Neurofeedback: Physical Therapy for the Brain

What if someone told you there was a way for you to learn to control your own brainwaves? And that by learning to do so, you’d be able to alleviate a host of unpleasant symptoms ranging from anxiety, low mood, insomnia, and even managing migraine headaches? Neurofeedback, otherwise known as neuro-biofeedback, is a psychological tool we can use to attempt these changes.

Neurofeedback is a form of brain training in which an individual learns to uptrain or downtrain specific brainwaves based on real-time data they are receiving, in the form of auditory or visual feedback. The excess or lack of certain brainwaves in specific locations of the brain are correlated with increases in certain symptoms. For instance, high levels of beta in an area of the brain called F4 are associated with struggles with hypervigilance, anxiety, and rumination (Collura, 2014). Thus, the premise of neurofeedback is to train the brain to create the most optimal brainwaves and reduce negative symptomology with a noninvasive, no-medication treatment.

Individuals are given real-time data in the form of EEG’s. They are then given a feedback system, which can be auditory (e.g., music or tones), or visual (e.g., videogames, movies, or moving illustrations). When the targeted brainwaves are performing at the desired threshold, the feedback system plays. When the targeted brainwaves "fall out" of the desired threshold, the feedback system freezes or fades out. This trains the brain to understand that if the feedback is to continue, the targeted brainwave must remain at a specific threshold. Over time, the brain learns to maintain this "position" and negative symptomology begins to dissipate and reduce in intensity and frequency.

Does it Actually Work?

The origins of neurofeedback date back to the early 1950’s and 60’s. Dr. Joseph Kamiya trained individuals to achieve an alpha state with the sound of a bell, and Dr. Barry Sterman taught cats to increase their sensorimotor rhythm, which reduced their epileptic seizures (Kamiya, 1971 and Sterman, 1972). Since then, neurofeedback has been used to treat a variety of conditions ranging from anxiety, depression, OCD, autism spectrum disorder, substance use disorders, insomnia, to medical conditions such as epilepsy, seizure disorder, and migraine headaches. When such a wide variety of conditions are being regarded by one treatment modality, skepticism naturally raises.

Neurofeedback is not a magic wand. I was first introduced to neurofeedback in my undergraduate studies and began actively practicing neurofeedback several years ago. I have worked with many individuals, and some improve more than others. Neurofeedback works best as a supplement, an additive to other treatments. I encourage all my patients to be actively involved in therapy and practicing skills taught in sessions. I have seen incredible results with patients who were at a standstill with treatment, maxed out on medication, and burnt out with therapy sessions. Neurofeedback provided the additional boost that was needed to break past the standstill. For individuals actively invested in their treatment, neurofeedback can be a wonderful addition.

Physical Therapy for the Brain

Think of it as physical therapy for the brain. Presumably, one goes through weeks to months of physical therapy before major progress is seen. Additionally, at-home exercises are prescribed. Such is true with neurofeedback, the brain’s physical therapy. Clients attend training sessions two to three times per week and are further instructed to engage in behaviors, skills, and lifestyle choices outside of sessions that support their changed brainwave functioning. Those are the patients that benefit most.

Recently, there has been a surge in individuals seeking out nonmedication treatment modalities such as neurofeedback and TMS (transcranial magnetic stimulation). Most patients have either exhausted medication options or are looking for more natural routes to wellness. I have personally worked with clients who made exceptional gains in their treatment once neurofeedback was incorporated. One specific client had such high levels of social anxiety that she struggled to function in work, personal relations, and social functions. Around session 10, she became more talkative with me and had a brighter demeanor. Around session 15, she began talking about wanting to pursue a different job and perhaps moving away, something that was once unthinkable for her.

For those looking for a different kind of therapy, neurofeedback can be an excellent alternative. It’s important to do your research and find someone who is well-trained and can set realistic expectations.