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Neurofeedback

Neurofeedback just might be the best-kept mental health secret out there. Neurotherapist Carly Reinkeluers joins me for a conversation about her experience with neurofeedback, how the technology works, and how to tell if you should try it. For more information on her Peterborough practice, you can find her here.

Bryn: Treatment for mental health concerns has always been considered a mixture of art and science, from talk therapy to psychotropic drugs. The reality of mental health as a field is that it is as much philosophy as it is quantitative data, but in the 1960s, 40 years after we discovered that the brain emits electrical current neurofeedback started to gain traction.

 

Neurofeedback is a technology, a type of biofeedback therapy that gives patients information on their neurological function in real time, and its proven to effectively treat mental illnesses from depression to chronic fatigue, to anxiety, to ADHD. Joining me today to talk about neurofeedback is Carly Reinkeluers, a neurotherapist who runs a practice in Peterborough,Ontario. Im Bryn Savage, and this is The Plum-Line, a podcast on mental wellness. Carly, thank you for joining me.

 

Carly: Thank you, Bryn.

 

Bryn: Thank you. Your history with neurofeedback starts with a personal story. Do you mind sharing that?

 

Carly: Yeah, definitely. Yeah. So, I started doing neurofeedback about 10 years ago. I was doing my undergrad at the time. Lot of panic, a lot of anxiety sort of built up over life. I was always a warrior, but sort of the pressures from school, just my brain just wasnt coping well, and so I found an amazing therapist who also does neurofeedback and NeurOptimal specifically.

 

Yeah, and I started doing it and I ended up doing it for a couple of years just because I liked it so much, but what I noticed was I would say probably after, you know, a couple of months, I noticed that my brain would start to get elevated and start to panic but be able to come back out of it that much faster, but then even over the course of even more sessions or more time, I couldnt even panic at all anymore, and I havent had a panic attack in over eight years. So, in terms of the shifts, I just noticed that after doing some NeurOptimal Sessions, I couldnt get to that state of elevation that I was in before. So that was so transformative for me because now I was able to be productive. I was able to, you know, finish school so much easier.

 

I ended up still going to teachers college, ended up doing my Masters in Counseling because I really wanted to work with people inmore of an individual context, and yeah, like you were saying, now I run aclinic in Peterborough. We work with people of all ages and its just awesome. I mean, weve sort of talked about this before with the reason why were doing this is just because it has been so personally transformative for us. So, we want to get it out there and share the word.

 

Bryn: You mentioned your optimal. Could in a nutshell talk about what neurofeedback actually is?

 

Carly: Yeah.So, neurofeedback and specifically NeurOptimal is brain training. So, its a non-invasive technology. Its incredible how much its developed over time, but its this non-invasive technology that uses alive EEG to read the brains electrical activity and provide it with feedback about what its doing so that it can learn to self-regulate on its own. So, the brain has this incredible desire and capacity to come into balance and it wants to, and so this is really just ultimately facilitating that process.

 

Bryn: Well get more into kind of the nitty-gritty on that a little bit later, but what is neurofeedback, like whats kind of the range of things that people use neurofeedback for?

 

Carly: Yeah.So, it can ultimately help with so many different things and its really about what each individuals brain needs, but we dont necessarily know what that is. So, you know, for example, I had an 11 year old kid on the autism spectrum come in who wanted support with focus and concentration. What ended up happening is his brain really just learned how to be more still. So, he also got really overstimulated.

 

So even though they were coming in for focus and concentration, what they really noticed in terms of the neurofeedback, helping out with was his anxiety, and this just kind of aligns with the ground-up approach, its training the brain from the ground up, its helping it to feel more calm. So, then all those other functions can surface the focus and the concentration. Its a nice side effect to training his brain to not feel overstimulated, and his mom knew over time.

 

We sort of knew that this was the result for him because one day they were watching TV and she just noticed, she looked at his feet and she noticed there were no scabs on it because he used to pick his feet so badly, so much that they would bleed, and then all of a sudden, she just noticed one day, oh my gosh, his feet are clear. So, he didnt need to engage in that coping mechanism anymore to try to feel calm, and so thats when we sort of knew that his brain was starting to really reduce how much adrenaline it was pumping. He was no longer as anxious.

 

Bryn: Yeah. Once the brain has more access to feeling safe, its better able to function on a cognitive level as well. It becomes more flexible and more resilient.

 

Carly: Yeah.Like youre saying, when we bring down that fight or flight system and everything else like concentration and cognitive function can surface, which is really great. I also had a client that was unable to feel physical pain at all.He came from so much trauma and his brain was so used to pumping so much adrenaline all the time and he couldnt actually feel any physical pain.

