For years, Jan Davis and Penel Thronson were fairly conventional Marin County therapists, seeing clients out of offices in their rambling wooden house on a Larkspur Hillside. Davis, a psychologist and former Montessori teacher, was a Jungian Analyst and conducted neurological assessments.
Thronson, a former psychiatric nurse, was a Marriage Family Therapist who saw couples and individuals.

Six years ago, however, they became early adopters of a hybrid, high-tech therapeutic approach called neurofeedback. Today, they are as likely to stick an EEG (electroencephalogram) electrode onto a client's skull and set him up in front of a computer game as they are to ask about his childhood, personality quirks or current emotional state.

What they are doing, improbable as it seems, is training brain waves. Two linked laptops feed their clients' brain waves - faint, rhythmic electrical pulses picked up through the skull - into a simple computer game. When the brain waves pulse in rhythms indicative of relaxed wakefulness the computer beeps and a rocker fires into space on the screen, or a Pac Man-like creature gobbles up dots. When the client produces slow, daydreamy brain waves or fast frantic ones, the beeping stops and the rocket fills back. There is no joystick or keyboard: Clients make the rocker fire or stop simply by changing their mental state. Over time, Thronson and Davis say, the brain learns to shift smoothly from calm to energized, rather than being stuck chronically in overdrive or underperformance. It's like taking a car with its brake stuck on and its engine revving, and freeing up the full range of gears.

Armed with their laptops, Davis and Thronson have so far treated more than 200 Marin Country children and adults with Attention Deficit Disorder and other psychological problems. After about 40 half-hour sessions, they say, most clients become calmer and more capable of sustained concentration, and children and teenagers often successfully avoid being put on medications like Ritalin. Dozens of studies and case histories from across the country indicate that neurofeedback has helped adults with neurological and emotional problems ranging from garden-variety depression to autism, manic depression, obsessive-compulsive disorder, migraines and severe epilepsy.

Neurofeedback is not new: It was first explored - and oversold - in the 1970s, as a relaxation approach to increase the alpha waves produced in meditation. At the same time, UCLA research psychologist Barry Sterman trained lab cats to produce slightly faster brain waves and accidentally discovered that the cats had become “immune” to epileptic seizures. Neurofeedback was then successfully used to reduce seizures in human beings with severe epilepsy, and a period of under-the-radar experimentation began.

Neurofeedback has long been regarded skeptically by many psychiatrists and neurologists, partly because of the overhype that attended it in the 1970s. But increasing numbers of licensed, middle-of-the-road therapists like Davis and Thronson (estimated at 5,000 nationwide) are trying it, and evidence of its effectiveness is growing. Last January, the medical journal Child and Adolescent Psychiatric Clinics of North America reviewed scores of studies involving children with ADD and found significant improvement in 70-80 percent of cases, a benefit roughly equivalent to that of medication, without its side effects.

At least one Marin mother says she doesn't need to see studies to be convinced. Last year, Davis and Thronson treated her then - almost friendless and impossibly disruptive 9-year old son, "Kurt," who had learning disabilities and ADD and fought her over everything from when to get up in the morning to what to eat for dinner. Even though the mother had spent thousands of dollars on a child psychologist and a learning disorder specialist, the child's behavior had not improved and she was under intense pressure from his elementary school to put him on Ritalin. "Kurt wasn't able to sit still in class," the mother recalls. "He would wiggle around, calling things out when the teacher was trying to give a lesson, poking the kids next to him, fiddling with their pencil boxes, and saying inappropriate things." His grades were twos on a four point scale (the equivalent of Cs).

Kurt had about 150 neurofeedback training sessions with Davis and Thronson over several months. After the first month, the mother says, "I saw a calmer, sweeter, more focused child who is - I hate to say he wasn't normal before - but he is like any other kid right now. He even holds the door for me." Kurt is no longer a school behavior problem and gets fours (the equivalent of As). The pressure to medicate him has stopped. "It
hasn't cured everything and it isn't going to," said his mother. "But it's made him able to manage what was previously totally unmanageable."

