ADHD and Neurofeedback

In the most recent edition of European Child and Adolescent Psychiatry, an international group of researchers published a meta-analysis of studies done on neurofeedback. It shows that the effects of neurofeedback training on youth with diagnoses of ADHD are sustained at least six months after training.  The authors found their results promising and called for more study of longer-term effects, as well as non-specific effects.  You can find this study here and an overview of the study here.

https://link.springer.com/article/10.1007/s00787-018-1121-4

https://www.brainclinics.com/meta-analysis-confirms-sustained-effects-of-neurofeedback-adhd

Although neurofeedback practitioners know anecdotally from contact with former clients that the benefits last years, there are few studies that look that far ahead.  One that did was conducted in Australia close to 15 years ago.  It found that children with a diagnosis of ADHD who received 40 sessions of neurofeedback not only did not lose the benefits of training a year later, they actually improved their focus.

Differences Found Between Male and Female Brains

Researchers at the University of Twente, the University of Zurich, and a researcher/renowned neurofeedback specialist at a brain clinic in Nijmegen have found distinct differences between male and female brains, according to a summary from Science Daily.  Using pattern recognition techniques, they found that there are gender differences in beta-wave frequencies (faster-wave frequencies where cognition and intellectual focus are known to occur).   This basic research lays the foundation into further exploration of gender differences, as well as potential gender-specific treatment responses to medical and psychological interventions.  Read more at Science Daily.

https://www.sciencedaily.com/releases/2018/02/180215105949.htm

How I Got Started

Many people, when coming for a consultation want to know about my background and how I decided to offer neurofeedback, so I thought I’d share that story here.

A few years after I had graduated with a master’s degree in counseling psychology, I ran into someone I knew when I had been a student doing clinical work.  She was from a different university, and our paths had not crossed after we finished working at the same non-profit mental health care provider.  So, it was with some surprise that she told me she had been thinking of me and had intended to start tracking me down.  She explained that she had something she wanted to share with me and invited me to lunch to discuss it.

Even though I looked forward to reconnecting with her, I had great trepidation about the fact that she said she’d had me on her mind despite the fact that we’d gone our separate ways years earlier and made no effort to keep in touch.  Who does that, I wondered.  To make matters worse, she had an excited gleam in her eye that made me suspect that she was going to pitch me to get involved in something like a multilevel marketing organization, which I had no interest in doing.

So, I was greatly surprised when she told me she’d been told by a friend about this exciting thing called neurofeedback and was certain it was right up my alley.  She spent almost an hour telling me all about her research into it and insisted that I not take her word for it but start researching on my own.

I was dubious that it could possibly be as wonderful as she made it sound, but I lived up to my promise to look into it, and the truth is that the more I read, the more excited I became. My friend was right that this was something that captured my interest and seemed like an excellent fit. I realized that if what I was reading was true, I could help make a powerful difference in people’s lives within just a few months.  I met with a couple of local practitioners, a couple of home trainers, and read voraciously.  A month later, I agreed to sign up to take a training class along with my friend.

Back then, neurofeedback was the subject of research in neuroscience labs, but almost no universities were teaching courses in how to do neurofeedback. Indeed, it never even came up as a topic in my graduate studies–perhaps this is because it is interdisciplinary and not just counseling or psychology-related.   Regardless of the reason, this meant that practitioners learned to offer it by attending seminars offered by private companies (and still do today).  The week-long introductory course I took with my friend was excellent, but it was obvious that a one-week class was wildly insufficient to be a competent provider.  More training was needed.

So, I signed up for extensive additional training with other companies and learned other theoretical approaches.  I visited the offices of practitioners and studied at their feet to acquire practical tips and techniques.  Once I felt I had enough academic learning, I started practicing with every guinea pig family member or friend who was willing to indulge me.  Then, I did a 500-hour supervised apprenticeship.  And, even though it is totally unnecessary, I took an exam with a certification board to earn the label of certified specialist.  Once past that first and rather steep learning curve to acquire basic competence, I continued to read and learn, because the field of neuroscience does not stand still.

Now, close to a dozen years later, I am grateful to that friend with the crazy gleam in her eye.  She was right that neurofeedback was and is an excellent fit for me.  I love what I do and feel excited about the challenge each client brings.  I feel honored that my clients trust my reliable tool and me to help improve the quality of their lives.

