Patented Technology to Empower the Mind

  

Neurotherapy as an

Adjunctive Treatment

for Substance Abuse Disorders

 Ed Pigott, Ph.D., Dennis Marikis, Ph.D., & Gregory Alter, Ph.D.

Neurotherapy encompasses a variety of drug-free technologies designed to improve brain functioning.  EEG biofeedback (also known as neurofeedback) is the most researched neurotherapy for treating substance abuse disorders.  Neurofeedback teaches people how to strengthen desired brainwave patterns to improve their ability to relax and maintain focused attention as well as develop many other positive mental states.  This learning process takes place by attaching electrodes to people’s scalps and then “feeding back” to them when the strength of desired brainwave patterns increase using an electroencephalography (EEG) machine. 

Over forty years worth of research has found neurofeedback effective in treating numerous conditions including ADHD, depression, and anxiety disorders among others.  Commenting on this extensive body of research, Dr. Frank Duffy (2000), Professor of Pediatric Neurology at Harvard, writes: "In my opinion, if any medication had demonstrated such a wide spectrum of effectiveness, it would be universally accepted and widely used." 

Neurofeedback for Substance Abuse Disorders: 

Starting in the early 1970’s, researchers began evaluating neurofeedback’s effectiveness as an adjunctive treatment for alcoholism (e.g., Twemlow and Bowen, 1976; Twemlow, Sizemore, & Bowen, 1977).  This early research used neurofeedback to teach chronic alcoholics to strengthen their alpha and theta brainwaves (5 to 12 Hz).  High rates of alpha/theta waves are found in skilled meditators and associated with states of profound relaxation, increased spirituality, and heightened suggestibility.  During these sessions, therapists would typically give patients abstinence-oriented hypnotic suggestions and positive affirmations.  Afterwards, patients would discuss their newfound insights while the therapists worked to reinforce long-term attitudinal change. 

Table 1 presents the key findings from this research.  Summarizing across studies, these researchers found that alpha/theta training: 

• Reliably strengthened alpha/theta waves;
• Decreased depression and promoted positive personality changes;
• Increased spirituality; and
• Decreased alcohol abuse during follow-up in 67% to 93% of subjects.
  

Table 1

Alpha/Theta Training Outcome Studies Lacking a Control Group

 

Study	Subjects	Key Findings
Twemlow & Bowen, 1976	67 inpatient chronic male alcoholics	Increased spirituality consistent with AA’s recovery philosophy.
Twemlow et al, 1977	21 inpatient chronic male alcoholics	Reliably strengthened alpha/theta waves promoting increased insight and positive attitude change.
Saxby & Peniston, 1995	14 outpatient alcoholics with co-morbid depression	Decreased Beck Depression Scale scores and improved numerous MMCI personality scales.  21-month follow-up findings indicated sustained abstinence for 13 of 14 subjects.
Kelly, 1997	19 inpatient Navajo alcoholics (16 males; 3 females)	Three-year follow-up found that 4 (21%) meet the DSM-IV criteria for "sustained full remission", 12 (63%) for "sustained partial remission", and 3 (16%) remained alcohol "dependent."
Bodenhammer-Davis & Callaway, 2004	21 alcoholics with criminal recidivism and head injury	Two-thirds showed substantial improvements in re-arrest rates and decreased alcohol abuse during the 6 to 18 month follow-up.

 

Peniston and Kulkosky (1989) conducted the first alpha/theta training experiment with alcoholics using random assignment.  Their subjects were inpatients in a VA substance abuse program with histories of chronic alcoholism and multiple past failed treatment attempts.  Compared to the traditionally treated inpatient control group, following fifteen 30-minute alpha/theta training sessions the neurofeedback group (n=10) showed: 

• Strengthened alpha and theta waves;
• Greater reductions on the Beck Depression Scale;
• Substantial positive personality changes (Peniston & Kulkosky, 1991); and
• A dramatically lower relapse rate one year after discharge (20% versus 80% for the control group).
  

 

Fahrion (1995) conducted the first large controlled study of alpha/theta training for people who abused drugs other than alcohol (e.g., cocaine, marijuana, etc).  The subjects were convicted male felons in a prison-based treatment program who were randomly assigned between the traditional program and the traditional program combined with neurofeedback. 

The neurofeedback group (n=39) received alpha/theta training sessions for 30-minutes a day, five days per week for six weeks.  Compared to traditionally treated inmates, the neurofeedback group showed higher rates of positive outcomes 6 to 12 months after release from prison as measured by clean urine drug screens and violation-free participation in parole programs (67% verses 53%).  In analyzing the data, Fahrion found that African-Americans were more responsive to alpha/theta training compared to Caucasians and less responsive than Caucasians to the conventional substance abuse treatment program.  Fahrion also found that alpha/theta training was more effective for non-stimulant abusing felons and not as effective for cocaine abusers. 

