Emotional Control and Neurofeedback

A recent issue of Psychology Today published this article that seems to advocate expressing more negative emotions: https://www.psychologytoday.com/articles/201501/beyond-happiness-the-upside-feeling-down.

I have some issues with this article. When most of us experience negative emotions, we are able to cognitively recognize that we need to process them in ways that are ultimately productive to ourselves and those around us. We use these emotions as a touchstone about the events in our lives and their relative importance to each of us as individuals. Then we prioritize getting ourselves into situations with more positive emotional results.

However in some instances, this article seems to be advocating letting at least some emotional reactions go unchecked. I largely disagree with that premise. Having unbridled negative emotions will quickly lead to trouble with interpersonal relationships. In our society, those who display strong and/or frequent negative emotions rapidly become marginalized. Many of us have experienced this in our own lives: the coworker who yells at everyone, the child who has frequent meltdowns, the family member who is always down and complaining about something….. We monitor our own, usually negative, emotional reactions to these people and then try our best to avoid interacting with them.

There is a good reason why people who express a lot of negative emotions are viewed as immature. Appropriate control of emotions is one of the ways that adults are different from toddlers–we have developed mature prefrontal lobes to our brains. The prefrontal lobes are some of the last areas of the brain to develop fully, and like just about every part of the brain, the more they are utilized in positive ways, the better they perform–especially in negative circumstances.

If you are concerned about whether your emotions are appropriately controlled, you should consult with a qualified therapist. Neurofeedback can play an important part in learning to maintain emotional control. Prefrontal control networks over the limbic (emotional control) system can be stimulated and strengthened. Practicing positive behaviors and control encourages positive experiences and lives!

Tips to Help Fall Asleep

http://www.huffingtonpost.com/2015/02/23/fall-asleep-faster_n_6713464.html?ncid=newsltushpmg00000003

These are great tips to help you fall asleep. However, like any behavioral skill, these need to be practiced consistently (read every night) in order for them to work. Neurofeedback can also enhance brain skill in winding down to fall asleep and help maintain normal sleep patterns to enhance good quality sleep through the night.

Chronic Stress

Evidence continues to mount that chronic stress takes a significant toll on the brain and body. Science News has a great overview of our current understanding:

Chronic stress can wreak havoc on the body

Even while we find ways as individuals and as a society to improve the circumstances that cause chronic stress, we need to recognize that for many it is difficult to avoid. Neurofeedback can help reduce brain stress and eventually help guide to a lifestyle that maximizes healthful, stress-reducing behaviors and practices.

Healing the Brain and Brain Plasticity

A great essay from the weekend Wall Street Journal about maintaining brain health through aging, injury, and disease processes. There are no guarantees in life, but there is excellent proof that physical, emotional, intellectual, and social engagement in life enhances brain function into middle and old age. This article did not mention neurofeedback, but does discuss other forms of brain entrainment like auditory therapy. Neurotherapy is unique in that it persuades the brain’s own white and gray matter to perform training tasks on their own. It is a “learned” process that is dependent on the brain plasticity described in the article.

http://www.wsj.com/articles/SB20167761076414843692504580443981315539578

Use of Complementary and Alternative Medicine in Children with Neurological Conditions

A study of children in the US with certain common neurological conditions such as headaches, migraines, and seizures showed that they were nearly twice as likely to use some form of complementary or alternative medicine (CAM) than children without these conditions. http://www.ncbi.nlm.nih.gov/pubmed/24753991 Of the CAM techniques used, the most popular were mind-body techniques.

This data seems to reflect how poorly current medical models for treatment of these conditions perform in real world settings. In my practice, I see two main issues. The first is the lack of effective treatments, mostly in the form of medicines. However, even such highly technological and expensive procedures as deep brain stimulators seem to have only limited efficacy. Even more prominently, is the problem of unacceptable side effects. So many medicines that are meant to correct certain aspects of brain function cause symptoms that can be just as debilitating or worse than the original problem. The biggest issue is often sedation. In children as well as adults, being “out of it” for much of the time makes them inaccessible for high quality social interactions, learning, exercise, and other activities that are essential for normal brain development and maintenance.

No wonder these children, or more likely their parents, are turning to CAM.

While neurofeedback is not a panacea, it tends to have some significant positive impact on most brain-based conditions. Its lack of side effects is one of its most notable benefits over medicines or invasive surgical procedures. Neurofeedback allows most brains to re-engage with their environment. Then social skills improve, learning become easier, physical activity levels increase, and overall well-being makes improvements.

