The Neurofeedback Institute | FAQs
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Common Questions

What are some uses of neurofeedback?
Neurofeedback addresses problems of brain disregulation. These happen to be numerous. They include the anxiety-depression spectrum, attention deficts, behavior disorders, various sleep disorders, headaches, migraines, PMS, and emotional disturbances. It is also useful for organic brain conditions such as seizures, the autism spectrum, and cerebral palsy.

What are some uses of neurofeedback?
Neurofeedback addresses problems of brain disregulation. These happen to be numerous. They include the anxiety-depression spectrum, attention deficts, behavior disorders, various sleep disorders, headaches, migraines, PMS, and emotional disturbances. It is also useful for organic brain conditions such as seizures, the autism spectrum, and cerebral palsy.

How does neurofeedback work?
We apply electrodes to the scalp to listen in on brainwave activity. We process the signal by computer, and we extract information about certain key brainwave frequencies. (All brainwave frequencies are equal, but some are more equal than others.) We show the ebb and flow of this activity back to the person, who attempts to change the activity level. Some frequencies we wish to promote. Others we wish to diminish. We present this information to the person in the form of a video game. The person is effectively playing the video game with his or her brain. Eventually the brainwave activity is “shaped” toward more desirable, more regulated performance. The frequencies we target, and the specific locations on the scalp where we listen in on the brain, are specific to the conditions we are trying to address, and specific to the individual.

Does this involve any kind of electrical stimulation?
No. At no time is there any electrical stimulation given to the brain. The brain is simply taught to behave in a healthier manner. Just like a muscle learns via repetitious training, the brain can also learn through continual practice and reinforcement.

Does it hurt?
No. It is painless. It does not involve any types of needles and it is not invasive in nature.

Does age matter?
No. Children, adolescents and adults can all be trained to improve brain function.

How do I know if it is the right choice for me?
Whenever considering any type of intervention, you should always seek the advice of a qualified health professional (such as a neurologist, psychiatrist and/or clinical psychologist). They can assess your needs and make appropriate recommendations. In many cases, neurofeedback practitioners offer a free consultation at which they can let you know if you are a good candidate for this treatment.

Will the symptoms return?
Once enough sessions are conducted and the symptoms are addressed, the brain should maintain improved function. However, if an emotional or physical trauma (such as a blow to the head) is experienced the symptoms may return.

What are some conditions that are helped with neurofeedback?
Addictions » Alcoholism » Anger Management » Anxiety »
Asperger’s Syndrome » ADD » Bruxism » Chronic Fatigue »
Chronic Pain » Headaches » Insomnia » OCD »
Peak Performance » Trichotillomania »

Addiction is a brain-based problem, and it demands a brain-based solution. The will is over-rated when it comes to the addicted brain. Fortunately, a new era opened up at the outset of the “Decade of the Brain” with the publication in 1989 of Eugene Peniston’s epoch-making study of Viet Nam Veteran alcoholics (see Alcoholism below). The result was that outcome was in no way dependent on the drug of preference, whether we were talking about heroin or crack cocaine or methamphetamine or alcohol.

The inclusion of neurofeedback in residential treatment tripled the favorable outcome in terms of relapse prevention over the best conventional treatment when looked at one year post-treatment. At three years, the ratio was even better.
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The breakthrough study on the application of neurofeedback/ EEG biofeedback to alcoholism was performed by Eugene Peniston, psychologist on the staff at Fort Lyons Veterans Administration Hospital in Colorado. The treatment outcome for alcohol addiction treatment for Viet Nam veteran pilots was abysmal at the time. Peniston had personally experienced biofeedback and neurofeedback at the Menninger Clinic where an early research group in EEG biofeedback was continuing its work. The group was aware of the benefits of EEG biofeedback for alcoholism, but that was not their real interest.

Peniston took the method back with him to Fort Lyons where he undertook a controlled study. The results were striking. Every veteran who did the neurofeedback (ten out of ten) was no longer abusing alcohol after the training, whereas everyone in the control group, which received the regular in-patient treatment, continued the pattern of addiction after release. The contrast could not have been more dramatic.

These results were then replicated by others. The result is that we now have a technique for the remediation of alcohol dependency that has high predictability.
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Anger Management
One of the easiest conditions to work with using neurofeedback / EEG Biofeedback is anger control. One trains the brain, and anger simply falls away.

