PSYCHOLOGY
Neurofeedback

Introduction to Neurofeedback 

 

We certainly live in interesting times, and to think that only a few years ago people with severe epilepsy submitted to having their brain cut in two to stop seizures. The path of medical science has been long and arduous, many famous pioneers did not win fame and fortune or even acceptance in their life-times. Instead they had to wait until the medical establishment caught up with their life-saving discoveries.     

 

In the field of psychology severe depression and psychosis was once treated by destroying part of the brain. In 1890, a German research scientist, Friederich Golz, found that removing specific parts of a dog’s brain made them calmer and less aggressive. This was taken further by Antonio Moniz who 'cured' people by drilling two small holes on either side of the forehead and severing the prefrontal cortex from the rest of the brain. He received the Nobel Prize for his pioneering work – lobotomy. Dr Walter Freeman preferred the ice pick and mallet, he toured the US in his 'lobotomobile' completing over 3,000 operations in his lifetime. It wasn’t until the 1950’s that public opinion turned against this barbaric practice.     

 

Things started to brighten in the field of mental health in the 20th century. In 1924 Hans Berger invented the electroencephalogram (EEG) and discovered the famous alpha rhythm of 10 Hz (beats per second). This started an avalanche of research into the brain using EEG. Then, in 1965, Dr Barry Sterman made history by training cats to produce a specific brainwave rhythm, the Sensory Motor Rhythm or SMR. Dr Sterman proved that the brain, like other body systems, could be trained. This was a landmark discovery, the brain could be trained to whatever frequency the researcher wished.    

 

At this time NASA astronauts were experiencing seizures during flight training, Dr Sterman was asked to investigate. He found that the aviation fuel was responsible by exposing his cats to the fumes. The cats reacted to the gas, they experienced seizures and many died, however a small group resisted the symptoms and fell asleep. He went to his records to find that these were the cats he had trained using his EEG biofeedback instrument. Dr Sterman then went on to research epilepsy and found that by training at certain frequencies his patients had fewer seizures and less reliance on drugs, many were cured. Today Neurofeedback (also called EEG biofeedback) is a successful drug-free adjunct treatment of epilepsy.    

 

Since Dr Sterman’s discovery, neurofeedback therapists, mostly psychologists, have found that brainwaves can be trained with this new technology. The training of specific brain sites at specific frequencies has been used to successfully address such symptoms as depression, anxiety and even bed wetting. Many people suffering the effects of strokes, head injuries and memory loss have been assisted with neurofeedback. Today it is used throughout the world for neurological disorders. Japanese companies send their executive staff to centres in the USA to train, the successful Italian World Cup soccer team trained with neurofeedback: 'brain training' has entered the corporate and sports field.    

 

An area that has been quite extensively researched is the treatment of children with Attention Deficit Disorder (ADD). ADD is characterised with symptoms of distractibility, inattention, inability to focus and stay focused, low self-esteem, an inability to organise themselves and, frequently, poor socialisation skills. Children and adults with ADD often have subsequent learning problems and fall behind in their studies. Treatment frequently involves training the left side of the brain increasing self-esteem, social relationships, muscle tone (which also helps with bed wetting and incontinence) and has been shown to improve IQ by up to 20 points in some students.

 

The behavioural problems of ADHD (Attention Deficit Hyperactive Disorder) respond well to neurofeedback, however they are not easy to treat and involve multiple emotional and neural arousal sites and can take many sessions.    

 

The two most distressing symptoms that present for neurofeedback are anxiety and depression. Anxiety is an 'over-aroused' state causing extreme nervous distress; while an 'under-aroused' state characterises depression and low self-esteem. By training the brain at specific sites to compensate for these levels of arousal, the brain will begin to self-regulate. Neurofeedback training aims to produce a more efficient and balanced brain, easing, and sometimes removing, the symptoms of depression and anxiety. Neurofeedback is non-invasive and completely drug-free.     

 

At our clinic the most common disorder presenting for neurofeedback is anxiety and panic attacks. Fortunately we have found that most people respond very quickly to neurofeedback training, often achieving levels of calm after one session. It must be remembered, however, that training effects will only last around one or two days at the start of training. After around 10 sessions most people will begin to have relief for longer, 2 days then 3 days etc. as the brain begins to reproduce the changes from each training session. It is the frequency and number of training sessions that makes the difference. The more sessions the longer the effects last and you will eventually only need training weekly, then fortnightly etc. The brain is learning how to produce the new frequencies and this takes time and training, much like learning to ride a bike. 

