Over the next few months, I intend to go back through news reports to share articles on neurofeedback. This is the first of that coverage.

Last summer, a study published in the Journal of Complementary and Integrative Medicine and reported in Medical Xpress showed that a few sessions of neurofeedback made a difference in reducing mental fogginess for people who had undergone a course of chemotherapy. The study was small, and certainly 18 sessions would not be considered enough outside a laboratory setting, but it was promising and matches real-world experiences.

You can read the Medical Xpress article here.

You can read a summary of the study itself here, although the full article is behind a paywall.

My sons took piano lessons when they were little, and somewhere along the line I decided that I, too, wanted to learn. Their teacher squeezed me in after their sessions, knowing full well that I wasn’t going to be able to practice as much as the boys did, simply because my schedule was incredibly full.

One day, the teacher told me that I needed to relax my wrists. I did and proceeded to play. She repeated herself, I checked myself, and again launched in to playing what I was supposed to play. Exasperated, the teacher grabbed my forearm, raised it in the air, and shook it. My hand followed the forearm, rigid in the air. She said, “THIS is not a relaxed wrist.”

I must’ve looked at her in puzzlement, because she sighed. She raised her own forearm, shook it as she had mine, and showed me that her hand flopped around. “THIS is what relaxation looks like,” she explained to me.

Finally, I got it. I THOUGHT my wrist was relaxed, but it was not. Her piano lesson that day taught me so much more than music. I realized that I was way more stressed than I thought I was, and that I hadn’t the slightest idea how to relax until she showed me how physical relaxation actually looked.

This brief interaction happened close to 20 years ago, and it started me on a journey that helped me understand that what we think is normal and relaxed is not necessarily either of those things. It isn’t what led me to neurofeedback, but I was finishing my master’s degree in counseling psychology at the time and knew an important lesson when I received it. I’ve remembered it all these years.

Knowing that sometimes, we are so stressed that we can forget what true relaxation looks and feels like helps me when I work with my neurofeedback clients. I understand that sometimes, when people tell me they feel sleepy during brain training, it is just their nervous system calming them and that the sensation is not a familiar one. I understand what it feels like to rediscover how wonderful a calm mind and body can feel.

I needed a piano teacher to teach me this lesson. I am not sure who or what circumstances in your life led you to realize that you’re too stressed and not at all relaxed. Neurofeedback is an important tool that can help dial down the ways in which you may be bracing yourself—both metaphorically and physically—against the world around you. And, believe me, it feels good to let go of that stress.

Neurofeedback intensives are what they sound like, intensive training for people who want to get started and achieve their goals faster. They are good for people who have deadlines, who are willing to do brain training four or five days a week, and who perhaps have goals or barriers that make intensive training their best option. I find that people tend to request intensive training over the summer and during winter break, making it ideal for college students at home or high school students with flexible schedules. It also works well for retirees, people who work from home with the ability to leave their office at times, and and people such as teachers who get breaks from their usual work.

What is an intensive course of neurofeedback?

Typically, neurofeedback entails two or sometimes three hours a week of appointments. Intensives increase that amount to four or five times a week and on really rare occasion, twice daily sessions.  The point is to complete a full round of brain training in at least half the time and sometimes even faster. I’ve had a few trainees who finished their training in as little as two and a half weeks.

Is it safe to go faster?

Yes. Neurofeedback is safe. It can, however, be tiring to have one’s brain work so hard on a daily basis. Until not too long ago, there were practitioners who offered five-day packages in which a person did neurofeedback for long hours each day. This was usually for a relaxing and meditative protocol called alpha training, but over the past few years, luxury facilities have opened that offer intensive neurofeedback using other protocols, as well.

Can one mix and match the intensive with more regular training?

Yes! It is possible to start off intensively, then back off to a more typical pace. It is also possible to start off more slowly, then work intensively when one’s schedule allows.

Who will this NOT work for?

Good candidates for intensive neurofeedback are the same as those for regularly timed training. They are willing to make the commitment of time and effort to show up and do the work, and they minimize behaviors that will undermine training. Working to get good and regular sleep, eating real food, doing some kind of movement, and being outside in nature all help get better results.

It’s okay if you don’t sleep well, because the relaxation from neurofeedback is likely to help you sleep better. What is not helpful are bad habits like staying up too late, then getting up too early.

It also isn’t the best for people who are taking month-long vacations. If you’re going to be away for more than two weeks at at time, we should talk, because it may be preferable to wait to get started until you’re back in town.

If you have the kind of goals that are outside the more normal 40 sessions, this may or may not be beneficial for you. I suggest contacting me for a conversation about whether it makes sense in your situation, because it will be more nuanced than can be discussed in a generalized blog post.

If you are just wanting to try neurofeedback a couple of times to see how it goes, this is not the path for you, either. It takes time and practice to get results, and dabbling won’t be helpful.

What is the cost?

The cost is the same as regular neurofeedback. I charge $320 for a brain map and $135 per session, charged 10 sessions at a time.

Do you have openings?

