What Happens during a Neurofeedback Session?

Neurofeedback helps the brain to learn how to self-regulate. Once brainwaves are corrected and communication is improved to the central nervous system, unwanted symptoms of common conditions or disorders begin to dissipate. One would begin to see mood, behaviors, emotions and even physical symptoms begin to improve since everything is tied into the brain.

During a Neurofeedback Session:

The individual receiving neurofeedback training sits in a comfortable position and will wear an electrode clipped on each ear lobe, or behind the ear on the mastoid bone. A ground electrode is place on the opposite ear, mastoid bond, or a Z location on the scalp (FZ, CZ, PZ) with an “active” sensor (this could be 1+ sensors) at a particular brain site that has been targeted for training (i.e. the brain sites that the QEEG brain map indicated was different from normal). The active sensor that is designated as the “target” site is connected to the scalp by abrading the area with alcohol or NuPrep and secured with EEG paste. The brainwave activity recorded by the active sensor is then relayed and displayed on the computer monitor. Depending on how many active channels, the EEG brainwave pattern is shown with a thermo (a colored bar) and a moving line at the top of the screen depending on the software being used. Many neurofeedback software programs are set up similarly. 

There are many types of neurofeedback training. Some include fast wave training; such as, SMR up at CZ or PZ. Or at other active sites with the goal is to enhance faster activity (beta). All brainwaves are recorded and determined by multiple colored lines representing each brainwave activity (delta, theta, alpha and beta) and fluctuates up and down in accordance with the individual’s own brain waves. The entire process is based on operant/classical conditioning technique and provides a stimulus with a reward system (tones or fading screen/audio) to feedback to the subconscious brain.  A threshold is set at an appropriate level so when a protocol is determined and the practitioner plans to reward beta brain waves with the goal for beta activity is able to “stay above it” (exceed the threshold) at least 60-70% of the time. Each time the beta “jumps” over the bar (i.e. each time the beta recording reaches or exceeds the set goal threshold), the computer plays a tone, or another stimulus is produce as a reward for reaching the goal threshold (Movie will play, video game will proceed to move character forward or audio or tone will be heard).

With consistent practice and exposure to this feedback, the brain begins to recognize a relationship between its own activity and what is being set to achieve. This is all observed on the computer monitor and it is a subconscious process to the individual. The trainee is comfortably sitting watching a movie or listening to music with their brain relearning how to self-regulate to a more optimal mental state. 

Once the brain learns what is expected to do in order to make the line or bar successfully stay above the threshold a certain percentage of time, and receives the reward, it will continue to do so more consistently. A horizontal convergence appears on the practitioners screen which shows how well the trainee’s brain is learning and responding.

The next phase is looking for vertical compression, this is when the trend lines of all of the component bands begin to compress toward the bottom of the screen. This is the consolidation phase of neurofeedback and indicates that it’s either time to change the protocol or complete a new qEEG brain map. The trend graph lines should consistently complete this trend over a few session that shows the lines converging vertically towards the bottom of the screen 

Although this sounds hard to believe, it has been established that biofeedback can help improve lowering blood pressure by becoming physically aware of breathing and biological rhythms. The same is true for neurofeedback and this process helps most people learn how to control their own brain waves, and optimize their own internal emotional state. The changes seen during a QEEG brain map and neurofeedback sessions are quantifiable and observable through measurements taken during these sessions and assessments. Comparing brain map reports can see observable changes along with taking baseline self-administered tests like the, ATEC,  Becks Depression Inventory and Anxiety Inventory, to name a few.

Neurofeedback learning may be looked at in three ways: subconscious learning, the forming of a conscious association between feelings and brain states, and the development of connectivity and flexibility in neural pathways.

Subconscious learning occurs in a process whereby the brain, at a level below awareness, begins to recognize itself on the computer monitor and to make the changes required to keep the bar above the high jump. As this is occurring, the individual may feel quite disconnected from the process. People feel as though they are simply watching the display and listening to the tones, without experiencing it as a personal process being driven by their own neural activity. This learning is on a subconscious level. This learning process occurs over time and outside the level of conscious awareness.

The second way that learning occurs is through the conscious association between indications that the target is being met (i.e., the visual and auditory cues) and how the individual feels. Often, a description of how it feels to meet the target defies words. For example, many people are unable to express in words what “more alpha” feels like although they can tell when it is occurring.

This process of learning is conscious, and involves the development of an awareness of sensations in one’s body that were not present before. In this way, individuals are able to voluntarily do what is necessary in order to produce that sensation at will. There is the sense that “this is what it is supposed to feel like when I produce more alpha.”

Finally, change through neurofeedback occurs as a result of exercising underdeveloped neural pathways. The more the brain practices moving into a more optimal state, the more flexible it will be in responding to demands. The brain can be hypo- or hyper- connected, which has been shown to as a “lack of” or “too much” communication fluctuating in certain areas of the brain. This can cause an overall lack of communication to the central nervous system and the rest of the body developing many types of negative symptoms.

An example would be a child with ADHD. Many scientific journals have noted that too much theta brainwaves are presented in the child’s frontal lobe, which causes the lack of focus, attention and impulsiveness one would find as key indicators to this particular disorder. When too much activity is present for the brain to sift through  miscommunication occurs to other locations and this is how key symptoms begin to emerge and behaviors are formed. 

Neurofeedback is seldom used in isolation from other techniques. It is commonly used in sessions with your psychologist to include neurofeedback  and other techniques such as EMDR and/or cognitive-behavioral exercises to support the changes you would like to make in your life” (Thompson, 1999).


References:

Budzynski, T.H., Budzynski, H.K., Evans, J.E. & Abarbanel, Al. (Eds.) (2009). Introduction to Quantiative EEG and Neurofeedback (2nd ed.) Oxford, UK: Academic Press Elsevier.

Robbins, Jim. A Symphony in the Brain. NY: Atlantic Monthly Press, 2000.

Evans, James and Andrew Abarbanel. Quantitative EEG and Neurofeedback. San Diego, CA: Academic Press, 1999.

Thompson, Lynda and Michael. Neurofeedback combined with training in metacognitive strategies: effectiveness in students with ADD. Applied Psychophysiology and Biofeedback, Vol 23, No. 4, 1999, pp. 243-263.