Audio-Visual Entrainment as a Treatment Modality for Post-Traumatic Stress Disorder (Part Four)
By David Siever
Abstract: Post-traumatic stress disorder (PTSD) is the aftermath of trauma. Trauma spans a diverse spectrum of unfortunate life experiences such as sexual abuse, assault, car accidents, war, and natural disasters. PTSD occurs when the inflicted can no longer mentally cope with the situation. Following trauma, permanent changes occur within the brain that increases “racy-headedeness,” guardedeness, anxiety, depression, insomnia, plus memory and cognitive impairments. The behavioral aftermath of PTSD also typically involves increased aggression and drug and alcohol abuse. Audio-visual entrainment (AVE) has been shown to reduce anxiety, insomnia and improve coping for police officers and military. AVE has also been shown to reduce depression and anxiety among vets with chronic fatigue syndrome and fibromyalgia.
As mentioned previously, people with lingering PTSD and clinical depression are low in serotonin, dopamine and norepinephrine. Figure 15 shows that 30 minutes of white-light AVE at 10 Hz increased serotonin levels by approximately 23%, endorphin levels and norepinephrine by 18%, (Shealy, et al, 1989) leading to increased hopefulness, self-esteem, mental sharpness, improved sleep, reduced pain and reduced anxiety.
The Effect of White Light AVE on Neurotransmitter Production
Cerebral Blood Flow and Metabolism
SPECT and FMRI imaging of CBF show that hypoperfusion of CBF is associated with many forms of psychiatric disorders. Of particular concern are conditions involving hypoperfusion of CBF in frontal lobes. Frontal lobe issues include anxiety, depression, attentional and behavior disorders, and impaired cognitive function (Amen, 1998). Adequate CBF is essential for good mental health and function. AVE increases brain glucose metabolism and CBF (Sappy-Marinier et al., 1992). Figure 16 is a study by Fox and Raichle (1985) showing marked increases in CBF, with a 28% peak increase at 7.8 Hz in the striate cortex (a primary visual processing area). Overall whole brain oxygen consumption increased by 5%. Accomplished Zen meditators show a peak frequency of 7.8 Hz during meditation (Cade, 1987).
Cerebral blood flow at various AVE repetition rates.
In addition, AVE has also been shown to increase CBF throughout various other brain regions including frontal areas (Mentis, et. al., 1997; Sappy-Marinier, et. al, 1992). A whole head PET analysis of visual entrainment at 0, 1, 2, 4, 7, and 14 Hz on 19 healthy, elderly (mean age=64 years) subjects (Mentis, et. al., 1997) found that regional cerebral blood flow (rCBF) was activated differentially with the:
1) left anterior cingulate showing maximal increases in rCBF at 4 Hz.
2) right anterior cingulate showing decreases in rCBF with frequency.
3) left middle temporal gyrus showing increases in rCBF at 1 Hz.
4) striate cortex showing maximal rCBF at 7.8 Hz.
5) lateral and inferior visual association areas showing increases in rCBF with frequency.
In 1995, David Trudeau, a physician with the VA Hospital in Minneapolis conducted a study on 15 war vets, all suffering from PTSD. The volunteer subjects received 60 daily sessions of AVE at 18 Hz. Pre and post intervention, QEEGs, Beck Depression Inventory (BDI), McGill Pain Questionnaire (MPQ), Test of Variables of Attention (T.O.V.A.), and DSM-IV Attention Deficit and Hyperactivity Disorders (ADHD) symptom checklist were done. None of the subjects had Wender Utah criteria for childhood ADHD.
As of summer 1999, ten subjects have completed the study. Following 60 daily sessions of 15 minutes of AVS at 18 Hz, there was a significant decrease in BDI scores from an average of 17 to 9 (p<0.05) and DSM-IV impulsivity-hyperactivity criteria from 3 out of 9 to 0 out of 9 (p<0.01). Consistent with the decrease in self-assessed impulsivity is a trend toward decreased impulsivity on the T.O.V.A. Anecdotally, subjects reported onset of dreaming and improved sleep and higher energy levels. Focus may be improved following AVS, and depression symptoms may be improved. Clearly more study is required, and further trials should include sleep assessment.