I can schedule a brain map, which is typically done before late afternoon, now. By the third week of June, I anticipate having multiple openings to begin training. Give me a call or email me through the contact form on this page for more information.

Sometimes, it’s nice not to have to write everything from scratch. This website from BrainTrainUK provides a great deal of relevant and important information about PTSD, complex PTSD, trauma, developmental trauma, and how neurofeedback may benefit. It includes links to important studies. If you are interested in these topics, visiting this practice’s website is likely to be informative and helpful.  https://braintrainuk.com/

Getting started with neurofeedback usually means having a measurement of one’s electrical brainwave activity, and there are a few ways to go about this. All involve individual electrodes that connect to the scalp and detect the very faint electrical signal that makes it through the skull. The difference is a matter of how those wires are constructed. They can be individually wired, or they can be connected in the form of a cap.

Many practitioners like caps, because there are advantages. Using a cap eliminates the need to know how to find precise spots on a person’s head, because the cap stretches tightly and approximates the right locations.  It also makes it easier for less-experienced technicians to do a good job. And, some people think that using an EEG cap makes one look more technical and professional.

However, I no longer use caps. The primary reason is that my clients never liked them, and I don’t think that people who are coming to my office to train their brains—especially if they need to calm their brains—need to be unhappy to make progress.  There were two key reasons why traditional gel caps were a problem:

• Gel-based caps can cause pain. I’ve had several clients come to me after being in other practices where the cap left angry, red dents in the person’s forehead. All caps fit tightly, and if left on for very long, just plain hurt. Worse, I’ve had clients who said that the syringes and probes for parting hair under the cap drew blood. There is no need for inflicting pain to do brain training.
• Gel-based caps are messy. Caps that use gel, like the red one in the photo, fit like a shower cap (this cap is loosely placed on a styrofoam head, so it does not fit as you see it here). The electrodes protrude below the cap onto the wearer’s scalp, and each electrode has a hole in which one uses a syringe to insert a conductive gel. Even if there is a rare person who doesn’t mind using these caps on a regular basis, the gel is sticky and must be removed with a shower. Going back to work or school after training is possible but made tricky by the gel.

There are also saline-based caps, which are still problematic but have fewer complaints. The saline cap I once used was made with neoprene, and the electrodes protruded below the cap, just like gel caps. One inserts saline into the electrode hole rather than gel, which eliminates the need for showers after brain training. The water just evaporates, and someone doing training can go on to other activities after their appointment with no grooming issues. And, of course, the neoprene caps for saline-based training also reduce if not eliminate the need to know how to apply the international 10-20 system that we use to find spots on the scalp. Despite the ease of use, though, saline caps fit just as tightly as caps that require gel, with the additional hassle of a strap that fits tightly under one’s chin. The clients I tried this with were not happy about how confining the chin strap felt for them, and they still didn’t like having electrodes press into their scalp.

So, I got rid of my caps and now exclusively use electrodes. The electrodes I use require a water-soluble paste but do not need a tight-fitting cap. I use cotton balls with a little rubbing alcohol on them after sessions to remove as much of the paste residue as I can. It takes the same amount of time for me to use electrodes as the caps required, and people leave my office able to be in public without anyone wondering what happened to their hair. The caps may look more technologically advanced, but they function exactly the same as an electrode in that they detect the brain’s electrical signal and transmit it to an amplifier.

The most important part of my decision to stop using caps is that my clients experience no pain or discomfort from doing brain training with me.  No pain, no gain is just not a thing in my office.

Over the past several weeks, I have had clients tell me that doing neurofeedback with their eyes closed feels like a brain massage or brain spa. It made me realize that I have not really talked about what it feels like to have a neurofeedback brain-training session. You may not choose the words brain massage or brain spa, but I think you’d find that it DOES feel pretty good.

During a session, you will have electrodes attached to your scalp if you are doing standard EEG training and a headband if you are doing any kind of HEG training. The electrodes are attached with a water-soluble paste that washes out with soap and water, although I use rubbing alcohol on a cotton ball in my office. Sorry-no shampoo bowls and actual scalp massages are part of the process (though wouldn’t that be wonderful!). It may feel unusual to have someone other than a hairdresser or loved one touching your scalp, but that sensation passes for almost everyone after the first session.

This practice of using electrodes–sensors, really–may vary from what you have heard or experienced in other offices. Some practitioners use caps that look like shower caps, with the electrodes embedded in the cap. Instead of paste, these caps either use a gel that must be washed out later or a saline. I no longer use these caps, because they get uncomfortable after a short while, the gel is messy and usually requires shampooing that same day. I briefly had a cap that used saline instead of gel, which was wonderful in terms of leaving the office after training with a totally clean scalp, but it comes with a chin strap that too many found constricting. For me, the most comfortable option remains larger electrodes and paste.

If you do brain training with your eyes closed, you will get to choose a comfortable position, and you will be listening to reward tones that your brain is triggering the software to play. It is not usually a melody, though it sometimes come close and there are a couple of exceptions to this. It is deeply relaxing.

