What is QEEG Neurofeedback, and how does it help in brain function? In this episode, Timothy Hayes interviews Dr. James Kowal, Ph.D., BCN, about his amazing diagnosis and treatment plan for specific psychological and psychiatric disorders, including traumatic brain injuries. Using state-of-the-art technology, Dr. Kowal breaks down their process of quantifying their data for the psychiatrist to decide whether or not to give medication. He highlights how a percentage of people with specific problems respond positively to the QEEG neurofeedback. Dr. Kowal believes in treating the brain as if it is a chemical engine. Join him in this very informative discussion to learn more about neurofeedback technologies used in the process.
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Using QEEG Neurofeedback For Diagnosing And Treating Mental Illness With Dr. James Kowal, Ph.D., BCN
Dr. James Kowal PhD is a board-certified neurotherapist, a member and presenter at the International Society for Neurofeedback and Research, board-certified expert of traumatic stress, approved-consultant in clinical hypnosis, approved-consultant in EMDR, a certified sex therapist, certified Thought Field diagnostic therapist and an approved trainer for the Callahan Techniques. Dr. James Kowal and his staff at Life Worth Living make use of technological advances in neurotherapy to help people overcome difficulties associated with anxiety, depression, Asperger’s, autism, attention deficit, traumatic brain injuries, concussions, migraine pain, obsessive thoughts and compulsive behaviors, mood disorders, post-traumatic stress, memory problems, learning disabilities and cognitive problems.
In addition to being board-certified in neurotherapy, members of Life Worth Living are also board-certified experts in traumatic stress. They use innovative trauma methods such as EMDR, Holographic Memory Resolution, Thought Field Therapy, Emotional Freedom Technique, clinical hypnosis, HeartMath and other methods in the treatment of post-traumatic stress. Their office is located on the north side of Naperville, Illinois, near I-88 in the western suburbs of Chicago. They are in network with most mental health insurance companies and Medicare. They offer a free information seminar held on the first day of every month at 7:00 PM at the RUAH Center at 1110 North Washington St. Naperville, Illinois.
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Welcome and thank you for joining us. I’m excited to hear a whole different aspect of the work you do. I’m a psychologist, you’re a psychologist, but you’re a lot more than that with the work you do with the qEEG neurofeedback. How did you get into this work?
This is a second career for me. I was originally a mathematician and a systems engineer and the head of systems engineering group for Bell Laboratories. I worked there for 30 years. I planned a retirement to overlap my career in psychology. I went back to school, got a second Master’s degree in Counseling Psychology and became a trauma therapist. I did that like a ministry. I worked two evenings and weekends out of a local church and I help people who were traumatized, who were abused. That went on for four years until 1999 because, at that time, I had 30 years of service at Bell Laboratories. I decided to take a full pension because I had 30 years of service.
Dr. Drehmer and I, who was also a clinical psychologist and a trauma specialist began the Center for Traumatic Stress. We got that up and running in 2000 and I said, “If I’m going to do this full-time, I’m going to go back and get my doctor’s degree.” I went back to school to get a doctorate in Clinical Psychology. While I was doing my residency on the campus of Indiana University, a doctor came and showed us qEEGs and I was taken in by that. You could see everything in the brain. You could see depression, anxiety, ADD, OCD. This was fantastic. It enabled me to combine 30 years of my computer knowledge with ten years of psychology. I was all excited. I came back. I was on the staff at Linden Oaks Hospital, which is our mental hospital here in Naperville. I had friends who were psychiatrists. I showed them what we found during my residency and I was all excited and said, “Do you guys do this? Do you see what you can see inside the brain?” They said, “No. We don’t do any of that.” I said, “Why don’t you do that?” They said, “That’s neurology.” I said, “Neurology. Don’t you guys think the brain has anything to do with behavior?” Come to find out, that’s true.
Dan Amen, who is the Head of the Amen Clinics, he has eight of them throughout the country. He is a psychiatrist but he does qEEG, SPECT scans, digital analysis, even before he ever treats a patient. He told me psychiatry is the only field of medicine that does not study the organ they treat. They don’t look at the brain. I’m not a psychiatrist, so I don’t have to follow that model. I began incorporating qEEG brain maps so that I could see what was going on and what was behind the symptoms people were feeling and experiencing. Later, I could use the qEEG as differential diagnoses because people come in with a set of symptoms and they get classified, whether it be ADD or some other set of symptoms. If you look at the brain, sometimes it confirms that. Other times, it shows that something else is going on, producing the same symptoms. If you don’t look at the brain, you’ll never know.
