Key Takeaways
- Prism is an FDA-cleared neurofeedback therapy for posttraumatic stress disorder (PTSD) that trains patients to calm the brain's overactive alarm system — the amygdala — using real-time feedback from their own brain activity.
- Treatment is non-invasive and drug-free: you wear an EEG headset while interacting with a computer simulation, and nothing is delivered into your body.
- Prism does not require you to retell, relive, or process your traumatic memories, removing one of the biggest barriers that keeps people from starting PTSD treatment.
- Prism is FDA-cleared as an adjunctive treatment, meaning it works alongside your overall care plan — psychotherapy, medication, or both — under the direction of a healthcare professional.
- Diamond Edge TMS in Vancouver, Washington, is the first clinic in Oregon and Southwest Washington to offer Prism for PTSD, alongside TMS, psychotherapy, and medication management. Schedule an appointment to find out whether Prism is right for you.
A New Option for People Living With PTSD
Roughly 13 million Americans live with posttraumatic stress disorder in any given year — after combat, assault, accidents, medical crises, or disasters. Yet many never receive effective treatment. Some can't tolerate medication side effects. Others have tried trauma-focused therapy and found that retelling the worst moments of their lives was more than they could face. Many simply put treatment off for years, managing symptoms alone.
Prism, developed by GrayMatters Health, offers these patients something genuinely new: a way to work directly on the brain circuitry of PTSD without medication and without ever having to describe what happened.
Diamond Edge TMS, led by Dr. Jerald Block, is the first clinic in Oregon and Southwest Washington to offer this technology. As a combat veteran and board-certified psychiatrist with more than 25 years of experience, Dr. Block has spent his career bringing evidence-based, leading-edge treatments — first TMS, and now Prism — to the patients of Vancouver and the greater Portland area.
What Is Prism?
Prism is a prescription neurofeedback therapy cleared by the FDA as an adjunctive treatment for symptoms associated with PTSD. In plain language: it's a system that measures a specific PTSD-related signal in your brain and teaches you, session by session, how to turn that signal down yourself.
If you'd rather skip the science, jump ahead to 'What Happens During a Prism Session?'
The Science: Targeting the Brain's Alarm System
Deep in the brain sits the amygdala — the region that acts as your internal alarm system. When you face danger, the amygdala fires, triggering the surge of fear, vigilance, and physical arousal that keeps you alive in a crisis.
In PTSD, that alarm system becomes stuck in the 'on' position. Research has consistently shown that amygdala hyperactivity underlies many of the core symptoms of PTSD: hypervigilance, exaggerated startle, intrusive memories, and the feeling of being unable to relax, even in safe situations.
The challenge has always been that the amygdala sits too deep in the brain to measure easily. How do we know it is 'on,' and how do we turn it 'off'?
This is where academic research was helpful. In large research facilities, PET scans and functional MRIs were used to measure and image the amygdala's activity. Researchers could see when that part of the brain became active and which stimuli triggered it. Show someone an image of an angry face and — bang — the amygdala would light up. And in people with PTSD, that response was exaggerated. If the angry face was shown for the briefest of moments — so short that the person was never even aware they saw it — the amygdala would still light up.
This was great for research and advanced the field immensely, but at day's end it was impractical for patient care. Imaging the amygdala in real time is expensive, time consuming, and difficult.
Now, consider EEGs. EEGs are excellent at detecting large-scale events, such as seizures. During a seizure, part or all of the brain fires in synchronized electrical pulses. The resulting EEG patterns are distinctive and are often used in the diagnosis and management of seizure disorders. Beyond seizures, there are many other specific uses that rely on EEGs — detecting delirium, for instance, or identifying REM sleep.
That said, EEGs are not particularly good at detecting deep brain activity. Deep areas, like the amygdala. The output is hard to read; it can be difficult to tease the signal out from the noise.
But what if you combined the fMRI and EEG data? Perhaps a 'signature' could be reliably detected in the EEG if you knew the precise moment the amygdala began to fire.
That is what GrayMatters Health did. They used advanced statistical models to fuse data from EEGs and functional MRIs, creating a validated biomarker. Functional MRIs were taken, demonstrating activation of the amygdala. These were then correlated with EEGs recorded at the same time. What resulted was a specific EEG signal linked to activity seen on the brain imaging. As a result, a functional MRI was no longer necessary — the EEG alone was enough to know when the amygdala was firing. That breakthrough is what makes Prism possible in an outpatient office rather than an MRI suite.
Neurofeedback: Learning by Seeing Your Own Brain at Work
Neurofeedback is a form of training in which you watch a live representation of your own brain activity and learn, through practice and immediate feedback, to change it. Think of it like physical therapy for your emotional regulation circuit: the amygdala and the systems that control it are exercised like a muscle, repetition by repetition, until regulation becomes strength.
What Happens During a Prism Session?
Understanding what treatment looks like removes the mystery and anxiety of starting. Here is the short version of what a session involves.
The Setup
At each visit, you'll sit in a comfortable chair in our Vancouver office and put on an EEG headset. The headset only listens; it reads your brain's electrical activity through the scalp. Nothing enters your body — no magnets, no electrical stimulation, no medication, no needles.