Davis and Thronson, who work as a team, are among a few dozen Bay Area therapists using neurofeedback. (A promising two-year pilot program that treated 60 disabled students at the College of Marin was closed in 2003 due to budget cuts.) I interviewed them together at their comfortable home office in Larkspur in early March. After the interview, they took me to a nearby table holding two linked laptops to give me a sense of neurofeedback training. Thronson clipped earring - like wires to my earlobes and used a sticky wax to lodge a wired sensor onto my scalp. It picked up my brain waves from the surface of my skull and fed them into the computers.

The first laptop showed my brain waves as rows of gray wiggly lines, moving rhythmically across a screen. The other translated that data into a simple computer game called "Island," showing the wake of a boat stretching toward a brown volcano on the horizon. When my brain waves showed I was relaxed but alert, the computer made a beep, I got a point, a star appeared in the sky and a wide strip of white spread toward the horizon. When I got too day-dreamy, a purple square on the lower, left of the screen jumped outside its box and the beeping stopped. When I became too tense, an orange square on the right did much the same thing. Sometimes the screen fell silent; at other times, I produced a river of continuous beeps. When I earned 500 points, the volcano released a pretty cascade of colored balls.

Neurofeedback seems like an odd hybrid-combination of computer games, old-fashioned counseling and science-fictiony brain science. It is reported to help so many diverse conditions - from autism and Asperger’s syndrome to ADD, not to mention migraines, epilepsy and depression. Is this why some people think it's snake oil? Can one technology really help so
many different conditions?

Jan Davis (JD): Yes, indeed it can. All these conditions are created in the brain. The brain is literally directing our physiological, psychological and intellectual functioning. And certain specific areas in the brain regulate different aspects of our life. We can now identify brain wave patterns associated with some of these difficulties - including epilepsy, autism, anxiety and several distinct types of depression. When we impact that pattern by putting an electrode over a spot and training the brain waves to beneficial frequencies, people can sometimes - not always, but sometimes - feel the improvement right there in the chair.

I just worked with a very energetic executive with high anxiety who had difficulty sleeping. He'd gone back on medication, which he hadn't wanted to do, because he simply couldn't function without sleep. Within three sessions, we had broken the pattern. But we need to do many more sessions to create new patterns for his brain.

What got you interested in the first place?
JD: A longtime client came in after not seeing me for a while, and I was aware that there had been a fundamental shift in her psyche.

What precisely had changed?
JD: Her whole demeanor - the way she occupied space in a room. She was more engaged with me, and physically much more relaxed. I had not seen that sort of change in her before - not with medication, or therapy, or taking a vacation. She was just more present. I asked what she'd been doing, and she finally said, "Neurofeedback." I decided this was something I needed to explore. She told me she had worked with a psychologist in San Jose - Mark Steinberg, the author of a book on neurofeedback called ADD: the 20-hour Solution. I met with him and saw how it worked. I then discussed it with my colleague, Penel, and we decided to take the training.

What did you notice first when you took the training?
JD: That the people running the training program weren't straining. A total absence of strain.

Did you try it yourself? What was the effect?
Penel Thronson (PT): Yes, it was a settling, a calmness. I've struggled with mild depression, as many women have, and that hasn't been nearly a problem since. I have an increased ability to focus. If I'm in a negative or bad space, I can always shift it with a brief session. Sometimes, if I need to, I just imagine I'm doing "Island" [one of the games] - people who are overaroused and anxious like that particular game, because it's calming.

JD: Occasionally when I have big presentations, I go back to do a tune-up...

I want to go back to my first question-how can something so simple really affect so many different conditions?
JD: Neurofeedback teaches self-regulation - it helps people shift and control more of what goes on inside them.

How does staring at a screen making a rocket fire do that?
JD: When we think of serious self-regulation, we think of a yogi. Once upon a time, there were all kinds of things - like the heart rate, respiratory system and consciousness - that we thought we had no control of. The yogi informed us that this was not so.

Like being put in a coffin for day, without food or water and being able to slow down your heart rate and breathing almost to nothing?
JD: Exactly. We're not interested in the coffin, but we are more interested in helping people not blow up at their boss when they can't stand him.
PT: If someone comes in anxious, we frequently can calm them down right in the chair.

