Neurofeedback equipment is not that hard to operate, but it requires expertise to use it well.

If you’re searching for a provider, you of course want someone who has expertise, not just a rudimentary understanding of how to operate their system. The trouble is that it can be a challenge to find the right person, because there is a lot of noise about what makes for a good brain trainer.

The reality is that people from all walks of life learn to do neurofeedback. From my perspective, the largest segment of providers are mental health providers—psychologists, counselors, and social workers. Next in line are lay persons and health-care providers like chiropractors and occupational therapists. The fewest number of practitioners are MDs or DOs—and they’re usually psychiatrists, but not always. Teachers and tutors are somewhere in the mix, too. Neuroscientists in laboratories are increasingly active in researching neurofeedback, but I am only aware of a few who run neurofeedback clinics associated with their universities.

With such a diversity of people from many professional backgrounds involved, it can be confusing for someone who wants to do neurofeedback to find someone who has a solid track record of producing positive outcomes. There is no such thing as a degree in neurofeedback at this time. Looking for licensure is not possible, because no license is required to do neurofeedback. The reason for this is that neurofeedback is a tool to provide biofeedback for the brain. It is not a separate profession.

Moreover, brain training with neurofeedback is safe. The FDA determined that neurofeedback is safe enough to be considered a relaxation tool, so devices do not even need to be registered. There is no safety reason to restrict access to the tool or control who can use the tool. (There is, of course, restriction on who can practice medicine or psychology, so if one is making medical/curative claims, that person should be operating within what is called their scope of practice.)

Over the past several decades, guild organizations have stepped into the breach and tried to assert themselves as the foremost authority and gatekeeper of who is competent at neurofeedback. Associations have morphed over time, as have certification boards. Some groups have even tried to limit who is allowed to do neurofeedback, going so far as to take legal action against people and organizations. It has been a messy battle for power and control.

Sorting through this can be frustrating as a potential trainee, and it can be frustrating on the provider side, too. For example, I acquired certification by completing a 500-hour residency, completing 50 hours of supervision, and passing an examination. After all that work, the certification board folded, so I can claim to once have had that certification, but it does not exist anymore.

Now, my certification comes from a company that only certifies those who use its philosophical approach. It’s nice to have outside affirmation of my training, but at this point in my career, I do not think certification matters very much in terms of my expertise or effectiveness.

Several years ago, an individual who had been called upon as an expert witness in some of the internecine battles over neurofeedback asserted that fewer than 30% of all neurofeedback practitioners sought out certification. Most felt it didn’t add to their expertise and that it was more of a marketing tool than a sign of competence. I agree with that perspective (especially after having clients come to me in the wake of disappointment from working with certified but unskilled providers).

So, what does someone do when looking for a provider? What are the signs of competence? How does one discern and decide? I would argue that the following things matter:

• Years of experience. Look for someone who has primarily been doing neurofeedback—not merely dabbling with a few clients here and there—for a length of time that convinces you they know what they’re doing. If it’s a new practitioner, that is NOT necessarily a problem, as long as they are working under supervision with someone more experienced. Sometimes, new people have a zeal that makes them more attentive than someone for whom neurofeedback has become routine. BUT, someone new who is working on his or her own, without regular check-ins with a mentor or supervisor, is a riskier situation. Again, a license or degree in any field does not confer expertise in neurofeedback. It sounds a bit silly to say, but only training and experience in neurofeedback provide expertise in neurofeedback.

• Instructor status. If someone teaches others how to do neurofeedback, then it is highly likely that they have enough expertise to work with you. Just be sure that the person teaches more than just theory or brain science; they need to know how to DO neurofeedback, not just talk about it.

• Learning background. Ask about where and how a person received their neurofeedback training. Going to a one-week seminar is in no way enough training to be an indicator of competence. There is a steep learning curve with neurofeedback, and although It’s possible to hang out a shingle and do business after a quick seminar, it’s not wise.  That said, don’t be alarmed by people who say that they initially learned through private training. Very few universities in the United States teach neurofeedback. This means that learning is left to private companies, who often do training in hotel conference rooms and online. That is okay and not a sign of a problem. Excellent learning can happen in these environments.

