Neurofeedback

All right, people, I think I've finally been participating in these shenanigans long enough to be able to explain to you, with at least some degree of clarity, what's going on over here with the neurofeedback thing.

I won't be able to get too fancy about it, which is probably best-- this stuff seems to get pretty fancy pretty quickly and leaves the laymen amongst us behind.

And let's face it, we're pretty much all laymen when it comes to complicated electro-neuroscience, amirite?

For a general overview of what neurofeedback does, I'll quote Dr. Q:

Neurofeedback is an adjunctive mental health treatment that helps optimize or fine-tune the functioning of the central nervous system. While psychotherapy addresses questions of meaning, relational patterns and skills, and facilitates grief and coping with life stressors, neurofeedback can be used to calm a nervous system that has become chronically overaroused through repeated life stressors, or to train the brain to create and sustain more focused attention. Calm, focus, and balance.

Sounds kind of like what I said last time, eh?

Dr. Q talks about how neuroscience goes beyond the understanding of the the brain within the confines of psychology and theories of personality-- it moves into the realm of the arousal model and the electrical activity of the brain: 

The arousal model goes something like this: your CNS or brain works like a brake and gas pedal at the same time. Without good brakes (overaroused), you can’t be calm. Without gas (underaroused), you can’t get going, focus, or sustain attention. There are also patterns of mixed or unstable arousal.

What we have found is that a traumatized brain (whether the trauma occurred through discrete specific events like a car accident, or more subtly throughout development as in chronic emotional abuse or neglect, e.g. a person who grows up with a mentally ill parent) tends to be overaroused. A person feels anxious often, or hypervigilant, and reacts out-of-proportion to stressful events of everyday life. This can really interrupt the functioning of an otherwise bright and capable person!**

Um. Ahem. Sound like anyone you know read know?

So in other words, in case you didn't catch that perfectly-tailored-to-kate-the-girl-who-lived final paragraph, one of the primary functions of neurofeedback is to calm an overaroused brain and restore balance and normal, calm regulated activity.

SIGN ME UP, BABY!

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I'll describe a baseline-setting and a typical (as I understand it, so far) neurofeedback session so you can get an idea of how this works. It's really fascinating and my inner Sherlock (and the inner Sherlocks of many I've told already) is extremely excited about all of this business because it's super geek-heavy and intellectually satisfying to sink your teeth into, and yet there's enough surreal craziness to it to make it seem a bit magical, too.

And there are pictures!

Okay, so the first thing that happens is that the doctor needs to get a baseline setting.

This means that they need to measure the current activity in your brain, as it is, so that they can compare it to normal, healthy brain activity and see where the trouble spots are.

On a typical person, this can be accomplished by applying sensors to eight different spots on the scalp and taking a EEG (electroencephalogram) measurement. An EEG measures the voltage fluctuations within the neurons of the brain.

So they hook you up to all these sensors. The sensors look like this:

That is a sensor. That is NOT, however, my hairline. Hmph. As if.     

The sites for the sensors are determined by a head chart that makes sense to the doctor, but, alas, not to me. There are a few, actually, in increasing degrees of detail and complexity, but I'll show you the simplest one, which shows prime placement settings to get good readings for general areas of the brain that will give the doc good information about the function within major brain structures:

Surprisingly, this IS my head. Dr. Q went to place the sensors and she was like, "Wait, have you done this before?"
And I was all, "What do you mean?"

So, in the first session, the doc applies sensors to the eight most primely-located spots of the ones in the chart above (F3, FZ, F4; C3, CZ, C4; and P3, PZ, and P4 among them, as I recall), to gather info from the temporal and frontal lobes where all your higher functions happen, including language, organization, and memory retention; the parietal lobe and the central crossing between the two hemispheres, where all your sensory functions take place; and the occipital lobe, where your visual processing happens.

PTSR point of interest: see those big markers at C3 and C4? My amygdala-- my Lizard Brain-- is just under those. I just learned that, just now. 

Wow. 

That explains something I'll tell you about later.

Anyway, the sensors are applied and the wires go to a router that is attached to the doc's computer.

Here's an important point: no actual electricity is zapped into me during this process.

You might have been wondering about that. You can stop.

All the sensors do is read what's going on. They do not attempt to affect anything.

