The Alcoholic Brain - 3 Ways Neurofeedback Can Keep You Sober

Current scientific evidence points toward a type of brain that is predisposed toward alcohol addiction. Many people have heard of the heritability of alcoholism. I had always focused my thoughts on the liver. An alcoholic is said to have a naturally high tolerance because their livers work just a little too well. The alcoholic’s liver is a real alcohol metabolizing work horse, allowing the soon-to-be alcoholic to drink more with less of the negative effects of being intoxicated. With the increased exposure to the drug over prolonged periods of time, the easier it is for the person’s body to get hooked.

Later it became clear to me that the specific effects of the drug were attractive to certain kinds of people, mainly anxious ones. Alcohol, like benzodiazepines, is a powerful anti-anxiety medication. For the anxious person with no other option available, alcohol can be an island of safety and relief. The more often the anxious person takes their “medications”, the greater the likelihood that their bodies will become physiologically dependent.

As I become more familiar with the research on the brains of alcoholics and study the QEEG’s of my own clients living in sobriety, I have developed a much more nuanced perspective on the psychophysiology of addiction and “anxiety”. I use quotes here because the word has a deferent meaning for each person that uses it. I will put off that discussion for a later blog.

The main take home point is that for many, the same brain that pushed them into addiction often remains even after they are sober, although often the situation has gotten worse. Many alcoholics continue to suffer from a pre-existing stress disorder even after they get clean. This is part of why relapse is so, so common in this group. Obviously, many of the therapeutic activities they engage in help, but often only after a series of painful and costly relapses. Neurofeedback offers those suffering in sobriety a way to get a fresh start and remove a huge part of the suffering that drove them to drink, made it so hard to get clean, and continues to threaten their sobriety.

3 Ways Neurofeedback Can Keep You Sober

1)     Treating Alpha Deficiency: Perhaps the most common finding in QEEG studies is that alcoholics typically don’t produce enough alpha, especially in the sensory cortex of their brains. Alpha is the brainwave most closely associated with relaxation, mindfulness, and rest. For healthy people, it increases by 50-100% when they close their eyes (called the “alpha response”). Alpha plays a critical role in the transition to sleep. For those with too little, they feel chronically tense, often have trouble sleeping, and are frequently not comfortable in their own skin. Unfortunately for them, the first drink of alcohol causes a dramatic increase in posterior alpha. Except after the alcohol wears off, alpha is lower than it was before. After the chronic alcoholic gets sober, their alpha power will remain lower than it was before drinking for some time, if not for the rest of their life.

2)     Excessive Beta: Beta is the frequency of volitional and engaged mental activity. In the right amounts, it allows a person to stay focused and get things done. However, excessive beta activity is often the result of thinking too much, sometimes about the same things repeatedly. In the higher frequencies, excessive beta means worry, rumination, and too much thinking. Beta often reflects the degree to which the brain is able to inhibit its own activity. When beta is too high, it may mean the brain is having trouble “turning off”. The brains of alcoholics after becoming sober are markedly higher in beta frequencies. This suggest that many are suffering from cortical hyperactivity. Alcohol, which activates one of the brain’s main “break pedals”, can bring on instant relief. In my clinic, we normally start with a slow frequency pEMF stimulation regime, which changes the ratio of excitatory and inhibitory neurons, giving the brain a better organic capacity to calm down. We then follow up with neurofeedback training, which teaches the client to voluntarily control that activity, so they can turn it on when they need to and then turn it off when it is time to rest.

3)     Impulsivity and Relapse Prevention: The healthy brain has mechanisms that allow us to stop ourselves from doing something stupid, especially after having done the same stupid thing repeatedly in the past. The regions of the brain involved in inhibition of behavior are located in the central and frontal regions. Depending on the QEEG (brain map), sites along these regions can be targeted for neurofeedback training to increase the sober alcoholic’s ability to comfortably abstain from taking the first steps toward drinking. Part of this has to do with the brain’s ability to use past experience to guide current behavior. If we can make decisions that are directed toward creating happiness and avoiding suffering, we can avoid allowing life’s many pitfalls to push us back into our addictions. When we find dysfunctions in one or more of these area, the client often lack’s the “emergency break” that would otherwise allow them to stop that painful emotion into an action they will later regret.

Behavioral Training of Early Executive Functioning Game #3: How Effective Therapy for Your Child with Autism or ADHD is a Matter of Behavioral Exercise

The final game I would like to review is basically Red Light Green Light on steroids. The rules are very similar. I learned this game from a martial arts teacher in Maine. He seemed to have more than a representative sample of kids with impulse control, hyperactivity, and difficulty paying attention. He turned his class in to an ADHD boot camp.

Game #3 (of 3): Karate Statues

1)     The game starts with the child or children standing on one side of the room with the adult on the other. Touching the wall, the kids can start to approach the adult only when the adult is turned away and can’t see them. When the adult turns back and looks at the children as they approach, the children must stop moving entirely (like a statue). When the adult turns back around, they can start moving toward him/her again. If the adult sees the child move, the child needs to return to where they began and start over. The first child who touches the adult “wins”. In the one child version, the child earns a point for touching the adult and the adult wins a point if he/she catches a child moving when they look.

