Internet Addiction, Pornography Addiction
Neurofeedback can improve addictions treatment outcomes and lead to improved results when utilized as a companion therapy or as a stand alone therapy. One widely used neurofeedback process is called the “alpha-theta protocol” or the Peniston protocol, which was based upon the researcher Dr. Eugene Peniston who refined and researched it. The technique actually goes back to the Menninger Clinic and previous work by Elmer Green, Dale Walters, and Steve Fahrion over thirty years ago.

Background
Alcohol and drugs are psychoactive substances. They act in the brain, and their effects represent changes in neurological functioning. It is possible to learn to control one’s brain states from within, without drugs and alcohol. In this way, addictions can be overcome without a lifetime of struggle and craving. Neurofeedback (also called EEG biofeedback) trains the brain to modulate its level of activity, to become more or less activated according to the needs of the individual. Some addictions, such as alcoholism, often involve brain over-activation. In these cases it can be helpful to teach the brain to quiet down, become less activated. In other cases, for example in people with ADHD who abuse amphetamines, the brain is under-activated and needs to learn to speed up.

Alcoholism
It has been found that many alcoholics, and some other addicts, are deficient in alpha and theta waves. These types of brainwaves are associated, respectively, with a relaxed, alert state and a state of reverie and intense imagery. These alcoholics are cortically hyper-aroused and find it hard to relax and imagine.

Evidence shows pretty clearly that this pattern of hyper-arousal is present before a person becomes alcoholic, although alcoholism itself eventually exacerbates it, reducing alpha and theta even more. This is a condition of anxiety, inability to relax; a chronic state of excess tension. Drinking alcohol temporarily increases the amount of alpha and theta waves and reduces cortical arousal. This is associated with alcohol-produced euphoria. It can even look as if these alcoholics are made more normal when they drink! After a few hours, of course, the good feeling wears off as the basic pattern of low alpha/theta and increased fast beta comes back. The person is more anxious and tense than before.

Research has shown that success in alcohol treatment is worse for those alcoholics who have the least alpha and theta activity, and the most beta. This finding supplements the discovery that alcoholics as a group have less alpha and theta and relatively more beta than non-alcoholics. That is, alcoholics form a continuum, with the most cortically hyper aroused (those with less alpha and theta) showing worse outcomes than others who are less hyper aroused.

Neurofeedback for alcoholism, and some other addictions, is a process of teaching the client first to increase the amount of alpha waves, and then to increase theta. The person eventually progresses into a relaxed, then dreamy and hypnogogic state. Eyes are closed, and they receive feedback via sounds presented through headphones. Usually a reclining chair is used, a blanket is offered to increase comfort and the sense of security and the room is darkened or a light-preventing mask is used.

While in the hypnogogic theta state the client is asked to do visualizations picturing refusal to drink (or to do drugs) and abstinence from alcohol and other substances. In the many clients who also suffer from post-traumatic conditions the hypnogogic state facilitates the re-experiencing of traumatic memories in a setting that allows them finally to be processed and remembered in normal ways and places in the brain. Spiritual experiences often accompany the reprocessing of old memories.

Recreational
A second subset of addicts is cortically under-aroused and need to activate their brains. Cocaine and methamphetamine users, for example, are different from most alcoholics – in some ways 180 degrees apart. Those who prefer speed often show high amounts of theta to start, and so need a different protocol, at least at the beginning.

Although this is a different pattern from alcoholism, we see the same effort at self medication here: amphetamines reduce slow wave activity (theta and low alpha waves) and increase beta. This is rewarding for the sluggish, under activated brains of the cocaine and amphetamine users.

Steve Fahrion describes the alpha/theta experience as one of “exploration and discovery” in contrast to a process of “active coping.” The latter focuses on increasing faster brainwaves called “SMR” and “beta” that characterize quiet focus and concentration.