The Simulation
You'll then interact with a computer simulation on a screen. In one scenario, for example, you watch a busy waiting room full of restless, noisy characters. Your task is to settle the room. You do so by calming your own brain's stress signal. Maybe you think of a specific image, or hum a particular song — whatever you do, if your amygdala-derived biomarker quiets, the scene responds in real time: the characters settle, the noise fades.
There is no 'right technique' handed to you. Each patient discovers their own mental strategies — some use breathing, some use imagery, some find approaches all their own. What matters is that the screen gives your brain instant, honest feedback about what's working.
The Skill That Stays With You
Over a course of treatment — typically a series of sessions spanning about eight weeks — those strategies become practiced, reliable, and portable. Patients learn to recognize the feeling of their alarm system ramping up and to bring it down deliberately, not just in the office but in traffic, at work, in crowds, and at 3 a.m. That self-regulation skill is the treatment. It's yours to keep after the sessions end.
What Does the Evidence Show?
Prism's FDA clearance was based on a clinical trial of 79 adults with chronic PTSD. Treatment significantly reduced PTSD symptoms with minimal adverse effects. Importantly, the improvements were maintained at three-month follow-up after treatment ended. That durability matters: it suggests patients aren't just responding to the sessions themselves but are genuinely acquiring a lasting regulation skill.
As with any treatment, individual results vary, and Prism is not a cure or a guarantee. At your consultation, Dr. Block will review the evidence with you candidly and help you weigh whether Prism fits your situation.
Who Is Prism For?
Prism may be worth discussing with your doctor if you're an adult with PTSD and any of the following sound familiar:
- You want to avoid medication, or medication alone hasn't been enough. Prism itself is entirely drug-free.
- You've avoided trauma-focused therapy because you dread retelling what happened. Prism uses neutral, non-trauma-based scenarios. You will never be asked to revisit or describe the traumatic event during training.
- You're a veteran or first responder. Skills-based, practical, and measurable, Prism tends to resonate with people from military and emergency-services backgrounds. As a fellow veteran, Dr. Block understands both the culture and the confidentiality concerns that come with these careers.
- You want an active role in your recovery. Prism doesn't do something to you — it teaches you to do something for yourself.
How Prism Fits Into a Complete Treatment Plan
It's important to be straightforward about what 'adjunctive treatment' means: the FDA cleared Prism to be used under the direction of a healthcare professional together with other pharmacological and/or non-pharmacological care — not as a standalone replacement for treatment. Many of our patients continue psychotherapy or medication management during Prism, and some find that lowering their baseline arousal with Prism makes the rest of their treatment more productive.
Because Diamond Edge TMS offers psychotherapy, medication management, TMS, and Prism under one roof — with one physician directing your care — your treatment plan is coordinated rather than fragmented across multiple offices.
How Is Prism Different From TMS?
Patients often ask how Prism relates to transcranial magnetic stimulation, since we offer both. The two are fundamentally different tools:
- TMS delivers something to the brain. Magnetic pulses stimulate specific brain regions from outside the skull. TMS is FDA-cleared for treatment-resistant depression and OCD.
- Prism delivers nothing to the brain. It only measures brain activity and teaches you to change it yourself. Prism is FDA-cleared as an adjunctive treatment for PTSD.
For patients with more than one condition — depression alongside PTSD, for example — having both technologies in one clinic allows Dr. Block to sequence or combine treatments thoughtfully rather than forcing a single tool to do every job.
Take the First Step
If PTSD has kept you on high alert for years — and if medications, or the prospect of retelling your trauma, have kept you from getting help — Prism may open a door that felt closed.
Diamond Edge TMS is currently the only clinic in Oregon and Southwest Washington offering Prism for PTSD. Contact Diamond Edge TMS today at (360) 838-3654 or request an appointment to find out whether Prism belongs in your treatment plan.
Frequently Asked Questions
Does Prism hurt, and are there side effects?
No. Prism is non-invasive and painless. The EEG headset simply reads your brain's electrical activity from the scalp — nothing is delivered into your body. In the clinical trial supporting FDA clearance, adverse effects were minimal. Most patients find sessions calm, and even pleasant, and can drive themselves home and return to their day immediately.
Will I have to talk about my trauma during Prism treatment?
No. Prism training uses neutral, non-trauma-based simulations. You are never asked to describe, relive, or process the traumatic event during sessions. If trauma-focused psychotherapy would also benefit you, that is a separate decision you and Dr. Block can make together — at your pace.
Do I have to stop my medications or current therapy to start Prism?
No — quite the opposite. Prism is FDA-cleared as an adjunctive treatment, designed to work alongside your existing care. Most patients continue their current medication or therapy during Prism treatment, and Dr. Block coordinates the overall plan so each piece supports the others.
Is Prism the same as the neurofeedback offered at wellness centers?
No. Generic EEG neurofeedback programs vary widely in quality and typically train broad, non-specific brainwave patterns. Prism is different in two key ways: it targets a validated, amygdala-derived biomarker developed from combined EEG and fMRI research, and it carries FDA clearance for PTSD based on clinical trial evidence. It is a prescription treatment directed by a physician, not a wellness service.
