It Really Is All in Your Head: Neurofeedback Can Change Your Brain
By Joan Trossman Bien 08/26/2010
Science fiction is now science for everyone
You’ve seen the old movies. A terrified victim elaborately wired up with electrodes on the head, strapped down in the lab of a mad scientist. He is about to steal the brain with the flip of a switch. Visible electrical impulses zap through air as the loud buzzing confirms that, YES, it is WORKING! And then the poor captive’s brain is emptied. That is what many people envision when the process of “neurofeedback” is described.
However, despite placing some electrodes on the patient’s head, actual neurofeedback is quite gentle. It is often a very effective way to either reduce symptoms or eliminate them altogether for a wide range of brain-related issues.
And instead of some wild-eyed scientist in a dirty lab coat maniacally throwing a switch, the real control rests entirely with the patient’s own thoughts.
Neurofeedback is a more sophisticated cousin of biofeedback that specifically alters the brainwaves of the patient in order to alleviate brain-spawned symptoms. The technique has been researched and closely studied for 30 years. New research is showing promise for previously untreatable conditions.
Even critics of mainstream brain studies have endorsed neurofeedback therapy. Mark Waldman is an author from Camarillo who specializes in the brain-related benefits of meditation and prayer. Waldman is a vocal skeptic of many traditional medical practices and studies, yet sees great potential in neurofeedback.
“Neuroscience is in such a state of infancy that I like to say that we’re mostly doing neuro-speculation,” Waldman said. “But I am very impressed with the research on neurofeedback.”
Simply put, neurofeedback is performed the same way as biofeedback, by being hooked up to a monitor of one’s own body functions, only it focuses on the patient’s brainwaves. With biofeedback, the patient watches heartbeat, blood pressure and other functions that are normally out of his or her awareness, and attempts to regulate them.
Neurofeedback is similar but often begins with a quantitaive electroencephalogram (QEEG), which is used to create a map of the brainwaves. Using this map, the therapist diagnoses what is going on in the brain, pinpoints the exact brainwaves that are irregular, and designs a treatment program for teaching the patient to regulate his or her own brain waves. Once the brainwaves are altered, the patient feels a lessening of symptoms and a boost in the brain functions. Sometimes, the results can be permanent.
The benefits of neurofeedback are many. The treatment is noninvasive, it does not affect any other part of the body in the way that medication affects the whole body, and there are no reported negative side effects.
But neurofeedback has its problems, too. For many conditions, the therapy is a long-term and continuous comittment that demands great motivation and participation by the patient. This often requires two or three visits to the therapist each week, often for several months. The equipment is expensive and is usually only available in the doctor’s office, although some therapists have developed mobile treatment.
And the biggest hurdle for many people is the cost of neurofeedback therapy. If a pill is available that is designed for that condition, insurance providers would prefer the cheap and easy road of medication. Patients who may be time-constrained or who are looking for immediate relief generally find taking a pill to be a lot easier than going to the therapist two to three times a week.
Also, while medication is usually covered by insurance, neurofeedback is still labeled as experimental by most insurance companies. But some insurance plans will pay for part of the treatment, depending on both the plan and the cooperation of the patient’s primary care physician.
Clinical psychologist Barbara Blume of Ventura has been using neurofeedback in her practice for about 12 years and says insurance companies sometimes help pay for the treatment. “If the patient’s physician is an advocate, it can help obtain some insurance coverage,” she said. “About half of my patients get some kind of reimbursement.”
The pill delusion
According to Blume, pharmaceutical companies can have tremendous influence over both the physician and the patient. Many physicians still accept “freebies” from the drug companies, ranging from pens to catered office lunches to all-out “educational” junkets. Occasionally, drug manufacturers may reimburse a physician for providing patients to participate in a drug trial, sometimes without the patient being aware that the doctor is being paid by the drug maker.
“It is not an easy road,” Blume said. “I get a lot of people in my practice who have been on medication before, sometimes for decades, particularly people with depression, where they may go from one medication to another. A lot of doctors don’t think out of the box.”
