment regimen. "My formal education
didn't really provide any alternative treatments," she
says. "It was traditional psychotherapy and talk therapy.
When I look back, I think this would have benefited a lot
of the children and families earlier in my career."
The equipment looks fairly unexceptional, including the
electrodes, which could pass for iPod headphones and are
glued strategically to my head and temples. Wyatt clips a "ground
wire" to my ear. The wires run from the electrodes to
a black amplifier box the size of a small paperback. This
deceptively simple-looking piece of machinery, which can
cost several thousand dollars, processes electrical signals
from my brain and sends them to a laptop, where they're represented
graphically on the screen. Wyatt boots the laptop, opens
a neurofeedback training software program and settles me
into one of the comfy chairs that make her cozy, carpeted
office look more like my mother's living room than the white-tiled
clinic I'd expected.
After Wyatt hooks me up, I'll use my brain waves to control
a video game. When I achieve the desired mental state, a
small red bug will move around the screen eating flowers
and emitting a happy chirping sound. To succeed at the game,
I must eliminate brain waves that interfere with relaxed
concentration—those associated with hyperactivity,
depression and that all-too-familiar feeling of "zoning
out."
I'm coming off a sleepless night of diaper-changing, rocking
and feeding, so focus isn't exactly my forte right now. But
after watching the bug languish sadly for a few minutes,
I begin to practice some deep, yogic breathing and try to
stop my racing thoughts about work, home and deadlines. Sure
enough, the band representing my desired brain activity jumps
and the red bug begins to rouse himself from his stupor,
eat a few flowers and chirp with approval.
After years on the outskirts of medical respectability,
neurofeedback has been vindicated by a growing body of evidence
showing its potentially remarkable benefits to everyone from
elite athletes and musicians to violent criminals and children
with Attention Deficit Hyperactivity Disorder (ADHD). The
U.S. National Library of Medicine's database of scholarly
articles, for example, contains dozens of positive scientific
studies on neurofeedback published in the last two years.
The results, from some of the world's top universities and
research hospitals, suggest that neurofeedback is a promising
treatment for a range of cognitive health issues: seizures,
low IQ in kids with learning difficulties, vertigo and tinnitus
in the elderly, and substance abuse, even with notoriously
addictive, destructive drugs like crack cocaine.
Advocates say neurofeedback has emotional benefits as well. "You
feel very good on this," says John Gruzelier, a professor
of psychology at the University of London's Goldsmiths College.
And all these effects are generated by the patient's brain,
not by drugs. No wonder some proponents describe neurofeedback's
effects in spiritual, as well as physical, terms.
It all starts with those slimy electrodes attached to the
scalp, which pick up a small part of the electrical symphony
produced continually in our brains. Neurons, the billions
of cells that make up our cerebral cortex and nervous system,
transmit information by firing electrical and chemical signals
across synapses, the junctions where they meet. These tiny
electrical pulses are central to our consciousness and bodily
lives: Each time our hearts beat, we blink at a bright light
or smile at a bit of good news, that action requires a flurry
of electrical activity.
The brain's electrical impulses take the form of waves that
researchers categorize by frequency—the number of times
they repeat each second (see "Making waves" box).
The slowest are the delta waves, which the brain typically
produces during deep sleep. Next are theta waves, another
slow undulation at four to eight cycles per second, often
associated with creative and subconscious thought, which
we produce when we're sleepy or daydreaming. We make alpha
waves of eight to 12 cycles per second when we're alert and
relaxed, and still-faster beta waves when we engage in active
problem-solving or become alert or anxious. The fastest patterns,
above 30 cycles per second, are made by gamma waves—usually
faint and difficult to detect, but associated with high-level
thought.
An overabundance or deficiency at one of these frequencies
often correlates to conditions such as depression and other
emotional disturbances and learning disabilities. Children
with ADHD, for example, often have too many slow brain waves
(delta or theta) and not enough of the faster waves that
allow them to focus, engage and think productively.
Neurofeedback reads these waves, feeds them into a computer
and translates them into visual form—in my case, the
ladybug's states of lethargy correlate to levels of electrical
activity in my brain. The underlying principle is that by
seeing your brain waves you can gain control over them, training
your brain to produce desired levels of activity, much like
you train your voice to produce certain musical notes. And
once those brain waves are in play, the desired brain state
comes with them. If, for example, you've got too much anxiety-producing
beta, try inducing some theta to calm down.
