This presentation will provide the non-sleep specialist neurofeedback provider with an overview of the tools and techniques necessary to recognize, assess and manage a variety of sleep complaints with which clients typically present. One rationale for alleviating sleep disturbance in this population is that left unmanaged poor sleep will undermine the effectiveness of neurofeedback training.

Also presented will be a summary of the current thinking in management of Insomnia today based on the recent NIH State of the Science statement, June 2005.

Workshop #127): From Neurofeedback to Sleep: Tools and Techniques to Recognize and Manage Insomnia to Enhance Neurofeedback Efficacy

This workshop will provide the non-sleep specialist neurofeedback provider with tools and techniques necessary to recognize, assess and manage a variety of sleep complaints with which clients typically present. One rationale for alleviating sleep disturbance in this population is that left unmanaged poor sleep will undermine the effectiveness of neurofeedback training. Additionally, you will learn enough to manage even your difficult insomnia clients rather than needing to refer out.

Also presented will be a discussion on the current thinking in management of Insomnia today based on the recent NIH State of the Science statement, June 2005.

Workshop #130): Psychoneurenergenetics and Neurofeedback : A Bridge Between East and West?

This workshop is designed to provide the neurofeedback provider with a radically different view of the therapeutic approach to the neurofeedback training process and it’s relation to ancient mental training practices, like mindfulness meditation.

Plenary #132): Psychoneurenergetics and Neurofeedback: A Bridge Between East and West?

This presentation is designed to provide the neurofeedback provider with a radically different view of the therapeutic approach to the neurofeedback training process and it’s relation to ancient mental training practices, like mindfulness meditation. The psychoneurenergetic view holds that there is an energetic connection established between the client, practitioner and technology that allows a more direct connection with the client in the therapeutic relationship, through fostering presence in the moment. This energetic connection is always present in a caring therapeutic relationship, yet, usually goes unrecognized or unappreciated as the powerful tool that it is.

Plenary #126): From Neurofeedback to Sleep: Recognize and Manage Sleep Disturbance to Enhance Neurofeedback Efficacy

Workshop #127): From Neurofeedback to Sleep: Tools and Techniques to Recognize and Manage Insomnia to Enhance Neurofeedback Efficacy

What is the connection between sleep and neurofeedback training?
Is there a relationship between adequate sleep and neurofeedback efficacy?
How does one manage the myriad complaints and presentations that accompany insomnia, and know when to refer out?
Are there techniques, other than or in addition to neurofeedback, that actually work?
What is the State of the Science of Insomnia, according to the NIH?

This workshop is designed to provide the non sleep specialist neurofeedback provider with the tools and techniques necessary to recognize, assess and manage a variety of insomnia complaints with which clients typically present. One rationale for alleviating sleep disturbance in this population is that left unmanaged poor sleep will undermine the effectiveness of neurofeedback training. Additionally, you will learn enough to manage even your difficult insomnia clients rather than needing to refer out.

Time permitting, also presented will be a discussion on the management of Insomnia today as reflected in the recent NIH Statement on State of the Science.

What is insomnia?
The most common sleep complaint in adults is insomnia, generally defined as the subjective sense that sleep is difficult to initiate or maintain, or that sleep itself is non-refreshing. Prevalence studies have shown that nearly one-half of the adult population experiences insomnia (30-50% acute problem, 10-15% as a chronic problem). Many sufferers report daytime consequences similar to those associated with chronic sleep deprivation: fatigue, performance decrements and mood disturbances. The daytime impairments result in poor quality of life, decreased productivity, higher accident rate and increased morbidity with augmented use of medical facilities. These findings present an obvious cause for concern in society.

Treatment: Where possible, treatment should be addressed toward correction of the underlying cause, particularly when there are associated medical/psychiatric issues. Simple changes in routine, living situation and food intake may be effective. In all cases, education regarding the mechanics of sleep, i.e., sleep promoting and interfering behaviors, is important.

Specific treatment regimens are generally implemented in accordance with the time-course of symptoms. Transient insomnia, lasting a few days to a couple of weeks is usually associated with transmeridian travel, a brief illness or stressful event (next day exam or presentation) and hypnotics can be used as the main therapy. The most effective are the newer medications with similar chemical structure or agonist like compounds to the benzodiazepine class. Short term insomnia, lasting several weeks to a month is usually associated with more traumatic life events that can be negative (death of a loved one, divorce or sudden hospitalization) or positive (marriage, job promotion, birth of a child). Although hypnotic therapy is indicated over the short term, behavioral therapies and education are important to prevent the development of chronic insomnia. The longer insomnia persists, the more complex are the causes and treatment.

Long term or chronic insomnia may last months to years. There are well-recognized effective behavioral treatments available to address the symptoms of chronic insomnia: sleep restriction, cognitive therapy, relaxation therapies, stimulus control and neuro/biofeedback feedback, generally referred to as cognitive-behavioral therapy (CBT). These therapies have common modes of action and relieve insomnia by either reducing emotional/somatic arousal (cognitive and relaxation therapy, stimulus control, neuro/biofeedback) or improving sleep efficiency (sleep restriction). CBT is typically employed during an 8-10 week program and has been recently shown to be the most beneficial treatment regimen for chronic insomnia by the NIH, with long-term efficacy. The longest controlled trial of any hypnotic is one year and given the chronic persistent nature of insomnia it is unclear of the long-term role of these medications. While recent advances in hypnotic selectivity have provided improved medications, when withdrawn treatment effects are reduced or lost completely. Consequently, hypnotics should not be viewed as the sole source of treatment particularly in the case of chronic insomnia. Rather, medication should be utilized as reinforcement for the educational and behavioral techniques.

