What is Neurotherapy / Neurofeedback?

Neurofeedback is direct training of brain function, by which the brain learns to function more efficiently. Neurofeedback is also called EEG biofeedback, because it is based on electrical brain activity, the EEGelectroencephalogram, or EEG. Neurofeedback is training in self-regulation: it is simply biofeedback applied to the brain directly. Self-regulation is a necessary part of good brain function, allowing the brain to function more efficiently and effectively. It aims to help individuals improve emotional, behavioural and cognitive functioning by training patients to increase certain brainwaves whilst inhibiting others, to promote optimal brain regulation. Unlike medication, neurofeedback has long-term benefits as it actually treats the core functional problem rather than simply masking symptoms. Whilst stimulant medications can be effective for up to 12 hours benefit, completing a program of neurofeedback is found to have long term benefits (with current research showing benefits present after 10 years post treatment).

How does it work?

Neurofeedback is based on operant conditioning, a type of training that involves rewarding patients to inhibit certain brain wave frequencies and increase other frequencies. This is done by placing electrodes on the scalp and then providing instantaneous feedback about the brain’s activity. This awareness allows the opportunity to gradually recondition brain activity. Changes in brain patterns are associated with positive changes in physical, emotional, and cognitive states.  Often the individual is not consciously aware of the mechanisms by which such changes are accomplished, although people routinely acquire a “felt sense” of these positive changes and can then access these states outside the feedback session. For the first few sessions of training, individuals will be able to observe the effect of neurofeedback for up to 24-36 hours, and the benefits of neurofeedback will last longer following more training sessions. Standard neurofeedback training usually involves 30-40 sessions. Consistency is very important for the training in order to yield enduring benefits.

Brainwave Modification

There are several dominant brainwaves that reflect different states of arousal. Modification is made to the selected brain waves based on the characteristics of arousal level reported. It usually takes up to 5 sessions to find the optimal training protocol for each individual.

Training for over-arousal

Individuals who are experiencing symptoms of over-arousal tend to have excess beta brain waves and decreased SMR brain waves. Treatment goal for over-arousal individuals is to reduce the level of beta waves, and increase SMR waves. A reduction in excess energy levels allow the mind and body to be more relaxed and calmer, yet alert at the same time.
Examples of an ‘over-aroused’ brain:
  • Busy mind/ many competing thoughts
  • Impulsive
  • Fidgety
  • Hyperactive
  • Easily bored
  • Risk seeker
  • Impatient
  • Agitated
  • Aggressive
  • Anxious/ fearful
  • Tense
  • Feel overwhelmed
  • Frequent tension headaches
  • Holds resentments
  • Difficulty falling asleep

Training for under-arousal

Individuals who are experiencing symptoms of under-arousal tend to have excess theta brain waves and decreased beta brain waves. The treatment goal for under-aroused individuals is to reduce the level of theta waves, the level of drowsiness, and increase beta waves. At the end of each training session, individual should feel more awake, focused and motivated.
Examples of an ‘under-aroused’ brain:
  • ADHD – inattentive presentation
  • Poor concentration
  • Inattentive
  • Distractibility
  • Frequent day dreaming
  • Spaciness/ fogginess
  • Forgetful
  • Lack of motivation
  • Depression/ low mood
  • Lethargy
  • Sensitive/ feelings easily hurt
  • Frequent wake at night
  • Not feeling rested after sleep
  • Falls asleep in low stimulation situations
  • Low self-esteem 

Changes to monitor

Neurofeedback training is a painless, non-invasive, non-pharmaceutical procedure, and patients often report it is a pleasurable and fun experience. Everyone’s sensitivity to treatment varies, not everyone will have the same reaction to the treatment. For the first few sessions it will be important to get feedback about the effects of the training.
Changes to observe after a training session:
  • State of relaxation
  • Feelings of being tense
  • Levels of alertness
  • Clarity of thinking
  • Thinking about problems excessively
  • Levels of anxiety
  • Changes in mood
  • Any physical discomfort. (eg., headaches)
There is no evidence from the literature that the treatment is harmful or that it creates negative side effects. Sometimes in sensitive individuals the training can be too strong and the individual may become overly aroused (if under-aroused) or overly under-aroused (if over-aroused). Usually these symptoms wear off and the training can be adjusted, although it is possible to have the effects reversed in another training sessions if preferred. If you notice any unusual changes or negative effects after a training session, such as anxiety, agitation, difficulty falling asleep, fatigue, feeling spacey/ cognitively dull, please let your trainer know as soon as possible so that training protocol can be modified.

Scientific evidence

Research has shown that problems with brain regulation are associated with a broad range of psychological and psychiatric conditions (e.g. attention issues, anxiety, and sleep issues). Research over the past 40 years has shown that neurofeedback can be highly effective in altering brain dysregulation via principles of neuroplasticity, without the use of medication, in a non-invasive manner. A meta-analysis looking at the efficacy of neurofeedback treatment in patients with ADHD showed that neurofeedback treatment has a medium to strong effect in reducing inattention, impulsivity and hyperactivity symptoms for ADHD patients (Arns, de Ridder, Strehl, Breteler & Coenen, 2009). In November 2012, the American Academy of Paediatrics approved biofeedback and neurofeedback as a Level 1 or “best support” treatment option for children suffering from ADHD. Likewise, the American Psychological Association has also recognised that research has proven this treatment to at the highest level of efficacy of treatment for ADHD (‘Level 5’ by their ratings). It has also shown promising benefits with various behavioural disorders, anxiety, depression, sleep problems, chronic pain, minor head injury and seizure disorders.

Neurofeedback now recognised as one of the most effective treatment options for ADHD. In November 2012, the American Academy of Pediatrics approved biofeedback and neurofeedback as a Level 1 or “best support” treatment option for children suffering from ADHD.

Neurofeedback Monitoring Questionnaires