BIOFEEDBACK IN A CLINICAL SETTING IMPLICATION FOR POLYGRAPHY Biofeedback What is Biofeedback? Biofeedback is the use technology to identify, modify and control one’s biology, emotions and thoughts Types of Biofeedback Neurofeedback (qEEG) Symptom specific (pelvic floor dysfunction, etc.) Autonomic Nervous System activity control Cognitive/Emotional Regulation Polygraph Advantages of Each Neurofeedback Requires expensive equipment and extensive training Target specific neurological deficits Identifies areas of deficit in Brodmann areas Map of areas of low and high activity determine treatment Under activated areas can be stimulated for additional activity Areas of over activity are balances by activation of inhibitory systems Brodmann Areas EEG Neurofeedback Types of Biofeedback Symptom Specific Treatment Requires expensive equipment and extensive training Typically carried out in a medical setting Target symptoms that are treatable without medication Teach clients to self treat outside the practitioners office Develops independence from regular medical intervention Types of Biofeedback Autonomic Nervous System Activity Uses a variety of equipment (ranging in price) Treats systemic medical issues Target symptoms that are treatable without medication Teach clients to self treat outside the practitioners office Develops independence from regular medical intervention Pelvic Floor Feedback Types of Biofeedback Cognitive/Emotional Regulation Uses equipment that of varying price (typically inexpensive) Can be effectively used by practitioners with very little training Can be used by clients remotely (home, work, travel) Effectively regulates the body, causing changes in the internal state Types of Biofeedback Polygraph Uses expensive equipment Requires extensive training Only clinical use is to break down denial Should NOT include any type of emotional management by the client Passive response Polygraph UNDERSTANDING THE BODY AND BRAIN Understanding the Body and Brain A brain in your hand… Or just try the clenched fist method Wrist and arm is spinal column, thumb becomes limbic system, and fingers and back of hand become cerebrum. The entire system is held together tightly. The cerebrum, the outer part, is divided up into lobes. Frontal Lobes Planning, thinking Rational and executive control center Monitor higher order thinking Direct problem solving “Regulates the excesses of the emotional system” “Self-Will” area – our personality – trauma here can cause permanent and dramatic changes in personality. Time/sequence Spirituality Courtesy of Drew Caesar www.about-healing.com • • Limbic - so called “old mammalian brain”– emotions, desires, fight, flight, or freeze Includes many parts of the brain – thalamus, hypothalamus, corpus callosum, amygdala, hippocampus, pituitary gland, olfactory nerves. Courtesy of Drew Caesar www.about-healing.com Hippocampus Hippocampus (Greek for “seahorse” because of shape) Plays significant role in consolidating learning converts information from working memory to long term storage which may take days or months (think tx. concepts) checks information from working memory and compares to stored experiences – essential for creating meaning Damage to it means that memory doesn’t go into long term storage. Some evidence says that it plays a role in remembering facts, objects, and places but not much of a role in recall of long term personal memories (Lieberman, 2005) Courtesy of Drew Caesar www.about-healing.com Amygdala Amygdala (Greek for “Almond”) Found at the end of the hippocampus Involved in emotions – especially fear and threat and assessment of threat Connected with organisms survival behaviors, flight, fight, freeze, mate, eat Some evidence to indicate it attaches emotions to memories tagged for long term storage. The Lizard Brain Brain Stem – So called, reptilian brain, resembles the entire brain of reptile Of the twelve nerves that go to the brain from the body, eleven end in the brain stem. Consists in part of the Medulla oblongata – heart rate, breathing – body temperature, digestion monitored and controlled. Houses the Reticular Activating System (RAS) responsible for brains alertness Courtesy of Drew Caesar www.about-healing.com Selecting Appropriate Clients Disorders PTSD Highly aroused Depersonalized Reactive Anxiety General Panic Traumatized Clients Attacks Dissociative Disorders Depressive Disorder NOS Substance Abuse Sexual Arousal Disorder Impulse