If somebody politely tells you you are being loud, will you be more mindful of your volume? Most likely. How about if somebody says in passing that you are always smiling, will you consciously try not to smile? Probably.

In either of the above scenarios, somebody tells you about something you are doing (e.g., talking loudly, smiling a lot), making you aware of it. This awareness leads you to become more intentional about how you act, specifically inducing you to control the behavior in question.

This is pretty much the same way neurofeedback therapy works.

What is neurofeedback therapy?

Neurofeedback therapy is a non-invasive procedure used as a primary or adjunct strategy for managing attention-deficit/hyperactivity disorder and other conditions like depression, anxiety, anger management, stress, migraine, learning disabilities, memory loss, and sleep disorder. It can also enhance focus and help one achieve peak performance.

Neurofeedback is biofeedback for the brain.

Biofeedback is an approach that involves using sensors to measure specific bodily functions and then showing the results on a screen to make the subject aware of the results. The therapist then suggests particular strategies (e.g., change in posture and breathing pattern) that the subject may implement to try and change the results.

In neurofeedback, the bodily function measured is brain wave activity, and feedback is provided through audio and video output.

What does neurofeedback therapy do?

As a biofeedback approach, neurofeedback therapy gives the brain feedback on its brain wave patterns or activity. It’s akin to holding a mirror up to your brain and then telling it (i.e., your brain), “See this? This is how your brain responds to what you’re seeing and hearing.”

Neurofeedback therapy hinges on the premise that the brain can train itself to stop undesirable brain wave patterns on its tracks and generate more desirable brain wave activities. To achieve this, however, the brain must first be aware of what it is doing and how it responds to stimuli. Only then can the brain train itself to self-regulate.

Thus, instant feedback is crucial to neurofeedback. The self-awareness stemming from the provided neurofeedback is what will induce the brain to regulate its brain functions sub-consciously. Only when the brain can see its brain wave activity can it try to control such activity for the better.

How is neurofeedback done?

Before neurofeedback therapy, first, there must be brain mapping. Electroencephalographic scanners are used to “listen” to the electrical signals in your brain. Your EEG readings are then statistically compared against a database of other people’s readings, and an EEG map is drawn to represent your brain’s unique activity patterns.

Brain mapping checks if your brain’s electrical signals are within or beyond the norm. It will also pinpoint potential problem areas that neurofeedback therapy can help address.

After identifying potential issues, the neurofeedback therapist will design a specific brain training plan to address your brain’s unique needs. Once your training plan is ready, you will start with your neurofeedback therapy sessions.

During a neurofeedback session, you will be asked to sit comfortably and focus your attention on a monitor showing your favorite movie or television show. EEG monitors will be attached to specific places on your scalp. The EEG sensors will monitor your brain activity in real time as you watch your show or movie.

Software designed for the purpose will log, compile, and interpret your brain’s electrical signals. Whenever your brain shows desirable activity, the movie or show you’re watching on TV will have much clearer audio and video. The audio and video quality will revert to normal at the end of the positive brain activity.

This change in video and audio quality is the feedback the brain gets on its brain wave activity. Clearer sound and video signal to your brain that it is exhibiting desirable brain activity, while less-than-stellar audio and video quality indicate non-desirable brain wave patterns.

Through repetitive instant feedback, the brain will begin to recognize its brain wave activity and actively regulate it. It will soon start prioritizing desirable brain activity to produce the preferred outcome: clearer audio and video.

Does neurofeedback therapy really work?

Neurofeedback is a brain training mechanism. Does it work? There is evidence to show that it does.

Arns, Clark, Trullinger, deBeus, Mack & Aniftos (2020) conducted a quantitative review of recent studies (a selection of meta-analyses, controlled trials, and reviews). The researchers used a stricter version of the American Psychological Association guidelines to rate the efficacy and effectiveness of neurofeedback therapy as an ADHD treatment strategy. They concluded that standard neurofeedback protocols can be deemed “efficacious and specific,” according to strict APA guidelines and can be considered a well-established treatment for ADHD.

Gray (2017) also conducted a study on the use of neurofeedback for the treatment of the symptoms of traumatic brain injury. That study also exhibited how neurofeedback is a promising treatment modality for managing TBI symptoms.

Another paper published in the Journal of Korean Medical Science (Lee et al., 2019) explores the effectiveness of neurofeedback in depression management. The study shows neurofeedback therapy can be an effective adjunct modality for treating depressive symptoms in patients with treatment-resistant depression.

The above are but a handful of studies conducted on neurofeedback therapy. There are lots more, and they provide evidence that neurofeedback therapy works.

Can neurofeedback damage your brain?

Neurofeedback is a non-invasive procedure. It is very safe and is unlikely to cause any brain damage. Side effects have been reported, but these are often limited to fatigue, sleepiness, nausea, headache, and dizziness.

Such side effects are reasonable considering the treatment method. After all, one watches a TV show with constantly fluctuating audio and video quality. Moreover, the brain exerts some effort regulating its brain activity; that can, of course, cause one to feel fatigued.

What is the success rate of neurofeedback?

In a review of studies conducted on neurofeedback for Parkinson’s disease motor symptoms management, the researchers (Anil et al., 2021) noted a success rate of 47% to 100%.

A review of other studies will show evidence of the effectiveness of neurofeedback therapy as a primary or complementary treatment modality for various conditions like ADHD and depression. However, success rates, like the one mentioned above for Parkinson’s disease, highly vary.

No universal success rate defines the experience of those who have tried neurofeedback. The efficacy of neurofeedback treatment varies on a case-to-case basis. Many factors influence how effective any course of treatment can be, including the therapist, the specific methodology, and the patient’s circumstances.

Neurofeedback Therapy: Alternative to Medication

Neurofeedback therapy is an excellent alternative or augmentation strategy for managing various conditions, including ADHD and depression. You can also use it to improve memory functions and focus, say for an upcoming professional qualification exam. This safe and non-invasive procedure is definitely worth checking out.

Dr. Upasana Gala

Dr. Upasana Gala

Dr. Upasana Gala is the founder and CEO of Evolve Brain Training, an award-winning neurofeedback-centered institute that focuses on using non-invasive brain training techniques to maximize the brain's true potential.

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