Myths About Neurofeedback

Why haven't I heard about these Evidence-Based Technologies or Approaches before?

While EEG and Neurofeedback have been around since the 1960’s in university settings like UCLA (Barry Sterman) and the University of Tennessee (Joel Lubar), and while these approaches have been used in NASA’s space program from its onset, with Top Gun pilots at Miramar, and while it is currently being used by the military to detect/confirm and treat TBI’s (Fort Campbell), and while it is being used in the Courts at the highest levels of evidence Daubert & Frye), there are many professionals who are not aware of Neurofeedback/EEG biofeedback, nor the efficacy of these kinds of approach over certain medicines, or as an integrative or complementary approach to traditional medicine. This is perhaps due to a variety of reasons.

One of the biggest myths about EEG Biofeedback or Neurofeedback is that Physicians who are not familiar with the research or the practice will often say there is no research in major journals to support this form of treatment or training. However, this is not the case as one can see from the list that follows below. What is often meant is that there are no double blind placebo controlled studies of large sample sizes.  In this regard there is some truth, there are only a few studies that meet these gold standard criteriaMore are currently being conducted, however, conceptions about neurofeedback and the Gold Standard criteria of research ignores several very important factors.

The fact is:

  1. Neurofeedback is typically a highly individualized approach which doesn’t lend itself well to reductionist approaches associated with the gold standard criteria type of research.  In fact many IRB’s (Institutional Review Boards) have stated that it is unethical to withhold a treatment that is known to be efficacious even in a sham condition
  2. People also learn very quickly when they are receiving a sham treatment.  When these facts are coupled with the high costs of doing the gold standard research, it is easy to understand why more of this research is not currently available.  However, there are numerous smaller scale studies using different research methodologies that show the efficacy of neurofeedback and that are not double blind protocols, and numerous case studies that support the use of Neurofeedback for a large variety of conditions, including peak performance as seen in some of the Olympic athletes. (See research)

It is also very important to note that there are many instances of medical practices that are not based on this gold standard criteria, in use today.  Some examples include: most surgical procedures, “off branded use of medications (i.e., use of medications for disorders that have not been clinically studied, or with populations that have not been studied like children and adolescents) or “poly-pharmaceutical approaches” (use of multiple medications at the same time).  The gold standard criteria are almost never levied against practitioners in this regard despite the known risks.  And finally, there are few long term studies of the effects of psychotropic medicines on the brain and organs of the body because these kinds of studies are currently not required by the FDA for approval. Nor does the FDA require that pharmaceutical companies publish their failed research.

To address the research question noted above in more detail, the following examples are simple searches on the subject of EEG and its correlates.  It should be noted that not all journals related to this topic are listed on Pub Med as well, so there are even more articles than are noted below. Pub Med is used here because it is one of the more well-known major sources of research data. Data below as a result of a search completed on September 1, 2013.

  1. If one goes to the Pub Med website and enters in the search window EEG, one will find (152,152) research articles noted.
  2. If one goes to the Pub Med website and enters in the search window and enters in EEG and Depression one will find (5870) articles.
  3. If one goes to the Pub Med website and enters in the search window EEG and Anxiety one will find (2727) articles cited.
  4. If one goes to the Pub Med website and enters in the search window EEG and ADHD one will find (1273) articles.
  5. If one goes to the Pub Med website and enters in the search window EEG biofeedback, one will find (1417) articles noted.
  6. If one goes to the Pub Med website and enters in the search window qEEG one will find a total of (826) articles noted.
  7. If one goes to the Pub Med website and enters in the search window Neurofeedback one will find (2203) articles noted.

Furthermore, recently the American Board of Pediatric Physicians has recently rated neurofeedback as higher in its efficacy for the treatment of ADHD than medicines such as Ritalin or Concerta.

Some practitioners have referred to Neurofeedback approaches as Voodoo because insurance companies in most instances will not pay for it, though that may be changing in the near future due to the regulations associated with Affordable Care Act and Parity legislation, and because Neurofeedback is first and foremost an evidenced based.

Some make the mistake of thinking that Neurofeedback results are all based upon placebo effects.  However, Neurofeedback approaches started in the laboratory with animals who are not capable of the same kinds of placebo effects as humans.

Likewise Neurofeedback goes against the traditional model of Western medicine in which medications are the primary mode of treatment for the majority of disorders, and stresses the balancing of body systems to improve healthy functioning.

Neurofeedback represents a new paradigm (i.e., model) for dealing with brain related problems and with dealing with a variety of other issues related to the body’s functioning.

Another possible reason for the confusion about Neurofeedback is that it is utilized in a multi-disciplinarian fashion across the world.  Practitioners from a large variety of disciplines and countries recognize its efficacy and use it to address a variety of conditions.  This multi-disciplinarian group includes Physicians, (Neurologists, Psychiatrists, General Practitioners, Pain Specialists, Functional Medicine Physicians, Dentists, Psychologists, Neuropsychologists, Therapists and Counselors, Occupational Therapists, Physical Therapists, Peak Performance Trainers, Researchers, Chiropractors, Doctors of Osteopathy, to name the most common. And because so many different disciplines use the equipment in their specific modalities often times each uses language that is slightly different from other disciplines.

There are now a variety of Neurofeedback approaches in use including some that use qEEG, EEG, pEMF, Magnetoencephalopathy, MRI, Hemoencephalography, (NiR, PiR) as part of the process.

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