Top 10 Questions about Neurofeedback

As a board certified neurofeedback practitioner, I've helped clients make significant changes in their lives for the past 5 years using the tool of neurofeedback.
Recently, with publication of Bessel van der Kolk's new book, The Body Keeps the Score, my office has been getting a flurry of calls from people with a variety of concerns who are wondering, "Is neurofeedback right for me?"

I thought I'd share with you some of the questions that have come up, along with my answers. Here are the top 10:

1. What's neurofeedback?
Neurofeedback is a kind of biofeedback that helps you learn to change your brainwaves. When you can observe something you can change it, and neurofeedback allows you to observe your brain at work. This, in turn, helps you learn to improve your brain's performance and shift how you feel.

2. What kind of results can I expect from neurofeedback?
Neurofeedback is a tool, so the results depend in part on the focus and skill of the practitioner. In my practice, I use neurofeedback in Berkeley to improve AD/HD, anxiety, and sleep. My clients tell me that they see improvement in focus, attention, concentration, memory, productivity, creativity, sleep, the ability get through stressful events with a sense of calm, and quality of life. In contrast, an M.D. might use neurofeedback to reduce seizure activity treat migraines, a psychologist to reduce the symptoms associated with autism, or a physical therapist to help reduce pain.

3. What is a neurofeedback session like?
After a brief check-in, I attach tiny sensors, connected to your scalp using a simple saline solution. These sensors monitor your brainwaves. When you make the desired change (more fast waves, perhaps, or less slow waves), you get audio and visual feedback -- a sound, a picture that unfolds across the screen, or perhaps a documentary video.

After 30-40 minutes of feedback, we check in about the session, and talk about what you might do at home to support the neurofeedback. For example, you might keep a sleep log, start a 5-minute mindfulness practice, take something off your calendar, or listen to an audio.
4. How often do I need to come in?
Because neurofeedback is learning, visits need to be often enough that learning is reinforced. Once to twice a week is optimal, although more frequent sessions often lead to faster change. My clients tend schedule appointments about 6 times a month.

5. How well does neurofeedback work?
Research studies generally show a success rate of about 80%. Many clinics report higher success rates, in part because they can tailor services to the needs of each client. In my practice, 90% of my neurofeedback in Berkeley clients report major progress toward their goals.
Typically, you'll know within first month if neurofeedback is helping you reach your goals.
6. How long will it take me to get the results I want?
That's a bit like asking how long it will take to get physically fit. The answer is: it depends on your goals and where you're starting. Someone having trouble with sleep due to a situational stressor will progress faster than someone who's been anxious as far back as they can remember.

Most of my neurofeedback clients have 6 sessions a month, so it usually takes between 2 and 6 months to get significant and lasting results. Ultimately, though, you decide how long to continue and when you've reached your goals.

7. Will the results last?
Yes. As with any type learning, if you have a solid base, the results tend to last. Even if you haven't been on a bicycle for years, for example, you can still find your balance fairly quickly. With neurotherapy, the "base" seems to be about 20 sessions. A number of studies have followed people for two years after neurotherapy ends, and found that clients maintain their gains or continue to improve. In one study on AD/HD (Lubar), researchers found that even after 10 years, the gains lasted.

There are a few situations that by their very nature need ongoing reinforcement. For peak performance, for example, it takes ongoing attention to stay in top mental and physical shape. Other conditions, such as age-related cognitive decline, usually need a few sessions every 3-4 months to maintain the gains. A serious environmental stressor might also mean a new series of sessions.

8. Are there any side effects?
Neurofeedback is a form of learning, and no lasting side-effects have been reported. There are sometimes transient effects, both positive and negative, as the brain moves toward better self-regulation. In my practice with neurofeedback in Berkeley, some clients have reported changes in energy, mood, or sleep. For some people feelings bubble up, for example, or there is a period of intense dreaming. Others notice only that their symptoms begin to improve.

9. Are there articles that show the effectiveness of neurofeedback?
Yes. Over 40 years of research and over 1,000 published articles support the effectiveness of neurofeedack, especially for AD/HD, and more recently for anxiety and mood. You can find a few good background articles on neurofeedback here.

10. Can I do neurofeedback if I am in therapy or on medication?
Yes, neurofeedback works well with therapy.
It is helpful to avoid stimulants such as caffeine for at least 2 hours before each session. And yes, many neurofeedback clients start while on other types of medication. It is often possible to reduce or stop medication psychoactive medication under appropriate medical supervision (with permission, I can talk with doctors about how neurofeedback in Berkeley can support this goal).

What's Next?
There is currently a waiting list for my practice. However, if you're seriously interested, send me an e-mail with a brief description of your concerns and your goals, so I can see whether my expertise is a match. Neurofeedback is more effective for some issues than others, and I want to work with people for whom it's likely to be effective. Next we'll set up a time to talk, and go from there.

You can also take a look at How to Choose a Neurofeedback Practitioner on my website.