Audio-Visual Entrainment as a Treatment Modality for Post-Traumatic Stress Disorder (Part Three)
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.
Audio-Visual Entrainment as a Treatment Modality for PTSD
All sensory information, except for smell, must pass through the thalamus in order to gain access into other brain regions. When lights are pulsed into the eyes or tones pulsed into the ears, the nerve pathways from the eyes and ears carry the evoked potentials into the thalamus. When a repetitive stimulus of the proper frequency and sufficient strength to excite the thalamus is present, their frequency signature is shown in the EEG. From there, the entrained electrical activity within the thalamus is amplified and distributed throughout other limbic areas and the cerebral cortexes via the cortical-thalamic loop. This is a signaling loop between the cerebral cortex and the thalamus that generates the alpha rhythm at roughly 10 Hz during neuronal rest (Demos, 2005). This effect of modulating the cortical-thalamic loop with light and sound is known as audio-visual entrainment (AVE). In essence, AVE) is the continuous electrical response of the brain in relation to the frequency of the stimuli plus the mathematical representation (harmonics) of the stimulus wave shape.
The Digital Audio Visual Integration Device (DAVID) AVE devices present pulsed light to the user via a pair of glasses (Tru-Vu Omniscreen™ Eyeset) with an array of flashing LEDs and pulsed tones through a pair of headphones. Because most maladies have an abnormal brain wave signature, the DAVID AVE device can help treat a host of maladies including anxiety, depression, insomnia, impact of trauma, a racy mind, attentional disorders, fibromyalgia and cognitive decline and risk of falling in seniors.
Entrainment occurs best near the natural alpha frequency from 9 to 11Hz (Toman, 1941). The results of a study by Kinney et al, (1973), shown in Figure 3, shows strong and pure entrainment at 12 Hz. The harmonics (small wavelets) seen in the EEG are a reflection of the harmonics produced in the EEG from the Xenon square-wave, strobe-light stimuli.
Entrainment primarily shows itself in the frontal, central and parietal regions. (Siever, 2002). AVE presents itself strongest at a person’s natural alpha frequency, which is close to 10 Hz for the normal population (Toman, 1940). Given that PTSD most commonly causes enhanced beta and suppressed alpha activity, coincident with high arousal (Jokic’-Begic’ & Begic’, 2003), AVE can rapidly reverse the brain wave effects of PTSD as shown in.
Hows the results of a 19-channel QEEG (Demos, 2005) as processed through the SKIL (Sterman-Kaiser Imaging Labs) database in 1 Hz bins (sorted into 1 Hz groupings) showing the frequency distribution of AVE at 7.8 Hz. The area within the green circle at 8 Hz shows maximal effects of AVE in central, frontal and parietal regions (at 10 microvolts, in this case) as referenced with the area in the oval on the legend. It is through these effects that AVE has proven effective in treating depression, anxiety and attentional disorders. A 16 Hz., second harmonic is also present (the circled image), which is typical of semi-sine wave (part sine-wave / part square-wave) stimulation.
Brain map in 1 Hz bins – during 7.8 Hz AVE (SKIL-Eyes Closed) AVE at 18.5 Hz has also been shown to produce dramatic increases in EEG amplitude at the vertex of the head (Frederick, Lubar, Rasey, Brim, & Blackburn, 1999). It was found that: eyes-closed 18.5 Hz. photic entrainment increased 18.5 Hz EEG activity by 49%. eyes-open auditory entrainment increased 18.5 Hz. EEG activity by 27%. eyes-closed auditory entrainment increased 18.5 Hz EEG activity by 21%. eyes-closed AVE increased 18.5 Hz. EEG activity by 38.3%.
Normalizing EEG Activity in Depression
Studies suggest that a significant number of those with PTSD develop depression, characterized by frontal alpha asymmetry with more left frontal alpha activity as compared with right frontal alpha activity (Gordon, et al, 2010; Rabe, et al., 2008).
To help treat depression from an electro-neuro perspective and re-balance the frontal lobes we need to re-excite the left frontal lobe (the happy side) and suppress the right frontal lobe (the fear-based side). So two conditions must be met:
a) we must inhibit the excessive left-frontal alpha (thus “waking” it up).
b) we must simultaneously boost right frontal alpha (calming it down). Therefore, we need a means whereby we can affect both frontal lobes independently of each other.
It has been shown (above) that AVE clearly increases alpha and beta activity, but to treat depression, we also need a way that can suppress alpha in the left frontal lobe. Visual Entrainment has been found to inhibit brain wave activity at the ½ frequency of stimulation, thus satisfying condition a). Shows an ADHD child with aberrantly high theta, in which 14 Hz visual entrainment was used to suppress it at the 30 minute mark. (Collura & Siever, 2009). Notice how rapidly the excessive theta disappears. In the case of depression, we can stimulate with 20 Hz and inhibit the 10 Hz alpha activity.
Suppression of Theta in an ADHD Child Using 14 Hz Photic Stimulation.
