Over the past forty years, neurofeedback has been used in the treatment of chronic pain, epilepsy and migraines. Neurofeedback is a type of biofeedback that uses real-time displays of brain activity. Typically, sensors are placed on the scalp to measure activity, which is displayed using video displays or sound. Clinician and author of “Neurofeedback in the Treatment of Developmental Trauma,” Sebern Fisher, focuses on neurofeedback’s ability to help treat severe childhood abuse, neglect and abandonment, otherwise known as developmental trauma. Fisher argues that by “training” our brain-waves to operate at different frequencies, the rhythms of the brain, body and the mind are normalized. This guide provides an in-depth look at the cutting-edge research on the central nervous system and the ways in which neurofeedback can help to rewire our brains and our lives. This book is suggested for those interested in utilizing neurofeedback in their life, for their own treatment or for the treatment of their patients.
This book is split into two parts, the First Part One covers Fisher’s “Underlying Theory” in 4 chapters and the Second Part covers the integration and practice of neurofeedback in 5 chapters. The book also includes an Appendix with a Neurofeedback Assessment Questionnaire, FAQ and a FPO2 Protocol Guide, as well as References and an Index.
Current research on attachment shows that a caregiver’s soothing and nurturing behaviors instill a sense of trust and safety within a child. When a caregiver is not physically or emotionally available, this causes the child to live in a state of chronic fear. In Chapter 1, Fisher explores the mind in developmental trauma and explains what can occur when a child lacks a sense of “mother/other” and “baby/self.” The mind of those who have suffered from developmental trauma, is one that Fisher describes as a “vacant universe of no self and no other and the unrelenting assault of fear” (36). Fisher writes that without this essential piece of the child’s identity, they are left with a continuous fear reaction and the neural connections grow stronger and even more reactive as the child grows into adulthood. To help make better treatment decisions for children and adults with developmental trauma, Fisher writes that understanding the DSM V and the nosology of mental disorders may actually hinder us. She has found that this is because it causes us to rely more on observable symptoms, most of which are shared across most DSM V categories. Fisher argues that we should spend more time focusing on individual behavior and brain patterns that are associated with one another. Fisher writes, that “as neurofeedback practioners, we will learn to see through the diagnosis to discern the underlying patterns of arousal. It is the arousal embedded within the diagnosis that we are treating” (6).
Chapter 2, becomes a bit more technical as this chapter will focus primarily on the brain structures most impacted by developmental trauma and on “the rhythms that give rise to what I call the fear-driven brain” (37). The author gives a brief 2-page description of each structure. The first of which describes the brainstem and hypothalamus: two vital structures both responsible for life sustaining functions including, respiration, sleep-wake cycle, hunger, pain perception and core consciousness. She references the groundbreaking work of Steven Porges and the polyvagal theory, describing the vagus nerve and dysregulation caused by trauma. Fisher writes that, “the most common complaints in developmental trauma are vagally mediated: stomachaches, constipation and irritable bowel” (41). Fisher agrees that “vagal pathways support self-regulation throughout the body as well as the all-important sense of membership in the tribe,” which relates to a dysfunctional early care-giver attachment relationship. Fisher also cites Damasio’s hypothesis that the brainstem, hypothalamus and basal forebrain constitute the origins of self in the nonconscious brain. The author writes that this “thesis is important to neurofeedback providers” (44) because it, “underscores the central role of the hypothalamus in fear regulation” (44) and might explain why our “regulatory systems are very susceptible to the very stress hormones that it attempts to regulate” (44). A case study is provided which may help to further explain how these “primitive brain structures factor into trauma and in the circuitry of fear” (45). Later in this chapter, Fisher explains how electrical networks and brain circuits are also integrated into the fear reaction.
In Chapter 8: The Integration of Neurofeedback and Psychotherapy, Fisher moves from brain structure to direct integration of neurofeedback within psychotherapeutic practice. Fisher writes that in her own clinical experience, before discovering and implementing neurofeedback into her practice, she had no way of helping her clients “stop the surges where they begin: in the brain” (247). When a parent disappears emotionally and physically, or even worse, when they appear and turn against their child, the very best outcome is an agonized yearning for the parent, a yearning that may not ever be satisfied. Each individual may fill this void differently. “The goal of neurofeedback is to quiet the alarm of the abandoned infant that drives the transference, rather than trying to address the terrible hunger with insight or transference-driven reenactments.” In other words, not automatically working to fill the void but instead working to quiet the alarms set off by the appearance of this void.
Throughout this book, Fisher includes many examples of ways in which neurofeedback has helped her clients to better understand their own developmental trauma and how clients’ better understanding of their own brain dysregulation may lead to better outcomes post-treatment. The book provides essential clinical skills including how to introduce the idea of neurofeedback to clients, how to combine it with psychotherapy and how to perform assessments. Sebern Fisher provides a look at exactly how this innovative model can be used to engage the brain to find inner peace.
Fisher, S. (2017). Neurofeedback in The Treatment of Developmental Trauma. New York, NY. W.W Norton & Company, Inc.
Hardcover: pp. 382.
