Train your brain with neurofeedback

When my daughter had a seizure one Saturday morning two years ago, I was terrified and distraught as I held her in my arms. In the months that followed, MRI scans ruled out a brain tumour or other causes and the word “epilepsy” started appearing on high rotation. My husband and I were devastated. The thought of putting our nine-year-old girl on powerful medications that could cause everything from weight gain to concentration issues was upsetting in the extreme.

Then my sister called, asking if I had heard of neurofeedback. I drew a blank. Like biofeedback, long used to read a person’s muscle tension or body temperature to help them learn to improve conditions such as irritable bowel or chronic pain, neurofeedback is a kind of biofeedback technique targeted specifically at the brain. As I Googled the term, I was astounded by what I found: a huge body of research pointing loudly to neurofeedback’s potential to bring wide-ranging health benefits to people with health states and conditions that profoundly affect quality of life.

In the end, we were not able to use the technique because we live too distant from the city and there was not a practitioner nearby. Also, my daughter did not end up needing medication. She was diagnosed with the kind of epilepsy in which seizures happen infrequently then come in clusters of two or three and may not recur for nine months or a year.

However, neurofeedback has since provided a backup plan for us emotionally should my daughter’s seizures ever become more problematic. Its applications to re-establish equilibrium to the brain and heal a vast array of conditions are gaining increasing interest and evidence every year.

Roots of plasticity

Neurofeedback has its roots in behavioural psychology and has revealed the brain to be more plastic and within our control than we ever believed. It allows people to influence their own brainwaves and achieve greater cognitive equilibrium through training techniques that involve repetition and practice.

“The idea is that, if you can sense it, you can change it,” says Dr Moshe Perl, one of Australia’s leading neurofeedback practitioners. “Neurofeedback is a specific form of biofeedback which gives the trainee moment-to-moment information about the rhythmic electrical activity from various places in the brain. The person is soon able to induce changes to their brain-wave patterns. These changes lead to improved flexibility and stability of the brainwaves in general, which in turn leads to improved flexibility and stability of behavior in response to external demands on the person in the course of day-to-day activity.”

Could this lead us to actually shape our brains the way we shape our bodies with daily exercise? It’s not beyond the realms of possibility. Neurofeedback takes the view that life’s challenges, such as emotional trauma and illness, can upset the rhythm of the brain and these repeated assaults over time can lead to permanent neural misfiring. A growing body of studies has shown that neurofeedback can help people affected by conditions such as autism and attention deficit hyperactivity disorder (ADHD). The research has shown neurofeedback is as effective as stimulant medication such as Ritalin. It can also help with issues such as tics and bed-wetting.

Less researched but anecdotally reported is the ability of the technique to help treat the current global plague of emotional health issues such as anxiety and depression. In the future, instead of a prescription for medication, neurofeedback may be used to guide people to retrain their brainwaves to function in a healthier band and arrive at a calmer, more stable or uplifted state of mind. While psychiatry looks at emotional states as a process of chemical reactions in the brain involving mood-altering neurotransmitters such as serotonin and dopamine, neurofeedback looks at what comes before and beyond those chemical processes, focusing on the electrical circuits, frequencies and differing electrical waves or rhythms of the brain linked to emotional states.

Early research

The research in this area began in the 1960s and 1970s, arising from studies in biofeedback, which showed that, if taught the right techniques, people could consciously control functions such as their heart rates. Scientists also soon learned you could teach people to change their brainwaves by simply giving them a reward in the form of a beeping light or a pleasant-sounding tone.

The protective capacity of neurofeedback first became apparent by accident. In the 1970s, Barry Sternman, a psychologist from the University of California, was doing some research on sleep in cats. Using operant conditioning, such as rewards, Sternman taught a select group of the cats to create an alpha frequency in their brains so he could study how it impacted on their sleep. Sadly, those cats were then used in a different experiment where the Department of Defence was studying the effects of rocket fuel and injected the cats with the substance. They reacted by panting, then suffering a seizure — all except the cats that had undergone the operant conditioning, which did not experience any of these side-effects at all. The neurofeedback they had undergone had somehow strengthened their brain function to have a higher threshold to manage disruption, making the cats resistant to detrimental responses, despite the physical crisis of having rocket fuel in their bloodstream.