 

Ensure you improve your diet and exercise regularly. Clients who do both neurofeedback and improve their nutrition generally make faster progress. And don’t forget your relaxation, earning to relax helps your nervous system repair and regenerate, use your relaxation Mp3.

 

There are many causes for the human brain to become over or under aroused, the most common are genetics and birth trauma, followed by stress, head injuries and toxins such as lead, mercury, industrial chemicals, thyroid disorders etc. When brainwave patterns are dysregulated (over or under aroused) you don't feel as emotionally balanced as you should. Nerves may start to misfire, either too fast or too slow, causing anxiety, depression and other symptoms.

 

We always recommend a minimum of 40 sessions, preferably with two (or more) sessions per week. Training involves attaching sensors to the scalp using conductive paste. These sensors ‘read’ the brain waves which are interpreteed by the computer. The therapist determines which frequency bands require training. 

 

Meditation is a field where neurofeedback is making its mark. During meditation the brain emits strong amplitude alpha and theta frequencies, the deeper the trance the more theta is produced. It is while in the theta state (4 to 8 Hz) that people experience lucid dreams, gain creative insights and experience states of deep healing. Training the theta state is done using a theta synchrony protocol developed initially to treat substance abuse and Vietnam veteran's with Post Traumatic Stress Disorder (PTSD). So successful was this approach that people without a disorder sought treatment so that they too could have the blissful experience it produced. Through neurofeebdack it is possible to see the exact moment a person enters the lucid or theta state. 

 

This meditation protocol can be used with 'depth' psychotherapy, allowing patients to release repressed trauma at an unconscious level, eliminating the burden of reliving frightening life events. This is a valuable tool to enhance and fulfil people's lives who have lived for years with depression, anxiety and trauma.

 

Alpha coherence and alpha synchrony are proving to be useful for training peak performance. This brainwave phenomenon appears when elite athletes, artists, musicians and even academics enter the 'flow state'. We now train synchronous alpha and theta which can have wonderful results for those wishing to learn to meditate and achieve optimal performance. Training alpha to harmonise on both sides of the brain is a new and fascinating practice in neurofeedback which is receiving some valuable research attention. As important as this is not everyone can tolerate alpha training, usually because they have a dominance of alpha somewhere in their brain, more alpha can sometimes make symptoms worse. It is important to see trained and experienced neurotherapists for this reason. 

 

Executives and national sports teams use brain training to help cope with the stresses of working and playing in a competitive environment. Handling multi levels of management, projects and staff issues requires mental faculties operating at optimal efficiency. Managers reach burnout in some corporate sectors faster than others, as their organisational and mental skills deteriorate they feel that they are being pushed to the edge. Developing a counselling / neurofeedback program tailored to their needs is one way to stave off burnout and move forward.    

 

Today neurofeedback therapists must hold professional qualifications in a psychological or medical field. There are many ‘brain–training’ instruments on the market but only the therapist-level instruments can train specific sites and frequencies effectively. These instruments are only available through qualified therapists. This maintains the high standard of practice in this fascinating field. 

 

 

Acceptance by the scientific community

 

'With neurofeedback the child is exercising the nerve pathways that control attention and mental processing. As these neural pathways are exercised, children develop a sense of what concentration feels like, and they get excited about it. After practicing these exercises over a period of time, the pathways involved in attention and learning seem to work more efficiently. This enhanced brain activity becomes a natural part of the child's functioning.' -- William Sears, M.D., Associate Clinical Professor of Pediatrics at the University of California, Irvine, School of Medicine and practicing pediatrician for more than three decades.

 

Many years of experience in clinics all over the world and numerous scientific studies have shown that the process of EEG biofeedback is an effective means to improve, even normalize, attention in individuals with ADHD, to elevate mood in those with depression, to facilitate recovery in those with addictions, to relieve anxiety, improve cognitive function, and to decrease seizures. Although neurofeedback is considered to still be experimental, the following quotes demonstrate it has its place in psychological treatment.

