What is
neurofeedback training?
- This is way for a people,
including children, to learn about what is happening inside
their own brains as their state of mind or awareness changes.
This process is also known as EEG (electroencephalographic)
biofeedback or brainwave training.
- It is done in a quiet room with
the person seated in a comfortable chair near a typical looking
PC. The trainer takes a couple of minutes to attach a few small
sensors to the head with a waxy sort of paste that helps to
both hold them in place and to assist the sensors pick up the
electronic signals which the brain is constantly producing. (It
is pretty much like putting on EKG sensors for a cardiogram.)
Sometimes a cap or Velcro straps are also used to help hold
things in place.
- The thin wires from the sensors
are then plugged into the interface box for the computer system
and the connections are checked to be sure everything is being
recorded correctly. There is nothing that comes FROM the
computer to the sensors. It is strictly a one-way trip from the
sensors TO the computer. It is painless and there is no chance
of any electrical shock because there is an optical isolation
device between the computer and the person. The only physical
sensation is a very slight awareness of the sensors in the hair
or clipped on the ears.
- The PC processes the information
picked up by the sensors and displays information (feedback) on
the screen. Then the training work starts and continues
typically for 20 to 45 minutes or so. There are various 'tasks'
the person does based on information the computer presents in
pictures, sounds, etc. The selection of which 'tasks' or
'protocols' to use is based on each particular situation.
Whenever a person gets too tired or feels uncomfortable the
session is stopped.
How many sessions
does it take and how often do you do them?
- Sessions are usually conducted
at least once a week and often twice or three times per week.
The learning goes faster if the sessions can be closer
together. Progress is subtle and it might take about 10 sessions
before changes start becoming evident, but the data recorded at
each session can be easily reviewed by both the trainer and
trainee (or parent) to determine the advance. Some conditions
can take up to 60 or more sessions to complete the training
while some can finish in less than half that number. Recent
advances in the science and art are tending to shorten the cycle to
achieve permanent results.
Do you have to go
back for 'refreshers' later?
- Since this is a learning
process, once advances have been made they do not require
refresher training to stay at that level unless some new
injury, for example, causes new problems or reactivates old
ones. (Typists don't have to keep going back to typing class in
order to keep their ability to type do they?)
What preliminary
workup precedes neurofeedback training?
- A careful history of the person
is taken, symptoms are noted, other conditions (medical,
psychological, etc.) are discussed. Records from a referring
physician or counselor are reviewed.
- Other studies such as a T.O.V.A.
or one of the many standardized tests may be done as the
situation calls for.
- A Quantitative EEG (QEEG)
reading may taken. This data is analyzed with comparisons
to "normed" databases from such places as New York
University, Harvard, etc.
- These preliminaries often
require two hours or more. As a result of this data gathering,
consults with other professionals may be indicated before
neurofeedback training would start.
Where do I look to
check further on neurofeedback?
- There are two professional
societies whose members do this kind of work. The newer group
is the International Society for Neurofeedback and Research (isnr.org) with a very large that contains
hundreds of pages of reprints from scientific journals. The
older society is the Association for Applied Psychophysiology
and Biofeedback (AAPB) aapb.org.
There are international web pages in Europe and Australia,
with new ones appearing elsewhere, too.
- Membership in ISNR and AAPB
overlaps considerably. A person who is a member of either is quite
likely to be a member of
the other, also.
- Two peer-reviewed professional
journals will routinely include articles on neurofeedback.
1) Biofeedback and Self-Regulation (Plenum Press) has been
published for a number of years in affiliation with the AAPB
and can be found in many libraries.
2) Journal
of Neurotherapy which began in 1995, is the official
scientific journal of ISNR. It is produced by The Haworth
Press, Inc.
- Scores of other scholarly
journals for medical, psychological, sociological, human and
social services providers from time to time publish articles about
neurofeedback. If one does a literary word search the best
candidate would be to search on the word 'neurofeedback' or
'biofeedback' or on a combination of something like 'EEG' +
'biofeedback'.
