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Explaining Neurotherapy

Written By : Justine Loewenthal
Registered Counsellor and EEG Technician


Neurotherapy has been demonstrated to be highly effective in treating varying degrees of psychological and physical disorders, especially ADD (Attention Deficit Disorder). It uses state of the art technology to allow the ADD child to gradually change his or her own brainwave patterns for optimal functioning.

An optimally functioning brain has the flexibility to change states of attention and arousal. Each situation requires an appropriate mental state. A brain in which there is dysregulation will have difficulty in doing this. It is out of sync with itself.

Neurotherapy is based on the principle that certain disorders stem from an over or under-activity of a part of the brain. Neurotherapy assumes that the brain's electrical activity is a reflection of mental states and that this activity can be trained.

We refer to neurotherapy training as opposed to neurotherapy treatment. Training implies that the child being trained plays an active role in the training process. Treatment implies a passive role. The learning that takes place in neurotherapy is an active process. This encourages an internal locus of control in the child.

Many disorders are a result of a dominance of undesirable brainwave frequencies. Through neurotherapy, we strive to lower the intensity of the frequencies that are causing the symptoms for the child and in doing so; the child will be more likely to achieve his or her full potential.

Neurotherapy has no long-lasting negative side effects. Because it is a learning process, negative information that is not reinforced, will not remain.

History of Neurotherapy

Dr Barry Sterman worked with cats in the 1960's, and found that, through operant conditioning, they could be trained to produce a specific brain wave pattern between 12hz and 19hz. He named the rhythm, occurring between 12hz and 15hz, sensory-motor rhythm (SMR).

Dr Sterman then found that cats that had been conditioned to increase their SMR were substantially more resistant to seizures when exposed to rocket fuel than cats that had not been conditioned. He attempted the same operant conditioning to increase SMR in human patients with epilepsy and found that their seizures decreased in frequency, duration and severity. Sometimes, seizures were completely controlled.

A psychologist, Joel Lubar, from the University of Tennessee, came to the University of California in Los Angeles to work with Dr Sterman. The question was raised as to whether hyperactive children may benefit from neurotherapy. In controlled studies, it was shown that a significant number of the children provided with SMR training objectively benefited.

Brainwave States

Electrodes placed on the scalp are able to record electrical activity produced by the brain. The electrical pattern is called a brainwave. The height of a brainwave is called the amplitude. The greater the amplitude, the more power there is.

Every brainwave frequency has a function. The goal of neurotherapy is to give the child the flexibility to access the appropriate brainwave state, instead of being "parked" in one frequency.

The human brain produces all brainwaves all of the time. Depending on the level of arousal, a specific frequency will be dominant. Ideally, the dominant frequency must reflect the activity that the child is engaged in at that time.

Delta (0.5hz – 3hz), the frequency dominant during sleep, is the slowest. Delta may also be dominant after a brain injury or in certain learning disorders.

A dominance of theta activity (4hz – 7hz) or under-arousal causes many of the symptoms associated with ADD. Too much theta in the frontal part of the brain will result in impaired executive functioning. Many children with ADD have problems with time management and planning, organisation, keeping an organised area and concentration. Because theta is a slow brainwave state, information will be processed too slowly and much information is not retained in a classroom situation. Excessive theta is not conducive to learning.

Alpha (8hz – 11hz) is associated with passive attention and creativity.

SMR beta (12hz – 15hz) is associated with concentration, calm focus, decreased anxiety, mental alertness and external awareness.

Beta (15hz – 18hz) is involved in active attention and learning of new concepts.

High beta (21hz +) has a correlation with emotional intensity, anxiety, and hyperactivity. Children with ADD have an immature brainwave pattern because of the excess of slow activity. This does not make their EEG abnormal, however. The ratio between the faster "concentration" waves and the slower "daydreaming" waves is different from children without attentional problems.

The difference in the ratio between fast and slow waves is usually more pronounced during tasks that require concentration, such as reading. Children without ADD will produce more fast waves when they attempt to concentrate. Children with ADD produce more slow waves. This occurrence contributes to that child's inability to process the information in the classroom at the correct speed.

Arousal

Arousal refers to a continuum of states of excitation, ranging from coma on the one end of the continuum to panic on the other end. The internal arousal system controls states of attention, wakefulness, sleepiness, impulsivity, mood, awareness, behaviour and appetite.

A dysregulation of this delicate arousal system is at the core of ADD. This may result in a variety of behavioural, emotional and cognitive problems.

