I walk through an open corridor, chilled by the shade of hunter green trees. It’s always quiet here, but the frothy gurgle of a fountain softens the click of my boots. I’ve made this walk before, so I know to take a seat when I get to the clinic. No checking in. I try not to eavesdrop on the patient before me, her words hardly muffled by an opaque room divider.
When it’s my turn, I plop into the familiar chair and gaze at a triptych of brain paintings. I can close my eyes and name exactly what hue the artist chose for the cerebellum, the amygdala, and the hippocampus — I’ve stared at them so many times. Instead, I update my practitioner on how I’m doing, mining for new details since I last saw her days ago. We have to talk about something. It’s weird to let someone scrub your head with an alcohol wipe in silence.
“We have to talk about something. It’s weird to let someone scrub your head with an alcohol wipe in silence.”
When she’s done, she asks me what video I’d like to watch. This feels like a formality since she queues up a puppy montage before I answer. She primes my head with a sticky goop, then attaches electrodes. Each electrode sprouts a wire that plugs into an electroencephalogram (better known as EEG) machine. It’ll measure the electrical activity in my brain.
When my mad scientist look is complete, the computer in front of me lights up with chubby golden retrievers tumbling in a field. But my brain soon does the wrong thing and the video shuts off.
Confused? You’ve probably never had neurofeedback. Consider this your introduction to the therapy that’s soon projected to exceed 2 billion dollars. I’ll tell you what my experience getting dozens of treatments was like, and share my conversations with a couple of experts in the field.
Let’s get into it.
What is neurofeedback?
Neurofeedback is a form of therapy that helps you control your brain activity. When you participate in a neurofeedback session, you get real-time feedback on your brainwaves, which eventually helps you exert more influence over them. (Not unlike a workout at the gym!)
“You get real-time feedback on your brainwaves, which eventually helps you exert more influence over them.”
According to Po-Chang Hsu, M.D., M.S, a medical expert at Alpas Wellness, neurofeedback can help us create lasting, positive changes in the ways we self-regulate and think. In other words, it takes advantage of neuroplasticity — a buzzy term that points to our brain’s ability to “rewire” itself over time based on new experiences.
There are several types of neurofeedback therapy to choose from, but for this article, I’ll focus on the kind that uses an EEG machine to measure brain waves. Depending on your goals and the practitioner you choose, you may undergo neurofeedback therapy that utilizes visual elements (like I did), auditory feedback, or a litany of other tools. Some practitioners even use virtual reality-based feedback.
Does neurofeedback work for everyone?
“We have never had a client for whom [neurofeedback] doesn’t work,” says Erik Olesen, licensed psychotherapist and neurofeedback practitioner. “We have, however, had a few clients who stopped [neurofeedback] training too soon, so they didn’t realize the benefits or the [treatment].”
Now that’s a bold statement. As someone who had middling results with the therapy — more on that soon — I wouldn’t assume everyone who didn’t benefit simply stopped too early. Just like any other treatment, age, medication, comorbid conditions, genetics, and even commitment to the therapy can affect results.
That said, most clinicians will tell you somewhere between 70 to 85 percent of patients see substantial improvement from neurofeedback. The general consensus seems to be that it works especially well for ADHD, but providers say it can help address a wide variety of conditions—from depression and anxiety to traumatic brain injury and insomnia.
“Most clinicians will tell you somewhere between 70 to 85 percent of patients see substantial improvement from neurofeedback.”
As neurofeedback gains traction, we’ll ideally get bigger and better studies on its efficacy. Right now, research has been limited by small sample sizes, varying protocols, and the fact that it’s being tested on such varied conditions, according to Po-Chang Hsu. He says he’d like to see future studies “focus on larger, well-controlled randomized trials, standardized neurofeedback protocols, and consistent outcome measures.” Plus longer-term follow-ups on study participants.
Can neurofeedback be used in conjunction with other therapies?
Because neurofeedback is noninvasive, it can be paired with many other therapies. In fact, doing so is encouraged.
“Because neurofeedback is noninvasive, it can be paired with many other therapies.”
“As a licensed psychotherapist, I’ve observed that the combination of neurofeedback and psychotherapy works much better than therapy alone. The therapists I work with in our practice agree with this,” says Olesen.
That said, extreme caution should be used when pairing neurofeedback with additional neuromodulation modalities like transcranial magnetic stimulation. And care should always be taken if you are also using psychoactive drugs or epilepsy drugs.
It’s critical to speak with your practitioner about any interventions you’re trying before you sit down for your first session.
My experience with neurofeedback
I wasn’t searching for neurofeedback when I discovered it. I was looking for a solution to my tumultuous menstrual cycle. I found a naturopathic doctor who specializes in hormonal issues and anxiety, and while I don’t think she requires her patients to receive neurofeedback in conjunction with her health counsel, it was strongly recommended. I agreed to try it; I was desperate for relief from the depression, anxiety, and OCD that flared with my period. Plus, I was at a lucrative point in my freelance writing career, which made getting treatment possible.