Scott and Kaiser (1998) evaluated adding beta (12-18 Hz) training to alpha/theta neurofeedback for people who abused stimulant drugs.  Numerous studies have found beta training effective in treating children and adults with ADHD by increasing their ability to concentrate and decrease impulsive behaviors (Hirshberg, 2007).  ADHD has a high co-morbidity rate with substance abuse particularly when the preferred drug is a stimulant (Biederman et al, 1995).  The researchers hypothesized that beta training would enhance concentration while reducing impulsivity and thereby decrease subjects’ likelihood of dropping out before program completion. 

Scott and Kaiser randomly assigned inpatients in a 45-day substance abuse program between conventional treatment and the conventional program plus neurofeedback (n=48).  The neurofeedback group first received 10 to 20 beta training sessions to improve their cognitive functioning followed by 30 alpha/theta sessions.  Compared to conventional treatment, the neurofeedback group showed: 

• Significant improvement in their ability to sustain attention;
• Substantial positive personality changes including greater improvements on the MMPI’s depression, hypochondriasis, hysteria, psychasthenia, social introversion, and psychopathic deviance scales;
• Higher treatment retention rates particularly during the initial phase of beta training when stimulant abusers are at greater risk for dropping out; and
• Decreased likelihood of relapse following discharge.
  

 

Building on this earlier research, Scott and associates (2005) published in the American Journal of Drug and Alcohol Abuse a study evaluating the effects of neurofeedback on a mixed substance abusing population.  The researchers randomly assigned subjects between the neurofeedback (N=60) and control group with the control subjects receiving additional therapist time equal to the time spent in neurofeedback training.  All subjects also participated in the facility’s “Minnesota Model” 12-step program. 

Similar to their prior study, the neurofeedback group first received 10 to 20 beta training sessions to improve their cognitive functioning followed by 30 alpha/theta sessions.  Compared to conventional treatment alone, the 60 clients randomly assigned to also receive neurofeedback showed:

·          A 41% increase in program completion (76% versus 54% for control subjects);

·          Improved ability to sustain attention and inhibit impulsive behaviors;

·          Decreased rates of anxiety, depression and psychopathic deviance; and

·          Decreased likelihood of relapse during the 12-month follow-up phase (23% versus 56% for control subjects)

Summarizing across these studies, research has found that neurofeedback training improves substance abuse treatment outcomes by: 

• Decreasing rates of anxiety, depression, and psychopathic deviance;
• Improving cognitive functioning and the ability to sustain attention;
• Decreasing impulsive decision-making;
• Improving outcomes for minorities (Fahrion, 1995; Kelly, 1997);
• Dramatically improving program completion rates; and
• Decreasing the likelihood of relapse.
  

 

Given these findings, neurofeedback is an evidenced-based intervention that warrants broad inclusion into substance abuse treatment programs.  Unfortunately while this research is compelling, neurofeedback is seldom used in actual practice because:                       

• Neurofeedback equipment is expensive typically costing between four and six thousand dollars per machine;
• There is a limited number of trained professionals;
• Sessions are typically provided one-on-one versus in the group therapy format common in substance abuse treatment programs; and
• Neurofeedback is simply too professional-time intensive and expensive for the vast majority of treatment centers to implement on a program-wide basis.
  

 

The NeuroAdvantage Solution: 

NeuroAdvantage, LLC is a neurotherapy technology and professional services company founded by clinical psychologists with over 50 years of cumulative neurofeedback experience.  Our key technology is the NeuroAdvantage™ Trainer.  The NeuroAdvantage™ Trainer enables people to experience the proven effectiveness of neurofeedback—without the hassles of electrodes and at an affordable price. 

Unlike neurofeedback, the NeuroAdvantage™ Trainer uses enjoyable light and sound neurotherapy (LSN) to strengthen desired brainwave patterns.  This patented technology is based on over 70 years of research and takes advantage of our brain’s natural tendency to synchronize with pleasant rhythmic stimulation. 

Using an early EEG machine, Adrian and Matthews (1934) were the first researchers to document that having subjects stare at a flickering light changed their brainwave activity.  Toman (1941), followed by Walter and Walter (1949), built on this discovery and found that the hertz (Hz) frequency that the light flickered at caused subjects’ same brainwave frequency to grow stronger. 

Since these early pioneers, numerous other neuroscientists have documented the ease with which our brains synchronize to rythmic light stimulation (e.g., Barlow, 1960; Inouye et al, 1979; Nogawa et al, 1976; Townsend et al, 1975).  Neher (1961) found that this same synchronization effect occured to repetitive sound stimualtion.  In 1999, Frederick and associates found that LSN’s combined rythmic light and sound stimulation increased the targeted brainwave pattern’s strength by an average of 38.3% in a single session alone.  A white paper summarizing this research is available at: www.neuro-advantage.com/page/851224. 