Current Research
William Scott and David Kaiser, in California, are currently engaged in three-year follow-up as part of a large study comparing state-of-the-art addictions treatment with the same program augmented by neurofeedback. A clinical vignette will help to understand the experience:

“About halfway through his process, a Vietnam veteran experienced a vision of hovering over himself while replaying every tour and battle he remembered and some he had forgotten. He states that he felt safe because he was only witnessing the experience rather than reliving it. It appears that he processed the events under a low-arousal state where they could be re-stored as past memories, rather than current ongoing trauma.”

Research on Neurofeedback for Addictions
Eugene Peniston, with his collaborator Paul Kulkosky, did their first study in 1989, with a small group of hard-core VA alcoholics. The results were hard to believe, and Steve Fahrion and others took it upon themselves to verify them by calling relatives of the 10 addicts. They did confirm what Peniston and Kulkosky found: after thirteen months, 8 of the 10 were sober. They have since followed these same 10 clients for 10 years and 7 remain abstinent (one has died). They also found that the clients treated with hand warming and neurofeedback showed lower levels of beta-endorphin, a neuropeptide that indexes stress. A follow-up study in 1990 found that a number of personality variables improved in the neurofeedback group relative to a control group. These included scales from the MMPI, the Beck Depression Inventory, and the Millon (MCMI).

In 1992 Fahrion and colleagues studied one client intensively during alpha-theta neurofeedback. This man was an alcoholic – sober for 18 months but experiencing stress-related craving for alcohol and fears of relapse. They found that after neurofeedback the client showed markedly lower response to stress. Both during relaxed states and during stress, the client was much more relaxed after neurofeedback than he had been before. The patient, his wife, and colleagues reported that he functioned in a much more relaxed way and was no longer experiencing a craving for alcohol.

William Scott’s and David Kaiser’s study was mentioned earlier. They studied 43 controls and 48 experimental subjects in a residential inpatient treatment setting. This facility, CRI-Help, based its treatment on the “Minnesota model, a 12-step oriented program supported by group, family, and individual counseling.” In addition, the experimental group received 40 to 50 neurofeedback sessions. The experimenters began with 10 to 20 sessions of SMR-beta training aimed at increasing cognitive control before beginning alpha-theta work. As mentioned before, this was because of the high initial theta found in stimulant and cocaine abusers. The SMR frequency is found in the motor cortex and signifies a state of physical stillness and mental concentration. Beta (just slightly higher in frequency) may measure a state of somewhat greater cognitive focus.

Like Peniston, Scott and Kaiser used the MMPI to track progress, and found that the experimental group showed much more personality change than the controls. Follow-up at 24 months showed that the differences between the groups were even greater.

The Scott-Kaiser study was initiated by the Chairman of the Board of CRI-Help. He stated, “It must be recognized that we are dealing here not only with typical research subjects but rather with the most difficult type of addict currently in rehabilitation. Most were assigned to CRI-Help by the courts or their care was otherwise mandated. To have observed this kind of improvement over what we consider to be a model, state-of-the-art program already is simply remarkable.” He concluded that when these results are confirmed in other studies “they will change the standard of care in the field.”

Such confirmations already exist. In the Kansas prison system, at least as hard-core a group of addicts as those in Los Angeles, Steve Fahrion has gotten excellent results using essentially the original alpha-theta protocol. His clients were over 500 criminals who were also addicts (about equal numbers of alcoholics, marijuana and cocaine users). The alpha-theta group was significantly less likely to fail than the controls. This was especially clear among those who had the worst record initially and among African-Americans particularly.

Two large studies in Texas are also very impressive in demonstrating the effectiveness of alpha-theta neurofeedback. One was done within the state corrections system by Alphonso Bermea, and three-year follow-up data was strongly indicative of success using the neurofeedback treatment. The second is a study with addicted street people (95% are crack cocaine addicts). Sixty-nine (69) people have completed treatment and have been followed for from six months to one and one-half years.