- On the internet all of the well
known locator services contain thousands of references on the search
word, 'neurofeedback'. There are a variety of mental health and
psychology lists that will point to resources. Using these services will surely provide enough
leads to get any person's research going.
How well proven is
Neurofeedback? Does it work?
- Over the past dozen years hundreds of new
clinical reports have appeared in a wide variety of respected
"peer-reviewed" professional journals about the usefulness of neurofeedback to
address more kinds of human conditions. Certainly the most
widely reported kinds of neurofeedback training have been done
with ADD/ADHD kids and adults and with various forms of
substance abuse and addiction. And there is a growing amount of
literature telling of using neurofeedback training to assist
conditions such as epilepsy, various forms of pain management
including migraine, various kinds of immune disorders
(including AIDS), stroke and brain injury (closed and
traumatic), learning disabilities, Tourette's, PMS, post
traumatic stress disorder, Bruxism, depression in various
monopolar forms, also bipolar depression and multiple
personalities, violent offenders, high blood pressure, multiple
sclerosis, some types of asthma, even profound comas.
- This is not to say that there
are as many "blinded" or "well-controlled" studies for all of this,
as there are for expensive pills. Far from it. After all, there is
no multi-billion dollar industry feeding huge sums to faculty and
leading researchers to do that type of high-cost research.
Nevertheless, a growing number of researchers, many of them in
Europe, are publishing research with sufficient size and adherence to tight
protocols. And those 'well-controlled
studies' have substantially confirmed the reports made by respected clinicians.
- Cautious persons generally, and
in particular, people like physicians and psychologists who
have substantial professional careers at stake, will often be
hesitant to believe the clinical reports and small 'controlled
studies'. Some will insist on 'large double blind studies' not
realizing it is unethical to do a double-blind or reversal
study where training is involved. But large randomized
clinical trials, the designated standard of the National
Institutes of Health, Center for Alternative and Complementary
Medicine, are starting to appear. At the same time
the professionals who are reporting these things (usually they
are psychologists or physicians, too) are not notably foolish
or irresponsible. If they act imprudently, their own careers
and reputations will be at risk.
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Is there any
government funding for neurofeedback research or training?
- The short answer is, "yes,
but nowhere near the scale of medical research." It is
growing, however. Public announcements about funding
studies on neurofeedback from the US Veterans Administration
and the National Aeronautics and Space Administration (NASA)
have been made. Neurofeedback research is being conducted at
US, UK, Canadian, German, Israeli, Czech, Austrian, and other
public universities, government hospitals and treatment
facilities, etc., and there a growing number of these studies
being published. A few of the US states have funded
programs utilizing neurofeedback training and research and from
time to time, reports or research papers about these are
published, too.
What are some
examples where Neurofeedback has been helpful?
- Addictions
In the treatment of
addictions, there are several 'controlled studies' in which
different investigators achieve consistent results with other
studies. Several of these published studies have reported
success rates up to 80%, an especially strong statement since
these studies are often done with some of the most recalcitrant
subjects, folks who have been dropouts from many other sorts of
intervention. Some of these studies have used as their only
subjects those persons who had failed all other
treatments. These results have been achieved in both
institutional and out-patient settings. There are some
unofficial signs that the US Veterans Administration may now
consider neurofeedback to be a standard approach to
dealing with addiction problems.
- ADD/ADHD
There have been more
studies reporting on neurofeedback training for ADD/ADHD than
for any other condition. Some of these are 'controlled' studies
which reported statistically significant changes in things like
scholastic improvement, increased IQ scores, improved family
relationships, return to 'normal' range on T.O.V.A. and other
standardized tests. In some cases, medications are completely
discontinued and in others they have been considerably reduced.
Long term follow-up reports show that this is very well
maintained without further requiring further neurofeedback
training.
- Trauma, Depression, PMS,
CFIDS
Studies with various
kinds of 'slowed brain' conditions, such as PMS, minor head
trauma, depression, and even some with CFIDS are all reporting
that some people respond to neurofeedback training and have
reduced symptoms, require less medication, or can go off
medication.