• Substance, not marketing fluff. If someone has a website that makes bold sales promises without much meat in the content, it’s probably best to ask some pointed questions. Advertising (you know the sort—claiming to be the only cutting-edge organization, or the only place that has X credential or skill, or that they’re the largest and best) is not equivalent to expertise. Look for someone who is willing to share their knowledge, not just try to baffle you with superlatives.

• Your intuition about fit. I’ve written in earlier blog posts that I believe the relationship between trainer and trainee is important to outcome. If you feel like you cannot connect with your practitioner, or you’re just a number, or something else just isn’t right, then look elsewhere. There are enough practitioners in the DMV to find the right person for anyone.

I feel that because I’ve just made strong statements about how to determine who may and may not be a good provider, I should re-share my credentials:

I, like most practitioners, did not learn neurofeedback in my graduate counseling program. In the early 2000s, I had almost a month of full-time trainings with more than one organization. In addition, I studied under a clinical psychologist, and I studied under a someone who himself was a protégé of one the research pioneers for the field. I had a 500-hour residency and had over 50 hours of supervision during that time. I once had two certifications but now have one (and I have no intention of acquiring any more certifications). I practiced neurofeedback exclusively for most of my years in practice and only in the past few years added hypnosis. I teach others how to do neurofeedback, primarily through online instruction but sometimes in person. This is sometimes through a company that sells equipment and sometimes private clients who seek my help. I consult with one of my long-time mentors on complicated situations, just to remain sharp and include different perspectives.

The bottom line when you’re looking for a provider is to find someone who has solid training in neurofeedback, is seasoned or seeks guidance from a seasoned person, and is a person with whom you feel you can work. Don’t rely on credentials like degrees (MA vs PhD vs MD/DO doesn’t equate to neurofeedback training) or certifications.

If you think I might be a good fit for you, please reach out. If you’re not in the Northern Virginia area and are reading this, I can either help you with home training or may be able to help you choose a practitioner in your area.

Not too long ago, I had someone say to me that they thought neurofeedback was snake oil. After I recovered from the shock of realizing that this person believed what they were saying and were bold enough to challenge me with it, I wondered how many other people secretly thought this, or perhaps hope neurofeedback is for real but fear that it is not.

Sadly, I think the tactics of some practitioners—who are usually well-intentioned—make it even more difficult to discern what is true and what is not about neurofeedback. There are neurofeedback practitioners who are straining to make neurofeedback into a form of medicine that can diagnose psychological and physical ailments. I have seen QEEG reports (a type of brain-map report) suggesting that it is X-percent likely that a person whose brain map was done has a learning disability or a traumatic brain injury, for example. In my view, that takes the world of neurofeedback way off solid ground. When people see or hear of reports like this, it’s no wonder they question the validity of neurofeedback. Yes, we can often see patterns in the brainwaves that point to problems, but at this time, neurofeedback is not a tool for diagnosing illnesses or disorders. It is a tool for training and reshaping energy patterns in the brain.

Then, there are the brain hackers and high-technology folks who are trying to devise portable devices that can serve as cheap break-throughs to the world of biological self-improvement. Some of these devices work and do what their makers say; many cannot. It’s easy to become jaded when viewing or hearing slick marketing campaigns full of fluff but utterly lacking in substance. The reality is that high-tech, portable devices are probably the direction in which the field of neurofeedback eventually will go. We’re not quite there yet, and potential users are wise to consider it to be a little like the Wild West—there’s gold out there, but it’s pretty hard to find. Regular neurofeedback has been around for decades and remains a much safer bet.

Neurofeedback absolutely has a scientific foundation. It emerged from a UCLA neuroscience lab in the late 1960s. Its practice is and has always been partially guided by what has emerged from research laboratories. This science disappoints some who expect huge, randomized, controlled studies, because it’s smaller in scope and budget than what those with deep pockets can fund. But, the research is there.

Even more progress in the field of neurofeedback comes from practitioners in regular office environments and not just university settings. In the late 1990s and early 2000s, a great number of breakthroughs were discovered by people whose clients guided them to new protocols and approaches. They work.

