When I first began learning about neurofeedback, I attended training with different companies and different psychologists who had expertise in the field. My understanding grew, but it all finally came together and made sense for me once I met and began studying under Peter Van Deusen, owner of Brain Trainer International.  His approach is practical, science-based, and open to anyone who wants to know more.

Pete’s generous approach to teaching and sharing information did not end with his in-person workshops. He offers video training and online, one-on-one sessions with his staff, and he has built an international network of providers who follow his methods. He has made himself available to brain trainers in ways that many others have not, which is one of the reasons that, although I use approaches and techniques from other pioneers in addition to Pete, I largely follow the Brain Trainer method.

I am such a believer in Brain Trainer’s practical, science-based ways of approaching brain training that, once Pete has finished putting together a new curriculum that is the culmination of three decades in the field, I will be joining just over a dozen instructors nationwide who will be teaching in-person training courses on how to do neurofeedback using the Brain Trainer approach.

In addition to all this effort in to teaching and training, Pete Van Deusen provides in-depth responses to trainer questions on a list-serve for brain trainers.  He recently posted a lengthy response to a newer trainer who had questions about the mechanics of brain training in which he pointed out several key points:  that the brain is a complex system and not a machine, that every brain is the result of how it has experienced the world, and that feedback affects the brain and not the mind.  With his permission, I am re-posting a lightly edited version of his response to that trainer.  Enjoy!

Complex, Adaptive Systems. First, we begin with the recognition that the human brain, often considered the most complex system in the universe, is not a car or a computer or an assembly line or any other “linear” cause-and-effect system. We have examples all around us of what are called “complex-adaptive” chaotic systems.  How is it possible that all these “genius” academics with their Nobel prizes in economics have managed to drive the world’s economies smack into walls despite their brilliant economic models; or that all the published climate scientists who drive our policies keep predicting, based on their best models, that all coastal cities will soon be under water (for nearly 100 years now), that winters will cease to exist, etc. because of a single measure of CO2 levels in the atmosphere?  The answer is simple enough.  Climate and macro-economies are excellent examples of chaotic systems. They just don’t respond in the neat linear ways to theories predict.  They are quantum systems.

So, what is a complex-adaptive system?  In effect, it is a system made up of large numbers of players organized into large numbers of organizations which work together according to some simple principles. As Wikipedia defines it: a system in which a perfect understanding of the individual elements does NOT convey a perfect understanding of the whole.  The rules seem fairly simple: such systems are strongly dependent on their original conditions; their sub-systems learn and change as a result of experience; they are stable because they are self-reinforcing, but they have the potential to change dramatically and very suddenly; and they can be changed by feedback loops.

Pathology vs Normalcy. Most of us have learned about human behavior according to a rather linear approach called the “pathology model”. In that model there is a definable normal state and, hence, what deviates from that is pathological–diagnosable. In neurofeedback, the so-called “scientific” (QEEG compared against a “normative” database) approach is implanted in this model. A person with PTSD, for example, is pathological, and we can define exactly what specific measurable micro-measures of brain activity are the cause by comparing the individual against a statistical construct made up of a bunch of individuals.  This is the equivalent of Newtonian physics, with nice neat rules, vs. quantum mechanics where, for example, a particle can be in two places at the same time depending on where we are looking for it.

If you accept the concept of complex-adaptive brains over the linear approach, then the result is a mind-blower:  EVERY BRAIN IS 100% NORMAL. Based on where it started (initial conditions)–perhaps in the body of a very anxious mother–and based on the experiences that are encoded in the stable energy patterns within it–the brain is the only brain it COULD be. You might even say, “a brain that developed embryonically in a bath of anxiety chemicals and which experience abuse or neglect in its most formative years (when its habitual responses were being developed) and which survived all of that into the present could only be abnormal if it were NOT anxious, hyper-vigilant, unable to trust and balanced autonomically on a razor’s edge.

