The Complete Guide to Neurofeedback 

This guide will explain everything about brain training neurofeedback. Read on to learn more.

Article Contents

What Is Neurofeedback Therapy?

What do Betsy DeVos, Former Secretary of Education, Tobias Harris of the Philadelphia 76ers, and Tony Robbins, motivational speaker, have in common? They have all utilized neurofeedback therapy to improve their lives.

If you’ve never heard of biofeedback or neurofeedback therapy, you may be wondering, what is neurofeedback? Neurofeedback is a type of therapy that improves mood, sleep, anxiety, attention, and even athletic ability. It’s not a new type of therapy—it was pioneered in the 1950s by two researchers, Dr. Joseph Kamiya of the University of Chicago, and Dr. Barry Sterman at UCLA. These researchers used neurofeedback equipment to learn that the brain reacts positively to a reward system and that people can retrain their thought patterns through various reward systems. Since then, neurofeedback has continued to gain popularity as a treatment for many conditions.

So, how does neurofeedback work? A noninvasive test called electroencephalography (EEG) measures brainwaves and transmits them into a graph or audio. Your healthcare provider then interprets the graph or audio and determines which brainwave frequency feedback could benefit you.

Learning More about Neurofeedback

What is a Brain Wave?

Now that you know what neurofeedback therapy is, you may be wondering what an actual brainwave is. Brainwaves are synchronized waves of neural oscillations; in other words, brainwaves show the electrical activity happening in the brain. The brain produces five different brain wave states: gamma, alpha, delta, beta, and theta. All five brainwave frequencies have different but equally important impacts on your health and mental wellness. Studying brain waves can help identify possible problems with someone’s cognitive, emotional, or neurological function.

How Does Neurofeedback Work?

When considering this sort of therapy, it’s important to determine what treatment is needed. You may also want to set goals for treatment, allowing you and your healthcare provider to track your progress.

Measure the Brain Wave Activity

To measure brain wave activity, you must get an EEG test. Though some people may be hesitant to get this test for fear of pain or even brain damage, EEGs are noninvasive and merely detect brain activity — they don’t stimulate it. Your neurofeedback therapist will give you a cap to wear with metal discs, called electrodes, attached to it. You’ll watch a video or listen to audio intended to stimulate different reactions in the brain, and the EEG will measure these reactions to determine what sort of treatment is needed. The electrodes will transmit the electrical activity in your brain to a computer to make it readable by your neurofeedback therapist.

Train the Brain with Positive Feedback

After getting an EEG, you can discuss with your neurofeedback therapist what the best course of action will be for your individual needs, and you’ll then begin training the brain with positive feedback. The goal is to create harmony between brainwaves. Disharmony of the brainwaves — some moving too fast, and others too slow — is thought to be the root cause of many conditions and disorders.

In many cases, you’re asked to “control” a video with your mind, making the screen brighter with healthy thinking patterns and darker with negative thinking patterns. Over time, you’ll learn to control your thoughts and emotions better.

Think of the example of riding a bike: the more you do it, the more it becomes ingrained as muscle memory. Neurofeedback operates under the same concept — if you train your brain to be in certain states (calmness, happiness, focus) more often, you’ll experience those states more often naturally. Neurofeedback also utilizes a reward system, so patients will be “rewarded” with audio or video when thinking in healthy ways. Over time, the brain — seeking a reward — will continue to respond in healthy ways, even without neurofeedback treatment.

Repeat Training

Individuals will repeat training for as long as needed; there is no standard number of sessions, as each person will require different levels and lengths of therapy.

What is Neurofeedback Used to Treat?

One of the most appealing parts of neurofeedback therapy is treating various conditions, from chronic pain to Parkinson’s. While neurofeedback can treat multiple issues, not all neurofeedback therapists can treat all conditions. For this reason, it’s essential to find a neurofeedback therapist who treats the condition(s) you’re looking to treat.

Mental Health and Psychiatric Disorders

Neurofeedback treatment is used commonly in the treatment of mental health problems. This includes those with OCD, anxiety, panic, and other mood disorders. A 2019 study showed promising improvements for people with treatment-resistant depression (TRD): nearly 60% of people with TRD saw improvement in their symptoms and recovery.

Neurofeedback encourages calmer, happier, and safer feelings. For example, treatment for anxiety disorders may involve decreasing excess beta waves (associated with anxiety) and increasing alpha waves (associated with calmness).

Developmental Delays and Behavior Disorders

People with ADHD, pediatric acute-onset neuropsychiatric syndrome (PANS), and autism spectrum disorder (ASD) have had success with neurofeedback therapy.