 

So when we started doing neurofeedback, actually NeurOptimal specifically, his brain was learning how to feel safe again, and with that, it didnt need to pump adrenaline as much anymore, and then subsequently he started feeling pain again, and that was obviously a big shift for him because, you know, when he first came in to start doing the neurofeedback, I mean, he couldnt feel pain to the point where at one point hed broken his femur and he walked himself into the doctors office, and then all of a sudden hes feeling, you know, even the little pain from a paper cut or something small, and that was a big shift, but it was because his brain was now feeling safe enough to experience those sort of natural functions.

 

Bryn: Yeah. We dont think about it, but feeling pain is actually a really important function, and then I think about the opposite end of the spectrum, which is people who find that their chronic pain is lessened through doing neurofeedback.

 

Carly: Again, it goes right back into the brain entering into that sort of parasympathetic or rest state, you know, were reducing stress in the body, were putting it into the rest rate where good immune function happens and good digestion happens and just resting and restoring and repairing in general happens. So, it feeds into that good cycle of repair for the body. So absolutely it can be really helpful.

 

Bryn: Ive seen neurofeedback really effectively treat, I mean, a huge variety of experiences. So, things from migraines to stress PTSD I mean, you mentioned the immune disorders, but anxiety, depression, ADHD, and then also things like insomnia, which are all connected to that ability to have access to resting.

 

Carly: Yeah, and ultimately, I mean, were living in a world right now in particular where rest is really difficult. Our brains are on high alert, theres so many unknowns, theres so many things changing. So, its not surprising that were having a lot of these sort of outcomes and neurofeedback, like you were saying, ultimately can support these things.

 

Bryn: So, I often get asked some version of does neurofeedback work?

 

Carly: Thats the golden question. Yeah. I think the reality is the brain wants to come into balance, right? Thats its natural instinct. It doesnt want to be stuck. It doesnt want to stay stuck. It doesnt feel good to be stuck. I really have people say that it doesnt work in some capacity and generally those who find, say that it doesnt work are generall yexpecting it to work quickly or have an immediate response, and I mean, as we sort of talked about before, were working from a foundation up, its a ground up approach. Its not a band-aid solution. So, were rerouting potentially years of how a brain has functioned in a certain way.Right. Were rerouting how a brains been conditioned to function.

 

So, in learning new set of skills, its going to take sometime, and I think thats the piece thats really important in the beginning for people to know is its not necessarily going to be an immediate fix like we might sort of want or expect. Were rewriting a system, were training the brain a set of skills from the ground up like learning how to ride a bike, but the really awesome thing is once it knows how to ride the bike, it doesnt forget, and it might get a little wobbly after a couple of years, but it has that base foundational skill, and so thats why in the beginning, it could be a little bit more time, but generally most people it works really well for and they find it to be very life-changing.

 

Bryn: The other piece of it too, and again, well get into this in terms of how neurofeedback works, but your brain is constantly orienting to its environment, and so really what neurofeedback is about is giving it enough information that it can train towards feeling better.So, I think the other piece of that is just the repetition of it. Its sort of like working out. I mean, you cant work out once and then expect to feel better because for most of us we first work out and it feels pretty rough, so.

 

Carly: That aligns too with the, I mean, forming any new habit, right. We have to get over a little bit of that initial hump period of this is going to be a little bit more difficult in the beginning.

 

Bryn: So how long does it take for neurofeedback to work?

 

Carly: Yeah, this is another like golden question everybody asks, but its certainly its different for each brain. I mean, that is the best, most accurate response we can give. Every brain is so different. Generally, we tell people we want to sort of have a habit thats formed and stay stuck. Generally, people expect youre going to want to come in, you know, around 30 times to see like something stick, but before you actually notice changes a much might be way much sooner than that, that you start to actually notice shifts, and you know, every practitioner we sort of, we find different things. Im not too sure what you tell people in terms of when to maybe expect noticing shifts.

 

Bryn: Yeah. I generally tell people to not expect to notice anything before six to eight sessions. When theyre done consistently, but I often see for many people, the shift is actually faster, and thats interesting, actually I tell people around 20 sessions is sort of what theyre aiming for. So youre right, different practitioners will tell people something different, and I think to me what I like about that, just the fact that its, you know, ballpark 20 to 30sessions it means that its a more cost-effective mental health strategy, and to me its so important to have a treatment available that is more accessible to people then, because therapy can be quite pricey, and coming back, you mentioned a couple of minutes ago that each brain is different and I think its worth diving into that a bit more. So, how the brain works and so kind of understanding how neurofeedback might affect that really does start with understanding the brain.

 

Carly: Yeah, definitely. I mean like we were talking about right, the brain has this incredible capacity for learning, and what weve learned over time is that the brain is -- what we used to think is that the brain is incredibly static, its unchanging, and what we know now is that neuroplasticity allows for the brain to learn at any point in life, you know, regardless of how old we are, our experiences, the brain has this incredible capacity to change.

