Brain Training and Psychotherapy ($)

We think about our thoughts when we should be thinking about how we think.

“Being ignorant is not so much a shame, as being unwilling to learn.”
— Benjamin Franklin

I was recently invited to contribute a chapter to a book on approaches to psychotherapy. This is an illustrated version of what I wrote.

---

Neurofeedback

Brain training organizes the central and peripheral nervous systems to be more resilient, flexible, and responsive and, at the same time, less reactive and less hyper-vigilant. This training can be done without any cognitive, emotional, or behavioral feedback, but purely by means of modulating brainwaves of different frequencies at different locations in the brain.

This training requires 20 to 40 sessions of brainwave neurofeedback and forms of biofeedback such as heart-rate variability, progressive relaxation, and breathing yoga (pranayama). It results in more organized and resilient cognition, emotions, and metabolism.

The equipment required for neurofeedback is noninvasive. It consists of an amplifier to record electrical measurements at anywhere between three and 20 sites on the client's scalp, and a computer to process the signals. The system’s sensitivity to muscle artifact requires the client to remain still and relaxed for the 20- to 40-minute duration of the sessions.

During this time, they may watch simple animations that vary in motion, color, or contrast, or listen with their eyes closed to audio whose changes in rhythm and volume reflect dominant changes in their brainwave patterns. They might be given a goal, such as reaching some displayed score, but generally the only suggestion is to be comfortable and relaxed.

Dramatic physical and mental changes often result over the course of training. Neurofeedback is one of the most effective treatments for substance addiction and is uniquely effective in restoring balance in the case of central nervous system conditions such as attention deficit, insomnia, anxiety, depression, traumatic brain injury, stroke, compulsive and reactive behaviors. Brainwave training does not directly address behavioral categories listed in the Diagnostic and Statistical Manual, which are often misunderstood to be physiological states.

New brainwave patterns learned by operant conditioning can result in:

• Improved executive function, which is the organization of thoughts, associations, and memory.

• Improved prosody: the sensitivity to subtle cues in the speech, expression, and behavior, and consequently becoming more expressive in one’s own speech and behavior.

• Improved proprioception: the awareness and control of the body in space.

• Expanded awareness, resulting in greater tolerance of uncertainty and unresolved issues, less cogitation and rumination, improved mindfulness, and deeper self-reflection.

• Better physiological regulation involving coordination of the sympathetic and parasympathetic nervous systems, as well as improved connection between the cerebral and enteric systems. This results in better control of circadian rhythms, improved diet, lessened reactive tendencies, and improved emotional stability.

Cerebral nervous system training can be approached by either training the nervous or cognitive systems, since the two are linked. Training the nervous system is accomplished through computer-assisted neurofeedback.

The nervous system can be trained using cognitive and emotional techniques that correlate with the nervous systems. Rather than focusing on behavior, as in cognitive-behavioral therapy, training the nervous system aims to improve one’s aptitudes, leading to more enduring and fundamental metabolic changes.

Mark Rothko

A Content-Free Approach

Brain training is unique in being a content-free approach to remediating conflicts and restoring balance. As a skill building exercise, the client is not thinking, regressing, or confronting issues, situations, or opportunities. Clients typically respond to brainwave training by noticing nothing, which is an obstacle to investing in the training. Instead, clients perceive situations changing around them without effort or engagement. Mood improves, relationships improve, situations lose their urgency, and previous reactive responses weaken or disappear.

I remember in my training I had the unusual experience of expanded awareness, as if I had been living in a conceptual box whose walls were taken away. I noticed dramatic improvement in my aim in throwing objects, and a heightened emotional sensitivity. One’s subjective experience rarely changes, but one perceives people reacting differently to them. Despite requiring no effort, neurofeedback training is mentally tiring.

Neurofeedback-aided therapy is a different and complementary approach to psychotherapy, as it does not deal, or deals indirectly, with intellectual and emotional function. There is effectively no resistance to change in brainwave training because the client has no cognitive or emotional experience of obstacles to new brainwave states. Clients encounter their own limits in flexibility, strength, mood, focus, and resilience, but these are experienced as neurological states rather than intellectual situations, if they’re experienced at all.

---

If you’d like to explore how you think frames what you see, call me. I can suggest ways to expand both of these.