Sebern Fisher lifts the veil on developmental trauma in her eloquently and brilliantly written book, Neurofeedback in the Treatment of Developmental Trauma. Calming the Fear-Driven Brain, (2014).
The world is waking up to the devastation of the aftermath of the trauma inflicted on the developing brains of those children who are abused or neglected. Owing to the Adverse Childhood Events Study by Anda and Felitti , the work of Sebern Fisher, Ruth Lanius, Allan Schore, Bessel van der Kolk and others, an awareness is finally dawning of this human catastrophe that Fisher referred to in a private conversation as not being different from global warming. According to a survey done by the Centers for Disease Control and Prevention in 2009, 8,755,000 children per year in the United States fall victim to neglect and assault. The effects of these histories are mostly to be endured for a lifetime. It can safely be assumed that the incidence of adverse childhood circumstances is even higher in South Africa.In her book, Fisher explores and explains the disastrous effects of these adverse childhood circumstances with great compassion and deep awareness.
Clients and patients show up at our practices often because they do not manage to regulate either their behaviour or their emotions. Most of us in private practice have been conditioned to look through the lenses of DSM-diagnoses which inhibits our thinking and often masks the truth. Fisher (2014) unveils that truth when she explains how fear that is prominent in all disorders such as PTSD, DID, ADHD, conduct disorder, OCD, BPD, bipolar disorder, borderline personality disorder, eating disorder, substance abuse and many other disorders that we as therapists are presented with on a daily basis, have at their core dysregulated nervous systems that are very often consequential of histories of abuse and neglect.
Fisher explains succinctly in chapter 2 of her book how the physical brain is affected in developmental trauma. She gives an overview of the different regions of the brain impacted by these childhood circumstances and provides information about and insight into the underlying neuroscience necessary to guide the neurofeedback practitioners in their protocol decisions.
Neurofeedback practitioners ought to stay responsibly abreast of relevant research and the work of leading specialists in the field. One of the new insights that led to an eureka moment for me personally in my attempts to understand the abreactions that I saw with clients being trained according to the principles of the arousal model when I read Fisher’s book, was the fact that traumatic childhood histories are often encoded in slow brainwave activity. Most of us would typically do left sided high frequency training when we encounter high delta and theta amplitudes and accompanying depressive symptoms. Although this presents as typical low arousal, in the aftermath of trauma it is not that. The autonomic nervous system response of an individual with this profile is fear-driven and manifests as the “freeze-response” according to the polyvagal theory of Porges. Freezing, Fisher explains, is a hyperactivation of the parasympathetic nervous system and in developmental trauma results in dissociation.
Throughout her book, Fisher emphasizes that the neurofeedback practitioner ought never lose sight of the fact that the CNS of the individual with developmental trauma is fear- and terror- driven and that the function of the neurofeedback practitioner is that of calming the fear-driven brain as the title of the book suggests.
In chapter 7, neurofeedback protocols for developmental trauma are discussed and the low reward frequencies that are suggested will be surprising to many practitioners that are not trauma informed. Once the dynamics of the effects of developmental trauma on the brain are understood ( which after the mindful reading and even re-reading of the book, will ensue) the practitioner will be comfortable in working at introducing lower reward frequencies in neurofeedback protocols. The case study of Rennie discussed at length in chapter 9 bears testimony to the efficacy of this approach as will your own experience.
The therapists that have not yet included neurofeedback in their approaches will find new insights born from experience, skill and brilliance into complicated aspects of the psychotherapeutic relationship with this challenging population and I am convinced, be swayed toward incorporating this modality of applied neuroscience into their practices. In chapter 8, Fisher writes comprehensively about the integration of neurofeedback and psychotherapy.
The success rate of other therapies in the treatment of developmental trauma is far from acceptable. Neurofeedback in the treatment of developmental trauma as underwritten by the latest neuroscience research, is currently the best available option. Our role as neurofeedback practitioners in addressing this pandemic of a different nature is of paramount importance and the book of Sebern Fisher equips us in an in-depth and far-reaching manner.