Treating PTSD with Cognitive Processing Therapy

Many individuals are affected by post-traumatic stress disorder (PTSD) on a daily basis. The experience of a trauma can be difficult to process and can lead to feelings of helplessness, hopelessness, sadness, fear, and panic, an inability to focus and concentrate, loss of self-control, avoidance behaviour and social withdrawal, flashbacks to the traumatic event, and in severe cases thoughts of suicide. Treatment to reduce symptoms can help individuals return to normal functioning and prevent symptoms from worsening over time.

At the Toronto Neurofeedback and Psychotherapy Centre we offer Cognitive processing therapy (CPT) to treat PTSD. CPT is an evidence-based treatment that is effective in treating individuals diagnosed with PTSD or struggling with stress symptoms associated with traumatic events. This includes, but is not limited to, work-related trauma as may be experienced by first responders, child abuse, rape, and major life-threatening accidents. This type of cognitive-behavioural therapy focuses on client goals as well as their thoughts, emotions, behaviour, and physiological responses to reduce trauma symptoms and improve psychological well-being. CPT uses a combination of assessments, psychoeducation, worksheets, and homework to help clients challenge and alter unhelpful beliefs and thoughts related to their traumatic event and modify their behaviour, while promoting a new and healthier understanding of their lived experience.

It is highly recommended that clients commit to 12 weekly therapy sessions to get the most benefit out of the therapeutic process. Reach out to our office to find out more or book your first session with one of our therapists.

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EMDR, PTSD and Neurofeedback

Post-traumatic stress disorder (PTSD) affects the lives of many across the world. In Canada alone 9.2% of individuals will be diagnosed with PTSD in their lifetimes and many more will suffer from symptoms associated with trauma exposure. Experiencing a trauma can leave an impression on the brain and body triggering emotional and physiological responses. These can include feelings of helplessness, hopelessness, sadness, fear, and panic, an inability to focus and concentrate, loss of self-control, avoidance behaviour and social withdrawal, flashbacks to the traumatic event, and in severe cases thoughts of suicide. Individuals may also experience physical symptoms like sweating, heart pounding or racing, headaches, and muscle cramps especially when triggered or recalling memories of the traumatic event. Treating PTSD by targeting the body, brain and mind can result in successful reduction of many of these symptoms. If not treated, symptoms can worsen over time and have a devastating impact on daily functioning, relationships, and life in general.

Dr. Bessel van der Kolk’s book, The Body Keeps the Score, provides a wonderful account of his work with real-life trauma experiences, a worthy explanation of changes that occur in the traumatized brain and body, as well as a description of the evolution of trauma treatment. Dr. van der Kolk highlights two trauma-specific interventions that have gained popularity and success in the treatment of trauma symptoms in recent years, Eye Movement Desensitization and Reprocessing (EMDR) and neurofeedback.

EMDR is a type of psychotherapy that can help you process the memories associated with your trauma. The goal is for you to no longer find the experience distressing. In sessions, you will work with a therapist who assists you in engaging in a series of eye movements while recalling and focusing on specific details of the traumatic memory. Through EMDR, the memory becomes less pervasive and intense as it becomes integrated with other memories of the past.

Common results of EMDR sessions include:

  • Reduction in distress and flashbacks brought on by the memory
  • Diminished emotional and physical symptoms
  • Improvement in daily functioning and living and interpersonal relationships
  • An ability to recall the traumatic event without being triggered
  • Improved stress management

Just like EMDR, neurofeedback can help you recover and heal from your trauma. When you experience a traumatic event, there are changes that occur in their central nervous system and body. Brain patterns and frequencies are rewired and dysregulated which affects trauma symptoms. Neurofeedback works by gently pushing the brain out of stuck patterns and stabilizing the brain and thus weakens the client’s response to the trauma. It does this by focusing on brain wave frequencies and sends a slightly different frequency back to the brain. For a few seconds, the brain is given something to do by copying the new frequency. After a few sessions of neurofeedback, clients may begin to experience the following:

  • Improvement in executive functioning (i.e. improved ability to plan and organize activities, move from one task to another with more ease, improved and clearer focus, attention, and concentration)
  • Improvement in sleep and reduction in flashbacks and nightmares related to trauma
  • Reduction in thought looping
  • Reduced emotional and physical symptoms associated with the trauma
  • Improved control over one’s emotions

EMDR and neurofeedback have been found to be effective in treating PTSD and trauma symptoms even when compared to other forms of trauma treatment like medications. One major benefit to EMDR and neurofeedback treatments is that clients experience little to no side effects and the approaches are considered safe. At Nicole McCance Psychology and the Toronto Neurofeedback  and Psychotherapy Centre, we are pleased to offer our clients struggling with trauma the option of EMDR therapy, neurofeedback, or a combined therapeutic approach.  