If you do brain training with your eyes open, you will also hear tones that your brainwaves are earning from the software. At the same time, you will receive visual rewards. This usually means making a video or movie “go” with your brain. It can be a film, or it can be something as simple as occasionally changing screen savers on the monitor in front of you. The reward tones fade into the background as you make the movie go or gain clarity on the photographs, and you may also adjust the volume so that they are not too distracting.

Most people find that eye-closed training is deeply relaxing. Sometimes, folks don’t want to get up out of the training chair to leave the office after finishing their training, simply because it feels so good. Sometimes, people report seeing colors or other images of the sort that may pop up during meditation. Most importantly, those who are unwilling or unable to feel comfortable closing their eyes in the office are not forced to do so.

For those who do eyes-open training, the relaxation may sometimes feel like fatigue, especially at the onset of brain training. Most, even those who are working to increase their focus, will find training calming and sink into the chair while doing their training.

If you’re interested in coming in for a consultation, I tend to play back recordings of sample brainwaves so people can hear an example of the types of sounds they might hear during a training session. If you want, I can also let you see your own brainwaves—it’s kind of cool! I do not typically allow for a sample session with real feedback, because I want to see and measure your brainwaves before doing any actual training. I think most people can get a good sense of things anyway.

Whether you call it a brain spa, a brain massage, or just plain brain training, I think you’ll end up agreeing with me that it feels nice.

When neurofeedback first emerged from a neuroscience laboratory at UCLA in the 1970s, it was to a psychotherapy office in Beverly Hills. The clinical psychologist there offered neurofeedback the same way one typically does psychotherapy—once weekly. Since then, however, various practitioners with various philosophies have developed their own approaches to how much and how often to train.

You will find that psychotherapists who have discovered the power of neurofeedback and want to integrate it into their mental health care offerings still tend to provide brain training during their psychotherapy sessions, one-to-four times a month, with the actual brain-training portion of the session lasting perhaps 20 minutes.

Then, there are practitioners of neurofeedback spin-off modalities such as pIR HEG (passive infra-red hemoencephalography) who also offer sessions once weekly, but for 30 minutes. They have found that doing more than 30 minutes of training in any given session can lead to over-training and rebound effects, meaning that whatever you’re training to reduce bounces back even more strongly not too long after finishing that day’s training. Even when twice weekly pIR HEG sessions happen, they seem not to get a person to the finish line any faster. This is once instance in which I agree with the once-weekly approach.

However, with standard EEG neurofeedback, we have progressed in our thinking and have found that multiple and longer sessions each week bring fast and lasting results.  In fact, some practitioners until recently offered five-day intensives in which trainees engaged in neurofeedback training for many hours each day. This method benefited individuals who either didn’t have a practitioner near their home or who wanted to hurry up and be done with sessions (often, busy executives who traveled intensively).

Many of my colleagues, however, are at neither the extreme of stringing out sessions to once or twice a month nor of training for many hours each day. This is because we have found that once-weekly sessions still require the same number of sessions to make results “stick” without requiring a series of follow-on tune-ups that some recommend.

We have stepped away from being caught in the psychotherapy model and instead operate on what we believe is a better practice for most types of neurofeedback—a once and done model of training at least twice weekly, and finishing up altogether in only five-to-six months. If you come to my office, then, you can plan on two one-hour sessions each week, with about 40 minutes of actual brain training per session. The reasoning behind this approach is that, in the beginning, any results from neurofeedback last only 12-24 hours, depending upon the person. If one trains twice weekly, that provides more productive and relaxed time after sessions each week. As sessions progress over time, the results spread out to last days at a time, and then to last, period.

Some people do prefer to train even more intensely. Typically, a more intensive schedule would start out with sessions initially every three or four days, then taper down to twice a week as the results build. It is also fairly common to have individuals who are on super-tight schedules who wish to train still more frequently, with daily or even multiple times daily sessions. This is common among college students home for break or younger students with busy summer camp and travel schedules.

The twice-weekly framework becomes even more beneficial when one is sick or traveling. If one falls ill and misses a once-weekly session, that means no training occurs for two solid weeks (yes, they can reschedule, but life in Northern Virginia often means the calendar fills in around regularly scheduled appointments). If a trainee misses a twice-weekly session, that second session in the week is already built in to daily life, so there is a reduced chance for backsliding.

This whole topic of how much and how often to train can end up being confusing to a person who wants to pursue brain training but isn’t sure what the best approach for them or their child may be. My bottom line is that I want my trainees to come for sessions as often as they can without it being a burden so that they can finish up as quickly as they can, and hopefully never needing to return for “tune-ups.” For the average person, this means around 40 sessions, with my normal range going from 25 to 50 sessions. I have found that those who stop after only 20 sessions have their results fade over time, and returning for another 10-20 sessions seems like a waste. I won’t do that.

If you are considering neurofeedback and aren’t certain about how training could fit into your calendar, call or email. If it doesn’t sound like a good time to be doing training, I will tell you that.