However, recent studies have pointed to a growing problem with treating depression solely through medication. First, researchers discovered that two-thirds of family physicians and one quarter of psychiatrists do not use the established protocol for determining the existence of major depression. This could lead to patients with mild to moderate depression being prescribed costly antidepressants, sometimes for decades.
The second problem that is now coming to light is that those same antidepressant medications, while being quite effective for major depression, are less effective for mild and moderate depression. This could explain why some patients try many different antidepressants in search of one that actually helps them.
Another issue is the placebo effect, which can skew study results. Waldman believes it has been intentionally minimized in scientific study conclusions over the years. “Many of the medications that have already passed FDA approval would not pass today because of the placebo effect,” he said. “The placebo effect is intrinsically your inner belief and faith in yourself, the doctor and the treatment. If you believe it works, it does work. Even if it is a sugar pill, even if you know you are being given a placebo.”
When changing your mind really works
When is neurofeedback an appropriate and effective therapy? What conditions does it help improve or cure? And which patients are best suited for this type of treatment?
A patient who decides to explore neurofeedback needs to know what to expect in terms of the actual process and reasonable expectations of success.
Gabrielle (not her real name) is a 21-year-old college student who plans to become a teacher. But her battle with migraine headaches, and the attendant anxiety of when the next one will hit, made getting through the day more and more difficult. Gabrielle said medication was helpful but it was only a temporary solution. She wanted to stop the headaches altogether and move on with her life.
“Neurofeedback is a big commitment, but the results have been so successful that it has been an easy decision for me,” Gabrielle said. “I am a student and I work, and I am still able to receive two treatments a week which only last about half an hour. Within a week of treatments, my headaches were gone and I have not had any since.”
Gabrielle said the headaches had her feeling overwhelmed by daily life. “My attitude has changed about the future,” she said. “I am so excited that I will never have to suffer from headaches again. Why temporarily relieve the problem when you can fix it?”
Therapists are reluctant to guarantee a cure for any condition however decades of research have shown that neurofeedback can reduce symptoms and improve the patient’s quality of life.
Aside from headaches and mood disorders such as depression, anxiety and OCD (obsessive compulsive disorder), neurofeedback can be used to address ADD (attention deficit disorder) and ADHD (attention deficit hyperactivity disorder), conditions that often present during childhood. Children who are unable to concentrate or who are hyperactive are usually treated with drugs. These medications have been very effective for many children but, as with all temporary solutions, they wear off and the condition remains. Many parents are wary of the side effects of these drugs, and in the past, family physicians sometimes have been accused of being too quick to prescribe the drugs without a full psychiatric work-up and diagnosis.
Blume said there is scientific evidence that neurofeedback can improve ADD/ADHD symptoms. “We now have preliminary studies that suggest that people with ADD have subcortical changes in their brain as a result of neurofeedback training as measured by pre- and post-functional MRIs,” she said.
Blume explained the way neurofeedback works. “It seems to bypass the genetic components of a person’s wiring and retrain the brain,” she said. “With repetition of training, the brain holds the correction.”
Other difficult-to-treat conditions such as fibromyalgia, chronic fatigue syndrome and post-polio syndrome have responded to neurofeedback. Blume said all of these syndromes carry an inability to sleep soundly. Brain mapping of patients with these conditions has indicated the presence of an excess of alpha brainwaves, even during sleep.
“There is a constant idling rhythm of alpha brainwaves,” Blume said. “When you don’t get into deep sleep, the immune system doesn’t heal. If you don’t sleep, you don’t heal. I am not going to say definitively that the pain is gone with fibromyalgia, but neurofeedback improves the quality of life.”
Another condition that is often overlooked is traumatic brain injury. Blume calls mild traumatic brain injury “a silent epidemic” because the damage is not visible with traditional tests such as CT (computed tomography) scans or MRIs (magnetic resonance imaging). Two groups of patients that disproportionately suffer from this type of brain injury are military veterans returning from the Middle East and professional football players. But it can happen to anyone.
Linda (not her real name) is the mother of a teenage daughter who suffered a head injury when she was a baby. Linda said her daughter had fallen off a table when she was three months old, striking her head. The pediatrician waved her off, saying that since there was no apparent injury, she would be just fine. But Linda’s daughter struggled with schoolwork throughout her childhood.