That might sound like trippy science fiction, but it's based
on technology that's been around since the German psychiatrist
Hans Berger began using electrodes to measure and categorize
human brain waves in the 1920s. The recordings of the human
brain-wave activity produced by this technology—electroencephalography,
or EEG—are the cornerstone of neurofeedback. By the
1970s, it was possible to feed that information back to patients
who heard a rewarding tone when they produced a pre-selected
frequency of brain waves. What's new is both the sophistication
of the feedback display and the precision with which therapists
can target different parts of the brain wave spectrum. On
top of that, neurofeedback has become cheaper, more efficient
and more readily applicable to a vast array of brain disorders.
"When I was doing quantified EEG back in the 1970s,
computers were the size of filing cabinets," says James
R. Evans, a former University of South Carolina psychology
professor and current clinician at the Sterlingworth Center
in Greenville, South Carolina. Evans, who has written and
edited dozens of articles and books on neurofeedback and
is a consulting editor to one of the field's flagship publications,
The Journal of Neurotherapy, says those technological hurdles
limited neurofeedback's therapeutic reach in the early years: "You
had to have a large-scale grant to afford the equipment and
electrical engineering people to keep it going."
By the early 1990s, the same technology that brought us
personal computers and Xboxes had changed all that, and without
huge research investments therapists could focus specifically
on brain waves that correlate to mental states. A quantified
EEG could show that a patient's brain contained waves outside
the normal range, and new software made it easier to create
training protocols or use existing ones to boost or reduce
activity across a frequency or region of the brain. Neurofeedback
began to gain a devoted following of patients and clinicians
who swore by its effects. Martin Wuttke is one of those clinicians,
a neurofeedback pioneer known for getting remarkable results—starting
with himself.
A former heroin addict, Wuttke discovered meditation could
help him beat the drugs, and soon he was running meditation
and counseling sessions for other addicts. "I found
that the key to recovering from addiction was a spiritual
experience," Wuttke says. "That's what the Twelve
Steps [of Alcoholics and Narcotics Anonymous] are all about,
but I felt like that had gotten lost." To facilitate
that experience and give it credibility by grounding it in
science, Wuttke turned to neurofeedback.
Alcoholics and drug addicts often have too many fast brain
waves—which is perhaps why they seek a chemical fix
to calm and soothe overactive brains, he says. With the right
technology, neurofeedback practitioners believe they can
wake up parts of the brain that are too sleepy and calm down
regions that are spinning out of control.
For Wuttke, the results were life-changing. As people moved
through his program, he says, "Their depressions went
away, their pains went away, their anxieties went away." Wuttke
believes patients become less likely to backslide once they
realize they have access to inner calm without drugs or alcohol,
an insight he describes in terms of "awakening."
Neurofeedback's potential hit home when Wuttke's son, Jacob,
was born with brain injuries and major developmental problems. "At
age 2, he had no muscle tone and some severe difficulties," says
Wuttke, "but the pediatric neurologist couldn't give
us any answer about why or how to treat him." Wuttke
and his wife at the time, Amy O'Dell, took matters into their
own hands, developing a comprehensive treatment regime incorporating
neurofeedback.Facing the difficulties of asking a child so
young to control his brain waves, Wuttke and O'Dell observed
the feedback screen and stimulated their son when his brain
produced the desired patterns. "We would be very quiet
when his brain wasn't within parameters, and then when it
was, we would squeeze him and say, 'Good work!' and orient
his brain to those moments."
At the beginning of the process, Wuttke describes his toddler
son as "hypotonic": unable to sit on his own or
hold his head upright. But "within 60 days, his brain
started to come alive," Wuttke says, and this cognitive
awakening was the first step in a process that soon had his
son crawling, walking and running. After witnessing the results,
Wuttke and O'Dell established Jacob's Ladder, a school for
developmentally challenged children in Atlanta, Georgia,
run by O'Dell. Although Jacob couldn't retain five letters
of the alphabet at age 6, by age 14 he was reading at a 12th
grade level, and the school had achieved national recognition.
That experience helped Wuttke formulate his "neurodevelopmental" approach,
in which he uses exercise, dietary supplements and neurofeedback
in concert to establish and rewire broken pathways in the
brain. Since then, Wuttke has trained thousands of neurofeedback
practitioners and garnered a cadre of patients who describe
neurofeedback in transformative terms.
Beth Black, for example, fairly raves about the way Wuttke's
neurofeedback regimen impacted her 7-year-old son. "Ethan's
a completely different kid now," she says. When Black
adopted Ethan at 5 months old, he'd already endured severe
neglect and suspected pre-natal drug use by his mother, so
it wasn't entirely surprising that the boy faced challenges.