I’m familiar with Dr. Amen and I love what he talks about how it’s seemingly ridiculous to him that psychiatrists refuse to look at the brain scans, and that makes them the only physician that refuses to look at the organ they’re treating. What happened with Dr. Amen is he was attacked for using what his colleagues thought should have remained research material in a clinical setting. Have you gotten any pushback like that?
The pushback that we get is from insurance companies. They say all of this is experimental. If they classify it as experimental, they do not have to reimburse for those services. However, the International Society for Neurofeedback and Research has underway a number of studies that are double-blind studies that are high quality and have a large number of participants. They are showing that using the qEEG, we can both differentially diagnose with additional information more accurately and we can treat more effectively.
I’m going to Denver to hear more about the findings of these studies, some of them are still underway. Neurologists are starting to begin to use qEEG and neurofeedback as an alternative way of treating. They have pointed out that we do not have an effective set of procedure codes for neurofeedback. It’s more than biofeedback. It changes the brain much like neurofeedback changes the brain. However, it is not a type of procedure that qualifies for therapy, psychotherapy in fact, but we change the brain the same way. They’ve asked the committee to come up with new codes. By the way, those codes have to be reimbursed at a higher rate because we use expensive equipment to do this type of both, gathering information for diagnoses and for treatment. With the help of neurologists, I see that this is going to begin to change.
If you don't look at the brain, you will mistreat a patient based on symptoms. Click To TweetYou’ve mentioned two different things here. One of them is the assessment or diagnosis. They’re getting a clear picture of what’s happening. The other part is the treatment. What kinds of things can you assess and what kinds of things can you treat with the qEEG neurofeedback?
The advantage that we have, in fact, Dan Amen did not have when he began was that we have a normative lifespan database to compare to. When we collect data on a patient, we can compare that data by gender, age and handedness. We see how they fall in a normal distribution so that certain frequencies at certain locations can be over or underactive. We have since then correlated those findings with symptoms that people have experienced. With this, we can find the areas of the brain which are over or underperforming for specific frequencies. My mentor, who was Joel Lubar, discovered that if you ask the computer to form a theta/beta ratio, you will always get a hotspot and if that spot is over three, it confirms the diagnosis of ADD. That has been accepted by the American Academy of Neurology with independent testing and found to be 94% accurate in designating ADD.
I get a number of patients here that come because they don’t want to take medication or they want to get off of medication for ADD. The first thing I do is a qEEG and if that ratio came out to 11.0, it confirmed they have ADD and I get a lot of information of how to treat that, how to lower the theta and bring up the beta and that’s what we do with neurofeedback. Another case came in and said they had ADD, had been taking medication for a couple of years and it hasn’t been helping. I do a qEEG and I find the theta/beta ratio was 1.07. They do not qualify for ADD. Why isn’t he paying attention? We look to see if he had a learning disability and he did not. By this time, parents are saying, “Why do all his teachers say he has ADD?” I said, “Take a look at this left side of it. At the first upper left-hand corner, you see both sides of the brain are equally active.” However, one hertz faster, the right side dominates the left. If you go one more hertz faster, the left dominates the right. If you go one more hertz faster, the right dominates the left and so on. That is the hallmark of an absence seizure. His brain is seizing. It’s an epileptic form activity, and while that’s going on, the child stares. He freezes and stares and people will call his name and try to get his attention and he can’t break away because his brain is fighting the two hemispheres across each other. You treat that differently than by giving them a stimulant.
One more case was a boy who came in. He had good grades, except everyone complained he wasn’t paying attention, he had ADD. They tried giving him medication and after one dose, the father went back to the psychiatrist and says, “You’ve got to get him off of this stuff. We can’t handle him. We’ve got to scrape him off the ceiling. He’s hyper.” I take a look at his qEEG and his theta/beta ratio was 1.8, that’s nearly perfect. He does not have ADD. The father says, “What else could it be?” He has normal low frequencies, they’re all green. He does not have a learning disability. Did we check for seizures? There’s his brain activity and although it’s a little higher on the left than on the right, he does not have absence seizure indications.