2)     This game takes the inhibition skills learned in Red Light Green Light and puts them to use in response to a purely visual stimulus. Visual attending is more effortful and fatiguing than auditory attention. This is at least partly due to the fact that the child needs to maintain an eye gaze on the adult to detect the No Go condition. Unlike sound, which can be detected pretty much no matter what the child is doing (except talking), visual stimuli require that the eyes be fixed in the direction of the source of the cue. Also, Karate Statues requires that the child halt all motion (including the muscles of the mouth which would otherwise be required for talking). So overall, this game requires a much higher degree of control and focus to be successful.

3)     This game can be made easier by allowing the child to take a fixed number of steps after the adult has turned towards the children. Some kids may need as many as three to be successful 70% of the time (the recommended win rate). It can also be made easier if the adult slows the speed at which they turn around so as to give the child more time to react.

4)     The game can be made harder by:

a.      Requiring that the game only starts when the adult says “go”. This means the child needs to inhibit the impulse to start moving at the beginning of the game when the adult turns around (on all other occasions the sight of the adult turning away is a Go signal). So the initial Go signal is both an adult turned away and the sound “go”.

b.      The adult can make gestures that they are about to turn away (a fake) but then not. So the child would need to abstain from moving for a split second in order to ensure that the Go signal is legitimate every time they saw the adult begin to turn away.

c.      I like to go up to the kids while they are frozen in place and offer a high five, point at an imaginary event happening just behind them, or tell them that they have something on their shirt. They have to resist the urge to respond to stimuli that they normally physically respond to.

5)     Don’t forget the reward! Kids will give substantially more effort and progress faster if they are working for something. A little bit of reward can pay off big time in better progress and more willing participation.

This concludes a three-part series on using normal kids’ games to enhance your child’s executive function and give them more control over their behavior. These techniques have proven effective in some of the most rowdy and uninhibited youngsters. I hope your children will benefit from something you picked up in reading my blog.

Behavioral Training of Early Executive Functioning Game #2: How Effective Therapy for Your Child with Autism or ADHD is a Matter of Behavioral Exercise

Game #2 (of 3): Red Light Green Light (RLGL)

1)     In this game, the child stands on one side of the room and touches the wall. From the other side, the adult says “Green Light” and the child can then start moving toward the adult across the room. When the adult says “Red Light” the child is supposed to stop immediately. If they take any extra steps or start moving before “Green Light” is called, they have to return to the starting wall and start over. If the child stops when they are supposed to, then after some number of green lights they are able to tag the adult.

2)     The way that I play, the child earns a point every time they tag me, but I get a point if they take extra steps after “Red Light” is called and they have to go back to the wall. If a pair of children are playing, the child who tags me the most after a series of trials wins.

3)     RLGL teaches the child to stop a response that is already in motion because of a relatively unexpected stimulus. They have to notice when the sound “Red Light” is made, and inhibit the movement of the legs while avoiding falling. They have to focus on the sounds coming from the adult and ignore other, irrelevant stimuli. The cue that they need to attend and respond to correctly is only auditory, which is a class of stimuli that are easier to attend to than visual ones. We don’t have to have our bodies oriented in a specific direction in order to be affected by sound stimulus (unlike visual), so it requires less control and is harder to ignore.

4)     Kids diagnosed with neurodevelopmental disorders, like autism, ADHD, Down’s Syndrome, Fetal Alcohol Syndrome, or traumatic brain injury can have a great deal of trouble with this. Some kids will try to run fast, only to find out that it is not possible to stop without at least one extra step. Some kids will often miss the cue and keep running. Others will be unable to stand still and wait until green light is called.

5)     Some modifications to ensure your child is mostly successful and enjoys playing the game:

·        Saying the cues slowly, allowing the child more time to stop forward motion.

·        Allowing the child to take one, or even two extra steps before you make the call that they have run a red light.

·        Holding up your hand just before you say “Red Light” so they know that it is about to come.

6)     After your child has mastered the standard version of the game, there are a few things you can throw in to make it more challenging and stimulating of neural development.

·        Say “Red Light” after the child has stopped so that he or she needs to listen to what is being said and is not just starting reflexively when they hear you make a sound.

·        Say things like “Green Monster” instead of “Light” so that the child has to listen to the whole utterance. If you said “Green Bright” instead of “Monster” it would be even harder.

·        Require that the child freeze their whole body when you say “Red Light” so that they are practicing a greater degree of motor control.

RLGL is a great way to teach kids how to inhibit impulses and attend to important sound stimuli. It builds the brain muscles needed to succeed in a wide variety of settings, especially school and in social interactions. Augmented with neurostimulation and neurofeedback, children show definite and rewarding improvements and succeed in more aspects of their lives. But remember, alone, RLGL will only produce results slowly and only when it is done on a daily basis for weeks or months. Rome wasn’t built in a day! And it’s always a good idea to do the game before a more preferred activity (preferably as part of a routine) or offer a small reward for participating, especially when the child performed exceptionally well.

