Reward Frequency — A Breakthrough in Getting Low Enough
by Sue Othmer | May 10th, 2006While our inhibit filters typically cover the entire 0-30+ Hz band, it is clinically useful to target the reward frequency very specifically for each individual and each site. We find that the optimal training band can be anywhere from 0 to 30+ Hz. We also find that the majority of our clients need reward frequencies much closer to 0 than to 30 Hz. Every time we find a way to train which allows more calming, it seems that we have a surprising number of clients for whom we wish we could achieve even more calming.
With interhemispheric training, we know that the optimum reward frequency at T3-T4 (or C3-C4) for a given individual reliably predicts the optimum reward for interhemispheric training at parietal or occipital sites (4 Hz lower) or frontal or prefrontal sites (2 Hz lower). Since many high-arousal clients need a T3-T4 reward frequency lower than 4-7 Hz, we are unable to train low enough when we move to the back of the head. This is often a problem for autistic, reactive attachment disorder or bipolar children, and even for very hyperactive ADHD children.
We have more recently moved to left and right side training separately in order to train low enough for a significant number of clients. In revisiting left and right side reward frequencies, we find that left-side training typically requires a reward frequency 2 Hz higher than right side. The primary advantage is that we can move front or back — staying on one side — without changing reward frequency. Whatever is optimal at T4-C4 will also be optimal at, for example, T4-P4 and T4-Fp2. This has allowed us to work much more effectively with high arousal clients. But again we have a surprising number who require a 0-3 Hz reward right side, and some who need 0-3 Hz left side as well. And still we are often wishing we could get lower.
During a recent phone consult, Carl Shames told me that he had been experimenting with bringing down the center frequency of the reward band by narrowing the filter. On his BrainMaster he moved from training 0-5-2.5 Hz (equivalent to 0-3Hz) down to 0.5-2.0 and then 1.9 and 1.8. He was finding that he was getting a significantly more calming effect with the lower center frequency.
We have used 3 Hz (or sometimes 2 Hz) wide filters to maintain sufficient speed of response and prompt feedback. Mathematically, narrower filters respond more slowly. But as we get down near 0 Hz, everything moves more slowly in any case. Clearly the clinical effect is still there with these narrower bands near zero, so this is worth pursuing and we will see how it sorts out. In the last couple weeks we have begun moving a number of clients down from 0-3 to 0-2, 0-1.5 and even 0-1.0 Hz. Slight changes are giving us obvious effects, so it is likely that even 0.1 Hz shifts in the top frequency will have an impact at these frequencies.
Yesterday we had an amazing breakthrough with a young child who is severely autistic and severely agitated. While he has benefited significantly from about 15 sessions so far, he has continued to be tense and anxious and unhappy in sessions, and fearful in his life. Last week we moved from T4-P4 0-3 Hz down to 0-2 Hz. The effect was slightly better. Yesterday we moved to 0-1.5 Hz. The effect in the session was amazing. There was no fussing or crying or squirming. He was physically relaxed and calm as he gazed intently at Inner Tube. He even smiled during the session. I had never seen him smile before. He made contented noises instead of whimpering. At the end of the session he turned and kissed his mother. I am looking forward to hearing the report when he comes back for the next session.
Today I did a session with an adult with extreme high arousal — anxiety, fear, panic, etc. — at 0-1.0 Hz. She has already benefited significantly from many sessions of neurofeedback, but we have struggled to achieve sufficient calming. After T4-P4 and T4-Fp2 0-1.0 Hz her heart was lighter, she reported the lifting of fear, and she was smiling when she left the office. Fp2 or FpO2 are sensitive sites, which we sometimes have difficulty training because we can’t get low enough. For those high arousal clients who tolerate only T4-P4 at 0-3, these lower bands open the possibility of also successfully training right prefrontal for fear and attachment issues.
We are again extending the range of whom we can help and how much we can help them. I never know where the next breakthrough will come from, but they do keep coming and they are always fun to sort out and incorporate into our work.