By this time, the father says, “For four years, all of his teachers said he has ADD.” I said, “Take a look at this. This is a good beta from 12 to 18 hertz. It is highly active. His brain is running four times faster than any of his peers because this data is normed by gender, age and handedness. This child is bored.” His brain is running fast that he’s got it so he doesn’t have to pay attention anymore and his mother sat up and says, “That’s what his fourth-grade teacher said.” She claimed that she proved it by giving him permission to get out of his seat and go around the class and do anything he wishes while she was teaching because she learned that if she ever called on him, he would turn around and he would give her the answer.
That’s how he was absorbing information. He did not have to sit and make eye contact with you in order to acquire the information. That is the kind of thing that we use qEEG for. You would treat this different. You can see that if you gave this young boy a stimulant and you increased his beta activity, you’d scrape him off the ceiling, you would not be able to live with him, his brain would be on fire and that’s what they experienced. Dan Amen was right, if you don’t look at the brain, you will never know and you will mistreat based on symptoms and pencil and paper types of tests. That’s what we do and this is only one example of one disorder that we can effectively accumulate much more detailed information on how the brain is functioning, for the purpose of properly diagnosing them and then eventually treating them.
The next question is what is the treatment like with qEEG? How do you treat?
QEEG Neurofeedback: To maintain attention, you need a low amount of slow activity.
What we do is we find what location needs to be treated. We also find what frequencies are abnormally high and low. We place an electrode on the brain at that location and we plug them into a computer. We then program the computer to look for 5 to 8 hertz and to look for 15 to 19 hertz and to separate that data out and present that to the patient in real-time how much his brain is producing, low frequencies and high frequencies. The goal here is to lower the low frequencies and to raise the good frequencies. This is a video game, it’s an action game, this cartoon will begin to juggle the balls when the beta gets lowered below a threshold.
In the first bar graph, there is a goal and if the brain activity is operating below the goal, it turns green and the figure begins to juggle the balls. We want them to do something else. While that’s going on for every half second that they continue to juggle, they get a point. Points are gained when they are below the threshold. We need to do a second thing. We need to increase the beta. By increasing the beta, we set another goal for the 15 to the 19-hertz range and if it’s below the threshold, it turns red. As soon as the brain increases and goes above the threshold, the bar will turn green and the music will play. They will have headphones on and they would hear the music.
This is being done in real-time so that if the brain goes back to the old pattern, it will drop below the threshold and the music stops. The music goes on and off, that’s annoying. Annoying is good because the brain does not like annoying, and it figures out, “How do I keep this music playing?” It realizes that if it increases good beta, the music continues to play. The screen reports the percent of the time that the music is playing versus silent. We use those figures to make sure that the person is being rewarded about three-quarters of the time. If they fall below 60%, it’s not enough reward for the brain to learn what it can do to achieve its goal. If it gets up to 85% to 90%, it’s easy to achieve the goal. The brain doesn’t have to change much. We want the brain to change because the normal pattern is running too much theta and not enough beta. We continue to do this repeatedly, twice a week for 30 minutes, and the brain learns a new pattern.
Our brains are patterning, they run patterns. While it’s running that pattern, it’s not taking in information. If we go in and we alter its pattern, we reward it to learn a new pattern. It will learn that. There will be less slowing and more assimilation of information and the child will want to pay attention because they’re now getting it, they’re learning. That’s the process, is playing video games, which I have few kids not willing to do. Adults, we can entice the same way by making it a challenge, “You did 1,500 points last time, let’s see if you can make 1,600 this time,” and they keep pushing their brain to alter its pattern. Once you learn a pattern, the brain will continue to run that pattern.
In one of the interviews that I heard you do with Dr. Cory, one of the things you talked about was some of the research about how the effects last. There was some research comparing the benefits of medications for the same kinds of issues compared to the benefits, side effects and lasting benefits from the qEEG neurofeedback. What can you tell us about that?