Too bad allopathic medicine is just beginning to realize what many health providers and health consumers have realized for a long time. Treatment of brain-based symptoms need to be carefully individualized. Frequently, CAM techniques like neurofeedback, which promotes brain regulation, are an excellent place to begin.

Efficacy of Brain Training

As a longterm neurofeedback practitioner, it is frustrating to see articles like this one in the New York Times Magazine, http://www.nytimes.com/2014/10/26/magazine/can-video-games-fend-off-mental-decline.html?smid=fb-share.

Neurofeedback is here and more widely available than ever. While it is important to keep refining our techniques and moving ahead with complementary techniques, the very existence of neurofeedback as an efficacious way to neuroregulation and improved brain health and function is totally missed.

We must also avoid relying solely on technology as “the answer” for promoting good brain health. The human component is essential for most people. The Othmer technique of neurofeedback includes that important person-to-person interaction that can make every difference in the response to treatment.

Neurofeedback in an Integrative Medicine Practice

I found out today that Amazon is now taking pre-orders on a book for which I wrote a chapter. My aim in the chapter to to look at each patient as a whole person who needs to functions well as possible in our society. I present a number of case studies to show how this is applied. In an ideal world, I would like to see all doctors and medical health providers follow similar approaches. In the long run I think we could decrease health care costs and increase satisfaction with health care delivery.

Deep Brain Stimulation

Scientific American has posted a guest blog on their MIND feature from psychiatrist Don Malone of the Cleveland Clinic. He has been involved with research on Deep Brain Stimulation (DBS) for a number of brain conditions including obsessive-compulsive disorder and depression. Here is his article:

http://blogs.scientificamerican.com/mind-guest-blog/2014/10/28/a-miracle-technology-can-lift-severe-depressionbut-real-recovery-has-only-just-begun/

My first reaction to this article was, “Why have the patients he describes received trials of medication, counseling, electro-convulsive therapy (ECT), and other treatment modalities, but not EEG neurotherapy before undergoing as drastic and invasive a procedure as DBS.” DBS involves introducing a foreign object, a wire, into the brain. It needs to be connected with the electronic stimulator. This has the potential to be a major cause of complications just as any time the integrity of the body is breached. On top of all this, it seems to work well in only about 50% of those who undergo the procedure and it is very expensive to set up and maintain.

EEG neurofeedback significantly helps around 80% of those who undergo neurotherapy for depression and OCD. It is non-invasive and usually costs considerably less than 1/10th of initial DBS. Few patients need follow up neurofeedback sessions to maintain their functional gains. Wouldn’t this be a much more productive way to spend our healthcare dollars? Those who seem to be good candidates for DBS after a fair trial of EEG neurofeedback could then be referred on for the procedure.

Secondly, I agree with the main premise of his blog. While a few people seem to grab better brain function and soar with it, others need to be coached and counseled into using their brains in ways that they have never know or realized possible. This is a learning process and like any learning process takes time, effort and persistence. Brain health needs to be supported by excellent health habits such as diet, exercise, sleep, appropriate brain challenges, good mental health support, and minimizing stress. Quick and easy fixes are rare.

The Evolution of Memory

Today’s Washington Post had an interesting interview of Michael Kahana of the University of Pennsylvania. He is working with the US military to develop an implantable device that will help those with memory disorders. However, his bottom line is that those of us with more-or-less normal brains need to go through the tedious task of practice to learn any skill in which we wish to be proficient. The practice is skill specific. So practicing mental exercises on the computer seems to improve one’s skills in those mental exercises. I know that my skills in crosswords and sudoku have improved remarkable in the years that I have enjoyed doing them, but it does not seem to help my ability to remember people’s names.

He implies that the converse, not practicing skills may promote losing the ability to do those skills, is also true. There is a discussion on relying on electronic devices as our memories. I believe in a compromise. Continue to keep up a regular intellectual tasks through a variety of exposures. However, since knowledge increases in such a spectacular way, knowing how to look something up on your electronic device is a wonderful way to further explore new intellectual and cognitive challenges.

http://www.washingtonpost.com/national/health-science/study-set-for-brain-stimulation-device-to-help-restore-memory/2014/10/24/c8cada24-4583-11e4-b437-1a7368204804_story.html

Neurofeedback seems to be a good way to put the brain through a series of challenges to remediate or improve memory abilities. It’s utility in helping recovery from traumatic brain injury is well documented. Evidence that it can help stabilize deterioration in dementia has also been described. However, I agree with Professor Kahana that specific practice in the tasks that we wish our brain to perform must be part of any memory improvement scheme. After all, how many people do you know who learned how to speak Chinese by learning to ride a bicycle?