The mental health space is full of advice, therapies, medications, seemingly quick fixes, self-help books and apps, and more options than ever before. The bottom line is that people are struggling and finally talking about it, but so many solutions can be overwhelming and hard to narrow down. I always recommend starting with the least invasive options and moving forward from there. This article helps explain neurofeedback, offering a window into this unique non-invasive treatment, from the basics of brainwave training to what you can expect in a typical neurofeedback session.
Introduction to Neurofeedback Therapy
Neurofeedback is a term that might sound like something scary, out there, or even woo-woo, but it’s a surprisingly straightforward solution. Also known as electroencephalographic (EEG) biofeedback or neurotherapy, neurofeedback therapy is a type of brain training that teaches self-regulation of brain function. It is a non-invasive, painless process that aims to help individuals manage their brain wave patterns.
I’ve been using neurofeedback to help support kids and adults with various cognitive and mental health challenges, such as anxiety, depression, OCD, ADHD, perfectionism, aggression, fear, and PTSD.
What is Neurofeedback?
History of Neurofeedback Therapy
The roots of neurofeedback trace back to the 1950s, when researchers such as Joe Kamiya began experimenting with ways for individuals to directly influence their own brain activity. Over the decades, neurofeedback has progressed from a form of biofeedback seen as an experimental concept to an established treatment modality endorsed by major organizations such as the American Psychological Association.
Importance of Brain Health
Understanding and prioritizing mental health is possibly the most important and meaningful effort we can take in our lives. With depression, anxiety, and complex trauma gaining more awareness, and with the unique brain function and neuro-differences presented by conditions like autism, ADHD, and OCD, finding safe and effective ways to improve brain health is at the top of the priority list in many people’s lives.
Who Can Benefit from Neurofeedback?
The beauty of neurofeedback lies in its versatility; it has been used in a wide range of applications. From children with autism to adults with anxiety or athletes seeking peak performance, neurofeedback may offer a path toward improved brain health and function.
Definition and Explanation of the Process
At its core, neurofeedback is a type of biofeedback that monitors brain waves in real time and provides user feedback with sound and visuals (either scenes, movies, or games) to help people learn to regulate their brainwaves. It is a non-invasive therapy that works to improve brain function and alleviate symptoms of some mental health conditions.
Understanding Brainwaves
Before diving into the intricacies of how neurofeedback therapy operates, one must understand the foundation – our brain waves. The human brain operates in several distinct frequencies, each associated with various states of consciousness, from deep sleep to highly focused attention.
Overview of Different Brain Waves and Their Significance
There are five main types of brainwaves, each serving a unique purpose in our mental and emotional landscape:
- Delta Waves: Sleep, repair, complex problem solving, unawareness, deep-unconsciousness
- Theta Waves: Creativity, insight, deep states, unconsciousness, optimal meditative state, depression, anxiety, distractibility
- Alpha Waves: Alertness and peacefulness, readiness, meditation, deeply relaxed, recall, optimized cognitive performance
- Beta Waves: Thinking, focusing, sustained attention, tension, alertness, excitement
- Low Beta (also referred to as the sensory-motor rhythm (SMR): Mental alertness, physical relaxation.
- High Beta: Intensity, hyperalertness, anxiety
- Gamma Waves: Learning, cognitive processing, problem-solving tasks, mental sharpness, brain activity, organizing the brain
Understanding how to shift and modulate these brain waves is the heart of neurofeedback therapy, we can work to train them up or down to achieve balance and optimization.
Is Neurofeedback Safe?
Yes, neurofeedback is considered a safe treatment modality. As a non-invasive and drug-free approach, neurofeedback therapy offers a safe alternative or supplement to traditional medical treatments for mental health conditions. Some people are better candidates than others depending on their specific concerns and goals. Just like any therapy, it’s important that the therapist fully understands what is going on for any individual in their care. We have to look at all aspects of one’s symptoms, history, environment, and experience in order to create a proper treatment plan. Neurofeedback training is not a one size fits all approach. Good therapy requires a good therapist and a holistic view of the client.
How Neurofeedback Works
Electroencephalography (EEG) and Biofeedback
Biofeedback is a learning technology through which a person gets feedback (information) from a device that helps them learn to control their own internal, usually automatic, bodily functions. One example of this is a mirror; when we work out in front of a mirror, we can isolate certain muscles and easily shift our form to be more effective. Neurofeedback training uses EEG Biofeedback. Reading electrical activity in the brain is called Electroencephalography (EEG). In a neurofeedback session, individuals wear EEG sensors on their scalp that pick up brain wave activity and translate it on the computer screen to make it make sense to the therapist and client, providing the information (feedback) in real time.
Brain Waves and Neurofeedback
The goal of neurofeedback is to guide individuals in shifting their brain wave patterns toward a more desirable, balanced state. For example, those with ADHD may see improvement and balance between Alpha and Beta wave activity associated with focus and attention. People who struggle with anxiety or overthinking can benefit from increasing the use of Low Beta waves and decreasing High Beta wave activity. Each type of brain wave is important, they all have distinct functions in specific areas of the brain, most of us overuse some and underutilize others, the goal of neurofeedback therapy is to teach the brain how to use the right waves at the right time.
Neurofeedback Training Process
During a neurofeedback session, individuals focus on computer-based exercises that are customized to train specific brain waves based on their goals and designed to reinforce positive changes through audio and visual feedback.