In the end, neurofeedback is biofeedback for the brain—a computer holding up a technological version of a mirror so that the brain has a sense of its activity and how to change. Biofeedback works. Neurofeedback works.

Does it work for everybody, in all circumstances, for all things? Of course, not. It’s not a magical panacea. It’s a learning tool. It’s way more powerful tool for brain change than the snake oil scoffers want to believe. I like to think of it as a powerful learning tool that involves both science and the art of competent practice. I have seen so many transformations, both big and small, that I trust the process.

If you’re interested in learning a bit more, give me a call or sign up for a consultation. You can see the equipment and how it works, meet me, and better decide whether to use neurofeedback to improve your life.

Back when I took my first classes in how to do neurofeedback, my instructors made sure that we knew the history of neurofeedback. We were taught that, like so many scientific advances, NASA had an indirect hand in moving forward UCLA neuroscientist Dr. Barry Sterman’s research using cats and, later, a research assistant to discover that biofeedback for the brain worked. We learned that Dr. Margaret Ayers, a Beverly Hills psychologist, worked with Dr. Sterman to bring brain training to a few of her clients. We learned that Siegried and Sue Othmer, parents of one of Dr. Ayers’ neurofeedback clients, were so impressed with what neurofeedback did for their deeply distressed child that they pushed to bring neurofeedback to the broader public. (There was also a great deal of drama involved in this process, and still today, people remain upset that so-called “laypersons” like the Othmers could get away with offering neurofeedback.)

What often gets lost in the big-picture story is the Othmers’ son, Brian. He had so many problems in his short life, and neurofeedback played a significant role in alleviating some of his troubles. One can read an overview of his story in the book A Symphony in the Brain, but that book is getting old and is not read by as many people as it was when it first came out.

So, I was pleased earlier this week to stumble across Brian’s story on Siegfried Othmer’s EEGInfo site. I do what I do in many respects because of Brian’s journey; all neurofeedback practitioners owe the entire Othmer family a debt of gratitude. All Siegfried and Sue Othmer had to go on at the time was trial and error. And hope. Their courage, and Brian’s, took neurofeedback out of a UCLA neuroscience lab and brought it to the world.

I encourage you to take a few minutes to read his story, which you may find here. That link takes one to the EEGInfo newsletter page, and as new newsletters get published, older issues slide down. If you are reading this post in the future, please scroll down in time to the 24 August 2024 edition.

Although the general public seems to be much more aware of neurofeedback than it was when I first started doing brain training almost 20 years ago, I think it’s still confusing and perhaps even a bit overwhelming to be someone who’s exploring whether to try neurofeedback or has decided to try it but isn’t quite sure how to choose a trainer. One of the questions I recommend that people ask potential providers is how they get started with new trainees. The answer to that may enlighten you and help you decide which way to go. Below are the ways providers can choose from to get started:

Just Dive Right In.  If you have a practitioner who says something along the lines of trusting the equipment to know what to do with the brain so nothing more than the usual getting started paperwork (your contact info, etc.) is necessary, you have a practitioner who uses one-size-fits-all equipment. Such persons may deny it and will say that the system is so sophisticated that it knows what to do with you. But, such systems train the same spot on the scalp for every person. How these machines operate is a bit of a mystery. They do work for some people, but this type of approach falls short (in my opinion, of course) more than other approaches.

• Systems in which equipment assesses where on the brain to train you, then uses microcurrent to “reset” the brain, are a variant of the dive right in category. Others may feel differently, but I am extremely wary of microcurrent neurofeedback to the point that I do not even appreciate that it is called feedback, as the feedback loop is not really there. Despite knowing that others may feel differently, I strongly do not recommend microcurrent work.

Clinical Interview. If you have a practitioner who tells you they will do an interview and determine where on the scalp to train based on the things you tell them about what is wrong or what you want to improve, this person adheres to a philosophy that trusts that certain symptoms are related to certain brainwave patterns. These practitioners may use infra-low training or other symptom-driven systems, and they generally train at just a couple of spots on the scalp. I think this approach is good when working with young children or other people who cannot tolerate having a brain map done, such as those who have autism or other neurodivergence. I use a variant of this sometimes myself (though I train more than just a couple of places), and I know you can get good results with this approach.

