What is Neurofeedback?

Neurofeedback, also referred to as brainwave or EEG biofeedback, or Neurotherapy, is a state-of-the-art training tool for the brain. Neurofeedback can be used to improve variety of health conditions or increase personal potential. It works by informing the brain (via vision and audition) about its own performance. The brain then naturally modifies its activity pattern to improve the performance. It is a gradual learning process that leads to permanent improvement in the brain functioning. 

Receiving feedback from the environment is the primary way we learn a new skill. When learning how to ride a bicycle, the brain is receiving feedback from gravity on its states of balance. The brain then learns how to balance on two wheels, and riding a bicycle becomes a new skill. After a short while you don't even have to think about how to ride a bike to do it, and this new skill becomes permanent. Neurofeedback works in exactly the same way.


Self-regulation is a key principle of all body systems, including the nervous system. It allows the systems to function better and withstand the challenges of internal and external environments. However, sometimes the self-regulating response selected by the system is not the ideal response. For example, stress response is an attempt by the nervous system to assist the organism in emergency situations, however, often it persists in not-really-emergency situations and can easily become a problem in of itself. Neurofeedback provides an experience to the brain that helps it to choose an appropriate self-regulating response for better functioning. In summary, Neurofeedback challenges the individual's brain to self-regulate to a more functional state.

How It Works?

After a thorough evaluation, training begins. Sensors are placed on the scalp, and the brainwaves are recorded, amplified and sent to a computer. In a typical session the trainee is simply asked to play a video game or listen to sounds/music and watch images. In some protocols the person is simply asked to relax, while his brain activity is recorded. The recorded brain signals are processed and analyzed to provide an appropriate feedback. The feedback takes the form of changes in what the trainee sees, hears or feels with his hands and body. The brain naturally detects any consistent changes in the environment even ones that are below conscious level. The brain’s natural response to consistent changes in the environment is to modify its own function to better explore the changes it has just detected. Shaping this process gradually leads to new brainwave patterns. Once this new learning is consolidated, the new patterns stabilize and become permanent; continued Neurofeedback becomes unnecessary. During Neurofeedback, the brain is changing in much the same way as when a new skill is learnt, for example riding a bicycle or driving a car.

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Neurofeedback step-by-step

  • Initial Free Consultation
    The free consultation takes 30 - 60 minute. It can be done in-person in our office or by phone. We will answer any relevant questions you may have, and will explain how Neurofeedback can benefit you or your loved one. It may become apparent that Neurofeedback is not appropriate for you at this time. We may refer you to a different type of therapy, or provide Neurofeedback sessions in parallel with the other type of therapy.

  • Comprehensive Evaluation / Assessment
    A set of 5 sessions, approximately 1 - 2 hours each, precedes the main training sessions, during which (a) our specialists conduct a detailed clinical interview with you; (b) you fill in a questionnaire; (c) if necessary, specialized performance tests may be administered using game-like devices/tasks; (d) quantitative EEG recording is conducted using a wireless EEG headset. This is a simple and undisturbing procedure during which you wear a comfortable, unobtrusive headset and rest quietly with eyes open or closed, while we record your brain signals.
    This assessment procedure allow us to determine in a scientific, objective manner the current state of your brain and develop a training plan to address your particular goals. Additionally it defines a measurable baseline for an objective evaluation of the effectiveness of the Neurofeedback training. The training that follows these 5 sessions is therefore individualized to cater for your needs/goals and its effectiveness can be followed in an objective way

  • Neurofeedback sessions
    Each Neurofeedback session takes approximately 1 hour. Usually the sessions are scheduled 2 - 3 times per week, however your specific schedule will be determined based on your individual training plan and needs.
    During the session, one or two electrodes will be placed on your head and earlobes. Then for about 40 - 60 min. you will simply play a video game or listen to sounds/music or watch images on the computer screen.
    At the beginning of each session you may report any changes / effects you noticed since last session or any other information you deem relevant to the course of the training.

  • Reassessment
    After every 10 session a reassessment will be conducted. The procedure lasts 2 - 3 hours and includes (a) detailed clinical interview; (b) specialized performance test, if necessary; and (c) quantitative EEG recording similar to the initial evaluation / assessment procedure.
    The reassessment may determine that the goals are achieved and the Neurofeedback is no longer necessary or that more sessions are required. For certain conditions such as anxiety or insomnia, normally 20 sessions lead to significant improvements, however other conditions such as ADD/ADHD or learning disabilities often require at least 40-50 sessions.

Brainwaves and Neurofeedback

Typical Neurofeedback relies on two research-proven facts: (1) it is possible to recondition and retrain brainwave patterns, and (2) changes in the brainwave patterns can affect the mental and physiological state of the subject.

Raw EEG signal (1 sec)

Raw EEG signal (1 sec)

Brainwaves, as measured by EEG at certain scalp locations, occur at various frequencies (measured in cycles per second or Hertz (Hz)) and are commonly separated into frequency bands: Delta (0 - 4 Hz), Theta (4 - 8 Hz), Alpha (8 - 12 Hz), Beta (low 12 - 15 Hz, mid 15 - 18 Hz and high 19 - 30 Hz) and Gamma (above 30 Hz) bands. Very roughly each of these bands can be associated with a different level of awareness.

