Home, Neurofeedback - Q and A with Rachael
Welcome back... To you, the reader, who is actually reading this blog I hope you are managing these crazy times as best as possible and staying safe! (I have no idea what that actually means but everyone seems to say it). As well, thank you for continuing to peruse the site and my apologies if you were hanging off my every word and have found the delay in posts unsettling, although I’m fairly confident thats not the case...
Picture above; My Mother suggested we change the colour palate for the counter tops to a Hale Navy... So we did. As an aside, its a really beautiful shade!
Despite feeling somewhat OK with our California self quarantining approach we began to grow more weary of our health and safety due in large part to the lingering question mark that surrounded our travel medical insurance conundrum. Long story short and after much consideration we opted to sadly wave goodbye to the golden state. The airstream, the hyper baric oxygen chamber and I have been back on Canadian soil for about a month now and like many of you I’m sure are finding COVID lockdown challenging. That being said, we feel extremely grateful to have such amazing company and a country living environment that allows Nuk to stay very in tune with his non threatening hunting tactics.
There is nothing like a global pandemic to put things in perspective. Pre existing mental health challenges or not this stretch of time is I’m sure testing you in never before ways. For myself, we try to approach each day as it comes and attempt to not get to consumed, although its easier said than done, with the media. We sleep, we read, we talk - both to our company and ourselves and although limited cell reception we try to strike up a dialogue with the outside world on a daily basis. We run, we dive into Pinterest Airstream holes, we worry about the future, we worry about our future, we swim (more to follow), we build. As an aside, we have graduated from C level trailer carpenter to B minus. Its exciting.
Since arriving back in Ontario and unfortunately having to shelf the project for the time being I decided to reconnect with a therapist Rachael Frankford. Rachael and I spent some quality time together this past Fall, 22 times to be precise and she was instrumental in helping to kickstart my healing journey. Rachel is a Toronto based social worker/psychotherapist who uses neuroscience-based approaches including mindfulness, sensorimotor (body orientated) psychotherapy and Neurofeedback. The Neurofeedback piece was how I first discovered Rachael as I had heard some amazing things about the technology and approach in helping to treat a variety of mental health disorders including patients who had suffered a traumatic brain injury.
Neurofeedback is a gentle, non-invasive biofeedback technique that shapes brain functioning by monitoring and feeding back its own activity with sophisticated computer systems. This activity can be in the form of electrical brain waves (EEG neurofeedback) or blood flow (Hemoencephelograpy). Neurofeedback harnesses Neuroplasticity which we have touched on in early posts, which is the the ability of the brain to form and reorganize neural networks through learning and experience.
The below is a Q and A with Rachael which I thought given the times might be helpful for some to read.
As always thanks for reading and wishing you a great month of May.
Q. How and Why did you become a therapist?
Before becoming a social worker, I studied cultural anthropology at McGill University and upon graduating I left to explore the world and experience different cultures. I lived in Japan for almost 3 years where I studied the Zen arts and had my first taste of “mindfulness” and the "practice" of being in the present moment. From Japan I pursued my personal interest; Western Buddhism by going to live at the San Francisco Zen Centre where I studied meditation and Buddhist psychology for another 2.5 years. This experience was pivotal in my own healing from depression but I felt that there had to be some practical and accessible way to bring these insights into the world outside of the meditation centre and engage in work that helps people through their suffering, particularly from physical and mental health problems. This led me to pursue a career in social work and continue to explore this connection.
After graduating in 2000 from U of T, I worked as a medical social worker at St. Michael's Hospital, an inner city hospital in downtown Toronto for over 15 years in the departments of psychiatry, family practice, cancer care and palliative care. I worked with a diverse, inner city population, typical of Toronto, and learned to how to provide services that are sensitive to cultural, socio-economic, racial, and sexual diversity. In the latter years, I worked as a counsellor in psychiatry where I developed an outpatient group psychotherapy program and ran CBT (Cognitive Behavioural Therapy) and MBCT (Mindfulness Based Cognitive Behavioral Therapy) groups for anxiety, depression and trauma. I also developed a 4 week, trauma informed program called MAST (Mindfulness Awareness Stabilization Training) with the support of a Bell Grant to improve access to mental health care to marginalized populations.
In 2013 I opened my private practice which became a full-time practice in 2017. This has allowed me to develop my own “Neuropsychotherapy” practice that is grounded in evidence-based practices and integrates cutting edge, neuroscience-based therapies such as EEG Neurofeedback, mindfulness and body-oriented therapies
Q. Why and when did you start adding Neurofeedback to your practice?
Many emotional, psychological and physiological challenges stem from patterns of brain dysregulation. With Neurofeedback we can train the brain to function in healthier and more optimal ways by improving its innate capacity to heal and self-regulate. I added Neurofeedback to my psychotherapy practice 4 years ago. My practice included a number of people suffering from PTSD and developmental trauma and I had been using traditional talk therapy approaches integrated with somatic therapy but found that it just wasn’t enough to change people’s ability to regulate their emotions. I heard Bessel Van der Kolk speak about Neurofeedback as an effective treatment for trauma and read Sebern Fisher’s book on Neurofeedback for developmental trauma. Both resources convinced me that adding this approach would give clients the relief they needed by training their very sensitive nervous systems. I did a lot of research on what system to train with and decided to go to California to train with the Othmers at the EEG Institute. They have a lot of credibility in the field and have a very high standard of training and ongoing clinical support for mental health clinicians.
