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Anxiety & Traumatic Stress Disorders (PTSD) - Quick Facts

  • Anxiety symptoms can be very broad ranging from generalized agitation, poor focus, or insomnia to full-blown panic attacks.
  • Anxiety also has behavioral expressions: Obsessions, Compulsions, and self-harming rituals (e.g., cutting) can all fall under this category.
  • As such, how we approach different forms of anxiety should be different too.

We look to the brain, to very specific biological markers, to tell us where and, more importantly, why anxiety is manifesting. PTSD, for example, has a very specific EEG marker, as do obsessions / compulsions and extremely poor stress tolerance. Finding which area of the brain is contributing to symptoms is extremely helpful in the reduction of symptoms. It also helps with classification.

Sometimes anxiety is ‘functional’ messaging: your biology telling you that something is wrong, or something needs to change. Sometimes anxiety is biological mis-messaging: meaning the alarm is going off when there is no fire, leading you to feel anxiety when you are, or should feel, ‘safe’. Sometimes it is a mix or a cross-wiring of past and present experiences. For example, you’ve been through a few fires and are now constantly on heightened alert looking for smoke.

At Swingle Clinic, we look to the brain to discover the connections. We help you ‘listen’, untwisting the wires, refining your brain-body messaging system so that your psychoneurophysiological (yes, that is a mouthful) response is an accurate messaging system you can trust and (re)learn to act on when necessary.

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Anxiety Disorders

For anxiety disorders, please book a 5 point ClinicalQ assessment.

About the Condition

Anxiety disorders are a group of well-recognized conditions, which are included in the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition – Text Revision (2023). While most people feel anxious or worried from time to time, others experience severe feelings of anxiety or panic, often triggered by everyday stressors, that can feel overwhelming, uncontrollable, or exhausting.

Recommended Neurofeedback Treatment

Anxiety will typically show up as elevated fast frequencies in the beta and gamma range, particularly at the rear of the brain, combined with a deficiency of calming, slower frequency theta waves. Protocols to reverse this pattern, often conducted in a recliner with eyes closed, can help retrain the brain to allow the client to relax and the brain to quiet.

Many clients who have difficulty with calming (relaxing) benefit from adjunctive peripheral biofeedback, such as heart rate variability and respiration training, and feedback on specific muscles that have been chronically tense. This helps clients learn to integrate mental with physical relaxation. In addition, clients may benefit from Cranio-Sacral Therapy (CST), a gentle, hands-on manual therapy that releases tensions as well as restrictions deep in the body, which can develop over years of anxiety-related tension.

Typically, these adjunctive modalities will be integrated into a regular neurofeedback session with no additional charge.

Additional Recommended Psychological Services

When anxiety is related to emotional trauma, sometimes counselling or psychotherapy such as EMDR can help resolve the underlying emotional issues. Often, people with anxiety benefit greatly from lifestyle changes, such as learning to set and respect their own boundaries, assertiveness, addressing and reformulating unhelpful beliefs, and practicing relaxation or meditation.

Anxiety medication is often prescribed and is managed by the prescribing physician. Anxiety medication can often have profound effects on the EEG, and can be particularly difficult or even unsafe during withdrawal. Your clinician can consult with your physician to ensure the timing of any medication reduction is appropriate, given your progress in therapy. You will need to sign a release of information form to give your consent for your clinician to consult with your physician.

Many people who suffer from anxiety self-medicate with alcohol and other drugs, such as marijuana, which can lead to their own problems. Please ensure you inform your clinician about any substances you are using to assist with your anxiety. Sometimes, discontinuing these substances requires medical management to ensure a safe and comfortable withdrawal, so it may be better to seek support, particularly early in the process.

Recommended Reading

Biofeedback for the Brain

Trauma and Stress Related Disorders

For stress and trauma, please book a 5 point ClinicalQ assessment.

About the Conditions

Reactions to stress vary from good coping with everyday stressors, such as heavy traffic and work-related deadlines, to burnout, to severe Post-Traumatic Stress Disorder (PTSD). Often, a person’s coping skills are unable to manage the level of stress they are faced with, either because of day-to-day mental and emotional overload, or from the haunting memories of a traumatic event which fall outside of everyday stressors, such as exposure to a life-threatening situation, or historical abuse. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) covers a range of trauma and stressor related disorders, including PTSD. Although burnout is not recognized as a diagnosis, it is a common presentation at the Swingle Clinic, particularly burnout in reaction to work overload, workplace bullying, and caregiver burnout.