Behavioral Training of Early Executive Functioning Game #1: How Effective Therapy for Your Child with Autism or ADHD is a Matter of Behavioral Exercise

What we often see is in the more classic presentation of disorders of attention and goal-directed behavior are problems in predictable regions of the brain. The ones that are most commonly involved (prefrontal and anterior cingulate cortexes) are the ones that I believe respond best to behavioral training. My current favorite method of treatment for kids with deficits in the skills governed by these brain regions involve games where the child needs to be able to stop and start forward motion based on the presence or absence of a stimulus, inhibit mirror reflexes, and resist impulses to engage in behaviors that will result in loss of reinforcement.  Over the next few days, I will be giving those that are interested some ideas of how to transform fun and familiar games into cognitive training workouts.

Game #1 (of 3): Simon Says

1)     The one rule of Simon Says is that the participants must cooperate with a verbal demand to engage in a specific behavior or gesture given by another person only when the specific demand is preceded by “Simon says”. When it isn’t, then the child is expected to maintain their preceding posture. The game is substantially more difficult when the person playing the role of Simon models the verbally prompted behavior or gesture as the give the verbal demand.

2)     Simon Says requires the child to inhibit the impulse to follow a verbal command and imitate another person’s movements/gestures. Inhibiting compliance with a verbal command is made harder after a series of cooperative responses has been reinforced which is related to the Behavior Analysis principle called Behavioral Momentum. In addition, humans reflexively mirror a human model. This is why yawning is contagious and why it is hard not to look up when you are standing in a crowd all modeling that behavior. The tendency to imitate the movements of others is built into the brain, right alongside a related system that usually inhibits that impulse. For some children with dysfunctional orbital medial prefrontal cortexes (especially on the right side), they have trouble inhibiting the impulse to follow a directive or imitate a model.

3)     Simon says can be modified to meet the level of the child and guarantee a greater level of success than failure, which is an important part of gaining the child’s willing participation in the activity. It is important to gradually build up the skill, which will likely take repeated practice over an extended period of time. I usually find that in the more disabled children, it may take 6 months before meaningful improvement is obtained.

4)     Its always a good idea to offer rewards/reinforcers for participating and succeeding at the activity. This will ensure effort and willing future participation.

5)     Modifications To Help the Child Achieve a High Ratio of Success

·        Start with just verbal prompts like “touch your nose” without modeling the behavior. This way the child just focuses on inhibiting responding to a verbal stimulus and not a visual one at the same time.

·        Do “Simon Says” (Go cue) and without “Simon Says” (NoGo Cue) on a rotating basis. This way the child will have the ability to predict when the prompt will vary based on the constant cycle. You can also make a cycle of 3 NoGo’s followed by 1 Go cues or vice versa, or other patterns.

·        Some kids have a really hard time not imitating a physical model, for these kids, you might need to start with the prompt to “touch your nose” for the Go cue and “don’t touch your nose” for the NoGo cue. Once they learn to inhibit the imitative reflex, they can start learning to respond to the normal “Simon” cues.

·        The game gets substantially harder when you provide an unpredictably longer series of Go cues before the NoGo, because the child will have built up some momentum in cooperating with the demands. By giving 3-7 Go cues, the child will need to be exerting extra effort to notice when the “Simon” is left out of the demand.

·        The speed or the rate of presentation of Go and NoGo cues will also be harder for the child to process. As the child’s brain grows and matures, they will be able to be successful with faster presentations of demands.

This is the first of a series of games that can be transformed into brain training exercises that can help kids function better. These build core executive functioning skills and are even more effective if combined with neurofeedback, biofeedback, and brain stimulation technologies. At Lighthouse Neurofeedback and Behavior Analysis, your child will get the best that modern science has to offer.

How So Much of Autism Boils Down to One Major Part of the Brain

Over and over again in my work with children diagnosed with autism I observe a consistent deficit: these children lack the ability to direct their attention on purpose. Often I see that glint in a child’s eyes as I repeatedly fail at getting them to look at a picture or object that I am holding in front of them. I interpret it as them saying “I know what you are asking me to do, but I just can’t get myself to look at that thing”.

I understand this deficit to be the result of a dysfunctional anterior cingulate cortex (ACC), the part of the brain I find to be the most important in my work with ASD children. If you have an autistic child, read the list below and ask yourself if the items remind you of him or her (or them God bless you):

5 Ways a Dysfunctional ACC Causes Autistic Symptoms

1)     The ACC plays a major role in the recognition of pain signals from the body. Dysfunction in the ACC can lead to amplified distress upon the occurrence of pain, making pain that much more painful. It also detects if a pain signal occurs or not, making some with problem ACCs under-responsive to pain stimuli while they are over-responsive to what otherwise would be neutral. This affect is heightened when the subject is engaged in a cognitive task.

·        Children with Autism and other Neurobehavioral disorders often have atypical responses to painful and neutral stimuli.

2)     The ACC is in charge of detecting relevant social cues and directs other parts of the brain to organize responses. When it is not working right, it may totally miss critical signals from others (like a disgusted look from someone watching you pick your nose) or over-respond to others, like in social anxiety. Based on the info coming into the ACC, we learn from our social mistakes and gradually become more successful in our interactions with others.

