Neurofeedback, what to expect:

photo credit: Jill Perkins

photo credit: Jill Perkins

A lot of my clients are very nervous when I introduce the idea of neurofeedback. They haven’t heard of the therapy, don't know what to expect, and the idea of attaching electrodes to your scalp is just strange enough to feel threatening. The goal of this post is to demystify the process a little bit. I can’t speak to any one client’s specific process, as it is a little different with each client, but I can speak in terms of general trends.

Neurofeedback is a way to teach your brain to better self-regulate; to do things in a way that feels better and is more efficient. It does this by presenting your brain with a reflection of its own activity, thereby giving your brain the opportunity to recognize what is working, and what is not, by the millisecond. Your brain will then naturally start to self-correct towards what works better. 

A few things to know:

Neurofeedback involves touch, as I have to put the electrodes on your scalp. I attach them using a water soluble conductive gel, that I call goop, and that will get in your hair. The electrodes do not do anything to your brain.  They are literally just receiving information about the natural electric activity that happens all the time, in every brain. The information is processed by a qEEG machine, and is reflected back to you by some media that you are watching on the computer screen.  The images on the screen will change size, and color density, and the volume will change, as well; this is the feedback, this is the reflection of your brain activity. Most people are surprised to learn that the feedback also doesn’t do anything to your brain; I can watch the movie right beside you, see the same feedback, and my brain won’t do anything differently.  The change happens because your brain recognizes itself, and its own activity.  At that point, your brain naturally chooses to do things differently, again in a way that feels better and is more efficient.

What will this look like for me?

The first step is to find the correct frequency to work at. When we begin we have no idea what your brain is going to like.  We start blindly, and then find the frequency through trial and refinement.  We try a frequency for a couple of minutes, and then, hopefully, you can report back to me how it makes you feel, and based on that report, we choose to take the frequency higher or lower.  We then inch our way up or down until we find the frequency that feels best.  

For some people this process is very easy, for others it is very difficult.  If the frequency is too high it can feel like euphoria, impatience, or caffeination; at its worst, it can make it difficult to sleep that night.  If the frequency is too low it can feel like tiredness, exhaustion, heaviness, excessive emotionality; at its worst it can feel like depression. Try not to let this scare you; I’m careful, and methodical, and take the process very seriously; I’d rather make changes slowly than leave someone feeling terrible.  Also, the effects of the first session tend not to last more than 24 hours.  You need repetition for the effects to begin to last longer than that.  With some clients I am able to find the frequency the first day, for others it can take a few weeks; it all depends on how easily the client is able to connect to their emotions and body, and report back to me, and also how easily I am able to understand what the client is saying, and translate that into knowing if the frequency is too high or too low.  

Once we find the right frequency, then we can begin to move the electrodes around to train different regions of the brain.  Different regions are responsible for decision-making, emotional regulation, developmental trauma, dissociation, feeling out of body, anxiety, attention span, depression.  We are working to soothe your nervous system, and where we place the electrodes determines what effect we’ll have.

The first three sessions, should happen in a two week period: the first session, and then about two or three days later, the second session, and then about five days after that, the third session.  By that time, we generally will have a good idea of the right frequency, and for most people the effects should last about a week. After about a month and a half of weekly sessions, with most people, we can begin to taper sessions to every other week without sacrificing any of the positive effects.  After a couple of months of that, we can taper even more. The important thing to note here is that every brain is different, and will adapt at its own pace.  

Who will neurofeedback benefit?

The short answer: everyone.  Top athletes and musicians use it to improve their response time and precision.  People with psychotic disorders use it to soothe the nervous system so they are able to handle stress better, and are less likely to experience a psychotic break. 

  • I recommend it to all of my clients who suffer from a generalized or severe mood disorder (anxiety or depression).  

  • I recommend it to clients who have financial difficulties and can only see me for a short time; the goal with neuro is to train your brain to do things more efficiently on its own; sessions taper off as your brain gets used to doing things in a different way.  

  • I recommend it for clients with developmental trauma, or PTSD, that is so devastating that to process it through EMDR runs the risk of re-traumatization.  

  • I recommend it to clients who suffer from addictions because you can work on the emotional need and the problematic decision-making at the same time with little risk of abreaction.

Is neurofeedback better than psychotherapy?

Some people think so.  I know of two psychologists who stopped practicing psychology because they found neuro to be more effective.  I don’t even really like to use it, it’s a little boring for me to have my clients watching movies, but it has been so beneficial to my clients that if I want the best results for them, which I do, I feel I have to have it on offer.

Are the effects permanent?

The neurofeedback community says yes, with enough repetition. I’m not sure.  I’ve done more neuro on myself than I have on anyone else, and still I can do with a few sessions about every six months.  

Other stuff:

  • There are lots of different methods of doing neurofeedback. I practice the Othmer Method.  It is only taught to licensed doctors and therapists, as it is very effective.  I like this method because it relies on the client’s report of their own subjective experience; everyone’s brain is so different, and the subjective experience is what we are trying to improve.

  • I have a booklet in which a few clients have written about their experiences with neurofeedback for the purpose of my sharing it with other clients. I’m going to ask them if they would be OK with me sharing on this platform, as well.

  • I found neurofeedback as a client. It was so effective for me that I signed up for the training before I was even licensed as a therapist (back then they allowed laypeople to train in this method).