In many people with developmental disorders, the brain lacks the correct networks for communication. Therefore, neurofeedback can be beneficial for people with autism who struggle to communicate. Neurofeedback can significantly change the brain networks to improve symptoms, communication, and self-regulation.

Neurological Conditions and Brain Injuries

Neurofeedback treatment for those with neurological issues and brain injuries includes those who have traumatic brain injury (TBI), stroke, tinnitus, or Parkinson’s. In Parkinson’s patients, the brain can get “locked” into a particular way of behaving as their neurons travel the same pathways repeatedly. Neurofeedback is groundbreaking for Parkinson’s patients because it allows them to control their brains, creating new neural pathways and improving symptoms.

Athletic and Academic Performance

Even people who don’t have mental health conditions or neurological issues can benefit from neurofeedback. Because neurofeedback calms and focuses the mind, people in high-pressure situations — like athletes, executives, and students—can benefit from neurofeedback to achieve optimal functioning.

What Are the Different Types of Neurofeedback?

Neurofeedback treatment isn’t one-size-fits-all. There are different methods and protocols used to treat various conditions. How does neurofeedback work in the context of each protocol? Read on to find out.

Types of Brain Waves

Amplitude Training

Amplitude training regulates the magnitude of electrical activity at locations in the brain determined to be abnormal through evaluations of the EEG and other symptoms. It focuses on certain parts of the brain that need increased or decreased brainwave activity to function normally. Research shows amplitude training can help with ADHD, autism, anxiety, addiction, depression, learning difficulties, and more.

Slow Cortical Potential Neurofeedback (SCP-NF)

This type of therapy aims to help people with ADHD, epilepsy, and migraines. Research shows it could be a treatment for ADHD as a potential alternative to medication; in a study with children with ADHD who received this type of neurofeedback treatment, results showed improvements in attention, IQ, and behavior.

Z-Score Training

This type of neurofeedback is for people who have insomnia. According to one case study, it even improved a group’s symptoms after 15 sessions that were 20-minutes each. Z-Score training trains multiple brain areas at once to make the brain calmer, relaxed, and alert.

In addition to the different types of neurofeedback treatment, different protocols are used to treat different issues.

Alpha Protocol
Alpha training helps to reduce pain, improve memory, decrease stress and anxiety, and treat brain injuries. Alpha frequencies can also lead to deep breathing, reduced heart rate, and a more regular breathing rate.

Beta Protocol
Beta training is used to improve focus and attention. It can also help with reading ability, cognitive processing, worry and obsessiveness, and helping with alcoholism and insomnia.

Alpha/Theta Protocol
This brain wave therapy is commonly used to decrease stress. It can also treat severe depression, addiction, and anxiety while encouraging creative thinking, relaxation, and healing from trauma.

Delta Protocol
Delta training alleviates pain, headaches, and traumatic brain injuries. It can also improve sleep and anxiety.

Gamma Protocol
This training increases mental sharpness, brain activity, and improves problem-solving abilities. Gamma training also reduces migraines and improves short-term memory.

Theta Protocol
Theta brain wave therapy reduces depression, anxiety, daydreaming, distractibility, ADHD, and other emotional disorders.

What Should I Expect from Neurofeedback Training?

Neurofeedback training is a different experience for everyone. The beginning of treatment may be frustrating, and you may find it difficult at first to control your brain the way you’re supposed to when completing the activities. However, this is completely normal and improves over time.

Because training the neural feedback system requires some focus and concentration, you may feel tired after your neurofeedback sessions. Bio neurofeedback is an adaptive learning process, so you’ll be continually learning and training your brain in new ways with each session. As you progress in neurofeedback therapy, your neurofeedback therapist will track your symptoms with behavioral questionnaires and may also administer a neurofeedback test called the CPT test, which tests attention span and impulsivity. Regular testing and tracking symptoms can help you and your doctor see your progress.

Determine Response to Treatment

Some people who try brain wave therapy may worry that their symptoms aren’t improving and wonder if neurofeedback is effective. Though some people experience significant improvements in their symptoms after just one session, it takes much longer than that for many. Research shows an average of 12-20 sessions is required to achieve maximum benefits from the therapy. Though it may be a slow process, it has a lasting impact.

People who complete neurofeedback training report feeling:
  • Calmer
  • More attentive
  • More focused
  • More engaged with conversations and people


Studies show it’s effective in:
  • Increasing brain activity in older adults, helping the aging brain
  • Helping children with ADHD
  • Helping people with treatment-resistant depression
  • Treating addiction
  • Aiding anger management
  • Lessoning symptoms of chronic fatigue disorder
  • Improving eating disorders
  • Improving obsessive compulsive disorder (OCD)
  • Improving oppositional defiant disorder (ODD)
  • Improving sleep disorders
  • Improving mental health conditions
  • Improving neurological conditions

What Conditions Can It Help?