·        ASD kids are very often socially oblivious or insensitive. Many of their social skill deficits stem from problems learning from everyday social interactions. I believe this is part of why social stories are so effective. They don’t require the learner to detect and respond to errors. They teach through a different pathway and mechanism.

3)     The ACC holds expectations about what the person is about to experience. When something happens in the environment that is not expected, it emits a “ping” telling other parts of the brain to turn on and pay attention. It has the same response when we do something that is unintended, when we make an error in the performance of some action. It tells another part of the brain to turn on and fix the problem so that the desired outcome can be achieved. This is a core process in behavioral learning.

·        This is why many behavior analysts prefer an Errorless Teaching Approach to language training in autism. These kids have deficits in learning through trial-and-error teaching methods and often experience error with more emotional distress than is helpful in a teaching situation.

4)     The ACC is the Grand Central Station, the Air Traffic Controller, and master conductor of the brain. Once an event has been detected, it orchestrates a specific brain network response. It decides which parts will be involved and which parts will not. ACC dysfunction can make it hard to switch gears and to optimize the brain’s response in order to achieve the best outcome that is available.  

·        Kids with autism are famous for problems with disengaging from a behavior or topic of conversation and for engaging in a different task, especially when it is not of immediate interest. This experience can be experienced as painful and distressing.

5)     Although I mentioned it a little above, I think the most important role I see the ACC playing is in predicting what will happen next. The “ping” I mentioned above is called the ERN or Error Related Negativity. It is set off when something happens that was not expected. I have worked with kids that acted like they were under a constant barrage of ERNs, reacting aggressively to every minor turn as they walked through hallways that they had transversed several times before. Their ACCs were massively over-reacting and seemed to be triggering the wrong part of the brain resulting in a fight-or-flight response to any stimuli that it thought was out of place or surprising. When you give kids like this excessively frequent “precues” (advanced warning reminders) about aspects of the environment that they will be encountering in the next moment, their tolerance for transitions dramatically improves.

My greatest joy and frustration about neurotherapy is that it can normalize the functioning of a dysregulated Anterior Cingulate Cortex. With pEMF (pulsed electromagnetic field stimulation), tACS (transcranial alternating current stimulation), tDCS (transcranial direct current stimulation), and Low Level Light Therapy, we can push the ACC into more normal functioning. Then we use Neurofeedback to fine tune its behavior. The benefits on kids with autism can be astounding. My frustration stems from the fact that so few treating these kids know the first thing about the organ that is responsible for these sometimes massive deficits.

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pEMF, Neuroplasticity, and Brain Healing

Many people have heard of neurofeedback and biofeedback, but few seem to know much about the amazing effects of therapeutic electromagnetic fields on the brain, bones, and organs. An ever-growing body of research has shown both in the lab and in clinical settings that EMF, in the hands of a skilled technician, can:

1)     Increase the bodies capacity to relax and the brains ability to resist overstimulation

2)     Turn on receptors in the brain and other organs that reduce inflammation

3)     Reduce brain damage following a stroke

4)     Improve cognitive function in MS patients

5)     Facilitate and speed up nerve regeneration following an injury to the peripheral nervous system.

6)     Spur the growth of the axons that connect neurons together.

7)     Accelerate bone repair and heal gaps left after bones have stopped healing on their own.

8)     Reduce pain and improve range of motion following a joint injury.

At Lighthouse Neurofeedback and Behavior Analysis, we us Neurofield’s advanced Pulsed Electromagnetic Field (pEMF) generator to heal neurological dysfunction and tackle systemic inflammation. We use advanced techniques to normalize dysregulated connectivity problems that prevent the brain from operating efficiently and effectively. For clients with sensory processing problems, pEMF can change their brains so that they can better inhibit over-activity that leads to being overwhelmed by sound and light stimuli in the environment. Everyone will be hearing more and more about this wonderful, safe, and unbelievably effective treatment (unless the drug companies continue to keep the science hidden in obscurity).

How to Head Off Attention and Writing Problems at the Same Time if You Are Worried

The two populations that I work with that most consistently hate writing and have a heck of a time paying attention are kids with ADHD and Autism. This got me thinking about what it is about writing that is so darn awful. It quickly occurred to me that writing is the activity that requires the greatest degree of focused, one-pointed, and sustained attention. I believe that may be the single most important and common factor in why a child learns to hate this activity.

Recently, when consulting with the family of a 3-year-old adopted child with apparent problems with paying attention and an early distain for writing, the parents voiced concerns about how the child’s school may pressure the child to start writing before he is ready.  It occurred to me that I may witnessing the first beginnings of a war that this child may be fighting with adults trying to get him to write for the rest of his academic career. For a child struggling with impulse control, problems focusing, and regulating his emotions, learning to write was going to be hard. If his teacher’s felt compelled to force feed him writing skills when he was physiologically incapable of focusing to the extent he needed to, the demand to write and the behavior of writing could easily become a trigger for behavioral dysregulation.

