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What is Neurofeedback?

Neurofeedback is an adjunctive therapeutic method applied in the treatment of a number of neurological and psychological disorders such as post-traumatic stress disorders, depression, anxiety disorders, and epilepsy. It yields a good outcome when combined with other therapeutic modalities including medications and psychotherapy.

Neurofeedback: What is it?

Neurofeedback, also known as EEG (electroencephalogram) biofeedback, neurofeedback therapy, and brainwave feedback, is a therapeutic intervention designed to monitor, assess, and train brain waves to help individuals regulate and improve their brain function and reduce symptoms of certain neurological and psychological disorders. This procedure uses a specialized equipment, the EEG, to measure and record the electrical activity of the brain.

Neurofeedback is a non-invasive procedure which has been found to be completely safe and painless. The foundation of neurofeedback was laid in 1924, when Hans Berger, a German psychiatrist made the world’s first EEG recording using two electrodes and a ballistic galvanometer to record the brain activity of a 17-year-old boy who was undergoing a neurosurgical procedure. Berger coined the words “alpha waves” and “beta waves”. Joe Kamiya, the father of modern neurofeedback, then conducted further research to demonstrate that people could control their brain activity using neurofeedback.

Neurofeedback Theory

Neurofeedback is based on the concept of brain functions as a result of brain wave activities. This theory suggests that brain disorders –neurological or psychological- result from dysregulation of these brainwave activities.

How Does Neurofeedback Suggest the Mind Work?

The brain produces its cognitive and motor functions through the activities of brain waves. These brain waves are of four basic types: beta waves, alpha waves, theta waves, and delta waves.

The beta waves are fast and have a low amplitude. These waves are associated with alertness, wakefulness, and concentration on an activity.  The alpha waves are slower than the beta wave and have a higher amplitude. These waves are associated with mental coordination, learning, and mind-body coordination.

The alpha waves are triggered by quiet reflection, taking a break from work, or taking a walk.

The theta waves are associated with memory, subconscious information, vivid imagery, and learning. These waves are slower than the alpha waves and have a higher amplitude.

The delta waves are the slowest brainwaves, and also have the highest amplitude. These waves are associated with deep dreamless sleep states and regeneration.

However, while one brainwave may dominate in a certain situation, the others remain active only at lower levels. In some mental and neurological disorders, these brain waves may be dysregulated, with the undesired wave produced at the wrong time or the desired one not produced when required.

How Does Neurofeedback Cause Change?

Neurofeedback is useful for the treatment of diseases characterized by dysregulated brain wave activity. It helps individuals to restore optimal brain functioning by self-regulating their brainwaves. Neurofeedback therapy is used as a complement to conventional therapies, as neurofeedback therapist believe that a regulated brain is more responsive to conventional therapy such as medications and psychotherapy.

The electroencephalograph uses electrodes and sensors which are placed on the scalp to record brain activity. These sensors analyze electrical patterns on the scalp. The EEG tracks brain activity by detecting the brain waves which may be controlled using neurofeedback techniques to help alleviate the symptoms of some neurological and mental diseases.

While one type of brain wave may be predominant in the brain during a certain activity, the others are still active, albeit at much lower levels. Some neurological or psychological diseases are characterized by dysregulation of these brainwaves, such that the brain may be understimulated or overstimulated at inappropriate times. Neurofeedback helps people with diseases characterized by dysregulated brain activity to retrain their brain and restore normal brain functioning.

During a neurofeedback session, an individual’s brain wave activity is tracked and relayed to the individual via visual or auditory signals. These signals inform the patient about the inappropriate production of undesired brain waves, and this information helps them to retrain their brains to increase the production of desired brain waves and reduce the production of undesired waves during a given situation.

What Happens in a Neurofeedback Session?

A neurofeedback session typically lasts for 30 minutes to an hour and may be conducted once to three times weekly. The sessions may be conducted for an average of 20 weeks. The number of sessions you need, however, depends on the nature and severity of the illness.

A typical neurofeedback experience involves you sitting on a chair with sensors attached to your scalp. These sensors are connected to a computer EEG program which will process and record your brainwave activity. The number of sensors which is used depends on the facility – some may use just two brainwave sensors and two ear sensors, while others may use a specialized cap device with nineteen fitted sensors. While sitting, you will be able to watch the information displayed in graphics on a program to enable you to control your brain activity.

Other facilities may not require your input but use brain training systems to regulate your brain activity. Upon sending feedback data to your brain, the program trains it to regulate its wave frequencies to stimulate the desired brainwave activity. As your brainwave patterns improve, feedback will be provided to you via the program. With each session, you may begin to notice gradual improvement in your sleep patterns, stress levels, and thought processes.

Techniques used in Neurofeedback

There are several methods and systems of neurofeedback and these are grouped into categories – brand name neurofeedback systems, EEG neurofeedback, and 3D (QEEG LoRETA) neurofeedback.

Brand name neurofeedback refers to the “packaged” brain training devices which all have built-in functions and protocols which may limit the ability of the therapist to train certain areas of the brain or modulate certain brain functions. The EEG neurofeedback is the traditional type which uses two main sensors: 2 brainwave sensors and 2 ear sensors, and a ground. 3D neurofeedback is an advanced form of neurofeedback which uses 3D brain imaging and training tools. It uses a specialized cap with 19 sensors with which the therapist can train a number of brain areas simultaneously. This session requires a lot of skill and experience from the therapist and the equipment is expensive, informing the huge cost of each session.


