Neurofeedback Book Review by Alan Bachers, Ph.D.

Neurofeedback in the Treatment of Developmental Trauma by Sebern F. Fisher, reviewed by Alan Bachers, Ph.D.This is a review of a book we usually put in the category of traditional, protocol based neurofeedback approaches. That being said, this is an extremely valuable body of work for anyone interested in watching a pioneer evolve training protocols and clinical expertise in working with the extraordinarily difficult populations of developmentally traumatized individuals. I predict the book will launch innumerable neurofeedback careers, dissertation topics, research studies, and demand for access. To those unfamiliar with the field, her book is a clear and startling delineation of her work with children even into adulthood termed by experts to be irredeemably damaged; “unadoptable,” “untreatable,” “unsalvageable.” As any journey begins from where we are, hers began as the director of a residential treatment facility for children and adolescents. Absent, ambivalent, ruptured, or disorganized attachment to a mother figure in the extreme typifies the early incapacitating experience in those she encountered, resulting in a life of not existing as a self, and having a central nervous system frozen in fear and sometimes bizarre outbursts of self- or other directed lethality. For those tasked with dealing with such people, neurofeedback represents a truly new paradigm with profound benefits for both those who treat and are treated. From her earliest statements Sebern issues challenges to the status quo: “…we can exercise more influence on the mind by addressing the brain than we can have on the brain by addressing the mind.” (p.68)

Through the neurofeedback procedures she describes in great detail, she directly engages the individual brain in its own reparative and ultimately transformational capacities. These results heretofore unexpected, or never seen, by either patients or their therapists, demonstrate the revolutionary nature of this technology and its application. To those already familiar with neurofeedback’s benefits from their individual training, the elegantly described transitions in the many “impossible” cases will sharpen their tool set and enlarge the scope of their capacities to bring neurofeedback to ever widening groups.

The field of developmental trauma as a brain event is distinguished from traditional DSM diagnostic rubrics, providing a framework for dealing with the brain on its own terms and not as an accumulation of arbitrarily categorized symptoms. The framework for intervention is created by relating the existential realities of developmental trauma sufferers to actions and interactions among brain regions. The “wiring and firing” of the disordered brain is translated into regional patterns of brainwave frequencies and amplitudes that become accessible to training protocols derived from decades of clinical experience. Finding the “sweet spot” between too much upregulation or too much downregulation of each region or presenting symptom constitutes the art of this particular neurofeedback treatment. Fisher describes with clarity and clinical detail the evolution of the theory and practice of neurofeedback as a protocol based treatment, all of which is focused on discovery or regulation of affect in the individual. Technical descriptions are always anchored in clinical examples – including failures – of such interventional adjustments. Part two of the book is a comprehensive introduction to the practice of neurofeedback – assessment, protocol development, and subtle aspects of training. Its important integration with psychotherapy are covered in ways that will be welcomed by someone new to the field as well as old hands. Fisher emphasizes the role of clinical acumen always requiring constant innovation to help patients who don’t even experience a self, to adapt to sudden awakenings for which they are completely unprepared, and to integrate such changes, however haltingly, into being human in a suddenly changing landscape. She concludes with three extensive case histories that give a sense of the range of treatment options and outcomes. Anyone dealing with dysregulation of this magnitude will benefit from her painstaking experiences and their descriptions.

In her afterword, Sebern describes the work of mathematician Stephen Wolfram and his class 4 space that gives the math for where neurofeedback is taking us. The relief of human suffering, quantum leaps across the entire range of human experience, attainment of escape velocity beyond the event horizon that assures our never being pulled back into the black holes of our histories, all are being evoked in this new paradigm. Her work with the most damaged of brains demonstrates the evocation of human evolution in action, inherent in every nervous system. What we will see when many similarly participate will change everything we know about everything.

To add context here – as with any set of complementarities, e.g. black/white, yin/yang, left hemisphere/right hemisphere, cold/hot, each is comprised of the other extensively but decreasingly as the extremes are approached. In a similar vein, this book captures a position I’ll arbitrarily term the “left” side of the neurofeedback complementarity typified at the extremes by terms such as: professional in charge, top down, reductionist, linear, reward/inhibit, narrow frequency ranges, specific, operant conditioning, qEEG dependent, mechanism based, treatment oriented, specific focus, class 1,2,3 (Wolfram), explicate (Bohm). These are typified in the neurofeedback systems of EEGer, BrainMaster, Cygnet, etc.

The “right” side of this complementarity – a reflection of one’s general orientation, starting point, or entry portal to neurofeedback – might be typified by terms such as: trainee’s brain in charge, bottom up, wholistic, non-linear, all frequencies in play throughout, diagnostically agnostic, training oriented, class 4 (Wolfram), implicate (Bohm). This approach is found in Zengar’s NeurOptimal Dynamical Neurofeedback Training system, and includes many aspects of Len Ochs’ LENS system.

Fortunately, the results for both, or the overlapping center of the Venn diagram, map very much the same large set of robust results. While adherents to each end of the complementarities will bring objection as to positioning of their particular view, all together they comprise an enlarged set of possibilities for transforming human suffering. One’s particular light will be lit pretty much right HERE within the entire complementarity, with subsidiary glimmers spread throughout the context. Sebern gives good examples of the overlap. She goes to great lengths to describe the non-linear dynamical results of her work – that the Newtonian measures used belie results that are quantum in the brain and non-linear in effect. It will emerge over time which approaches are the most effective and/or efficient. To date, in the hands of those with skillful means, all approaches bring unheard of results compared to other interventions.

Sebern Fisher is a friend and respected colleague whose book I have been pleased to review. For those who would appreciate a companion book that makes brain anatomy accessible, Rita Carter’s also just published The Human Brain Book is an excellent choice.