John Carmichael’s PTSD Work with the Royal Canadian Mounted Police (2006).
Dr. Carmichael is the approved and designated clinical psychologist to the Royal Canadian Mounted Police in British Columbia, Canada. Currently, most of his private practice in clinical psychology is with police officers who most typically present with depression in which accumulated traumatic incidents have played a significant role, or with Post-Traumatic Stress Disorder (PTSD), or with both depression and PTSD. Given that the police have a tendency to wait until the last minute for treatment, their symptoms are very marked in both number and intensity and have been on-going for a considerable time.
However, since discovering our DAVID technology, Dr. Carmichael now includes audio-visual entrainment for all of his police clients with depression and/or PTSD once there is psychophysiological confirmation that they have mastered diaphragmatic breathing, that they can establish an RSA pattern, and that the entrainment creates desirable changes.
Most police officers continue to use the DAVID AVE devices on a daily basis. It is clear that well over 90% of his police clients find the DAVID helpful. Among the most common findings are:
A rapid decrease in both autonomic nervous system hyper-arousal/hyper-reactivity and muscle tension (I show clients the changes during their first session with DAVID in my office);
A longer and longer duration of these positive effects the more frequently they use the DAVID;
A rapid increase in mental calmness and corresponding decrease in “monkey mind” (thoughts all over the place);
Rapid improvements in sleep (reduced latency to sleep onset, decreased night waking, and increased sense of restfulness come morning) when they use it at regular bedtime and again if they wake during the night and are unable to fall back asleep within 15 minutes; and what appears to be self-initiated changes in both behaviour and cognitions even before any formal introduction of cognitive behavioural therapy.
Chronic rumination, hypoperfusion of CBF, loss of neurotransmitters, altered brain wave activity, and adrenal fatigue all contribute to PTSD and the continuation of PTSD. These effects also play a part in anxiety, bodily ailments of all kinds, aggression toward family and civilians at large, depression, substance abuse, and loss of work productivity. Interventions to help those with PTSD are poor at best and can have significant, unwanted side-effects.
The DAVID AVE dissociates those experiencing PTSD away from destructive distressing rumination, increases blood flow, normalizes brain wave and neurotransmitter production, calms the limbic system, restores the adrenals, and produces somatic relaxation. The subjective benefits of AVE are reduced anxiety, improved sleep, improved mood, increased energy, improved relationships with family and civilians, reduced physical problems, improved productivity and reduced dependence for medications or self-medicating on alcohol and recreational drugs.
There are hundreds of anecdotal cases of childhood and adult trauma, including abused women, police and emergency personnel confirming the benefits of AVE as a treatment methodology. AVE has been shown to reduce depression and impulsiveness while improving sleep in war vets with either chronic fatigue syndrome or fibromyalgia syndrome (Trudeau, 1999). AVE also has a proven history in treating posttraumatic stress related disorders for the Royal Canadian Mounted Police (RCMP) in Kamloops, British Columbia, where 90% of the officers respond with improved sleep onset and quality of sleep and with reduced daytime anxiety.
About the Author
Dave Siever of Mind Alive, Inc. has lectured and provided workshops with leading psychological institutions including the Association of Applied Psychophysiology and Biofeedback, the International Society of Neurofeedback and Research, the College of Syntonic Optometry, American College for the Advancement of Medicine, Walden University, the University of Alberta, Open University-England, A Chance to Grow Charter School, STENS Biofeedback Training Programs and other venues. Dave Siever has been designing and studying AVE since 1984 when he originally developed the DAVID1 to help performing-arts students overcome stage fright.
©Mind Alive Inc. (2012) Dave Siever