Hey All,

The designer of the LENS recently put together a brief paper on his experiences with a couple of Iraqi War Vets who benefited from the LENS. I think you will agree that the results are amazing. The designer, Len Ochs, is going to present this paper to the VA Hospital administration as a possible therapeutic modality for traumatic brain injury and PTSD for soldiers. I obtained permission from him to post this publically.

The Infrared and Low Energy Neurofeedback Systems (LENS) and Military Trauma
Len Ochs, Ph.D.
This paper presents information on two cases of wartime clinical applications of infrared stimulation and the Low Energy Neurofeedback System (the LENS).
Michael Beasley, Cathy Wills and I went to San Antonio, Texas to Brooke Army Medical Center (BAMC, pronounced “bamcee”) October 25 and 26. 2009. BAMC, Brooke Army Medical Center, San Antonio, Texas is a large impressive center that appears to be doubling its size. It is a regional trauma center and a teaching institution, with one of the largest APA psychology internship programs in the US. All military branches are represented by the BAMC teams; Air Force, Army, Navy, Marines. BAMC also houses one of the largest burn units in the country. Many of the burn patients are kept in a medication-induced coma for weeks/months while their burns heal.
To help illustrate the size of BAMC, San Antonio is the 7th largest city in the US. Yet one can drive by BAMC for about 10 minutes on I-35 and still be in the Fort Sam Houston-BAMC complex. It is so large that some of their staff have been known to take 30 minutes to move from their offices to their cars to then leave the base.
The medical teams are truly exceptional, multidisciplinary, extremely dedicated and caring; well beyond the norm of any hospital I’ve seen. The BAMC team was comprised of Colonels, Captains….MDs, psychiatrists, psychologists, nurses, MD-Acupuncturists, social workers, counselors, technicians, and others. Egos tend to get checked at the door.
We saw patients that had been treated at BAMC through the Department of Defense and then transferred to the VA. These patients had wounds inflicted while being deployed in a conflict zone. Additionally some had symptoms of PTSD and multiple physical problems including pain. Some of the problems they acquired by the war were compounded by problems acquired during their treatments. They presented us with some very complex and difficult problems to work with. The complexity and severity of the symptoms and their suffering were not typically problems that come to the attention of those in private practice. I therefore expected that they would not respond within the two sessions (one per day) they had given us.
About the LENS:
The Low Energy Neurofeedback System (LENS) uses non-visible and non-audible feedback for moments at a time. Sessions of LENS are usually spaced once a week or even less depending on the evaluation of the client’s needs. However if the clients are hardy enough they can be given LENS sessions on successive days.

My appreciation to Cathy Wills, CNS, MSN, RN, CEO of OchsLabs, Inc, and to Michael Beasley, MS, CEO, Neuropaths, for their input, guidance, and companionship through this process.

The LENS treatment consists of the client being connected through scalp electrodes to an EEG in the usual way of traditional neurofeedback. Unlike traditional neurofeedback, there is nothing for the client to do: the LENS does it by acting as a catalyst to initiate the brain’s own removal of unnecessary self-protective blocks to communication. Furthermore the conduct of the LENS is not affected by client movement and restlessness, making its minute-long sessions ideal for children.
Instead of using self-regulation as a means of reducing symptoms as is done in the operant model of traditional neurofeedback, the LENS uses the still-present remaining non-conscious self-regulatory capabilities of the recipient to respond to the feedback, which catalyzes increased self-regulation as an outcome.
The intensity of the feedback (the electromagnetic field carrier waves used to convey the feedback) is weaker than the electromagnetic field around a wrist watch and a millionth of the power of the Alpha Stim or Cranial Electrical Stimulation (CES). While how the LENS operates remains speculation, the clinical realities are that the LENS is reasonably rapid and reliable in its ability to affect positive clinical outcomes. Furthermore, if the feedback programming is removed from the system the LENS no longer reliably delivers increases in functioning.
After a clinical interview and evaluation is done, a topographic map is performed using the LENS. In contrast to standard qEEG maps, the LENS map tells the clinician exactly how to apply the LENS to reduce symptoms and enhance functioning. The standard 10-20 International electrode system of scalp sites is used for sensor placement in all phases of the LENS application. Feedback is provided through the sensors. The active electrode is applied to the scalp and moved from scalp site to scalp site in a way predicted by the LENS maps, while the reference and ground sensors remain connected to the ear lobes through linked ear clips.
The use of the LENS proceeds on the basis of the assessed client differentiation, reactivity, hardiness, fragility, compensation, and anxiety that will be briefly discussed later in this paper. These assessments are conducted during the first interview, and updated with the client at each session. The initial evaluation and frequent clinical re-assessments of the patient’s responses to the LENS, rather than diagnoses or types of symptoms, lead the clinician to continuously modify how the LENS is used.