But that doesn’t mean that every brain is ideally functional given the situation in which it finds itself today.  The habit patterns that drive “what just happens” in its responses to experience may have little to do with the realities or possibilities of its current situation.  In fact, in many cases, those habits end up actually KEEPING the brain in the very state of isolation and fear they were originally designed to protect it against.

So, we can’t go back and change the initial conditions.  And we can’t even remove or expose or understand those experiences (many of which happened before there was language or experience to create a context)–though that is largely the raison d’être of psychotherapy.  And feedback, the only real hope for changing these habits, has two severe limitations:  First, most of it comes from the reactions of other people (that’s how the brain sees the world: I do this, I get that in return). Other people are subjective: the same action may get diametrically opposed reactions depending on with whom you try it or even when with the same person. Second, any complex-adaptive system is self-reinforcing: that is, it sees what it expects to see, and this is especially true if there is a context of meaning or emotion to the feedback.  People who fear social situations experience that others don’t like them, no matter what the others actually felt or did.

It’s pretty hopeless unless you recognize a few things. First, although most clinicians are trained all about the mind–and more specifically the conscious mind–that particularly linear way of looking at things through our left hemispheres–the research for more than 3 decades has demonstrated very clearly that it is not the mind but the brain that controls how we think, feel, act and perform. In fact, it has been shown over and over that our experiential responses (the “what just happens” in our lives) is directly related to electrical/energetic patterns encoded in our brains.  These are very stable. They are learned in response to experience and reinforced until they become habitual.  You may think of them as “subconscious”.  If you are honest with yourself, you will likely have to admit that THEY control us, not our conscious rational/logical mind.  So psychotherapy, which tries to change the brain by changing the mind will always be limited to helping us learn to live with what just happens–but it cannot help us learn to live without it.  The real key is to change the brain–not the mind. When those patterns in the brain are released, what “just happens” in our lives changes, and it changes automatically, and it changes for good.  It becomes the new habit.

About Feedback. Assuming you get and believe all that, one of the crucial tasks of a brain-trainer is to recognize that WE ARE TRAINING THE BRAIN, NOT THE MIND.  But how can we train the brain?  Only way to change a complex-adaptive system is through feedback. But feedback is produced by subjective sources and it is understood by a self-reinforcing entity.

Enter neurofeedback. Its very name tells us that it provides feedback not to the mind but to the brain. And the feedback is produced without emotional characteristic, purely objectively and not subject to “understanding”.  In fact, one of the greatest challenges of a great trainer is to refuse to enter into the client’s (and often her own as well) desire to “explain” and “understand” the feedback. My clients hate it when I do this, but eventually it works. I tell them right up front, “I’m not training your conscious mind. In fact your number one job is to keep your thinking mind OUT of the process.” So when they ask me what the feedback means, or how do I tell if I’m doing well or how do I understand the feedback, I ask them this simple question:  “Who’s asking this?”  They soon realize that it’s their conscious mind asking, and that I’m not going to even try to answer them.  I tell them that brain-training provides a perfect mirror in which their brain can see itself reflected and hence can try new things. The only thing that can mess it up is if their conscious mind keeps jumping between the brain and the mirror and trying to explain or guide or understand.

When we first developed this approach in the middle 1990s with a software called WaveWare, it was in response to the recognition that when we had anxious or obsessive clients, and the feedback gave them points or any kind of evaluatable experience, they would immediately begin thinking and trying and judging.  They moved (in a nice self-reinforcing way) in the direction where they were most comfortable and hence in exactly the opposite direction from what the training was attempting to help them learn. So, we set up the feedback as music. For example, if I am asking the brain to make less 23-38 Hz activity, then I assign a note on the musical scale to each level of amplitude being produced by that brain. I might have the note increase in pitch as the amplitude goes up.  I might have the volume get louder the worse the brain is doing and have it get softer as it moves in the right direction.