The capacity for anger remains. What has been gained is a measure of control. Our internal experience of untrammeled anger is that it is a good fit to the circumstances. After neurofeedback, the outside world just doesn’t seem quite so deserving of our anger. Our perceptions both of ourselves, of the other, and of the situation will have broadened, and that is an unalloyed good.
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There are any number of ways in which a person’s physiology canbe trained to function in a calmer fashion at lower levels of physiological arousal or state of agitation. A lot of the work with anxious people involves teaching them the ways in which they can help their own condition with conscious influence on their own physiology.

A simple change in breathing strategy, for example, can bring about profound changes in health and well-being. One does not have to go around thinking about one’s breathing all the time, either. The learning of new ways of functioning will lead to the adoption of new habits by the body-mind. One is consciously engaged with one’s physiology only a small fraction of the time-perhaps when one is under challenge, or one is standing on the threshold of a command performance.

Neurofeedback / EEG Biofeedback can help as well. Gently the brain is trained to operate out of a calmer place. Initially this may take the anxious person out of his or her historical comfort zone. Even if this is actually a zone of discomfort, it is still what the person is accustomed to. The loss of anxiety may actually seem like the loss of a kind of safety. Anxiety may not feel good; but it is at least keeping the person alive! The sudden disappearance of anxiety may leave the person feeling exposed and insecure.

So it is important to train people toward calmer states while keeping them within their comfort zones. The training is therefore highly individualized, and that is the breakthrough that neurofeedback has made possible.

We encounter three classes of anxiety:
1) anxiety so severe that it is practically disabling to the person
2) an anxiety level that interferes with the quality of life and keeps the person from optimum functioning
3) living in a condition of high arousal that costs a person in terms of energy expenditure now and possibly depression or even reduced life expectancy later; however, the state may not be felt as one of anxiety. Such a high-wire act may in fact be seen as a pathway to success and be rewarded as such. But it is costly, and not at all necessary because it is inefficient and ultimately exhausting.
Each of these takes a different approach in training. The more severe condition may also have its roots back in the early childhood history of the sufferer, and that also has implications for what is to be done. Fortunately, with neurofeedback one can even reach back figuratively into early childhood history and alter the present consequences of such early trauma. If the present experience of anxiety is rooted in early memories, then a thorough going resolution of the issue will involve a retraining of the physiology that will involve a reworking of the early trauma history. With neurofeedback, that can all take place quite benignly through sequential training procedures.

The benefit of resolving anxiety conditions are not just to be seen narrowly with respect to anxiety per se, but will influence the person’s entire quality of life. Altered will be how the person pays attention; emotional relationships will change; and the person will relate differently to the perceived “self.” This is not something that the anxious person is necessarily even capable of imagining. It may simply have to be experienced.
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Asperger’s Syndrome
Recent advances in neurofeedback protocols have given considerable impetus to work with Asperger’s Syndrome. The advantage here isthat the person at issue may in fact exhibit considerable intellectual gifts, which can be helpful in neurofeedback. Training for this condition involves a primary focus on emotional regulation, with a secondary focus on anxiety(worry) and obsessional features that may be present. Other non-verbal learning disabilities may also be present, and these may require specific attention.
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Attention Deficit Disorder (ADD)
Even after all these years, Attention Deficit Disorder is still only poorly understood. Attention is so central to how we function that one canhave a different view of the matter of attention deficits depending on one’s perspective. These different perspectives each have some degree of validity, but they may be difficult to bring under one hat. It may even be necessary tosee the subject from various perspectives in order to encompass it. So in the following, we add one more perspective. Read on for a fascinating journey.

One can start from the vantage point that it is the business of the brain topay attention. It must be vigilant to threats to our existence; it must organize our response to the world; and it must look to its own affairs. In that regard, the brain appears to be very self-absorbed. Most of its resources are spent paying attention to itself. Only a very small percentage, on theorder of one percent, is spent paying attention to the outside world.

So if we observe a child that is highly distractible, impulsive, and hyperactive, does the problem lie only in what we can observe? No. The problem lies more broadly in the issue of how the brain organizes its attentional and regulatory faculties. What we observe is analogous to the part of the iceberg that sticks out of the water. There is a lot more of the iceberg that we cannot see. Similarly, in the ADHD child we observe “disregulation” in a variety of functions where it may be less obvious: in the organization of sleep; perhaps in immune or endocrine function; perhaps in auditory processing; perhaps in emotional regulation; and perhaps even in the regulation of blood glucose levels.

The operative word in Attention Deficit Hyperactivity Disorder is “Disorder,” and it can affect a variety of functions. In other words, we see ADHD as a Disorder of Disregulation, and the extent of that disregulation is a function of how carefully we look.

