Couples therapy or counseling presents its challenges to even the most seasoned of therapists. The additional challenge of a three-to-ten session limit that managed care companies often impose can be overwhelming with a violence-prone, multi-problem couple. At the Brain Wave Treatment Center we often use EEG Biofeedback (Neurofeedback) as our short term therapy model, due to its power and efficiency. We will present the case of Dan and Sarah to illustrate how this approach can provide meaningful long lasting change.

This couple had been married for 22 years when they were referred to our center for family problems by their managed care company, who initially granted three and later extended to nine sessions for each partner. Our assessment led to a diagnosis of intermittent explosive disorder including spousal abuse. This couple reported a history of chronic conflict, which resulted in periodic explosive behavior on the part of the wife, during which she would ragefully throw things and otherwise respond aggressively with her husband and son. Upon first meeting, she appeared humbled by her out-of-control aggressive experiences. Her symptoms, as she described them, indicated a severe problem within the family. Chronic tension between the husband and wife, both resulted from and contributed to her explosive behavior, and as often exists there appeared to be a cyclic pattern to the nature of this behavior.

By the woman's description, it appeared that their 12 year old son, was also beginning to participate in angry outbursts, which had been modeled by his parents. After the intake Touch Association Retraining was recommended for the couple.

Treatment began with a single session education process designed to familiarize the couple with Neurofeeback. They were advised that a three sensor placement would be used and that none of these sensors would conduct electricity toward them, rather their brain electricity would be processed by the EEG Instrument and the computer resulting in a series of tones. They were told to increase the frequency of the tones. They were also informed that the procedure was designed to help them gain a new bio-electro-chemical skill, i.e. enhancing slow brain wave activity, which is calming, resulting in enhanced feelings of well being and personal, behavioral, and emotional control.

In subsequent meetings each of them experienced separate 30 minute EEG Biofeedback sessions. Increased amplitudes of slow brain wave activity (Alpha and Theta), which induces a lowered psycho- physiological arousal state, was reinforced via computer tones. Once they each demonstrated initial proficiency in increasing slow wave activity in the office, the home generalization procedure was implemented. In this phase they were instructed to engage in slow wave activity at home during a mutually agreed upon time each day, while they made physical contact by holding hands. Both reported compliance. Within 5 weeks they were reporting enhanced feelings of closeness and experiencing less conflict. The couple also stated that their son's aggressive and defiant behavior had diminished and that he appeared calmer as well. In this early phase of home re-training, Sarah stated that when she and her husband did not engage in the home assignment she became more agitated and angry. While the efficacy of EEG Biofeedback in treating individuals diagnosed with intermittent explosive disorder and couples involved in abusive relationships has not been well documented in controlled studies, we have had good success in such cases. We speculate that chronic relationship tension changes with the introduction of repeated positive associative experiences, as can be experienced within lowered states of psychophysiological arousal such as that induced by brain wave training to increased amplitudes within the theta (4-8 Hz) and alpha (8-12 Hz) ranges.