I then realized how important it was for children’s mental health to have early, frequent, and enjoyable opportunities to practice creating lines on paper in deliberate and increasingly intricate ways. This is not an issue of literacy. The problem that I am concerned about avoiding is not about reading, although it would remove one of the bigger obstacles to it (kids will learn to read faster if the have the ability to attend to the lesson and persevere in handwriting words). This is about exercising the brain’s ability to maintain a single focus of concentration for extended periods of time. If kids practice writing lines in various patterns for short, but gradually increasing periods of time and levels of intricacy, they will not only develop concentration, but also the power to inhibit impulses to move. Making intricate lines requires the child to sit still.

Fool Proof Way to Avoid Attention and Impulse Problems Starting in Young Children

1)     Buy several sets of pre-k workbooks of mazes, connect the dots, and other pre-writing activities that your child would not mind doing.

2)     Set up a time that the child can practice every day, preferably the same time and embedded within a routine that happens daily as well.

3)     Determine an effective reward the child can have for completing a short pre-writing exercise.

a.      This can be an improved dessert, extra books at bedtime, later bedtime, extra 1:1 time, whatever is valuable enough to enable the child to engage in the task without much resistance.

b.      If the child is ready, you can use a check system and if he/she does a certain number of days in a week (like 5) then they get a bigger prize.

4)     Start with only 5 minutes of work. Make sure to stay near and observe the child working. Praise line straightness, staying within the lines, keeping pen to paper for longer periods, and other indicators of better fine motor control.

a.      Avoid displays of negative emotion to the child while doing the work. It is essential that only positive emotion be paired with this activity.

b.      Feedback about errors may be okay, but only state it in neutral terms without emotion (I noticed you crossed the line here, I see a space between your line and the boundary, etc.).

5)     Keep the atmosphere fun and exciting to pair making lines with positive emotion.

6)     Monitor your child’s developing skill level and choose activities that are increasingly more difficult.

7)     Over many months, gradually increase the duration of time the child spends drawing lines to increase his/her stamina.

By the time the child is expected to start writing sentences, the child will enjoy the physical and mental challenges and associate them with positive feedback from adults.

 Autism, the Brain, and Neurofeedback

Autism Brain

Autistic symptoms are almost all the result of brain dysfunction. To this day I am astounded by how many differences I see among the QEEGs of people diagnosed with autism. I believe that is at least partially the result of the fact that the causes of the dysfunction are varied. Different events cause different brain problems. This leads to changes in performance and behavior that were similar enough that they were grouped under a single umbrella term: autism. The way that I see it, the problem areas of the brain involved are:

1)     Right Hemisphere Hyperconnectivity: When the right hemisphere, which oversees much of abstract thinking and ability to see the big picture, is underdeveloped and undifferentiated, it leads to a rigidity in thinking and behavior.

2)     Prefrontal Lobes, especially the right hemisphere: This part of our brains enables us to inhibit behavior motivated by emotion that would lead to negative outcomes.

3)     The anterior cingulate cortex: The AC allows for voluntary control of attention. Without it we are like a leaf in the wind, unable to direct our attention flexibly and based on priorities.

4)     Sensory cortex, especial with regards to inhibitory processing: The brain needs a healthy balance of inhibitory and excitatory neurons. When the ratio is off, the brain has trouble filtering out incoming sensory stimuli.

5)     Fusiform Gyrus: It has portions that govern the processing of information from human faces, which can be excessive. If it’s not working right, facial information can be overloading.

6)     The Mirror Neuron Network: This area allows for rapid learning of motor and social information through simple observation. It allows us to learn from others by just being around them and without purposeful instruction.

7)     The Default Mode Network: This is the part of our brain that is constantly generating simulations of upcoming events. It gets us ready for future events so that we can take transitions in stride.

8)     The Cerebellum: This organ plays a role in fine coordination of extremely complex movements and learning of sensorimotor relationships that allow for fine tuning ongoing motor behavior. Think of catching a fly ball or hitting a golf ball onto a distant green. There is research supporting the idea that it allows for flexibility and adaptability during social interactions as well.

At Lighthouse Neurofeedback and Behavior Analysis, we use the most cutting edge equipment and techniques to help normalize the brain dysfunction that lead to the challenges faced by autistic clients in adapting to the world’s demands. We use pEMF, tACS, tDCS, and photomodulation to break up stuck patters, teach parts of the brain to communicate effectively, and wake up parts that are asleep. Neurofeedback is used to teach the brain what healthy functioning is and then reward it for doing a good job. The combination can be effective at normalizing brain function to an extent that is virtually unheard of in classic medicine.

4 Simple Things You Can Do to Help Your Child Have Better Behavior

Many behavior problems in children arise from a mismatch between children’s developing brains and the environments in which they live. There are several straight-forward changes that you can make that are almost guaranteed to improve your child’s mood, learning, and behavior:

1)     Routines and Scheduling: Make your child’s day as predictable as possible. Take every step needed to avoid the unexpected, especially for things that are less pleasant to do. Do things that have to be done every day in steps that are in the same order and at the same time. Routines are great for the most unpleasant and monotonous of the day’s activities. Once a routine is established (for getting ready for bed or school, cleaning their room, etc.) the more the child can get through it on autopilot and will generally give you less grief. Post unusual events on a white board, or make sure to give the child advanced warning for any changes when possible. Your child will have an easier time dealing with change and challenge if they don’t have to deal with surprise as well. The best thing would be to post the day’s schedule on a white board that is updated at the start of each day and read out loud, even for literate children.

