Neurofeedback Q & A

I’ve heard of biofeedback. Is it related to neurofeedback?
Any form of information provided by equipment regarding what’s happening in the human body at the present moment is called biofeedback. Biofeedback equipment doesn’t do anything to you. It just has the capability of sensing and reporting what is happening within your body in that moment. This can be as simple as a mirror, a scale or a thermometer, or as complicated as an Electrocardiogram (EKG). Neurofeedback equipment can sense and provide feedback as to how the brain is functioning at a specific moment in
time.

Neurofeedback – what is it?
Neurofeedback, sometimes called EEG biofeedback, is direct training of the brain which then learns to function with greater control and stability. This is a gradual process just as the training of the muscles of the body when you go to the gym. As the training proceeds, the equipment gives feedback to the therapist and rewards the correct performance by the client/patient. By giving the positive feedback the brain activity is shaped to more beneficial patterns. This is simple operant conditioning.

How is the Neurofeedback training done?
The first step is an indepth evaluation which includes a detailed questionair, any previous assesment reports, consults with professionals who are working with the client/patient, an extensive discussion of strengths and difficulties and an on-going commitment to feedback, feedback, feedback! throughout the course of treatment.
If the person has experienced head injuries, coma, seizures, or has many conflicting symptoms we may recommmend a brain map(see brain maps). Part of the evaluation includes a first neurofeedback session that introduces the client to the training. Gold sensors are placed at specific sites on the scalp to record brainwave activity. After our determination of the optimal training level the brain is rewarded by sound and sight from the computer everytime the brain achieves the desired range. This whole process is often done with the brain not the hands playing a video game! Eventually, the brainwave activity is "shaped" by rewards and positive feedback toward more desirable, more regulated performance to improve the person's self-regulation.

How does training transfer to everyday situations?
The wonderful thing about neurofeedback is that it “frees up” the client/patient to have more ability to attend to his/her life in a much less stressful manner. The subtle influences of the training can create a greater ability to:
• Focus
• Have more endurance for demanding tasks
• Be calmer and less anxious
• Lift depressive thoughts

Often there is an internal flexibility that gradually occurs, but appears to the client/patient to just suddenly “happen” without a plan from our conscious mind. When this does happen it often feels like the whole world is “brighter”.

Can neurofeedback training be used while a patient is on medication?
Yes. Many individuals who begin neurofeedback training are on medications to assist their psychological and/or mental functioning. After participating in neurofeedback sessions for awhile they may want to discuss a possible reduction in the dosage of their medication with their physician. It is not uncommon for the individual to have less need for medication as their symptoms lessen.

How many training sessions does it take?
The real answer is that it depends. It depends on:
• The age of the client/patient - Youngsters often can only tolerate shorter training periods
• The type and severity of the presenting symptoms - certain situations can require many sessions.

Noticeable changes typically occur between the first and tenth session. Neurofeedback is measured in 30 minute increments. Each time the client/patient comes to our office we aim for 45 minutes (1 1/2 increments) of neurofeedback two times each week. The overall number of sessions can vary widely from a low of 30 to a high of over 90. We recommend a minimum of 30 thirty minute sessions (this would be 20 appointments) and see how the client/patient is doing at the end of that time. The goal is to complete enough training to insure consistent and lasting benefits. Like piano lessons, a lot of practice is needed to over-train the brain so that the changes become the dominant pattern.

How long does the effect of training last?
Again, the answer is that it depends. If the client has done enough training, and the right type of training long-lasting results have been reported. Some long term studies have been undertaken and have shown sustained carry over of improvement.

Some problems, such as Autism, Brain Injury, Cerebral Palsy, Tourette’s or other neurological problems may require on-going treatment to maintain improvements. For degenerative problems, including MS, Parkinson’s and Alzheimer’s, reports suggest that neurofeedback can help to stabilize the problem or seem to slow the process. Also, reports indicate neurofeedback may help to optimize brain function with whatever resources still exist so that the “quality of life” is the primary result rather than remediation of the problem.

Some clients/patients may experience a relapse of symptoms as the result of an injury, trauma, or extreme stress. This may be due to underlying neurological issues, genetic vulnerabilities, or other factors. It varies from client/patient to client/patient. For some the treatment will hold and never need “maintenance” (“refresher”) sessions once a month, or once every 3-6 months and for others, on-going training sessions may be appropriate. For many only occasional “maintenance” (“refresher”) sessions can be sufficient to get them back on track. The intensive training is seldom needed again. It’s as if it doesn’t take much to get back to that place once the brain has gotten “it”. It just depends on the individual client.