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What is Neurofeedback?

The brain communicates through chemical and electrical signals. Medications are how we most commonly address healthcare issues understood to be associated with chemical signaling pathways. But electrical signaling is the fundamental neuronal process that underlies all aspects of brain function (White, L. E. Ph.D., (2012). Overview of Neural Signaling- Tutorial Notes. Duke University). We can address electrical signal communication through neurofeedback.

Medication Management: About

Neurofeedback is a form of biofeedback - a noninvasive procedure that measures a client's brainwaves and provides them with real-time feedback about how their brain is functioning-(how much electricity it is producing in any given location). This is achieved through visual cues such as watching images/videos on a screen that shrink and expand, darken and lighten, or through audio cues with increases and decreases in volume. It aims to help teach clients self-control of brain functions by providing them information about how their brains react to certain stimuli. Over time, clients learn to recognize when their brain is in a certain state. They can then learn to recreate a desired state, such as relaxation and calm, or to avoid undesired states, such as excessive fear and anxiety. With the guidance of a trained clinician the brain is given the tools to retrain itself to respond more effectively to everyday situations. Extensive research in neurofeedback has found it to be effective in addressing issues with posttraumatic stress disorder (PTSD), developmental trauma, anxiety, depression, sleep, addiction and attention.

Using information from symptom presentation, and consulting head maps of function (map of what different parts of the brain are primarily responsible for overseeing), bandwidth guides (charts indicating which electrical bandwidth frequencies tend to be associated with which symptoms) a brief neurofeedback assessment and ongoing collaboration between clinician and client, various protocols are selected. These protocols refer to the location of sensor placements on the head and which bandwidth of electrical activity the session will focus on increasing or decreasing depending on the client’s goals.

What is a typical session like?

The client sits comfortably in a recliner with anywhere from 3-7 sensors placed on their scalp/ears with adhesive/conductive gel. The sensors do nothing to the client. They only sense the amount of electricity the brain is producing at the locations they are placed on the head (no electrical shocks or magnetic pulses are introduced). That information is converted into a visual or audio signal the client's brain can use to help it know whether it needs to increase or decrease electricity at that site.

Long story short- clients get to sit and watch a tv show/movie or listen to music/soothing sounds while their brain figures out what it needs to do to be able to see the screen with optimal clarity, or listen to the music/sound at an ideal volume based on the parameters the clinician has set for optimal functioning. The client's brain trains itself once it has the information (feedback) that allows it to see what is happening with its own electrical activity. Sessions last about an hour beginning with discussion about what the client has experienced since their last session and then approximately 20-30 minutes of actual training time. Some clients will notice changes after the very first session. Other clients may take 10-20 sessions to begin recognizing subtle shifts in their functioning. It took Rachael 6-7 sessions to notice anything for herself.

What is the experience like? 

Positive Training Effects
  • ​Sleep generally improves

  • Increased energy

  • Enhanced calmness

  • Enhanced focus/attention

  • Improved concentration

  • Improved memory

  • Reduced emotional reactivity

  • Reduced ability to resist emotions

Examples of Other Potential Observations

  • Changes in visual perception (enhanced color/contrast)

  • More awareness of dreams and more vivid dream quality.

  • Boundary Clarification (relationship changes-i.e. becoming more assertive).

  • Changes in food cravings or flavor perception.

  • Some physical discomfort brought on by mental health issues often subsides (i.e. upset stomach).

Are there negative training effects?

As training progresses there can be some adverse side effects along the way. These tend to be rare and only typically last at maximum 24-48 hours. If the brain does not find a change valuable it will not maintain it (unless we keep training it). It is important that the client works collaboratively with their neurofeedback provider by informing them about these experiences should they occur during or between training sessions so that trainings can be adjusted accordingly.

  • Irritability

  • Headache

  • Anxiety

  • Insomnia

  • Nightmares

  • Agitation

  • Moodiness

  • Sadness

Who is a good candidate?

  • Presently working with a primary therapist (and will continue to work with them throughout the process). Neurofeedback sessions do not allow for extensive time to process personal experiences so it is important to have another primary therapist to process your changing experiences with more completely.

  • Able to commit to at least weekly trainings. Training is cumulative and each week builds on the last. Clients are asked to commit to a series of at least 10 trainings to determine if neurofeedback is proving to be effective in helping them move toward their therapeutic goals.

  • Willing/Able to commit to/make changes that allow for sufficient sleep, moderate exercise and a fairly healthy diet. (clients cannot train if they are asleep and new neurons cannot be built without proper nutrition).

  • Not presently contending with delusions, hallucinations, significant self-harming behaviors or suicidal ideation.

Training these issues requires a more precise assessment (QEEG) than Rachael is currently able to offer. Because there can be short term adverse effects from training, clients need to feel stable enough to safely navigate these subtle shifts.

The big picture.

Neurofeedback ultimately works because it helps the brain better communicate with all of its different parts so that it can perform better. It helps connect mind and body, logic and emotion.

Neurofeedback calms the fear centers of the brains so that learning and reasoning can take place. Clients can step back and consider their situations (past, present and future) more objectively. This in turn makes interventions such as talk therapy more effective because clients can process difficult topics with less emotional dysregulation. They become better able to comprehend possible solutions and less hesitant (fearful) about attempting a new approach.

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