Does Neurofeedback Work?

While neurofeedback does not cure neurological diseases, it is a helpful complementary therapeutic approach to improving the symptoms of some of these conditions. It helps to regulate brain functions to achieve a healthier brain activity and alleviate these disorders. This self-regulation helps individuals to consciously influence their brain function and alleviate their symptoms.

What Kinds of Concerns is Neurofeedback Best for?

Neurofeedback is a useful complementary treatment for a number of concerns including post-traumatic stress disorder, depression, substance use disorders, schizophrenia, anxiety disorders, seizure disorders and epilepsy, dementia, insomnia and hypersomnolence, autism, traumatic brain injuries, stress-related psychological problems, developmental delays in children, attention deficit hyperactivity disorder, and age-related cognitive decline.

How are Neurofeedback Specialists Trained?

Certification in EEG neurofeedback can be obtained from the Biofeedback Certification International Alliance (BCIA) and it comes with a four-year validity. Candidates for BCIA certification in neurofeedback must hold an acceptable degree in medicine, psychology, or other allied healthcare professions. They must also meet the clinical and education requirements, and successfully complete a written certification examination. In addition, prospective therapists must abide by the professional standards and ethical principles as prescribed by the BCIA.

Concerns and Limitations of Neurofeedback

There are some limitations and concerns about the use of neurofeedback in the treatment of mental disorders:

  • Some mental health professionals argue that there has been only limited research to back the validity of neurofeedback as a treatment for these diseases. It is viewed as an experimental technique by these professionals.
  • Neurofeedback costs more than other forms of therapy, and this may reduce the number of persons who can access it.
  • It may be difficult finding a reputable facility for neurofeedback therapy. This is because of the limited availability of the specialized equipment and trained personnel needed for EEG feedback.
  • Neurofeedback therapy is a complementary therapy, providing improved brain function only when combined with other forms of therapy including psychotherapy, relaxation techniques, and behavioral modification.

Important Practitioners in Neurofeedback therapy

Joe Kamiya and Barry Steadman are practitioners whose work greatly advanced neurofeedback therapy in the 1960s. Kamiya demonstrated the ability of an individual to control their brain activity by entering the “alpha state”, a mental state associated with relaxation. Steadman discovered, by accident, in an experiment that cats could be trained to increase their EEG activity by using food incentives. He later found that these cats could resist the convulsive effects of NASA’s lunar landing fuel. This led to a conclusion that humans can learn to reduce their seizures by using the sensorimotor EEG rhythm training.

How to Find a Therapist

There are many ways to find a good neurofeedback therapist, however, one of the best ways is by speaking with former clients of a therapist. You can also check through the BCIA Board Certified Practitioner and Mentor Directory to find a neurofeedback therapist close to you. This directory also helps you identify therapists who are certified in neurofeedback specifically and those who have a general biofeedback certification.

What Should I be looking for in an LMHP?

The essential factors you need to consider before choosing a neurofeedback therapist include:

  • Independent License – Your chosen therapist should have an independent license within their jurisdiction. This means that the neurofeedback therapist must hold a license in a discipline related to the condition to be treated. For instance, for the treatment of post-traumatic stress disorder, a neurofeedback therapist with a primary degree in medicine, psychology, or training in neurology or psychiatry is preferable.
  • Registered by a Governmental Body – A neurofeedback therapist licensed and registered by the governmental jurisdiction where they practice will more likely abide by the practice ethics and standards than one who is not or who is registered by a non-governmental professional body or a non-jurisdictional government.
  • Area of expertise – A therapist may be skilled in neurofeedback for the treatment of depression and not in the treatment of epilepsy. So, if a neurofeedback therapist has a reputation in the treatment of one condition, he may be inexperienced in the treatment of another. Therefore, you need to ensure that your chosen therapist has the necessary expertise in addressing your concern.
  • Empathy – You need to find someone with whom you are comfortable discussing your concerns with and who is compassionate and patient during the process of recovery.
  • Knowledgeable – Your neurofeedback therapist must be knowledgeable and show enough understanding of your concern.
  • Communication – Your prospective neurofeedback therapist should be able to clearly explain the neurofeedback procedure, its benefits, limitations, and possible outcome.

Questions to Ask a Potential Therapist

These are essential questions to ask a potential therapist before proceeding with neurofeedback therapy:

  • How will neurofeedback therapy help my condition?
  • How long will a session of neurofeedback therapy last?
  • How many sessions of neurofeedback are needed to resolve my symptoms?
  • How long have you been providing neurofeedback therapy?
  • What types of neurofeedback technique do you use?
  • Will the brain training be done by me or a provider?
  • How long does the neurofeedback training last for?
  • Any lifestyle changes to make my brain training more effective?
  • Do you have any references or fellow practitioner I could speak to?

Final Thoughts on Neurofeedback Therapy

Neurofeedback therapy is a form of biofeedback therapy used in the treatment of neurological and mental disorders. However, neurofeedback therapy is an adjunctive treatment for these diseases and does not provide a cure. It has been shown to be effective in the treatment of certain concerns including autism, attention deficit hyperactivity disorder, seizure disorders, movement disorders, traumatic brain injuries, anxiety disorders, post-traumatic stress disorders, and substance use disorder.







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