Recommended Neurofeedback Treatment

Trauma will typically show up as deregulation of the normal alpha wave (8-12hz) response of a 50% increase in alpha waves at the rear of the brain, between eyes open and eyes closed conditions. This alpha “blunting” is associated with a suppression of emotions, and often an impact on short-term memory. Anxiety will typically show up as elevated fast frequencies in the beta and gamma range, particularly at the rear of the brain, combined with a deficiency of calming, slower frequency theta waves. Protocols to reverse these patterns, often conducted in a recliner with eyes closed, can help to re-train the brain to allow the client to relax / quiet, and get back in touch with repressed emotions and memories. Occasionally, an opposite pattern of excessive alpha waves is noted, more often associated with dissociation and difficulty staying present and grounded, again, often combined with patterns of anxiety and hypervigilance.

Many clients who have difficulty relaxing / quieting benefit from adjunctive peripheral biofeedback, such as heart rate variability and respiration training, and feedback on specific muscles that have been chronically tense. This helps clients to learn to integrate mental with physical relaxation. In addition, clients may benefit from Cranio-Sacral Therapy (CST), a gentle, hands-on manual therapy that releases tensions as well as restrictions deep in the body, which can develop over years of stress-related tension.

Typically, these adjunctive modalities will be integrated into a regular neurofeedback session with no additional charge.

Additional Recommended Psychological Services

Several psychotherapeutic treatments are helpful for emotional trauma. Eye Movement Desensitization and Reprocessing (EMDR) can be particularly helpful with single incident traumas, such as car accidents. For more complex PTSD, going back to childhood issues, Schema Therapy can be helpful for changing long-standing life patterns. Counselling can also be complementary to Neurotherapeutic treatment assisting with the processing of traumatic release.

Recommended Reading

Biofeedback for the Brain

Further reading...

Anxiety Disorders

Burti, L., & Siciliani, O. (1983). Increase in alpha-rhythm in anxious subjects using biofeedback: A preliminary study. Psichiatria Generale e dell Eta Evolutiva, 21(2–4), 79–97.

Chisholm, R. C., DeGood, D. E., & Hartz, M. A. (1977). Effects of alpha feedback training on occipital EEG, heart rate, and experiential reactivity to a laboratory stressor. Psychophysiology, 14(2), 157–163.

Dreis, S. M., Gouger, A. M., Perez, E. G., Ruso, G. M., Fitzsimmons, M. A., Jones, M. S. (2015) Using Neurofeedback to Lower Anxiety Symptoms Using Individualized qEEG Protocols: A Pilot Study. NeuroRegulation 2(3), 137-148.

Garrett, B. L., & Silver, M. P. (1976). The use of EMG and alpha biofeedback to relieve test anxiety in college students. Chapter in I. Wickramasekera (Ed.), Biofeedback, Behavior Therapy, and Hypnosis. Chicago: Nelson–Hall.

Hammond, D. C. (2005). Neurofeedback with anxiety and affective disorders. Child & Adolescent Psychiatric Clinics of North America, 14(1), 105–123.

Hardt, J. V., & Kamiya, J. (1978). Anxiety change through electroencephalographic alpha feedback seen only in high anxiety subjects. Science, 201, 79–81.

Holmes, D. S., Burish, T. G., & Frost, R. O. (1980). Effects of instructions and biofeedback in EEG-alpha production and the effects of EEG-alpha biofeedback training for controlled arousal in a subsequent stressful situation. Journal of Research in Personality, 14(2), 212–223.

Huang-Storms, L., Bodenhamer-Davis, E., Davis, R., & Dunn, J. (2006). QEEG-guided neurofeedback for children with histories of abuse and neglect: Neurodevelopmental rationale and pilot study. Journal of Neurotherapy, 10(4), 3–16.

Keller, I. (2001). Neurofeedback therapy of attention deficits in patients with traumatic brain injury. Journal of Neurotherapy, 5(1-2), 19–32.

Kerson, C., Sherman, R.A., Kozlowski, G.P. (2009). Alpha suppression and symmetry training for generalized anxiety symptoms. Journal of Neurotherapy, 13(3), 146–155.

Kirschbaum, J., & Gisti, E. (1973). Correlations of alpha percentage in EEG, alpha feedback, anxiety scores from MAS and MMQ. Archives fur Psychologie, 125(4), 263273.