 

"Neurofeedback should be viewed as one of the three essential or primary forms of intervention - psychotherapy, psychopharmacology, and neurofeedback. In my experience, neurofeedback is every bit as important and powerful as the other two forms of treatment." – Dr Laurence Hirshberg of Brown University Medical School, a psychologist specializing in Developmental Disorders and Autism. Frank Duffy, MD, Neurologist, Head of the Neuroimaging Department and of Neuroimaging Research at Boston Children’s Hospital, and Harvard Medical School Professor, conducted an independent review of the literature on neurofeedback for Clinical Electroencephalography (2000). He summarized his findings as follows: “The literature, which lacks any negative study of substance, suggests that EEG biofeedback therapy should play a major therapeutic role in many difficult areas. In my opinion, if any medication had demonstrated such a wide spectrum of efficacy, it would be universally accepted and widely used.” 

 

In a recent paper ‘Update On Attention-Deficit/Hyperactivity Disorder’ published in Current Opinion in Paediatrics, Katie Campbell Daley reviewed the research and practice standards on treatment of ADHD. Dr. Campbell serves on the staff of the Department of Medicine, Children's Hospital Boston and in the Department of Paediatrics of the Harvard Medical School. She concluded: "Overall, these findings support the use of multi-modal treatment, including medication, parent/school counselling, and EEG biofeedback, in the long term management of ADHD, with EEG biofeedback in particular providing a sustained effect even without stimulant treatment...parents interested in non-psychopharmacologic treatment can pursue the use of complementary and alternative therapy. The therapy most promising by recent clinical trials appears to be EEG biofeedback." 

 

A recent special issue of Child and Adolescent Psychiatric Clinics of North America (January 2005, 14:1) was devoted to emerging interventions that affect brain function. Neurofeedback was featured in seven of the ten chapters in the volume. The volume editors provided an overview and clinical perspective on all the approaches presented. About neurofeedback they concluded: “EEG biofeedback meets the American Academy of Child and Adolescent Psychiatry criteria for clinical guideline (CG) for treatment of ADHD, seizure disorders, anxiety (OCD, GAD, PTSD, phobias), depression, reading disabilities, and addictive disorders. This suggests that EEG biofeedback should always be considered as an intervention for these disorders by the clinician." 

 

What can I expect from my neurofeedback session?

 

Sessions last about 30 minutes, during this time you will have 1 or 2 ear clips plus 1, 2 or more leads which are placed on your scalp with conductive paste. We apply the conductive paste to the skin to conduct the brainwaves to the EEG system and to facilitate sticking the lead to the scalp.The leads pick up the tiny brainwaves which pass from the mid-brain, through the cortex (grey and white matter), through the skull and finally through the scalp. The EEG amplifier reads the brainwaves (electrical impulses), this is amplified and passed to the computer via a USB lead. During the session just sit back and enjoy the game, movie or music. Your brain works out how to train itself at a subconscious level. If you try to force it there are generally no extra benefits except you may become more fatigued.

 

Eye, face and neck movement can impact on the feedback as the electrical impulses from the muscles are in the same frequency bands as brainwaves: so please don't chew gum or eat or drink when training. During training you will generally feel nothing, a little eye fatigue producing a low grade headache afterwards is common in the first few sessions. It is a good idea to have a rest after your sessions. Results usually occur between 2 and 24 hours after the session. When beginning the effects may only last one day (24 hours), but with repeated training your brain remembers and can 'hold' the new patterns longer and longer. This is why we recommend regular and frequent sessions, to get the brain up to speed quickly to alleviate symptoms. Frequent training helps to maintain improvement until you only need training once a week, then once a fortnight etc. until you no longer require neurofeedback.

 

Every person is different and it may take several sessions (or more in some cases) to work out the best placements for the leads and the frequencies to be trained. In some cases, while determining the correct sites and frequencies, you may experience agitation or flatness, if this occurs it should disappear within 12 hours: and please make sure you mention it to your therapist as soon as possible as this helps them determine the best training protocol for you.

 

How do I know it is working?

 

Most people feel changes after one or two sessions, others after 10 or 20, it generally depends on the severity of your symptoms. It is important that you work closely with your therapist, talk, email or ring if you have any questions or concerns. Therapists rely on your feedback to guide training protocols.