Your conscious mind can’t make any sense of it, because you aren’t a brain–or at least you aren’t your own brain.  But your brain is always looking at whatever inputs are arriving and seeking relationships between them and what it has just done. So the brain begins to notice that when it is more activated in a certain area, it effects the music in one way and when it is less activated it affects it in another way.  Of course the anxious client will ask me, what’s supposed to happen?  Is the music supposed to go up or go down?  And I tell them, “it’s just music. listen to it.” But what should happen? There’s no “should” in music, I tell them.  Shut up and close your eyes and listen to the music.

Of course, they don’t believe me. If I were really smart, I’d be as anxious as they are.  And I can see that fast-wave activity staying high or going up as they try desperately to figure it out, or grumble (usually silently) about what a jerk I am, but eventually they usually give up and when they do, the fast activity starts to go down and the brain learns that it can release a long-held habit and the world doesn’t fall apart.  In fact, it might even feel better.

Feedback is very powerful if you don’t try to understand or explain it.  But there are two types of feedback, each of which has specific benefits.  There is continuous feedback and contingent feedback.

The music is continuous feedback. It is never “off”, so the client can’t judge it. Rather it gives information continuously by changing pitch and volume, so the brain learns from it.  The chimes (or the video, which plays/pauses depending on how well the brain is meeting its targets) are contingent feedback.  They give direction.  The brain learns from the music that there is a relationship between what it does and the sound–it writes and plays its music, and the music it plays is its own feedback.  But it doesn’t necessarily know which direction we’d like it to try. The chimes only play during the “best” 10% or 25%, when the brain is surpassing our targets for it.  So I tell the client, “listen to the music. Sometimes you’ll hear the chimes play, and just know that’s VERY good. But don’t TRY to make them play, because you can’t.  Just listen for them so you notice when they play.” Now the brain knows the direction it can go to best test a new way of operating.  And, if the eyes are open and there is a silent fractal video playing, the video runs or pauses (contingently) when the brain is (or is not) meeting the challenge.  All without the conscious mind having to “help” it. 

The hardest and most crucial technical task for the trainer in running a session is to set the targets.  Make them too easy and the client scores all the time and the brain learns nothing. Make them too hard, and the client rarely scores, gets frustrated and the brain learns nothing.  When you have multiple thresholds, it becomes even more complicated.  If you have one threshold set to 80% success, the brain should get feedback about 80% of the time.  Two separate thresholds of 80% each are a different story. One may be passing part of its 80% while the other is in the 20% of not-passing, and vice-versa. Worst case scenario, your client may only get feedback (.8 X .8=) 64% of the time. The more targets you have, the greater the chance that the client may be passing (for example) 3 of them but not all 4 and get no feedback.

This commentary was intended for a professional practitioner, so please don’t feel overwhelmed if some of what Pete Van Deusen said about neurofeedback felt too complex for those of you who are simply trying to decide whether neurofeedback is right for you.  My intention in sharing it was to give you a sense of the thinking behind why and how the Brain Trainer system works.  If Pete’s commentary triggers questions for you, please feel free to email or call me. I’d be happy to answer.

I am offering a Basic Users’ Seminar for those looking to build their expertise in using the Brain Trainer system.

We will cover:

• A review of the Brain Trainer approach to neurofeedback
• The basics of BioExplorer and how to customize it for your needs
• Running sessions, including troubleshooting
• Personalized sessions focused on your questions and concerns

This seminar is for you if you:

• Have done initial training with Brain Trainer but feel like you want more.
• Have a basic idea of what you’re doing but continue to feel like you need in-person guidance.
• Want to boost your confidence that you’re using the system correctly.
• Have many questions but don’t know whom to ask.

I am limiting this seminar to six students so that each person has plenty of time to ask questions and receive focused training.

