Mitchell Sadar
Profile
Mitchell Sadar, Ph.D., BCN,BCB-HRV is a licensed psychologist who was the director of a Pennsylvania Correctional Institution’s inpatient program for over 15 years. In 1999 he was trained in neurofeedback and tried to bring this modality to the correctional population, but his attempts were not accepted by the Department of Corrections. He then resolved to dedicate his work to biofeedback and developed his private practice. Since 2015 he has been the president of the Northeast Region Biofeedback Society. His background in neuropsychology readily lent itself to learning how the EEG can facilitate neurofeedback training. In 2018, along with his practitioner wife, Angelika Sadar, he was invited to be part of BrainARC Switzerland and began developing evaluations and protocols based on the research of HBImed, Switzerland. Since that time, he has focused on developing assessments that include an analysis of EEG and ERPs to help to guide biofeedback/neurofeedback protocols but also include recommendations regarding psychotherapy and lifestyle changes.
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Angelika Sadar
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Angelika Y. Sadar, MA, BCN, BCB-HRV is a licensed psychologist who is board certified in neurofeedback and heart rate variability and is a BCIA approved mentor in neurofeedback. She has been in private practice in the greater Philadelphia area since 1985. Her work over the years has involved all age groups and clinical presentations. She is a treatment coordinator at Sadar Psychological and is a nationally recognized speaker providing education and offering training to other professionals in neurofeedback, biofeedback, and hypnosis. In 2018 she was invited to be part of BrainARC Switzerland and began developing evaluations protocols based on the research of HBImed, Switzerland. Presently, her clinical focus is on patients with complex/comorbid presentations and consulting with other psychologists, medical practitioners and other clinicians regarding EEG, neurofeedback and practice development. She is the executive director of the Northeast Region Biofeedback Society and a board member at large of The Association of Applied Psychophysiology and Biofeedback.
Dr. Linda Walker
Profile
From the time I emerged from college (the first time), prepared for a career in journalism, I felt driven to find ways to be part of the solution to the challenges I saw in the world.
Not quite satisfied with what I contributed as a writer, I pursued a master’s degree in human relations and counseling through University of Oklahoma and began my career as a helping professional in the mid 1990s. I later added post graduate certificates in addiction studies and school counseling, and a doctorate in psychology with an emphasis in psychophysiology from Saybrook University.
In my early work, I helped adults who had developmental disabilities find ways to live independently and experience life to their fullest. Since then, I’ve had the privilege to work with people from diverse backgrounds and circumstances seeking to find their balance, wellbeing and optimal function. Along the journey, I’ve spent time working in community mental health, juvenile justice, private practice and corporate health.
I added neurofeedback and biofeedback to my practice in my work within a residential treatment facility for juvenile delinquents in 2000. Assessment using qEEG came a short time thereafter.
As a counselor, I was seeing young adults who had one last chance at remediation. They had trauma, mental health and behavioral conditions, learning disorders, substance use problems, post concussive incidents and toxic chemical exposures — and usually all rolled up into a single young person! They had tried practically every medication and therapy in the book.
I began to question what more I could offer these young men and women to help them toward a better future.
That answer came in the form of neurofeedback and biofeedback. With a structured curriculum integrated into the residential treatment program, the number of restraint interventions decreased, medication need decreased and kids began reporting they made honor role in school — the first time for most of them. The program was documenting these changes and tracking data. Sadly the economic downturn spelled an end to the program in 2010.
Having witnessed the power of psychophysiological therapies to effect change in those I helped, I moved forward professionally within my own private practice. The past decade has indeed been busy!
I continued seeing children with challenges. In addition, I began to see adults and children with chronic disorders, such as pain and epilepsy. With an institute for performing arts nearby, I also began to expand my knowledge in working with optimal performers.
I have been privileged to direct assessment for a neurotherapy group that had clinics throughout Michigan, develop and teach biofeedback for Western Michigan University, and work with Bio-Medical, Thought Technology, and Biofeedback Federation to teach courses, mentor and develop software. I’ve had the opportunity to advise best practice in the field of psychophysiology and to participate in research efforts.