Still, by the time he entered first grade at age 6 it was
clear to Black, director of the Family Art Therapy Center
in Clayton, Georgia, that Ethan's problems were cause for
serious concern. "We first noticed that when you teased
him, he wouldn't understand or react normally, but would
have these explosive tantrums," she explains.
Failing socially and academically, Ethan hated school despite
the efforts of his teachers and his mother to implement a
program of special instruction and behavioral therapy. "He
said no one liked him and he wanted to die, and when he would
get really upset he would have to exhaust himself before
he could get control," Black recalls. A child psychologist
labeled Ethan with ADHD and prescribed medication, but Black
was desperate to avoid drugs and turned to Wuttke instead.
Using an evaluative brain-wave scan, Wuttke determined that
Ethan lacked normal levels of beta, the relatively fast waves
associated with attention and concentrated thought.
They implemented a training program of neurofeedback and
listening therapy to boost this band and improve the boy's
concentration, and within two weeks Black was a believer. "For
the first time ever, he could tell me a story in sequence;
within three weeks, he was scoring 100s on his spelling tests
and just blowing us and his teachers away." After seven
weeks, Ethan was able to calm himself, and the explosive
anger was a thing of the past.
Black was so impressed that she applied for a grant to use
neurofeedback with the juvenile offenders sent to her clinic
regularly for court-assigned behavioral therapy. Counseling
these young offenders had been "a waste of money," according
to Black, but the seven juvenile offenders who entered the
program of intensive neurofeedback therapy flourished.
"The judge came to us at the end of this program," Wuttke
remembers, "and said, 'What did you do to these kids?'" Within
weeks those who'd dropped out were back in school, performing
so well on standardized tests that their learning disabilities
seemed to have disappeared.
Such stories abound. "Our whole family was in trouble
because of my daughter's depression and discipline problems," says
Joann Bullard, whose daughter received treatment at Wuttke's
clinic in the Netherlands. "She was going to have to
go on medication because there just weren't any other options," Bullard
says, but after 60 sessions of neurotherapy, "there
was a total turnaround, and we're grateful every day." Another
father, Ben Odukwe, says he visited specialists around the
world after his son Onura was diagnosed with mild autism,
but saw no real results until the boy entered Jacob's Ladder
school and began a neurofeedback program under Wuttke's supervision.
Onura's father notes that the boy's "communication,
his confidence, his handwriting and dexterity all transformed," and
at age 16, he's entering mainstream school for the first
time.
Neurofeedback doesn't cure conditions like ADHD, depression
or addiction. Instead, it enables people to produce the appropriate
brain waves, which helps provide the attention, rest or contemplative
awareness needed to deal with underlying issues. You can't
manufacture these brain waves by force of will. I quickly
discovered that success comes from letting go. "It's
not a conscious thing," Wuttke emphasizes. You have
to "surrender to the process [and] let your brain take
over. You are going to deep parts of the brain and neutralizing
disruptive brain waves, and often in this extreme state of
quietude, key memories and patterns come up, almost like
you're in a half dream state, and there's sort of a rewiring
that occurs."
Wuttke likes to say our brain tends to follow certain "scripts," patterns
of thought that take us to the same place over and over.
Neurofeedback, as it forges new pathways in the brain, helps
us devise new scripts.
Even as the technology has advanced and the success stories
have grown into a rich anecdotal lore, however, neurofeedback
continues to face skepticism and resistance from parts of
the medical establishment. It has only begun to gain widespread
acceptance as a therapeutic tool recently. "It was an
up-and-coming treatment modality in the 1970s," says
Evans, who has worked with the technology in academic and
clinical settings. But he says neurofeedback lost scientific
credibility when the early, simple equipment was adopted
by and became associated with "hippies" in pursuit
of "instant Zen."
Neurofeedback still has its skeptics among consumers too,
especially since it remains unregulated; anyone who can afford
the equipment can rent an office, hang a shingle and treat
patients (see "How to choose a neurofeedback practitioner" box
on page 51). Today, however, Evans says, "We've reached
a tipping point where there are hardcore science people working
in neurofeedback and articles being published in good journals,
and it's becoming much more difficult for mainstream medicine
to ignore. No one can say any longer that there is no science
behind it."
The studies that have generated the most enthusiasm are
the ones suggesting that the treatment offers a drug-free
alternative for children with ADHD. A review of the scientific
literature in 2005, for example, noted that 75 percent of
kids with ADHD treated with neurofeedback improved—compared
to about 70 percent treated with drugs—and no study
has reported negative effects. A 2007 study from the University
Hospital of Tübingen in Germany showed that after a
treatment regime lasting several months, children diagnosed
with ADHD not only improved their behavior and increased
their ability to concentrate "significantly," but
added nearly 10 points to their IQs—a result maintained
six months after the study ended.
