BrainPaint® neurofeedback is a noninvasive form of treatment during which the client listens to musical feedback while practicing various relaxation and meditation techniques. BrainPaint® uses several small sensors attached to the scalp and the recorded levels of brain activity are viewed on a computer screen. This simultaneously produces auditory and visual feedback to help train the client’s brain into producing more functional and adaptive patterns of brain waves. Clients receive 16 sessions of BrainPaint® and their progress is assessed every step of the way.
Some of the benefits of neurofeedback include improved mood, increased confidence, improvements in performance and memory, and a decrease in obsessive, addictive thoughts. Neurofeedback can also assist clients in managing symptoms of certain co-occurring or underlying mental health disorders, such as depression and anxiety, which can be significant barriers in addiction recovery.
– See more at: BrainPaint
Promises utilizes an amazing tool called neurofeedback, or EEG biofeedback, to help identify and treat co-occurring disorders, which in turn raises abstinence rates substantially and helps those in recovery stay clean and sober. Neurofeedback is a safe, comfortable way to dramatically reduce clients’ vulnerability to relapse.
Most people suffering from substance abuse disorders are also struggling with underlying issues, such as depression, anxiety, insomnia, and trauma. These co-occurring disorders often trigger relapses for clients in recovery (or prompt clients to leave treatment prematurely), so it is extremely important for clients to be treated for both their substance abuse disorder and any underlying conditions.
In a UCLA study (published in the American Journal of Drug and Alcohol Abuse in 2005), 77 percent of participants who received neurofeedback in conjunction with a 12-step program remained abstinent at 12 months, compared to 44 percent of those who didn’t receive neurofeedback, but who stayed in treatment longer. This study has also been successfully replicated by other research teams.
Another study of homeless male crack cocaine users showed that after receiving 12 months of neurofeedback (along with a 12-step program), 12 men graduated from the program per month. Before the study, only 12 men graduated per year.
With just a small laptop and a few simple sensors, neurofeedback utilizes sound and visual brain frequencies to correct areas of hyper- (over) and hypo- (under) arousal in brain activity. Over time, neurofeedback helps correct symptoms of co-occurring disorders such insomnia, depression, anxiety, and attention-deficit disorder. The software—created by a company called BrainPaint—also features an intensive assessment that incorporates 12-step language, making it a perfect fit for Promises clients.
The Brain in Recovery
Science has come a long way in helping us understand the way the brain changes in addiction. In this section, we will provide updates of current research on addiction, recovery, and the brain.
First, a few key points to understand about the brain and addiction.
Some characteristics of addiction are similar to other chronic diseases.
Just as cardiovascular disease damages the heart and changes its functioning, addiction changes the brain and impairs the way it works. Below is an image of the brain (left) and the heart (right).
These images show how scientists can use imaging technology to measure functioning of the brain and heart. Greater activity is shown in reds and yellows, and reduced activity is shown in blues and purples. Both the healthy brain and the healthy heart show greater activity than the diseased brain and heart, because both addiction and heart disease cause changes in function. In drug addiction, the frontal cortex in particular shows less activity. This is the part of the brain associated with judgment and decision-making (NIDA).
Addiction is similar to other chronic diseases in the following ways:
- It is preventable
- It is treatable
- It changes biology
- If untreated, it can last a lifetime
Drugs of misuse “trick” the brain’s reward system.
The brain can experience ‘pleasure’ from all sorts of things we like to do in life; eat a piece of cake, have a sexual encounter, play a video game. The way the brain signals pleasure is through the release of a neurotransmitter (a chemical messenger) called dopamine into the nucleus accumbens, the brain’s ‘pleasure center.’ This is generally a good thing; it ensures that people will seek out things needed for survival. But, drugs of misuse such as nicotine, alcohol, and heroin also cause the release of dopamine in the nucleus accumbens, and in some cases, these drugs cause much more dopamine release than ‘natural,’ non-drug rewards.
Below is a picture (helpguide.org) of the brain and the nucleus accumbens, in addition to some other brain regions that are affected by addition.
And, here is a picture from our own research of the brain activated by alcohol (Gilman et al., 2008). The nucleus accumbens is activated.
Addictive drugs can provide a “shortcut” to the brain’s reward system by flooding the nucleus accumbens with dopamine. And, addictive drugs can release two to 10 times the amount of dopamine that natural rewards do, and they do it more quickly and more reliably (helpguide.org).
Over time, drugs become less rewarding, and “craving” for the drug takes over…
Over time, the brain adapts to the effects of the drug (an effect known as tolerance), and because of these brain adaptations, dopamine has less impact. People who develop an addiction find that the drug no longer gives them as much pleasure as it used to, and that they have to take greater amounts of the drug more frequently to feel high. There is a distinction between liking and wanting the drug; in time, the ‘liking’ decreases and the ‘wanting’ increases. Over time, people use the drug simply to feel “normal.” They continue to seek and take drugs despite the tremendous problems caused for themselves and their loved ones.
