PTSD & Anxiety
The Amygdala-Based Protocol
For people whose nervous system is stuck in overdrive — too vigilant, too reactive, too on. The amygdala-based Prism protocol trains you to settle the brain region behind those responses, without medication and without revisiting the trauma in session.
Why the Amygdala?
The amygdala is the brain's threat-detection system — the region that decides, in milliseconds, whether something is dangerous. In PTSD, it becomes overactive: it flags neutral situations as threats, drives hypervigilance, and makes it hard to feel safe even when you are. In chronic anxiety and emotional dysregulation, similar overactivity often shows up.
The amygdala-based Prism protocol trains you to down-regulate that signal — teaching your brain, in real time, what calm looks like and how to find it on your own.
What This Protocol Is Used For At Our Practice
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PTSD — the condition for which this protocol was developed and FDA-cleared
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Anxiety — overlapping mechanisms; many patients carry both PTSD and anxiety symptoms
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Emotional dysregulation — difficulty managing intense emotional states, often connected to chronic stress, complex trauma, or co-occurring conditions
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ADHD (research interest) — Prism researchers and collaborators at NYU Langone are studying the amygdala-based protocol's role in adult ADHD; a 2024 pilot study showed reductions in ADHD symptoms.³ This use is not currently FDA-cleared and would be discussed with you on a case-by-case basis.
“We think this approach offers significant potential not only for treating PTSD, but also for other disorders in which amygdala dysfunction plays an important role, such as depression and attention deficit hyperactivity disorder.”
— Lenard A. Adler, MD, Director, Adult ADHD Program, NYU Langone Health. Source: NYU Langone Physician Focus
What the Research Shows
Prism's PTSD clearance was based on a multi-center clinical trial of 79 patients. After 15 sessions over 8 weeks:
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67% had clinically significant symptom improvement
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32% achieved remission
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Significant improvement across all PTSD symptom clusters, including sleep
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90% patient compliance with the full treatment course
Adverse events were mild and resolved on their own — most commonly temporary headache or fatigue.¹
A 2025 combined analysis of 128 PTSD patients confirmed sustained improvement at 3-month follow-up across all symptom clusters, with large effect sizes.⁴ A separate analysis specifically of sleep disturbance — which affects up to 90% of PTSD patients — showed clinically meaningful reduction in sleep symptoms in 64% of participants.⁵
What Treatment Looks Like
15 sessions over 8 weeks (twice weekly, ~45 minutes each) in our quiet treatment room. Each session involves wearing a soft EEG cap and engaging with a simple animated waiting-room scene that responds to your real-time brain activity. You bring the mental work — finding the strategy that calms your system; Prism shows you, moment by moment, what's working.
References:
¹ Fruchter, E., Goldenthal, N., Adler, L. A., Gross, R., Harel, E. V., Deutsch, L., Nacasch, N., Grinapol, S., Amital, D., Voigt, J. D., & Marmar, C. R. (2024). Amygdala-derived-EEG-fMRI-pattern neurofeedback for the treatment of chronic post-traumatic stress disorder: A prospective, multicenter, multinational study evaluating clinical efficacy. Psychiatry Research, 333, 115711. https://doi.org/10.1016/j.psychres.2023.115711
³ Adler, L. A., Anbarasan, D., Leon, T., Sardoff, T., Descorbeth, O., Cho, D., Stern, Y., Kraft, O., Hendler, T., & Marmar, C. R. (2024). Pilot study of Prism EFP neurofeedback in adult ADHD. Journal of Attention Disorders, 28(5), 905–912. https://doi.org/10.1177/10870547231215283
⁴ Goldental, N., Gross, R., Amital, D., Harel, E. V., Hendler, T., Tendler, A., Levi, L., Lavro, D., Harmelech, T., Grinapol, S., Nacasch, N., & Fruchter, E. (2025). Amygdala EFP neurofeedback effects on PTSD symptom clusters and emotional regulation processes. Journal of Clinical Medicine, 14(7), 2421.
⁵ Tendler, A., Stern, Y., & Harmelech, T. (2025). Can amygdala-derived-EEG-fMRI-pattern (EFP) neurofeedback treat sleep disturbances in PTSD? Brain Sciences, 15(3), 297. https://doi.org/10.3390/brainsci15030297