Trauma can come in a variety of sorts, whether emotional, physical, or brain trauma. Trauma unexpectedly occurs when there is a sudden overwhelming challenge that we are not ready for and cannot handle, especially one that makes us think we could have died or been otherwise paralyzed with an inability to act. Things can occur that are beyond our current ability to understand or manage. Such events can occur at any age and can occur once or be repetitive.
Trauma can lead to enduring effects that limit our productivity and loving relationships through the changes it causes to our mind, body, and brain. Fortunately, many biofeedback and neurofeedback methods help restore us to health and happiness following trauma.
The physical residue of emotional trauma includes changes to hormones, neuromodulators, and brain function. Changes in heart rate variability (HRV), respiration, skin conductance, skin temperature, and muscle tension (EMG) may also be involved. Changes to one’s thinking and behavior usually occur.
Biofeedback (BFB) and neurofeedback (NFB) methods directly address some of the key changes to the body and brain that are often caused by trauma. Moss, Shaffer, and Watkins (in press) assigned a level-4 rating of efficacious for BFB and NFB for PTSD based on multiple randomized controlled trials.
BFB and NFB use precise sensors and computer analysis to teach self-awareness and self-control, to show in a very real way that there is a new truth beyond the emotional pain, inability to act, and hopelessness that trauma seems to say are true. With repetition, one learns that it can influence the physical effects of trauma that might have seemed permanent. Increasing confidence about one’s effectiveness makes it possible to act more freely in ways that return meaning to life.
For many people following trauma, BFB can be the best way to begin because of the relative ease with which one can control functions like breathing and muscle tension. For example, success with HRV biofeedback is achieved with easily learned breathing skills. This provides a firm foundation for progressing to NFB to restore brain function to health.
As one succeeds with BFB and NFB, not only do the brain and physical changes from trauma decrease, but one also begins to think differently, believing one can face life stresses confidently. That belief disconfirms what trauma had sought to tell us, that we are helpless. As these successes from BFB and NFB accumulate, and as our thoughts and beliefs change, it becomes much more possible to act differently in real life and cope with situations and people that were previously feared and avoided. The implication is that integrating BFB and NFB with psychotherapy can be especially helpful and lead to enduring benefits for living a more fulfilling life.
An example of a client with childhood developmental trauma is TR, a 41-year-old man injured in a car collision, sustaining a mild concussion. He was referred for help to manage the anger that had worsened since his concussion. qEEG data were collected as part of his assessment; the summary results are shown below. Note that the scale is set to show z-scores in color between +/- 1.5 and +/- 4.5 standard deviations to identify better the location of the highest elevations, some of which exceeded 4 standard deviations.
Baseline Eyes-Closed NeuroGuide z-Score FFT Summary Report
Baseline Eyes-Open NeuroGuide z-Score FFT Summary Report
The most notable qEEG findings were of excess high beta at F3 and F4, both with eyes closed and with eyes open. These findings were used to guide the selection of neurofeedback training.
The first stage of training focused on down-training high beta amplitude at F3 and F4 with eyes open. In the second stage of training, an alpha-theta protocol to increase frequencies in the lower alpha and higher theta range was used at P4 with eyes closed. Integrated with neurofeedback training was cognitive-behavior therapy consistent with an Acceptance and Commitment Therapy model, together with skills training for progressive muscle relaxation training and slow diaphragmatic breathing.
Below are qEEG findings at the conclusion of neurofeedback training. Reductions in excess high beta can be seen at both F3 and F4, in both eyes-closed (untrained) and eyes-open (trained) conditions. Additionally, TR and his wife reported significant reductions in anger expression, the training goal.
Post-Neurofeedback Eyes-Closed NeuroGuide z-Score FFT Summary Report
Post-Neurofeedback Eyes-Open NeuroGuide z-Score FFT Summary Report
In sum, BFB and NFB change the physical effects of trauma. These methods open doors to improved self-awareness and self-regulation and show in a real, immediate way that there is hope for change. It becomes possible to make healthy choices, see the world with less fear and more confidence, and act for good in a world with value and meaning.
Chung, A. H., Gevirtz, R. N., Gharbo, R. S. , Thiam, M. A., & Ginsberg, J. P. J. (2021). Pilot study on reducing symptoms of anxiety with a heart rate variability biofeedback wearable and remote stress management coach. Applied Psychophysiology and Biofeedback 46, 347–358. https://link.springer.com/article/10.1007/s10484-021-09519-x
Fisher, S. F. (2014). Neurofeedback in the treatment of developmental trauma. W. W. Norton.
Moss, D., Shaffer, F., & Watkins, M. (in press). Posttraumatic stress disorder. In G. Tan, F. Shaffer, R. Lyle, & I. Teo (Eds.), Evidence-based practice in biofeedback & neurofeedback (4th ed.). Association for Applied Psychophysiology and Biofeedback.
Price, J., & Budzynski, T. (2009). Anxiety, EEG patterns and neurofeedback. In T. H. Budzynski, H. K. Budzynski, J. R. Evans, & A. Abarbanel (Eds.), Introduction to quantitative EEG and neurofeedback: Advanced theory and applications (2nd ed., pp. 453-472). Academic Press.
Rolnick, A., Bassett, D., Gal, U., & Barnea, A. Anxiety disorders. In M. S. Schwartz & F. Andrasik (Eds.), Biofeedback: A practitioner’s guide (4th ed., pp. 439-465). Guilford Press.
Sherin, J. E., & Nemeroff, C. B. (2011). Post-traumatic stress disorder: The neurobiological impact of psychological trauma. Dialogues in Clinical Neuroscience, 13, 263-278. https://doi.org/10.31887%2FDCNS.2011.13.2%2Fjsherin
van Der Kolk, B. A., & Saporta, J. (1991). The biological response to psychic trauma: Mechanisms and treatment of intrusion and numbing. Anxiety Research, 4, 199-212. https://doi.org/10.1080/08917779108248774
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