EEG Neurofeedback Frequently Asked Questions

What conditions do you treat?

Neurofeedback practitioners do not use the medical model of “treating.”  Instead we operate from the principle that many emotional, behavioral, and physical problem conditions are caused by disregulation in one or more neural networks in the brain. Such disregulation may have been caused by injury, trauma, genetic predisposition, or environmental factors.  Through Neurofeedback the brain learns to self regulate, and restore itself to optimal functioning.

This may mean improving connectivity in under functioning neural networks, as might be the case in ADHD or autism related disorders, or even traumatic brain injury. It could mean calming down over aroused segments of the brain, as in anxiety disorders, PTSD hyper vigilance, or emotional over reactivity and anger control. Or it could mean raising the arousal level for a depressed person.

As the brain learns to self regulate, it becomes more stable and more resilient to stress. Usually this leads to enhanced feelings of overall well being, including the ability experience joy and pleasure.  In many cases, even physical, emotional, and relationship problems, that were not the original focus for coming to see me, are much improved.

Are there negative side effects from Neurofeedback?

No. The first two sessions are an interactive process, during which you and I need to find the optimum reward frequency (ORF) for your brain. During this process you may start to feel tired, groggy, foggy, or perhaps a little hyper or jumpy.  These are indicators for me to move the target reward frequency up or down.  Once we have the ORF, you will feel relaxed and alert as watch your colorful feedback game. (The ORF may need to be adjusted later, as your brain becomes more settled).

In the more than 40 years since Neurofeedback was first introduced there have been no recorded cases of major or lasting negative side effects. However, the positive effects of Neurofeedback tend to be long lasting.

Does Neurofeedback put any electrical charges into my brain?

No, Neurofeedback is a passive, non-intrusive system of training the brain. Three small sensors are attached to your scalp with small dub of electro paste. Two of them will pick up the neuro electrical activity in your brain, while the third one acts as “ground.”  Because brainwaves are measured in micro volts (1/1000 of a volt), the signals from the sensors are sent to a neuro amplifier before being passed on to the computer.  A sophisticated software program (Cygnet) filters the signals (to eliminate unwanted stray electrical signals).  The Cygnet program then converts the signals from the brain into visual, auditory, and even tactile feedback.  The “feedback” you see is one of several types of colorful video “games,” all with musical sound tracks. Responding to the images, the music, and the vibrations of a cute puppy, the brain quickly learns to keep the “game” moving along.  By doing so, the brain is learning to regulate and stabilize itself.

What is tactile feedback?

You get to hold a cuddly stuffed puppy which is connected to the feedback loop from the computer.  It vibrates when you are meeting the reward goals and thus reinforces the brain when it is doing well.

Is Neurofeedback hard work?

Most people experience Neurofeedback as pleasant and relaxing. The visual, auditory, feedback is interesting, and even pleasurable. As you get drawn into it, the brain does the work for you.  It has the ability to observe how it does. The brain adjusts itself in response to the feedback, to keep the action on the screen moving. It is actually better for you to relax and trust your brain to do the work, than to consciously “control” the game.

Is it difficult to get kids to do this?

Generally kids from age 3 on upwards take to this like ducks to water. They get to choose one or another of the video “games.” With the new colorful and challenging game applications, each with excellent graphics, boredom is no longer a problem.  The kids often are surprised how quickly the session is over.  Time flies when you are having a good time.

What is the typical length of a Neurofeedback session?

Total time for a session in my office is 50-60 minutes.  Actual Neurofeedback time is usually around 30 minutes.  Sensitive brains, or young kids might initially tolerate only a few minutes, but quickly get used to longer periods.

From session to session we like to track changes in symptoms. So the first part of a visit involves reviewing progress since the last session. This may involve problem solving for behavioral or relationship issues.

How do you measure progress?

I use two methods for tracking progress.  For children or adults with ADHD, we use a standardized test of variables of attention at either the first or second session.  After ten sessions we repeat that test and see the areas of improvement.  We also use an automated symptom tracking program, which can be used from home.  At the intake session we identify the target (problem) symptoms for which we would like to see positive change. They are rated in intensity and recorded on a tracking sheet and fed into the computer.  The client is given a computer access code, so that you can “input” changes you or others have observed on a daily basis. This generally gives us a visual picture of a curve of decreasing intensity of the problem over time.

How many sessions of Neurofeedback does it take to resolve problems?

This depends on how much disregulation there is in the brain. In general, we see improvements within 3-5 sessions.  However, based on the fitness training model, we want to make sure that the brain has permanently learned those self regulating mechanisms. For many people this will be around 20 sessions.

I ask incoming clients to commit themselves to at least 10 sessions. We then take stock and see how many more sessions are needed and whether to change directions.  The end point may vary with the severity of the disregulation, and the length of time it has been embedded. The ideal is to reach a point where optimal functioning can be maintained without ongoing need for reinforcement.  We find that point when we look at the symptom tracking system and see that the majority of symptoms have either disappeared or have stabilized at a low level.

What makes it possible for Neurofeedback to bring about permanent changes in the brain?

The brain is ‘plastic’ and ‘malleable’ and therefore can change. This phenomenon is known as Neuroplasticity. It is the ability of the human brain to change as a result of one’s experience. The brain can do this because nerve cells or “neurons” are interconnected in neural networks. “Brain Plasticity” refers to learning by adding or removing neural connections, or adding cells (neurogenesis). We know that exercise and socialization contribute greatly to the brain’s ability to generate new cells, form neural networks, communicate better, and self-regulate.  Neurofeedback, by stimulating the brain to observe its own functioning, also increases Neuroplasticity. Once new connections have been formed they may last a life time. Thus, the improved overall functioning, once embedded in the new connections, is permanent.

