Neurofeedback: Training the Brain to Healthier States

For many sufferers of chronic disease, an oversensitive or sluggish central nervous system may be a cause or contributing factor to symptoms such as pain, anxiety, panic, depression, inattention, tremor, and even seizures. The good news is that the brain can be trained to “calm down” or”speed up” with a technique known as neurofeedback.

What is Neurofeedback?

Neurofeedback is a form of biofeedback, that is, the monitoring of a biological function with the aim of learning to have some control over it. For instance, people can actually learn to reduce their blood pressure with the help of a device that gives them continuous blood pressure readouts, and electrodes that measure muscle tension can be used to help people learn to relax. With neurofeedback, the bodily function being monitored is electrical activity produced by the brain, or brain waves, using a device known as an electroencephalogram (EEG).

Over the past 30-or-so years, the brain wave patterns of healthy people and people with various mental or physical conditions have been measured and collected by researchers all over the world. That provides a large database of “normal” brain wave patterns as well as those associated with known diagnoses such as ADHD, autism, mood disorders, anxiety, and other problems. With that knowledge, efforts can be made to teach the brains of people suffering from certain symptoms to produce “healthier” patterns of brain waves.

It’s essentially a learning process, says Suzanne Lamontagne, MEd, a psychologist in Montreal, Canada who offers neurofeedback as part of her private practice, called West Island Neurofeedback. During treatment, patients’ brain wave patterns are recorded and translated, via computer, into a form of feedback, usually a sound and/or moving visual image. The computer is programmed to generate the feedback when the brain produces certain desired brain wave patterns. “When that happens, the brain, if it’s engaged, starts to re-orient itself and regulate itself to that feedback, producing altered neuroelectrical volleys that relax some areas and stimulate others in an incredible symphony of activity. We’re teaching the brain through reward or lack of reward to produce certain functions so that when a person needs to access a particular skill or state, the brain can reproduce it.” Notably, no changes are imposed on the brain in one session, just as with relaxation training or meditation, although like these techniques, anatomical and physiological changes can occur over time.

A positive feature of neurofeedback according to Ms. Lamontagne, a doctoral candidate completing research in neurofeedback and smoking cessation, is that it is virtually impossible to accidentally train the brain to evoke enduring unhealthy brain wave patterns. The brain is just too smart for that. Certainly, an overly anxious person might feel some discomfort if the practitioner boosts brain wave patterns associated with anxiety, but since there is no inherent reward to the brain for producing unhealthy patterns, it quickly “forgets” it when the treatment stops, unless they insist on continuing such training despite the symptoms. Brain wave patterns that produce healthy states, such as relaxation, pain relief, and focus, on the other hand, are inherently recognized by the brain as being desirable and can be strengthened and made permanent over time.

What Does Neurofeedback Treat?

There is good evidence that neurofeedback can help treat some forms of epilepsy, chronic migraines, and the sorts of attention issues found among those with attention deficit hyperactivity disorder (ADHD). Clinical studies also demonstrate benefits for post-traumatic stress disorder (PTSD), anxiety, traumatic brain injury, fibromyalgia, and insomnia. But the technology has the potential to improve any condition in which an overly sensitive central nervous system or an underfunctioning arousal system play a role. So, for instance, a person with asthma whose condition is exacerbated by stress or a person with irritable bowel syndrome (IBS) whose symptoms are exacerbated by anxiety would likely find neurofeedback helpful. It’s a little bit like meditation. Over time, regular meditation can help the brain develop a calm and relaxed approach to the world and all its stimulation, and neurofeedback can do that too. With neurofeedback, however, the brain retains the new learning even when practice ends, as long as it has been effectively learned. Outside of a clinical setting, people use neurofeedback to optimize their athletic or business performance, control anger, improve alertness, or help attain more “Zenlike” states.

The Neurofeedback Experience

For the person undergoing the treatment, neurofeedback is deceptively simple. Electrodes are placed over specific areas of the brain where certain patterns of brain waves can be detected. These electrodes are attached to a computer, which produces an audible and/or visual reward when desirable patterns are detected. So, for instance, the computer screen might display a bird flying in the sky to soothing music when the brain produces the desired patterns, with the image freezing and the music stopping when the pattern moves outside desired parameters.

Finding a Practitioner

The relevance of EEG patterns in mental health and wellbeing is being increasingly recognized by such important and influential bodies as the American Academy of Neurology (AAN) and the National Institute of Mental Health (NIMH). As interest grows, so does the availability of neurofeedback as a treatment option, although it remains somewhat poorly regulated. To find a good practitioner, Ms. Lamontagne suggests looking for someone who is also a licensed health care professional. “You can’t take someone with PTSD and plunk a[n electrode] cap on and say, This is going to make you feel better and off we go! You have to perform a good psychological and EEG assessment to deal appropriately with that population,” she says.

Practitioners of neurofeedback should also be accredited by an international organization known as the Biofeedback Certification International Alliance (BCIA), which ensures they have undergone the minimum training needed to perform it properly. It’s also a good idea to ask the practitioner the same questions you might ask any clinician, such how long have you been performing neurofeedback? What conditions have you treated? And what kinds of results have you obtained? Be sure to work with a practitioner who keeps up with research in the area (it is currently moving at light speed) and has a solid understanding of EEG science, she says. Practitioners with a solid understanding the science behind neurofeedback are most adept at tailoring standard neurofeedback protocols to their individual patients’ needs, and this optimizes results.