Success is defined very stringently, through four criteria, all of which must be met:

  • Not on drugs (verified though random UA)
  • Not homeless
  • Not unemployed (at work or in school)
  • Not arrested

Note that when they enter treatment none of these men were employed or had a home. All were on drugs or alcohol and most had lengthy police records. The results have been overwhelming positive. Preliminary results show that 83% of clients are successful in meeting all four criteria. The project received a $3 million grant from the Katy Endowment to fund it for three more years.

Alcoholism and Alcohol Abuse
Drinking is woven into the fabric of many societies-sharing a bottle of wine over a meal, going out for drinks with friends, celebrating special occasions with champagne. But because alcohol is such a common, popular element in many activities, it can be hard to see when your drinking has crossed the line from moderate or social use to problem drinking.

If you consume alcohol simply to feel good, or to avoid feeling bad, your drinking could become problematic. Alcoholism and alcohol abuse can sneak up on you, so it’s important to be aware of the warning signs and take steps to cut back if you recognize them. Understanding the problem is the first step to overcoming it.

Understanding drinking problems
Many people drink regularly without experiencing any harmful effects, other than perhaps a slight hangover on rare occasions. Yet millions of others suffer from alcoholism and alcohol abuse, making even an occasional drink dangerous.

How can some people drink responsibly, while others drink to the point of losing their health, their family, or their job? There are no simple answers. Drinking problems are due to many interconnected factors, including genetics, how you were raised, your social environment, and your emotional health. Some racial groups, such as American Indians and Native Alaskans, are more at risk than others of developing alcohol addiction. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems. Finally, those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol may be used to self-medicate.

Since drinking is so common in many cultures and the effects vary so widely from person to person, it’s not always easy to figure out where the line is between social drinking and problem drinking. Taking an honest look at why you drink may help you figure out which side of the line you fall on. Remember, though, the bottom line is how alcohol affects you. If your drinking is causing problems in your life, you have a drinking problem.

Signs and symptoms of alcohol abuse
Substance abuse experts make a distinction between alcohol abuse and alcoholism (also called alcohol dependence). Unlike alcoholics, alcohol abusers still have at least some ability to set limits on their drinking. However, their alcohol use is still self-destructive and dangerous to themselves or others.

Common signs and symptoms of alcohol abuse include:

  • Repeatedly neglecting your responsibilities at home, work, or school because of your drinking. For example, performing poorly at work, flunking classes, neglecting your kids, or skipping out on commitments because you’re hung over.
  • Using alcohol in situations where it’s physically dangerous, such as drinking and driving, operating machinery while intoxicated, or mixing alcohol with prescription medication against doctor’s orders.
  • Experiencing repeated legal problems on account of your drinking. For example, getting arrested for driving under the influence or for drunk and disorderly conduct.
  • Continuing to drink even though your alcohol use is causing problems in your relationships. Getting drunk with your buddies, for example, even though you know your wife will be very upset, or fighting with your family because they dislike how you act when you drink.
  • Drinking as a way to relax or de-stress. Many drinking problems start when people use alcohol to self-soothe and relieve stress. Getting drunk after every stressful day, for example, or reaching for a bottle every time you have an argument with your spouse or boss.

The path from alcohol abuse to alcoholism
Not all alcohol abusers become full-blown alcoholics, but it is certainly a big risk factor. Sometimes alcoholism develops suddenly in response to a stressful change, such as a breakup, retirement, or another loss. Other times, it gradually creeps up on you as your tolerance to alcohol increases. If you’re a binge drinker or you drink every day, the risks of developing alcoholism are even greater. But whether or not alcohol abuse turns into alcohol addiction, many of the problems will be the same.

Signs and symptoms of alcoholism (alcohol dependence)
Alcoholism is the most severe form of problem drinking. Alcoholism involves all the symptoms of alcohol abuse, but it also involves another element: physical dependence on alcohol. There’s a fine line between alcohol abuse and alcoholism, but if you rely on alcohol to function or feel physically compelled to drink, you’ve crossed it.

