Neurofeedback

Neurofeedback (NFB), also called neurotherapy, neurobiofeedback or EEG biofeedback, enables an individual to train brainwave activity, as measured by electrodes on the scalp, via feedback of EEG information in the form of a video display, sound or vibration. If brain activity changes in the direction desired by the therapist, a positive "reward" feedback is given to the individual, and if it regresses, either a negative feedback or no feedback is given (depending on the protocol). Rewards can be as simple as a change in pitch of a tone or as complex as a certain type of movement of a character in a video game. This experience could be called operant conditioning for internal states.

A number of different brainwave goals have been proposed by different researchers in the field. Generally, these goals are based upon research describing abnormal EEG patterns or on results from a quantititative EEG (QEEG). A popular goal is the increase of activity in the 12–18 Hz band (beta1/SMR (sensori-motor rhythm)) and a decrease in the 4–8 Hz and/or 22–28 Hz bands (theta and/or beta2). The most common and well-documented use of neurofeedback is in the treatment of attention deficit hyperactivity disorder: multiple studies have shown neurofeedback to be useful in the treatment of ADHD  (Butnik 2005) (Masterpasqual et al 2003). QEEG has shown that ADHD is often characterized by an abundance of slow brainwaves and a diminished quantity of fast wave activity (Butnik 2005); neurofeedback treatment seeks to teach individuals to produce more normalized EEG patterns.

Some ADHD researchers are unconvinced by these studies, including the psychiatry professor and author of several books on ADHD, Russell Barkley. Barkely opines that neurotherapy's effectiveness in treating ADHD can be ascribed to either uncontrolled case studies or the placebo effect : in return, neurofeedback advocates note that Barkely has received research funds and personal remuneration from drug giant Eli Lilly pharmaceutical and other drug companies.

Other areas where neurofeedback has been researched include treatment of substance abuse, anxiety, depression, and epilepsy.

Related technologies include hemoencephalography biofeedback (HEG).

History and application
In 1924, the German psychiatrist Hans Berger connected a couple of electrodes (small round discs of metal) to a patient's scalp and detected a small current by using a delicate galvanometer. During the years 1929-1938 he published 14 reports about his studies of EEGs, and much of our modern knowledge of the subject, especially in the middle frequencies, is due to his research (Kaiser 2005).

Berger analyzed EEGs qualitatively, but in 1932 G. Dietsch applied Fourier analysis to seven records of EEG and became the first researcher of QEEG (quantitative EEG). (Kaiser 2005)

Later, Joe Kamiya popularized neurofeedback in the 1960s when an article about the alpha brain wave experiments he had been conducting was published in Psychology Today in 1968. Kamiya’s experiment had two parts. In the first part, a subject was asked to keep his eyes closed and when a tone sounded to say whether he thought he was in alpha. He was then told whether he was correct or wrong. Initially the subject would get about fifty percent correct, but some subjects would eventually develop the ability to distinguish between states and be correct a highly significant percentage of the time. In the second part of the study, subjects were asked to go into alpha when a bell rang once and not go into the state when the bell rang twice. Once again some subjects were able to enter the state on command. Others, however, could not control it at all. Nevertheless, the results were significant and very attractive. Alpha states were connected with relaxation, and alpha training had the possibility to alleviate stress and stress-related conditions. Neurofeedback appealed greatly to the social movements of the 1960s as well, when altered states were a lifestyle. For example, in 1973 Elmer Green took a portable psychophysiological lab to India to study Eastern holy men, all of whom possessed the incredible ability to control their heart rate, blood flow, and other autonomic functions, all of whom generated alpha waves continuously while doing so, according to Green’s EEG. Despite these highly dramatic and compelling claims, the universal correlation of high alpha density to a subjective experience of calm cannot be assumed. Visuomotor activity seems to be of primary importance in alpha neurofeedback, and the ability to generate alpha with the eyes open and the lights on could develop different skills and results if the procedure were carried out in total darkness or with the eyes closed. Alpha states do not seem to have the universal stress-alleviating power as the early expectations indicated. However, this is not cause to reject the concept of biofeedback entirely. Many other biofeedback treatments have emerged, since Kimaya’s alpha experiments.

The work of Barry Sterman, Joel F. Lubar and others has indicated a high efficacy for beta training, involving the role of sensorimotor rhythmic EEG activity. This training has been used in the treatment of epilepsy, attention deficit disorder and hyperactive disorder, and other mood disorders. The sensorimotor rhythm (SMR) is rhythmic activity between 12 and 16 hertz that can be recorded from an area near the sensorimotor cortex. SMR is found in waking states and is very similar if not identical to the sleep spindles that are recorded in the second stage of sleep. Studies have shown that enhancement of sensorimotor activity through operant conditioning designed to increase SMR is an anticonvulsant process and is therefore an effective treatment for epilepsy. For example Sterman has showed that both monkeys and cats who had undergone SMR training had elevated thresholds for the convulsant chemical monomethylhydrazine. These studies indicate that SMR is associated with an inhibitory process in the motor system and therefore increasing SMR through operant conditioning increases the ability to control seizures. Most of the individuals who have been treated with biofeedback in research studies are among the most severe epilepsy patients, where anticonvulsant drug therapy was unable to control their seizures. However, even in this most severe group of patients, research found that beta and SMR training on average produces a 70% reduction in seizures. In these severe cases of medically intractable epilepsy, biofeedback has been able to facilitate greater control of seizures in 82% of patients.

