Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: Jun 01, 2009

Integration of Neurofeedback in the Therapeutic Work With Torture and Trauma Survivors: A Case Study

BSc Psych and
MSc
Page Range: 56 – 62
DOI: 10.5298/1081-5937-37.2.56
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Abstract

This paper describes a case study of a 14-year-old African refugee boy who survived multiple traumas related to war, displacement, and deprivation. Traumatized from the age of 2, his presentation was primarily one of affect dysregulation. In order to address both the core hyperarousal and the unavailability of the necessary cortical and behavioral skills required to regulate affect, an approach was chosen that integrates neurofeedback (electroencephalographic biofeedback) and psychotherapy.

We trust that the description of the process provides others with new practice options and an enthusiasm to expand in this direction.

Keywords: torture; post-traumatic stress disorder; affect regulation; neurofeedback; stages of trauma counseling
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Copyright: © Association for Applied Psychophysiology & Biofeedback
Figure 1.
Figure 1.

The 24 pictures show the degree of difference from the database average in electroencephalogram (EEG) power in each of four standard bands of EEG activity: delta, theta, alpha, and beta. These types of brain electrical activity reflect the level of activation of the brain area (cerebral cortex) being monitored by the electrode. Slower EEG activity, as in the delta (1–3 Hz), theta (4–7 Hz), or alpha bands (8–11 Hz), indicates lowered blood flow and fuel (glucose) use in that part of the brain. Faster activity, as in the beta band, shows increased brain activity. The type of activity also reflects the overall level of arousal of the person: delta activity (2–4 cycles per second [cps]) accompanies deep sleep, theta (4–7 cps) states of drowsiness, alpha (8–11 cps) relaxed states, beta range (12–18 cps) activity reflects an alert attentive state. High beta range (20–24 cps) may indicate tension and anxiety. The color indicates the degree of excess or deficit from the database average. Red means that the given type of brain activity is extremely in excess; dark blue means extremely in deficit. Light green shows the database average. A color version of this figure will be posted, along with the article, at http://www.aapb.org/magazine.html.

Figure 2.
Figure 2.

Pre- and posttreatment scores on the Test of Variable Attention (TOVA).

Figure 3.
Figure 3.

Quantitative electroencephalogram (QEEG) before the treatment. A color version of this figure will be posted, along with the article, at http://www.aapb.org/magazine.html.

Figure 4.
Figure 4.

Quantitative electroencephalogram (QEEG) after 20 sessions. A color version of this figure will be posted, along with the article, at http://www.aapb.org/magazine.html.

Figure 5.
Figure 5.

“See pre- (left) and posttraining (right) Fast Fourier Transformation (FFTs) for Eyes Closed. Note a dramatic decrease in temporal alpha at T5 and T6; pretreatment they were the same amplitude as at Pz; posttreatment they are smaller in amplitude as compared with Pz, which is normal. Also for frontal sites the decrease in alpha power is very clear.” The comments were extracted from the clinical report of Dr. Martijn Arns, independent assessor (Arns, personal communication, 2008).

Contributor Notes

Correspondence: Mirjana Askovic or Deborah Gould, 152 The Horseley Drive, Carramar, Sydney, New South Wales, Australia, email: Mirjana.askovic@swsahs.nsw.gov.au or Deborah.gould@swsahs.nsw.gov.au.