In fact, they never  do. The thing about neurofeedback-- the thing about biofeedback in general-- is that all it does is provide the patient with information about the body, and the patient uses that information to make changes his or herself.

So no creepy scientist hijinks take place during this or any other post. In case that was what you were here for.

I'll let you know if it comes to that. I am not, shall we say, averse.

So there you are, hooked up. And then you sit there for a while, while the doctor's computer gathers a bunch of information from your brain. 

You can watch while it happens. It looks like so:

Voila.

It measures the voltage in three general ranges: alpha, beta, and theta waves.

I'll be able to explain more about those types of waves in the future. I don't know much about them now, and the more I look up to try to explain what I do know, the more I confuse myself. Suffice it to say that there are waves and they are squiggly and they mean something to some people and those people can tell me things when they see them, and I will tell you that stuff when I hear it.

The important bit is this: the baseline reading from my brain was compared with normal, healthy function from normal, healthy brains, and then certain conclusions were drawn and certain assertions and decisions were made based upon those conclusions.

_____

In a typical session, the doctor compares the baseline reading to normal function and prepares a treatment protocol based upon the particular needs of your particular brain. 

For example, if you show too little beta frequency in your frontal lobe, it is likely that you are having trouble with energy, focus, and getting tasks completed. You are probably experiencing a lot of stress and may be having trouble sleeping and experiencing anxiety as a result.

So the doctor will develop a protocol to work on increasing the beta frequency in your frontal lobe.

How, you might ask?

Well. Check THIS out:

While she's got your frontal lobe sensor spots hooked up to her computer so she can see what they're doing, she might set up a few "reward" and "inhibit" settings for the frequencies in that part of your brain. That means that she'll put a floor and a ceiling on the acceptable healthy frequency range that she'd like to see your brain stay within.

This is all on her computer, remember. Just a little boundary marker around where she'd like to see that squiggly line come in from the sensor.

And then she gives you a computer screen of your own to look at. 

Your computer screen isn't hooked up to any sensors. On the screen is a picture of something pleasant to look at-- I always pick flowers (my other option is "horses and butterflies," which sounds a little too 9-year-old-girl for my taste).

The picture, however, is covered by a blank screen that is divided into squares. As you sit there, relaxed, watching the screen, not doing anything deliberately (this is a completely passive process-- the more you try to "control" it with your conscious mind, the less it works), you begin to hear a steady series of BEEPs, and with each BEEP, a single square is uncovered and a bit of the picture underneath is revealed.

(I couldn't find a good picture of this to show you)

You may have guessed this already: each BEEP and square of picture is your reward for an interval of time staying within the "healthy" frequency as set by the doctor and as detected by the sensors.

The brain, being a pattern-seeking machine, instinctively interprets these BEEPs and picture-parts correctly as the rewards they are and tries to get more of them. Basically, it begins to autocorrect itself, attempting to keep the pattern going and accumulate more of the rewards.

Amazingly, as the brain does this, it begins not only to strengthen its ability to create and stay within that frequency, but the other structures of the brain begin to regulate around that healthier frequency, automatically becoming healthier themselves in the process.

_____

Amazing, right?!

I KNOW!!

So, that's what happens with a typical person.

Ha ha.

Surprise surprise: I am not that person. Turns out I have several enormous red flags of the sort that have caused Doctor Q to

1. Tell me that she would not have felt comfortable taking my case even a year ago, and would be willing to refer me to people with more experience if I preferred, but that if I didn't mind her seeking supervision on my case now, she would like to accept the challenge, and
2. Frequently look at me as if I were a delicious, juicy steak.

Migraines, PTSD, and TBI are all particular complicators of neurofeedback, and each condition calls for an extremely careful and delicate touch. 

All three together, and at the extreme levels that mine present, call for some acrobatics that, at times, defy logic and physics-- some protocols are completely at odds with each other. 

So, in order to prevent exacerbating anything or retraumatizing me or making anything worse, Dr. Q has been averse to doing anything beyond very basic calming techniques on me for these first few weeks until we are able to get the results back from a far more detailed EEG that we did this past week.

It's called the "QEEG." (Hence "Dr. Q." See what I did there?)

In this test, we did basically the same thing as the first one, except I was attached at ALL of the sensor sites: 

BINGO!

