What Is Neurofeedback Therapy?

Neurofeedback therapy, a form of applied psychophysiology and biofeedback, may utilize basic and clinical neuroscience techniques like brain mapping and training to monitor a patient’s brainwaves, help a patient control their brainwave patterns, and create new neural pathways in the brain. Through this treatment, it’s possible that patients learn to change the way their brain responds to certain stimuli. This type of treatment can be an example of psychophysiology, the study of the relationship between humans' physical and mental processes. While neurofeedback therapy and neurofeedback treatment may not be effective for everyone, several groups benefit from its applications.

Neurofeedback therapy

Those who work in the EEG neurofeedback therapy field may include psychologists, physicians, neurologists, biochemists, and other scientists. Some examples of mental health conditions and symptoms that have been treated using EEG neurofeedback are listed below:

• Attention-deficit hyperactivity disorder (ADHD)
• Anxiety
• Mental or physical dependency and drug addiction
• Phobias
• Depression
• Chronic pain
• Memory challenges, brain function, and brain fog
• Obsessive-compulsive disorder (OCD)
• Seizure disorders
• Fibromyalgia
• Irritable bowel syndrome (IBS)
• Heart disease
• Sleep disorders
• Post-traumatic stress disorder (PTSD)
• Traumatic Brain Injury (TBI) 

Additionally, clinical neurophysiology studies are continuously evaluating how neurofeedback therapy and EEG signal therapy can help manage other disorders, such as Applied Psychophysiol Biofeedback’s 2010 study on its uses in improving spelling for those living with dyslexia. In addition to treatments, neurofeedback has also shown to be successful in being able to diagnose ADHD.

Neurofeedback therapy and brain activity

Doctors and therapists interpret five sensorimotor rhythms using EEG biofeedback, including neurofeedback protocols such as alpha waves, beta waves, delta waves, theta waves, and gamma waves. Theta and delta waves are low-frequency brain waves that occur when you are sleeping or tired. They are slower brain waves. On the other hand, alpha, beta, and gamma brain waves are at a higher frequency, occurring when you are awake. 

Alpha waves indicate slower brain wave activity. This type of brain wave is seen in a quantitative EEG when you are relaxed and not concentrating on anything. Beta brain waves are slightly higher in frequency, signaling attentiveness. Beta waves are most commonly observed in waking hours. Finally, gamma waves operate at the highest frequency and are linked to periods of intense concentration or problem-solving faculties.

Measuring brain waves with neurofeedback therapy

By placing sensors on the scalp, a trained therapist may monitor and measure your brain activity and brain patterns and use brain analysis software to find and identify specific activities potentially at the root of discomforting symptoms like anxiety, depression, insomnia, chronic pain, or dependency. If an area of concern is found, the therapist may develop a specific training plan to restore your brain activity to a more comfortable and efficient functioning state through EEG neurofeedback training.

During a session, the therapist compares what your brainwaves are doing to what you want them to accomplish. As the brainwaves enter a preferred state, you may be rewarded with a positive image on a computer screen, such as a movie or a video game. The images and sounds on the screen may tell you that your brainwaves are doing the right thing because the video game or movie will only turn on when you are in the desired brain wave state. 

These sessions may teach your brainwaves how to act in response to certain stimuli. Like engaging in physical exercise to build specific muscles, the more you exercise your brain, the more opportunity it has to reach its highest effectiveness. 

For instance, if you have trouble falling asleep and cannot concentrate or focus during the day, this treatment may examine your brainwaves and determine if you have had more intense brain waves. Once the software reads the brainwaves, neurofeedback therapy can produce a brain map that the therapist can interpret. They can then devise a plan for you to improve your sleep. 

During your session, you may be hooked up to the brainwave monitor and the computer so that when your brain starts to push the brainwaves in the proper position, your movie or game will start. When your brain waves change, the movie or game will go dark. After some time, your brain should start catching on and improving, so the therapist may increase the difficulty level to further reinforce the brain's new activity. 

For example, in the case of lifting weights, once you can lift a certain amount, you may add more weight to continue building your muscles. Neurofeedback therapy can be similar. The number of sessions it takes for patients to learn and change may depend on each person and their stated goals. However, a therapist can track your progress through a behavioral rating scale.

Types of neurofeedback therapy

Neurofeedback therapy is a form of EEG biofeedback that assists in the self-control of your brain function on your own by using mental stimulation and strategies. The idea of EEG biofeedback sessions is to increase the brain's efficiency and teach it how to keep brain waves moving at the optimal frequency and direction. There are several types of neurofeedback therapies and EEG biofeedback techniques for specific symptoms or mental health diagnoses. With the help of software, a therapist can build a treatment specialized to your needs. Your typical session will be tailored to your goals. 

Frequency of power 

Frequency of power neurofeedback therapy is a commonly used treatment, also known as surface neurofeedback. It uses two to four electrodes to change the speed of certain brain waves in particular parts of the brain. If you want slower brain wave activity, you might benefit from this type of training. This therapy might treat disorders such as ADHD, insomnia, anxiety, depression, and obsessive-compulsive disorder (OCD). 

Functional magnetic resonance imaging (fMRI) helps control brain activity based on feedback from deeper subcortical areas. This is typically used for phobias, Parkinson's disease, brain injury, anxiety, depression, and ADHD.

