This article is my modification of an article originally posted at the Brian Othmer Foundation.
Neurofeedback
FAQ
What is neurofeedback?
Neurofeedback is direct training
of brain function, by which the brain learns to function more efficiently. We
observe the brain in action from moment to moment. We show that information back
to the person. And we reward the brain for changing its own activity to more
appropriate patterns. This is a gradual learning process. It applies to any
aspect of brain function that we can measure. Neurofeedback is also called
EEG biofeedback, because it is based on electrical brain activity, the
electroencephalogram, or EEG. Neurofeedback is training in self-regulation. It
is simply biofeedback applied to the brain directly. Self-regulation is a
necessary part of good brain function. Self-regulation training allows the
system (the central nervous system) to function better.
What is neurofeedback good
for?
Neurofeedback addresses problems of brain disregulation. These happen to be numerous. They include the anxiety-depression spectrum, attention deficits, behavior disorders; various sleep disorders, headaches and migraines, PMS, emotional disturbances. It is also useful for organic brain conditions such as seizures, the autism spectrum, and cerebral palsy.
May this be considered a cure
for some of these conditions?
In the case of organic brain
disorders, it can only be a matter of getting the brain to function better
rather than of curing the condition. When it comes to problems of disregulation,
we would say that there is not a disease to be cured. Where disregulation is the
problem, self-regulation may very well be the remedy. But again the word cure
would not apply.
But the symptoms may go away,
so it's all the same in the end?
Indeed, with neurofeedback the
symptoms may be entirely absent. A person with diagnosed Attention Deficit
Disorder may be able to train the brain to pay attention, so that condition will
no longer be diagnosable. A person coming in with migraines may no longer have
them. (However, that person may still have a greater "vulnerability"
to migraines than the average person on the street.) A person with epilepsy may
no longer have seizures. (Although that person still retains a vulnerability to
seizures.) A child with severe rages and temper tantrums may not have them
again. Etc.
How is this done?
We apply sensors to the scalp to
listen in on brainwave activity. We process the signal by computer, and we
extract information about certain key brainwave frequencies. (All brainwave
frequencies are equal, but some or more equal than others….) We show the ebb
and flow of this activity back to the person, who attempts to change the
activity level. Some frequencies we wish to promote. Others we wish to diminish.
We present this information to the person in the form of a video game. The
person is effectively playing the video game with his or her brain. Eventually
the brainwave activity is "shaped" toward more desirable, more
regulated performance. The frequencies we target, and the specific locations on
the scalp where we listen in on the brain, are specific to the conditions we are
trying to address, and specific to the individual.
What conditions can be
helped?
In the work at the Stress and
Biofeedback Clinic, we are especially concerned with the more
"intractable" brain-based problems of childhood whose needs are not
currently being met. This includes first of all seizures and febrile
convulsions. It includes the severely disruptive behavior disorders, such as
conduct disorder and bipolar disorder. It includes the autistic spectrum and
pervasive developmental delay. It includes cerebral palsy, acquired brain injury
and birth trauma. Many children have sleep problems that can be helped:
bedwetting, nightmares and night terrors, sleep walking, and teeth grinding. We
can also be helpful with many of the problems of adolescence: drug-taking,
suicidal behavior, anxiety and depression. And we can also help to maintain good
brain function as people get older. The good news is that almost any brain,
regardless of its level of function, can be trained to function better.
How do you know how to train
a particular brain?
Over the years, certain training
protocols have been developed that are helpful with certain classes of problems
such as attention, anxiety and depression, seizures and migraines, as well as
cognitive function. There are a number of assessment tools we use to help us
decide which protocols to use. These are simple neurodiagnostic and
neuropsychological tests.
What happens if neurofeedback
clients are taking medications?
With successful neurofeedback
training, the medications targeting brain function may very well no longer be
needed, or they may be needed at lower dosages, as the brain takes over more of
the role of regulating itself. This decrease in medications is particularly
striking when the medications play a supportive role in any event, as is often
the case for the more severe disorders that we are targeting with our work. It
is important for clients to communicate with their prescribing physician
regarding neurofeedback and medications.
If neurofeedback deals with so many conditions, why
have I not heard of it before?
Neurofeedback involves
"operant conditioning" of the EEG. As such, it is a psychological
technique more than a medical one. The technique is not generally taught in
medical school, but operant conditioning is a well-known technique in the
science of psychology. On the other hand, most psychologists do not usually deal
with the kinds of problems we are targeting. Hence we need to attract a greater
variety of professionals to this field. The
Brian Othmer Foundation exists for this purpose, among others.
Is neurofeedback a
reimbursable treatment?
Most insurance companies will
reimburse something for the treatment. However, coverage for chronic mental
health concerns is rarely adequate in the United States, so parents may have to
advocate strongly with their insurance company for reimbursement.
What are the customary costs
of neurofeedback training?
The typical per-session fee
ranges from $40 to $125 depending on the part of the country and the
qualifications of the professional. In addition there are costs of assessment,
which are usually billed separately. Discounts may be available for massed
practice, or for pre-payment plans.
Neurofeedback sounds like a real breakthrough. Is it?
And should I be hopeful for my child?
Yes, and yes again. The most
significant scientific frontier in health care at this time is to understand how
our brain functions. We are beginning to learn the brain's "operating
system," and these findings are not without clinical implications. We have
already learned how to make almost any functioning brain function better. But we
can promise only progress, not perfection. The parent's first role in this is to
resist the message "there is nothing more that can be done for your
child," and to move forward to experience what neurofeedback may offer.
Is home-training a
possibility?
Many of the conditions we
address with neurofeedback involve long-term training, as the brain's capacity
to function is gradually enhanced. For some children, neurofeedback may remain a
useful challenge over their life span. To make this economically viable, remote
training is an available option for parents. Remote training refers to home
training under the (remote) supervision of a clinician. After parents have had
their child trained with a clinician for at least twenty sessions, they may
transition to remote training and continue on that basis, consulting with the
clinician regularly to monitor progress and determine changes in protocol. Then
training can be done frequently and consistently, on an affordable basis.
Who provides neurofeedback?
Neurofeedback is typically provided by mental health professionals such as physicians, nurses, psychologists, family therapists, and counselors. These professions usually work with people one-on-one. The training is also be provided by nurses, clinical social workers, rehabilitation specialists, and educators. MDs also provide the service, but with the exception of psychiatrists will usually have the service provided by a trained staff person.
Could it help you or your child? Ask Dr. Cliff about your child's problems or your problems.
What do doctors say about neurofeedback?