These accomplishments have been very gratifying and it’s a privilege to make a contribution to the advancement of helping therapies. That said, my heart still lives in the opportunity to work with others, to meet them where they are in their journey and to use the tools and skills I have to help them along their way. That goes for those whom I mentor and teach, as well as those who come to me as clients.
Experience with neurofeedback
Not only does our intstructor have 20+ years of experience in Neurofeedback, she is also passionate about getting you accomplished in your Neurofeedback Learning Journey.
"The idea behind Alpha-Theta-Training is to create an access between the conscious and the unconscious level." About the use of Alpha-Theta-Training in therapy and as a method of self-care - an interview with Meike Wiedemann
Together with neurobiologist and neurofeedback expert Meike Wiedemann, we conducted an interview on the topic of alpha-theta training. She explains what Alpha-Theta-Training actually is, how she uses it in her everyday practice and why it is a method of self-care.
BEE Medic: Dear Meike, thank you very much for taking time for us today. Can you start by describing what Alpha-Theta-Training actually is?
Meike: Alpha-Theta-Training is a component of the so-called Othmer Method. With Alpha-Theta, we basically resort to frequency band training. In contrast to awake training, we also speak of deep state training with alpha-theta training, because the state you want to achieve with it is a kind of trance state. In Alpha-Theta-Training, patients sit on a comfortable chair with their eyes closed. Patients should keep their eyes closed throughout the process in order to have better access to processing psychological issues in these deep state areas. ILF awake training is mainly used for physiological regulation. Alpha-Theta-Training goes one layer deeper to address psychodynamic processes and also access unconscious processing. The idea behind Alpha-Theta-Training is to create an access between the conscious and the unconscious level. Alpha-Theta-Training therefore aims more at psychodynamics and less at physical regulation. Whereby it must be said that inner-psychic processes that shape our behavior are also closely connected to physical sensations and vice versa. In Alpha-Theta-Training one opens the pipeline so that the conscious and unconscious systems can be "connected" and thus the resources in the unconscious can also be used.
BEE Medic: What does alpha actually stand for and what does theta stand for?
Meike: These are the classic frequency bands. Alpha is a frequency band around ten hertz and theta is lower, between four and seven hertz. The state in alpha is a slight relaxation, you can speak of a relaxed focus. In comparison, theta is even lower. When we talk about the whole spectrum of waking states, there is this relaxed focus and then when you "go inward" more and more and withdraw into yourself, then we are more in the theta range and the subconscious states.
BEE Medic: How do you use the Alpha-Theta-Training in your practice?
Meike: The Alpha-Theta-Training is always an addition to the ILF-Training, to the so-called awake training. With ILF Neurofeedback, a basis is first created over several sessions, there is no fixed number. That is, you first have many sessions of awake training to reduce symptoms and stabilize the person to be treated. Then you can work with it for topics that involve psychodynamic processes. For example, changing beliefs, letting go of old habits, or even in processing traumatic content. The next step is to dive one layer deeper to resolve things as well. In the further course of an alpha-theta session, neurofeedback promotes both alpha and theta waves. In the beginning, patients feel a slight relaxation in the alpha range. After five to ten minutes, the patients usually go one step deeper into these trance-like states. As a rule, they then switch between alpha and theta, or sometimes have longer states in theta. This is the area in which one has access to the unconscious areas. The application of Alpha-Theta-Training differs between patients. For some it is advisable to do Alpha-Theta-Training every second session, for others it may be necessary to work with it every three, four, five sessions first, in order to maintain the symptom reduction achieved in the waking training and not to cause any regression. But what the patients experience in Alpha-Theta-Training are dream-like states. Things come together and they find solutions that they would never have thought of with conscious thought. However, it is not always consciously that things "click". It often happens on an unconscious level.
BEE Medic: Why is it so important to prepare for Alpha-Theta-Training with ILF Neurofeedback?