Skeptics have long argued that the benefits of neurofeedback
to children with ADHD could be attributed to the placebo
effect—or that the children could achieve similar improvement
if they spent the same amount of time working with parents
on focused tasks like assembling puzzles. By this logic,
it isn't the technology of neurofeedback that helps children
with ADHD, but the attention and effort of parents and therapists
working in concert to support learning and concentration.
To find out the truth, Swiss researchers at the University
of Zurich created a controlled study to isolate neurofeedback
from other factors. One group of children with ADHD was given
neurofeedback, while another entered an intensive behavioral
therapy program that used traditional techniques to teach
them to focus. The results were dramatic: Children in the
neurofeedback trial improved markedly on indices of attention
and "metacognition" (the awareness of one's mental
processes), whereas children in the behavioral therapy group
showed no significant improvement.
But there was just one caveat. The researchers noted that
the results seemed "mediated by unspecific factors,
such as parental support or certain properties of the therapeutic
setting and content." So, while neurofeedback works,
it isn't a magic bullet—parental support and the right
clinical setting, which might include other therapies, are
key to realizing its potential.
Importantly, however, that potential goes beyond the treatment
of disorders. Indeed, neurofeedback seems remarkably effective
at improving mental focus and concentration, even for apparently "normal" individuals. "We've
just done a study training eye surgeons," says Gruzelier
of Goldsmiths College in London, "and we found that
the rhythm that's very effective in reducing hyperactivity
in ADHD children also helped enhance surgical performance
by 20 percent." The aim was to do the surgery as quickly
and accurately as possible, and neurofeedback training, which
enhanced beta waves while relaxing the cerebral cortex to
reduce hyperactive movements, seemed to enhance surgeons'
ability to modulate their performance. "Instead of just
charging at the target," Gruzelier says, "they
were actually slightly longer and more methodical in their
preparatory time, then faster and more accurate on task."
Athletes and performers often associate such success with
being "in the zone." Many athletes believe neurofeedback
allows them to pause racing thoughts and live wholly in the
moment of the game. Prominent among them is Chris Kamen,
the center for the Los Angeles Clippers basketball team,
who was diagnosed with ADHD as a child and struggled in his
early career, despite his imposing seven-foot height. In
2007, he discovered neurofeedback and soon improved his scoring
and rebounding by more than 50 percent. As important, Kamen
says, his life off the court improved as he stopped making
impulsive decisions.
Kamen not only attributed the success to neurofeedback,
but became a spokesperson for Hope139, a Michigan company
dedicated to bringing neurofeedback technology into schools
and businesses to improve performance. Neurofeedback has
gained such a lustrous reputation that the Italian professional
soccer team A.C. Milan has created a glassed-in "mind
room," where the team gathers for mental tune-ups. In
the mind room, players watch their brain waves play out across
a computer screen while a team of sports psychologists monitors
their progress.
Gruzelier emphasizes that neurofeedback's performance-enhancing
results go beyond relaxation or the relief of anxiety—effects
that might be achieved with sedatives or more conventional
relaxation techniques. "We've compared this to other
techniques that have reduced anxiety but have not enhanced
performance in the same way," says Gruzelier, citing
his studies of professional dancers and musicians who did
neurofeedback training to quiet the brain's fast-wave activity
and produce more slow theta waves. These studies showed remarkable
improvements "not only in artistry, but communication,
the way people expressed themselves, the presence they have
on stage."
Elite students at the Royal College of Music in London improved
their performance an average 17 percent, according to a panel
of independent judges, and competitive ballroom dancers achieved "professionally
significant" improvement in just five weeks. Moreover,
Gruzelier notes his recent research hasn't only replicated
these results, but shown they extend to novice performers. "There
are dramatic improvements," he says. "Breath and
pitch improve. Where they didn't sing in tune to begin with,
they did afterwards."
Gruzelier attributes such results to the technology's ability
to allow slow waves to travel farther, uninterrupted, across
the brain. That facilitates interaction between areas of
the brain that don't typically connect, he says. Normally,
such a process is disrupted by the fast waves that characterize
our waking life–a kind of mental static. "It's
been known for centuries that the hypnagogic experience,
the border between waking and sleeping, is the source of
remarkable insights," Gruzelier says.
Neurofeedback's apparent ability to bring those insights
into the light, however, is what seems remarkable, especially
since we still don't understand key factors about how it
works—how, for example, people control their own brain
waves. "It's very much a black box," explains John
Kounios, a professor of psychology at Drexel University in
Pennsylvania.