How does it work? It's ironic to think that staring at a machine would make people better able to relate to other people.
JD: It's more than that. There are four categories of brain waves that we track: delta, theta, alpha and beta. Each is a different range of frequency - somewhat like rhythm. We need all of them to be in their proper relationship. If we have too much of one and not enough of another wave in a certain place in the brain, it could show up as a personality issue or an inability to process information.

Can you give me a for instance?
JD: Let's go for beta. Beta are moderately fast brain waves that we use for focusing and concentration and ability to stay on task. If we have too much high beta-fast brain waves - particularly in the frontal area of the brain behind the forehead, we can have somebody quite irritable, who can fly off the handle easily and generally be very cranky. But if you're not generating enough beta, you can have somebody who daydreams and has
an inability to focus and concentrate. We're going to want to wake up the brain and get the person to be more present to what's going on.

What about slower waves?
JD: Theta is a slower wave. Some people say it is the source of our creativity and a place where we daydream and muse. If you have too much theta, you may be off in your own little world, daydreaming. Creative people may have a lot of theta, but they are able to utilize this in a more functional way. People with limited theta have a hard time imagining things, and are stuck in a fairly concrete world. We need the theta. but if we have too much, we're going to have a problem.

So you need all four of those types of brain waves?
JD: The idea is not to make you super brainy and super calm or super whatever. We are seeking to support brain flexibility to enable the individual to respond appropriately to their life and circumstance; to perform optimally in a variety of situations.

How exactly does it work?
PT: There's a lot of discussion in the field about how this works. We don't really know. We may be increasing blood supply in the brain, and affecting how the neurotransmitters are functioning, the very basic communication between brain cells and areas of the brain. We attach electrodes

JD: Nothing goes into the brain. No drilling. [laughs] When we attach electrodes we are recording brain activity, and rewarding slight changes through the games.

Who was the first person you worked with?
PT: Two weeks after we came hack from the first training, I worked with a woman who was trying to pass the oral exam for her psychology license. She had completed her whole doctoral program with high honors, but when she got to the orals of the exam-it became a nightmare. She'd
failed it twice and she was just beside herself. They'd throw her some question, she'd start to get anxious, her anxiety would build and her frontal
lobes would shut down and she didn't have access to what she knew. From then on, it was a losing battle.
JD: She had an inability to access the frontal and prefrontal areas. We needed to stimulate the brain...
PT: We helped her succeed then, but could assist her in an even better way now.

What does inability to access the frontal lobes mean?
JD: She had difficulty excluding extra neous information and staying focused and organized with what she wanted to do and what to accomplish.
Her increasing anxiety complicated the situation.
PT: This is frequently a problem with women in high demand situations. The frontal lobes are the CEO of the brain. They help you focus, stayon track, shift gears.

Where are they?
JD: -From the forehead back to just in front of the ears.
PT: -She came to us four months before she took her boards. We really brought down her anxiety fast, and the test situation she was able to function at her best, and she passed. She was dedicated and committed. You've got to be able to show up and tolerate the treatment. It can be tedious and boring. She came about 30 times, and she easily passed the next exam. It was dramatic, she's so pleased. and it's holding.

What about with children?
PT: Let's tell her about hurt. He came last year when he was 9. He was hyperactive and really provocative. He could piss somebody off in a second, he was really good at it, and his mother was just frantic. In his case his treatment was rather counterintuitive Most people think you have to calm a kid like that down. We found out he needed more stimulation. He was trying to provoke the world into keeping hint alert.

Make the world stimulate him?
PT: If you gave this kid a giant Coke [caffeine], he'd calm right down. When he first came in, he was all over the wall. He didn't want to do it, it was boring, he was pulling on stuff -
JD: - at least at first he was. He was without doubt

PT: -anyway about the fifth game period in the first session, he suddenly calmed down, went into his body, started to ask questions. It was a dramatic, observable shift in about 20 minutes. Then we knew we were on the right track. We were training him to produce more high beta waves on the left side of the brain. We just did two-three sessions per week for six months.