Delta brainwaves(1 sec)

Delta brainwaves

Delta (0 - 4 Hz) are the slowest and highest amplitude brainwaves. They occur primarily during the sleep and in some abnormal processes. The increase in Delta brainwaves is associated with decreasing awareness of the physical world around us.

Theta brainwaves(1 sec)

Theta brainwaves

Theta (4 - 8 Hz) brainwaves are classed as "slow" brain activity and represent a daydreamy, detached state of mind that is associated with mental inefficiency. The very slow Theta brainwaves are associated with a very relaxed state, representing the twilight zone between wakefulness and sleep.

Alpha brainwaves(1 sec)

Alpha brainwaves

Alpha (8 - 12 Hz) brainwaves are associated with a state of relaxation and represent the disengaged, idling mode, waiting to respond when needed. They occur whenever a person is alert, but not actively processing information. It is the major rhythm seen in normal relaxed adults. When the Alpha brainwaves are within normal ranges we tend to  experience good moods, see the world truthfully, and have a sense of calmness. If we merely close our eyes, an increase in Alpha brainwaves occurs shortly. 

Beta brainwaves(1 sec)

Beta brainwaves

Beta (12 - 30 Hz) brainwaves are considered "fast" brain activity and have smaller amplitude than slower brainwaves. They are associated with a state of mental, intellectual activity and outwardly focused concentration. It is the state that most of brain is in when we have our eyes open and are engaged in cognitive activity.

Gamma brainwaves(1 sec)

Gamma brainwaves

Gamma (above 30 Hz) brainwaves are the fastest and lowest amplitude brainwaves. They are associated with improved memory and perception performance, optimal brain functioning and increased mental abilities. Gamma rhythm also serves as a binding mechanism between different parts of the brain and is involved in cross-modal sensory processing.

However, it is important to understand that these brainwave bands do not occur in isolation from each other and are not equally distributed in all parts of the brain - always some degree of each band is present in different parts of our brain. Our mental health, cognitive and emotional abilities depend critically on when (in what state of awareness? during which mental process?), where (which part of the brain?) and with what relative strength these brain rhythms occur, and how the rhythms occuring in different parts of the brain (e.g. symmetrically in different brain hemispheres) relate to each other (e.g. in terms of absolute / relative amplitude or coherence).

For example in awake alert state (normally dominated by Alpha and Beta brainwaves), Delta brainwaves occur in areas of the brain that go “off line” to take up nourishment.

Brain functions

Brain functions in different lobes

When an excessive amount of slow brainwaves (Delta and Theta) are present in the executive (frontal) parts of the brain the persons may have problems controlling their impulses and moods, and become hyperactive. They can’t focus very well and exhibit diminished intellectual efficiency. In general, with relatively strong slow brainwaves in the frontal parts of the brain, it becomes difficult to control attention, behavior, and emotions. Peak performers decrease Delta brainwaves when high focus and peak performance are required, while most individuals diagnosed with ADD / ADHD, naturally increase rather than decrease Delta activity when trying to focus. Dominating slow Theta and Delta brainwaves are present in persons with ADD / ADHD, Depression, head injury, stroke and epilepsy. However, Theta brainwaves are also present in persons with peak levels of creativity, deep levels of relaxation, meditation and hypnosis. Therefore it is essential to understand the sources of the different brainwave bands in individual persons, before associating them with specific mental processes or disabilities.

Physical pain is associated with decreased Theta and Alpha rhythms over the right part of the head (in the temporal-parietal brain regions). Good healthy Alpha production over the posterior parts of the head (in the occipital-parietal brain regions) promotes mental resourcefulness, aids in the ability to mentally coordinate and enhances overall sense of relaxation. In anxious and tense conditions, an excessive high frequency Beta and Gamma brainwaves are often present. However, Beta brainwaves occur also during some stages of sleep. They may be absent or reduced in areas of cortical damage. A decrease in Gamma rhythm in certain brain regions is associated with cognitive decline. Peak performers tend to have large amounts of Gamma brainwaves compared to others.

Brain hemisphere functions

Brain functions in different hemispheres

Another critical factor that determines our mental health, and cognitive and emotional abilities is the activity balance between left and right brain hemispheres. For example, overactivated right hemisphere and underactivated left hemisphere almost always lead to health conditions such as Depression, Anxiety and other similar disorders. Overly activated right hemisphere significantly weakens our immune system, thus the balance between brain hemispheres is not only essential for mental health, but also is a condition for improvement of our immune function.

Neurofeedback training
For the training to be successful and exempt from negative reactions, it is essential that before the Neurofeedback training begins, a comprehensive assessment is performed by qualified experts, and an individualized training program is developed that considers the distinctive brainwave patterns of the trainee and addresses his/her specific goals and symptoms. The person's brainwave patterns cannot simply be inferred by only observing his/her behavior. Therefore, a detailed brainwave recording is required during the assessment phase. In our case, the assessment includes an extensive clinical interview, a continuous performance test and a brainwave recording using multichannel quantitative EEG. Following the assessment an individualized Neurofeedback training program is developed that addresses the particular goals of the trainee.

The key components of the individualized Neurofeedback training program are the person and goal specific target frequencies and parts of the brain that need to be self-regulated. The program often includes also Neurofeedback protocols for balancing of activity between brain hemispheres. At the conclusion of the Neurofeedback training, usually the brainwave patterns are more balanced, optimized, and the brain, the nervous system and the whole organism is in better functioning and more stable state.