A Physical and Emotional Pain Application:
One of the people we saw clinically was a retired Army Sergeant who had multiple surgical problems in addition to her war wounds. She said she was going for the record of having had the most surgeries and the worst PTSD. She said she never laughs anymore. This grimness also characterized the other soldiers we talked with. This appeared to be a tough soldier with protracted facial and ankle pain. She was about to have a surgical consult immediately after our session for a temporal mandibular joint replacement. Since this pain appeared to be peripheral and not to be centrally-mediated, I used an infrared light on her jaw, which within one minute dropped her pain level to near zero from a score of 10 – a typical result from the use of infrared light. For a few moments she had a look of pure, innocent speechlessness on her face. Her mouth opened; she turned to the Colonel and said “You get this; this works” and she began to smile excitedly. The entire staff present saw this. To see this happen within 60 seconds after so many years of fruitless treatment was impressive to say the least.
Later that day an Army Colonel heading the nursing department was told what happened by one of her officers who had sat in on the Sergeant’s appointment. The colonel demanded the usual “Why haven’t I heard of this!” What followed was “Do you have any research on this?” Cathy, of course had abstracts of and references to over 2500 controlled studies with her, and supplied the stack of papers to the Colonel.
The Sergeant cancelled the scheduled surgical consultation for her jaw.
On the first day the Sergeant also received a single-site trial application of the LENS to assess her reaction to the LENS feedback. The single site was used because I was wary about giving too much feedback during a session in which she had already had a reasonable amount of infrared stimulation; I didn’t want to tire her out. But I did want to use some feedback as a test of her hardiness.
On day 2 the Sergeant’s jaw pain was back up to a 6 or 7, but not as high as the 10 that it reached on day 1. A few seconds of the IR light on her jaw brought no relief; so I directed her to use it on the origin of the jaw muscle. Within another minute her pain level was back to zero. She then left for a physical therapy session for her torn Achilles tendon, returning again just prior to yet session with us later that day. And as usual after PT, her affected ankle was swollen and painful. A few minutes of IR light on her ankle almost completely eliminated the swelling and pain. This was not missed by the staff. By the end of 20 minutes all of her pain was eliminated and she was chuckling. “The pain is gone, you need to buy these, they work” was her synopsis to the integrative medical team. It was wonderful to see her becoming slyly more playful with us by the end of day 2.
After day 2’s infrared treatment a full LENS map of her EEG sites suggested the probability of head injuries. She said that during combat she fell on the right side of her face while wearing her helmet. This necessitated surgery, which precipitated a numbness of the right side of her face, which preceded the left-sided facial pain for which we used the infrared light. And by the end of the combined infrared light and EEG sessions, she also had the beginnings of the return of sensation in her right cheek.
The second soldier we saw only once: he had had open heart surgery some six weeks earlier, had an acute infection (originating from the area of one of his drainage tubes) which he said had spread to his ribs and was on “about 30 medications”. He was referred back to medical that day and did not return for a second therapy session; he might have been hospitalized.
Reactions to Emotional Trauma – or so it seemed:
The third soldier was a retired naval officer who had nightmares every night since his helicopter crash during the first Gulf War. He served as a photographer at that time, and was there amid the stench of death. This he smelled through his gas mask. He reasoned that if the gas mask didn’t protect him from the smell, then it wouldn’t protect him from the anticipated poison gas, either. So he took his gas mask off and discarded it.
He had been haunted him every night by the dream-memory of a hand that stuck up out of the sand. As he was taking a photograph, he accidently stumbled backward onto that hand. That incident continued as an ongoing vivid memory. This man had also been a corpsman, was very strong, and quite articulate and discerning. When the helicopter he was riding in fell to earth, he hit his head on the wall of the aircraft. It was then that his nightmares began. Since that time he and his wife were becoming increasingly estranged. His irritability, distance, pessimism, lack of sleep, depression, and grimness contributed to the distancing of his wife from him. She has told him he changed and is not the person she married. He said, “I don’t buy my wife flowers anymore.”
I was concerned that some of the most difficult patients had been put before me. When I had initially heard the clients’ symptoms, it was not apparent that these soldiers had acquired head injuries. The seriousness of their symptoms and initial apparent lack of head trauma, made the task of trying to help them seem a hopeless task to me. However, as the interviews proceeded and I heard about their head injuries, I began to be able to think more clearly. I realized that anxiety, itself, could be exacerbated by head injury; and became much more optimistic. Knowing that the response of TBI to the LENS can be rapid, I thought that we might see a sharp reduction in nightmares as the response to the TBI cleared. Additionally people typically respond well to the LENS if their problems occur suddenly. The response is even better if they were high functioning before their accident.
