Hypnosis

Introduction

Attention Deficit Disorder comes under many names and manifests itself in many different ways. The basic definition of ADD includes a difficulty in concentrating and staying on a task with or without symptoms of hyperactivity. There are many different symptoms included in this definition, all listed in DSM IV. In this paper I will not differentiate between subtypes of ADD as the predominantly inattentive type, the predominately hyperactive impulsive type and the combined type.

The difficulties caused by ADD are numerous and manifest themselves especially in the educational setting. This is not to say that there are not difficulties in other areas of the human existence as personal relations, work etc. But the educational setting is the easier place in which assessment and treatment can take place.

Nowadays the most popular intervention in cases of ADD is through the use of medications (stimulant, antidepressant, tranquilizers and anticonvelescent medicines). Sometimes educational coping strategies, biofeedback and psychotherapy are used too. At times, no treatment is given at all out of the assumption that the problem "will go away" by itself when the student will "grow out of it". Recent research suggests that ADD symptoms do not disappear with age, especially when no treatment was used: "As adults they [the formerly ADD children] often experience difficulties in interpersonal relationships leading to a high rate of divorce, difficulty in holding jobs, and decreased potential for professional advancement" (Lubar, 1985).

In spite of the many existing coping strategies it seems that there is still place for more directions in the treatment of ADD. Not taking away from the effectiveness of medicine, it could be advantageous to find another method that achieved the same goal without the side effects of chemical agents (both physical and psychological). Or in the case of educational strategies - without the enormous effort and manpower involved in learning, developing and teaching the various strategies. A more effective, side effect free and cheap strategy is needed.

Electroencephalogram (EEG), Brain Waves and ADD

The electroencephalogram, or in short EEG (literally "writings of electricity from the head"), is a measurement method for the electrical activity of the nervous system. EEG measurement is performed by attaching macroelectrodes to various parts of the skull and recording the electrical activity of the brain in these areas. The various activity levels of the brain are defined as brain waves and divided into four basic groups according to wavelength. Delta waves range between 0-4 Hz, Theta waves range between 4-8 Hz, Alpha waves range between 8-13 Hz and Beta waves are greater than 13 Hz. Alpha waves are typical of states of quiet rest, none particular activity and sometimes when the eyes are closed. Beta waves are typical of states of alertness, attentiveness or active thinking. Beta waves appear also in the REM sleep stage along with Theta waves while the other sleep stages are characterized by Theta and Delta brain activity .

Many researchers noted a discrepancy between the EEG of subjects with learning disabilities or ADD and normal subjects. Typically, the ADD subjects were characterized by brain activity on the slower end of the frequency spectrum "The most important characteristic is either an excessive amount of theta activity, a lack of beta activity or a combination of these" (Lubar, 1985.

The existence of such differences suggests the usage of EEG recording as a good diagnostic tool in the assessment of ADD and Learning Disabilities. Lubar does not differentiate between LD and ADD subjects but as the focus of this paper is on treatment of ADD I will limit my dicusssion to the results of ADD subject without imlying anything about effects on LD subjects. On that note, some work was also done in the last decades on using brain activity modification as a treatment tool for ADD.

Biofeedback as Treatment for ADD

As mentioned in the previous section, ADD is characterized by a different brain wave activity than the norm. In this section I will discuss the recent work done on treatment of ADD by the manipulation of brain wave activity mainly through the use of biofeedback but also through the use of meditation and relaxation strategies.

Biofeedback, [is] a technique by which patients monitor their own bodily functions in an attempt to alter those functions. Primarily used in treating painful or stress-related conditions, biofeedback helps a patient control physiological processes that are normally considered involuntary.

In biofeedback training, electronic or mechanical instruments attached to the patient measure physical functioning, such as the degree of muscle tension. The machines then transform this information into amplified signals that the patient can hear or see-for example, a beep or a flashing light-thus enabling the patient to know when internal responses are abnormal. This feedback information can then guide the patient in trying to gain control over the internal condition. (Microsoft Encarta, 1995).

Biofeedback is used mainly in the field of medicine but also in the field of psychology in the treatment of disturbed behavior that has a physical basis.

Substantial work on biofeedback as treatment for ADD was and is done by J.F. Lubar, a professor of psychology at the University of Tennessee, Knoxville. Lubar made a connection between his belief that ADD has a neurological basis and the affects of biofeedback treatment on attention. This connection led him to experiments in the treatment of ADD through the use of biofeedback, which usually proved successful. The main objective of the biofeedback treatment was to increase levels of beta activity and decrease the levels of theta activity in the brain of the ADD subjects. In his articles Lubar reports highly successful results:

"Six children were provided with long term biofeedback and academic treatment.... All six children demonstrated considerable improvement in their schoolwork in terms of grades and achievements test scores. None of the children are currently on any medications for hyperkinetic behavior" "We have found that for each year of feedback training, there is approximately a 2.5 year increase in overall grade level performance, with some subjects improving as much as four years" (Lubar, 1985).

Finally, in his article from 1991, Lubar reviews 15 years of biofeedback treatment with ADD subjects describing different treatment techniques, various results and finally suggesting