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Research Findings


Early Development of Alpha and Theta Brainwave Training

Eugene O. Peniston, Ed.D., A.B.M.P.P., B.C.E.T.S., F.A.A.E.T.S.
The Peniston-Kulkosky Brainwave Neurofeedback Therapeutic Protocol:
The Future Psychotherapy for Alcoholism/PTSD/Behavioral Medicine

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Electroencephalographic (EEG) biofeedback has been in use since the early 1970's for treatment of anxiety disorders and a variety of psychosomatic disorders. Early work conducted by researchers such as Kamiya and Kliterman focused on alpha wave biofeedback (Kamyi & Noles, 1970). Much of this initial research associated changes in EEG state with different states of consciousness (Basmajian, 1989). Researchers learned that certain tasks, such as mental arithmetic, reduce or suppress alpha wave production. Furthermore, researchers found that these changes in brain activity were positively correlated with changes in electromyographic (EMG) activity and skin temperature. This finding was significant in that it suggested that brainwave activity could be operantly conditioned in the same manner as EMG or temperature. Alpha waves are smooth, high amplitude waves in frequency range of 9-13 Hertz (Hz). Alpha wave biofeedback was explored by some researchers, as a treatment adjunct for alcohol abuse (Passini, Watson, and Dehnel, 1977). There were two theoretical rationales: first, investigators had reported that EEGs of alcoholics were "deficient in alpha rhythms and alcohol use induced more alpha wave activity (Pollock, Volavka, Goodwin, et al., 1983). Clinicians speculated that alcoholics might drink less if they could be taught to produce more alpha waves (Jones & Holmes, 1976). Secondly, many alcoholics and other drug abusers reported using alcohol or other drugs to relax. Thus, biofeedback training was proposed as a way teach alcoholics an alternative to using alcohol to relax. Alpha training did not, however, appear to be of benefit to most alcohol abusers because they were unable to learn to increase their production of alpha waves.

Various types of relaxation training and/or stress reduction techniques have been used in the treatment of alcoholism. These techniques include progressive relaxation training (Klajner, Hartman, & Sobell, 1984), meditation (Wong, Brochin and Gendron, 1981), Hypnosis (Wadden & Penrod, 1981), and alpha wave feedback training (Passini, Watson, Dehnel, Herder & Watkins, 1977; Watson, Herder, & Passini, 1978).

Several studies have investigated the effects of alpha biofeedback training in the treatment of alcoholism (Passini et al., 1977; Watson et al.,1978). The theoretical rationale for the use of relaxation procedures has usually included two assumptions: (a) that substance abuse is caused or exacerbated by stress and anxiety, and (b) that relaxation training is effective because it reduces anxiety and increases an individual's sense of perceived control over stressful situations (KIajaer et al., 1984). Results indicate that alpha training reduces chronic anxiety and does appear to have some long range therapeutic effects on anxiety levels. However, even though there has been some evidence of positive findings attributable to the use of these relaxation techniques, many of the studies involved poor methodology and results are equivocal at best.

Interest in the combination of alpha-theta training evolved from investigation of sleep and creativity (Budzynski, 1973). One earlier study found that, as individuals became drowsy, their brain waves commonly changed from high-amplitude alpha to low-amplitude theta (Vogel, Foulkes, & Trosman, 1966). During the transition, some individuals experienced a hypnogogic state in which they had vivid visual imagery and auditory and visual hallucinations. Investigators studying creative individuals noted that when their subjects were in a state of "reverie," they produced increased amounts of 6-8.5 Hertz (Hz) activity (Green, Green & Walters, 1970). In an effort to facilitate production of the reverie state and hypnogogic imagery, the investigators developed an alpha-theta biofeedback system that provided information to the subject about both alpha and theta production. As memory for the content of images in the hypnogogic state is often poor, subjects were asked to verbalize the imagery. The investigators thought that the production of the alpha-theta twilight state "should prove to be a powerful technique for the study creativity enhancement in particular, and the hypnagogic state, in general." They suggested the possibility of using the alpha-theta state for psychotherapy (Budzynski, 1973).

Alpha brainwaves are smooth, high-voltage brainwaves in the frequency range of 9-13 Hertz. Some research suggests that alpha brainwaves are associated with a subjective state of relaxed alertness or tranquillity (Brown, 1970; Stoyva and Kamiya, 1968) while other research suggests that alpha brainwaves are not associated with any particular subjective physiological state (Walsh, 1973).

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The theta rhythm state is defined as a dominance for 4-7 Hertz brainwaves. Transient elevation of theta occur during Zen meditation (Kassamatsu & Hirai, 1969) or while entering the early stages of sleep and are reported to be associated with vivid visualization, imagery and dream-like states. The origin of theta waves is predominately the hippocampus (Michel et al., 1991), although theta activity can be recorded throughout the cortex and cerebellum (Green, Green & Walters, 1971).

In the late 1980's, the advances in digital processing technology gave clinicians and researchers biofeedback equipment that significantly improved the quality of EEG neurofeedback signal compared with that previously available using analog filters. The availability of high-speed desktop computers opened new possibilities for neurofeedback training and research. New neurofeedback equipment incorporated high-speed analog-to-digital converters and computers for data logging and the creation of data displays using fast-fourier transforms. In addition, some neurofeedback equipment could now automate data logging and session statistics.

It was during the late 1980s and early 1990's that Peniston and Kulkosky developed an innovative therapeutic EEG alpha-theta neurofeedback protocol (Peniston & Kulkosky, 1989, 1995) for the treatment of alcoholism and prevention of its relapse. The Peniston/Kulkosky brainwave neurofeedback therapeutic protocol combined systematic desensitization, temperature biofeedback, guided imagery, constructed visualizations, rhythmic breathing, and autogenic training incorporating alpha-theta (3-7 Hz) brainwave neurofeedback therapy (Blankenship, 1996; Peniston & Kulkosky, 1989, 1990, 1991, 1992; Saxby & Peniston, 1995). These investigations prompted a reexamination of EEG neurofeedback as a treatment modality for alcohol abuse. Successful outcome results included a) increased alpha and theta brainwave production; b) normalized personality measures; c) prevention of increases in beta-endorphin levels; and d) prolonged prevention of relapse. These findings were shown to be significant for experimental subjects who were compared with traditionally treated alcoholic subjects and non-alcoholic control subjects. Subjects in several studies were chronic alcoholic male veterans, some of whom also suffered from combat-related posttraumatic stress disorder. For many subjects, pharmacological treatment was not generally beneficial. Data suggested that alpha-theta brainwave neurofeedback training appeared to have potential for decreasing alcohol craving and relapse prevention.