It is important to understand that the symptom-reduction response curve to the LENS is not dependent upon the severity of the client’s symptoms. Typically, symptoms from mild TBI are resolved in 6 sessions with the LENS if the clients were high functioning prior to their injury. This 6 session number is quite sturdy and has been derived from clinical observation over a 19 year period. Response to the LENS tends to be rapid even when the symptoms ranged from irritability to suicidiality. A full map was done in one session confirming both the probability of head injuries and his sturdiness – in that he was able to tolerate an entire LENS map in one sitting.
On day 2 this PTSD came to the meeting reporting that, for the first time since his head injury, he did not have nightmares. He also slept well until 5:30 in the morning, which was a radical departure for him. He was smiling. However he was also quite angry at his treatment at the hands of both BAMC and the Veterans Administration. He said that at the VA where he was receiving group therapy, the staff’s position has been that the soldiers’ progress was now “their (the soldiers’) responsibility”, and the VA had no further treatment to offer. This patient was clear, rational, and reasonable – and showing one of the other effects of the LENS: the patients often reach a stage of increased and unpleasant clarity – which, if managed with compassion, can become a springboard to make some major life changes. A second map was performed, showing significant changes in his EEG from the mapping session done on the first day. The mapping process, itself, changes the EEG and increases function if the amount of feedback provided by the map is proportionate to the patient’s tolerance and sensitivity.
A ten-day follow up shows that this client continues to improve. He reported having no nightmares since the 2 sessions over a week ago. He was also laughing at the second session of LENS, which hasn’t happened in a very long time. One of the most important marks of the depth of progress to me is the return of a sense of humor. Humor, I think, needs a basis in comfort and self-trust. Unless these are present humor is often absent.
It became quite evident that rapid patient response to the LENS is well suited in these areas for which no conventional treatment exists. The chance to help thousands of soldiers with prolonged wounds in both the physical and emotional realms makes us want to do our very best to both bring immediate relief, and to document the efficacy of the LENS in double-blind randomized controlled studies. It will take future studies to determine the exact mechanisms by which the LENS process works.
Both the first and third patients responded so rapidly and significantly, that all present were really surprised. I was pleased that we could have a positive impact on even the most terribly wounded soldiers and former soldiers. We were all immensely impressed with the quality, sincerity, and passion by the staff at BAMC for the welfare of the patients at this hospital.
LENS is an interruptive system using a hierarchically-nested sequence of interruptions. The strategy suggested by the maps may take apart the system that prolongs the presence of inhibitory transmitters that cut communication in the brain, and allow the brain to break from its maladaptive behavior which produced the clients’ symptoms.
It is this systems-approach that has given therapists the experience that the LENS is so easy to work with for difficult and complicated problems. The LENS map is a central part of understanding the system.
Operant conditioning used in traditional neurofeedback often involves overlearning the correct responses on the part of the patient, so that the responses become increasingly automatic. Like operant conditioning, the LENS is a resonant feedback system driven by an aspect of the client’s physiology: the client’s EEG. The LENS differs from operant conditioning in two ways: First, its feedback directly catalyzes changes in the brain without mediation from the senses and information processing by the brain. In fact, what slows traditional neurofeedback is that it much more directly depends on the processes that are often impaired. Second, the systems approach from the LENS mapping process gives us a key to efficiently unlocking the complex processes that perpetuate neurochemical self-protection and impaired communication. Because the person’s brainwaves (EEG) are a core part of the system that is driving the client’s symptoms, the effect of the LENS occurs more rapidly and becomes more integrated following LENS.
The LENS does not require learning with long periods of reinforcement as with operant conditioning. In fact, after a course of the LENS, people’s functioning continues to spontaneously improve with almost no further sessions. The LENS acts to remove barriers to the connectivity of the brain which increases the brain’s functioning.
The initial and subsequent clinical evaluations tell us how to select the particular blends of feedback components to keep the person able to maximally and usefully able to respond to the feedback. The mapping gives us a physiological strategy to best interrupt the system that keeps the person’s function impaired. Having these understandings may allow the brain to re-establish its neurochemistry to allow the return and enhancement of function and adaptiveness.
The exceptions to LENS efficacy are:
• When functioning is already maximized. Such people exist, and are difficult, if not impossible to overdose with the LENS, no matter what we throw at them.
• When there is one and only one problem. The LENS addresses in a structural way re-establishment of communication in the brain. It is not directed to specific symptom removal, or changing the EEG at specific sites (although this happens as a natural consequence of this approach).
• When there is co-morbid infection, toxicity, or inflammation. These need medical attention.
• Progressive conditions once they have reached advanced stages. However improvements are readily seen for several years in functional impairments in early stage progressive conditions.
In summary, the LENS does a good job of providing millisecond-exposures of feedback at levels of strength that are weaker than that given from digital watches. What the LENS cannot do is to self-pace its own administration to the patient. We need clinicians to understand and provide that. The training of clinicians to administer the LENS always includes information about what contributes to that pacing.