NIH Statement on State of the Science
1. Acknowledges for the first time that Insomnia, while comorbid with many other disorders, particularly psychiatric disorders, is a distinct and independent disorder requiring separate, simultaneous management.
2. This statement recognizes the paucity of data on long-term consequences of insomnia and the long-term effects of current therapies.
3. Supports the finding that CBT is the most efficacious therapy at present, particularly in long-term gains, although there is some very new evidence to suggest that newer benzodiazepine-like agonists may be effective for up to one year.
4. Calls for significantly increased and broadened research agenda, including head-to-head comparisons between hypnotics with a CBT group.

What is the relationship of sleep disturbance to neurofeedback efficacy?
Clearly, the brain that is not restored by sleep is less apt to perform well under normal circumstances. Since NF efficacy is thought to be dependent upon brain plasticity, and brain plasticity requires normal functional capacities, sleep-deprivation adversely impacts brain plasticity.

Workshop #130): Psychoneurenergenetics and Neurofeedback : A Bridge Between East and West?

Can neurofeedback bridge Eastern and Western healing practices?

Are you aware of the existence of an energetic connection between your client, the technology and you?

If so, how do we as practitioners prepare ourselves to participate in this energetic exchange event?

Is there a difference between “healer” and “clinician”? Between clinician and client?

What is the current thinking embraced by the Dalai Lama about the impact of ancient mental practices on western medicine, adventitious suffering and healing?

This presentation is designed to provide the neurofeedback provider with a radically different view of the therapeutic approach to the neurofeedback training process and it’s relation to ancient mental training practices, like mindfulness meditation.

The psychoneurenergetic view holds that there is an energetic connection established between the client, practitioner and technology that allows a more direct connection with the client in the therapeutic relationship, through fostering presence in the moment. This energetic connection is always present in a caring therapeutic relationship, yet, usually goes unrecognized or unappreciated as the powerful tool that it is. Essential elements of practices such as Tonglen, a Buddhist method for exchanging suffering for peace, and ways to become energized, rather than drained by such practices will be demonstrated and discussed.

Workshop members will be invited to become participants in this attempt to involve mental practices used to sense the energy present in the moment, and to share views on how this may be possible in their own lives and practices.

Also presented will be some the most current thinking on the science of meditation/mental training as reflected in the recent (November, 2005) Mind and Life Conference XIII with HH Dalai Lama, Contemplatives and western neuroscientists. I will update clinicians on the vast healing potential that the intersection of ancient mental practices, medicine and science, have for alleviating suffering in the world today.

Workshop Outline

I. Overview of a typical neurofeedback session
a. Role of the practitioner
i. Goals
ii. Director approach to effecting change
b. Role of the client
i. Goals
ii. Non-participatory expectations
c. Role of the technology
i. Tool for inducing change
II. Sea change event-personal transformation
a. Recognition of the energetics underlying therapeutic relationships
b. Immersion in the energetic field of client/self/technology
c. Pre/post case presentation
III. Overview of typical psychoneurenergetic neurofeedback session
a. Role of the practitioner
i. Goals
ii. Facilitator approach to effecting change
b. Role of the client
i. Goals
ii. Increased participation tied to expectations
c. Role of the technology
i. Facilitates presence necessary for change
d. More case studies
e. Demonstration of this interactive process with full audience participation
i. Volunteer hooked up to equipment
ii. Audience brought through anxiety-provoking visualization
iii. Audience brought through deep relaxation visualization
iv. Both scenarios reflected in technology viewed live on computer screen
IV. Brief overview of science of mindfulness meditation and neurofeedback
a. Use of mindfulness meditation to improve conditions requiring self-regulation such as depression, anxiety, stress, asthma, psoriasis, cardiovascular disease
b. NF improvements similarly effected through self-regulation
c. NF as tool to effect more rapid mental training
i. Especially in those who have trouble “sitting” meditation
d. Energetics as the connection between meditation and NF?
e. Psychoneurenergetics - a new field??
V. Future proposals based on science of mediation, neuroenergetics and NF discussion
a. Can NF bridge the divide between East and West?
b. Can psychoneurenergetics assist clients to become active participants in their own health care?
c. Can psychoneurenergetics assist health care providers to become equivalent participants in the health care they provide?

Plenary #132): Psychoneurenergetics and Neurofeedback: A Bridge Between East and West?

Ed B O'Malley Ph.D.
Norwalk Hospital Sleep Disorders Center
Norwalk Hospital
Norwalk, Connecticut 06612

phone: 203 852-2145
cell: 203 216-3323
fax: 203 852-2945

edom7@optonline.net

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Ed B O'Malley	Ed B O'Malley BS in Psychology SUNY Stony Brook, PhD Neurobiology Cornell Univer (1992), PostDoc Sleep Research NYU (1992-94), Sleep Medicine Fellowship NYU (1994-96), Research Assistant Professor of Medicine NYU School of Medicine, and Director Norwalk Hospital Sleep Disorders Center 1996-present Edward B. O'Malley, PhD, D,ABSM Director, Norwalk Hospital Sleep Disorders Center Norwalk Hospital 34 Maple Street Norwalk CT 06856 203 852-2145 ed.o'malley@norwalkhealth.org