Lubar addressed attention disorders using essentially the same protocol. His research indicates that by inhibiting motor function, input function, which relates to attention, is also inhibited. Lubar’s protocol, which has been adopted by most practitioners as the standard protocol for treating patients with attention disorders, is to inhibit both 2-10 Hz slow waves (alpha and theta) as well as 19-22 Hz waves and encouraging activity in the 12-19 Hz range. This procedure has been supported since alpha activity is known to decrease during cognitive functions and to be inversely related to metabolism. Lubar’s hypothesis for what is happening in an ADD brain is that there is a decreased metabolism and decreased blood flow to the subcalossol cortex. Alpha is inhibited to counter these problems. Lubar has published 10-year follow-ups on cases and found that in about 80% of patients biofeedback can substantially improve the symptoms of ADD and ADHD, and these changes are maintained. Currently, treatment for attention disorders is the most common application of EEG biofeedback. However, the treatment is also effective in the treatment of traumatic head injuries and sleep disorders as well as epilepsy.

More recently, within the last 5-10 years, neurofeedback has taken a new approach, in taking a second look at deep states. Alpha-theta training has been used in the treatment of alcoholism and other addictions as well as post-traumatic stress disorder, the dysphoric disorders of women, musicians, and psychopathic offenders. This low frequency training differs greatly from the high frequency beta and SMR training that has been practiced for over thirty years and is reminiscent of the original alpha training of Elmer Green and Joe Kamiya. Beta and SMR training can be considered a more directly physiological approach, strengthening sensorimotor inhibition in the cortex and inhibiting alpha patterns, which slow metabolism. Alpha-theta training, however, derives from the psychotherapeutic model and involves accessing of painful or repressed memories through the alpha-theta state. The alpha-theta state is a term that comes from the representation on the EEG. During this therapy, when the alpha waves amplitude is crossed over by the rising amplitude of theta waves, the state is called the alpha-theta crossover state and is associated with resolution of traumatic memories.

The physiological mechanisms behind these therapies are very unclear, but the theory is that repressed memories and unresolved traumas exert a stress on the brain that interferes with normal operation. EEGs of alcoholics have revealed an inability to produce the alpha waves generally associated with feelings of relaxation and comfort. However, following the use of alcohol, theta and alpha waves increase. This can be expected considering the drowsiness and relaxation are common effects of alcohol. Therefore, alcoholics may be self-medicating their abnormal level of low frequency waves. Studies have demonstrated a high efficacy of alpha-theta therapy in treating alcoholism. Peniston and Kulkosky found that while alcoholics in a control group receiving standard treatment showed significant increases in beta-endorphin levels as a result of stress caused by abstinence from alcohol, alcoholics receiving the alpha-theta treatment did not. On four-year follow-ups only 20% of the traditionally treated group of alcoholics remained sober, compared with 80% of the experimental group who received neurofeedback training.

Low Energy Neurofeedback System (LENS)
The LENS system, or The Low Energy Neurofeedback System is a neurofeedback system that uses an electromagnetic field as the carrier wave for the feedback. With this method, the EEG leads serve as bi-directional conduits for both the brainwaves and the feedback signals. This neurofeedback method is distinct in that the duration of treatment for ADD/ADHD, depression, PTSD, Tourette’s, and seizures is claimed to average a fewer amount of sessions, and the system settings and electrode site selection change from client to client, and for any client, change from time to time. In addition, the same range of side effects as occurring with traditional neurofeedback appear more rapidly.

Scientologists, Parapsychologists, and Less Mainstream Users of Neurofeedback


Some neurofeedback equipment companies make extraordinary claims based on the scientific appeal of electronics and the mysteries of the brain. For example, some brain training products are sold to consumers promising to raise the IQ (Scientology), self esteem, and to reach zen meditative and deep hypnotic states. Furthermore, paranormal activities such as remote viewing, past life regression, and other psychic phenomena and development have been associated with neurofeedback, especially concerning the sale of the equipment. It is claimed by some neurofeedback machine sellers that psychic phenomena are commonly experienced when using neurofeedback during any session.

The Church of Scientology claims that its methods of Scientology auditing may entrain the brain, leading to the same benefits as proposed by neurofeedback researchers. These benefits include heightened spiritual awareness, increased mental health, brain repair, reduced stress, and increased attention, IQ and memory. Scientologists claim that auditing offers feedback to the subjects, allowing them to maintain healthier states of mind by entraining brainwave patterns and stimulating healthy activity of neurons, while removing emotional blockages and body thetans. Though the majority of Scientologist "audits" take place using an E-meter, a simple galvanometer, according to Dianetics Scientologists also use a combination of EEG and EDA (electro-dermal activity) using electroencephalographs, amongst other methods, for neurofeedback.

Measuring the brain's activity is a standard procedure in medicine, and can give interesting indicators of how the brain works. Whether EEGs can be used to improve spiritual awareness is still inconclusive.

See also: Psychophysiology, the study of the connections between neurobiology and psychology.