Trauma and Stress Related Disorders

Bell, A. N. (2018). Tuning the traumatized brain, mind, and heart: Loreta z-score neurofeedback and HRV biofeedback for chronic PTSD [Dissertation Research]. Available from ProQuest Dissertations & Theses Global. (2190681731). Retrieved from https://tcsedsystem.idm.oclc.org/login?url=https://search-proquest-com.tcsedsystem.idm.oclc.org/docview/2190681731?accountid=34120

Bell, A., Moss, D., & Kallmeyer, R. (2019). Healing the neurophysiological roots of trauma: A controlled study examining LORETA z-score neurofeedback and HRV biofeedback for chronic PTSD. NeuroRegulation, 6(2), 54-70. https://doi.org/10.15540/nr.6.2.54

Bluhm, R. L., Williamson, P. C., Osuch, E. A., Frewen, P. A., Stevens, T. K., Boksman, K., … Lanius, R. A. (2009). Alterations in default network connectivity in posttraumatic stress disorder related to early-life trauma. Journal of Psychiatry & Neuroscience: JPN, 34(3), 187–194.

Bracciano, A,G., Chang, W-P., Kokesh, S. (2012). Cranial electrotherapy stimulation in the treatment of posttraumatic stress disorder: A pilot study of two military veterans. Journal of Neurotherapy.

Currie, C. L., Remley, T. P., & Craigen, L. (2014). Treating trauma survivors with neurofeedback: A grounded theory study. NeuroRegulation, 1(3–4), 219.

Foster, D. S., & Thatcher, R. W. (2015). Surface and LORETA neurofeedback in the treatment of post-traumatic stress disorder and mild traumatic brain injury. In R. W. Thatcher & D. S. Foster (Eds.), Z score neurofeedback: Clinical applications (pp. 59–92). San Diego, CA: Academic Press.

Fragedakis, T.M., Toriello, P. (2014). The Development and experience of combat-related PTSD: a demand for neurofeedback as an effective form of treatment. Journal of Counseling & Development, 92(4), 481-488. doi: 10.1002/j.1556-6676.2014.00174.x

Gapen, M., van der Kolk, B. A., Hamlin, E., Hirshberg, L., Suvak, M., Spinazzola J.(2016). A pilot study of neurofeedback for chronic PTSD. Applied Psychophysiology and Biofeedback. doi:

Graap, K., Ready, D. J., Freides, D., Daniels, B., & Baltzell, D. (1997). EEG biofeedback treatment for Vietnam veterans suffering from posttraumatic stress disorder. Journal of Neurotherapy, 2(3), 65–66. [Conference Paper]

Huang-Storms, L., Bodenhamer-Davis, E., Davis, R., & Dunn, J. (2007). QEEG-guided neurofeedback for children with histories of abuse and neglect: Neurodevelopmental rationale and pilot study. Journal of Neurotherapy, 10(4), 3–16. Retrieved from https://doi.org/10.1300/J184v10n04_02

Imperatori, C., Farina, B., Quintiliani, M. I., Onofri, A., Castelli Gattinara, P., Lepore, M., … Della Marca, G. (2014). Aberrant EEG functional connectivity and EEG power spectra in resting state post-traumatic stress disorder: A sLORETA study. Biological Psychology, 102, 10–17. Retrieved from https://doi.org/10.1016/j.biopsycho.2014.07.011

Jokić-Begić, N., & Begić, D. (2003). Quantitative electroencephalogram (qEEG) in combat veterans with post-traumatic stress disorder (PTSD). Nordic Journal of Psychiatry, 57(5), 351–355. Retrieved from https://doi.org/10.1080/08039480310002688

Kluetsch, R. C., Ros, T., Théberge, J., Frewen, P. A., Calhoun, V. D., Schmahl, C., …Lanius, R. A. (2014). Plastic modulation of PTSD resting-state networks and subjective wellbeing by EEG neurofeedback. Acta Psychiatrica Scandinavica, 130(2),123-136. doi: 10.1111/acps.12229

Kluetsch, R., Ros, T., Theberge, J., Frewen, P., Schmahl, C., & Lanius, R. (2012). Increased default mode network connectivity following EEG neurofeedback in PTSD. In International Society for Traumatic Stress Studies (ISTSS) 28th Annual Meeting: Innovations to Expand Services and Tailor Traumatic Stress Treatments, November 1-3, 2012, Los Angeles, CA [Abstracts]. International Society for Traumatic Stress Studies (ISTSS). Retrieved from https://doi.org/10.1037/e533652013-382

Lanius, R. A., Frewen, P. A., Tursich, M., Jetly, R., & McKinnon, M. C. (2015). Restoring large-scale brain networks in PTSD and related disorders: A proposal for neuroscientifically-informed treatment interventions.