Beyond these early experiments, neurofeedback was first used to treat cases of “recalcitrant epilepsy”, where all other treatments, such as powerful medication, had failed. In repeated cases, the brain-training technique has been able to reduce the number and intensity of seizures so that people suffering epilepsy can live a normal life with fewer or no seizures.

Neurofeedback in practice

Before a neurofeedback session, electrodes are secured at specific points all over a person’s scalp to pick up their brainwaves using EEG signals (electroencephalography). These signals are then relayed to a computer screen, where they are visually represented. An initial quantitive data, or QEEG, reading is taken to map this brainwave activity. This is analysed and, at the next session, training begins.

One or two electrode sensors are placed on the person’s head and two sensors that look like clip-on earrings are placed on their ears. “The sensors are connected to an amplifier, which amplifies the tiny (microvolt) signals from the scalp,” Dr Perl explains. “The amplified signal is then sent to a computer that analyses it. This information makes it clear which brainwaves need to be increased or decreased and where.”

The neurofeedback software uses these signals to drive a video game, which may involve Pacmen gobbling dots or space ships launching and winning a space race. The game only moves forward (through visual display changes, beeps and points being scored) if the person increases their brainwaves to the healthier brainwave zone by engaging in more focused or less over-active states of thinking and being.

The brainwaves are divided into four categories:

1. Delta (1–3 Hertz): Occurs when we sleep and involves slow, high-amplitude brainwaves.
2. Theta (4–7 Hertz): The state between deep relaxation and sleep.
3. Alpha (8–12 Hertz): The brain pattern during deep relaxation, but with awareness. Alpha waves are usually involved when we close our eyes and visualise a pleasant scene or let our minds wander.
4. Beta (13–30 Hertz): The state where we are fully conscious and aware. This state involves small, faster brainwaves, which allow us to be more alert and engage in intellectual activities such as solving a maths problem.

According to Dr Perl, “Slow brainwaves can carry information about being calm and sleepy (unfocused — delta and theta waves), fast waves carry information about focus and attention (beta waves), and very fast waves carry information about excitement, anxiety and agitation (high beta waves).”

During neurofeedback, the more the person is rewarded by attaining the desired brain frequencies and experiences that repeat satisfaction and sensation, the more likely it is that their brains will revert to that frequency, even beyond training sessions. The brainwave pattern that leads to optimal health varies from person to person, depending on their individual brainwave patterns and related health problems.

The effects

After individual neurofeedback sessions, some people report a crystal-clear focus and state of wellbeing often known as the Clean Windshield Effect. People who undergo neurofeedback for chronic health conditions also usually report an almost immediate and unexpected improvement in mood, sleep quality, energy levels, clarity of thinking and concentration. So, in treating a person for one issue such as panic attacks or migraines, neurofeedback may also result in relief from four or five other health issues as well.

However, the technique is not always used to treat significant health problems; some people simply employ neurofeedback to balance their brainwaves so they can counter problems such as insomnia or lethargy. Although few side-effects from neurofeedback have ever been reported, getting the balance of brainwave frequencies just right may involve a little fine-tuning. Tweaking a little too far towards arousal or a little too far towards relaxation may cause a short-lived intensity of that condition, which will wear off but needs to be addressed by changes to frequencies in the next training session.

Sue and Siegfried Othmer in the US have been pioneers in the use and study of neurofeedback since the 1980s when they used the technique to transform the life of their son, who suffered seizure and related behaviour disorder. They believe that neurofeedback’s ability to treat so many conditions is powerful evidence that physical and emotional health problems can be distilled into one core concern: disregulation of the brain, which has three different manifestations.

Brain as motherboard

According to this view, the brain is the motherboard of the body and neurofeedback works like a tune-up that gets the brain functioning at the right speed in the right lane or brainwave band and with the right neural pathways firing. Following on from this, emotional conditions such as anxiety, agitation and insomnia are all symptoms of an overarching arousal of the brain, while conditions such as concentration difficulties, lack of motivation and some types of depression are indications of under-arousal.