Control Antisocial / CD Inappropriate Clients Don’t Train Biofeedback Previous Use of Countermeasures Previous deceptive with denial Don’t Polygraph Uncontrolled Anxiety Dissociative Reactive/Victims Clients some drugs/medication The Technology emWave Iom (Wild Divine) Reading HRV Looks at the rhythm of your heart Emotions change the variability of signals Goal is to gain Coherence GSR An indication of mental activity More thought = higher perspiration Less thought = lower perspiration Perspiration = electrical conductance emWave Desktop Fear Reactions Fear triggers initiate a reaction in the autonomic nervous system including: Hypertension Perspiration Involuntary muscle movement Increase in GSR Increase in rapid breathing Techniques Mindfulness Decrease galvanic skin response Decrease stress response Quick Coherence Change in heart rate variability Decreased cortisol production Increases in attention, clarity Classic Systematic Desensitization Pendulation Emersion Use basic visualization of disturbing content Illicit negative emotions Notice sensory stimulation Stabilization Obtain stable physiological response Useful with emWave and Wild Divine No Nos Biofeedback should not be used as a minipolygraph Don’t give specific questions Do deal with the big concepts “Let’s talk about the feelings that come up with family” POLYGRAPH AND COUNTERMEASURES Demonstration Containment Model Criminal Justice System Community Members Sex Offense Specific Treatment Polygraph Examiner Types of Clinical Polygraphs Specific Issue Addresses offender denial Sexual History Disclosure Treatment Planning Risk Prediction Maintenance / Monitoring How Does the Polygraph Work? I can’t control my autonomic nervous system!! It activates the “Flight or Fight” response in humans and measures. 1. Heart Rate 2. Certain Respiration Patterns 3. Galvanic Skin Response (the skin’s resistance to electricity) 4. Blood Pressure These measures are associated with deception and are not themselves measures of lying. 1. Pre-Test 2. In-Test Sign release and consent forms Review medical conditions Explain purpose of exam Review equipment Review terminology Develop final questions Calibrate instrument No trick questions 2-4 relevant questions tucked inside 10-20 comparison questions Relevant questions must be specific Run 3 sets of charts Score and interpret chart markings (pen tracings) 3. Post Test Conducting an indepth interview with examinee, giving him/her an opportunity to explain deceptive findings Use of Polygraph in Offense Specific Treatment Types of Polygraph preconviction specific issue postconviction specific issue sexual history maintenance Benefits of Polygraph significantly increases disclosure resolve discrepancy between victim’s and offender’s statements ascertain limits of abusive behavior deter further acting out more accurate than clinical judgement You Play A Role In Polygraph Exam Accuracy “The Offender must believe in the ability of the lie-catcher.” Ekman, 1995 Examiners are trained to induce detection apprehension. You, too, can induce detection! Make consequences for not passing clear. Focus on telling the truth. Make it very clear that YOU believe in the exam and will act on its results. Can You Fool the Polygraph? Countermeasures fall into several categories: 1. 2. 3. 4. Physical-coughing, moving, biting tongue Mental- relaxation techniques Chemical-drugs, deodorant on palms Behavioral-directed toward examiner: stories of woe, demanding specific wording Examiners are trained to detect and deflect countermeasures. Summary: Polygraph 101 Polygraph Technology greatly enhances our ability to determine truthfulness and deception, but the real focus is developing truthfulness and honesty as life habits. “Passing the polygraph” is a distraction from the real issue: Success is a lifelong commitment to living without secrets and lies. English, Jones, in process, 2001 No Use of Biofeedback Polygraph and emWave Decreases total amplitude of response of all the physiological reactions Differences between reactions on the control and the relevant questions were still seen Polygraph on a client with emWave training is valid Polygraph and Wild Divine Slowed breathing (3-4) breaths per 25 seconds is a sign of breathing control Uncontrolled breathing should be 5-6 breaths per 25 seconds Blood pressure changes without movement may be a sign of countermeasures. Using Biofeedback (emWave) What is this and why does it matter?