European Journal of Psychotraumatology, 6. Retrieved from https://doi.org/10.3402/ejpt.v6.27313

Lanius, R. A., Vermetten, E., Loewenstein, R. J., Brand, B., Schmahl, C., Bremner, J. D., & Spiegel, D. (2010). Emotion modulation in PTSD: Clinical and neurobiological evidence for a dissociative subtype. American Journal of Psychiatry, 167(6), 640–647. Retrieved from https://doi.org/10.1176/appi.ajp.2009.09081168

Mills, Z. L. (2012). Neurofeedback experiences of clients with hyperarousal symptoms associated with PTSD. The University of the Rockies. Retrieved from http://gradworks.umi.com/35/44/3544522.html

Othmer, S. (2012). Psychological health and neurofeedback: Remediating PTSD and TBI. Retrieved from http://www.eeginfo-europe.com/fileadmin/images/research/anxiety/RemediatingPTSD_TBI.pdf

Othmer, S., & Othmer, S. F. (2009). Post traumatic stress disorder: The neurofeedback remedy. Biofeedback, 37(1), 24–31.

Peniston, E. G., & Kulkosky, P. J. (1991). Alpha-theta brainwave neuro-feedback therapy for Vietnam veterans with combat-related post-traumatic stress disorder. Medical Psychotherapy, 4, 47–60.

Peniston, E. G., Marrinan, D. A., Deming, W. A., & Kulkosky, P. J. (1993). EEG alpha-theta brainwave synchronization in Vietnam theater veterans with combat-related post-traumatic stress disorder and alcohol abuse. Advances in Medical Psychotherapy, 6, 37–50.

Pop-Jordanova, N., & Zorcec, T. (2004). Child trauma, attachment and biofeedback mitigation. Prilozi / Makedonska Akademija Na Naukite I Umetnostite, Oddelenie Za Biološki I Medicinski Nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences, 25(1–2), 103–114.

Putman, J. (2000). The effects of brief, eyes-open alpha brain wave training with audio and video relaxation induction on the EEG of 77 Army reservists. Journal of Neurotherapy, 4(1), 17–28.

Nelson, D., & Esty, M. (2012). Neurotherapy of traumatic brain injury/posttrumatic stress symptoms in oef/oif veterans. The Journal of Neuropsychiatry and Clinical Neurosciences, 24(2), 237-240.

Reiter, K., Andersen, S. B., Carlsson, J. (2016). Neurofeedback treatment and posttraumatic stress disorder: effectiveness of neurofeedback on posttraumatic stress disorder and the optimal choice of protocol. The Journal of Nervous and Mental Disease, 204(2), 69-77.

Ros, T., J. Baars, B., Lanius, R. A., & Vuilleumier, P. (2014). Tuning pathological brain oscillations with neurofeedback: A systems neuroscience framework. Frontiers in Human Neuroscience, 8. Retrieved from https://doi.org/10.3389/fnhum.2014.01008

Ros, T., Théberge, J., Frewen, P. A., Kluetsch, R., Densmore, M., Calhoun, V. D., & Lanius, R. A. (2013). Mind over chatter: Plastic up-regulation of the fMRI salience network directly after EEG neurofeedback. NeuroImage, 65, 324–335. https://doi.org/10.1016/j.neuroimage.2012.09.046

Russo, G. M., Novian, D. A. (2014). A Research Analysis of Neurofeedback Protocols for PTSD and Alcoholism. Journal of NeuroRegulation, 1(2), 183-186.

Tan, G., Dao, T. K., Farmer, L., Sutherland, R. J., & Gevirtz, R. (2011). Heart rate variability (HRV) and posttraumatic stress disorder (PTSD): A pilot study. Applied Psychophysiology and Biofeedback, 36(1), 27–35. Retrieved from https://doi.org/10.1007/s10484-010-9141-y

van der Kolk, B. A., Hodgdon, H., Gapen, M., Musicaro, R., Suvak, M. K., Hamlin, E., & Spinazzola, J. (2016). A Randomized Controlled Study of Neurofeedback for Chronic PTSD. PLOS ONE, 11(12), e0166752. Retrieved from https://doi.org/10.1371/journal.pone.0166752

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Swingle Clinic

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Fax: (604) 684-7659

#280-1090 W. Georgia St
Vancouver, BC, V6E 3V7
Canada