The Use of Biofeedback, CES, Brain Mapping and Neurofeedback with Youth Who Have Sexual Behavior Problems

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Introduction

During the early part of this decade, an increasing number of researchers, practitioners, and clinicians, within the field of assessing and treating sexually abusive and sexually aggressive behavior, among others, have begun to address the impact of trauma on the brain, especially in young people with sexual behavior problems, Teicher (2007), Creeden, (2006), Bengis & Cunningam (2006). This information and knowledge also has direct application to those young people who also have histories of abuse and/or neglect, Ziegler, (2005), Ogden, Minton, & Pain, (2006). In particular the professionals listed above and others have addressed the impact on youth with sexual behavior problems and those who have been sexually abused. This is important because many young people with sexual behavior problems have a history of abuse and neglect.

Teicher, (2008), notes that exposure to childhood abuse, particularly childhood sexual abuse, is a risk factor for development of impulse control disorders, and can lead to a cycle of violence and perpetration. Exposure to early stress can exert enduring effects on brain development that may underlie many of the consequences of exposure to sexual abuse. Research indicates there are negative effects of childhood sexual abuse on development of the hippocampus, corpus callosum, prefrontal cortex and visual cortex.

Martin Kafka, MD, Clinical Associate Professor of Psychiatry at Harvard Medical School notes, that the following are risk factors for sexual recidivism in adult males: negative mood states, mood disorder, ADHD combined subtype, PTSD, Conduct Disorder, and BiPolar Dysthymic Disorder. Kafka notes that 10-15% of males with anxiety and/or depression had sexual risk taking behaviors; and that "mood and anxiety disorders may be so common among sexual offenders, that these conditions and their associated effects are not distinctly identified as correlated with recidivism."

Trauma and Its Impact on the Brain

Trauma resulting from early childhood abuse and neglect impacts the brain in a variety of ways. The Training & Research Institute, Inc. in Albuquerque, NM (2004) notes that childhood physical, emotional, sexual abuse and neglect can cause antisocial behavior by over-excitation of the limbic system; the primitive midbrain region that regulates memory and emotion, and the prefrontal cortex; which is associated with judgment, consequential thinking, and moral reasoning. They note, for example: 1) The left hemisphere is responsible for regulation and oversight of logical responses to a situation; and control and mediation of emotional responses generated by the right hemisphere.

   The impact of childhood abuse or neglect results in diminished
   control of emotional response, resulting in poor or inappropriate
   reactions to emotional situations, angry outbursts, selfdestructive
   or suicidal impulses, paranoia, psychosis, and a tendency to pursue
   intense ultimately unstable relationships.

2) The prefrontal cortex is the internal editor of emotional states, consequential thinking, moral reasoning, and reactions to emotional crisis.

   The impact of childhood abuse or neglect results in increased
   potential for depression and delinquent and criminal behavior.

3) The corpus collosum creates communication between the right and left hemispheres.

   The impact of childhood abuse or neglect results in a significantly
   smaller corpus collosum, causing nonintegrated, inappropriate
   responses to everyday situations.

4) The temporal lobes regulate emotions and verbal memory.

   The impact of childhood abuse or neglect results in poor modulation
   of emotions, and an increased chance for temporal lobe epilepsy.

5) The hippocampus (part of the limbic system) is responsible for the formulation and retrieval of verbal and emotional memories.

   The impact of childhood abuse or neglect results in lower
   performance on verbal memory tests, possible continued mental
   problems, and concerns during the adult years.

6) The amygdale, (also part of the limbic system) creates emotional content for memories, mediating depression, irritability, and hostility/aggression, and governing reaction and responses to fear.

   The impact of childhood abuse or neglect results in a significantly
   smaller amygdala raising the risk for depression, irritability and
   hostility/aggression; and is also responsible for incorrect
   emotional "memories", absence of fear conditioning, and an
   increased chance of psychopathic tendencies.

7) The purpose of the cerebellar vermis is to modulate production and release of neurotransmitters, and has a significant number of receptor sites for stress related hormones.

   The impact of childhood abuse or neglect results in an increase in
   potential risk for psychiatric symptoms such as depression,
   psychosis, hyperactivity, and attention deficits, and in rare cases,
   psychotic symptoms are possible.

For patients who suffer from trauma, depression, and other mental disorders, we now know that we can use cognitive behavioral therapy (CBT) and trauma focused cognitive behavioral therapy (TFCBT) to reduce or even eliminate the need for psychotropic medications (Begley, 2007). CBT can:

a) mute over activity in the frontal cortex (while antidepressants often raise activity there),

b) can raise activity in the limbic system, and

c) "rewires" the brain to adopt new "thinking circuits".

In other words, one's own thoughts can virtually reshape one's emotions by redirecting one's own thought process, which in turns opens pathways for people to change their perceptions about themselves and others. This process is often referred to as "mindfulness" (Siegel, 2007; Kabat-Zinn 2005).

The brain is often negatively impacted when a person is traumatized. Trauma can result from a variety of experiences, which include, but …