The Cost
You’d be hard-pressed to find a practitioner who will administer a neurofeedback session for under $100. Where I live in California, costs often fall closer to the $200 — or even $300 — range. Most people need at least 10 sessions to see a difference in their mental state. Many may need 40 or more. So clearly, it’s an investment.
“You’d be hard-pressed to find a practitioner who will administer a neurofeedback session for under $100.”
This is where I’ll say that if receiving neurofeedback causes you financial strain, I don’t think it’s worth trying. I’ll talk more about the results I saw from my experience in a bit.
But if you’re reading this with a clenched jaw, wondering how you’ll finance treatment, you can take a deep breath. There are plenty of more affordable avenues that may work just as well (if not better) for you.
Receiving Treatment
Every session was the same, lasting an hour. My practitioner would start by connecting me to an EEG device that recorded my “baseline” brainwave activity — a critical metric for determining the efficacy of the neurofeedback. Each type of brainwave (Delta, Beta, Alpha, Theta, etc.) has a characteristic frequency range, and neurofeedback helps you learn to adjust the intensity of these waves within specific ranges. When your brainwaves are in balance, you’re set up for better mental functioning and emotional regulation.
“My brain — quickly learning to associate this brainwave state with an annoying blank screen — would yank itself back into the “correct” state and the video would resume.”
Once the EEG machine was ready, my practitioner would play a video on YouTube. As I watched, the EEG would continually measure my brainwaves, detecting when they fell outside of my ideal range. When this happened, the video would pause and fade to black. My brain — quickly learning to associate this brainwave state with an annoying blank screen — would yank itself back into the “correct” state and the video would resume.
When I first started neurofeedback, this happened dozens of times in one session. As the treatment progressed, it happened less frequently.
At the end of each treatment, my practitioner pulled up a graph of my brain waves again to see what progress was made. I’d often go home feeling tired, hungry, thirsty, or all three. She reassured me this was normal. My brain was working very hard to learn and maintain new patterns, using a lot of energy to do so.
The Results
The million-dollar question: Did neurofeedback cure my anxiety and depression? The short answer is no. But virtually no intervention will cure a mental health disorder; it’s too multifaceted. Instead, we should look at what tools we can combine to bring us more peace.
By this measure, I think neurofeedback was helpful for me. For one thing, I could see tangible proof of it in the graphs of my brainwaves. I also had many instances where I panicked less than I typically would. I remember taking a long stroll on the beach one day, realizing I had dropped my phone somewhere along the miles of claggy shoreline, and laughing at how little concern I felt.
“The biggest benefit of neurofeedback, for me, was the way it helped me calm down.”
The biggest benefit of neurofeedback, for me, was the way it helped me calm down. Anyone who’s been to the depths of depression and/or anxiety knows there’s a certain point at which you’re too frantic or dispirited to benefit from mindfulness, breathwork, and the like. I was at that point before receiving neurofeedback.
While it didn’t fully alleviate my anxiety and depression, it muted it enough that I could use other mental health tools successfully. That ultimately helped me get better.
Would I do it again?
If money were no object, I would do neurofeedback therapy again. I like that it’s non-invasive and designed to help you help yourself. Plus, there’s something to be said for dedicating at least an hour a week to your well-being.
“There’s something to be said for dedicating at least an hour a week to your well-being.”
However, neurofeedback, for me, was not the panacea I sometimes see it touted as. The longevity of its results is contingent on your ability to keep your brain in the state it was trained to be in, which is hard to do when stressors step in. Personally, I found myself back in a highly anxious state within a year of receiving treatments, and medication has been a more effective, longer-term solution.
Other people have seen more permanent results from neurofeedback therapy. For some, it’s been life-changing. And with advances in technology, there’s reason to be optimistic about its growing efficacy. The increasing prevalence of “home-based systems and AI-driven protocols, [will likely make neurofeedback] more personalized and accessible,” says Dr. Hsu, presumably leading to better results.
So, Should You Try Neurofeedback Therapy?
In my view, this comes down to time and finances. If you can fit sessions into your schedule and commit to spending at least a thousand dollars, then yeah — give neurofeedback a try! I certainly don’t think it’s a waste. For me, it felt like being handed a shovel to help dig my way out of a mental trench.
“For me, it felt like being handed a shovel to help dig my way out of a mental trench.”
On the other hand, if you don’t have the resources to try neurofeedback right now, don’t sweat it. Especially if you haven’t already tried other, more cost-effective interventions first (like cognitive or somatic therapy, eating well, exercise, or even medication).
If you do decide to undergo neurofeedback therapy, take time to find a provider who understands your goals, is highly experienced, and uses evidence-based protocols. Who knows? This may be the missing piece in your mental wellness puzzle.
Nicole Ahlering is a wellness writer living in Southern California. When she’s not writing, she’s combing the beach for shells, at the Pilates studio, sipping matcha, or doing crafts with friends. She believes the secret to happiness is slowing down.