Brain Map. The category of practitioner who tells you they start with a brain map is the sort who wants to “see” what the brain is actually doing before jumping in to training. There is a level of perceived precision that comes with this approach, but there are several subsets, ranging from those who measure very little to those who measure so much and make so many comparisons that it feels like false precision.

Some practitioners use one measurement from one or maybe two spots, call it an assessment or brain map even though it is rather cursory, and go from there. This can work, but it also misses an awful lot if it isn’t accompanied by an in-depth interview to fill in the measurement gaps. People who do this can get results, but it is, in my view, just a step above the “dive right in” category unless accompanied by a long interview.

Some practitioners use something called a QEEG, or quantitative EEG recording. They measure 19 spots on the brain, then send the recording to one of a few companies in the US that maintain databases of brain measurements. Their measurements are compared with the averages in those data bases, and training is based on how far off from those averages any one measurement might be. These measurements rely on the idea that there is a normal brain and that any one person might be within the norm or a few standard deviations away from the norm.

I personally object to the idea of a normal brain and that someone’s brain could be a standard deviation off. I also have found that sometimes, huge reports of EEG findings boil down to training at just one or maybe two spots on the brain. It feels like a lot of overly precise measurement—numbers gathered that a practitioner may not even be able to explain that boil down to the same thing a clinical interview could have uncovered, but with a lot less expense.

My Approach. I use a variety of brain map called a Trainers’ QEEG. This is a QEEG that measures 20 places on the scalp, but it does NOT compare the brain to normal or average. In fact, the recorded data is not sent out to any third-party company to be compared with other brains and is instead processed in my office. I use a system that is filled with algorithms based on what optimally functioning brains resemble. It compares the brain against itself, using things like ratios that researchers have determined are associated with highly functioning people (This may be a bit technical, but one example is that we know that the alpha frequency is best when it’s at least 15% higher on the right-hand side of the brain than in similar sites on the left.).

I like this system for several reasons. One is that it is not based on the notion that there is a such thing as a normal brain. I do not believe that putting a thousand or even five or 10 thousand brain maps together, then taking averages, leads to a picture of a healthy, normal brain. In fact, in the 1950s, the US Navy wanted its jets to have cockpits designed to fit all but outlier pilots. They did thousands of measurements, then took the average numbers and built a cockpit based on the average. Designers were surprised to find that there was not a single pilot with the average measurements, and that the cockpit was more uncomfortable than older ones. The Navy made my point—a mean or median doesn’t equal health, or best.

Another reason I prefer the Trainers’ QEEG (also called the Trainers’ Q) is that it does not assign pathology to a brain. It looks at relationships in the brain that may or may not be helpful to any one person, and those relationships may not be related to mental illness or learning disabilities. Anyone can do brain training to optimize their functioning. I won’t get obnoxious about it, but I really do believe almost anyone could improve their performance in life by doing a round of brain training. You don’t need to be abnormal to work with me and derive benefits.

The TQ also advocates whole-brain training. Some systems will take measurements, then only recommend training one or two places. The TQ advocates for a system called Whole-Brain Training. It entails rotating among spots on the brain in a circuit-like fashion–one day, you might do right-hemisphere training for relaxation, a second day you might train something called coherence, a third day you might train the sensori-motor strip, etc. Many of us who use this approach consider it to be like muscle-training. You wouldn’t train quadriceps only and ignore hamstrings, you wouldn’t train bicep and not triceps, and you wouldn’t lift heavy without including at least a little cardio. In a similar fashion, training one place in the brain might make slight changes, but big, systemic changes come from training the system itself. I love this thoroughness.

Finally, I like that the Trainers’ Q includes a questionnaire of subjective goals and objective information to help build a training plan. As one of my mentors used to say, a poet may want that daydreamy, excessive theta wave to be creative, and an electrical engineer may want that high-quantity of beta wave in the front to keep that linear, logical thinking going. A poet and an engineer are almost certainly going to have very different-looking brains (and will vary still more from an engineer who writes poetry or vice versa), but they may both be high-functioning and have training goals completely unrelated to what someone else might think of as a deficit or problem to be trained away. Questionnaires help us know why people want to do brain training and where they hope to be when they finish. Your goals matter, and brain training should adapt to your goals.