The brain is an electrical chemical engine. Psychiatry prefers to treat it as a chemical engine. What we are doing here is we’re treating it as if it’s an electrical engine. The fact remains it is an electrical chemical engine. The brain is a pattern engine and it learns pattern. It will continue to run those patterns until it learns a different pattern. Psychiatry goes in and it alters the chemical, the neurochemicals in the brain that affects the way the brain operates. When that happens, the brain will offset some deficiencies and the symptoms will remediate. However, since you did not train the brain to produce those chemicals but rather injected them through taking some medication. If you remove that medication, the brain goes back to its old pattern and the symptoms come back.
When we do this through electrical training, where we’re training the brain as if it’s an electrical engine and we are rewarding it, this is the same process that parents use all the time when they try to teach their young children how to balance themselves on a two-wheeler bicycle. You cannot tell them what to do. You tell them to steer and to pedal, but that only keeps them from hitting trees. You can’t tell them how to balance themselves. They have to try it and you have to be there to catch them or otherwise, they’ll fall. The brain doesn’t like to fall, so it’s highly motivated to stay on those two skinny wheels. They have to practice over and over again because they will wobble and almost fall and someone will catch them and put them back on the centering over the wheels. They will go a little further and they’ll try and fall again and you’ll catch them, and they keep practicing. The brain is learning how to keep its center of gravity, directly over those two skinny wheels. Once the brain learns that, it has learned a new pattern.
The brain is a pattern engine. It learns patterns and it continues to run those patterns. Click To TweetI tell parents, “Can you ride a bicycle?” Most of them can. I said, “How long has it been since you rode a bicycle?” I get various answers, “Last week, two months ago, two years ago, sometimes five years.” I said, “If you get on a bike this afternoon, do you think you would remember how to balance yourself?” Everybody says, “Yes,” because they have in fact done that at one time or another because the brain was trained. It learned a pattern. It might be wobbly the first 100 yards but after that, the brain kicks in and says, “I know how to do this. I can keep my center of gravity over those two wheels.” That way you can withdraw the training because you’ve trained the brain and now, it will last as long as you remember how to balance yourself on a two-wheeled bicycle.
I see a potential benefit here for quite a few people, not just for those for whom the medications are not helping at all, but for those where the medication helps but it has unpleasant side effects and/or the cost of some of these medications is a burden for some people. It seems as though what you’re doing is more facilitating growth and healing rather than treating symptoms.
Yes. We take advantage of the fact that the brain is a pattern engine. It learns patterns and it continues to run those patterns. I tell people the brain only knows two things and it’s not good or bad. That is a higher level of moral function you have to develop. The brain knows familiar and unfamiliar. It does not like unfamiliar. It gravitates always back to the familiar, whether or not it’s good for you. We want to train it to have a healthier pattern, a more productive pattern. With that, the brain will continue to run that pattern and people will have less need for medication, not have the side effects of that and be able to perform.
One good example is Lucas Giolito. He’s the pitcher for the Chicago White Sox. Before, he was the worst pitcher in the major leagues. He says his problem was lack of focus. He couldn’t concentrate. He couldn’t hold the focus long enough. He began doing neurofeedback. He did neurofeedback all through the off-season. After that, it’s a different story. He can maintain his focus and he became the leading pitcher in the American League and was the starting pitcher for the All-Star game. In one year, his performance completely changed because he trained his brain. He can maintain the focus that he needs to do the job that he enjoys doing.
The question comes to my mind, what’s the range of things that can be helped with the qEEG neurofeedback?
It’s most psychiatric conditions. We can treat depression. We can treat anxiety. We can treat obsession, compulsion, which is another example. Psychiatry calls it Obsessive-Compulsive Disorder. If they were to look at the brain, they would know that it’s two different disorders. If you have high beta activity in the left frontal region, you will have obsessive thoughts, racing thoughts, ruminating thoughts, you can’t turn your mind off. If you have high beta activity in the posterior right side of the brain, you will develop compulsive activities, be a perfectionist, you have to do it again and again to get exactly right. Only if you have high beta activity in the left frontal and the right posterior, you have Obsessive-Compulsive Disorder. It’s two different disorders and we can treat that.