Tolerance: The 1st major warning sign of alcoholism
Do you have to drink a lot more than you used to in order to get buzzed or to feel relaxed? Can you drink more than other people without getting drunk? These are signs of tolerance, which can be an early warning sign of alcoholism. Tolerance means that, over time, you need more and more alcohol to feel the same effects you used to with smaller amounts. Withdrawal: The 2nd major warning sign of alcoholism

Do you need a drink to steady the shakes in the morning? Drinking to relieve or avoid withdrawal symptoms is a sign of alcoholism and a huge red flag. When you drink heavily, your body gets used to the alcohol and experiences withdrawal symptoms if it’s taken away.

Alcohol withdrawal symptoms include:

  • Anxiety or jumpiness
  • Shakiness or trembling
  • Sweating
  • Nausea and vomiting
  • Insomnia
  • Depression
  • Irritability
  • Fatigue
  • Loss of appetite
  • Headache

In severe cases, withdrawal from alcohol can also involve hallucinations, confusion, seizures, fever, and agitation. These symptoms can be dangerous, so talk to your doctor if you are a heavy drinker and want to quit.

Other signs and symptoms of alcoholism (alcohol dependence):

  • You’ve lost control over your drinking. You often drink more alcohol than you wanted to, for longer than you intended, or despite telling yourself you wouldn’t.
  • You want to quit drinking, but you can’t. You have a persistent desire to cut down or stop your alcohol use, but your efforts to quit have been unsuccessful.
  • You have given up other activities because of alcohol. You’re spending less time on activities that used to be important to you (hanging out with family and friends, going to the gym, pursuing your hobbies) because of your alcohol use.
  • Alcohol takes up a great deal of your energy and focus. You spend a lot of time drinking, thinking about it, or recovering from its effects. You have few if any interests or social involvements that don’t revolve around drinking.
  • You drink even though you know it’s causing problems. For example, you recognize that your alcohol use is damaging your marriage, making your depression worse, or causing health problems, but you continue to drink anyway.
Myths about alcoholism

Getting to the truth behind the myths that you may be using to justify your drinking is crucial to breaking down the wall of denial.

Myth #1: I can stop drinking anytime I want to.
Maybe you can; more likely, you can’t. Either way, it’s just an excuse to keep drinking. The truth is, you don’t want to stop. Telling yourself you can quit makes you feel in control, despite all evidence to the contrary and no matter the damage it’s doing.

Myth #2: My drinking is my problem. I’m the one it hurts! No one has the right to tell me to stop.
It’s true that the decision to quit drinking is ultimately up to you. But you are deceiving yourself if you think that your drinking hurts no one else but you. Alcoholism affects everyone around you-especially the people closest to you. Your problem is their problem.

Myth #3: I don’t drink every day, so I can’t be an alcoholic OR I only drink wine or beer, so I can’t be an alcoholic.
Alcoholism is NOT defined by what you drink, when you drink it, or even how much you drink. It’s the EFFECTS of your drinking that define a problem. If your drinking is causing problems in your home or work life, you have a drinking problem and may be an alcoholic-whether you drink daily or only on the weekends, down shots of tequila or stick to wine, drink three bottles of beers a day or three bottles of whiskey.

Myth #4: I’m not an alcoholic because I have a job and I’m doing okay.
You don’t have to be homeless and drinking out of a brown paper bag to be an alcoholic. Many alcoholics are able to hold down jobs, get through school, and provide for their families. Some are even able to excel. But just because you’re a high-functioning alcoholic doesn’t mean you’re not putting yourself or others in danger. Over time, the effects will catch up with you.

Myth #5: Drinking is not a “real” addiction like drug abuse.
Alcohol is a drug, and alcoholism is every bit as damaging as drug addiction. Alcohol addiction causes changes in the body and brain, and long-term alcohol abuse can have devastating effects on your health, your career, and your relationships. Alcoholics go through physical withdrawal when they stop drinking, just like drug users do when they quit.