Neurofeedback, Neurotherapy, or EEG biofeedback is a method of training a client’s brainwaves using feedback (i.e. giving the client real-time information about their brainwaves). By setting appropriate goals, individualised for each client, this training can reduce psychological symptoms and performance can be enhanced. Effects are usually long-lasting or even permanent.
Below you will find answers to some frequently asked questions on neurofeedback.
Neurofeedback is a form of biofeedback. What is Biofeedback? It is a simple concept, one with which we are very familiar from everyday life. The idea is: If you can sense it, you can change it. Biofeedback uses machinery to extend sensory perception into areas where we would normally be unaware. Normal activities of life depend on sensory feedback, e.g. balance, walking, holding objects.
Biofeedback gives the trainee ongoing immediate information about some body function. Knowing the information better enables the trainee to modify the body function. Traditional biofeedback works with such things as muscle tension, finger temperature, skin conductance, heart rate, breathing rate, heart and breathing synchronisation, blood pressure.
Neurofeedback or EEG Biofeedback is a specific form of biofeedback which gives the trainee information about the rhythmic electrical activity from various places in the brain (EEG or brain waves), and challenges the brain to modify certain components of it.
Similar to training other biological measures, the trainee is enbled to induce changes in the brain wave patterns. These changes can lead to improved flexibility and stability of the brain waves in general, which can lead to improved flexibility and stability of behaviour in response to external demands on the person in the course of day-to-day activity.
One or two sensors are placed on the client’s head, and two sensors (like clip-on earrings) are placed on their ears. The sensors are connected to an amplifier, which amplifies the tiny (micro-volt) signals from the client’s scalp. The amplified signal is then sent to a computer that analyses the signal and divides it into the brainwaves we want to increase (these are often associated with good focus and attention), and the brainwaves we want to decrease (these are often associated with poor focus, impulsiveness, anxiety or agitation). The neurofeedback software uses these signals to drive a video game. The video game only moves forward (visual display changes, beeps are heard, points are scored) if the client increases selected brainwaves (often those associated with good focus), and decreases other selected the brainwaves (often those associated with inattention, anxiety or agitation). With repeated trainings in this way, the brain can learn to control attention and focus better, among other potential benefits.
Neurofeedback is not at all like electro-shock therapy. There are some neuromodulation techniques which rely on stimulating the brain with an electrical current or a magnetic field, however neurofeedback does not do this (except in the case of the low energy neurofeedback system – LENS). For the neurofeedback that we use and teach, we only measure the brain’s activity, and show it to the client as a video game.
There are over 300 published peer reviewed scientific studies of neurofeedback, with most (that we have reviewed) giving positive results.
With neurofeedback there is the possibility of abreactions and negative side effects. However, when dealing with appropriately trained and qualified neurofeedback practitioners who have experience working with the particular client population, these abreactions and negative side effects are typically mild in nature and do not last long.
It is important to disclose in-depth information about your mental and physical health to your neurofeedback practitioner, including but not limited to any current or past diagnoses, any current or past sensitivities (physical, mental, other – including allergies), any history of trauma (physical, emotional, other), any current or history of seizure disorders, any history of brain injury, and any history of migraines.
It is also important to immediately let your neurofeedback practitioner know if you are having a negative reaction to the neurofeedback (during or after the session). Your practitioners can then adjust the training to better suit you.
All information being processed in the brain is being transmitted by brainwaves, in a similar way to radio waves. When the sender and receiver are on the same wavelength and are tuned-in, information moves. The brainwave is not the information, but carries the information. Slow brainwaves can carry information about being calm and sleepy (unfocused – delta and theta waves), fast waves carry information about focus and attention (beta waves), and very fast waves carry information about excitement, anxiety, and agitation (high beta waves). When there are too many slow or very fast waves, or not enough fast waves, people will typically have difficulty with focus and alertness. By training the brainwaves we can help the brain to create a good balance between the different brainwaves. The reason neurofeedback is able to work with a variety of disorders is because many disorders show a dysregulation of the brainwave activity, which neurofeedback can help restore.
