Table of Contents
Introduction: The “untreatable child” and the story of my personal discovery of neurofeedback
Ch 1: The Mind in Developmental Trauma:
Differentiation of Development Trauma Disorder (DTD) from PTSD, post traumatic stress disorder and RAD, reactive attachment disorder.
Identifying the central issue in developmental trauma as unrepaired attachment rupture in childhood leading to a core feeling of motherlessness and severe emotional disregulation.
The implications of the ACE (Adverse Childhood Events) study, for physical and mental health in those with DTD.
Overview of sensory integration problems, lack of cause and effect thinking, right hemisphere (RH) learning disabilities.
The meaning of symptoms.
Motherlessness and disregulation in the therapy
Ch 2: The Brain in Developmental Trauma: A discussion of the ANS and the CNS in DTD. What the different lobes and structures contribute to function and dysfunction.
Identifying particular brain structures and networks most salient in DT. Possible overlap with temporal lobe epilepsy (TLE).
The electric brain. An overview of Buzsaki’s work on rhythmic, frequency-based oscillatory organization of the brain. We can appeal to these rhythms and the structures that engage in them with feedback to the frequency domain of the brain, the EEG.
Ch 3: Changing Patterns: Neurofeedback in Developmental Trauma: Introduction to neurofeedback, what it is and what it does. How it can be used to help quiet even severe brain storms, those suffered by people abused and neglected as children, like panic attacks, rages, chronic fear, and haunting states of shame by appealing to the frequencies that underlie them. The arousal/regulation model. There are case examples to illustrate this new paradigm throughout the book.
Ch 4: State, Trait and Identity: A description of a model that links disregulated, seizure or seizure-like events in the brain that create a nearly impossible self-regulation burden (in a recent look at these kids in state facilities here in Massachusetts, 72% have been diagnosed with temporal lobe epilepsy or TLE); how these affects fold into states ; how states practiced become traits and how ultimately we experience all of this as our identity. When we change arousal, we can change state, trait and ultimately even identity. Discussion of “trauma identity”, the identity forged primarily in fear and shame and what happens when these affects subside or, optimally, fade away entirely. I also discuss what I have come to see as the powerful field effects of early childhood neglect and trauma.
Ch 5: Introducing your Patient to Neurofeedback: Making the transition from psychotherapy alone to integrating psychotherapy with NF, managing expectations, informed consent and some of the implications for the therapeutic relationship. The imperative for and limits of training your own brain.
Ch 6: Assessment: Neurofeedback training relies on an initial clinical assessment and life style inventory focused on arousal and ongoing session by session assessment of training effects. The CNS and the ANS are exceedingly plastic and our goal is to nudge the brain toward its own capacity for self-regulation. This chapter is about being in “a conversation with the brain” and learning to “think neurofeedback”. An overview and discussion of assessment measures.
Ch 7: Protocols for Developmental Trauma: Protocols known to be helpful to fear driven brains generally and the neuroscience research that suggests them. Guidelines for how to think about developing new protocols.
Ch 8: The Integration of Psychotherapy and Neurofeedback: All psychotherapy outcomes depend on the patient’s capacity for affect regulation. In DTD, emotion regulation is addressed primarily by training the brain to regulate itself. I look at changes in the fear based personality as we quiet fearfulness and the new clinical challenges this brings.
Ch 9: Three Women; Developing Selves: Three case studies of developmental trauma. The first is a case of the apparent interruption of the intergenerational transmission of trauma- fascinating case study (35 sessions). The second is about a young woman with Dissociative Identity Disorder who integrates her alters-many and strong- into her sense of an integrated self (90 sessions). And the third is about a girl with Asperger’s, developmental trauma and eating disorder (over 300 sessions). Neurofeedback played the leading role in these cases, particularly in affect regulation and they were all integrated with ongoing psychotherapy. There is no claim here that primary regulation in severe DTD can be achieved in 35 or even 90 sessions, just reports on what happened in those time frames.
Afterword: I discuss the work of mathematician and physicist, Stephen Wolfram as it relates to complexity in the EEG and in the human psyche. There is a brief discussion of research obstacles in this field and how this situation seems to be changing as the Director of NIMH Tom Insel proposes the new paradigm of the human connectome. And I take a look at some of the social costs of DTD, particularly on school drop-out rates as suggested by the work of James Heckman. I make the proposal that schools adopt Brainwave Education (BE) to help address this problem and wrap up with the quote of a young woman who arrived for training after a meeting about her dissertation in education: “I can’t wait until we have a neurofeedback nation!”