Enhancing Posttraumatic Growth Using EEG Neurofeedback: Feasibility Case Studies with Healthy Trauma-Exposed Adults

Posttraumatic growth (PTG) demonstrably improves post-trauma well-being. Accordingly, therapies to enhance PTG are warranted. Proof-of-concept for using neurofeedback to enhance PTG was evaluated during four in-depth mixed-methods single-case experimental design (SCED) studies, with a 2-month follow-up, by examining effectiveness, feasibility, safety, participant tolerance, and mental strategies. Healthy participants who experienced trauma (female n = 2, male n = 2, ages 38–44) attended 2–3 sessions of 8-minute C3 alpha-upregulation EEG neurofeedback per week, up to a maximum of 20 sessions. EEG measures were collected at each session. Posttraumatic Growth Inventory- Expanded (PTGI-X) and Posttraumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (PCL-5) measures were collected pre-intervention, post-intervention, and at 2-months follow-up for each participant. Rapid ethnography was used to closely monitor biopsychosocial factors and safety. Training effectiveness was assessed using EEG, psychological inventories, and rapid ethnography. Results revealed PTG was significantly higher at 2-month follow-up compared to pre-intervention in all cases. In three cases, participants also reported reduced PTSD symptoms across the same timeframe. Post-intervention C3 alpha power increased in only one case. It is posited that changes including increased alpha/neural flexibility, brain network activity changes beyond C3, and/or increased self-agency may have contributed to increasing PTG. Delivery of weekly neurofeedback sessions was safe and well-tolerated in all participants. Cognitive focus and positive reflections were the most effective mental strategies for increasing alpha power during neurofeedback. This research offers proof-of-concept for the feasibility, participant acceptance, and effectiveness of using neurofeedback as wellbeing-focused therapy to enhance PTG in trauma-exposed individuals.