Independent hemispheric stimulation is accomplished by utilizing the optic chiasm (Siever, 1995), thus satisfying condition b). Stimulating the right fields of both eyes with a different frequency than the left-fields as shown in Figure 6, can accomplish this. Figure 6 depicts stimulus “A” at 12 Hz and stimulus “B” at 4 Hz. Notice the corresponding frequency evident in the opposite hemisphere of the brain. For treating depression, 18-21 Hz stimulation in the right fields would inhibit the left-frontal alpha from 9–10 Hz, thus boosting activity. Stimulating at 10 Hz in the left fields, will boost right-frontal alpha, thus calming activity.
Patented Technique for Independent Hemispheric Stimulation. Shows the QEEG (also referred to as a brain map) of a happy person as compared to the Sterman-Kaiser Imaging Labe (SKIL) normative database. This person constantly exhibits approach behavior towards socializing and what she considers to be fun activities. Notice that alpha activity is stronger in the right frontal lobe, the EEG signature typically associated with happiness.
Normative Brain Map of a Happy Person. (SKIL-Eyes-closed).
Shows a fairly typical brain map of a person with depression and anxiety from trauma as shown on the SKIL database. The scale is 2.2 standard deviations (SD) and the pink area in the alpha view is actually 2.6 SD. Activity above 2 SD is considered a clinical abnormality. Notice that alpha activity is higher on the left side coincident with a personality trait based on a focus of withdrawal and avoidance from selfr-perceived negative stimuli. Also, the generalized red colored region is an indicator of generalized cognitive fatigue. The Beta 2 activity is just approaching 2.2 SD (an indication of mild anxiety). Non-clinical persons have greater right frontal alpha associated with an attraction toward positive stimuli (Demos, 2005).
Brain Map of Individual with Depression and Anxiety (SKIL – eyes closed)
Approximately 10 minutes following a 30-minute AVE session designed to reduce the symptoms of depression, both alpha and beta activity is normalized as shown below in Figure 9. Notice that the frontal alpha activity and the Beta 2 activity, has been reduced to roughly 1.2 SD above the norm (non-clinical). The participant was also well aware of his elevated mood and energy. Brain map following depression reduction AVE session (SKIL – eyes closed) Body/Mind Effects of Audio-Visual Entrainment
We conceptualize AVE as achieving its effects through several mechanisms at once (Siever, 2000). These include:
1. dissociation/hypnotic induction
2. increased neurotransmitter production
3. increased cerebral blood flow
4. normalized EEG activity
Dissociation, as a tool in psychotherapy, helps in diminishing the emotional component of disruptive memories. Dissociation, when referring to AVE, is a disconnection of self from thoughts and somatic awareness, as experienced during deep meditation (Figure 10). AVE induced dissociation is rapid, requires only 4 to 10 minutes in most cases and provides an excellent means for clearing a tormented, chattery mind of destructive, fearful thoughts and allowing the person to relax and restabilize (Siever, 2000).
Clearing the mind (dissociating) from negative thoughts using AVE.
Visual entrainment alone, in the lower alpha frequency range (7 to 10 Hz), has been shown to easily induce hypnosis (a form of dissociation). It has been shown that nearly 80% of subjects enter into a hypnotic trance within six minutes during alpha photic entrainment (Kroger & Schneider, 1959).
Photic stimulation induction of hypnotic trance
Inducing dissociation using AVE was found to be more effective than dot staring or stimulus deprivation (Leonard, et al., 1999). AVE also proved to be effective in dissociating people with dissociative anxiety. As expected, subjects experienced increased anxiety during dissociation, but simultaneous relaxation with slowed heart rate was also observed (Leonard, et al, 2000). The DAVID AVE proved to be effective in stopping distressing mental chatter and as an effective desensitization tool for reducing anxiety that is often seen in the PTSD population.
As mentioned, the amygdala initiates the activation of the fight-or-flight response, which activates the hypothalamus, which in turn controls all autonomic functioning and is responsible for the tensed-up feeling in the body (chest breathing, shortness of breath, racing heart, cold, clammy hands, tense muscles, etc.) that is experienced during a fear response. Anyone who has consumed too much coffee will be familiar with these feelings.
Properly applied AVE produces a calming effect on limbic structures, such as the amygdala and hypothalamus, in which muscles relax (Thomas & Siever, 1989), electrodermal activity settles down, peripheral blood flow stabilizes (hand temperature normalizes to 86 to 90 F), breathing becomes diaphragmatic and slow, and heart rate slows and becomes uniform (Siever 2000). As a result, AVE can re-induce a relaxed state of mind and calm disposition, thus providing some badly needed time away from the distressing thoughts. Figures 12 and 13, show the calming effect of AVE on the somatic functions of forearm EMG (electromyography) and finger temperature (Hawes, 2000). Heart rate and heart-rate variability (HRV) are sensitive measures of stress (Stein, P., Kleiger, R. (1999). Figure 14 shows graphs of the emWave HRV analysis system by Heartmath. It shows dramatic improvements in both heart rate and HRV in a woman with PTSD after discovering that her husband molested two young girls. Within 10 minutes, her heart rate dropped by 22 bpm, and she showed dramatic reductions in both sympathetic and parasympathetic activity (notice the blue mountains). Forearm EMG levels during AVE (Hawes, 2000).
Peripheral temperature levels during AVE (Hawes, 2000).
Pre and post HRV in a woman with adult PTSD
©Mind Alive Inc. (2012) Dave Siever