DATES:  Saturday, September 7-Sunday, September 8

LOCATION: My office in Oakton, Virginia

COST:  $495 if registered by August 15^th, $550 August 16^th and later

TO REGISTER:  Email me for details at Tamera@BrainShapeLLC.com

If you are not yet at the point where you’ve decided to take classes in how to do neurofeedback, this class is not right for you, but you may contact me to explore beginner options. And, if you’re already a basic user who’s ready to take your skill set to the next level, feel free to contact me for more advanced training options.

This isn’t a topic that most practitioners want to address.  We want to share with you our success stories, not the people who have come through our door and left not fully satisfied with their results.

It seems less than honest, though, not to address the naysayers I encounter, usually on social media, who are certain that neurofeedback doesn’t work.  There are reasons they have come to that conclusion, and, although I don’t know any one person’s reasons without having the kind of  conversation that isn’t really appropriate in a public forum, I DO know several reasons why, sometimes, people feel disappointed.  Here they are, in no particular order of priority:

Medication Interactions.  Usually, taking medications doesn’t create a conflict, because neurofeedback trains the brain where it is. However, most seasoned practitioners will tell you that it’s not always easy to get results if the trainee is taking certain medications, especially benzodiazepine-class drugs. I am unaware of any scientific literature that explains this issue with “benzos,” but it’s a widely-experienced phenomenon.

In addition, neurofeedback can occasionally cause a person to experience symptoms of over-medication. Some trainees refuse to coordinate with their doctors to discuss the impact of neurofeedback on their medication regime and whether it is appropriate to reduce the dosage or discontinue the medication.  When no conversation occurs, trainees can end up disappointed.

I’ve also had the experience of having a client who came to me shortly after starting a medication that was causing tics, then was upset that neurofeedback couldn’t resolve the tics that were medication-induced. Neurofeedback is an amazing tool, but it cannot overcome chemically induced problems like that.

Inappropriate Training.  As noted in a recent blog (see it here), there are multiple theoretical approaches to training.  If a person receives training that they don’t need, because the practitioner’s theoretical approach couldn’t see the lack of need, then the training is going to be pointless.

Incompetent Trainers.  This one is a little embarrassing to admit, but sometimes, one encounters either an inattentive or incompetent practitioner. Most often, this happens with practitioners who only dabble in neurofeedback as a small part of their practice, people who are so busy that they are not paying attention to what they’re doing, or people who really shouldn’t be offering neurofeedback at all.  Occasionally, it happens with practitioners who started seeing clients before they really knew what they were doing, but usually, newcomers to the field are careful.  My observation is that student practitioners—such as interns who are trying to learn to provide neurofeedback—are so curious about what they are doing and are trying so hard to absorb so much that they usually do a superb job of monitoring sessions and providing good sessions.  Being new does not equal being incompetent, just as years of practice doesn’t necessarily confer expertise.

Trainee Concerns.  No professional is going to blame a trainee for lack of outcome.  Sometimes, though, people seeking neurofeedback training get in their own way and disrupt the outcome of training.  For example, I have had clients who dabbled in illicit drug use and wondered why something that changes brain state would interfere with brain training. I’ve had clients who stayed up too late at night, got up too early the next day, and then complained that neurofeedback wasn’t helping their fatigue issues.  I’ve had clients—especially teenagers—who extend themselves beyond healthy limits and then wonder why neurofeedback cannot help them focus and function better. I’ve had clients commit to training, then go on so much travel that they could not fit in consistent training. Most of the time, these individuals seem to lack awareness that their habits are more powerful than neurofeedback, which is a gentle teaching tool.  Thankfully, though, my rate of encountering such individuals is pretty low—less than about once a year.

Stuck Brains.  By stuck brains, I mean the brains of people who have challenges such as autism or serious health problems such as PANS, PANDAS, etc. Such people CAN be helped by neurofeedback, but it sometimes takes so many sessions to get modest results that the cost/benefit doesn’t make sense unless a family member learns to offer home training. With such people, it’s usually a guess as to whether a generally recommended round of 40 sessions will get good results.