Budzynski and associates (1999) took this research a step further.  They compared the effectiveness of academic counseling to 30 LSN training sessions at 14 Hz (beta) for a group of struggling college students.  Their study found that these sessions not only strengthened subjects’ beta waves but that these changes persisted while the students performed challenging mental tasks.  More importantly, in the quarter following treatment termination the LSN students’ GPA improved by an average of .7 points while the comparison students’ GPA dropped by .2 points indicating that LSN training generated lasting effects. 

Depending on the Hz frequency used, clinical researchers have found that LSN is a robust treatment effective in facilitating profound relaxation and meditative states (Freedman & Marks, 1965; Glicksohn, 1986; Lewerenz, 1963; Richardson & McAndrew, 1990; Sadove, 1963; Thomas & Siever, 1989; Williams & West, 1975) as well as in promoting healing for numerous mental and physical conditions including: 

• ADHD and Learning Problems (Carter & Russell, 1993 & 1994; Budzynski et al, 1999; Joyce & Siever, 2000; Joyce, 2001; Russell, 1997; Russell & Carter, 1997);
• Chronic Fatigue Syndrome (Berg & Siever, 2000; Trudeau et al, 1999);
• Chronic Pain and Fibromyalgia (Boersma & Gagnon, 1992; Siever, 1999);
• Dementia and Cognitive Decline in Seniors (Budzynski & Sherlin, 2002; Tan et al, 1997);
• Depression in Adults and Seniors (Berg & Siever, 2007; Kumano et al, 1996; Tan et al, 1997);
• Headaches (Anderson, 1989; Solomon, 1985);
• Premenstrual Syndrome (Anderson et al, 1997; Noton, 1997);
• Psychosomatic Conditions (Chijiwiina et al, 1993);
• Seasonal Affective Disorder (Berg & Siever, 1999; Siever, 2004); and
• Stroke (Rozelle & Budzynski, 1995; Russell, 1997).
  

 

Control Cravings, Reduce Depression, and Promote Positive Change: 

Research has found that for many people LSN triggers a pleasant dissociative state similar to that achieved through deep meditation and/or hypnosis.  Therapeutic dissociation is simply a “disconnect” or interruption in one’s awareness of thoughts and the passage of time thereby rejuvenating the mind.  Kroger and Schneider (1959) found that LSN induced a hypnotic trance in nearly 80% of subjects within five minutes (see figure 1).  In a large well-controlled study published in Behaviour Research and Therapy, Leonard and associates (1999) found that LSN was vastly superior (p<0.0001) in triggering dissociation compared to dot staring, a common hypnotic technique.  The NeuroAdvantage™ Trainer’s ability to rapidly trigger dissociation makes it an ideal tool for disrupting the destructive cravings and ruminative thinking that sabotage for many their road to recovery.

Bright light is increasingly recognized for its powerful beneficial effects in relieving depression.  In 2005, the American Psychiatric Association published a consensus panel report finding that light therapy had treatment effects equivalent to antidepressants for non-seasonal depression (Golden et al, 2005).  In 2006, Lam and colleagues found that light therapy was faster acting, and had fewer negative side-effects, than Prozac in treating the depression associated with seasonal affective disorder.  The NeuroAdvantage™ Trainer combines light therapy’s antidepressant effects with the ability to disrupt ruminative thinking while simultaneously strengthening desired brainwave patterns.

The NeuroAdvantage™ Trainer was designed to take advantage of these various lines of research.  Each Trainer enables users to control the light intensity and comes with 18 different LSN sessions.  Repeated three or more times per week, these Trainer sessions have the cumulative effect of enhancing overall wellbeing as well as improving the targeted areas of brain functioning. 

NeuroAdvantage has developed a special version of the Trainer to help people recover from their addictions and cravings.  This version is programmed with alpha/theta and beta training sessions designed to: 

• Improve mental concentration and focus;
• Decrease impulsive decision-making;
• Control cravings;
• Decrease depression;
• Relax the mind and body;
• Improve sleep; and
• Increase the likelihood of sustained sobriety.
  

 

To further enhance effectiveness, NeuroAdvantage has produced a growing library of audio coaching recordings people listen to during their Trainer sessions.  These recordings cover a variety of topics and use positive suggestions, affirmations, and guided visualizations to help people make desired changes in their lives.  Titles include:

• 12-Steps To Recovery Series
• Control Cravings
• Mindfulness Meditation
• Positive Thinking
• Beating the Blues
• Manage Your Pain
• Deep Sleep
• Stop Smoking
• Overcome Avoidance
• Healthy Eating
• Enjoying Exercise
• Deep Relaxation