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EEG Biofeedback is a
learning strategy that enables persons to alter their
brain waves. When information about a person's own brain
wave characteristics is made available to him, he can
learn to change them. You can think of it as exercise
for the brain.

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therapist computer is usually positioned
behind the patient. This enables the
therapist to monitor the patient's EEG
at any time during the session without
disturbing the biofeedback. |
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single electrode is placed on the scalp
(above the motor strip, typically) using
gel or paste and two other electrodes
are attached to the earlobes. Most
patient recline during training. |
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game computer is placed a few feet away,
directly in front of the patient. The
patient interacts (only using her EEG)
with the game computer for the next
30-40 minutes. |
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Each
display contains four EEG data streams (below
each stream are text and average data values).
The top line, slightly squiggly, is the person's
entire EEG recorded from the scalp by the single
active electrode. The three wavy lines below
show activity in three separate EEG frequency
bands or rhythms -- here, theta, SMR, and high
beta bands. The patient's goal is to increase
certain EEG frequency bands (e.g., SMR) while
decreasing others (e.g., theta & high
beta).The patient monitors her EEG frequency
band activity NOT as wavy lines on the therapist
machine, but as elements of a game on the game
computer. Each frequency band appears as a
colored rectangle which grows larger or smaller
in response to her brain wave activity.
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With
her brainwaves she is playing the game called
"Islands." Frequency band activity is
displayed at the bottom of the screen -- two
square "inhibit" boxes on either side
on a large "enhance" rectangle. At
this instant, she is doing quite well,
inhibiting or reducing the activity of the bands
represented by purple & yellow (at the
moment, mere dots in each corner of the screen).
She has increased her SMR activity to a point
where it overflows the middle (blue) rectangle.
As long as she keeps this up, she is rewarded in
the game with visual and auditory stimuli.
During the 30 minute session, she will work to
keep purple and yellow small and make blue large
as long as possible. Hundreds of times she may
need to alter her brain activity in order to
achieve a brain state which scores the most
points. For every half second that her
brainwaves stay in the desired state or
"zone", she scores another point, an
additional seagull appears in the sky (top of
screen, barely visible), a new stripe segment is
drawn on the highway (middle of screen), and a
beep sounds to announce it all. If or when she
attains 500 points, the volcano (middle left)
will erupt!
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EEG Biofeedback is used for
many conditions and disabilities in which the brain is
not working as well as it might. These include Attention
Deficit Hyperactivity Disorder and more severe conduct
problems, specific learning disabilities, and related
issues such as sleep problems in children, teeth
grinding, and chronic pain such as frequent headaches or
stomach pain, or pediatric migraines.
The
training is also helpful with the control of mood
disorders such as anxiety and depression, as well as for
more severe conditions such as medically uncontrolled
seizures, minor traumatic brain injury, or cerebral
palsy.

An initial interview is done
to obtain a description of symptoms, and to get a
picture of the health history and family history. Some
testing may be done as well. And the person does the
first EEG training session, at which time we get a look
at the EEG. This all may take about two hours. (The
details may differ among the various affiliate offices.
In some offices a full brain map, or quantitative EEG,
is routinely obtained, which may require a separate
office visit. Or more extensive testing may be done.)
Subsequent training sessions last about 40 minutes to an
hour, and are conducted from one to five times per week.
Some improvement is generally seen within ten sessions.
Once learning is consolidated, the benefit appears to be
permanent in most cases.
The
EEG biofeedback training is a painless, non-invasive
procedure. One or more sensors are placed on the scalp,
and one to each ear. The brain waves are monitored by
means of an amplifier and a computer-based instrument
that processes the signal and provides the proper
feedback. This is displayed to the trainee by means of a
video game or other video display, along with audio
signals. The trainee is asked to make the video game go
with his brain. As activity in a desirable frequency
band increases, the video game moves faster, or some
other reward is given. As activity in an adverse band
increases, the video game is inhibited. Gradually, the
brain responds to the cues that it is being given, and a
"learning" of new brain wave patterns takes
place. The new pattern is one which is closer to what is
normally observed in individuals without such
disabilities.
There are clinical reports or case histories concerning
the effectiveness of neurofeedback for the following
therapeutic applications:
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Addiction |
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Anxiety |
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Attachment
Disorder |
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Attention
Deficit Disorder |
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Autoimmune
Dysfunctions |
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Chronic
Fatigue Syndrome (CFS) |
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Chronic
Pain |
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Conduct
Disorder |
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Depression |
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Epilepsy |
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Sleep
Disorders |
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Stroke/TBI |
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Tourettes
Syndrome |
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Hypertension |
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In the case of ADHD,
impulsivity, distractibility, and hyperactivity may all
respond to the training. This may lead to much more
successful school performance. Cognitive function may
improve as well. In several controlled studies,
increases of 10 points in IQ score were found for a
representative group of ADHD children. And in two
clinical studies, an average increase of 19 and 23
points was demonstrated.
Behavior
may improve in other ways as well: If the child has a
lot of temper tantrums, is belligerent, and even violent
or cruel, these aspects of behavior may come under the
child's control.
In
the case of depression, there can be a gradual recovery
of "affect", or emotional responsiveness, and
a reduction of effort fatigue. In the case of anxiety
and panic attacks, there is gradual improvement in
"regulation", with a dropoff in frequency and
severity of anxiety episodes and panic attacks until the
condition normalizes.
In
the case of epilepsy, we observe a reduction in severity
and incidence (frequency of occurrence) of seizures. In
many cases medication may ultimately be reduced and side
effects of such medication may diminish.