In this way, Dr. Q (and her mentor, who will be doing the deep analysis of this data) can get the deepest, most detailed reading possible on my brain, broken up into the smallest segments.

Then they'll be able to develop protocols that can target small sections at a time and keep from irritating areas that don't need it and might not be able to sustain it.

Or, at least, that's my simplistic explanation for what's going on. I'm sure there's more to it, including what else they might uncover with this more detailed test.

I know I gave you a big laundry list of things I learned about my brain after the last test, but there were some things I left out of that post just because I was a bit overwhelmed by it all and, frankly, some of it seemed like small potatoes in the grand scheme of things.

Like the marker that indicated that I have Chronic Fatigue Syndrome, Fibromyalgia, and/or a major sleep disorder.

Um. Well. Duh. I guess it's hard to get too riled up over that when your anxiety and hypervigilance has your brain buzzing out of your skull every day of your life. What do they think makes me so tired and sore in the first place?

But I joke.

Actually, that one sort of washed over me in an ironic haze because those were the first things I tried talking to doctors about, way back in the 90s, way back when I first began to notice that something was wrong with me and it didn't make sense, and those were the first things that seemed to fit.

Doctors smiled condescendingly at me and sent me on my hysterical way, back then.

Today, my electricity doesn't lie.

Here's some more stuff my electricity doesn't lie about:

• My depression is still very high, despite the fact that I am on an antidepressant
• My anxiety is extremely high. High enough that it could be causing depression in its own right, and probably is
• My brain has difficulty shifting between states, meaning that I likely often find myself feeling (get this-- this is the exact word she used, I shit you not)-- "foggy"
• My brain shows signs of extreme sleep deprivation
• My brain function is very slow in the area of my TBI, which affects the function in the rest of my brain, making it function "inefficiently" as a whole
• My brain shows clear signs of extreme hyper-arousal, at a level usually seen in veterans recently returned from combat. This, of course, is my PTSR
• The level of this hyper-arousal is so extreme, in fact, that Dr. Q gently told me I am at very high risk for addiction, because people with levels of constant, relentless activity like this in their brains are typically looking for something--anything-- to calm it. 

Yep. Today, my electricity doesn't lie.

Today, my electricity is dealing up some motherfucking truth, and that motherfucking truth is that EVERY SINGLE THING I HAVE THOUGHT WAS TRUE HAS BEEN TRUE.

And more truth, I suspect, is on the way with the results of that QEEG.

One more thing before I go-- this has been a long post, I know, with a lot of information, but it's been building up and I needed to get this all out here and you know how I like to end on a bright spot and guess what? 

There is one!

One other thing I learned in that first EEG was pretty cool and I didn't get to tell you about it yet.

One thing you do a lot when you're taking these EEGs is close your eyes for a while and then open your eyes for a while. I guess it changes the way the readings come in in some important way or something.

Anyway, there's one particular area-- I forget which-- where they watch how much a certain frequency jumps when you close your eyes. Dr. Q's mentor calls a jump of 150 volts or more "The Artist's Signature." Apparently, he sees a big jump happen there in particularly bright, creative people.

Mine jumped by 280.

So high, in fact, that Dr. Q thought it was TOO high and ran it by him to double-check that it didn't mean something else entirely. I spent a couple of days in limbo, wondering if I was a creative or an axe murderer.

Turns out I needn't have worried. Said Mr. Mentor: I am an "extremely impressive" creative.

Said Dr. Q: "So... imagine, if we can get the rest of this sorted out and free all that creativity! You're going to be a force to be reckoned with!"

And I thought, you know, after all of this, I can honestly think of no better goal than that.

The Girl Who Lived: A Force To Be Reckoned With.

Oooh, oooh, and the sequel: The Girl Who Lived: A Force To Be Reckoned With 2: Electric Boogaloo!

COMING SOON TO A UNIVERSE NEAR YOU!


**Because neurofeedback is so awesome, and because too few people take advantage of it, and because Dr. Q is an excellent practitioner who deserves more business, I am going to give you her real name, which is Silvia Costales, MFT, BCN, and link you to her real website, which is here. Her office is located in Berkeley, CA, but if you are interested in neurofeedback, I strongly encourage you to look for a practitioner in your area.