Although neurofeedback is an extremely powerful and successful intervention for both remediating issues and enhancing optimum functioning, it’s effectiveness is highly dependent upon the expertise of the provider. Therefore, it is of utmost importance that you find the right provider. In choosing your clinician you need to check out his or her credentials and experience, both with your issues and with the practice of neurofeedback. Ask as many questions as you can before deciding on a clinician. Below are some guidelines:
At Midwest Neurofeedback, we welcome your questions and will do all we can to help you feel comfortable and ready for therapy.
The first step is a thorough evaluation. Then, treatment begins.
The person does all the adjusting. The equipment does not send any information to the brain; the equipment merely reads the electrical signals from your brain and gives feedback. The marvelous brain does the rest.
All human activity is dependent upon the flow of information through elaborate neuronal networks in the brain. It is the combined effect of this neuronal activity that produces the wavelike electro-chemical discharges (brainwaves) that we work with in neurotherapy. Different activities or states of consciousness are associated with different brainwaves. A healthy brain shifts through different brainwave states dependent upon the task at hand. A deregulated brain may be underaroused and unresponsive or overaroused and anxious, resulting in a diminished ability to shift states in response to environmental demands; we become “stuck” in a specific state of arousal, style of responding or mood state. Neurofeedback is designed to enhance brain function by improving the brain’s ability to switch states. That is, neurofeedback is used to “teach” the brain to increase its production of “situationally healthy” brainwaves and decrease the production of “situationally unhealthy” brainwaves. Over time, the brain adapts, resulting in greater flexibility and regulation of brainwave state.
Neurofeedback started in animal research. This early research, which has been validated in many peer-reviewed journals since the 1970s, showed: 1) the EEG can be changed through operant conditioning (based on Skinner’s work), and 2) that seizures are reduced with EEG training. These early studies were done with animals – with no chance of placebo effects. The basis for this field is extremely solid. There are a number of good outcome studies. No one has published any significant study suggesting that neurofeedback doesn’t work.
To date, the areas with the most empirical research involve ADHD, addictions, anxiety disorders, autistic spectrum disorders, depression and seizure disorders. A well recognized medical journal in child and adolescent psychiatry (JACP) devoted much of a special issue to research in neurofeedback in January 2005. It is well worth reviewing. It was edited by an associate professor from Brown Medical School, a psychiatrist from Harvard Medical School and a psychiatrist from University of California, Davis. (ask you practitioner for a copy).
Frank Duffy, a noted Harvard Neurologist, reviewed the literature in 2000. He wrote an editorial that identified some unresolved research issues. Then he added:
“The literature, which lacks any negative study of substance, suggests that EBT (EEG Biofeedback Therapy) should play a major therapeutic role in many difficult areas. In my opinion, if any medication had demonstrated such a wide spectrum of efficacy it would be universally accepted and widely used.”
The majority of outcome studies are in three areas: epilepsy, ADD, and substance abuse, in addition to basic research. Though many more studies are needed, the literature that exists is substantial. Most the research is published in small specialized journals. To understand the research and science requires reading multiple studies and articles about neurofeedback. That must be combined with a good understanding of the neurophysiology of cognitive behavioral function and the EEG (see Integrative Neuroscience). Add to this a good understanding of arousal, the thalamus and the brainstem. Once you’ve studied these, it provides a solid scientific underpinning for this emerging field.
Studies from around the world have demonstrated the effectiveness of neurofeedback in treating a variety of conditions and in enhancing abilities. A study at London’s Royal College of Music (2006), for example, illustrated the beneficial effects of neurofeedback on musical ability. In a controlled study, subjects receiving neurofeedback were judged significantly better than control subjects on measures of musical understanding, stylistic precision and imaginative interpretation. To date, the areas with the most empirical research involve ADHD, addictions, anxiety disorders, autistic spectrum disorders, depression and seizure disorders. Numerous controlled studies, including a recent study published in Pediatrics (2006), have documented the effective use of neurofeedback in the treatment of ADHD, anxiety, autism, chronic pain, traumatic brain injury, depression, learning disabilities, neurodevelopmental difficulties and migraines. In addition to controlled studies, evidence for the effectiveness of neurofeedback comes from an extensive number of clinical studies. A comprehensive bibliography on the research on neurofeedback can be obtained at www.isnr.org.
Neurofeedback has been used for over 30 years clinically, with hundreds of thousands of training sessions. There are no known situations where a long term adverse effect has been identified. There has never been a lawsuit for adverse effects of neurofeedback training.
Yet anything with the power to change things powerfully for the better could potentially have adverse effects. That’s why good professional training is critical. This tool can help improve sleep. In the short term, training a site and frequency not optimum for an individual could make sleep worse. Training can improve depression – or in the short term, it could exacerbate that symptom if done inappropriately.
Typically, change in any one session is very minor. Training effects can be rapidly reversed by changing protocols (sites and frequencies) – even within the same session. Monitoring change and shifting training protocols is part of the responsibility of a trained professional. Just as short-term side effects lead to changes in medications, short-term effects provide information useful in adjusting the client’s training.
Simply stated, neuroplasticity is the brain’s ability to change itself. Current research shows many aspects of the brain remain changeable (or “plastic”) throughout the life-span. This notion contrasts with the previous belief that the brain develops during a critical period in early childhood, then remains relatively unchangeable (or “static”) afterward. It was also believed that each of us was born with a finite number of brain cells and when cells died there was no new growth possible.
Neuroplasticity shows that both neurons (nerve cells) and neural networks in the brain are capable of changing their numbers, connections, and behavior in response to new learning, stimulation, damage or dysfunction. If specific areas or networks in the brain are damaged, other areas can sometimes take over and new neurons can be activated. The brain compensates for damage in effect by reorganizing and forming new connections between intact neurons. New learning and thus brain change occurs throughout our lives.
Brainwaves are generally classified into 4 distinct frequencies or speeds – delta, theta, alpha and beta – and our state of consciousness depends on which waves are dominant. Delta waves (.5-4 Hz) are dominant during sleep. Theta waves (4-7 Hz) emerge as you drift off to sleep; this is the “twilight,” hypnogogic state in which dream like images can surface. Between 8 and 12 Hz are alpha waves, characterized by calm, relaxed and meditative feelings, day dreaming and unfocused thought. Beta (12-36 Hz), which dominates our normal waking state, has been subdivided into SMR (12-15 Hz), beta (15-18 Hz) and high beta (19-36 Hz). SMR is characterized as a relaxed, but alert state; it is sometimes described as “highly alert, physical stillness.” Focused concentration, mental acuity and mental activity are characteristic of beta. High beta (>18 Hz) may be described as a hyper-alert state, sometimes leading to tension, anxiety and agitation.
A healthy person will shift through the different states dependent upon the task-at-hand. Different activities require different brainwave states. Increased theta is adaptive when we are drifting off to sleep, for example, but not when we are driving a car. Brainwave training protocols are designed to enhance brain function by increasing the brain’s production of “situationally healthy” brainwaves and decreasing the presence of “situationally unhealthy” waves. Training protocols affect a combination of signals, depending upon therapy goals and any brainwave dysregulation that may be present. There are specific protocols appropriate for different problems, but each protocol is individually designed to fit the person.