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.