 

Yeah. So ultimately our brain is comprised of billions of neurons, and even if we, I mean, we lose so many of those brain cells every day, we lose millions of them a day, but it would take 600 years to lose half of our braincells, and when we talk about brain cells, were talking about neurons communicating via electrical impulses. So, theyre sending signals to each other and these signals are communicating the information about whats going on in our environment, and these signals range in speeds from really slow speeds, all the way up to really fast speeds, and this is ultimately what the neurofeedback is picking up and what its training.

 

Its picking up this electrical information, and then its responding back to the brain, through the music, which I know well get a little bit into about how the NeurOptimal actually works, but these pathways are really are the roots of our thoughts and our feelings and behaviors, and when we think of stuckness like anxiety as a stuckness, we think of these pathways that have become really solidified over time, you know, or conditioned to function this way. It could be based on a traumatic experience, it could be based on just how we function for most of our lives, right?

 

So those are the pathways and those are ultimately the pathways, those electrical pathways are being broken up and dismantled a bit. You know, these really salient pathways, the brain is breaking up that stuckness through the neurofeedback, and that kind of goes back to what youre talking about with people, this sort of more effective strategy, mental health strategy, which works so well for people, and I get all the time people coming in who say, I just dont know how to talk through this anymore. I dont know how to talk through this stuckness. How do I get through this? It feels like something I need some support in a different way, and so the neurofeedback can be so wonderful in that way in breaking that up.

 

Bryn: You mentioned the fact that the brain loses millions of cells a day, but it also is adding new cells, and thats actually something thats really interesting with traumatic brain injuries or concussions, which is that someone whos recovering from a traumatic brain injury, neighboring brain cells from the area thats damaged actually can compensate for that damage, and so this, to me, thats the part thats most exciting, which is that your brain is dynamic and its alive. Its losing, but its also gaining. Its always inconstant flux.

 

Carly: Yeah. We have to give it way more credit than we do, I think.

 

Bryn: Yeah.

 

Carly: Its pretty amazing. Really amazing.

 

Bryn: Huh-uh. So, you mentioned the feedback loop. Would you mind going into that? So, what is neurofeedback on a deeper level?

 

Carly: Yeah.So when we talk about the feedback loop and when we talk about neurofeedback, were talking about NeurOptimal specifically in this case, which is the systems that we use in our clinical spaces, and a lot of people have used, but what NeurOptimal is doing is, so somebody is hooked up, the individual is hooked up to sensors, theyve got two sensors on their head, one on the left side, one on the right side, and then two ear clips on the right ear and one on the left ear and the sensors on their head are picking up their brain activity and sending that activity to an amplifier, which then sends it to the machine to be read.

 

So, this is the detecting and monitoring process. The machine is picking up, detecting the brain activity and detecting specifically changes or differences, which we call variability, and these sudden changes in neural activity are picked up, and then what its doing is itscommunicating back to the brain these changes that its observing and informing the brain about what its doing so that the brain can then make the necessary change s that it wants to, or it feels it needs to, to feel better, and so how its communicating those changes are through little interruptions in the music that the person is listening to, and its picking up this data very, very quick, 256 times per second, and so it almost comes through as little static.

 

A lot of the time individuals dont even notice it coming through, but its like a little static or a little interruption through the music, and this is that signal thats inviting the persons central nervous system to make a change, to do something different or to veer back to the present moment specifically. So, to reorient itself, like we were talking about. So, its almost like its facilitating that reorienting process of coming into balance. So, its like holding up a mirror to the brain. If you think about the feedback loop, its like were holding a mirror to the brain were saying here, look, look at what youre doing and then make changes.

 

So, if we think about how we even respond, when we stand in front of a mirror, we look at a mirror and then we start to automatically naturally adjust things that are happening around us. So, we might fix our hair, we might take something out of our teeth. We might adjust our posture. So same sort of concept that feedback loop is holding a mirror up to the brain saying, look at what youre doing, now, make some changes, but were not to tell you what those changes are. Youre going to decide for them on your own, and thats the really neat parts. Its the brain teaching itself, how to regulate, the neurofeedback just facilitates that process.

 

Bryn: Its sort of like the fact that there are mirrors throughout gyms, or when you video technique if youre an athlete. Where you may know something, you may know that, you know, your posture should be different, but until you actually see it, it can be very difficult to correct.

 

Carly: Yeah. Its like being a YouTube star. Yeah, absolutely. You know, I was just thinking of that sort of another analogy that weve talked about before with the rumble strips on the highway, right? That orienting process. Its like when were driving on the highway and anytime, we start to naturally veer off the path, these rumble strips are sort of designed and in the same process theyre designed to sort of kick our brains into high gear, to move back into the center, to reorient ourselves. So same sort of concept is anytime our brains starts veering off this, you know, path this ideal path of functioning, this little rumble strip sends that signal back to the brain to say, hey, get back on the path.