- Asthma
A study with a form of
asthma that has connections to psychological disorder reported
improvement for people who were mostly unable to receive ANY
help from conventional medical therapy.
- Epilepsy
In epilepsy neurofeedback has helped some to achieve complete
cessation of attacks and medications and in others a
substantially reduced frequency. One case reported a total
reversal of psychotic episodes and the cessation of epilepsy
incidents.
- Multiple Sclerosis
Multiple sclerosis patients whose disease had stabilized and
were getting no further benefit from common medical therapy
experienced improvements.
Why does
neurofeedback training work?
- Although the EEG is a very
limited indicator of the vast complexity going on underneath
the skull, it is better than anything else that is available at
low cost. All the other techniques for studying the brain require
very expensive equipment and typically are only done at expensive
facilities. But with portable and low cost EEG the raw brainwave data
is very
rapidly and easily processed with today's powerful microcomputers
enabling the
'results' to be presented nearly instantaneously to the person in various computer
screen and/or sound form (feedback). This enables the person to
perceive things about his/her own brain that cannot be known
otherwise. The brain (person) thus has information available
about its own internal functioning that could not be provided
in any other way. Any person's brain can use that added information to make
adjustments and improvements to itself. This is essentially the same process by
which we learn to sing, drive cars, hit golf balls, etc.
Will insurance pay
for it?
- Some medical insurers will cover
it, but others are either reluctant to pay or refuse claims. A
prescription from your physician for the training along with a
diagnosis may help establish your claim. Many people are
becoming members of vast health provider plans, so one has to
take what is offered under those arrangements. There are
diagnostic and treatment codes in the standard code books that
are appropriate, so there certainly is a basis for having
neurofeedback training covered. But no insurer is bound to any
particular books, they all make their own judgments.
What do I say if a
doctor, or family, or friends are opposed?
- One can begin by agreeing with
them that a healthy skepticism about lesser known ideas is
normal. Possibly you have had such feelings, too.
- If there is an opportunity for a
factual discussion, offer some facts. Maybe a print out of this
document would be a starter, or you can get reprints of some
articles off the internet. Reprint any of the many studies and
hundreds of pages available via the web.
- Probably the person you are
considering for the neurofeedback training will be glad to
supply good technical information to other professionals or to
you and your close circle. In the end, you will need to make
your own choices and others simply may not see it the same way
you do.
Is neurofeedback
only for 'problems'?
- Quite the contrary! Another
major focus of neurofeedback research is to develop enhanced
performance. In fact, over 20 years ago there was a sort of fad
about Alpha training. Serious and professional work along those
lines has continued and there is now much better science
underlying this work. To some people, perhaps solving problems
may seem to be more than making personal performance advances.
In actuality, there is not that much difference. Much of the
work with 'problems' is really trying to find ways to teach
people to self-regulate their functions and thus better realize
their innate potential and improve their performance.
- Very few researchers are
specializing their study of neurofeedback to help people make
better decisions, fulfill dreams, achieve higher levels of
physical performance, and the like. But most all neurofeedback
providers have a lot of interest in this and regard it to be a
very significant work. NASA has publicly stated their support
for neurofeedback research. It is just a conjecture, but
perhaps NASA's interest in this may center on enhanced
performance.
- Some professional or college
sports programs are using this, but for competitive reasons
they are keeping it pretty quiet.
Is neurofeedback
training compatible with holistic health concepts and practices?
- Absolutely!! Yes!! There
is a growing interest in neurofeedback training from the folks
who have been working with nutrition, holistic health, and
mind-body studies.
- There is a growing list of physicians
in varying specialties such as psychiatrists, internists, cardiologists,
etc. who are either expanding their personal practices or are
teaming with others into a multi-modal concept that looks
beyond the cures of conventional medicine.
- Anyone who looks beyond the
'disease/medicine paradigm' toward wellness and healthy living,
will be at least curious about neurofeedback training because
it is non-invasive, it utilizes the innate capacity of persons,
it enables people to exercise greater control over their own
lives, and it is focused on healthier and enhanced living
rather than disease.
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