Obviously, I like my approach to brain training. I believe it includes measurements to see the brain without slipping into false precision, and I believe it takes into consideration important qualitative information, too. This does not mean that I would ever say that other peoples’ approaches are insufficient. One can, indeed, get results from almost any competent, experienced provider. It’s just a matter of knowing what you want for yourself and choosing it, and discovering what the options are empowers the consumer.

I hope this gives you a sense of one thing you can ask as you’re interviewing potential providers to differentiate among us. If my approach appeals to you, consider contacting me for a consultation. If you choose an in-person consultation, I will show you the equipment, show you what a brain map looks like, and answer your questions. If you choose an online consultation, we can cover similar ground, but I obviously cannot connect you to my equipment.

Perhaps it was in graduate school, or perhaps it was when I was a resident counselor. I’m not sure at this point anymore, but somewhere along the line, long ago, I learned that researchers had explored all the most popular theoretical approaches to psychotherapy to learn which one was the best. Instead of figuring out which method was best for all things, they discovered that the single most important factor in the outcome for anyone in counseling was the relationship between the counselor and the client.

Years later, I learned that there was a place called Roseto, Pennsylvania, where heart disease was almost non-existent. Researchers studied this tight-knit community of immigrants from Italy and learned to their surprise that, despite bad diets, smoking, working in coal mines, and other unhealthy behaviors, the people in this community almost never developed heart disease. The reason their community stayed well, the study found, was that the people had solid relationships. They ate together in community. They spent time together. They were connected.

Finally, not that long ago, I learned that in Sardinia, one of the famed Blue Zones in the world in which many people live to a healthy 100 years or more, people also maintain relationships. In Sardinia, they walk, get time in nature, and they eat real food, yes, but relationships also have played a key role in their longevity.

Learning that relationship mattered most in counseling effectiveness affected my perspective in powerful ways, not just in my counseling work, but in my philosophies of dealing with everyone in my world. I built my neurofeedback practice around the notion that connection with my clients matters. Roseto and Sardinia reinforced that perspective, and I continue to operate with the idea that my EEG and HEG devices are just part of the story of why and how people retrain their brains’ energy patterns.

Also reinforcing that perspective was my primary mentor and instructor when I got started doing neurofeedback. Her practice was like mine—she worked with one person at a time, making exceptions only to train an additional family member of the client simultaneously. She had a welcoming office environment that was relaxing and comforting. Her presence itself seemed healing, and in the wake of meeting many of her former clients over the years, I know they felt the same way.

So, know that if you decide to work with me, you are most definitely going to get the high-technology touch. I am a strong believer in using technology to allow the brain to adjust itself. I like my tools and gadgets and know they work. I use them well.

Despite my love of using technology to solve problems, though, I believe it’s also important to make a human connection. I have taken to heart the idea that thriving involves good relationships with healthy boundaries. As a result, I purposely have not created a clinic in which multiple people are doing brain training at the same time, with a technician leading people in and out. Instead, you get just me. It’s pretty quiet in my space, and I’ve had more than one person say they wish they could just sit and have a mug of something warm to drink and hang out in my training room for a while.

Have I had people think I’m not scientific enough because I focus on creating a low-stress, softer environment? You bet. There are those who need a white laboratory coat to be convinced that they are working with someone who has expertise, and that is okay. There are practitioners in the area who can offer that experience. There is room for all approaches.

If, however, you’re looking for someone with deep expertise plus the ability to be a calming presence with an emphasis on human connection, I just might be the one for you. As I all-too-swiftly approach 20 years in practice, I am more convinced than ever that trust and connection with your practitioner is as important as knowing what to train, where, how, and when.

Give me a call, or schedule a consultation here.

I have once again heard from potential clients that they are looking for practitioners who have cutting-edge gear, thinking that these people will be the “best” practitioners. Despite the fact that most of my gear is new and pretty fancy, I’d argue that cutting-edge is just a marketing gimmick and not a way in which to choose a practitioner. Here’s why.

