The Electric Brain: Rediscovering the Other Half of Mind Activity and its Implications for Trauma

In 2010 Thomas Insel, the Director of the National Institutes of Mental Health, wrote an article in Scientific American in which he called for a return to the understanding of the mind in terms of rhythms and patterns of electric communication. For the last several decades, the dominance of pharmacology has nearly obliterated research into the electric landscape of the brain in favor of a brain-disease model of discrete disorders caused by chemical imbalances. But chemical imbalances are only half of the story. Brain activity is the sum of chemical and electrical activity.

Doctors and scientists are now asking questions about how electrical brain activity contributes to psychiatric problems. They are exploring how treatments targeting the electrophysiology of the brain can normalize abnormal brain patterns and increase emotional stability. One promising new treatment for developmental trauma is neurofeedback. Neurofeedback intervenes in the circuitry that promotes and sustains states of fear, a hallmark of chronic trauma.

Brain Wave Basics: Fast and Slow

This is an EEG of an eight-year-old diagnosed with ADHD. It shows three seconds of EEG recorded at 19 sites which shows the brain making normal brainwaves to start but then shifts into a dysregulated state where it makes the larger, slower brainwaves (theta). This dysregulated state is likely occurring when this child is inattentive. Credit: Appliedneurotherapycenter.com/qeeg

An EEG is an Electroencephalogram. It tracks and records brain wave patterns using electrodes placed on different parts of the scalp. Each line charts the activity in a different part of the brain. The EEG measures varying amplitudes and frequencies. Frequency is measured in hertz (Hz) or cycles per second (cps).

Credit: Bessel A. van der Kolk, M.D., “The Body Keeps the Score”

Brainwaves are divided into about six different categories. At one end of the spectrum are Delta waves, the slowest of which occur during deep sleep. Delta waves are are the slowest waves, in which the brain is idling and the mind is turned inward. If the brain is producing Delta waves when awake, one’s thinking will be foggy. Persistent Delta waves are also associated with poor judgment and impulse control. 80% of children with ADHD and many people diagnosed with PTSD have excessive slow waves in frontal lobes. In fact, in 2013 slow wave pre-frontal activity was certified by the FDA as a biological marker for ADHD. This is one possible explanation for why children with ADHD tend to have poor executive functioning: their rational brains lack control over their emotional brains.

Theta waves occur at the boundaries of sleep, in so-called “hypnopompic” states. Alpha waves are accompanied by a sense of peace and calm and are often activated during meditation. At the other end of the spectrum are High Beta waves- the fastest frequencies- which are associated with excited, agitated states when the brain is oriented to the outside world.

What Brain Activity Means for Trauma and Learning Disabilities

A Quantitative EEG (qEEG)is a computerized analysis of the EEG. It converts brain wave activity into a color map that shows which frequencies are highest and lowest in which areas of the brain. A qEEG can also show connectivity between brain areas, allowing scientists to see which areas are communicating and working together.

Psychiatrist Dr. Bessel van der Kolk argues in his book “The Body Keeps the Score”, that the qEEG “provides compelling evidence of arbitrary boundaries of DSM diagnostic categories. DSM labels for mental illness are not aligned with specific patterns of brain activation. Mental states that are common to many diagnoses, such as confusion, agitation or feeling disembodied, are associated with specific patterns on the qEEG.” The DSM, first published in 1980, classifies mental disorders based on symptoms alone. Dr. van der Kolk explains that individuals with long histories of traumatic stress often show excessive activity in the right temporal lobe, the fear center of the brain, combined with too much frontal slow-wave activity. This pattern of brain activation means that the emotional brain is hyperaroused and controls the other parts of the brain.

Problems with brain circuitry are implicated in learning disabilities as well. When there is interference in proper wiring of sensory-integration systems, learning disabilities can develop. Learning disabilities involve faulty connections between auditory and word-processing systems and poor hand-eye coordination. Neither drugs nor conventional therapy have been able to bring those areas of the brain back online after the closing of the critical window in early childhood. Neurofeedback can help people learn to organize time and space, distance and relationships even after trauma has interfered with development.

Neurofeedback works by looking at current brain activity and training the brain to fire differently. According to the Trauma Center at JRI in Brookline, M.A., a clinic that treats adults and children who have experienced trauma, which brainwaves are desirable varies from person to person. It has both objective (e.g., EEG) and subjective elements (e.g., reporting what makes you feel more alert, focused, relaxed, secure, etc.). As the brain is rewarded for making specific brainwaves, it can gradually learn to re-regulate its own functioning. The mechanism of action is similar to other forms of learning: the more the brain is rewarded while being trained in a desirable frequency, the more it will function in that frequency after training.

Towards A Better Diagnostic Framework

Grid of major pathways in human brain’s left hemisphere. Using diffusion spectrum imaging, which tracks movement of water through nerve fibers, researchers can trace groups of neurons as they cross from one region of the brain to another in living individuals. Credit: Van Wedeen, Massachusetts General/Harvard Medical School

In his 2010 article Thomas Insel noted that “Brain regions that function together to carry out normal (and abnormal) mental operations can be thought of as analogous to electrical circuits- the latest research shows that malfunctioning of entire circuits may underlie many mental disorders.” And in 2013 Insel announced that the NIMH was “re-orienting its research away from DSM categories,” noting that “patients with mental disorders deserve better.”

And so the NIMH has launched a project called the Research Domain Criteria (RDoC) project to lay the foundation for a more precise diagnostic system. This new system would map the cognitive, circuit, genetic and symptomatic aspects of mental disorders. Its part of the NIH’s broader effort, called the Human Connectome Project, to map the brain’s neural connections in their entirety. The NIH believes that mapping the connectome will help scientists better understand the roots of neurological disorders, explore how genes affect brain connections and how social and environmental factors effect the expression of genes.

Meaningful Relief for Those Suffering from Chronic or Developmental Trauma

As long as we see mental illness solely as a chemical imbalance we will continue to medicate, forgo investigation into trauma’s origins and miss the mark on treatment. In addition to understanding the brain’s chemical and electric dimensions, we must look at how the social environment shapes the brain. This is a special interest for me that I’ll write about it in another post.

Of all patients, the poor are most likely to suffer from this myopic approach. Medicaid spends more on anti-psychotic medications than any other class of drugs. In 2009 the New York Times reported that children from low-income families are four times more likely than privately insured children to receive antipsychotic medications. These medications interfere with motivation, play, creativity and curiosity. And they have an overall numbing effect on large segments of our communities.

Brain wave patterns explain why traumatized people have trouble learning from experience and fully engaging in their daily lives. Treatments like neurofeedback can calm the fear-driven brain. They hold immense potential to help individuals break free from repetitive firing of circuits of fearfulness, shame and rage.

I am very excited to see such a widespread interest in bridging the divide between biology and psychology. A more nuanced and emerging research based approach to psychic discomfort is long overdue. I envision a roll out of creative treatment strategies and brilliant professionals like rays of light dancing on calm ocean water to those suffering most. I know this may never come, but we must push forward because we “are only undefeated because we have gone on trying.”