“Unlike other forms of psychological disorders, the core issue in trauma is reality.” 
― Bessel A. van der Kolk,

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What is Play Therapy?

Play has always been an essential part of child development and is the main communication tool for children. Since play is a natural form of self-expression it can be utilized as a way of working therapeutically with children that are experiencing behavioural and emotional difficulties.

Play therapy incorporates many activities called ‘tools’ for children to utilize which help them express themselves and process events in their lives. Some of these ‘tools’ include art, sand, role play, and music. Using these tools, play therapy allows the child the opportunity to play out their feelings and problems. For children to partake in play therapy, they do not need to be able to verbally share what is happening for them, their world is expressed through their play!

Virginia Mae Axline (1911-1988), an American psychologist and a pioneer of play therapy, is known for the non-directive technique and establishing eight key principles for the therapist to follow. With this technique the therapist supports the child in being able to process their experiences at their own pace in a non-overwhelming manner. The therapist creates a therapeutic rapport which provides the children with acceptance, helping the child feel capable within themselves, and supports the child in gaining insights. Non-directive play therapy creates an approachable therapy for children to engage in.  Helping them feel confident, find their voice and process the tough stuff in life!

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What is Brainspotting?

Have you ever noticed how the direction in which you look affects the way you feel? Take a moment and think about a situation – first look to the left while thinking about it, and then look to the right. Do you notice the difference? Brainspotting is a psychotherapy based on how our nervous system and body become activated when we think about a traumatic event while looking in a certain direction. The particular positioning of the eye is correlated to our inner emotional and neural experience.

How does Brainspotting work?

With the assistance of a pointer, trained brainspotting therapists slowly direct the eyes of clients in therapy across their field of vision to find appropriate “brainspots,” with a brainspot being an eye position that activates a traumatic memory or painful emotion.  These eye positions, or “brainspots” may, through sustaining eye fixation, lead to a healing and a resolution of problems that are held deeply in the non-verbal, non-cognitive areas of our neurophysiology. Have you ever heard of the term “trauma processing”? Essentially, brainspotting utilizes both focused activation and focused mindfulness as its mechanisms of operation.

Who is Brainspotting suitable for?

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Brainspotting is suitable for those who have experienced either physical or emotional trauma. Those with PTSD and athletes, in particular, can benefit from brainspotting. It was while working with an Olympic ice skater that this treatment was discovered by Dr. Grand.

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Neurofeedback for Anxiety and Panic Attacks

Did you know that neurofeedback is very effective for panic attacks? Panic attacks are generally difficult to treat because of their unexpected onset. But Neurofeedback can be especially effective for panic attacks when administered in conjunction with psychotherapy.

Anxiety is a hyper aroused state of our nervous systems and results from too much high beta brain waves. Your brain might be dysregulated in this way and it doesn’t even know it. You may have even gotten accustomed to the feeling of anxiety so much so that you do not realize when you are anxious. Typical symptoms of anxiety include: Feeling constantly rushed or having a sense of urgency about everything, trouble breathing and impatience. These symptoms can lead to irritability and difficulty sleeping which results in concentration difficulties at work or even in your relationships.

You may be asking, how does neurofeedback work? The EEG electrodes can read your brainwaves and provide feedback to you on what your brain is doing. In the case of panic attacks, it interrupts the brain patterns related to the panic. Similar to the electrical signal sent to the heart when you experience dysrhythmia, neurofeedback interrupts your anxious beta brainwaves by sending a signal to your brain. The brain then knows to get back to its regular pattern. It only takes about ten to twelve weekly neurofeedback sessions for the brain to get back to its regular patterns.

