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Biofeedback Therapy for Addiction Treatment

What is Biofeedback Therapy?

Biofeedback is a non-drug technique and a therapy used to help control certain bodily functions such as heart rate and response to different sensations.1 During biofeedback, you are connected to electrical sensors that monitor your body’s reactions and help you receive instant information about your body. The information allows you to make specific changes to your body, such as relaxing certain muscles to reduce pain. Biofeedback helps you try different ways to change how you feel by having real-time information on how your body responds to different things. Biofeedback can help with chronic pain, headaches, anxiety, urinary incontinence, high blood pressure, and even in the treatment of substance use disorder.1

EEG Biofeedback and Neurofeedback

One type of biofeedback is brain wave feedback. Brain wave feedback works using scalp sensors to monitor your brain waves using an electroencephalograph (EEG).1 This type of biofeedback is called EEG biofeedback or neurofeedback.2 EEG biofeedback or neurofeedback is a way to address problems of brain dysregulation by learning to train the brain. By observing the brain in action, we can reward the brain when changing its activity and patterns to create a better outcome.2

Biofeedback Therapy for Addiction

EEG Biofeedback for Substance Use Disorder

Numerous studies have shown EEG biofeedback effectively treating disorders such as attention deficit hyperactivity disorder, anxiety, depression, post-traumatic stress disorder, headaches, insomnia, autism spectrum disorders, personality disorders, and substance use disorders. EEG biofeedback helps to promote neuroplasticity by helping you change brainwave patterns and alter specific neural functioning. When combined with other forms of therapy such as psychotherapy, EEG biofeedback can be very useful in treating substance use disorders, regardless of the substance.
This treatment works because the use of substances can significantly change brain activity and functionality. EEG biofeedback can help to shift those brainwave patterns and work towards your brain activating its reward system in response to positive changes rather than the presence of substances. It is important to note that because different substances change the brain differently, EEG biofeedback works slightly differently in treating different substances.

EEG Biofeedback for Alcoholism

A 2005 study conducted at the University of California, Los Angeles, showed that EEG biofeedback treatment helped improve abstinence rates when used to treat alcohol use disorders. This effectiveness is partly because EEG treatment helped keep the brain’s cortex active when resisting change (not using substances and maintaining sobriety instead). Additionally, EEG scans have shown that individuals with alcoholism are usually deficient in alpha rhythms, and alcohol use induces more alpha wave activity. If people in recovery from alcoholism could be taught through neurofeedback to produce more alpha waves, they may be less inclined to drink. EEG biofeedback could also teach ways to relax instead of using alcohol.

EEG for Heroin Addiction

Research has shown that most people who use heroin have dysregulated brain waves, including the alpha, beta, delta, and theta waves. EEG biofeedback can help to re-regulate those brain waves and restore the brain to its natural state.

EEG for Cocaine Addiction

Long-term use of cocaine can affect the amygdala, which is responsible for emotional learning. The effect that cocaine has on the amygdala is connected to substance cravings and encourages a cycle of cocaine use. Cocaine also alters the anterior cingulate cortex, which plays a part in processing emotions and memory. EEG biofeedback can undo the changes that cocaine causes to the brain and help individuals overcome those cravings and replace the initial reaction to cravings with healthier behavior.

Studies of Biofeedback in Substance Abuse Treatment

Peniston Protocol

One of the earliest uses of biofeedback in substance abuse treatment came from two doctors named Dr. Eugene Peniston and Dr. Paul Kulkosky, who used it to treat alcoholism.3 They developed the protocol during the late 1980s and 1990s and conducted a study in which they used the Peniston protocol. This protocol involved using finger temperature biofeedback to raise the body’s temperature and then increase the brain’s alpha, and theta amplitudes. This treatment helped create a deep state of calm. During this calm, participants were provided a guided visualization of their ideal personality, an alcohol rejection scene, and instructions to internalize these scenes into the subconscious. These studies resulted in 80% abstinence rates amongst participants.3

Scott-Kaiser Modification of the Peniston Protocol

The Peniston Protocol was later revised to include the approaches used in the Peniston Protocol for substance abuse (not just alcohol) and frontal alpha symmetry training for depression, slow cortical potential training autism spectrum disorders, and qEEG-guided neurofeedback as a universal treatment for other disorders. The Scott-Kaiser modification was shown to be effective in treating other substance use disorders and mental health disorders.3

CBT and Neurofeedback in Substance Use Disorders

The use of medications in treating substance use disorders is controversial because many of the medicines used to treat substance use disorders have their own risks. Methadone is an example of this. Methadone maintenance treatment is the use of methadone to replace the presence of an opioid. The problem is that methadone is highly addictive as well. For that reason, non-medical interventions such as neurofeedback and psychotherapy such as cognitive-behavioral therapy are very popular. These treatments are non-invasive and don’t have the same side effects and risk of addiction as medications do. Neurofeedback also pairs well with psychotherapies such as cognitive-behavioral therapy, as neurofeedback can restore the brain to its natural state, making psychotherapy more effective.

Biofeedback for Mental Health Disorders

How is Biofeedback Used to Treat Anxiety?

For many people, anti-anxiety medication does not seem to be as helpful as one would have hoped. With many side-effects, more and more people are looking for options beyond medications to treat anxiety.4 A great non-invasive non-pharmacological option is biofeedback. During biofeedback therapy, special sensors monitor your heart rate, respiration, blood pressure, or brain activity, all things which are affected by anxiety. Having this information, you can try to make changes to heart rate, breathing rate, and more. This practice can teach your body how to help your brain to calm down during sensations of anxiety. Studies have shown that anxiety and depression rates are reduced after three months of neurofeedback training.4

How is Biofeedback Used to Treat PTSD?

One of the most effective treatments of PTSD is exposure-based therapy; however, exposure-based treatment can be too intense for some people, causing them to drop out of treatment. Therefore, biofeedback might be useful in the treatment of PTSD. Biofeedback can help change how the brain reacts to different stimuli without unnecessary distress.5 Biofeedback can reduce the fear response that individuals with PTSD might experience when triggered by something that reminds them of their traumatic event.5


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