Neurofeedback is a training process in which an individual leads his or her brain through exercises that improve its performance and behavior. Much in the same way that a weight training program in the gym enhances muscular tone and thereby improves performance, neurofeedback training, when practiced consistently over a period of time, can improve the performance of targeted networks of neurons in the brain.
To better understand how neurofeedback works, we can think about brain networks and performance using the analogy of the brain as a symphony orchestra. In an orchestra, a successful outcome—making beautiful music—depends on the ability of the conductor and each musician to perform his or her part well and to coordinate his or her part with the rest of the group. A rogue clarinet player or a distracted percussionist can lead to less than optimal, or even sometimes, disastrous results. In much the same way, groups of neurons in the brain function in a similar manner as the conductor or a musician in the orchestra. All the tasks of the brain require these groups of neurons to send their messages at a given tempo and power in coordination with the other “players” in the brain. If another brain region alters its playing in one or more of these ways—perhaps in response to a changing situation in the environment—then each other group of neurons involved in the response must shift accordingly to keep the whole brain performing smoothly.
Our assessment process including the various parts of our clinical evaluation and the quantitative EEG/brain mapping study (QEEG), allows us to see which groups and networks of neurons related to the presenting problems are functioning well and which are not. Once identified, these suboptimal areas of functioning can be addressed and potentially improved with neurofeedback.
Neurofeedback is possible because of advances in computer science and neuroscience that are coupled with the long established principles of positive reinforcement that governs the training itself. Dr. Mitnick consults with Dr. Coben to create effective neurofeedback training protocols. Then our neurofeedback technicians program the training equipment with these protocols as well as provide guidance and coaching to allow the individual to train his or her brain as efficiently and effectively as possible. Four sensors are placed on the scalp and another one or two are placed on the earlobes. The electrical EEG signals can then be recorded from the individual at the locations which are to be the focus of the neurofeeedback training. No electrical input of any kind is transmitted into the brain via the sensors during neurofeedback training; the sensors simply record brain activity in the form of an EEG from their placement on the scalp.
Neurofeedback is a completely painless and noninvasive process. A laptop computer has the job of collecting the EEG signal from the sensors on the head. This laptop is linked to a video monitor that displays the feedback information to the person training in the form of visual feedback in an overlay of a DVD (chosen by the person training) or a simple and fun computer game with movement, color and sound. This feedback to the brain comes in the form of rewarding changes in the visual overlay (in the case of the DVD mode) or sounds and sights (in game mode), guiding the brain to better patterns of functioning .
Neurofeedback training accomplishes its task of improving brain health and performance using positive reinforcement, where a reward is given when certain conditions are met and then withheld when they are not. In neurofeedback training, the conditions that the brain must meet are set using the information gathered from the brain map and other clinical clues from the individual’s history and symptoms.
The brain learns to produce the desired effect in neurofeedback training the same way it learns to do everything else the first few times around: through the process of trial and error. When the brain meets the desired condition, likely randomly at first, and suddenly gets a reward, it begins to get curious and does what all brains are designed to do: figure out how to get more rewards; put another way, it learns how to achieve the goal of producing the desired brain wave activity. Now the brain is engaged in a process in which it is rewarded for persistently and increasingly producing the desired effect. As the brain gets better at this task, the neurofeedback technician makes the task a little more challenging, enough to continue to encourage progress but not so much as to make the brain frustrated or give up. Thus, the brain is learning to do this task just as it learns to throw a ball, learn Spanish or draw a circle, successively approximating until it becomes second nature!
Following each QEEG (brain map) the same neurofeedback exercise is repeated for 10 sessions of approximately 20 minutes, twice weekly (usually 5 weeks). Total training length averages 40 to 50 sessions, but varies widely according to many factors. Neurofeedback works best when an individual is well rested, when he or she is highly engaged in the training process and when the training process is relatively uninterrupted (meaning that the individual is coming consistently to train with as few breaks in the training as is reasonably possible). In addition to an accurate map of the brain and a meaningful psychological understanding of the individual, these other parameters of training need to be observed as well to get the best results. Individuals on medications that affect the way the brain functions (those for ADHD, depression, anxiety or other conditions) will likely have the need for adjustment, usually lowering, of their medications during the training. As the brain becomes healthier, the effects of the medications become less needed. Dr. Mitnick works with these individuals (and any other physicians involved) to make these changes in a smooth and effective way.