Your body always wants to be in homeostasis, a state of balance. It knows how balance feels and is always striving to attain it. The body knows when we are too cold, or too hot and it takes steps to bring us back to balance. The brain regulates your brain waves just like your body regulates your temperature. But the brain needs help achieving this balance when it is stuck in unhealthy patterns. By interrupting it through neurofeedback, we let it reboot and it reorganizes itself to become more regulated. This is when your symptoms will subside.

Your brain knows what it is like to be healthy. A healthy regulated brain has no symptoms. It sleeps well, is not agitated, it concentrates, has good memory and does not have panic attacks. Your worries are reduced, breaths are deeper and you feel safe. Most importantly, it makes you feel good!

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Neurofeedback for ADHD

Did you know that Neurofeedback is a research based treatment for individuals with ADHD? Traditional ADHD treatment has focused on medications. However, in recent years strong research has demonstrated that Neurofeedback achieves equivalent effects as medication. In fact, according the American Pediatric Society Neurofeedback is now a Level 1-Best support intervention for ADHD, meaning that it is considered a best practice treatment for ADHD.

At the Toronto Neurofeedback and Psychotherapy Centre we use QEEG assessments and Neurofeedback to target parts of the brain that develop early in a child’s development. Clients regularly report initial improvements in their child’s attention, followed by improvements in academic performance, social skills, decreased distractibility, improved memory, and decreased impulsivity.

By using QEEG assessments we are able to determine the difference in brain wave activity and observe regions of the brain which may be underactive or overactive. Research has shown that there is a difference in brain waves for children with ADHD. In addition, many empirical studies show changes in brainwaves post treatment as well as changes in behaviour (less aggressive, more cooperative, better communication, improved attention span and improved sensory motor skills.)

Head to our website to read many research articles on the benefits of Neurofeedback for children with ADHD.

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What are Brain Waves?

We have multiple different types of brain waves and our state of arousal depends on which brain waves are happening at the moment. Our brain waves are measured in hertz, or cycles per second.


Delta waves are slow and usually occur when we are in a deep sleep. We also frequently see delta waves in head injuries, as injured neurons tend to be slower.  

Theta waves occur when we are a bit more aroused. We see them when we are drowsy, groggy or right before we are about to fall asleep. Having a balance of theta helps our memory.

Alpha waves are ideally where we want our brains to be. They signal that we are alert but calm.

Low Beta waves occur when we are thinking but relaxed. We solve problems, have conversations and even read blog posts in this state!

Beta waves generally occur when we are actively thinking. They are heavily involved in cognitive functions; we are alert, focused, engaged and task-oriented.

High Beta waves signal anxiety, worrying and muscle tension. Lots of these waves can suggest we are having trouble letting things go.

Gamma waves are the highest frequency brain waves and also the most recently discovered. Whenever you have a moment of enlightenment you can thank Gamma waves for it!

Many psychological conditions are affected by the balance of brain waves. In anxiety, PTSD and panic attacks we see too much beta waves and not enough alpha. This could be a result of childhood trauma that has placed your brain in a rigid pattern which needs to be changed before you can get better.

In traditional therapy, too much high beta waves could be impacting your ability to learn the techniques your therapist is providing. High theta waves could also be giving you concentration problems and result in zoning out during a session. Using neurofeedback in conjunction with psychotherapy and cognitive behavioural therapy allows us to observe your brain waves and teach the brain to regulate itself. We want to achieve a balance of brain waves so the brain can reach the homeostasis it constantly craves.

girl-blowing-bubblesNeurofeedback can teach the brain to calm the autonomic nervous system which is related to anxiety. By balancing brain waves we can move you away from the sympathetic system response to a parasympathetic response. Once we reach our goal of reducing beta waves and balancing theta, you will feel calmer and relaxed.


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Dating After Divorce

people-2589780_1920A lot of people under estimate how difficult it can be to start dating after divorce, when you have children. You’re likely going to be dating somebody who has kids, as well, which means you’ll have to work around more then just two people’s schedules. If your children are young then you’ll also need to pay for a babysitter increasing the amount of money you’ll be spending to go on dates. Plus at the end of the day when you’ve put your kids to sleep, the last thing you probably want to do is get dolled up, go meet a stranger and hope for the best.

