On the Brain

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The results are staggering: A class of third-graders gains an average of 18 IQ points over the course of a school year. In a group of people with early-onset dementia, 84 percent see either stasis or improvement in pre-existing cognitive impairment, as opposed to deterioration.

These results are thanks to neurofeedback, a subcategory of the more well-known biofeedback.

Biofeedback is an effective treatment for 34 disorders, including everything from chronic pain to epilepsy to psychological issues, according to the Association for Applied Psychophysiology and Biofeedback. It can be divided into three classes: pelvic floor/muscle, for which there is significant research and which treats problems like irritable bowel syndrome and incontinence and pelvic muscle dysfunction; general, for most types of pain, among other symptoms; and EEG, i.e., neurofeedback, which can “train the way a single neuron fires,” says Baltimore practitioner Mark Trullinger of Neurothrive.

Using biofeedback, a patient with anxiety, for example, is able to physically see the way his or her body responds to stimuli, eventually learning to control previously involuntary reactions.

Baltimore-based psychologist and biofeedback practitioner Marc Lipton breaks it down: “When we get upset or anxious, we trigger the endocrine cascade, which triggers the ‘fight or flight’ response in our adrenal glands and releases norepinephrine. This causes blood to leave the hands and feet and go to the central organs, which is why our hands get cold. One form of biofeedback is to teach you how to warm your hands. … You’re basically training yourself to modify your blood chemistry to calm down.”

Neurofeedback involves a machine that monitors brain waves, and using sounds, lights, games or other types of feedback, helps it to identify and heal the neurons that aren’t working properly. Exactly how it works can really only be understood by extensive study — or, perhaps, by someone with a perfectly firing brain.

If it all sounds complicated, that’s because it is. Trullinger says that while bio-/neurofeedback has been around since the late ’50s, it is only recently that scientists are beginning to understand how it works (not just that it does).

“It’s definitely on the rise,” he says. “It’s kind of newly popular as we come to understand it more.” His doctoral thesis, in fact, raises the question that anyone learning about neurofeedback will inevitably ask: If this works so well, why isn’t it more popular?

The answer is complicated, but Trullinger says that biofeedback’s reputation took a hit in the ’70s and ’80s after “certain promises were made that were aspirational instead of practical.” The practice couldn’t live up to these lofty claims and was quickly written off.

Even today, Lipton says that patients should not expect the treatment to be a cure-all.

“It’s not a total substitute for medication and isn’t simply a technique you use independently,” he says. “But if a patient is using [biofeedback] consistently along with other psychotherapeutic treatment, it makes a very substantial contribution and gives a sense of hands-on efficacy.”

Another issue comes with the lack of regulation. As the AAPB states, “most states do not restrict who can perform biofeedback services. Thus, a person with no clinical training of any kind nor any specialized training in biofeedback may claim to provide biofeedback services.”

Trullinger, for his part, is certified by the Biofeedback Certification International Alliance, the industry standard. (The BCIA includes 1,496 practitioners in its U.S. directory.) Thanks to a media resurgence, better equipment and demonstrable results, however, Trullinger is confident that bio- and neurofeedback will only continue to grow. The field has experienced particularly rapid expansion in “peak performance” patients — those who do not have a specific impairment but simply want to improve their brain function in their athletic, academic, professional or personal lives.

Despite his confidence in the practice, Trullinger reiterates the importance of remaining realistic.
“It doesn’t always work for everyone, and there’s not a lot of understanding why it works for some people and not others,” he says. “But [for many people] I’ve seen significant results.”

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