iStock_000023236364_SmallMany of my clients come to me because they or their child have been diagnosed with ADD or ADHD, and they want to either minimize the need for medication, or avoid it altogether. Some come because although they haven’t been officially diagnosed with ADD, they have trouble with focus, organization, procrastination, stress and overwhelm. Neurofeedback is a great option for anyone who wants their brains to work better.

Neurofeedback, or qEEG biofeedback, has been recognized by the American Academy of Pediatrics as a Tier 1 intervention for ADD and ADHD, on the same level as medication. Unlike medication, however, neurofeedback – especially the Zengar NeurOptimal system I use in my practice – has no side effects, and actually helps improve the functioning of the brain over time. Or maybe more accurately – it gives your brain the information it needs so that your brain improves its own functioning, improvements that become wired in and part of your new normal.

In other words, with medication you get short term help but no lasting improvements, with neurofeedback you get short term help and your brain ends up in far better shape than it was in when you started.

How does it work?

The Zengar NeurOptimal I use “feeds back” to your brain information about the signal variability it’s picking up. The feedback triggers your brain’s orienting response that occurs whenever any of its self-regulatory mechanisms go offline. The brain checks out what the problem is within itself, and begins to self-correct. It’s the “self-correction” that creates the improvement and strengthening.

What happens in a neurofeedback session?

During the first session, we’ll talk about what you want to accomplish. We don’t do EEG’s – we’re much more interested in what you want your life to be like and feel like when you’re done. So we’ll go through a list of concerns you have, areas you want the neurofeedback to be helpful in improving, and rate them 0-10 as a baseline to measure against. After several sessions, we’ll go back to that list and you’ll re-rate them. Any change indicates that your brain is responding to the training. Sometimes things feel more “undone” at the beginning than later – think about how it looks when you’re cleaning out and reorganizing a closet. Your central nervous system has its own way of organizing itself in a way that is best for you, and may need a little time to undo then redo the patterns. This doesn’t tend to take very long, however – often just a few sessions.

For the neurofeedback training session itself, you sit in an easy chair, and we put a couple of sensor clips on each ear that have slender wires connected to them. We also put two sensors the size of a pencil eraser on the top sides of your head. You put on headphones.

For the next 30 minutes or so, you listen to music. It’s very easy — you can’t “try hard” to make it work faster or better. Your brain knows exactly what to do. You can read, play on your phone, talk, sleep – your brain responds to the feedback regardless of what your conscious mind is doing. In some respects, this process can be considered a kind of turbo-charged meditation, as your brain is being brought back to “present” over and over again, reorganizing itself every moment.

The Zengar creators have improved the process to such a degree that it’s now almost fully automated for time and level of feedback, adapting itself to your system in a nonlinear, dynamic way.

From your perspective, what happens during the session is that as the program picks up a variability in your brain signal, it triggers a brief pause, almost like a skip, or static, in the music. The unexpected break in the rhythm then triggers your brain to scan itself to see what’s going on and what needs to be done. It makes whatever correction is necessary to smooth things out again, and the music starts again. This all happens in a second or two.

When can I expect to see results?

Of course, this will vary from person to person, depending on the severity and complexity of the symptoms. You wouldn’t go to a gym being overweight and out of shape, and expect to walk out after one session in perfect condition, though that’s often the fantasy! Likewise, it takes a while for your brain to develop the right “muscles” in order for you to feel noticeably better.

Nevertheless, improvements can usually be felt after the first few sessions. Very often, people will report feeling relaxed and “clearer” even after the first session. In order to give it a reasonable trial, though, it’s necessary to give it about 6 sessions. After that, you would continue for a few sessions after you’ve stopped noticing improvements. The extra sessions give you the opportunity to notice changes that are emerging but not yet fully realized. It also gives your brain a chance to anchor the improvements it’s made.

With more complicated issues like a severe ADHD/learning disability problem, sensory processing issues, or Asperger’s syndrome, it’s often necessary to continue longer – sometimes a number of months or more. But again, given the alternatives, and given the payoffs for the rest of your life, it’s usually an investment well worth making.

Are the results long lasting?

Unlike like medications, which wear off after you stop taking them, the results from neurofeedback are stable over time. It’s like learning to ride a bike — once your brain has developed the pathways that correctly interpret and manage all the signals concerning the balance and movement on the bike, those pathways are there for good.

That’s why, although the initial time and cost commitment may seem like a lot, it’s cheaper and easier than taking medications over the long run. And in the end, you have a brain that works a lot better than it did before!

That being said, oftentimes it’s helpful to come in occasionally for “tune-ups” after the main training has been accomplished. Life gets complicated and stressful, or new developmental milestones are reached, and we might need a little help to get our brain caught up with it all. But the tune-ups can be just a session or two. And some people like to continue on a regular basis over a longer term, because it promotes peak performance.

Are there side effects?

One person said, “The only permanent side effects are good ones.”

There really aren’t any, especially as compared with medication. You might feel a little tired, or “brain tired,” but it usually goes away after a good night’s sleep. Some people feel a little spacey, but it’s similar to how you might feel after a deep nap or meditation. In some unusual instances, you might feel a mild headache — as if you had overdone it at the “brain gym” (I’ve thought of it feeling like my brain has done too many push-ups) — but as with physical overexertion, the best thing to do is another round of neurofeedback, at a gentler pace.

Having said that, each person has their own brain patterns that their central nervous system is helping to reorganize, and sometimes in the course of that reorganization you become more aware of the pattern itself. This increased awareness can be felt as things “getting worse” but they really aren’t. The Zengar system isn’t doing anything “to” your system, other than giving it information. It’s not telling it what to do with the information, it’s not judging the information as bad or good – like the rumble strips on the side of the highway, it’s just letting you know you’ve gotten off track. So continuing the training is the way to let your brain continue with its reorganization, and find a new and better normal for you, unhooking the “brain loops” and shallowing the “brain ruts.”

If you are taking medication, however, it’s very important to let your physician know that you are doing neurofeedback. As your brain improves its functioning, the therapeutic level of the medication you’re taking will change. You will need less and less to achieve the desired result. If you don’t adjust as you go along (with your doctor’s help), you may become over-medicated.

Martha G. Delafield, LCSW