Q. What would be the general make up of your practice, ie Depression, Anxiety, PTSD, ADHD etc
Everyone I work with has depression and anxiety. I work with a lot of trauma in my practice and many people have com-orbits like TBI, ADHD, fibromyalgia, chronic pain, and migraines.
Q. Do you think there is still a stigma to mental health? why or why not?
Yes. The stigma still exists but it’s changing a lot these days, especially with younger generations. I think its changing because we have a much better understanding of how to talk about mental health and how to make sense of it. Mental health does not discriminate about who suffers and who doesn't. I also think that the advances in neuroscience and our understanding of neuroplasticity – that the brain can change through training and experience is helping to reduce stigma as we can see it as something to be treated – not as a personal weakness.
Q. We spent a majority of the sessions together in Infralow Neurofeedback - what is this?
Infralow Neurofeedback is a type of Neurofeedback developed by Sue and Siegfried Othmer, that trains neural networks at very low frequencies. The idea is that neural networks are better regulated when organized around these very low frequencies and this is very calming, especially for your nervous systems which were very sensitive and unstable. This particular method is extremely effective for trauma and any kind of brain dysregulation issues such as TBI and migraines. This method integrates well with therapy but it requires a lot of collaboration and clinical decision making with your therapist to adjust the training and monitor progress in your symptoms. It is a different but I think much more effective method than simply hooking you up to machine which can be done by a technician.
Q. During our sessions you would sometimes reference the "window of tolerance".. Can you remind me what that means again?
The window of tolerance is a term used in therapy to refer to the range of arousal that we can experience in daily life without going into survival mode – or fight/flight/freeze. People who suffer from trauma or any kind of problem with emotion/nervous system dysregulation usually have a very narrow window of tolerance so they can easily find themselves going outside of their window with the slightest trigger. With Neurofeedback training, we widen the window of tolerance and increase resilience of the nervous system so that potential stressors do not feel so overwhelming and intolerable.
Q. Mindfulness meditation is a big aspect of your practice - Why?
Mindfulness meditation is another great tool to help people learn to regulate emotions and stress reactions in the body. I always encourage people to have a mindfulness practice while they do Neurofeedback training and to continue to use it after the training is completed so they can use their own practice to stay balanced and maintain the gains they experienced from therapy. Research shows that mindfulness meditation also changes the brain through ongoing practice and can help people to have more emotional resilience throughout their lives.
Q. How does being mindful help with depression and anxiety?
Mindfulness helps us to pay attention to our thoughts, feelings and physical reactions in the body. When we are practicing mindful awareness, we can notice when we start to feel depressed or caught in anxious thoughts without getting hijacked by them. This awareness gives us the ability to step back and be more conscious and skillful of how we manage these fluctuating states.
Q. Before we started I recall you describing the framework of the therapy to be less like "therapy" and more like a treatment - What did you mean by this?
Neurofeedback is approached as a treatment in that we are very systematic about the training by sticking to a regular schedule to train the brain and work with symptoms. We are very specific about tracking the symptoms and making changes to the training protocol as needed. I work very closely with clients as they go through the training to make sure we are working to calm an stabilize their nervous system. Often this requires changing frequency or adding a different training site of the brain for different effects. As a therapist, I integrate therapy with Neurofeedback by helping people to be reflective of the process and to make sense of how their symptoms have held them back and think about how changing their nervous system response can help them move forward in their lives.
Q. How has your practice shifted over the last month with COVID?
I have completely stopped doing Neurofeedback with clients which is unfortunate for people with heightened anxiety or for those who had to stop at the beginning of their training. I have been checking in with clients and offering them support through mindfulness training and encouraging them to use home biofeedback devices like Inner Balance by Heart Math or the Muse headband.
Q. What advice can you give to people who would typically be able to see their therapist but are unable to right now?
Please try to establish a regular mindfulness practice and use the great resources that are out there. The Insight Meditation Timer has lots of great meditations and programs that are easy to follow. I am working on creating a mindfulness course for mental health on teachable to help support people to have a regular, daily practice.
Online counselling is a great option. I have switched my whole practice to online/phone counselling and find it is just as effective as in person counselling, especially right now.
I have also been recommending Tara Brach’s podcasts and new book. Her practice of RAIN is a great practice for COVID-19 times.
Use the extra time you have for slowing down, journaling, and for self reflection.
For more information on Rachel please go to https://www.rachaelfrankford.com/