Author Werner Van den Bergh, M.D. recently spoke with BMED Press CEO, Christopher Fisher, PhD, about his newly published book, “Neurofeedback and State Regulation in ADHD: A Therapy Without Medication.” Below is a transcript of this interesting interview with this knowledgeable neurologist and neuropsychiatrist who has particular expertise in neurofeedback, EEG, and ADHD.
What was your inspiration for writing this book?
I have always been interested in theory-driven QEEG, in contrast with data-driven QEEG where one only looks at mathematical correlations without theoretical models to guide interpretation. The Berlin psychiatry school of the EEG vigilance model especially has fascinated me since for more than 20 years. Similar dynamic ideas of global EEG spectrum changes have also been described in one study by Sterman in 1980, but have never been taken over in the neurofeedback field, which generally is still too data-driven. The goal of my book was to reawaken these early profound insights and to offer a broader perspective to the neurofeedback field which in my opinion is still lacking.
How did you come about with the discovery that children with ADHD have EEG patterns similar to healthy people who are sleep deprived?
It was already known before the DSM-III (1980) that sleep problems are often part of ADHD. In later decades, this has been ignored, and recently attracted renewed research interest. Besides that, sleep deprivation is known to create a “frontal like syndrome” similar to ADHD, and sleep deprivation was a model for decreased vigilance in the Berlin psychiatric school EEG vigilance model. This Berlin school model is not well known in the United States and has its roots in European neuropsychiatry (French – Henri Ey; British – John Hughlings Jackson and Henry Head).
What is the main message you hoped that readers would take from the book?
Neurofeedback should not be considered as a simplistic magic box where targeting specific frequencies in the EEG is a goal in itself. Understanding that it affects the global EEG spectrum and that this is related to “vigilance” in the stricter meaning of the organizational and integrational level of the CNS (necessary for optimal “state regulation”) will improve the general approach of the clinician who is using such tool as part of a global approach where neurofeedback is not just a magic tool, but is integrated in the wider view of ADHD as a vigilance and state regulation deficit disorder.
How often do you use neurofeedback for ADHD in your clinical practice?
What is the future of neurofeedback for ADHD?
If the field goes on the way it is, it will get more and more marginal, and it will stay as an alternative, non-scientific therapy. But one should have the courage to make the choice to be accepted as a scientific therapy if one wants a real healthy future for the field.
What will take for neurofeedback to gain more mainstream acceptance?
[Those in the field of neurofeedback] should stop to make claims about a whole range of clinical conditions as indications for neurofeedback [treatment]. There are no serious studies about these various disorders, and, even more important in my opinion, one should first understand how in certain conditions EEG is a window into the pathophysiology of condition. In many disorders, we have to accept that EEG at best can show some interesting correlations in some clinical conditions, but when these are not reflecting basic pathophysiological elements of a condition, one cannot expect that training them will result in clinical improvements. And secondly, the field should be ready to understand not only QEEG data [i.e., data-driven approaches], but also [QEEG theoretical] models, such as the EEG vigilance model, to gain acceptance in the mainstream clinical EEG field.
This concludes this interview. I want to thank Dr. Van den Bergh for taking time to discuss his new book and remarkable insights into ADHD and neurofeedback. We hope that you have enjoyed this discussion.
How To Get The Book
“Neurofeedback and State Regulation in ADHD: A Therapy Without Medication” is available direct from BMED Press or at all fine internet book retailers.