What is Peak Performance Training?

Athletes, musicians, performers, writers, scholars and executives have all benefited from this unique form of training. The techniques for enhancing performance usually includes Neurofeedback training, coaching, visualization and guided imagery, and meditative techniques. These may assist with improved performance, increased endurance and the ability to experience a state of “flow” on demand — a heightened sense of concentration and focus with complete relaxation. Click the link to see an article on EEG Neurofeedback training for Peak Performance.

How often must I attend Neurofeedback sessions?

To produce quick changes in the brain it would be ideal to train 2 or 3 times a week. However, I realize that most people cannot make that time commitment.  At an absolute minimum, 1 training session a week is required, but results may be slowed by such a pace. Generally speaking,  I suggest to come twice a week for up to five weeks  and then reduce to once a week,  and later possibly to bi-monthly visits. Consistency is as important as frequency, especially in the earlier stages of training.

Are there cases where Neurofeedback does not work?

Neurofeedback has a good record of efficacy but it is not a stand-alone panacea; positive results cannot always be guaranteed. As mentioned above, clients with stress-related conditions of long standing, are likely to have functional brain disregulation that will take more sessions to resolve. In such cases we need to know that relaxation responses and changes may come more slowly then hoped for.  It is important to remember that we are dealing with organic functional processes, and that expectations of quick results may prove counterproductive.

In some cases Neurofeedback may not suffice as a stand-alone intervention. I often combine it with talking and problem solving, guided imagery, massage (to take the worst tensions out of the neck and scalp), and even nutritional counseling.  I may need to make appropriate referrals for testing or medication when needed.

Neurofeedback training cannot replace sound life-style choices. An unstable home environment, poor nutritional practices, poor breathing habits, unstructured sleeping habits, substance abuse, improper medication titration, a lack of willingness to improve, or not heeding professional advice  can make the difference between successful or mediocre results in receiving Neurofeedback.

Neurofeedback is a function-driven learning process, meaning that I make adjustments to ensure increased relaxation which promotes self regulation in the brain. Sleep quality, appetite, anxiety levels, ability to concentrate, etc. are all indicators that guide me during a course of training. Collaboration and communication between trainee and Neurofeedback provider are of the essence. A good flow of succinct information on functional changes you observe between sessions provides the basis for making adjustments, if needed.

What is Alpha-Theta training?

Alpha Theta training is a powerful Neurofeedback technique for calming and restoring the brain to a restful state.  It is normally only used after preliminary work to make sure that the brain is ready for this advanced technique. It has been exhaustively researched in connection with PTSD and addictions. It is currently being used in Afghanistan with combat stressed soldiers. The program at Camp Pendleton for Marines returning from the war theatre, called Combat Stress Reset, makes heavy use of Alpha Theta training.  I use Alpha Theta training primarily for veterans with PTSD, and survivors of traumatic emotional, physical or sexual abuse.

What is a qEEG, and do you use them?

Quantitative Electroencephalograph (qEEG) is the measurement of transient electrical patterns at the surface of the scalp, which primarily reflect cortical activity or “brainwaves. qEEG uses multiple electrodes at 19 or more sites to yield a comprehensive recording of brainwave activity that is analyzed relative to a normative database and converted by a computer to a topographic colorful brain map. The qEEG is not intended to be a “stand alone” diagnostic, but no other brain imaging technique is as fast or non-invasive, and it is often recommended for clients with brain injury or developmental disorders to assist in determining an optimum protocol for treatment.

Some clinicians require a quantitative analysis of clinical EEG or qEEG, with a written report and interpretation before administering Neurofeedback training, while others do not. No data exists indicating traditional q-EEG based training is any more or less efficacious then other protocols.

At this time, I do not use a qEEG to guide my training decisions.  Instead I use what is called the “symptom based” approach. In other words, I use the inventory of symptoms noted in the Intake to guide my initial decisions on where to train and what frequency to use.  The collaborative flow of information from the client then guides my subsequent adjustments of placements and frequency.

What feedback have you had from your clients about your work?

After years of crippling migraines, what a relief to no longer have them.  I have not had one since.  E.F.

When I first came for counseling, my body was wracked by tensions.  At the beginning of each therapy session, he had me lie on his massage table, and with his healing touch took the tensions right out of my neck, scalp and jaw. T.S.

I have two children with Asperger’s. It has been a great convenience to be able to bring in both kids at once.  While they receive Neurofeedback, Dr. Kirk and I talk about parenting issues. The positive changes are so encouraging.  J.K.

As a mother of a child with ODD, I had problems getting my son to work with any therapist.  Dr. Kirk is the first one he gets along with.  The positive changes in his behavior started after his first Neurofeedback session.  M.C.

I really appreciate Dr. Kirk’s holistic approach. Everything from psychotherapy, nutrition, learning relaxation techniques, to tuning up my brain for better performance.  P.R.

He helped me gain insight into my trauma history, to drop negative self talk, and to adopt positive attitudes and behaviors. After a few sessions of Neurofeedback, I no longer craved or needed the illegal drugs, which had gotten me into legal trouble.   A.R.

What makes it possible for Neurofeedback to bring about permanent changes in the brain?

White Matter Fibers Harvard Dataset
Frontal Cortex Connections