NOTE: This blog was updated in April, 2021
LW writes: “My wife’s therapist has recommended she start Neurofeedback therapy. After seeing a demonstration of what it is I am a little skeptical of how effective it would be. I’ve searched the internet and only see promotions for it and that it’s supposed to be helpful. Can you provide any information, opinion or recommendation for this type of therapy? Would it be considered New Age?”
Neurofeedback, like its cousin, biofeedback, is not inherently New Age but, as is also the case with biofeedback, the field is riddled with New Age practitioners who make all kinds of outlandish claims about it and are often poorly trained to use the equipment involved. Both practices remain in the realm of alternative medicine (the FDA has not approved the use of its equipment for anything other than relaxation) but have withstood rigorous scientific testing very well and are therefore gaining respect in the medical community.
For those who are not familiar with neurofeedback (formerly known as EEG biofeedback), it involves placing electrodes on a person’s head to monitor brain wave activity. For example, when used as an intervention for AD/HD (attention deficit/hyperactivity disorder), where patients have low levels of arousal in frontal brain areas, with an excess of theta waves and a deficit of beta waves, supporters say it can train the brain to increase the levels of arousal (increase beta waves and reduce theta waves) and thereby reduce AD/HD symptoms. Feedback is given to the patient with cues that can be as simple as an audio beep or as complex as a video game. When the brainwaves are of the desired frequency, the beep may inform the patient, or the character in the game will move in the proper direction. When the patient has learned how to increase these arousal levels, proponents believe improvements in attention will result and that there will be reductions in hyperactive/impulsive behavior. (National Resource Center for ADHD)
Neurofeedback was developed by American researchers in the 1960s and ’70s when it was used as an experimental treatment for conditions such as epilepsy. In 1968, M. Barry Sterman, a neuroscientist at the University of California, Los Angeles, reported that the training helped cats resist epileptic seizures. Dr. Sterman and others later claimed to have achieved similar benefits with humans. (See http://www.ncbi.nlm.nih.gov/pubmed/15564057)
It is also being used to treat autism, depression and anxiety.
An October, 2010 New York Times article describes this treatment as “controversial, expensive and time-consuming. An average course of treatment, with at least 30 sessions, can cost $3,000 or more, and few health insurers will pay for it. Still, it appears to be growing in popularity.” (Neurofeedback Gains Popularity and Lab Attention )
It is also gaining attention from mainstream researchers such as The National Institute of Mental Health which recently sponsored its first study of neurofeedback. Other researchers has found positive results from the use of neurofeedback, but many critics remain, such as William E. Pelham Jr., director of the Center for Children and Families at Florida International University, who is quoted in the Times article as calling neurofeedback “crackpot charlatanism.”
Some of the more recent research, such as a double-blind, placebo controlled study conducted in 2017 to measure its effects on insomnia found no significant impact of neurofeedback on this problem and questioned its usefulness in general.
“Based on this comprehensive and well-controlled study, we conclude that for the treatment of primary insomnia, neurofeedback does not have a specific efficacy beyond unspecific placebo effects,” the study concluded. “In addition, our study may foster a critical discussion that generally questions the effectiveness of neurofeedback, and emphasizes the importance of demonstrating neurofeedback efficacy in other study samples and disorders using truly placebo and double-blind controlled trials.”
The International Society for Neuroregulation and Research (ISNR), which is a membership organization that comprises people from many countries and various professional disciplines doing neurotherapy, neurofeedback training, and neurofeedback research, offers a list of promising research on its website. However, many of the studies had small cohorts and/or concluded with calls for additional study.
You are wise to proceed with caution about neurofeedback. As the Times article clearly warns, this treatment is largely unregulated with practitioners often devising their own protocols about how to conduct the therapy which means results can vary widely depending on what practitioner you use. Researchers caution that it is extremely important to choose one’s practitioner with care. Prospective patients are also warned that the actual devices should not be used by anyone but those who are properly trained.
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