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Neuro eedback therapy with alcoholsim and substance abuse disorder
Neurofeedback is a method that is used to display the state of the brain of a person. It is a type of biofeedback that is used to monitor a person’s brain waves through non-invasive electrodes attached to the scalp.

Introduction and Definitions
Neurofeedback refers to the presentation of information regarding the state of the brain in real time. It allows the person to generate the state of mind that is necessary or most appropriate for the behavior they desire. Neurofeedback makes use of a feedback electroencephalogram (EEG) to show a person’s electrical patterns in the cortex part of the brain. A baseline EEG or sometimes a multisite quantitative EEG is then used in neurofeedback assessments to identify abnormal patterns in the cortex. This then enables an individual with clinical training with feedback EEG to modify the patterns in order to optimize or normalize brain activity. . The reason for the focus on the cortex is because many medical and neurological disorders are characterized by abnormal patterns in the cortex. There are many researchers that have been published studies showing the effectiveness of neurofeedback therapy in the treatment of alcoholism and substance abuse. Alcoholism and substance abuse have become major problems in many countries across the globe. Substance abuse disorders comprise of those disorders that are related drug abuse. The disorders are the most common psychiatric conditions that result in serious cognition and behavior impairment. . The increase in cases of substance abuse disorders has led to many efforts being made towards developing treatment programs for people affected. There are various treatment methods for substance abuse that have been found to be inconclusive and this led to the search for an effective method. This search led to the findings, through research, that neurofeedback is effective in the treatment of alcoholism.

Biofeedback Therapy and Substance Abuse Disorders
Substance use disorders are characterized by cognitive, physiological, and behavioral symptoms as well as a change in the brain circuitry that may persist even after detoxification. The treatment of substance use disorders is not easy. Research shows that 65-70% of persons with substance use disorders who are treated using the traditional therapy methods such as the 12-step program and talk therapy relapse within one year. . Research on the use of neurofeedback as a form of therapy began in 1970, and since then there are numerous studies that have found neurofeedback therapy to be effective in the treatment of substance abuse disorders which includes alcoholism. Neurofeedback therapy involves a brain-computer interface that targets certain areas of a person’s brain activity. This is done by placing electrodes on the scalp to allow computerized systems to relay real-time feedback on the activity of the brain. Through neurofeedback training, the affected individuals receive feedback to inhibit or reinforce certain brainwave frequencies. . Normally, a person cannot successfully influence their brain wave patterns due to the lack of awareness of the brain waves. However, through neurofeedback training or therapy, one is able to see their brain waves on the computer screen when they occur hence creating the opportunity to influence and change them. The five brainwave frequencies include delta, theta, alpha, beta and gamma.

Brain Wave Frequencies
Previous studies show that approximately 80% of people can be able to retrain the functioning of their brain. The ability to retrain the brain functioning promotes the ability of neurofeedback training or therapy to treat certain problematic conditions that affect the functioning of the brain such as substance use disorders. . The five brain wave frequencies represent different functioning of the brain. Theta frequencies or waves influence a person’s emotions, spatial processing and memory. Alpha waves are responsible for resource allocation in the cortex, brain idling and thalamic function. They are associated with the brain going to a state of relaxation. Beta waves are responsible for arousal, anxiety, rumination and peak performance. These waves are active during problem-solving as well as concentration. They are associated with a state of mental and intellectual activity. Delta waves are those waves which we experience when asleep and they are the slowest. Gama waves, on the other hand, are associated with cognitive efficiency. . Different drugs produce different EEG abnormalities. Research shows that for alcoholics, EEG abnormalities are characterized by lower frontal alpha as well as slow-beta coherence. . There is also an increase in absolute and relative beta and a decrease in alpha and theta power. For exposure to marijuana, there is a decrease in alpha frequency and also a decrease in beta’s relative power. Heroin causes a deficit in alpha frequencies and an increase in beta frequency.

Alpha-Theta Training
Alpha-theta training is used primarily to increase the alpha and theta frequencies. The increase in the frequencies of the alpha and theta waves creates a twilight state where the person enters a relaxation mood and experiences effects that are similar to the meditation of the mind. The creation of the twilight state enables the individual to experience a hypnagogic imagery which is very important in the treatment process. The hypnagogic imagery helps the individual to create subconscious images which are helpful in the healing process. Peniston and Kulkosky argued that the inducement of a hypnagogic state creates a state of suggestibility which in turn enhances personal insight in the course of therapy thereby improving the recovery of the individual. . In comparison, the traditional treatment methods for substance abuse are more likely to increase the beta endorphins levels. An increase in the level of beta-endorphins can increase the anxiety in the individuals causing them to have more cravings for alcohol and other drugs. This is different from the effect experienced from alpha-theta training which reduces anxiety and cravings for the drugs. Neurofeedback training or the alpha-theta training has several protocols namely the Peniston protocol, the Scott-Kaiser modification of the Peniston protocol and the QEEG-guided neurofeedback training. The Peniston protocol was developed by Peniston and Kulkosky and its purpose is to enhance alpha and theta frequencies to create a theta state that increases awareness and suggestibility to improve the recovery process. . Research has shown that the Peniston protocol has been effective in the treatment of alcohol dependence. The protocol has also been effective in the treatment of other substances including prescription drugs and marijuana. However, this method has been inconclusive in the treatment of cocaine. The Scott-Kaiser modification of the Peniston Protocol is a modification of the Peniston Protocol done by Scott and Kaiser with the aim being to use neurofeedback training to treat people who abused stimulants. The use of this protocol for persons who abuse cocaine revealed that the people who underwent the treatment spent more time at the hospital compared to those that did not receive the treatment. Further, there were more than half of the research participants who abstained from cocaine entirely. The protocol involves conducting beta training in conjunction with alpha-theta training. . QEEG-Guided Neurofeedback training, on the other hand, was developed due to the need to have an individualized treatment approach for substance abuse disorders. This is due to the fact that it was not possible to have one protocol that fits perfectly well in all situations. The protocol involves the clinician starting with an assessment to identify the brainwave frequencies of the person concerned. Once the clinician had identified the brain wave frequencies, then he/she could proceed to develop an individualized protocol to train those frequencies.

The Efficacy of Neurofeedback Training
The research discussed above has shown that neurofeedback therapy is effective in the treatment of alcoholism and substance abuse disorders. In addition, neurofeedback therapy has also been used in other fields such as in sports, artistic performance as well as assisting students with ADHD. . In sports, neurofeedback training is used to enhance brain waves in the right area and then assisting the person to enter the zone which is a calm state where the person is performing at their best. This helps the person to perform as best as possible in sports. Similar results have also been experienced while working with artistic performers such as dancers and musicians. Neurofeedback has also been helpful in assisting students with ADHD which is a neurological disorder which is characterized by inattention coupled with impulsiveness. Neurofeedback therapy has been used to improve the attention of the students. . There is enough evidence that points towards the efficacy of neurofeedback training in the treatment of alcoholism and substance abuse. Neurofeedback therapy has helped addicts to abstain once they complete treatment.