Appendix, References, Index
Sebern F. Fisher, MA, is a psychotherapist and neurofeedback practitioner in private practice who specializes in attachment issues. She trains professionals nationally and internationally on neurofeedback, neurofeedback and attachment disorder, and the integration of neurofeedback with psychotherapy.
Pally, R. (2017). The Reflective Parent.
Reviewed by Molly Wilder, New York University
Some say that it takes a village to raise a
child into a well-functioning adult and it probably does. But without an entire
village of free childcare, we are often left with books to fill in the gaps. Today
hundreds of books claim to outline the “right way” of parenting. This often
leads parents to listen to conflicting advice which is not only confusing to
the parents but also to the children. Author of The Reflective Parent,
experienced psychiatrist and founder of the Center for Reflective Communities,
Regina Pally, comes from a more ground up approach to parenting. She argues
that “there is a lot more leeway in parenting” (xi).
As a young
parent raising her three children, she had read all the parenting books and was
left “feeling less confident than before” (xi). Through her pediatric,
psychiatric and psychoanalytic training, clinical work, studies in neuroscience
and personal experiences, Pally “learned that a parent’s reflective capacity is
the factor most closely associated with healthy child development.” (xi)
Throughout this book, ideas and skills required for reflective parenting are
interwoven with what we know today about child development, the neuroscience of
human social relationships and parent-child relationships. The Reflective
Parent is a practical and easy-to-read guide for anyone looking to build
stronger relationships with their children.
“Brain Basics” section at the beginning of each chapter is provided to
highlight the aspect of brain function being discussed in the following
chapter. For those who are a bit more skeptical of Pally’s main ideas, they may
want to refer to the “Science Says” boxes that are scattered throughout each
chapter that aim to present scientific experiments that support the concepts
being discussed in more scientific detail. At the end of each chapter, Stories
of Parents and Children “provide shorts examples of parent—child interactions
that illustrate the points being made” (xxii); Putting Into Words section gives
a few examples of reflective language a parent can use when talking with their
child; and “Take Home Lessons” gives tips and suggestions that parents can try
at home to strengthen their own reflective parenting and their relationship
with their child” (xxii). There are a total of nine chapters in this book along
with sections for the Introduction, Epilogue and References.
One: 10 Principles of Reflective Parenting, outlines 10 guiding principles to
follow when interacting with your child. The principles are “derived from what
science has shown helps parents to be as reflective as possible and to give
their children what they most need for all aspects of healthy development” (5).
One guiding principle, “#2 There is no perfect parent, and there are no “right”
or “best” answers or ways of parenting” encourages the reader to be more
confident when handling a situation with their child and to never take
parenting books as gospel. She writes, “You are the best judge of what your
child needs” (5). In this chapter, Pally also focuses on the skill of
reflective capacity and breaks it down into five steps. She notes that when
following these steps it is important for “parents to be reflective about their
child but also reflective about themselves” (13). At the end of this chapter
each of the 10 principles is accompanied by a real-world example which may help
some readers to better apply these principles in their own relationships.
Seven: Calming and Coping, aims to explain the stress response and recovery,
describe scientifically backed coping skills and tools for parents under high
stress. She includes antidotes for stressed parents like “being present in the
moment as much as possible and staying focused on what needs to be done now,
not on worse things that might possibly happen in the future” (155). Although,
some may claim that the phrase, “be in the moment,” is overused. Pally argues that
in this context being in the moment is especially important. She claims that “A
stressed parent’s weakened prefrontal cortex makes them more likely to misread
their child’s intention, to react more on impulse than to act rationally, and
to be less able to assess when they are off the mark in regard to their child”
(157). Later on in this chapter Pally outlines the ways in which parents can
respond to children’s stress in a more reflective way, as Pally believes that
“Your child’s main stress regulator: YOU!”
reflects that “the main point to keep in mind is that more than ever,
reflective parenting requires you to see your child as independent, competent,
and able to decide for themselves to run their lives” (230). She believes that
through a greater understanding of one’s own stress and barriers and an ability
to listen and observe, the parent-child relationship is likely to thrive. This
book serves as a guide to help build upon and strengthen these relationships
through reflective and introspective processes backed by research and experience.
Regina Pally is a psychiatrist and
psychoanalyst. She has been in private practice for over 35 years, with a
special interest in parents and couples. For 25 years, she studied and wrote
about neuroscience for mental health professionals. Most recently she has
dedicated herself to working in the community to improve the lives of children
and their families. In 2008, she founded the Center for Reflective Communities,
whose mission is to ‘promote healthy child development, by strengthening the
relationship bonds that children have with all those who care for them through
an emphasis on reflective thinking’.
Molly Wilder (Reviewer) is currently a Junior at New York University majoring in Applied Psychology. She is a research assistant for the Transgender Identity Formation Study (TIFS) at NYU Steinhardt, a grounded theory study aimed at understanding how transgender and gender-non-conforming people who identify as LGBQ perceive fluidity in their sexual orientation and gender identity. In addition to reviewing books for the IJP, she writes reviews for Somatic Psychotherapy Today.