Low-resolution electromagnetic tomography (LORE-TA) uses more electrodes than the other types, which allows the therapist to train more than one area of brain activity simultaneously. Most methods use two sensors and focus on one area, but by using this more intense method, therapists may treat OCD, depression, and dependency. 

Slow cortical potential neurofeedback (SCP-NF)

Slow Cortical Potential Neurofeedback (SCP-NF) is often used in treating ADHD, reducing epileptic seizures, and reducing migraines. This type of neurofeedback therapy works by improving the direction of slow cortical potentials.

Hemoencephalographic (HEG) 

Hemoencephalographic (HEG) is often used for treating chronic migraine symptoms. It uses the feedback of cerebral blood flow to determine the best course of treatment.

Low-energy

Low-energy neurofeedback systems give an electromagnetic signal to the patient’s brain waves to change their brain waves while they relax with their eyes closed. A low-energy neurofeedback system may be used for depression, anxiety, chronic pain, restless legs syndrome, traumatic brain injuries, sleep disorders, and ADHD treatment.

Brand-name neurofeedback therapy includes brain training systems that encourage and train the brain to reset itself or self-correct. Many of these self regulation systems are available on the open market and may not be as effective as those used by therapists. Do not partake in treatment without the guidance and supervision of a licensed therapist or medical provider. 

Treatment procedures or neurofeedback therapy protocols may target particular brain activity for specific symptoms during neurofeedback. Common types of neurofeedback therapy protocol include:

Your brain's alpha waves are linked to relaxation and feelings of calmness but may also be essential to focus and alertness. This procedure aims to relax your muscles and let you sleep when needed by improving your mental health while awake. It may be an advantageous treatment for brain injuries, memory challenges, mental performance concerns, anxiety disorders, or chronic pain.

Your beta waves are used in mental performance, such as schoolwork or job duties. This procedure is commonly used to treat mental health conditions like anxiety, anger issues, epilepsy, drug addiction, insomnia, learning disabilities, and trouble focusing or paying attention.

The alpha-theta waves control anxiety and stress. Often, this neurofeedback training effectively treats anxiety disorders like social anxiety disorder, stress from traumatic memories, and generalized anxiety disorder (GAD). It may also be used for depression or dependency. 

A delta wave can be associated with your deep sleep cycles and represents the slowest frequency of brain activity. Delta waves are the slowest brain waves. Delta wave neurofeedback training may be a treatment option for migraines, headaches, learning disabilities, brain injuries, insomnia, or generalized pain disorders/muscle tension.

Your gamma waves are linked to your cognitive memory and learning abilities. Strengthening and speeding up these waves with training may help with memory issues, problem-solving, migraines, information processing, organization, calculation, mental clarity, and overall cognitive functioning.

Theta brain waves are used for hypnosis, sleep, meditation, creativity, emotions, and memory. Theta wave neurofeedback training may be a treatment option for people experiencing ADHD, mood disorders, difficulty focusing, and mental health issues like depression and anxiety.

Neurofeedback therapy effects

Those with severe mental health conditions like schizophrenia, uncontrolled bipolar disorder, or psychosis may have adverse effects from this treatment. People with epilepsy or other seizure disorders should only receive neurofeedback training from a qualified neurofeedback therapy specialist or doctor. Patients should look for practitioners who are certified by reputable organizations like the Biofeedback Certification International Alliance (BCIA) to perform neurofeedback therapy. When signing up for this procedure, be honest about your symptoms and medical history. That being said, EEG operant conditioning under the right circumstances has been shown to decrease seizure rates associated with seizure disorder.

If a therapist or doctor is trained in neurofeedback therapy, it can be a safe procedure for children, adolescents, or adults diagnosed with various conditions including brain injuries and many mental health conditions. For example, a 2014 Frontiers Human Neuroscience study has shown early positive results on neurofeedback therapy for children with ADHD. Many types of this treatment may increase self-control in children and adults and improve cortical functioning.

Mental health side effects of neurofeedback therapy

As with any treatment, there can be side effects. Some studies have shown that neurofeedback therapy may be connected to mental health concerns like depression, mood swings, panic attacks, seizures, chronic fatigue, nausea, mania, or increased agitation or anxiety. 

However, in many of the incidents in these studies, the side effects were caused by the lack of experience or skill in using neurofeedback treatment and therapy. Before proceeding with any treatment, research and discuss options with reputable providers. Do not try this treatment on your own. 

Other treatments

Neurofeedback therapy is often used in conjunction with forms of psychotherapy. Research indicates that people who combine neurofeedback and psychotherapy can better participate in therapy and implement a therapist's suggestions, often under the influence of fewer medications. 

Neurofeedback therapy and psychotherapy are often used in the same clinical setting, which can take place in person or online. Many people may find online therapy preferable to an in-person environment, as the comfort of one's home may allow them to focus better and participate in therapeutic sessions. Additionally, online therapy appointments can be scheduled at your convenience, often reducing waitlist times or insurance issues. 

Online therapy for mental health and pain

While this treatment can require specific medical equipment operated by a trained, in-person therapist, participants can engage in talk therapy at their home, office, or a preferred location. Many therapists will use cognitive-behavioral therapy (CBT) as a complementary treatment approach to neurofeedback. Online CBT continues to show efficacy in treating disorders where neurofeedback therapy is also utilized, such as chronic pain, phobias, GAD, OCD, and PTSD. If you're interested in trying online CBT, you can sign up through a platform like BetterHelp, which offers a growing database of licensed professionals.