Othmer Method Neurofeedback: What It Is and What to Expect

When I recommend neurofeedback to a client, one word sometimes causes immediate concern: electrodes.

So let's start there.

The electrodes used in neurofeedback are sensors. They read electrical activity from your brain; they don't put electricity into your brain. There are no shocks, needles, or electrical stimulation.

The experience itself is generally much less dramatic than the terminology makes it sound.

What is neurofeedback?

Neurofeedback is a form of biofeedback. Sensors placed on your scalp detect your brain's ongoing electrical activity, and a computer uses that information to provide feedback through things you can see, hear, or sometimes feel.

The particular approach I recommend is the Othmer Method, which uses Infra-Low Frequency (ILF) neurofeedback and focuses on self-regulation.

The training is highly individualized. Rather than giving everyone with a particular diagnosis the same treatment, the practitioner adjusts the training based on your symptoms and, importantly, how you respond to it.

What actually happens during a session?

A practitioner places a few small sensors on your scalp using conductive paste.

Then you might watch a movie or another visual display while the computer provides feedback based on your brain activity. Depending on the setup, there may also be sounds or gentle tactile feedback.

You remain completely awake and aware. You don't need to meditate, concentrate intensely, figure out what the computer is doing, or consciously make your brain behave differently. And you don't need to talk about difficult experiences while you're doing it.

Mostly, you sit there and let the system do its work.

And again, the sensors are only reading activity. Nothing is being delivered electrically into your brain.

Why I sometimes recommend it

I don't refer every therapy client for neurofeedback.

I tend to consider it when someone's difficulty with regulation is making other therapeutic work particularly hard.

Emotions may go from zero to one hundred very quickly. Once upset, it may take a long time to return to baseline. Someone may move between intense activation and shutting down, become overwhelmed easily, dissociate, have significant sleep difficulties, or understand exactly what we're working on intellectually but have very little ability to influence what happens once their system is activated.

In those situations, being told to use your coping skills can be frustrating when your reaction is happening faster than you can access them.

And intensive trauma processing isn't always the right place to start.

Sometimes I want to help someone develop greater capacity for regulation first—or support that process alongside the therapy we're already doing. I also want to be thoughtful about whether the work we're doing in therapy could leave you more dysregulated outside of our sessions.

That's when I may suggest neurofeedback.

A referral doesn't mean something is wrong with you

If I recommend neurofeedback, I'm not telling you that you're too difficult for therapy. I'm not saying your problems are “all in your brain,” and I'm certainly not trying to change your personality.

I'm recommending another resource because I think it may make the work we're doing together more manageable and help us do that work safely.

If your emotional system reacts before you have an opportunity to use what we've talked about, greater capacity for regulation may give us more room to work.

I think of neurofeedback as potentially adding capacity, not replacing psychotherapy.

What are they trying to change?

The simplest answer is regulation.

That might mean becoming less easily overwhelmed, recovering more readily after something activates you, sleeping more consistently, or having an easier time remaining present when difficult emotions arise.

The practitioner pays close attention to how you're responding and adjusts the training accordingly. That's one reason I care about who provides the neurofeedback. This isn't simply a machine running the same program on everyone. The clinician's training and judgment matter.

Will I feel anything?

People's experiences vary.

Some notice changes fairly quickly; others notice them gradually. Your practitioner will want to know what happens both during sessions and afterward—particularly changes in sleep, energy, anxiety, irritability, alertness, emotional reactivity, or whatever symptoms are relevant to you.

Tell them about changes that feel good and changes that don't.

Sometimes neurofeedback can produce unwanted effects or simply feel like the settings aren't right for you. That information is useful because the training can be adjusted based on your response.

You don't need to be a “good” neurofeedback client or try to produce a particular result.

What does the research say?

There is published research on Infra-Low Frequency neurofeedback, but the evidence base is still developing.

A systematic review of ILF neurofeedback research found promising results while also identifying important limitations, including the relatively small number of studies and considerable differences among them. The authors concluded that more rigorous research is needed before firm conclusions can be drawn about effectiveness.

I don't consider neurofeedback a proven treatment for every condition for which it's sometimes promoted, and I don't recommend it as a cure.

I recommend it selectively when I think greater capacity for regulation may be useful.

Is it a replacement for therapy?

Not usually, in the way I use it.

Neurofeedback doesn't help you decide what you want from a relationship, grieve a loss, understand your history, establish boundaries, or figure out what kind of life you want.

But if you're less easily overwhelmed, recover more readily when something activates you, or have greater capacity to stay present with difficult emotions, psychotherapy may become easier to use.

The two can serve different purposes and work alongside each other.

Why this particular kind of neurofeedback?

There are many kinds of neurofeedback, and they're not interchangeable.

I recommend clinicians trained in the Othmer Method because that's the approach I know and have experience with. Its emphasis on individualized training and regulation fits the reasons I'm generally making the referral.

That doesn't mean it's the only worthwhile form of neurofeedback or that research has established it as superior to other approaches.

It means that when I recommend neurofeedback to one of my clients, I'm making a specific recommendation rather than suggesting they find any provider who happens to offer it.

You don't have to understand the neuroscience—or be convinced that neurofeedback is going to help—to meet with a practitioner, ask questions, and decide whether you're comfortable trying it.

That's really all I'm asking you to consider.