Because the brain is such an integral part of all the emotions, thoughts, and behaviors humans experience, there may be no limit to the conditions that neurofeedback can help with. Utilizing a neurofeedback test to determine your best course of treatment is the best plan. With that said, the most common conditions treated with neurofeedback are listed below.

Seizures and Epilepsy

Neurofeedback can help epilepsy patients reduce the frequency of their seizures.

In people with epilepsy, part of the brain becomes unstable and can trigger other parts to destabilize, which leads to seizures. However, studies show that neurofeedback makes it possible to “train the brain to de-emphasize rhythms that lead to generation and propagation of seizure and emphasize rhythms that make seizures less likely to occur.”

According to the same study, recent improvements in neurofeedback therapy have made it possible to eliminate seizures or greatly reduce the amount of medication needed to control seizures.

ADHD

Does neurofeedback work for ADHD? A study conducted in 2002 by Vincent Monastra studied 100 children who had been diagnosed with ADHD. All of the children were prescribed Ritalin, and half of them were enrolled in neurofeedback training. The kids who did neurofeedback training in addition to taking Ritalin showed the most remarkable improvements in focus, as well as a significant decrease in hyperactive behavior.

Additionally, only the children who underwent neurofeedback training showed encouraging changes in patterns of brain activity associated with increased focus.

The behavioral and neurological improvements persisted in the children who underwent neurofeedback training even after medication was stopped. However, this wasn’t the case for children who took Ritalin but didn’t participate in neurofeedback treatment. This study suggests that neurofeedback is a promising treatment for ADHD, and it also implies that neurofeedback can have long-lasting effects even after ending treatment.

Stress and Anxiety

Many people deal with anxiety — 25% percent of adults and 20% of children.

A recent study was conducted to monitor brain function during a neurofeedback test to treat anxiety. In this study, 26 people with high anxiety levels underwent real-time brain scanning (fMRI) neurofeedback to evaluate brain connectivity during the process.

By providing real-time fMRI-guided neurofeedback, people trained their brains to promote connectivity between their prefrontal cortex and their amygdala, leading to reduced anxiety during and after treatment.

This study demonstrated that enhanced connectivity between the prefrontal cortex and the amygdala leads to reduced anxiety, and the stronger the connection between these two areas, the stronger the reduction in anxiety.

Bipolar Disorder

Because neurofeedback can help with emotional regulation and control, people with bipolar disorder can benefit from this type of therapy. Neurofeedback can give patients with bipolar disorder more stable moods and improved symptoms of depression and anxiety.

Neurofeedback is known to reduce the need for medication for many conditions, so people who want to stop taking medication may find success in this sort of treatment. Additionally, people with bipolar disorder often have coexisting mental health issues like anxiety and PTSD — two disorders that neurofeedback can also correct.

Acquired Brain Injury

Neurofeedback treatment can benefit people who have had strokes, traumatic brain injury (TBI), brain surgery, concussions, or Parkinson’s disease. Data suggests that TBI survivors may benefit from neurofeedback as it shows a reduction of symptoms related to attention, mood, and mindfulness.

Can Neurofeedback Be Harmful?

Generally, neurofeedback treatment is considered a safe practice and carries minimal risks. The therapy itself isn’t associated with damage or harm to the brain. The most common side effects of the treatment include headset discomfort and tiredness. Still, people wonder, can neurofeedback damage your brain?

The consensus is that neurofeedback cannot damage the brain. Some studies indicate possible brain wave therapy side effects of agitation and irritability in patients with depression and central nervous system impairment.

There is also the chance that neurofeedback won’t work for you at all. Though it has worked for many, there is no guarantee you’ll respond to the treatment in the way you hope or the way your doctor predicts. This comes with the risk of wasting time and money.

Lastly, a risk of neurofeedback therapy is working with an unqualified neurofeedback therapist. Someone who is not qualified could miss important diagnostic information or miss symptoms and behaviors that need treatment.

Discussing Biofeedback

Neurofeedback: Does it Work?

Neurofeedback undeniably has a futuristic, science-fiction feel to it. Many people find it hard to believe that neurofeedback can treat mental health and neurological conditions through audio or video games.

But neurofeedback is an evidence-based therapy that has improved the quality of life for many people. While there is still much to be learned about neurofeedback as a therapeutic intervention, there is also evidence that indicates its efficacy in treating or improving several conditions, in some cases better than medication.

Research from Harvard University explains it best: “An important premise of neurofeedback training is that our brains have the ability to change the way they function. Research over the last several decades indicates that our brains are, in fact, malleable.”

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