It is not possible to
predict with certainty that training will be successful
for a particular condition. But for the more common
conditions we see, a reasonable prediction of outcome is
usually possible. More important, however, the
effectiveness of the training can usually be assessed
early in the course of training. For most conditions,
there are no known adverse side effects of the training,
provided that it is conducted under professional
guidance.

The brain is amazingly
adaptable, and capable of learning. It can also learn to
improve its own performance, if only it is given cues
about what to change. By making information available to
the brain about how it is functioning, and asking it to
make adjustments, it can do so. When the mature brain is
doing a good job of regulating itself, and the person is
alert and attentive, the brain waves (EEG) show a
particular pattern. We challenge the person to maintain
this "high-performance", alert and attentive
state. Gradually, the brain learns, just like it learns
anything else. And like with other learning, the brain
tends to retain the new skill.
We
observe that if the EEG is not well-behaved under these
circumstances, there may be adverse impacts on learning
ability, on moods, on sleep, and on behavior. With
training, these may be gradually brought under control,
along with normalization of the EEG.

EEG training is a learning
process, and therefore results are seen gradually over
time. For most conditions, initial progress can be seen
within about ten sessions. Initial training goals may be
met by twenty sessions, at which time the initial
retests are usually performed. In the case of
hyperactivity and attention deficit disorder, training
is expected to take about forty sessions, or even more
in severe cases. Teeth grinding usually responds in
twenty sessions. Some symptoms of head injury often
respond in less than twenty sessions (quality of sleep;
fatigue; chronic pain), whereas others may require
longer training before they show an initial response
(memory function, for example).

In the initial stages of
learning, the sessions should be regular and frequent,
at two, three, or even more sessions per week. After
learning begins to consolidate, the pace can be reduced.
Daily sessions can be very beneficial as well.

Many medical and
psychological insurance plans now cover biofeedback for
various conditions. Some require co-payments. Other
plans have annual caps. A prescription for the training,
along with a diagnosis, may be required from a physician
under the medical part of the plan, or from a licensed
psychologist under the mental health services part of
the plan.

Your doctor may not know of
this specific type of biofeedback. He or she will
maintain a healthy skepticism about any new approach
claiming numerous benefits. If your doctor is familiar
with EEG biofeedback in general, he may still be
thinking in terms of the more common early experiments
with alpha wave training, rather than with the training
we are dealing with here. Ask your doctor to examine the
recent research on the effectiveness of EEG biofeedback
in treating various disorders such as attention deficit
disorder and epilepsy. The following references are a
place where he or she can start:
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Lubar,
J.F. and Bahler, W.W. (1976) |
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Behavioral
management of epileptic seizures
following biofeedback training of the
sensorimotor rhythm. Biofeedback
and Self-Regulation, 1, pp.77-104.
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Lubar,
J.F. and Shouse, M.N (1976) |
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EEG
and behavioral changes in a hyperactive
child concurrent training of the
sensorimotor rhythm (SMR): A preliminary
report.
Biofeedback
and Self-Regulation, 1, pp.293-306.
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Lubar,
J.O. and Lubar, J.F. (1984) |
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Electroencephalographic
biofeedback of SMR and beta for
treatment of attention deficit disorder
in a clinical setting. Biofeedback
and Self-Regulation, 9, pp.1-23.
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Shouse,
M.N. and Lubar, J.F. (1979) |
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Operant
conditioning of EEG rhythms and Ritalin
in the treatment of hyperkinesis.
Biofeedback
and Self-Regulation,4, pp.301-312.
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The cost of the training
differs among offices depending on location, the
professional status of the person delivering the
service, and on supplementary services offered.
Discounts are often available for payment in advance.
Please call or email Penny at 845 369 6900 or
mbgmd@optonline.net
and speak to Penny about
the cost.
(Introduction by EEG
SPECTRUM, with whom we have been affiliates for
years. We use the fine Neurocybernetics equipment
exclusively on our office. Our thanks to the quality research done by Siegfried Othmer, PHD and Susan Othmer
in California who have done so much to expand the
clinical research in Neurofeedback)
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