Meike: You want patients to experience Alpha-Theta-Training from a safe position, and that needs preparation and physiological regulation through ILF-HD training first. Patients who are very loaded, whether it's emotional problems or neurological instabilities, something like migraine attacks or headache symptoms, can be re-triggered by alpha-theta training. Or if I do Alpha-Theta-Training without ILF Training with people who have had traumatic experiences, they may find themselves with their whole experience in that trauma. If someone is still extremely anxious and controlled, then he or she will not be able to engage in Alpha-Theta-Training either. What might happen then is that the patient:inside opens their eyes and says "I'm not doing that!" because they feel that they are losing control. The letting go and the relaxed state is then perceived as dangerous and too overwhelming, thus unnecessary fears can be triggered.
Therefore, a good preparation is needed, on the one hand with the ILF training and on the other hand, of course, a correspondingly good relationship with the therapist.
BEE Medic: With which patients do you do the Alpha-Theta-Training?
Meike: Alpha-Theta-Training can really consolidate the effects of ILF-HD-Training. For patients who are "not yet ready" after ILF training, Alpha-Theta-Training can give another boost to their further development. The person should only tolerate it well or be sufficiently prepared by ILF training or other self-regulation methods. I have had patients in training where I have said "Great, the headaches are gone, now we can phase out the training". And the patients have then said: "No, now we are really starting. I never thought I would get this far in my life and now I have this and that wish." Alpha-Theta-Training is also often used in peak performance. For example, an skier may go through certain stretches or an actor/ actress or singer may prepare for performance or exam in this state.
BEE Medic: What advantage does the Alpha-Theta-Training offer to your patients?
Meike: The Alpha-Theta-Training can give a further push in the change work, in the whole therapy process and allows a processing on a deeper level. When I train the Alpha-Theta, then I also train for the future: How can I get involved in such states? One can then create much more access to resources that lie in the subconscious and use more of them.
BEE Medic: Why do you do Alpha-Theta-Training with your eyes closed? And how does the feedback actually work?
Meike: In Alpha-Theta-Training it is important to close your eyes so that you can get into this deep state at all. In this state, Alpha-Theta-Training makes it possible to experience things again in a kind of dissociation. That is, it allows you to feel yourself in a safe state to be able to process things again from a different perspective. It's like an "inward look." You turn your focus away from the outside world and into the inside world. And that is of course difficult when you are distracted by images from the outside. Only with closed eyes do the alpha waves emerge to the extent that you can look inside yourself. The tricky thing about neurofeedback is that all the feedback you need, i.e. how the alpha amplitudes, theta amplitudes, steep rises in amplitudes are behaving, is all fed back auditorily. You don't have to worry about missing any feedback with your eyes closed. Nevertheless, we have the possibility to give visual feedback at the beginning of the software module Alpha-Theta-Reflections. This often makes it easier for the patient to get started. These are so-called guided imagery, which can be switched on in different languages, so that the patients are supported in reaching such a state.
BEE Medic: What are your previous experiences with Alpha-Theta-Training?
Meike: I have also worked with alpha-theta training in earlier times at the university. The experience is that patients get into such trance states relatively quickly without needing much guidance. In a therapeutic sense it is a fantastic opportunity for patients to support psychodynamic processes on an unconscious level, to process, to re-learn and to really use this deep state, just like you do with other methods. I also work with hypnotherapy. There are relatively many parallels to that.
BEE Medic: As a therapist, can you also use Alpha-Theta-Training on yourself?
Meike: I would recommend it to every therapist to train him/herself and to use these tools. And not only in the sense that one makes a self-awareness, but so that one knows what the patients experience during the process. For myself, the most profitable ones are Synchrony and Alpha-Theta-Training. There are different methods for self-care, but when I do neurofeedback, Synchrony and Alpha-Theta are my favorites. It really brings you down from the day-to-day, to another level, like a nice deep meditation. And it's super simple. You don't have to do anything except stick on the electrodes, start the program, and then let yourself be sprinkled, so to speak. I can then really dive into this deep state. I find that very beneficial and the rest of the day is completely different, much more relaxed and calm. From that point of view, if you have a Neurofeedback system available, I find Alpha-Theta-Training a relatively simple way of self-care.