Anxiety Cells Found in Brain

Researchers at Columbia University Irving Medical Center and University of California, San Francisco have found specific cells in the brain that trigger anxiety, according to Neuroscience News.  The discovery of these dedicated cells in an area of the brain called the hypothalamus means that researchers can now explore further why some over-respond to anxiety-producing conditions in their lives and also may help point to ways to alleviate anxiety.  Check out the article here.

To Really Learn Something, Repeatedly Learn It

Neurofeedback practitioners know that brain training involves rewarding the brain for changing, then repeating that reward over and over again until the brain self-regulates into new patterns and ways of being.  It’s why you don’t come just once for training and expect it to stick, you train repeatedly over the course of a few months.  Fortunately, the process is pleasurable, and almost all trainees look forward to training.  This up-ends the notion that learning cannot be fun and that training the brain is somehow a heavy and serious, no-fun business.

I was struck by this article from the website Raptitude, which also emphasizes the notion that if something is worth learning, one needs to study it more than just once, regardless of what that “it” might be.  The author makes the idea of repeatedly learning something sound pleasurable, so I hope you’ll take a couple of minutes and check it out here.

Trying to Decide Whether Neurofeedback is for You?

The longest part of the journey is said to be the passing of the gate.”

Ancient Roman scholar Marcus Terentio

I like to research pretty much anything before I make a significant purchase. I dig up as much data as I can find, make a decision based on those facts, waver, then decide again and again.  Eventually, I make a final decision that usually makes me happy.  My process of constantly revisiting data points drives my husband a little batty, but I happen to enjoy it.

The truth, though, is that after finding all the pros and cons for each option I’m seriously considering, I set aside the facts and choose the one that feels right to me—the option that makes me feel good about my choice. The data I gather inform my decision, but they don’t make it for me. It’s really a gut and intuition thing in the end.  And when I don’t do this, I’m often quite sorry about the choice I’ve made.

I suspect that although most people probably don’t savor the decision-making process itself like I do, most end up taking a leap of faith in the end that they’re making the right choice for them and their situation. If one doesn’t trust her gut, making a choice can be overwhelming.  If money is involved in the decision-making process, choosing to move forward with a decision can be downright daunting.  Questions arise about whether the expenditure of funds make sense for the family, whether you’ll get your money’s worth, whether you’ll be satisfied in the end, etc.

Choosing to spend on a tool like neurofeedback is harder still. It’s one thing to invest in something like a new pair of shoes and trusting that they’ll feel comfortable and serve you well when you get them home and another thing altogether to invest money in something that you’re not even certain you know what it is, let alone that it will help whatever it is you’re hoping it will help.

Making things more complicated is all the noise out there about who is and who is not a good brain trainer. No amount of advanced degrees or certifications matters if that person doesn’t serve YOU well or isn’t really as competent at providing a service as they are at marketing themselves as the very best.

So, what do you do? Gather more data?  Read a few more books?

My opinion is that you step beyond online searches and journal articles and books to find your comfort level. Reach out and interview a practitioner. If that person feels like a good fit and in your gut you have a sense of trust, then you’re probably going to be in good hands, even if you still feel nervous about trying something that, due to the cost and investment of time to work has still not become as wildly popular as I personally think it should be.  (Obviously, if you don’t have a good feeling about a person or clinic’s competence, caring, or ethics, step away.)

People who are considering neurofeedback can reach out to me and schedule a free consultation with no pressure. I do this because I think fitting well with someone is as important as competence with the technology.

I also think environment is important, and I want potential trainees to feel the environment I’ve created for them. If you step into my waiting room, my hope is that you will not feel like you’ve stepped into a medical office.  I have comfy upholstered chairs, an antique table, and a bookcase full of titles you’re welcome to pull down and browse.  I have water and tea available to enjoy, too.

My training space is, I hope, similarly inviting. I try to keep the space as calm and non-clinical as possible for a tool that involves things like EEG devices and electrodes and whatnot. You’ll find even more comfortable chairs, scenes of nature on the wall, and natural elements like rocks and fossils and seashells for those who need fidget items to hold.

As a result, if you’re expecting white lab coats, linoleum floors, and stainless steel trays, I may not be the right fit for you. If you’re looking for competence combined with deep caring and a soothing environment intended to promote relaxation for training, I’m probably an excellent fit. And, perhaps surprisingly for a high-technology solution like neurofeedback, the softer quality of fit really does matter.