The Brain Can Recover- but it Takes Time!!
How the brain recovers from addiction is an exciting and emerging area of research. There is evidence that the brain does recover; in the image below shows the healthy brain on the left, and the brain of a patient who misused methamphetamine in the center and the right. In the center, after one month of abstinence, the brain looks quite different than the healthy brain; however, after 14 months of abstinence, the dopamine transporter levels (DAT) in the reward region of the brain (an indicator of dopamine system function) return to nearly normal (Volkow et al., 2001).
Neuroplasticity and Addiction Recovery
Understanding how the brain heals creates new treatment options for addicts.
We used to think that the brain, once damaged, could not repair itself. Breakthroughs in neuroscience have shown that this is not true. Though individual neurons might be damaged beyond repair, the brain attempts to heal itself when damaged by making new connections or new neural pathways as work-arounds for the damage. This is called neuroplasticity, neuro (brain/nerve/neuron) and plasticity (moldability).
What does neuroplasticity mean for addiction treatment?
When we develop a habit, the brain creates a path in itself in support of that habit. As we engage in the habit over and over again, the pathway becomes well-worn or stronger. This is similar to lifting a weight. If you lift a weight over and over, the muscle will get stronger. In many ways, addiction can be explained as a neuroplastic event. The brain gets trained to do a particular behavior – use drugs or alcohol or gambling – eventually to the exclusion of all else. BUT, in treatment, we can retrain the brain, that is develop a new pathway that supports recovery. With intensive psychotherapy and other holistic interventions, we strengthen the new “recovery” loop within the brain. The brain then learns to enjoy recovery, those things that give us pleasure in our sober lives – family, work, interpersonal interactions. We retrain the brain and thus change our lives.
How does the brain’s function have a role in relapse?
Essentially, in addiction, the pleasure centers of the brain are hijacked by the addiction. Eventually, it is only the addictive behavior that brings the addict any sense of joy, or at least freedom from pain. This is not only a biochemical process; drugs themselves affect the brain’s biochemistry, but also a process of habit. The addict’s brain becomes accustomed to the addictive act being the source of pleasure – not family, friends, a good meal, or a job well done. We can retrain the brain and we can rebalance the addict’s biochemistry, BUT, the old neuropathways, the old links between addiction and pleasure are still there. This is why we suggest complete abstinence from drugs and alcohol to addicts. It doesn’t take much to jump start the old habit.
For example, you may not have been to your college campus in twenty years, but within minutes of arrival for a visit, it will become familiar to you – your old haunts, how to get around, etc. Addiction is no different. Recovery doesn’t remove the addictive thought process; it just gives the addict an opportunity to change behaviors.
What then is interpersonal neurobiology?
The term was coined by Dr. Dan Siegel of UCLA. It is a transdisciplinary approach to understanding how the brain works – weaving together understandings of why we behave as we do from fields as varied as anthropology, computer science, and psychology. Interpersonal neurobiology helps us to understand two things – first, how the brain actively works toward something called “integration” and second that the brain is developed to grow and heal itself in relationship to others.
Integration means health and wholeness. The brain wants all its disparate parts to work together. It is designed for you to feel whole and happy. In recovery, we help the brain reach that goal with whole health support.
Relationship also plays a significant role in mental health. Those who are isolated do not recover as well as those who have a loving support system in place. This is not just an intuitive deduction about mental health – there are many studies in neuroscience, the science of touch and psychology that support this claim. Thus, to help the brain develop healthy neuropathways and to foster recovery, we help the addict build this interpersonal support system both in treatment and beyond.
Central Pain Syndrome
Central Pain Syndrome is a neurological condition caused by damage to or dysfunction of the central nervous system (CNS), which includes the brain, brainstem, and spinal cord. This syndrome can be caused by stroke, multiple sclerosis, tumors, epilepsy, brain or spinal cord trauma, or Parkinson’s disease. The character of the pain associated with this syndrome differs widely among individuals partly because of the variety of potential causes. Central pain syndrome may affect a large portion of the body or may be more restricted to specific areas, such as hands or feet. The extent of pain is usually related to the cause of the CNS injury or damage. Pain is typically constant, may be moderate to severe in intensity, and is often made worse by touch, movement, emotions, and temperature changes, usually cold temperatures. Individuals experience one or more types of pain sensations, the most prominent being burning. Mingled with the burning may be sensations of “pins and needles;” pressing, lacerating, or aching pain; and brief, intolerable bursts of sharp pain similar to the pain caused by a dental probe on an exposed nerve. Individuals may have numbness in the areas affected by the pain. The burning and loss of touch sensations are usually most severe on the distant parts of the body, such as the feet or hands. Central pain syndrome often begins shortly after the causative injury or damage, but may be delayed by months or even years, especially if it is related to post-stroke pain. (NINDS.org)