The third malfunction is one of general instability, which can lead to unpredictable brain and body responses, a little like a bicycle with a slightly flat tyre that sometimes throws the rider off-balance. This instability leads to malfunction of the central nervous system. Where the disregulation is mild, it can cause problems such as ADHD and edginess. Where it is more extreme, the brain disregulation can lead to conditions such as epilepsy, chronic pain, migraines, panic attacks, teeth grinding, learning disorders mental health illnesses, including bipolar disease.

According to the Othmers’ theory, these three brain conditions — under- and over-arousal and disregulation — are largely responsible for people using drugs such as sleeping pills and antidepressants, alcohol and caffeine, depending on where their specific brainwave problem lies. Neurofeedback encourages the individual to self-regulate their brain to help it to reset, restoring brain balance.

Through repeated training, the person learns how to remain in that optimal brain zone and their health problems are reduced or in some cases resolve completely.

Applications

The potential applications for neurofeedback training are exciting and astounding. Alpha-theta training has been used to treat people with alcohol and drug addictions. Research shows that neurofeedback has improved memory in people with brain injury. In the area of criminal behaviour, a growing body of evidence suggests damage to the brain from abuse or injury as children may be at the heart of actions where people dissociate and hurt others or lose fear of consequences. Neurofeedback may prove the most effective method for helping to prevent further crime and is already being used in small trials in this area.

The US military now uses neurofeedback as a treatment for soldiers suffering mild brain trauma from injuries such as concussion or from conditions such as post-traumatic stress disorder (PTSD). In the future, it may be used to predict which soldiers are most at risk of suffering PTSD.

Meanwhile, neurofeedback is also being used in other areas, including music, to improve the performance of orchestral players and opera singers, and on the sports field, to give elite athletes a neurological edge.

The stabilising that occurs through neurofeedback is usually ongoing, although occasionally top-up sessions may be needed to prevent any further minor brainwave pattern imbalances. For a growing number of people, neurofeedback has proved the turning point that moved them from a place of chronic mental or physical ill health to one of homeostasis.

Beyond neurofeedback’s powerful application to improve certain physical states and anxiety and low mood, some proponents believe it has a profound spiritual impact, providing a very different pathway of enlightenment to reach inner peace. Once the training stabilises the brain, it functions in a healthier pattern and chronic emotions such as sadness and hurt are overcome, making a person more centred, full of joi de vivre and able to affirm the positive.

Accessing neurofeedback

Treatment sessions: These usually take place in a practitioner’s rooms and run for 50 minutes to an hour each time and a minimum of 30 sessions may be needed. Optimal results are usually achieved via three sessions a week, often dropping back to two sessions a week over several months. Some people start to experience immediate improvement while others may notice significant changes from around the 10th session.

Cost: The one drawback to neuorfeedback is that a course of treatment can be expensive, costing around $3000 or more. However, practitioners point out this is no more expensive than undergoing orthodontic treatment to have dental issues corrected. If the problem is a condition like anxiety or depression and your practitioner is registered with Medicare, you may be able to register under a healthcare plan and claim 12–18 sessions of Medicare rebates to reduce the cost of each session.

Equipment at home: People who live in remote areas or want to use neurofeedback on a number of family members at once can buy the machines (for a cost of around $6000) and sell them back at the end for around half that cost from Moshe Perl (03 9533 0555). However, you would still need to undertake training to use the equipment and seek guidance and occasional follow-up visits with a practitioner.

Practitioners: In Australia, most of the experts practising neurofeedback are health professionals such as psychologists, social workers, educational counsellors or GPs who have sought specific training into this area. Information about practitioners and equipment can be accessed via these websites:

The Australian Psychological Society, groups.psychology.org.au/nfpig
The Applied Neuroscience Society of Australia, appliedneuroscience.org.au/neurotherapy
The International Society for Neurofeedback & Research, isnr.org
EEG Info, directory.eeginfo.com/search_process.asp?searchtype=international&country=Australia
EEG equipment, eegspectrum.com

Stephanie Osfield is an award-winning freelance health journalist, published in Australia and overseas. She is an advocate of nutritional medicine and specialises in all aspects of health. You can follow her blog Savvy by Stephanie Osfield at savvysteph.com