How Does Neurofeedback Therapy Work?

By: Patricia Oelze

Updated March 16, 2021

Medically Reviewed By: Whitney White, MS. CMHC, NCC., LPC

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Neurofeedback therapy is also known as EEG neurofeedback, EEG biofeedback, or just neurofeedback, but they are all the same thing. This type of therapy is an excellent way to heal the brain, and when used in conjunction with psychotherapy, which heals the mind, you can expect to have a much more successful treatment outcome. While neurofeedback therapy is adaptable and useful in many situations, it does require a great deal of expertise to perform and may not be suggested to use with some people. Neurofeedback therapy is considered to be psychophysiology, which is the study of the relationship between the physical and mental processes or how the body and mind interact.

Who Can Benefit from Neurofeedback Therapy?

Some of the experts who work in this field include psychologists, physicians, neurologists, biochemists, and other scientists. Some of the disorders that are related to psychophysiology include those that have physical symptoms partially caused by emotional factors. Examples are attention deficit hyperactivity disorder (ADHD), anxiety, addiction, phobias, depression, chronic pain, memory problems, obsessive-compulsive disorder (OCD), seizure disorders, fibromyalgia, irritable bowel syndrome, heart disease, sleep disorders, and many more.

Brainwaves and Biofeedback

Your brain determines everything you do and feel, and although most individuals have perfectly normal brain function, they may still have some brain imbalances or emotional imbalances that can affect their daily routine and feelings. Neurofeedback therapy trains your brainwaves to do what they are supposed to do but to understand this; you have to know a bit about your brainwaves and how they affect everything you do and feel.

The nervous system is a two-part system which includes the central (the brain and the spinal cord) and peripheral nervous system, which in turn, includes your autonomic nervous system (the circulation, heartbeat, digestion, etc.). Your brainwaves are small electrical impulses that are produced as the cells in your brain communicate with each other. They can tell the doctor or therapist a plethora of information about how you function daily and how you feel, including your mood, stress level, thought habits, and your overall brain function.

Monitoring and Measuring Brain Waves

By putting sensors on the scalp, the therapist can monitor and measure your brain activity and use brain analysis software to find and identify specific activities that are giving you the negative symptoms you have been having. For example, anxiety, depression, insomnia, or addiction. After the area of concern is found, the therapist can build a specific training plan to pull your brain back into a more comfortable and efficient state. That is what neurofeedback does.

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When doing a neurofeedback therapy session, the therapist compares what your brainwaves are doing compared to what you want it to be doing. As the brainwaves enter a preferred state, you will be rewarded with a positive image on a computer screen such as a movie or a video game. The images and sounds you see will immediately let you know that your brainwaves are doing the right thing because they only turn on when you are in the desired state and will stop when your brainwaves cause your brain to go in the opposite direction.

Teaching Your Brainwaves

In doing this, it teaches your brainwaves what they should be doing rather than what they have been doing. Similar to doing physical exercise to build certain muscles, the more you exercise your brain into the preferred spot, the more it will be able to reach that spot. For instance, if you have been having trouble falling asleep and cannot concentrate or focus during the day, neurofeedback therapy can look at your brainwaves and determine what is causing the problem. Once the software reads the brainwaves, it will produce a brain map that the therapist can read and see what may be troubling you. Then they will devise a plan for you using your favorite movie or game.

Building the Brain Muscles

During your session, you will be hooked up to the brainwave monitor and the computer so that when your brain starts to push the brainwaves in the right position, your movie or game will start. When your brain goes the opposite direction, the movie or game will go dark. After some time, your brain will start catching on and get better at it, so the therapist will make it harder so your brain will get even better at it. Similar to lifting weights, once you can lift a certain amount, you add more weight to continue building your muscles.