In theory, most people could benefit in some way from neurofeedback that is administered by an appropriately qualified practitioner (qualified in their use of neurofeedback and in the use of neurofeedback for a particular client population and/or for peak/optimal performance). However, how much improvement is likely to experienced, how many sessions would be required, and the risks would need to be determined on a case by case basis. Additionally, the likelihood of positive results is much higher for more straightforward cases. Once the situation is more complex, the neurofeedback training protocols become more complex and there are other factors that have to be addressed.
Common uses of neurofeedback include helping to:
Neurofeedback has been used for many years to help top level performers, such as sports people, musicians and others perform better. Neurofeedback can reduce performance anxiety, and increase the ability to perform at top level more consistently. Neurofeedback is becoming more widely used for this purpose.
Defiance and aggression can improve with neurofeedback training. However, they are complex social responses and appear for a variety of reasons which may be related to brain overactivation (i.e., impulsiveness, high energy level) as well as to the person’s social environment. For example, the person may have a long-standing habit of being oppositional or aggressive. They may have few, if any, alternative behaviours (such as talking through or negotiation) when dealing with frustration. Also, many people who are aggressive or oppositional use these behaviours manipulatively to get what they want. When children who are stubborn, defiant or aggressive are seen for neurofeedback, it is necessary to have ongoing counselling with parents and the child in order to help the family deal more effectively with the child’s behaviour, while at the same time helping the child develop more adaptive ways of coping with frustration and stress. In these cases, neurofeedback can make the child more available for counselling and behaviour change, and can allow behavioural solutions to work more effectively.
Studies have shown significant improvements for Autistic children as a result of neurofeedback. Symptoms that have improved include: Lower anxiety levels, better speech, more relevant speech, improved orientation to the world, less obsessiveness and improved empathy. As with any complex disorder, neurofeedback is best used in conjunction with other interventions. In the case of ASD, getting additional help with speech, behaviour management and academics are typically beneficial. Also, with ASD we suggest that a thorough investigation of nutritional issues should be undertaken with a physician who specialises in nutritional medicine.
Neurofeedback is increasingly being used and researched to help treat those who have suffered traumas.
Traditional counselling methods are often not effective for sufferers of PTSD, at least not initially. Sufferers are often too anxious and hypervigilant to be able to engage in the counselling process. Also, recollection of traumatic events is often traumatising and so the client will avoid this at all costs. Neurofeedback (and other biofeedback techniques) can help the client become calmer, without any need to bring up traumatic material. Once the client’s nervous system is calmer, trauma resolution work can proceed more quickly and effectively.
At our clinic, before any treatment is administered, an initial assessment is done. This involves an interview to clarify the focus of treatment, and to understand the important background factors. Tests of attention and focus are given. These are “hands-on” (continuous performance) tests, which compare the client’s results to the results of other’s the same age and sex as the client. These tests are valuable in giving an indication of the presence and extent of any difficulties with focus and attention. A third part of the initial assessment involves a Brain Map, or Quantitative EEG analysis. The client wears a specially made cap (like a swimming cap) which has 19 sensors imbedded in it. These sensors are laid out in a standard manner, to allow EEG information to be gathered from all over the scalp. This information is analysed and results are compared to normative date (i.e. people of the same age and sex). Information about too much or too little brainwave activity in particular parts of the brain will help determine how the neurofeedback treatment will proceed.
The initial assessment usually takes 4 to 4.5 hours and is spread over two visits.
After the initial assessment, neurofeedback treatment is then started. Sessions usually last between 50 – 60 minutes. It is recommended that clients attend at least two times a week initially, then moving to once or twice a week. There is typically no harm in training more than three times a week, and in fact, intensive programs can be undertaken, especially for clients living a long way from the clinic. This would need to be discussed and determined on a case by case basis.
Without an assessment this is a difficult question to answer. Some clients need as few as 20 sessions, while others will need upwards of 40 training sessions.
Once someone has improved and stabilised there is typically little tendency for the gains to be lost.
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