Disappointing Results.  This happens when neurofeedback DID provide results, but they were not as earth-shattering as the trainee expected.  This comes about not only when providers over-promise, but when trainees are so desperate for a life change that they have unrealistic expectations about what neurofeedback can do. As one of my local, respected colleagues once said to me, “I can help pretty much anybody. The question is how much.” And, I have been known to quip to clients that I can help them calm their bodies and minds, but I cannot turn them into a Zen monk.

SOLUTIONS

Thankfully, there are answers to each of these problems.  First, the trainee can be an alert consumer by asking good questions during consultation sessions to determine that the practitioner is a good fit, seems competent/attentive, has not over-promised, and has a way of practicing neurofeedback with which the trainee is comfortable. You don’t need to be an expert at neurofeedback yourself to get a sense of things. In addition, the trainee can practice good habits and keep in communication with physical and mental health care providers as appropriate.  If you know your behaviors aren’t helpful, change or get help changing (neurofeedback cannot help you shut off your laptop and go to bed at a reasonable hour, for example). Finally, those with serious health concerns are more likely to get good results by creating a comprehensive plan for themselves and making neurofeedback one piece of the puzzle, possibly by learning to home train.

If you have further questions, I’d be happy to hear from you.

Recently, I’ve had clients express surprise that there are different types of neurofeedback, so I thought I’d provide a broad overview of the different theoretical and practical approaches to brain training.  Most forms operate on either the premise that measuring what’s happening in the brain to know where to train is important or that it is not important, but there also is a type of neurofeedback that provides no actual feedback at all.

Non-Measurement Approaches.

Some types of brain training are one-size-fits-all. This means that no matter what your training goals are, you will receive the same type of training as everyone else. Because the locations for this sort of training are generally in a part of the brain called the sensori-motor strip, such training is safe and gentle. It works best when you need training in that part of the brain, and the worst thing that happens is no change at all.  Many practitioners who do measure what is happening in the brain deride this approach because it is behind-the-times and operates blindly, but it does often work and is generally a lower-cost approach, because the equipment is comparatively inexpensive.

Another type of training is based on symptoms or goals.  For example, if one wants to focus better, the presumption may be that a specific site in the left pre-frontal quadrant of the brain is the source of the problem and so must be trained. The symptoms approach is older and tends to work, with the exception of the fact that symptoms may be related to many patterns in the brain and not just something happening in one location. An inability to focus, for example, may stem from issues in several places in the brain. Not too many people use this approach exclusively anymore, but it does come in handy with those who cannot sit still to be measured, especially children.

A third type of training that does not actually look at what is happening in the brain is called infra-low neurofeedback. Practitioners of this type of neurofeedback train the brain below what is usually detectable brain-wave activity, that is, below .1 Hz.  Critics of this approach point out that it is extremely difficult at this low frequency to determine whether one is actually training the brain, and that very little research has been done to back up using this approach at all.  Despite having little solid foundation to explain what is happening, though, ILF practitioners do get results. It takes about the same amount of time as other approaches to get results as other approaches.

Non-Feedback Approaches.

So-called microcurrent neurofeedback does not provide actual feedback to the brain. It involves zapping the brain with a mild amount of electricity, with the idea that this will jolt the brain into resetting itself. Practitioners of this approach claim that it is cutting edge and that fewer sessions are required to get results when compared with regular, EEG-based neurofeedback.  Microcurrent training is not new, however; it just has a new name (it was first referred to as LENS).  Although proponents say it’s a way of achieving results in many fewer sessions (often only 6-8), critics are wary of what could be considered an invasive approach. Not only have I heard of a large number of people who have not achieved results using microcurrent neurofeedback, I have heard of negative results—results that are the opposite of what the user intended.

Measurement-Based Approaches.

