After being exposed to Norman Doidge’s book, The Brain that Changes Itself, the CEO (our fearless leader Dr. Benita Quakenbush) of Avalon Hills said “we have to meet this guy”. Well, we were fortunate to do that and so much more. In the early days of helping Norman understand Avalon Hills and what makes us so different than other eating disorder treatment centers, he was a gracious guide in linking us with other pioneers in the field of mental health treatment.
Ed Hamlin, a well-known neuropsychologist, was one of the best finds of our careers.
Quickly we discussed our patient population with Ed and the status of eating disorder treatments and agreed that we needed to integrate an applied neuroscience component into our program based on advancements from brain mapping and neurofeedback in the world of mental health including issues such as ADHD, PTSD, Anxiety Disorders and Depression among others. As a result, we have been incorporating applied neuroscience in our program since our first training in January of 2015.
Our talented neurofeedback technicians acquired our first patient qEEG (aka brain map) in May of 2015. Although we had our guesses of what we would see, we waited with rapt attention for the findings to come in…
We have been almost too busy revolutionizing care to look back, but Ed has been diligently tracking the data from each patient’s intake, 30 day, and discharge qEEG measurements. Ed was on-site at Avalon Hills providing training for our neurotechs and treatment team last week. He had some important findings to share with all of us. Although we have been looking individually at the qEEG reports with each patient, and the results determine our neurofeedback training protocols, looking at the patterns is so exciting. This is the largest qEEG dataset for those suffering from an eating disorder and it continues to grow because we will never stop trying to learn more about effective and efficient treatment options to provide to our patients.
Ed shared information that helped all of our treatment team members understand the context of their interventions with each client. This will arm us to increase our ability to personalize interventions by understanding 3 of the major communication hubs within the brain.-The Default Mode Network, The Salience Network, and The Executive Control Network. Understanding how these 3 networks function together is critical to conceptualize how thought and behavioral patterns can become so ingrained, plus how to facilitate lasting change. When discussing with patients I also share this with patients as the Executive Network as the “brake” with the other networks listed above as the “gas pedal”. To have a functioning system, everyone needs enough gas to move towards valued directions, but yet enough coordination with a braking system that helps route a direction, knows when to slow down, and when to speed up.
Default Mode Network: Is our brain’s easiest route, this is like the information super highway. It is where we return when we aren’t really focused or goal directed. This network holds the knowledge of our sense of self in our past, present, and future.
Salience Network: This network connects the body, garnering input from the environment through the vagus nerve & the viscera. This network tells us to run from a growling tiger before we even know why we are running. Salience guides us in what we “feel” is important to us vs. what we think is important.
Executive Network: Functions to provide judgement, attention, impulse control, critical thinking, feeling and expressing emotions, and ability to learn from experience (among other important functions). This network is critical in inhibiting the impulses of the limbic system, which is our primal emotional system.
Recently, we also had the opportunity to also share data from the Avalon Hills Project with a group of over 50 clinicians in Portland at a local Oregon IADEP event. Important patterns from the qEEGs of Avalon Hills patients include:
- Lack of integration of the right insula. This is an area known as the “body’s monitor”. Our right insula is critical in helping us with our accurate “felt” sense of our bodies. This area is implicated in our hunger cues as well as taking in cues from the environment such as accurately reading the facial expressions of other people in our world. This is also the brain area that is most implicated in how people understand the visual representation of their bodies, almost like a mini Avatar. We can understand this finding explicitly in our work with body image issues.
- Frontal lobe dysregulation. A subset of our patients have BOTH excessive slow wave frequencies as well as excessive fast frequency activity. This is like the brain has two feet fully pressing the gas pedal and the brakes simultaneously. Dysregulation An example of this was evident in our milieu last week when a patient said “I want to give you my device, but I CAN’T”, a perfect representation of the difficulty of being so frozen and the difficulty of breaking out of maladaptive patterns.
The dataset continues to grow and we are eager to share it with the larger eating disorders and mental health community. We are just that driven to improve care- EVERY SINGLE DAY.