·        When a child has the ability to predict what is happening next and later on, they feel more in control of themselves and their worlds. This may sound contradictory given that scheduling by definition restricts choices. But when a child can settle into a predictable schedule composed of enriching activities sandwiched in between solid daily routines, they have more energy reserves to direct toward controlling their behavior, which makes them more capable of getting their wants and needs met in appropriate ways. Above all else, scheduling and routines are stress reduction tools. They free up the energy that would otherwise be wasted on recovering from the stresses that come from being unprepared for the challenges of the day that they have has little chance to adjust to. Lower stress means a better ability to accommodate and learn from the experiences they immerse themselves in all the time. We often take for granted that our children have the same ability to comprehend life’s inevitable inconsistencies as we do and our children may be paying the price.

2)     Publicly Displayed and Non-Negotiable House Rules and Expectations: Having a clear set of rules and expectations that are concretely defined, worded in positive terms, and visible in a public place serve as a constant reminder of what they need to do to get praise from you and avoid negative consequences. They also remind you to stay consistent in how you respond to negative behaviors and encourage positive habit development.

·        As children learn about how to manage life’s challenges, they need a good set of instructions. Unlike their adult counterparts, they don’t understand enough to make good decisions based on an in-the-moment assessment of the best course of action. Rules give them a clear guide as they navigate those challenges. Learning to follow them will prepare them for environments governed by rules (school settings, most work places, and many aspects of society). Rules, laws, and behavioral norms (expectations) are the hand-me-downs of our ancestors. Within them they hold their collective wisdom. The lessons they learned were consolidated in rules so that future generations could avoid the negative effects of the behavior they forbid. Expectations are procedural rules on what behaviors to engage in and under what circumstances. They are the past telling us what we should do to increase the likelihood of a good outcome. Both rules and expectations are generally telling us to act in a way that help us to choose to do things that forgoes immediate gratification in order to access a more delayed reward. Take my word for it, this is a really good lesson for kids to learn. Many of us have experienced and lived in a time of dramatic social, economic, and cultural change. We know in our bones that many of the rules and norms passed on to us from our forefathers are either pointless, harmful, or just irrelevant now. However, we should avoid the mistake of assuming that because some of those were not helpful, then all rules are.

3)     Notice and Praise the Positive Much More than the Feeding into the Negative: It is part of human nature to notice when things are not as they should be. The default tendency of many parents, caregivers, and teachers is to focus their responsiveness on error correction. This is often a valid and effective means of putting children on the right path, but for many kids with behavior problems, its actually making their behavior worse. This is because for some children, the attention they receive either as a direct result of a bad behavior or because they have a history of bad behavior (adults are “keeping their eyes on them”) is more valuable than the cost of getting in trouble.

4)     Use Rewards: Research is unequivocal in recognizing the potent effects of incentives on human motivation and achievement. We want our kids to behave well because they “want to” or they “know better”, but yet they often don’t. Many children need a little nudge to set them toward making better choices and then the longer term positive consequences of those choices. If they haven’t had as much experience with those consequences, then they really don’t know what they are missing out on. So setting up a reward (daily, weekly, and/or monthly) can give them the motivation to do what they know is right. Younger kids need more immediate rewards than older ones. Many reward systems fail because the rewards are too distant in time from the behaviors that produced them. My son was deathly afraid of going down the waterslide at the rec center, although he had never gone. I told him I would give him 10 bucks if he went down. He forced himself to do it the first time, and then went at least 50 more times that day because he loved it. He also got the opportunity to think of himself as brave rather than fearful. It was one of the best investments I have ever made.

 

Although my training is in Applied Behavior Analysis (ABA) and Neurofeedback, I am also a dad. I see parents that struggle with these problems every day and know some of the most basic elements of behavior therapy could help kids lead happier and more fulfilling lives.

The Physiology of Emotion (Affect) Regulation

Stress is an unavoidable aspect of life. Without it, we would be bored to death and lack the motivation to achieve. Most people know or have heard of lottery winners and recipients of large inheritances that fell prey to depression and aimlessness. I once heard that lottery winners had one of the highest rates of suicide. I don’t know if that’s true, but it kind of makes sense. Most of us would identify more with the impact of too much stress. It makes us sick, hurts our relationships, and can severely detract from our quality of life. For most adults, there are a variety of healthy and unhealthy methods by which to cope with stress. Healthy ones lead to a reduction in stress hormones and their damaging effects on the body. Most adults also have physiological mechanism to deflect, process, and manage the effects of stress. Healthy and physiologically developed adults have three working neurological systems that protect them from everyday stressors. If any of these are dysfunctional or underdeveloped, then relatively small stressors can have major effects on physical and mental health and the behavior that impacts both.

