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.

People often ask me whether they are a good candidate for neurofeedback. Brain training is not a medical treatment, so it’s not like filtering out whether you’re a good candidate for something like Lasik, for example.  Instead, it’s more a matter of attitude.  If you’re thinking about  trying brain training, consider these seven signs that it might work well for you.

1. You can attend consistently over time. Training the brain is akin to training the rest of the body in that you can’t just go every now and then and expect results. If you’re willing to come to regular appointments, neurofeedback is likely to work well for you. Conversely, I’ve had to turn away people whose travel schedules meant that they couldn’t attend regularly.  For them, it’s a waste of time and money.

2. You’re willing to provide feedback. Neurofeedback is not about a practitioner waving a magic wand. Rather, it’s about trainer and trainee working together to achieve a mutual goal. For this to happen, people who do brain training must be willing to provide feedback to the person managing their training.

3. Your thyroid is under control. Neurofeedback “sticks” the way learning any new skill sticks in the brain. Some things, however, impede this process, and unregulated thyroid disorders top the list. If you want to do neurofeedback and know your thyroid is wonky, it’s preferable to start working with a physician first to be sure that your thyroid is under control.

4. You are ready to let go of any addictions to drugs or alcohol. Neurofeedback is a gentle teaching tool and can be undone by leaving a session and going home to get high. Talk to a practitioner about your drug or alcohol usage and how it might affect training sessions.

5. You are taking other steps to improve your health. Some of my clients with the best outcomes have been those who most of the other things they need to do to take care of themselves: they try to create good sleep habits, improve their nutrition, see their physician if needed, get counseling if needed, and do other bodywork in the form of acupuncture, chiropractic care, massage, or cranial sacral work, if needed.  This doesn’t mean you need to be perfect in every way; it simply means you must be open to the idea that neurofeedback does not occur in a vacuum.

6. You follow your doctor’s instructions. Those who consult with and follow their treating physician’s advice tend to have better outcomes because their overall health improves.

7. You are fed up with the status quo and are ready for change. The number of people who are not really ready for change but give lip service to the idea of feeling different is surprising. I’m never quite sure whether it’s fear of the unknown or fear of spending time and money on something they know little about and so are skeptical, but most of my former clients will tell you that taking that leap of faith was worth it.  If you are ready to optimize your functioning in life and are prepared for changes, then neurofeedback may be right for you.

That’s really all there is to it. If you are interested in learning about how neurofeedback works, give me a call.

About once a year or so, I encounter someone who is afraid of neurofeedback and asks about the harm it can do. It feels like now is a good time to address this issue once again.

Neurofeedback is a form of biofeedback for the brain, which means that individuals have the metaphoric equivalent of a mirror held up to the brain and then receive rewards in the form of audio tones, making a movie go, or advancing in simple video games. It’s non-invasive, and many think of it as a teaching tool for a part of the body we don’t normally think we can control.  Given that it is such a gentle tool, it should come as no surprise that:

There are no scientific studies published in any peer-reviewed journals which indicate that a full training regimen of neurofeedback (25-60 sessions, depending upon the person) causes any lasting harm. None. 

This fact often isn’t enough to convince people, especially those who’ve read some of the wilder opinion pieces available from so-called authorities on the Internet, so they press for more details. Except, there really aren’t more details.  In the hands of a competent and attentive practitioner, the worst outcome is nothing changing.  This generally happens as a result of medications or conditions beyond the scope of neurofeedback.  It may also come from a practitioner using a one-size-fits-all approach to training rather than customizing training to individual needs.  Nothing changing is a frustrating waste of time and money, but it is not a physical harm.

The vast majority of the time, the opposite happens, and brain training feels good. Indeed, most of the so-called “side effects” of training please the people doing training.  Quite often, for example, people who train with me experience improved sleep, most likely because their bodies are relaxing for the first time in ages.  I’ve also had people experience side effects such as improving academic performance, learning to read music far more quickly than expected, and having aversions fade away.  My theory as to why this happens is that neurofeedback is not a tool that precisely targets specific pathways in the brain.  Instead, it trains pools of neurons within a couple of centimeters of each other.  This means that something as simple as training to relax results in the effects of relaxation in more than one aspect of life.

All this said, in the hands of incompetent or inattentive practitioners, there can be short-term troubles. I have heard stories of practitioners and technicians who have trained the wrong things during sessions and caused increased anxiety and/or panic attacks.  Even then, these are transitory—lasting less than a day—unless a person continues training the wrong thing for long enough that it becomes an ingrained pattern.  It’s hard to imagine a trainee tolerating that kind of negligence.

Occasionally, some individuals feel tired after sessions. This sense of fatigue most likely comes because the brain isn’t used to what the exercises are rewarding it for doing, and it almost always passes 10-15 minutes after the end of a session.  It is not practitioner error or a harm any more than tired muscles after a workout at the gym are a sign of harm.

The Real Question of Safety

The bottom line is that even though I have responded in this post directly to the question of harm, this generally isn’t really the question people want answered. The actual question which lies underneath this concern of harm is, “How do I know I can trust you with MY concern or with MY loved one?”

My response is that I do neurofeedback because I have passion for it as a tool. I’ve been using it for a long time, and I work on learning still more so that I am continually improving.  I have spent my entire professional career focused on appropriate service to others, and I promise to you that if you take the leap of faith to work with me, you will experience the caring that underlies my commitment to brain training.