Some manufacturing companies market their neurofeedback gear to practitioners (and sometimes, the public at large) as the most scientific and cutting-edge. It’s mostly marketing hype, and I suspect that there are practitioners—especially those looking for a low-effort way to get in to the field—fall for this marketing fluff. That, in turn, makes me wonder what people who are potentially wanting to give neurofeedback a try might think when practitioners pass along this “latest and greatest” mindset to them.

The truth is that the basic equipment gets better and better all the time, but there really haven’t been seismic shifts in what’s available for training.

Neurofeedback is based on measuring the electrical brainwave patterns at different sites on the head, then providing feedback to the body based on those measurements. The electrical signal is picked up by electrodes, and they display on almost all neurofeedback software via an oscilloscope. Basically, all oscilloscopes, regardless of whether a person is measuring electricity from brainwaves or building wiring, show the same thing. Some may have fancier graphics (on one of my pieces of software, I have the ability to change the size of the display, the graphic display of the signal, and even the colors in which it appears), but they all perform the same basic function.

The same is true of what we call amplifiers. The brain’s electrical signal is quite faint, because it has to make it through the bones of the skull, and the signal may include non-brainwave information (called artifact) that needs to be filtered out. The amplifier literally amplifies, or boosts, the signal, and the software filters the signal to help get as clean of a measurement as possible. Amplifiers are more sophisticated than they were in the 1970s, but again, they all perform the same basic task. Some can train one channel—site on the brain—at a time, some can train two, some can train four, and a very few can train eight (though eight-channel systems are rare and not always reliable or helpful). Some come in colorful boxes. Some are bigger in size than others. But, amplifiers all basically do the same thing.

Software makes a much bigger difference than hardware. Some software is marketed as plug-and-play to practitioners, so the devices are set up to be easy for anyone to learn to use quickly. Such devices work when they work, but practitioners are left with little vision to see what’s really happening, and they do not receive a good education on what is happening to any one client, or why, because it’s all happening in a proprietary black box.

I am not a fan of dumbed-down devices and find myself often frustrated with lofty claims of superiority that are more fluff than substance.

Other types of software are more solid, but users frequently don’t receive information on how measurements of brainwave activity get translated in to how to train the brain, where, etc. It’s much simpler to say, “Do THIS,” than to explain why, and when/how to vary from that original plan.

So, if neither software nor hardware are game changers in the “this is cutting-edge” arena, it means that the greatest weakness, and biggest diversifier, in the world of neurofeedback is the education of the practitioner. I don’t mean whether a person has a master’s or a doctorate, or any degree at all, because most graduate programs in mental health do little more than mention that neurofeedback is a tool that exists. Non mental-health professions, such as chiropractic, physical or occupational therapy, or school teaching, receive even less information in their programs about neurofeedback than those in counseling or psychology programs. No degree in anything confers expertise in neurofeedback, it is training in neurofeedback that confers expertise.

As a result, it’s still a bit of a Wild West situation for practitioners, and the buyer must beware. Most learning happens in hotel conference rooms and at conferences. There is great education out there, but whew, it is a challenge to discern, and it is still incumbent upon the client/customer to know to ask about education and not the technology itself (for the most part, anyhow; some one-size-fits-all devices aren’t that helpful even for those with a solid education). There are basic, introductory classes which last about a week in most cases, but they are not enough to really understand what one is doing. Neurofeedback has a steep learning curve, and it requires dedicated effort from each practitioner who is truly trying to master it and not just take shortcuts.

Since I raise this subject, I’ll also share my own background. I started with a week-long program through a company called EEGer. Then, I studied under a psychologist in private practice who took on a few local psychotherapists as students. After that, I took another week-long class with a company called Brain Trainer International. Because I wanted to work for certification, I did a 500-hour apprenticeship with a local practitioner. I’m not quite at 20 years of experience yet, but I continue to study and learn what is happening in the field, and I help mentor future practitioners.

My equipment is new, and I have pieces of software in my toolkit that are brand new to the market this year. Despite all the shiny newness of gear, I would argue that my competitive edge is almost two decades of experience based on solid education. I base this not only on myself, but on someone I studied with who used and got great results from gear that was from the late 1970s. Like that wise teacher, I’ll put my training and experience up against anyone advertising a new kind of hardware any day.