3 Parts of the Nervous System That Can Make Stress Manageable

1)     The Parasympathetic Nervous System: This part, which branches out from the medulla in the brain stem, functions to prepare the body for rest and growth. It slows down the body’s arousal when it comes into contact with stressors. It also sets the stage for the neuroplasticity that rest allows, so that we can learn and adapt to the challenges of life. When we can rest and relax in a complete way, we are able to give our bodies what they need to prepare for the next round of life.

2)     The Temporal Lobes: The temporal lobes sit next to amygdala and hippocampus and exert substantial influence over their activation. When the amygdala gets triggered, we go into a mode of “fight or flight”. This triggers the release of stress hormones and motivates behavior that we may later come to regret. They also play a large role in mood regulation. When I hear that a client has large mood fluctuations (often with a diagnosis of bipolar disorder or Mood Disorder NOS) while doing the initial interview as part of a QEEG assessment, I look closely at the temporal lobes when reviewing the Brainmap. I usually see that they are half asleep (excessive slow waves) and are not exerting much energy (low amplitude faster waves). When the temporal lobes aren’t working right, difficult events can produce a greater aggressive or fearful response than seems appropriate to the situation.

3)     Prefrontal Lobes: This part of the brain plays a big role in controlling our behavior. I frequently tell my behavioral clients that it’s okay to get mad, but you are still responsible for the behavior you engage in when you are. The prefrontal lobes are the last wall of defense that can prevent us from acting out on our strong emotions and make matters worse. When they aren’t working well, we are prone to acting out on stressful emotions, leading to even more stress when we experience the fallout.

Children and adults often suffer from problems that are ultimately caused by dysfunction in one or more of these systems. They often have a strong desire not to be so sensitive to stress or so prone to acting in destructive ways, but they simply can’t control it. Behavioral strategies might help, but rarely resolve the core underlying physiological cause. That’s what got me into neurofeedback, biofeedback, and neuromodulation. Now I have the tools to treat the core of the problem.

How can I help my child become more emotionally resilient?

Often a child’s emotional sensitivity to stressful events and difficulty calming down stems from problems in their autonomic nervous system (ANS). The ANS regulates most of the bodies most basic processes in two basic ways through its two major branches. 1) The sympathetic nervous system (SNS) regulates the  “fight or flight response” and prepares the body to engage in high-energy behavior, like playing a basketball game or running from a bully. 2) The parasympathetic nervous system (PNS) triggers the relaxation response and prepares the body for rest, digestion, and growth. Kids that have problems in these two basic functions are often not able to adjust their level of arousal to meet the expectations of the setting they are in. In class, they should be sitting in their chairs and attending to the teacher (relaxed and engaged) which is very different than the level of arousal they might have on the playground. But if the PNS is weakened or out of tune, they might be running around the class instead. These kids, lacking the ability to down regulate the arousal of the SNS with the activity of the PNS, over react to stress and have a hard time calming down afterwards. If this sounds like your child, you might want to try Resonant Frequency Breathing to start correcting the problem.

10-Steps to Teaching Your Child Resonant Frequency Breathing

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1)      Schedule training sessions to occur just before a preferred activity (like screen time, before dessert, before reading books at bed time, etc.). Pick a time that you will be able to train almost every day and at the same general time.

2)      It may be important to offer the child a predetermined reward for participating. This could be an extra 5 minutes of screen time, special dessert, or access to a preferred activity. Money works too.

3)      Start with just 5 minutes of training. Don’t get ambitious and let the session go longer, even if the child seems to be cooperating and tolerating things fine. You might find it harder to get the same level of cooperation the next time because the last session was just a bit too aversive. Also, making it short makes it easier for you to be consistent and less likely to believe there isn’t enough time.

4)      Make sure that you maintain the most positive and enjoyable demeanor with the child as you teach. Don’t let yourself get too frustrated or inpatient if the child takes longer to learn a component than you expected. Make the experience fun.

5)      Set easy to achieve objectives to build the skills needed for RFB. Here is a list of objectives below. Some kids will breeze through these, while others might take several sessions to get passed one.

a.       Breath Holding: This could be done at a swimming pool where the child pinches her nose, puffs up the cheeks, and then dips their head briefly under the water. At home, you could pretend to be going under water or you could do it in the bathtub. It might help to prompt them to take a deep breath before holding.

b.       Control over the Inbreath: Teach voluntary in-breath control. I like to tell the child to hold their clinched fist up to their nose pretending they are holding a flower. Then they take a deep breath in through their nose to take a big sniff of the flower. Aim to have the child do ten of theses in a row.

c.       Sequential Breath Holding: Teach the child to take a deep inhale and then hold for a count of three. They should be able to do this 10 times in a row before being ready for the next step.

d.       Extended Exhale: Teach the child to take a deep breath, hold for a count of 3, and then extend the exhale to a count of 4. They should be able to do this 10 times in a row before being ready for the next step.