Certainly the ADD, we see a lot of learning disability which is interference with high amplitude, low frequency. We can train that down and the child no longer gets distracted or disrupted in their thought processes. They finish tasks that they start. They can do sequences of steps, which they couldn’t do before. We can see people who have the inability to find the right words or construct an effective sentence for writing or speaking. All of that is on the left side of the brain. The words are selected from the front left side of the brain, in Broca’s area. Language is assembled in the Wernicke’s area, in the left posterior part of the brain. We will often find high amplitude low frequencies or high amplitude high frequency that disrupts that processing. If we can train that down, then we have effectively removed the distractors that have interfered with their ability to find the right words, construct sentences and think.
QEEG Neurofeedback: Psychiatry goes in and it alters the neurochemicals in the brain that affect the way it operates.
About any now, which ones can’t we treat? The brain certainly can fall into a condition of malfunction in terms of psychosis. Psychosis is a much more complicated thing. It is effectively treated with medication. Although we can remove some symptoms such as paranoia, we can reduce paranoia in paranoid schizophrenia. We can’t effectively stop or change schizophrenia itself. There are a few things like that that we can’t. We can help memory but it depends on what’s causing the memory problem. I’ve treated five patients who feared they were having the beginnings of dementia. Sure enough, they had high amps to low frequencies in the area of retrieving memories, short-term memory. We train that down and all of them reported that their memory is as good as it’s ever been. One person, in particular, I did a one year and a two year follow up and all of the problems were no longer showing up in the qEEG and they did not have any recurrence of symptoms. We know that we pushed back this degrading of memory at least two years.
Is it possible to be getting treatment with qEEG neurofeedback if you’re already on a medication for a problem?
Yes. We do not take people off of their medications when they come for treatment. There are a couple of exceptions. However, most medications, they can learn to train their brain while they’re on the medication. When we get good results, we can show it to the psychiatrist or physician and ask them to begin to wean them off the medication, so that they can pick up that responsibility of performing the brain functions necessary to do what they wish to do or offset the symptoms that they had.
When that happens, they work with their psychiatrists to decide whether or not they need as much medication, is that the implication?
That’s correct. We have quantified the data here to prove to the psychiatrist that their brain is picking up this function and they no longer need as much medication or medication at all. I find that most psychiatrists do want to take people off of medication because they know it’s a toxin to the body. Many of your drug commercials will tell you and warn you about liver conditions because anything you ingest if it’s a toxin, your liver is going to take it out of your system. If you continue to do this for many years, then you will damage your liver. It will not be able to continue serving you for the length of your lifespan. They do want to take them off, but they don’t have justification to do that. This provides the justification.
What can you tell us about studies about what percentage of people with these problems respond positively to the qEEG neurofeedback?
This is a summary of the kinds of successes that have been documented by professional societies like the International Society of Neurofeedback and Research. The first one was Margaret Ayers. Margaret Ayers was a pioneer in this field. She was a neurologist. She said she did neurofeedback with her patients and found better than 90% complete or nearly complete relief of symptoms. Next is Joel Lubar, the man that I studied with. He was the one who found the theta/beta ratio for ADD. He said he gets better than 90% and has gained substantially by doing neurofeedback training. Mike and Linda Thompson. Mike Thompson is a neurologist. Linda Thompson is a clinical psychologist. They have a general practice in Canada. They find between 80% to 90% success rate in relieving the symptoms of the patients that come to visit their office. Dr. Rothman, who I do not know, treats people with fetal alcohol syndrome and autism.
Injecting chemicals and then removing the medication makes the brain go back to its old pattern and the symptoms come back. Click To TweetFor three years, I and a colleague were treating fetal alcohol syndrome and doing research and presented at three different conferences on our results with some interesting successes. I have a number of autistic children that come. Autism is a characteristic by high amplitude low frequencies which is a distracting brainwave. They start doing something and they get distracted and they do something else and they don’t stay focused. Those tend to be my longer-term patients, but the parents keep bringing them because they see incremental improvements.
One mother says, “He now sits at the dinner table for the entire meal when we eat.” She continued bringing him and reported when the family watches a movie, he watches the entire movie with them. They see these incremental improvements and they continue wanting to build on that. Siegfried Othmer is a Canadian neurotherapist. He’s formally a physicist. He also went through a metamorphosis of careers and got out of physics and into neurofeedback. He’s seen reports out of 1,000 cases, 20% are miracle stories. 45% in proof substantially and relief of all the symptoms and 25% are satisfied that they have achieved the goals that they came in for. All of that is documented in a wonderful book called A Symphony in the Brain by Jim Robbins. It’s a layperson’s explanation of neurofeedback and the history of how we got started in doing this and what the new technology is affording us to be able to do.
