July 14, 2020 - Tuesday

Does Neurofeedback Really Work? And How Can I Tell?

By Renee Chillcott, LMHC
Does Neurofeedback Really Work? And How Can I Tell?We are frequently asked to explain Neurofeedback and then to show the results of training.  This isn’t the easiest task for us to master and I am writing this article to attempt to explain why.  The easiest way for me to relate information is through anecdotal metaphors so here it goes:
My father, at the request of my mother, goes to the doctor and they run bloodwork. The results revealed elevated PSA levels.  Prostate cancer was indicated, however, it was at a very early stage, so the Doctor advised my father to “get healthy” and come back in 6 months.
“Get Healthy” is a very broad term that is heard every day and you are supposed to know what it means.  But what exactly does it mean?  Does it mean just lower PSA count? Or a lower weight on the scale?  What in the world does HEALTHY mean?
What his Doctor didn’t explain more clearly is that there is no one value for “healthy” and that it means different things for different people.  What we measure in body can fluctuate and change from day to day and should be used as a guide rather than being taken literally.  Mental health is no different.
Neurofeedback works to make your brain “healthier” the same way that diet and exercise work to make your body “healthier”.  It’s difficult to put a number to health as it is a “STATE” rather than a goal.  The state of being physically healthy or mentally healthy means several systems working together in a positive harmony.
When you’re working to achieve physical health, the results can be difficult to quantify.  You may see some numbers change, however, the most significant indication that you are getting healthy is by how you “feel”.
If you feel healthy, you are healthy.  If you don’t feel better, you seek out another avenue or treatment.  Feeling better is the ultimate goal.
First, What is Neurofeedback?
Neurofeedback, also known as EEG biofeedback, has been studied and practiced since the late 60’s. It is exercise for your brain; allowing you to see the frequencies produced by different parts of your brain in real-time and then through visual and auditory feedback, teaches the brain to better regulate itself. Neurofeedback can be used to help detect, stimulate, and/or inhibit activity in the brain safely and without medication. It can help restore a wider “range of motion” in brain states, much like physical therapy does for the body.
While the client sits comfortably watching a movie or pictures appear on the screen (a calm and focused state), the EEG equipment measures the frequency or speed at which electrical activity moves in the areas where electrodes have been placed. This information is sent to the therapist’s computer. The therapist is then able to determine what frequencies are out of balance. For example, when the EEG shows that you are making too many “slow” or “sleepy” waves (delta/theta) or too many “fast” waves (high beta), the therapist adjusts a reward band to encourage more balanced activity. This encouragement or “reward” happens through an auditory reinforcement of “beeps” and sometimes through visual reinforcement of changes on the screen.
As it relates to my metaphor above, Neurofeedback Training is like “yoga for your brain”. You will FEEL the improvements even though you may have a difficult quantifying them.
How does a “beep” or sound train my brain to work better?
The auditory or sound reward that corresponds to an increase or decrease in desired brainwave
activity is able to affect the brain on a neurological level. Auditory reward stimulates auditory pathways, impacts the vestibular system, and has many connections to the reticular activating
system, which modulates wakefulness and attention. These systems operate in our brains without conscious effort. Therefore, neurofeedback teaches your brain through automated learning with little or no behavioral effort. Another way to say this is that neurofeedback involves operant conditioning or learning. This type of learning teaches us through a reinforced reward system. The auditory reward (beep) is delivered on a schedule of reinforcement that promotes optimal learning; not too hard and not too easy. This schedule of reinforcement or reward provides just the right amount of resistance to evoke a positive learning pattern.
What types of conditions
does neurofeedback help?
Symptoms of these conditions, among others, can improve through neurofeedback training:
• Anxiety • Sleep disorders • Depression
• ADD/ADHD • Sensory processing disorder
• Bipolar disorder • Seizure disorders
• Auditory/visual processing
• Chronic pain/Fibromyalgia
• Migraines/headaches • Traumatic brain injuries • Stroke • Cognitive decline
• Peak performance
• Oppositional defiant disorder
• Rages/mood swings
• Attention/focus/concentration
• Reactive attachment disorder
• Autism/Asperger’s • Learning disabilities
• Obsessive compulsive disorder
How do I know if it’s working?