e.       Synchronize breathing with a pacer: After mastering the steps below, the child is ready to start with a pacer. Set the pacer to 10 to 13 breaths per minute.  Whenever you set the pacer, the ideal is to have the inbreath be 40% of the total cycle and the outbreath to be 60%. So if it was a 4 second inhale, then the exhale would be 6 seconds. That is a 10-second cycle, which is 6 breaths per minute. Before starting the pacer, have the child take 3 deep breaths, holding each for a count of 3, and then exhaling for a count of 4. At the very end of the last exhale, start the pacer.  Watch and listen to the child breathing. If she gets off pace, stop the pacer and have her take another deep breath, starting the pacer again at the end of the out breath. If the child is consistently breathing in before the pacer prompts them to, you probably need to increase the pace. The goal of this part is to teach the child to synchronize her breathing with the pacer, not to slow the breathing down.

f.        Slowing Down the Pace: Reduce the rate by .5 to 1 second each day to the pace appropriate for their age (see chart below). I find that as long as I have the child take 3 deep breaths before starting the pacer, they are able to breath at slower and slower rates more quickly than you might expect once they have learned to synchronize their breathing with a pacer at a higher rate. Use the chart below to estimate what your child’s ideal pace of breathing is.

g.       Establish a routine: Continue to do the breathing for 3-5 minutes on a consistent basis. Generally, kids that have learned the skill are not very resistant about doing it because they usually feel significantly better afterwards. If you used a reward to do the initial training, you probably can dial it back or discontinue. Just tell your child that the breathing is like brushing your teeth and you need to do it to stay healthy.

RFB is a practice with both immediate and long last effects that accrue over time. I have seen children that consistently had 24 hours of good behavior after a 5 minute session, almost like it was a medication that eventually wore off. However, the best benefits come from having practices over a long period of time.

 

Welcome to the Lighthouse Parent's Blog

 

Do you have a child with a neurobehavioral disorder like ADHD, Autism, Traumatic Brain Injury, Cerebral Palsy, Seizures/Epilepsy, Learning Disability, Language Disorders, Tourette’s or other Tic disorders? Or maybe you parent a child that had a traumatic or toxic experience while in the womb, while being born, or just after and now experiences sensory-processing, emotion regulation, academic, and/or behavioral problems. As you probably know, this means your child is having problems meeting the demands of the world at least partially because their brains are not functioning well enough. In the past, scientists have led the world to believe that the brain is a static and unchangeable organ. The best a parent could hope for was to help the child cope with their dysfunctional neurology.

In 1964, Bennet and Diamond, published the first of a very long list of research that clearly shows that the brain is in fact the most flexible and changeable organ in the body. Not only is it able to change, it actually wants to. This concept is called Neuroplasticity and it is the underlying mechanism of almost all treatments for Neurodevelopmental disorders. This blog is for those of you out there who have hope for your children and understand how profoundly children’s lives can be changed if you have the right information, drive, perseverance, and a little bit of luck.

The world of services and therapies for kids with brain issues can be daunting, confusing, and utterly frustrating. My hope is to shine a light to help you find your way to the place of wholeness and wellbeing that you want for your child.

I am a behavior analyst (BCBA), neurotherapist, and relaxation trainer. I was also trained as a psychotherapist in Gestalt and body-centered psychotherapy. I have trained other clinicians in Attachment-Informed Behavior therapy, crisis management, and relaxation training. I consult and provide workshops in Colorado school districts. I have meditated in the Zen and Tantric traditions for 25 years. I love children and get no greater pleasure in life than to see them overcome their challenges.

Before getting into specific posts, the audience should know that I believe that in most cases the use of medications, especially when no other developmental therapies are being used, negatively impacts the process of neuroplasticity and therefore should be limited or avoided all together. There are many cases were medications are necessary and the best of all possible options, but there are many more (at least in my experience) where the benefits do not outweigh the costs. I think one of the most important clinical goals for many kids is to develop to the point where they do not need medications to help them regulate their brain functioning.

So this blog is intended to help families find and use therapies and techniques that they can use to help their children learn to regulate their own brains. If their brains are working better, they have better control over their behavior and they learn more from their experiences. When that happens, they live better lives and are happier.

Stay tuned….

Lighthouse Moves to Boulder

After two successful years in Maine, Lighthouse moved to Boulder Colorado in July. This is a return to Adam's grad school alma mater, Naropa University, and his home from 2002-2014.

This move marks the beginning of an exciting period of growth. We are now located in the prestigious Colorado Therapies building, among a community of extraordinary healers. Adam is re-connecting with former behavior therapy clients and immediately getting referrals for new neurotherapy clients. Word of mouth has brought in several new clients as people learn that Lighthouse is the only neurotherapy provider in the area using Neurofield® and other neurostimulation technologies.

Part of this move includes merging with Colorado Neurofeedback, an established Boulder Colorado neurofeedback practice. This merger brings together Adam Potter's expertise in behavior analysis, biofeedback, and neurofeedback with Nick Berger's expertise in family systems, psychotherapy, and neurofeedback.

Under the name Lighthouse Neurofeedback and Behavior Analysis, we will now be providing psychotherapy along with neurotherapy and behavior therapy.

This is an exciting time for Lighthouse. Stay tuned for more updates as we grow to serve more people and change lives.