Behavioral Medicine Associates, Inc.
Education Pages
Neurotherapy
Attention
Neurotherapy means
reinforcing
moments when the brain is doing activity that reflects a more desirable
state.
Many of us could stand a
little sharper focus of our attention.
Some of us have a really hard time with sitting still, focusing and
concentrating.
This condition can be bad enough to qualify for being called a
"disorder."
Attention Deficit Hyperactivity Disorder. One must see the brainwaves
of
people with ADHD to understand ADHD.
The brain activity can look much like Stage 2 sleep ("theta"activity)
while the person is
trying to read. ADHD is often marked by increased "sleepy waves" in the
EEG.
You can, however, always see brief periods of activation in the raw
EEG.
These "operants" of focus and alertness spontaneous periods when the
brain
becomes more activated are the moments which neurotherapy identifies
and
reinforces.
Many young children with
"ADHD" show this excessive theta activity, particularly over the front
end of the brain. The frontal and prefrontal (behind your forehead)
regions do "executive" things: planning, motivation, impulse control.
The systems behind those in frontal cortex regulate attention, ignoring
distractions, persistence and precise motor (muscle) control as well as
"mirroring." There are specialized neurons in part of the frontal
cortex (mirror neurons) that allow us to copy what we see others do,
even down to letting us feel what others feel. That's empathy. So if
the whole region is really too underexcited ("sleepy") to do the jobs,
you're going to have some problems.
Other people have too much
"alpha" activity over frontal systems. The systems are awake, but they
are just "hanging out," again, not doing their jobs. These patterns are
common in teens and adults with ADHD. Neurofeedback in this situation
simply lets the person know when their brain is a little bit more "on
the job."
Neurofeedback can
let you know
instantly
when you are slightly more attentive, more focused and less sleepy.
Because the increases in
alertness are initially small and
momentary,
a great deal of coaching and reinforcement is done during the training
sessions. The person practices raw attention to a computer display that
is
showing them a simple representation of their brain activity. It may be
as simple as a bar that goes up or down, a little airplane, or other
more complex displays. The computer also makes tones so the person
can
tell when they're paying better attention without looking at the
screen. We use just auditory feedback during neurofeedback training for
better reading, listening,
conversing,
doing math, drawing, and other school or work tasks.
The therapy part of
“neurotherapy” involves the therapist
establishing
strong rapport; skillfully encouraging new levels of effort; imparting
study skills, good attitudes, and self esteem; and training assertive
and
listening skills. This is all done in the context of twice weekly
neurotherapy sessions.
Neurofeedback can also let you know
when you are slightly more relaxed, when your mind is slightly less
busy.
When your brain is very busy it
makes a characteristic "signature" of fast, high frequency brainwaves.
A lot of this so-called "beta" activity happens when you are busy
thinking, planning, picturing situations, making judgments, running
possible scenarios of the future, remembering - sometimes involuntarily
- situations from the past.
All this busy-ness is fine, in fact it's a problem when your brain
won't do that pretty continuously in class or on the job. But some
people have the opposite problem. The brain won't kick out of this
excited state. Worrying, going over thoughts again and again, this can
become a problem that interferes with sleep, tripping off anxiety,
being "preoccupied." At the extremes, one becomes obsessive, driven and
life becomes a sea of unremitting tension. The EEG can spot this. The
signature is too much beta activity and too little "alpha" activity.
It's sort of the opposite of the inattentive type of ADHD.
Alpha waves happen around 10 times a second and are the signature of an
awake, but relaxed mind. If you are able to sit down in the middle of a
busy day, shut your eyes and just let it go for a few minutes, you
probably have pretty decent alpha. People who experience themselves as
never being able to "shut down," "let go," or just stop thinking so
hard probably don't have very well developed alpha.
Neurofeedback machines can easily pick up even very little alpha waves,
letting you know when you are getting a little more mentally relaxed,
while staying quietly alert. It's a lovely experience. In fact this
application of neurofeedback is really electronically-guided
meditation. No effort to "blank out" your mind is needed - or
desirable. Instead, you just hang out, resting with your eyes closed,
noting when a soft tone comes on. The tone lets you know your alpha
just got a little bigger. Gradually, you start to recognize where
you're going. Later, you've found your way into an increasingly
familiar state. You know how to get there, so you no longer need a
machine to help guide you.
For more physically-experienced tension, the fast, high amplitude beta
activity is usually happening over the sensory and motor control
systems (sensorimotor cortex) which is in a band across the top of the
brain. If this is "running hot" you will feel tense, even when you
don't particularly have a lot on your mind or a lot going on. In this
case we would "train down" the excess beta over this part of brain and
"train up" a lower frequency (the sensorimotor rhythm) that is the
relaxed, inhibitory rhythm of this part of brain.
For more mentally-experienced tension, the excess beta is likely to be
over the "association" areas of the brain, the parietal lobe which is
behind the sensorimotor cortex. The parietal lobe is sort of an
automatic thinking device that quickly and very automatically makes
connections - associations - between what you're experiencing with your
senses and what you've experienced before (memories). This part of your
brain is decoding what you're reading right now, for example. Notice
that you didn't have to decide to understand the words you're reading.
It just happens. That's what I mean by automatic. The same thing
happens with visual images, smells, things you touch. Everything
reminds you of something else, and generates verbal thoughts as well as
visual images. If I mention that I like to ski, pretty soon you're
having some thoughts and maybe images of skiing. The content will
depend on your experience with skiing. If these systems are
"overheated", making too much high amplitude beta, your thinking will
be incessant and will get hard to shut off. In this case we'd probably
train down the excess beta and train up alpha rhythms, the "idling"
signature of these regions.
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