Updated: Jul 8, 2019
It is with the cleverly crafted words of Fran Lebowitz that I begin our first blog post, “Think before you speak. Read before you think.” I start with this because I want to introduce readers to the type of conversations that will occur on this page. While our blog posts will certainly bring an element of relatability and personality, we also aim to cite and include information from evidence-based, peer-reviewed, scholarly articles in the hope of learning something new together!
With that said, our first blog post will briefly touch on the effects of trauma on the adolescent brain, particularly the female brain. Later, I will incorporate some research on why/how neurofeedback training can be of help to adolescent trauma survivors.
“40% of sexual abuse survivors participate in self-injurious behavior, of one form or another” (Lev-Wiesel & Zohar, 2014; as cited in Suyemoto, 1998). Often, this self-injurious behavior involves a level of dissociation (Lev-Wiesel & Zohar, 2014). Peritraumatic and persistent dissociation are two types of dissociation associated with self-harm and trauma. Peritraumatic dissociation is the type of dissociation we typically see present itself as a sort of “protective barrier” during the traumatic or stressful event. The best way I've heard this described, by Dr. Frank Ochberg, is that it essentially you "giving your body up to protect your soul", "a form of natural anesthesia." Whereas, persistent dissociation is longer lasting and can generally make it more difficult for the individual to access (and therefore, resolve) the memories (Lev-Wiesel & Zohar, 2014).
This causes concern because this persistence often paves the way for continuous psychopathology and distress due to the inability to process it. Dissociation and self-injurious behaviors are just two symptoms, or behaviors, that can surface after trauma. We see the effects of trauma on a much deeper level, as well.
For adolescent females, in particular, the occurrence of mood-related disorders appears to increase after trauma (Malhi et al., 2019). During the “pre-teen” years, many adolescent females receive labels such as, “moody,” “difficult,” or even “bratty.” However, we know that this critical development period is when the brain enters one of its most malleable, or “plastic” states (Malhi et al., 2019). High plasticity in the brain means more susceptibility, change, growth, and formulation of new connections. While this is crucial for development, the brain is left rather vulnerable to harmful experiences that involve stress and trauma (Malhi et al., 2019).
This harmful exposure often leads to symptoms associated with depression, anxiety, PTSD, and mood disorders. Our limbic system, the brain’s HQ for all things memory, emotion, and motivation (or stimulation), plays the VIP role concerning the development of mental health disorders after trauma (Malhi et al., 2019). Why? Because the limbic system houses our hippocampus, and our hippocampus is especially sensitive to trauma and distress (Malhi et al., 2019).
Interestingly enough, the type of trauma (emotional, physical or sexual abuse), age of the individual when the trauma occurred, and the individual’s sex at birth all play a unique role in how the traumatic experience impacts the hippocampus (Malhi et al., 2019). Research by Infurna et al., 2016 & Mandelli et al., 2015 found that emotional abuse typically produces more harmful outcomes, than does sexual or physical abuse (Malhi et al., 2019; as cited in Infura et al., 2016; Mandelli et al., 2015).
How does this relate to neurofeedback, and how can neurofeedback help?
“Developmental trauma,” a term essentially describing what I’ve described above, is the trauma occurring during a critical time of development (Frick, Curtis, Rainey, & Simpson, 2018). This type of trauma can have an especially damaging impact on our neurological functioning (Frick et al., 2018). This, however, is where neurofeedback training makes waves- brain waves, to be exact.
Neurofeedback training, a modality of “biofeedback training,” in short, “retrains and stabilizes” our brain (Frick et al., 2018). It achieves this through the work of a qEEG, rewarding our brain for doing what we ask it to via our protocol. Often, as is the case in our office, this “reward” is a movie of the client's choosing reappearing on the screen after dimming out. The movie reappears when the brain is doing what we’ve asked and disappears when it is not (AKA when it is performing how it is used to performing). The movie is accompanied by a secondary reward, an audio stimulation reward (such as a “ding” sound in the background).
In summary, we are helping the brain “re-train” itself. Research conducted by Frick et al., 2018 shows us that neurofeedback training can be particularly helpful for adolescent female (and male) trauma survivors by enhancing memory, impulse control, emotional regulation, attention, and focus. Furthermore, and the part that seems to resonate most with our adolescent female clients, is that self-esteem and self-confidence appear to increase!
All of this to say, this information helps us better grasp, understand, and practice empathy for these clients, while introducing a (relatively) new and effective form of treatment - neurofeedback. Which, in turn, will help our clients gain more self-awareness, and begin to show compassion for themselves: a therapist’s ultimate goal.
References/ If you’d like to read more:
Frick, M.H., Curtis, R., Rainey, H.T., Li, Y., Simpson, M. (2018). Working With Developmental Trauma: Results of Neurofeedback Training With Adolescent Females and Counseling Implications. Journal of Behavioral and Social Sciences, Vol (5). Retrieved from:
Malhi, G.S., Das, P., Outhred, T., Irwin, L., Gessler, D., Bwabi, Z., Bryant, R., & Mannie, Z. (2019). The effects of childhood trauma on adolescent hippocampal subfields. Australian & New Zealand Journal of Psychiatry, Vol. 53 (5). Retrieved from: https://journals-sagepub-com.proxy1.library.jhu.edu/doi/full/10.1177/0004867418824021
Lev-Wiesel, R., & Zohar, G. (2014). The Role of Dissociation in Self-Injurious Behavior among Female Adolescents Who Were Sexually Abused. Journal of Child Sexual Abuse, Vol (23). Retrieved from: http://web.b.ebscohost.com.proxy1.library.jhu.edu/ehost/detail/detail?vid=0&sid=814d0090-db27-4190-8c68-d13776431b6c%40sessionmgr103&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl
Suyemoto, K. L. (1998). The functions of self mutilation. Clinical Psychology Review, 18(5), 531–554.