Different Music Styles Means Different Brains

Most musicians probably already knew this intuitively, but researchers at the Max Planck Institute for Cognitive and Human Brain Sciences in Germany have found that the brains of classical musicians and jazz musicians operate slightly differently, even when playing the same piece of music.   The work underscores the point that everything we do in life shapes and reshapes our brain–usually in fascinating ways.  Read more about the study at Science Daily.

 

 

The Mind and the Brain are not Synonyms

Dan Siegel is quoted in this article from Quartz about the mind in a lovely way, “”I realized if someone asked me to define the shoreline but insisted, is it the water or the sand, I would have to say the shore is both sand and sea,” says Siegel. “You can’t limit our understanding of the coastline to insist it’s one or the other. I started thinking, maybe the mind is like the coastline—some inner and inter process. Mental life for an anthropologist or sociologist is profoundly social. Your thoughts, feelings, memories, attention, what you experience in this subjective world is part of mind.””

I find this fascinating, because it is sometimes very difficult for my clients to realize that they’re training pools of neurons in the brain and are NOT training the mind.

A link to the article is here:  Scientists say your “mind” isn’t confined to your brain, or even your body

Scientists say your “mind” isn’t confined to your brain, or even your body

Exploring Glial Cells

As far as we know, neurofeedback trains pools of neurons in the brain.  Another type of cell, called glial cells, are far more plentiful in the brain, but glial cells remain largely a mystery to neuroscientists.  Over the next decade, I believe we will see an explosion of research into and knowledge about glial cells.  I share this article from Science Daily to point to exciting things on the horizon.  Check out “Uncovering the Power of Glial Cells” here.

Timing Neurofeedback Training

One of the most frequent questions I’m asked is how often and for how long one must do neurofeedback training to see results that stick. The answer, “it depends,” can be frustrating, so let me share the range possibilities, because I customize work for each client.

Consistency Over Time is the Key

The number and frequency of sessions can change depending upon individual goals and timeframes, but if you want to see results and have them last, it’s necessary to do regular training over time. I like to compare exercising the body to exercising the brain, in that you wouldn’t expect exercising once a week, then skipping a few weeks before going back, to result in greater fitness.  It’s the same with neurofeedback.  To see results, it’s important to come consistently, with no more than a week in between sessions.

The typical person who does brain training comes for sessions twice a week for about five months, then tapers off to once a week and then once every other week before stopping somewhere around the 40-session mark. That said, many want to see results quickly or get as much training in as possible over as short a time as possible.  During spring and summer break from school, for example, many students will come in three or four times a week rather than the usual twice.  They still need the same overall amount of sessions, but condensing the timeframe opens them up to move on and do other things.

It is okay, though, to train more frequently, even every day, if you want to get training over with quickly. For someone that determined, all it takes is commitment to come five days a week. I once had a client who was leaving the area and had a hard deadline for squeezing in as much training as possible.  We did 90-minute sessions (rather than the usual 60 minutes) twice a day for a few weeks and got good results.  It was quite tiring for the trainee, and this extreme commitment to training isn’t for everyone, but it helps show how neurofeedback can be adapted to meet one’s schedule and needs.

The opposite—a little training, spaced out broadly, is not recommended, but it can be done if the trainee is truly dedicated. About a dozen years ago, I studied under a clinical psychologist who had a client that lived several hours away, in an area with no neurofeedback practitioners.  The parents brought the boy consistently, every other week for five years.  Five years!  It took that long to achieve results that lasted, but because the training was never missed, it eventually worked.  This family was highly motivated in ways that most of us are not, so you will find that most practitioners highly frown on such a practice. I personally will not work with anyone less than once a week, and I only agree to do once a week training under special circumstances, simply because it stretches out the process too long.

The other variable in training is the overall number of sessions needed. Most people need about 40 sessions, but I’ve done as few as 20 for people whose brains are already in good shape.  For others, especially those who are older and have more entrenched patterns, as many as 60-70 sessions might be in order.  Then, there are those with really stuck brains, and they may need upward of 100 sessions.  Knowing this can be upsetting, but the reality is that most people can achieve their goals in just a few months.

The bottom line is that neurofeedback training can be customized to meet your needs, as long as you are willing to make the commitment to do the work that will improve your quality of life.