The Steps Are:
• Teach the clinician to assess client perceptiveness, which lets us know how much feedback to provide at any one session: how long (.01 second to 20 minutes per session) to provide the feedback, how many sites on the head to do at any one session, how many times a week, and how much pull to ask the system to place on the person’s physiology.
• Teach the clinician to assess client reactivity, which lets the clinician assess both safety risks to self and others from the way the client presents, as well as how much of what kinds of support the client will need during the recovery process, social, medical, and legal.
• Teach the clinician to assess how much the client has compensated for childhood or teen age hyperreactivity problems such as tics, seizures, migraines, and explosiveness. The incomplete resolution of these problems can lead these symptoms to re-emerge for brief periods of time during the use of the LENS before they are completely resolved. We don’t worry about these problems when they are self-evident and active. The problems we assess for are those problems which manifested prior in life, but for which the person compensated. Because these problems are incompletely resolved, they can recur briefly before their complete resolution with the LENS. Both the client and the therapist need to be prepared for their brief reappearance.
• Teach the clinician to assess client hardiness vs. client fragility. This distinction allows us to assess how much feedback we can invite the client to experience. If we know the client is hardy, then we can ask the client to receive longer episodes of feedback with the knowledge that the client can rapidly recover from receiving too heavy an exposure to the LENS. If the client is fragile, however, the therapist must know that the client may take months to recover from an over-exposure, and needs to act accordingly setting limits on how much the LENS can be administered in any time period.
• Finally, teach the clinician to assess anxiety, critical in pacing the exposure to the LENS. The more anxious a person is, the more this anxiety becomes part of the ambience of their lives. Too rapid a reduction in anxiety is often greeted with alarm by anxious individuals: they want the noise back. Without it part of their identity gets lost. Under these conditions we need to slow down the LENS so the anxiety reductions can be more gradually experienced and more smoothly integrated.
These discussions are also necessary in our continuously re-iterative informed consent process that mobilizes the client’s motivation and sense of self-responsibility.
Whether we use the LENS or the infrared light for wounds, swelling, burns, diabetic neuropathy, and inflammation, in all, we need to teach clinicians to be better assessors and therapists, as the major part of our training in the use of the these modalities.
It cannot be emphasized too greatly that the success in the use the LENS with people is critically dependent upon matching the client’s make-up (whether determined genetically or environmentally) with the chosen LENS procedures. Assessment of the client’s make-up is done initially through verbal interview and questionnaires. This assessment continues in each LENS session, matching and rematching the procedure with the client’s increasingly-differentiated awareness, and as the client integrates the sometimes rapid changes induced by the LENS. When the client feels supported, when the client understands the changes in his or her own experience, the client can more smoothly be shepherded through them.
Regardless of what the maps show us, and what the questionnaires tell us, a key element is to appreciate how the person is responding. These are some of the questions faced by the LENS clinician:
• Does the therapist pick up changes in a person’s behavior and stop the LENS session based on subtle signals -- or plunge on and complete the map because there are 12 sites left to do?
• Has breathing, posture, fidgeting, coloration, etc. changed?
• Are the patients wired or tired?
• Is the patient more relaxed -- or agitated?
• Is the increasing anger and dissatisfaction with life a sign that the patient is becoming clearer, and showing less denial about the difficulties faced in life?
• Are the signs of increased amplitudes and standard deviations in successive records and maps accompanied by higher functioning – a sign that the brain is becoming less suppressed?
If any change is observed then a response to LENS has occurred. So… maybe it is time to stop this session and allow the client’s brain a chance to integrate these changes. As we look back on the data, if the map looks worse but the person is functioning better, then things are improving. If the map looks good but the person is worse, it may be time to change the procedure of the pace of working with the LENS. And because success brings with it increased differentiation in the client’s perception and response, it may be time to slow down – because less feedback is now necessary to accomplish the same goals.
A neuropsychologist who just getting started using the LENS wrote: “[I] Just wanted to share with you the comment of a Captain I have been treating when I told him I was coming out to train with the guy who developed this intervention. "Be sure to thank him for me and all the other soldiers who are being helped by this."”
I want to convey something of the exquisite spirit displayed by the wounded soldiers. We were doing something completely unknown to them and to the people on whom they depended – the hospital staff. Every single one of the soldiers expressed the sentiment that if what we were about to do with them would help other soldiers; they would do just about anything we would ask them to do. The altruism displayed there was thicker than in any other place I have ever experienced anywhere else in my life at anytime.
I love to be able to say at the end of a course of the LENS: “When you first came here your life was predictable: you have the same pain and recurrent reactions day after day. Your life is no longer predictable.” And how they cope with this lack of predictability becomes the true measure of who they become and what they can contribute to society.

Enjoy!