And if that is the case (we agree that we need lots of evidence on this point!), then the remedy is to be found in any technique that restores more ordered regulation. We know the end point: managing attention and behavior is the outcome of a self-regulatory process. We don’t have any kind of prosthesis in our medical armamentarium that can prop up our attentional faculties. The brain has to do it all. So whatever we undertake has to serve the cause of better self-regulation of attention and behavior.

More good news: When ADHD children learn this skill they find that the stimulant medication that may have helped them earlier is no longer necessary. This is true for at least 85% of them, according to published research. What does this tell us? It tells us that the entire problem of ADHD may simply beone of disregulation, and that once good self-regulation is learned, the problem disappears. It can no longer be identified within the child. It no longer exists. This in turn means that ADHD is not a concrete condition like cerebral palsy, but actually a much more wimpy kind of failure to self-regulate that is easily remedied. Train the brain to pay attention and voila, no more attention deficit. Some children will have to expend a little more effort to get there, but that’s true in all of education. Paying attention is a skill, only it happens to be one that is rather more central to our good function than some others.

Now we get to the heart of the matter: It’s not just about attention. It’s really about behavior-impulsivity, oppositionality, defiance, etc. It turns out that these just involve different aspects of the brain’s attentional repertoire. Emotional regulation occurs when we pay attention with our emotional faculties on-line and intact. The brain that can regulate its attention can also regulate its behavior.

It’s one story, not two or more.

So a single kind of brain training, targeting our attentional mechanisms, can effect normalization of behavior of the most intractable ADHD child. This is simply breath-taking. Now again, one wants some evidence at this point. You can find it at the research site,
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Teeth-clenching and teeth-grinding are quite common, and they appear to be nothing more than a problem of disregulation of motor control, complete with a label. The brain can be trained toward better self-regulation, and the symptoms subside. This is even true for nocturnal bruxism, because indeed the brain is still in charge even while we are asleep. The neurofeedback / EEG Biofeedback alters patterns of regulation, and these carry over into sleep.

Ironically, the first thing that a client may observe with neurofeedback for bruxism is that he may be clenching more rather than less. Actually, we strongly suspect that what is really going on is that the person is simply becoming more aware of the clenching that had been happening beneath his notice. Among other things, neurofeedback is training in awareness. After three or four sessions, the person will observe the clenching subsiding.

Successful neurofeedback may make it possible for the client even to leave the nocturnal mouth guard on the night table. Jaw aches may be seen to disappear. If bad habits should happen to reassert themselves after some while, an occasional booster session can be helpful in restoring good regulation.
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Chronic Fatigue Syndrome
There is no known remedy for Chronic Fatigue Syndrome, and neurofeedback does not constitute a remedy either. However, it can be helpful as part of an overall treatment program. In the early days of our work, we would feel gratified if we could boost the energy level of the chronic fatigue sufferer. However, these benefits often proved merely transitory. Sometimes the person would feel so energized that he or she would immediately plunge back into the maelstrom and then relapse soon after. So a more gradual building of support for a higher level of function is more appropriate. The symptoms of Chronic Fatigue Syndrome overlap considerably with those of Fibromyalgia, where we can be helpful as well.
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Chronic Pain
One of the prominent applications of biofeedback has been to the area of chronic pain. Most recently, it has been found that EEG biofeedback can be particularly helpful here as well. Startling results are coming out in which profound symptom relief can be obtained within a single session, although these gains are usually transient. Over time, clients can be trained to the point where these gains can be held onto permanently.

Chronic pain patients exhibit a variety of disregulations, not only pain. But when pain is present, it rises to the top of our hierarchy of needs.

It is the central fact of chronic pain that it has a significant component involving central regulation, and this fact frustrates all of the medical approaches to pain that attempt to address the source of the pain. The late Professor Liebeskind at UCLA, who specialized in pain, liked to recite a casein which a chronic pain patient was subjected to one procedure after another. As a tenth and final attempt to resolve the pain, a kind of frontal lobotomy was performed on the woman. Her pronouncement afterwards: I still feel thepain, but now I no longer care. Although this history is fortunately not being repeated anymore these days, the story does resonate with modern thinking. We may not be able to extinguish chronic pain, but we may be able to move the person to where he or she is the master, not the victim of the pain experience. That sense of mastery may be the key to what is doable at the present time.
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It is mystifying why the efficacy of biofeedback for headaches is not widely recognized, because this has been the case for a very long time.

