Substance Use/Abuse

See also The Impact of Medication and Drugs on Neurofeedback Training

I generally sit down with a new client who is admittedly–or appears possibly to be (on the assessment)–using drugs or alcohol and try to get him/her to specify what they get from using.  Also what they hope to achieve through training.  It is important to do this between you and the client only.  Then I explain that the substances change the way the brain works…temporarily…so that they feel better in the way they have just described; but in giving this temporary effect, they make it harder and harder for the brain to get there on its own. I ask them if they have a “problem” with the substance–an inability to control its use–and of course they say no. Then I tell them I would like to make a contract with them: they give me one month, during which they commit to not using their substance and coming at least twice a week for brain training.  I tell them that I will show them that they can teach their own brain to go to the place by itself that they are currently using the substance to go–and that learning this, the brain will be able to go there more easily and more consistently.  They will also begin to see some of the changes beginning that they want to see in their lives (able to concentrate better, lower anxiety or whatever).  Most agree (though some don’t, saving everyone a waste of time and money).  Then we talk about how they will actually keep their end of the bargain: when will they be most tempted to use despite their contract? how can they avoid those situations?  And I actually write down the agreement and both of us sign it.  In my experience it’s pretty rare that the client actually makes it through the month, which then raises between us the question of whether they really DO have as much control as they thought they had, but it also resets the contract period.  In most of these cases we were successful and the client did agree that the substances were no longer necessary/desirable.

You can certainly do the assessment.  The casual user will show some effects for up to about 10-14 days after use.  Even after a fairly short period of regular use it’s likely the effects will be there and more lasting.  But they will become more problematic the longer the client has/does use: especially frontal alpha, slow alpha and poor alpha blocking.

Alpha Theta

There is a specific protocol called Alpha Theta training which has been very helpful for many who deal with this pattern.   It is very much like the 12-step programs that lead you to the point of admitting that you don’t necessarily control your life and that guide you into contact with those parts of your past that you need to accept and integrate into yourself.   In most cases, once you’ve allowed that to happen, the “addictions” cease to be controlling.  I surely do alpha theta with these clients–as I do with nearly every client every 5th session–but I prefer to look for the hot temporals or reversals or coherence issues or midline issues or indications of a head injury that appear in the assessment and train those.   Fix those and the client may still choose to smoke from time to time when in a social situation or whatever, but they won’t “need” to.

I would always start A/T only after I had determined that the client was capable of producing an A/T ratio of about 1.5 with eyes closed in the parietal or occipital areas.  If you look at his alpha coherence levels in those areas, I’m pretty sure you’ll find them very low (below .30 or .40).  Try some P4 alpha up/theta down and also try alpha coherence training between P3 and P4 (two channels).  Do some relaxation and stilling work with the client until he gets the feel of the alpha state.  Without that, you don’t do alpha/theta… you do theta/theta, which for an alcoholic is probably too scary to get into.

Cannabis/Marijuana

Marijuana users have high alpha amplitudes, especially in front; lowered alpha peak frequency; poor alpha blocking.  I don’t use alpha theta to train marijuana users.   Yes it has been very useful with alcoholics and some drug addictions, but that’s not usually the issue with people who smoke marijuana.   I don’t consider that marijuana smoking is a training problem.   It’s just an issue that can complicate the training.

My approach has generally been not to speak to the parents about the smoking, but to deal directly with the client when we first sit down together. I ask him if he has a problem with marijuana, or could he stop for a month, if he chose to. I’ve never had anyone say they had a problem.  Then I ask what they smoke for–what happens, how do they feel different, when they smoke. I explain to them that trying to train the brain while continuing to use will be like trying to dig a hole in a swamp.  The brain won’t be able to learn to change itself, since it is being changed by an external substance. I challenge them to commit to me that they will stop smoking for 4 weeks (it takes about 2 weeks for the THC to clear from the system) and participate in the training with me 2-3 times a week, and I believe I can show them that they can get to the same place without the dope that they get to with it–and without the negative effects.  At the end of that time, if they don’t feel I’ve shown them what they can do on their own, they can always go back to smoking. I had a couple folks choose not to take my bet, and we just told their parents that it would be a waste of my time and their money at this point to train, because the client didn’t want to change. The great majority made the commitment (though only a handful ever kept it for 4 weeks).  When they slipped, I would be puzzled: “I thought you said you had control of this. Maybe it’s more of a problem than you thought.” and we’d re-dedicate ourselves and go on with the training. I don’t recall that I ever had anyone, at the end of the four weeks, say that I had lost the bet.

It is fairly common for alcohol or marijuana or cocaine to increase alpha levels in the brain temporarily–usually in the first couple drinks. That would tend to result in the person feeling calmer, happier, more present–which I guess would qualify as “fun.”  Especially true for folks who have too much high beta or low levels of alpha or both. The problem is that the effect passes if you continue drinking, so many abusers of alcohol tend to go on past the necessary level and then continue trying to get it back. And, getting into alpha this way tends to make it harder for the brain to get there any OTHER way.

Alcohol and Training

Drinking 1-2 glasses of alcohol per week does not interfere with training unless the person drinks right before the session.

Alcoholism

As for the alcoholic brain, it is commonly distinguished by very LOW T/B ratios.  Alcoholics are into denial.  Denial of what?  Of subconscious material.  Theta is subconscious.  Alcoholics don’t customarily go there.  They also tend to have low levels of alpha.  Alcohol consumption (early in the process) tends to bump up alpha, resulting in that sense of wonderful ease that is so rare for alcoholics.  Teaching them to relax, with temp or GSR (didn’t remember that they used GSR) was the first step toward getting them into alpha.