Study on the Combined Use of ILF Neurofeedback and trauma psychotherapy for Posttraumatic Stress Disorder
The study "Case Report: Infra-Low-Frequency Neurofeedback for PTSD: A Therapist's Perspective"
by Spreyermann (2022) shows how a combined therapy of trauma psychotherapy and Neurofeedback, specifically ILF Neurofeedback and alpha-theta training, can be used with patients diagnosed with complex post-traumatic stress disorder (C-PTSD). Two case studies are presented as well as an overall assessment of clinical outcomes over the past 7 years.
The study appeared in Frontiers in Human Neuroscience, May 2022.
Citation: Spreyermann R (2022) Case Report: Infra-Low-Frequency Neurofeedback for PTSD: A Therapist's Perspective. Front. Hum. Neurosci. 16:893830. doi: 10.3389/fnhum.2022.893830 PDF
Neurofeedback and complex post-traumatic stress disorder.
One speaks of a complex post-traumatic stress disorder if the persistent PTSD symptoms, such as hyperarousal, sleep disorders, panic attacks, nightmares, flashbacks, muscle tension, fatigue, lack of concentration, emotional instability and depressive symptoms have additionally led to personality changes and emotional dysregulation according to the criteria of the International Classification of Diseases 11th Revision (World Health Organization, 2022). Patients may receive Neurofeedback as an additive to their regular psychotherapeutic therapy if psychotherapeutic treatment has resulted in insufficient improvements in trauma-specific symptoms (van der Kolk et al., 2016). According to the guidelines of the German Society for Psychotraumatology, the indications for combined therapy include the symptomatic persistence of an overstimulated state, which can manifest itself, for example, in the form of anxiety and sleep disorders, despite trauma-focused psychotherapy and supportive medication. Another indication, which suggests a therapy with Neurofeedback, is the persistence of dissociative symptoms, in which the patients have an impaired perception of themselves as well as of their environment.
Case reports
The process of combined therapy is described and illustrated in this study using two representative case reports. Case 1 is about a 40-year-old woman suffering from complex post-traumatic stress disorder. Neurofeedback therapy was recommended due to residual symptoms after approximately 10 years of psychotrauma therapy. Over the course of 47 neurofeedback sessions, a decrease in symptom severity to below 30% of baseline was noted.
Case 2 discusses the history of a 35-year-old woman with complex post-traumatic stress disorder. Over the 4.5 years she was treated with Neurofeedback in combination with psychotherapy, a steady and very positive progression was noted. Among other things, she was able to reduce her extensive psychiatric medication as well as significantly improve her sleep quality.
Overall assessment of clinical outcomes
According to a qualitative assessment in the present study, the combination of trauma-based psychotherapy and ILF neurofeedback over the past 7 years has led to surprising and motivating results. In only 2 of the 80 patients with complex post-traumatic stress disorder, no improvement was observed with combined therapy and neurofeedback. 15% of the patients dropped out of the study prematurely, so that no valid statements can be made in this regard. In the remaining patients, an improvement in symptom burden of 60-90% on average was observed.
The study results suggest promising findings for patients with complex post-traumatic stress disorder. As you can see from the full text, the case reports cited show that people who have suffered greatly and have not been able to lead a regular life have been able to get back to their lives with the help of combined neurofeedback therapy.
Read the entire study here.
References
Spreyermann, R. (2022): Case report: infra-low frequency neurofeedback for PTSD: A therapist's perspective. Frontiers in Human Neuroscience 16: 893830. doi: 10.3389/fnhum.2022.893830.
van der Kolk, B. A., Hodgon, H., Gapen, M., Musicaro, R., Suvak, M. K., Hamlin, E., et al., (2016). A randomizes controlled study of neurofeedback for chronic PTSD. Randomized Controlled Trial>PLoS. 11, e01166752. doi: 10.1371/journal.pone.0166752