With all these difficulties in mind, I made a list of creative things you can do if you’re in this situation.

  1. Find a date that’s cheap. As mentioned, there’s a good chance you already need to spend cash on a babysitter so why not save money on the actual date. Do something like going for a walk instead, especially if the weather is nice. This also gives you a constant topic of conversation as you can talk about what you’re seeing as you walk. Walking also comes with less pressure than sitting in a restaurant. If you’re shy it can be nerve racking to sit across from someone you don’t know who’ll be staring at you all night. An added bonus, you’ll be getting exercise!
  2. Only meet for coffee or drinks. This is another way to save money since you won’t need to pay for a full meal. If you do find that you’re enjoying yourself you can always order an appetizer. Plus drinks or coffee is much less of a commitment if the date isn’t going well.
  3. Be adventurous. Make a bucket list of things that you personally want to do or see and plan fun dates based on your list!  This could include things like going for a hike, going to the beach, a wine tour or festivals in your area.

Overall dating after divorce is more difficult because it’s more complicated but hanging in there is key.  Also surrounding yourself with social support, specifically spending time with people who have successfully found love after divorce will keep you both hopeful and inspired!couple-1845620_1920

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Are your problems “first world” problems?

sunset-2525181_1920I ran into a friend the other day at the gym and she started telling me that her and her husband have been renovating their house and they recently bought expensive light fixtures for their kitchen. Once installed, she didn’t like the way the lights looked. She also found herself obsessing about how ugly they were and nagging her husband to take them down. It got to the point that every time she walked into her newly renovated kitchen she was fixated on these eye sores. It even led to a few arguments between them.

After days of dealing with this, her husband gently pointed out that her being bothered by the new expensive light fixtures was a “first world problem.” This was eye opening for her and after hearing that comment, it helped her to let go of the stressful reaction. Instead she switched her focus to the fact that she has the means to renovate her kitchen to begin with.

It’s easy for us to get caught up in the details of our job or how our partner hasn’t emptied out the garage or even how a friend hasn’t gotten back to us yet. We can become obsessed with the little things and allow it to ruin our day or even our week.

My intention is not to minimize what you are going through but to help you change your perspective. The truth is a lot of what we stress about are “first world problems.” What that means is we take for granted how easy our lives actually are. We have clean water, a cold fridge (probably with food in it), access to free healthcare and likely live in safe neighbourhood. Things could be so much worse. Lets remind ourselves of what we do have instead of focusing on what we don’t. Notice how your mood changes, almost instantaneously when you change your focus.father-1633655_1920

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How to be a good friend

girls-462072_1920Believe it or not, it actually takes certain skills to be a good friend. By “good friends” I mean people who are supportive, empathetic and may even help you reflect on your life. For example I have clients who tell me that when they reach out to a friend for support they often hear comments like “ I went through the same thing but worse, so I’d rather have what you’re going through now.” This statement minimizes the other person’s feelings and they are less likely to reach out for support, as they may even feel more alone after this conversation.

If you struggle with how to respond to a friend calling you when they’re upset, here are some things to keep in mind:

  1. Don’t change the topic to yourself. A lot of people think that it will help their friend to hear that you relate to their struggle but the truth is if you bring this up right away it can come across as self-centered. Instead, try asking open-ended questions, like “How are you feeling about all this?” When someone is calling you about something that happened they probably want to talk about how it makes them feel so make sure to give them the chance.
  1. Empathize. Say things like “Oh my God, that must be so hard”, or “I can’t imagine what you’re going through.” If the person is angry, get angry with them! Feel their emotions with them and express those emotions back. It can help this person feel better to have that comradely because they want to feel justified.
  1. Validate them. Think about your friend’s history and relate it to how they are feeling, saying things like “It totally makes sense that you would feel this way since the same thing happened to you last time, you must feel so hurt.” At this point you could also mention that you went through something similar and you remember how it made you feel.

As with any skill, being a good friend can be learned. Try practicing these tips the next time a friend, or someone who could become a friend, comes to you with a problem. You may find your friend circle expanding!pinky-swear-329329_1920



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