Kounios conducted a double-blind study of elderly subjects
that showed neurofeedback may help improve cognitive processing
speed and "executive function," the mental operations
that help us plan and organize our lives, but he admits the
cognitive process underlying neurofeedback is still something
of a mystery. "Although neurofeedback has been around
for 40 years, we still don't have the slightest clue as to
how people do this," Kounios says. "It's not as
if there aren't any good theories. There are just no theories,
not even bad ones–just the observation that this is
something animals and humans can do."
That sometimes makes for surprising results, as in the case
of Kounios' study, which increased the production of alpha
waves in the frontal lobes of elderly people. The frontal
lobe often deteriorates as people age, which makes problem-solving,
abstract reasoning and all kinds of planning more difficult.
And so, as Kounios' subjects boosted their alpha activity
in this region of the brain, they demonstrated an improved
ability to respond when presented with new information and
to make quick decisions in cognitive tests. Such results
are preliminary but exciting. Kounios emphasizes that the
field needs funding for large-scale studies that can establish
the basic science of neurofeedback and determine which training
protocols are most effective, "but there's no question
in my mind that this has significant potential and the phenomena
are real."
This is a common refrain among researchers and practitioners. "It
works," agrees Evans. "Almost anybody can get the
equipment and get 60 percent good results. The question is,
what are those people doing who get 90 percent? Some people
give vitamins along with their treatment; others pray with
clients or use counseling. In many respects, these people
fire a shotgun and we don't know which pellets hit."
That's why Wuttke is creating an institution that will train
a core group of people who can replicate his results and
methods. His mission is to establish a network of neurofeedback
clinics and training facilities in Europe through his work
with the LifeWorks Foundation.
"One of the biggest risks right now is that this becomes
a novelty, where people can buy some software and hook into
it at home and play a game," says Wuttke. "That's
going to happen, but it takes away from the profound clinical
applications, which have to be part of a more comprehensive
approach."
Wyatt agrees. "For most patients, whether they're suffering
from depression or post-traumatic stress syndrome, I don't
believe that neurofeedback offers a complete solution any
more than I believe a doctor can give you a drug that offers
a complete solution. Neurofeedback can calm the brain down,
but then you still often have to deal with underlying issues."
The desire to get at those underlying issues is why Wuttke,
an ordained non-denominational minister, keeps coming back
to the notion of spiritual growth. "When you incorporate
all these things and straighten out the brain, the ultimate
goal is for people's spiritual awareness to start manifesting
itself," he says. Indeed, recent studies of Tibetan
Buddhist monks by Richard Davidson, director of the Lab for
Affective Neuroscience at the University of Wisconsin-Madison,
have shown links between spirituality and the processes encouraged
by neurofeedback. In particular, monks who are experts in
meditation seem capable of generating extraordinary levels
of gamma waves as they achieve a state typically associated
with "transcendence."
From a materialist perspective, the key seems to be neurofeedback's
ability to help us connect memories and sense perceptions
that have been laid down in disparate regions of the brain—to
achieve the feeling of unified consciousness by unifying
the brain's electrical impulses. But if neurofeedback can
foster and even enhance such a state, this begs the question
of whether the phenomena we typically describe in terms of "spirituality" are
just physical by-products of a material mind.
Wuttke turns such skepticism on its head. "The way
I look at it," he says, "we may be able to map
an experience through physiology, whether it is a profound
sense of peace or a religious sense, but that doesn't mean
the material brain is the source of those experiences." Instead,
he sees the brain as "a transformer, something that
conducts energy between metaphysical and physical reality." He
admits neurofeedback can't necessarily help any Joe off the
street achieve the transcendence of a Tibetan yogi, but adds, "It
has been my experience that everybody is enlightened; they
just don't know it."
After my first session of neurofeedback therapy, there's
little chance I'll be confused with one of the enlightened—something
my wife readily confirms. But as I watched the red bug move
with increasing dexterity about the screen, it certainly
felt empowering to see how much control we can exert over
our minds, moods and selves. Over the next few weeks, it's
a sensation I'll recall during moments of stress, like the
long nights with my ever-wakeful children. Just this recollection
seems to have some tangible effect, slowing the quickening
pulse and quieting the static I've seen in the graphic representations
of my brain waves. As Wuttke would say, we can sometimes
be locked into old scripts, reacting to our world in ways
we don't understand or seem to control. Neurofeedback's potential
is so inspiring, in part, because it can help us rescript
our brains and, thus, rewrite our lives.
Blaine Greteman trains the brains of undergraduates as a
professor at Oklahoma State University.
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