EEG Electrode Placement for Targeting Brainwaves
The positioning of EEG sensors is crucial, as it determines which part of the brain’s activity is being monitored and trained. Specific placements target different regions associated with various brain functions.
Training the Brain to Self-Regulate
Neurofeedback is like learning to ride a bike; it requires practice to develop new patterns. As the brain receives feedback on its activity, it learns to adapt, leading to improved self-regulation over time. As the individual’s brain activity changes, they receive immediate feedback. If working to increase certain brainwave frequencies, success might be reinforced by the screen becoming more clear or bright. If working to decrease certain brainwave frequencies the screen might appear cloudy or dim and clear up once frequency reduces.
Benefits of Neurofeedback Therapy
The potential benefits of neurofeedback therapy are vast. Here are a few of the conditions and areas it has shown promise in helping patients:
ADHD and Focus Improvement
For patients with ADHD (Attention Deficit Hyperactivity Disorder), neurofeedback therapy aims to increase beta wave frequencies associated with focus and attention. Studies have shown significant improvements in attention span and reduced impulsivity after a course of neurofeedback sessions. It is becoming one of the leading treatments for ADHD.
Anxiety and Stress Reduction
Through neurofeedback therapy, individuals can enhance their Alpha wave patterns, leading to a calmer and more focused state of mind.
PTSD and Trauma Recovery
Neurofeedback can help individuals with PTSD or traumatic brain injuries better manage and reduce hyper-arousal states, leading to a reduction in stress, anxiety, depression, emotional reactivity, and other trauma-related symptoms.
Sleep Disorders and Relaxation
By guiding individuals to seamlessly transition from fast to slower brain wave frequencies, neurofeedback may help people fall asleep faster, regulate sleep cycles, and improve overall sleep quality and regularity.
Cognitive Function and Peak Performance
Neurofeedback is not just for those with clinical conditions. Athletes and high performers are using it to optimize their brain function, improving concentration, motor skills, creativity, and overall cognitive performance.
What to Expect From a Neurofeedback Therapy Session
Curious about what happens in a neurofeedback session? Here’s what you might encounter:
Initial Assessment and Goal Setting
To begin, your therapist will conduct an assessment of your symptoms and goals for treatment. This includes a discussion of your history, your symptoms, and any concerns you have. We are looking at the big picture, so everything matters. When we first begin it’s important that we create a plan that will be the most effective and efficient, your brain is working hard in your session, we want to make it count.
Placement of Sensors and Electrodes
Sensors and electrodes will be placed on your scalp to record brainwave activity. This process is entirely painless and should be comfortable for you.
Monitoring, Feedback, and Reinforcement
Once the EEG is set up, your therapist will monitor and record your brain wave activity to establish a baseline for your session. Less is more, total training time is about 20-30 minutes. As your session progresses, you’ll receive feedback on your brainwave activity in the form of visual or auditory stimuli designed to encourage desirable brainwave changes. As a trauma therapist, I’m focusing on your experience, checking in every few minutes to ensure the training is helpful and comfortable. During the session, we might train more than one site, or towards more than one specific goal as we work through your treatment plan.
Progress Tracking and Adjustments
Throughout your neurofeedback treatment, progress will be tracked and adjustments made to the training protocol as needed, to ensure you are moving towards your treatment goals. Once treatment starts, it’s important to assume that neurofeedback is a possible contributor to any changes in your day-to-day experience and communicate with your therapist during each session. This may sound silly or extreme, but when we change one variable, it’s impossible to know exactly what else will adjust to keep up, this could mean different food cravings, energy levels, interests and motivation levels, digestive changes, sleep patterns, and more. Our brain is in charge of our entire body and mind, so when it behaves differently, it can impact almost anything. When you tell your therapist what you’re noticing it helps improve your treatment plan and outcomes.
How Many Neurofeedback Sessions Do You Need to See the Benefits?
Neurofeedback is not a one-size-fits-all approach, and the number of sessions needed to see benefits can vary significantly. Typically, a course of 20 to 40 sessions is recommended, with some individuals requiring fewer and others more. It’s common to start to notice changes right away and get used to some symptom improvement by session 6. We schedule 10 sessions initially as this gives the client and their brain enough consistency to start noticing positive changes and gain momentum towards new habits, continuing sessions are encouraged to be set up 10 at a time, but can be individualized for each client.
A Summary of How Neurofeedback Therapy Works
Neurofeedback therapy offers a range of benefits for individuals seeking to enhance their well-being. Improving Alpha wave patterns promotes a calmer and more focused state of mind. It can also aid in managing PTSD symptoms, improving sleep quality, and optimizing cognitive function for peak performance. A typical treatment course consists of 20 to 40 sessions, with noticeable changes often observed early on. With personalized adjustments and progress tracking, neurofeedback therapy provides a pathway to achieving individual treatment goals and building positive habits.
References:
- Demos J. N. ( 2005). Getting started with neurofeedback ( 1th ed.). New York: W.W. Norton. [Google Scholar]
- Marzbani H, Marateb HR, Mansourian M. Neurofeedback: A Comprehensive Review on System Design, Methodology and Clinical Applications. Basic Clin Neurosci. 2016 Apr;7(2):143-58. doi: 10.15412/J.BCN.03070208. PMID: 27303609; PMCID: PMC4892319.