Learners in the classroom situation require a specific level of arousal in order to retain the information presented to them. A dysregulated brain will be ineffectively self-managed and will have trouble recognising the cues to change arousal levels to accommodate a new task. An inconsistent performance record is a common problem among ADD children. This is due to fluctuations in management of arousal.

Learners with ADD are in a state of under-arousal caused by an excess of slow brainwave activity. Some symptoms of under-arousal include impaired concentration, procrastination, lack of motivation, low self-esteem, and depression. It often takes these children a long time to fall asleep at night and they wake up irritable in the morning.

Learners with ADHD also have excessive theta activity. In addition, they have excessive high beta. They may act as though they are driven by a motor. They are usually impulsive, distracted, hyperactive and short-tempered.


Arousal is determined through behavioural rating checklists completed by significant others (parents, teachers) as well as extensive information obtained in clinical interviews with the child and parents. Constant feedback from parents, the child, the school and other therapists, is essential.



DSM-IV Classification

According to the DSM-IV International criteria for classification and diagnoses of attention disorders fall within the following three categories:

  • a) Attention Deficit/Hyperactivity Disorder, Combined Type
  • b) Attention Deficit Hyperactive/Hyperactivity Disorder, Predominantly Inattentive Type
  • c) Attention Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type

In Neurotherapy it is very important to be able to diagnose Attention Deficit Disorder correctly as it would ensure that the approach in treatment is correct. It has previously been indicated how information is gained to determine the approach. It must also be noted that the work of Dr Daniel Amen is also incorporated in determining the treatment programme for neurotherapy.

Dr Daniel Amen, a psychiatrist, has done extensive research since the 1990's on ADD clients by using a sophisticated SPECT Scan (nuclear medicine that evaluates brain blood flow and activity patterns).

Through brain-imaging Daniel Amen identified symptoms for different types of ADD. He has identified six types of ADD.

A thorough knowledge of the neurophysiology of the brain is also needed to enable one to use the correct treatment strategy.

Type 1: Classic ADD
Primary symptoms: inattentive, distractible, disorganised, hyperactive, restless and impulsive. This pattern tends to be seen much more frequent in boys.

Type 2: Inattentive ADD
Primary symptoms: inattentive, sluggish, slow-moving, low motivation, often bored; daydreamers. This pattern tends to be seen more in girls.

Type 3: Over-focused ADD
Primary symptoms: trouble shifting attention; frequently gets stuck in loops of negative thoughts or behaviours; obsessive behaviour; excessive worrying; inflexibility; frequent oppositional and argumentative behaviour.

Type 4: Temporal Lobe ADD
Primary symptoms: inattentiveness, irritability, aggressiveness, dark thoughts, mood instability, learning problems, inattention and impulsivity.

Early in his imaging education, Daniel Amen discovered how important temporal lobes are in psychiatric illness, mood instability, violence and learning disabilities.

Type 5: Limbic ADD
Primary symptoms: inattentiveness, chronic low-grade depression, negativity, low energy, frequent feelings of hopelessness and worthlessness.

Some people say that Limbic ADD is really a combination of ADD and depression. That may be so, but we see this combination very frequently in our ADD patients and it leads us to specific treatments that seem best for this type.

Type 6: "Ring of Fire" ADD
Primary symptoms: inattentiveness, extreme distractibility, anger, irritability, over-sensitivity, moodiness, hyper-verbal and extreme opposition.

As previously mentioned, AD(H)D is a result of dysregulation of certain brainwave patterns. AD(H)D is not the only disorder that may arise out of a dysregulation of that pattern. It is often likely that there will be a number of problems experienced at the same time, for example ADD and depression, ADD and learning problems, ADHD and epilepsy, or ADHD and Tourette's Syndrome. Neurotherapy can address these problems together by allowing the child to gradually adjust the frequency responsible.

Neurotherapy involves the brain creating new neural pathways and learning a new, more desirable way of functioning. This is a long lasting change. The number of sessions to expect for a successful neurotherapy process depends on the severity of the problem and well as the comorbid factors involved. Generally speaking, a significant improvement is to be expected in 20 – 40 sessions.

References

  • Amen, Daniel G. M.D. (2001). Healing ADD.
  • Sears, W. & Thompson, L. (1998). The A.D.D. Book.
  • Steinberg, Mark, Ph.D. & Othmer, Siegfried, Ph.D. (2004). ADD The 20-Hour Solution.
  • Thompson, M. & Thompson, L. (2003). The Neurofeedback Book.
  • Hill, R. & Castro, E. (2002). Getting Rid of Ritalin.