One widely known approach to measuring what’s actually happening in the brain before doing neurofeedback training is called QEEG, or Quantitative EEG.  This approach entails measuring 19 channels, or locations, on the brain, then comparing those results with a normative database. What this means is that QEEG practitioners are comparing their trainees to a “normal” brain based on averages in one of several large databases, and the definition of normal depends upon how good the data in the collected databases are.  Although this approach sounds highly scientific, many take strong exception to the idea of a “normal” brain and what that might mean.

Another broadly used, measurement-based approach is the Trainers’ QEEG, or TQ.  The TQ measures electrical activity at 20 spots on the brain and focuses on training the whole brain, not just one or two spots.  It rejects the idea that there is a such thing as a normal brain, and training instead focuses on optimal functioning.  Essentially, the brain map to assess patterns measures the brain against itself rather than a group or a standard of normalcy, allowing for highly customized training.

What’s the “Best” Training?

With all these different theoretical and practical approaches to training, it’s no wonder that someone trying to find a good neurofeedback practitioner can get confused easily.  The truth is that any of these approaches can work well, and a few can also be useless.  If you read or hear someone claiming that their approach is the best/only one that really works, you may want to beware, because such claims are generally based on posturing and marketing more than fact.

I personally rely primarily on the TQ Whole Brain approach, because I like the idea of customized training that is based on seeing what is actually happening in the brain, yet I don’t like what I view as the false precision of saying that someone is “1.5 standard deviations away from normal.”  I like that it’s not a one-size-fits-all way of doing training, which increases the chances of having a positive impact. I also am uncomfortable with what I see as the false promises of training to achieve a normal brain or treating diagnosed mental health disorders that do not correspond with brainwave activity in any meaningful way (There is no one spot in the brain that corresponds with any one diagnosis.).  So, what I do suits my philosophy of training and does not diminish the potential value of other practitioners.

However, I HAVE heard some peculiar theories of neurofeedback that were grounded neither in science nor in more Eastern approaches to brain fitness.  For example, one client came to me after not getting results with another practitioner.  She explained to me that the other person had assessed her chakras to know where to train and was surprised that I did not.  That is not a standard or even acceptable way of looking at electrical brainwave patterns.  Techniques like reading pulses are good for acupuncture or heart-rate variability training, but not for determining neurofeedback protocols.

When my colleagues speak, I like to listen, even when it’s a topic with which I’m already familiar.  Yesterday, Sebern Fisher, neurofeedback practitioner and author of the book Neurofeedback in the Treatment of Developmental Trauma, offered an online talk through the company Sounds True about calming the fear-driven brain.  It’s a great introduction to neurofeedback if you are a Sounds True fan (www.SoundsTrue.com) and is one unit of something they are offering called the Brain Change Summit.

During her presentation, Fisher shared with viewers a video showing the outcome of neurofeedback training for a boy with a severe form of ADHD.  It was one I hadn’t seen before, which is no surprise, as I don’t spend much time surfing the Web looking for testimonials.  Keep in mind that the boy’s story is an extreme positive response to training, and not everyone undergoes a near-total transformation like his.  Still, I like it well enough to share here, and I hope you’ll take four and a half minutes to watch and learn.  Check it out at:  https://www.youtube.com/watch?v=rr1nSXJtVxk

Researchers at Columbia University School of Engineering and Applied Science have once again shown that neurofeedback can be used for performance enhancement.  Their work, which was recently published in the Proceedings of the National Academy of Sciences and was summarized in Science Daily, is, despite the article headline, a first only in its use of virtual reality.  It is not the first to show that helping people to get into what is known as the zone or a state of flow helps improve performance.

The engineers’ work instead builds on a sizable body of work showing that neurofeedback can help performers of many tasks still their head chatter and allow their bodies to do what they’ve been trained to do. Elite athletes and the Olympic and professional level have long used neurofeedback for performance enhancement. Musicians also like to get into that zone, and professor emeritus John Gruzelier of the University of London has done extensive research on the impact of neurofeedback on measures of musicality. Researchers have also worked with Top Gun pilots and Navy Seals.

You can read more details about the research at Science Daily.