Combining EMDR with Neurofeedback

In 2015/16, I was facing a particularly challenging time in my life, personally and professionally. The impact was such that I developed an unretractable insomnia that prescription medication wasn’t alleviating, and while EMDR was keeping me afloat, it wasn’t enough. A psychologist friend who had benefitted from Neurofeedback (NF) following his stroke suggested I try it. NF fundamentally changed the way my brain functions and reduced the underlying anxious brain I once had. My insomnia resolved after 16 sessions.

Neurofeedback (NF) is best described as “brain training” for the layperson. Technically, NF is electroencephalogram (EEG) biofeedback. It is useful for treating seizure disorders, AD/HD, depression, post-traumatic stress injury symptoms, anxiety disorders, and optimal performance for sharpening mental focus for athletes, musicians and CEOs. There have been 150–200 peer-reviewed journal articles on its efficacy each year since 2014.

For Complex PTSD, I’m not sure anything is better than Neurofeedback (NF) because it’s completely natural, non-invasive, gentle to the client (watching movies and playing video games is not a threatening or frightening activity), and incredibly powerful. NF will probably result in the same number of sessions for a treatment plan compared to psychotherapy, minus the abreaction. No tissues are needed during the sessions and there's no jolt to the nervous system. NF has reminded me of the power of brain regulation and the brain’s own desire to function as efficiently as possible.

I do not. Developments in neuropsychology and brain imaging over the past 20 years have shown us as a treatment community that verbal narrative does not sufficiently treat trauma. This is because of the specific ways in which Broca’s area of the brain and the limbic area of the brain function separately from each other. We cannot reach trauma with words. Bessel van der Kolk calls this “speechless horror”.

Neurofeedback has the ability to target specific areas of the brain that need calming and increased self-regulation.

Per a 2020 randomized controlled study, 24 sessions of Neurofeedback (NF) “significantly decreased PTSD symptoms, internalizing, externalizing, other behavioral and emotional symptoms and significantly improved the executive functioning of children aged 6–13 with severe histories of abuse and neglect who had not benefitted from any previous therapy.”

More information is available at the following link:

https://www.researchgate.net/publication/342908715_The_impact_of_neurofeedback_training_on_children_with_developmental_trauma_A_randomized_controlled_study

This can absolutely be done. Anna Gerge published a study in 2020 in which 10 sessions of Neurofeedback and one session of EMDR were combined to treat a client with Complex PTSD and a dissociative disorder. The four-month follow-up had such a significant improvement that the dissociative disorder and PTSD diagnostic qualifications were no longer met.

More information is available at the following link:

https://www.sciencedirect.com/science/article/abs/pii/S2468749920300272?via%3Dihub

Neurofeedback (NF) can be used for both. Gerge’s study (see above) speaks to the efficacy of using both modalities. Alpha Theta NF is used for trauma reprocessing and is the most gentle to a client’s nervous system that I have witnessed as a therapist. The client is so relaxed that they are almost asleep during the reprocessing. I use NF in the stabilization phase and trauma processing phase of treatment.

EMDR is helpful to directly target and unravel negative self-image and its impact on relationships. Neurofeedback tends to produce similar positive results; spouses and intimate partners of clients often express that the client is easier to live with, less argumentative, more relaxed, and has a generally happier disposition.