As the brain learns, you will see the changes. However, everyone learns at different speeds, so it cannot be determined how quickly someone will learn. On average, children take about 10-20 sessions to see changes and we can discuss what to expect during the intake appointment. For adults changes are usually noticed within 10 sessions. Total treatment is an average of 40 sessions, however we individualize treatment – some people need more and some less. As mentioned before, the goal of Neurofeedback is to achieve balance and flexibility so recognizing that it’s working can be a challenge. First, as no two brains are alike, no two people have the same experience with Neurofeedback or learn at the same speed. Second, setting up treatment goals can also vary from person to person and as you are unable to control how fast or for that matter, how our brains learn, you must learn how to observe. This ability to observe can be quite challenging for some people. Up to this point in life, your brain hasn’t been behaving the way you would like it to. So, observing changes requires a bit of practice. We will be discussing your experience with you when you come in for each session. And third, you’re going to be looking for an absence of symptoms. Looking for something to “not” be there definitely requires reflection rather than observance. We’ll teach you how to look back at the end of an event, day, month, and even couple of months, to see if you notice things are different. And most importantly, we listen to you telling us how you “feel”.
Are there numbers I can see
or a test to show progress?
Neurofeedback measures brain waves in several different ways. It measures the frequency of neuron firing in HERTZ and the size of the signal or AMPLITUDE in MICROVOLTS; it can also measure coherence or connectivity of the waves in SYNCRONY. There are several quantitative measures of dysregulation that we correlate to symptoms. However, you’re not coming in for quantitative relief, you’re seeking treatment for symptom relief. There are different Neurofeedback systems available for a practitioner to use and new ones continue to be developed. New systems claim to teach the brain more efficiently, therefore producing faster results. Unfortunately, we cannot control how fast the brain learns and we end up back to the same situation of “as no two brains are alike, no two brains learn at the same speed”. There are tests for functioning that may be done at the onset of treatment, if needed or desired. Tests for levels of processing functioning, attentional functioning, behavioral functioning, mood functioning, and more may be administered to provide the client with a baseline. However, regardless of the outcome of these tests, or regardless of the printout from a Neurofeedback session, results only count if they are observable. A QEEG (Quantitative EEG) can be performed at any point during treatment to identify dysregulated brain patterns and some practitioners will perform a second or third throughout treatment to quantify progress. Analytical measures are available, however, we caution our clients on the misinterpretation of these measures and focus on how you are “feeling”.
The QEEG is a quantitative EEG. It’s also called a brain map and does just that…it gives us a map of what is going on with the entire brain at one time. We attach electrodes to the whole head, 19 spots, and then record the brain waves with eyes open for 5 minutes and with eyes closed for 10 minutes. This recording is then sent to an independent specialist be read and analyzed. They are able to not only give us a summary of significant findings but the report also shows the results of analyzing the data several different ways. The brain activity is not only compared spot by spot over the entire head, but we can also look at connections, symmetry, how different parts are communicating and all of this data is compared to a database of peers (same sex, handedness and age). It can help us see what areas need to be addressed more efficiently than just training spot by spot.
We don’t always need this data to make improvements in symptoms but we do recommend it in certain situations. A QEEG can also be helpful information when diagnosing and/or trying to decide the best medication/supplement recommendations.
What is an example
of improvements I may see?
At our center, our goal is to teach you how to tune into your own functioning. With children, we also teach the parents how to look at overall functioning rather than piecing together events or moments. We help you open your mind to possibilities with Neurofeedback rather than give too many examples that confuse the process or feel like a placebo. Changes you may experience or observe after a session are indicative of a learning process that will lead to improved functioning. Examples of those positive changes may be:
Sleep patterns/quality of sleep
Energy levels, calmer or more activated
Ability to focus or concentrate
Physical symptoms such as pain, headaches,
migraines, tics, balance issues
Mood or emotions
Motivation and organization
Feelings of Well Being
Obsessive behaviors or thoughts
Anxiety patterns or trauma patterns
Learning, communicating, and/or performance
Getting started is easy, just give us a call. The Brain and Wellness Center staff will answer all of your questions, and help you get scheduled. If you are wondering what services are best for you? We can help determine that at the time of the intake, in a telephone consultation, or you can schedule a face to face consultation and see our facility. Call, email or message us today! Brain and Wellness Center, 7301 W. Palmetto Park Rd., Suite 102A, Boca Raton, FL 33433. (561) 206-2706,
e-mail us at info@bocabraincenter.com, or text us at (561) 206-2706 or visit our website at www.BocaBrainCenter.com.

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