 

Bryn: Specifically, so the type of neurofeedback that we use, and there are a lot of different types of neurofeedback. The type that we use is looking more at the coherence of the brain. So rather than wanting to up train or down train specific amplitudes, its looking more at the overall function of the brain, and I think that thats maybe the one differentiator between different types of neurofeedback, right?

 

Carly: Yeah, and then this is why we sort of call it the dynamic non-linear model; were not telling the brain something specific we want it to be doing. Were just allowing it, facilitating that natural process for it to just come into balance in general. Thats why sometimes I just call it general brain training.

 

Bryn: I think the nice side of that, another question that I get asked a lot is what side effects can I expect from this? I think thats the nice thing about doing a more general approach is that the side effects tend to be lessened, and so kind of the worst side effects that I ever see would be feeling a little bit spacey or feeling a little bit more activated after a session, but generally I think the side effects are quite limited for people because its more general.

 

Carly: The side effects, I mean, just like you were talking about before with going to the gym where, you know, we might expect that were going to have sore muscles or feel more drained after going to the gym. For some people, because the brain is training itself to break out of old habit or its breaking up, you know, these habitual ways of functioning, and I mean, that can be a lot of work for the brain that can be quite tiring. So, I noticed a lot of people, especially in the beginning do feel quite tired after session sometimes, but thats when we often just encouraged just if, you know, you can have a day to just chill out or not do anything too intense if possible, and yeah, that stuff will fade over time as the brain comes into balance, but mostly side effects kind of wed expect in the beginning as the brain is challenging itself to do something different than what its used to.

 

Bryn: Related to that the clients experience of neurofeedback would you mind, just so that people kind of have a sense of what it actually feels like in the moment.

 

Carly: So, like we were saying, right, youre hooked up to music, kids or even some adults, I mean, you can also watch a movie, but the music is like meditative music. Its very calming. So, the process is just basically laying in a comfortable chair and listening to like music and letting the system and your own brain do what its designed to do, and the really neat part is people can come in if youre feeling anxious, if youre feeling overwhelmed, if youre just having a bad day in general, it still works.So, you dont have to be feeling a particular way to come in.

 

You can just come in as you are, and its still going to help, its still going to be doing something. I have some people that fall asleep in the chairs because they do feel so relaxed and it still works as well. So thats the great part. Is it doesnt require conscious effort. It just requires people just giving themselves the sort of gift of a half an hour or 45 minutes to just chill and then let it kind of do its thing, but its a pretty easy, or you know, it can be difficult for some people, especially in the beginning just to the idea of sitting still, and its still doing something, but its pretty enjoyable process. People generally really, really end up liking it end up really enjoying that time of the week for themselves.

 

Bryn: When I was pregnant with my daughter, I did neurofeedback every week and I was fairly stressed out at that point, and so for me, that was just a way that I managed the stress and I just remember how nice it was to sit in a chair and just relax for half an hour every week, and I mean, the really nice side effect for that was not only relief from stress for myself, but then I have a pretty relaxed kid.

 

Carly: Oh my gosh, shes so chill. Yeah.

 

Bryn: That really stacks up in terms of some of the studies that we see about maternal stress and the impact or the resilience of infants that they, you know, if when a mother has access to feeling calm during her pregnancy, that that just is really helpful for infants.

 

Carly: Yeah, definitely. Well, you think of like, if the mum system is feeling more relaxed and entering into that parasympathetic state, like we were talking about before, then were pumping less stress hormone to the baby. Right, and then the baby just subsequently can just feel more calm as well, and thats the great thing about the NeurOptimal and neurofeedback in general is it can happen with people who are pregnant, I think thats a question that we do get sometimes if people can do it while theyre pregnant.

 

Absolutely. Yeah, and I was thinking, you know, sort of circling back to as somebody who, you know, my struggles, which brought me to neurofeedback where a lot of perfectionistic tendencies and the idea of sitting still and being bored was very distressing for me once upon a time, but I remember coming into the neurofeedback sessions and eventually I loved it so much because it gave me permission to be still for an hour, but still feel like I was doing something really productive at the same time, and until eventually, it trained my brain to be okay with stillness and boredom. Its pretty amazing, and its changed a lot of lives and I mean, ourselves included, right.

 

Bryn: Carly, thank you so much for talking to me about this today.

 

Carly: Of course. Thank you for having me.

 

Bryn: Carly Reinkeluers is a practicing neurotherapist in the GTA. You can find her contact information as well as other resources and podcasts on The Plum website. Im Bryn Savage, and this isThe Plum-Line, a podcast on mental wellness.

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