Those who might have spotted the problem continued to point Linda in the wrong direction. The second-grade teacher told her that her daughter had ADD. Linda said that for six years, she took her daughter to doctors and experts, searching for answers. She said the family physician only offered medications that Linda shunned to avoid the side effects. A visit to a neurologist was also discouraging.
“The neurologist did not believe she suffered structural damage,” Linda said. “He said she just didn’t like school because he did a computer test for attention and my daughter passed.”
Linda felt powerless to help her daughter. “Every year, she fell further behind in school and suffered low self-esteem, frustration and severe fatigue,” she said. “I felt there was no help, and it was extremely frustrating.” Linda suspected that her daughter was not getting proper sleep. A dentist ruled out sleep apnea and said her breathing appeared to be normal.
Only when Linda had her daughter brain-mapped did the traumatic brain injury show up. “Her brainwaves were closer to sleep most of the time,” she said. “She also had brainwaves that would cause anxiety and insomnia at night and stop her from receiving restful sleep.” At age 14, Linda’s daughter finally had a diagnosis and treatment and within 10 sessions was noticeably better.
A possible breakthrough
Neurofeedback is also used to treat addictions, strokes, epilepsy, incontinence, weight control, balance problems and dementia. But the biggest news right now is the newly documented success with autism.
Dr. Tom Sorensen of Westlake Village is a clinical psychologist who has been using neurofeedback therapy for 10 years as an adjunct to traditional talk therapy. He said he doesn’t strictly limit neurofeedback therapy to office visits.
“I use a lot of take-home devices so patients can receive treatment seven days a week when needed.” Sorensen said he also relies on the detailed brain mapping technique.
A recent article on autism has grabbed his attention. “One of the most exciting research ideas to emerge this year is an article about the ability to scan the brains of autistic children,” Sorensen said. “This is done as neurofeedback is being applied. The researcher then charted the neuron growth from the parietal and temporal lobes forward to the right frontal cortex. The data indicate a dramatic improvement in cognition and social skills. This is very exciting because once the connections have been made and the treatment is stopped, the connections continue to grow on their own.”
The potential for use of neurofeedback techniques is as wide open as one’s imagination. Being able to manipulate an object with your mind, actually a minor form of telekenesis, sounds like fun. Mattel and Uncle Milton Industries agree and they each had a blockbuster game on the market last winter. They both used the same format: players wear a headset that can monitor brainwaves. By concentrating or focusing, the players control a fan that moves small balls through a course of obstacles. Mindlflex by Mattel runs $80 and Force Trainer by Uncle Milton costs $130. Sega Toys and Toshiba have recently joined together to develop computer games with a telekinetic theme.
But the use of brainwaves does not stop there. Honda and Toyota are both researching possible ways to use the technique both in automobiles and wheelchairs. And a research arm of the Department of Defense has given $34.5 million to Johns Hopkins University in Baltimore to develop prosthetics that respond to mind control for quadriplegic patients.
Changing your brain without neurofeedback
Waldman has written books and lectured extensively on changes inside the brain and how to improve its function without neurofeedback. He has studied the effects of meditation and extended prayer on the brain, which can be seen by SPECT (single photon emission computed tomography) scans and MRIs. Both look deeper into the brain than the areas that display brainwaves.
“As for effects on the brain, meditation is similar to praying for up to 12 minutes a day by focusing intently on some positive concept or any object that gives you a sense of well-being,” Waldman said. “After doing this for eight weeks, you will begin to see structural and functional changes in the brain. For advanced meditators, you will find changes in the functional areas of the brain as high as 25 percent, and structural changes by as much as 10 percent. That’s huge.”
Waldman said this type of meditation has nothing to do with religion. “It doesn’t seem to matter what religion or spirituality it comes from,” he said. “You can strip it of its sectarian aspect and teach it on a secular level, plug in a totally different theology, and it is just as effective.”
Waldman mentions one more way to improve your brain. “There is a 30-year longitudinal study from the Mayo Clinic and a 40-year longitudinal study from Duke University showing that having an optimistic framework and belief literally adds two years to your life,” he said. “All the research on hope, faith and optimism shows that it is probably the best thing you can do for your brain.”