Thank you for that overview. What’s an area that I haven’t asked you about yet that you’d like our audience to learn of or to know about what you do?
First of all, when they go and have a set of symptoms that are causing problems either in their family or their loved one and they’d go to the medical community and they begin to experiment and try different medications and they do not seem to be working or they have side effects that they can’t live with, not to give up hope. That is the view of treating the brain as if it’s a chemical engine. There’s another approach, an alternative approach of treating the brain as if it’s an electrical engine. That may serve them to get this success they want to have and not to be discouraged because treating it as a chemical engine did not work.
David Burns is a psychiatrist. He’s famous. He wrote the book, Feeling Good, and a number of other books. He was here in Loyola Illinois teaching and had an audience of 250 therapists in DuPage County. Early in his program, he made a statement, “Psychiatry will make no further advances until they stop treating the brain as if it’s a chemical engine and begin treating it as if it’s an electrical engine.” I could’ve stood up and applauded because that’s exactly what I do. I believe he is right because we have given parents hope when they were at the end of their rope. Not being able to take medications and thinking that there was no other help for their child.
You’re located in Naperville. I’m assuming you don’t work alone. Who’s on your team there in Naperville?
I have four neurotherapists here. I have two clinical psychologists. One of them does all of our EEG. Another one does more of the advanced types of neurofeedback, as well as being a neuropsychologist, and he can do a typical neuropsych testing. However, we have the advantage of doing the traditional neuropsych testing and combine the information and validate it with qEEG data. We do that. We treat 172 patients a week. We have the most complete neurofeedback laboratory in the entire Chicago area. Not only do we have the best EEG equipment in every hospital around here, and I know that because I get the EEG from hospitals around here and I’m not impressed. Hospitals do not spend a lot of money on EEG equipment. They only care about whether or not you’re having a seizure and if they buy mediocre equipment, it will tell you you’re having a seizure. They spend their money on MRI machines and the real big-ticket items like the diffusion tensor imaging machines and so on. That’s the way we gather our data.
QEEG Neurofeedback: If you have high beta activity in the left frontal region, you will have obsessive thoughts. In the posterior right side of the brain, you will develop compulsive activities.
When it comes to treatment, we have five different types of neurofeedback technologies to apply. Each of these technologies has its strengths and its weaknesses. Once we see what the goal is and what we need to change, I have five different types of computer technologies to apply and there’s no one in Chicago who’s got five. I belong to EEGChicago.com. We are ten highly certified neuro therapists throughout the Chicago area. We have the most complete laboratory and we’re out here in the Western suburbs.
What’s your website before we close this out?
It’s www.UltimateBrain.com.
Thank you so much for your time.
You’re welcome. Thank you.
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About Dr. James Kowal, Ph.D., BCN
As a Board Certified Expert in Traumatic Stress and trauma specialists we employ many other methods besides talk therapy: EMDR, Thought Field Therapy, Emotional Freedom Therapy, Clinical hypnosis, Internal Family Systems, Holographic Memory Resolution, Ego State Therapy and Neurotherapy (EEG Biofeedback or Neurofeedback). Thus, we are able to help patients get to the root cause of many psychological disorders by using state-of-the-art technology, neuroanalysis, and advance methods and techniques of neurotherapy and psychotherapy. We have four different types of neurofeedback technologies available to match the patient’s needs to the best, state-of-the-art technology available.
As a BCIA Certified neurotherapist, I do quantitative EEGs and brain map analysis that provides detailed information that aids in making an accurate diagnosis and treatment plan for: ADD, ADHD, anxiety, depression, mood disorders, OCD, PTSD, panic, memory issues, learning problems, concussions and traumatic brain injuries.
We employ energy psychology with such advance technology as Nutri-Energetics System, which scans a person’s quantum energy field and identifies distrubances in the field for most body organs, meridians, muscular/skeleton system, nutrition and sensitivities and use infoceuticals to help correct the information flow in the human system.
