FPO2 Protocol Guide

The following article is about using Neurofeedback training on a particular area of the brain located in the area of the skull landmark FPO2.

FPO2 is a site that can be used in those cases that indicate an over activation of fear circuitries in the brain, such as in those suffering from developmental trauma, post-traumatic stress, reactive attachment disorder, personality disorders, anxiety disorders and depressions characterized by high arousal. The amygdala is the part of the brain that learns and holds fear memory. FPO2 lies within “the greater amygdaloid region” (Schore) or the very part of the brain that is responsible for mediating the reactivity of the amygdala. Training at this site often quiets the fear driven brain.

Cautions: Training at FPO2 has been known to activate fear memory as well. This is not necessarily negative, but you have to be in the position to deal with these memories should they arise.

There have also been two reports of precipitation of a seizure when training at FPO2. The amygdala is highly susceptible to kindling. Seizure history may be a contraindication for FPO2 training, at least until there is more overall brain stability.

Site: FPO2 stands for “Pre-frontal occipital” (“frontal pole”) and “2” signifies the right side. The site is at the juncture of the nose and the brow bone, immediately adjacent to the eye socket. There is often a small notch in the bone or a spot that is sensitive to pressure right at that ‘corner’. This is where you place the electrode.

It is best that the trainee is lying back, to make the placement easier to secure and also to recruit slow wave activity. We naturally make more slow waves when we are lying down. A properly placed headband can help hold the electrode in place.

Training eyes closed is recommended for the same reasons- more naturally occurring slow wave activity and less chance of paste getting in the eye. Some people however are afraid to train with eyes closed and respect this. (They will make more artifact eyes closed than eyes open.) The effects do not seem dependent on the eyes being closed.

Rewards: Depending on tolerance and overall arousal of the trainee, rewards may be anywhere from 8-11 Hz (too high for most) and as low as 0-3 Hz. Usually people will feel the effects within three minutes. If they don’t, it could be an indicator that you are rewarding at too high a frequency. Most people will like how they feel if you find the right frequency. As with any protocol, trust the trainee report. If they don’t like it, don’t persist.

Inhibit: 0-6 Hz. This inhibit is in place to protect against abreaction. (Even when the reward and inhibit overlap, as they often do in this protocol, the inhibit is protecting against excessively large amplitude or bursting slow waves, those that would tend to destabilize. The inhibit band actually allows 75% of the inhibited frequency through. We are only inhibiting 0-6 Hz 20-25% of the time. In short, it works to have reward and inhibit frequencies overlap. (The brain figures this out, even if, at this moment, you can’t.)

Time: FPO2 can be a very powerful training. Most people begin to feel the effects within 3 minutes. 3 to 9 minutes is probably enough. If the trainee wants more, less, or none, trust that.

FPO2 effects noted to date:

Positive effects:

  • Reduction in fear
  • Calming/Equanimity
  • Reduced inflammation ?
  • Increased creativity
  • Access to emotional memory – ‘opening’
  • Appetite reduction
  • Bliss
  • Increased sensitivity to smell
  • Reduction in pain

Negative effects

  • Triggered seizure (two cases known to date) Stop training.
  • Triggered release of fear memory
  • Sense of smell too strong
  • Syntax/language problems (can be addressed with left side training, T3, F7, T-F7)
  • Impacts on short-term memory (can be addressed with left side training, T3)
  • Disinhibition, such as swearing or shopping