Beta is what again?
PT: It's involved in the ability to be alert and stay connected to the task.
JD: We were activating his brain, because his brain was asleep in specific areas. He was a very complicated case. In addition, we trained him at multiple sites.
PT: One major issue that was observed in his brain map, by a board certified neurologist, was that about every 20 minutes, whatever he was doing,
there'd be an observable parietal spike. This is an electrical discharge in the parietal lobe of the brain.
JD: Think of it as the radio was on, and suddenly the radio went off the station and there was loud static blaring.
PT: He looked to others as if he was willfully goofing off and not paying attention. Whatever he was doing or trying to attend to would be interrupted, but lie was totally unaware. Now he no longer has to get others mad at him to help him stay engaged or stimulated.

Is there a downside to this technology?
PT: You can make someone real bitchy. You can send them home fighting with everybody. If they are highly overaroused and you give them high beta, they can't sleep, they have to come on back in. That happens sometimes. We'll tone it down.

It's almost Dr. Strangelovey.
PT: Very powerful.
JD: Powerful and elegant. It's so subtle. I have a son who is ADD, the lazy type of ADD. He lives in Santa Cruz. I gave him training, and he said [mimicking blare tone of voice], "Oh, it's fine," and he and his wife drove home. His wife called later to say he was awake all the way home, didn't fall asleep, got home, emptied out the car, made his lunch for the next day and put away all the stuff they had in the car and cleaned it up. My
son said it was no big deal, but to his wife it was!
PT: -Think about it. If you're underaroused all the time, and you suddenly have more energy. You can do things. You think it's kind of magic.
But it's just that you've been woken up a bit.

Usually what would he have done?
JD: He would have had to stop for coffee to keep awake, and staggered into the house and said, "I'm just exhausted, I have to go to bed." Then he'd have struggled to get up in the morning.

Does it ever succeed where therapy has failed?
JD: There's a very high-powered software designer I'd been doing therapy with. Every eight or nine years she would have a breakdown, and she was headed for one. We did the neurofeedback. She stayed out of the hospital, she continued to work, she was able to pull through things, and now she is completely off medication and she hadn't been off medication for years. She's put her whole life back together. Because of her lack of awareness of herself, we wanted to build a steady platform inside. So we trained near the temporal areas, which govern resiliency and inner security. Just above the ears. What about the negatives? What proportion are not helped? Or get worse?
JD: If it makes someone worse, we will modify the program and calm them down. We've had people say they didn't think it was that beneficial.

Other negatives?
PT: When it starts to shift, sometimes it scares people. They don't know who they are any more.

It's very different to say you don't have enough beta waves than to say your mother didn't bond with you...
PT: It's a learning model. The kids love it that they're teaching the brain to do something else that it couldn't quite do before.
JD: I used see people with brain damage from head injury and stroke. You could tell them to write down everything if their memory was gone. But you couldn't say, if you go to the gym you can build up this muscle. Now I can say, if you do the neurofeedback, you can build it up.

Are you less frustrated as a therapist?
Both: [nodding vigorously] Yes.
JD: In talking therapy you can talk about how you relax, how to be more present. But if you take them into the neurofeedback, you can give them an experience of it.

What do you do when these kids are bouncing off the wall and you want them to sit in a chair and stare at a screen?
PT: Anything to keep them in the chair.

Such as?
PT: We tell them that the good news is you're going to play video games. The bad news is that it's not a very exciting video game. It's kind of tedious. So we bet with them and gamble with them. When we were doing some EEC testing, I was paying Kurt quarters if, for 30 seconds, he did not move. You could see him struggling, but at least he wouldn't move. I think he made close to five bucks that first day.

With teenaged boys, I'll say, I bet you can't get double the points this time. They get competitive and then they're interested. We pay them dimes, quarters, dollars. I burn CDs for them from iTunes, get the parents to stop at In-N-Out Burger on the way home-whatever works.

You're shameless bribers.
PT: If we need to be. These kids are already trying. They want it to work. We're just trying to keep their butts in the chair.