So let us spread the good news: Biofeedback and neurofeedback are excellent remedies for both what are called “tension” headaches and for migraines. In fact, treating migraines is not substantially more difficult, and it is not significantly less effective, than treating ordinary tension headaches. What this is really saying, of course, is that nearly every personis already carrying the remedy for their own headaches with them. Their nervous systems simply need to be trained toward better self-regulation.

We can go further. Clinical success in dealing with migraines is greater for neurofeedback than for almost all other conditions in our own experience. And we can go further still. Most people who seek out neurofeedback for migraine are not those who have an occasional migraine. These people tend to make do with whatever medical remedies are available. We tend to see clinically those who have had a debilitating migraine history for many years, and they finally found their way to our office. And yet the neurofeedback training is efficacious for such people.

In the event that there should be a breakthrough migraine now and then even after the neurofeedback training series is completed, the client may choose to have a booster session along the way, or else avail themselves of neurofeedbackhome remedies.

One of the newer approaches just involves the training of cortex to a higher level of activation. This tends to abort an incipient migraine. One is reminded of research with cluster headaches showing that breathing pure oxygen can abort the headache. Training the cortex to higher operating temperature may be accomplishing the same thing: making more oxygen available to the pre-frontalcircuitry, sufficient to abort the migraine mechanism.

Our objective, of course, is not merely to abort migraines as they are coming on, but to get rid of them entirely. With modest attention to lifestyle issues and risk factors, this should be achievable with neurofeedback for the vast majority of migraine sufferers.
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Garden-variety insomnia tends to fall into two categories: difficulty falling asleep and difficulty staying asleep through the night (or of falling asleep again after nocturnal waking). We distinguish between these because in some approaches they train somewhat differently. There is an association between the sleep-onset difficulty and anxiety, and between the sleep maintenance issue and depression. And just as we might train depression and anxiety somewhat differently, the same goes for the related sleep issues.

Good sleep is more than the absence of insomnia. The training of brain function gives one the possibility of achieving sound sleep even if one has not experienced it since perhaps infancy! This is one area where neurofeedback diverges from medical remedies for insomnia. The medications do help one sleep, but by and large they extract a price. Over the long term there is the hazard of dependency, and over the short term there may also be a price to pay in terms of quality of sleep.
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Obsessive-Compulsive Behavior
This type of behavior is neurologically kin to Tourette Syndrome (TS). Almost everything we say about neurofeedback for Obsessive-Compulsive Disorder (OCD) applies to TS and vice versa. The techniques are identical, and our recent breakthrough with respect to OCD also applies to TS.

This condition benefits greatly from training of the pre-frontal lobes because it centrally involves the dopamine circuits that project there. It also benefits greatly from the tailoring of the protocol to the person, which is what has made the recent clinical gains possible. The most intractable cases ofOCD appear to respond to training at very low frequencies. The implication in the neurophysiological realm is that we are dealing with a condition of extreme over-arousal. The implication in the psychodynamic realm is that we may be dealing with a condition grounded in a trauma history. Both considerations call for training at very low frequencies as part of the protocol.
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Peak Performance Training
There are many people for whom good brain function is critical, but the objective has largely been achieved through conventional means. The concert pianist trains brain function through the tireless practice of his craft. Tiger Woods continues to hone his skills with great diligence. But what does the diplomat do who has to function in critical negotiations after changing six time zones? What does the surgeon do when he is roused out of deep sleep for emergency surgery at three in the morning? What does the aging commercial pilot do when he confronts his re-qualification test in the simulator?

We are at a threshold now where the training discipline of a sports competitor or the rehearsal discipline of a performance artist has become relevant to anyone who is dependent on good mental function. Actually, the burden is not nearly so great as in sports or the arts. After an initial series of neurofeedback sessions, people can usually maintain with only rare booster sessions, possibly as few as one per year.

If one’s challenges arrive on a schedule, one can prepare with remote training. A professional golfer can plan to do a session prior to a tournament. A singer can compose herself prior to a performance with a calming neurofeedback session. The traveling diplomat can help to reset the circadian clock with a strategy that includes neurofeedback. The pilot booked on long-distance flights can ease the strain of time zone shifts with neurofeedback. The graduate student petrified before his oral exams can prepare with a few sessions of training.
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The symptom of hair pulling is seen typically in connection with Tourette Syndrome, and our story for trichotillomania is essentially the same as for TS in general. It may be useful to point out here that the phenomenon of “symptom substitution” is commonplace in TS. One may see quick results with trichotillomania only to find that the Touretter begins to report some other prominent symptom emerging. So it is not sufficient to target a particular symptom in TS. One must target the whole condition comprehensively.