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.