Types of Neurofeedback Therapy

Neurofeedback is a form of biofeedback that lets you regulate your brain function on your own by using mental stimulation and strategies. The idea is to increase the brain's efficiency and teach the brain how to keep the brainwaves flowing in the right direction. There are several different types of neurofeedback therapies that work for certain disorders. With the help of the software, the therapist can build a treatment to train your brain for your issues. The different types include:

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• Frequency or Power Neurofeedback is the most commonly used neurofeedback therapy and is also known as surface neurofeedback. It uses two - four electrodes to change the speed of certain brain waves in particular parts of the brain. This typically treats anxiety, ADHD, OCD, and insomnia.
• Functional magnetic resonance imaging (fMRI) can regulate the brain's activity based on the feedback from deeper subcortical areas. This type of neurofeedback therapy is typically used for phobias, Parkinson's disease, anxiety disorders, and ADHD.
• Low-resolution electromagnetic tomography (LORE-TA) uses more electrodes than the other types, which lets the therapist simultaneously train more than one area of the brain. Most types of therapy use two sensors and focus on one area, but with this more intense therapy, it can treat OCD, depression, and addictions as well as the other disorders mentioned above.
• Hemoencephalographic (HEG) neurofeedback is typically used for treating chronic migraine symptoms. It uses the feedback of the cerebral blood flow to determine the treatment needed.
• Low-Energy Neurofeedback System gives an electromagnetic signal to the person's brain to change their brainwaves while they relax with their eyes closed. It is typically used for depression, anxiety, chronic pain, restless leg syndrome, brain injuries, sleep disorders, and ADHD.
• Brand-name neurofeedback therapy includes brain training systems that encourage and train the brain to reset itself or self-correct. Many of these systems are available on the open market and are not as effective as those used by therapists.

Treatment Procedures

There are also different treatment procedures or protocols that are used to target certain areas of the brain for specific symptoms or problems. They include:

• Alpha Wave Procedure

Your brain's alpha waves are linked to relaxation and feelings of calmness but are also important to focus and alertness. It will relax your muscles and let you sleep when needed but will help improve your mental health while awake. This is the preferred treatment for brain injuries, problems with memory, mental performance issues, anxiety disorders, and chronic pain.

• Beta Wave Procedure

Your beta waves are used in mental performance and have to be used with care because there may be side effects if not used correctly. This type of procedure is commonly used to treat anxiety, anger issues, epilepsy, addiction, insomnia, learning disabilities, and trouble focusing or paying attention.

• Alpha Theta Wave Procedure

The alpha-theta waves control anxiety and stress. This is the most commonly used procedure for anxiety disorders such as social anxiety disorder, post-traumatic stress disorder, and generalized anxiety disorder (GAD). It can also be used for addiction, trauma, and depression.

• Delta Wave Procedure

Your delta waves are associated with your deep sleep cycles and are the slowest brain waves you have. Delta wave treatment is typically used for treating migraines and other severe headaches, learning disorders, brain injuries, insomnia, and generalized pain disorders.

• Gamma Wave Procedure

Your gamma waves are linked to your cognitive memory and learning abilities. Strengthening and speeding up these waves can help with memory issues, problem-solving, migraines, information processing, organization, calculation, mental sharpness, and cognitive thinking.

• Theta Wave Procedure

The theta brain waves are those that are used for hypnosis, sleep, meditation, creativity, emotions, and memory. Some of the conditions treated with theta wave therapy are ADHD, emotional disorders, inability to focus, depression, and anxiety disorders.

Who Should Not Use Neurofeedback Therapy?

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Some individuals who are suffering from serious psychiatric conditions such as schizophrenia, uncontrolled bipolar disorder, or psychosis can have adverse effects from this type of therapy if not used correctly. Also, those with epilepsy or other seizure disorders should only get this treatment from a qualified neurofeedback specialist or doctor. In cases where the patient has not disclosed that they had previously had seizures, the treatment has been known to trigger a seizure. That is why it is important to be completely honest with the therapist or doctor.

Can Neurofeedback Therapy Be Used on Children?

As long as the therapist or doctor is trained in neurofeedback therapy, it is safe for children. In fact, it has been especially effective in treating learning disorders, speech disorders, developmental disorders, ADHD, autism, Asperger's syndrome, OCD, anxiety, sleep disturbances, and brain injuries. Many types of neurofeedback therapy have been proven to increase the ability of a child to self-regulate and improves cortical functioning. However, just as with adults, it should only be used with extreme caution by a licensed and trained neurofeedback specialist if the child has epilepsy or a severe psychiatric illness.

Are There Any Side Effects?

Just as with any kind of treatment like this, there can be side effects. Some of the studies have shown that neurofeedback therapy may be connected to increased depression, mood swings, seizures, panic attacks, chronic fatigue, nausea, mania, and increased agitation or anxiety. However, it is thought that in most or all of these incidences, the side effects were caused by the lack of experience or skill in using neurofeedback therapy. Before proceeding with any treatment it is good to research and discuss options with reputable providers.