Neurofeedback FAQs

How do I get started?

If you are ready to start with an initial evaluation or if you have further questions before starting Neurofeedback, call the office at (703) 644-8039 or email paige@paigefishel.com.

How does neurofeedback work?

Neurofeedback trains your brain by providing information to the brain in real time about its own activity, encouraging and rewarding changes based on that monitoring and feedback.

Neurofeedback is aimed at training dysregulated brain wave patterns to regulate and organize themselves in healthier patterns. Dysregulated brain waves can cause a variety of symptoms such as anxiety, depression, lack of focus/ concentration, inflexibility, sleeplessness, impulsivity, inattention and various other symptoms.

During neurofeedback training, a client's brain wave activity is assessed via a computer-based program and simple auditory and visual feedback guide your brain to gradually make more or less of specific brainwave frequencies, or to regulate connections between areas of the brain. As a result, symptoms are alleviated and can even be eliminated.

During neurofeedback sessions, the client sits in a comfortable chair, relaxes and electrodes are placed on the client's scalp using saline paste. The client watches a movie or plays a video game and the sights and sounds on the screen change according to the client's brainwaves.

The adjustments to the screen and sounds are the "feedback,' and this method of rewards and positive reinforcement is how the client's brain is trained to produce the new brainwave activities associated with your brain training goals.

What is a brain map? Do I need one?

Yes, a brain map is definitely needed if you decide to do neurofeedback. Based on your individualized brain map, protocols will be tailored to your brain so that optimal brain functioning can be reached.

A visual brain map is created using a QEEG (Quantitative Electroencephalogram) which records the electrical signals that form brain wave patterns and maps the patterns to areas in the brain where they occur. Your recording is compared to a database of thousands of "typical" brains in order to identify patterns that are outside the typical.

A QEEG brain map can reveal dysregulated brain wave patterns and is used as a guide to assess functional issues and identify areas that may be associated with your issues and symptoms. Based on this information, a neurofeedback training protocol is designed to correct imbalances and retrain brain wave functions.

What does a typical session look like?

The client sits in a comfortable chair and a few (usually 2-3) sensors are placed on the scalp to measure brain waves in real time. The client will simply relax while receiving audio or visual feedback from a screen. The client may watch a movie or video game, or relax with eyes closed listening to music and audio signals.

Based on rewards, the brain then retrains itself to create and maintain healthier patterns. This learning takes no conscious effort on the client's part; the client will simply relax, watch the movie or screen and the brain does that work. Sessions are generally scheduled for 1 hour, twice a week, with 30-40 sessions (15-20 weeks) for optimal results.

How many sessions do I need?

Clients generally need around 30-40 sessions to lock in lasting changes. Everyone is different, however, so it is not a one-size-fits-all approach. Depending on the client's dysregulation of brain wave patterns, as well as other factors, this will determine how many sessions are needed.

Are there any side effects of neurofeedback?

Neurofeedback has very limited side effects and most clients feel no physical effects after a session. In rare cases, some people may feel tiredness, dizziness or experience a mild headache shortly after a session. At times, a client may experience some tiredness after a session due to the brain being fatigued after a "workout." This may be expected as you work out your brain in the beginning. In general, neurofeedback is a very safe, natural and non-invasive treatment option.

What type of symptoms do you treat? What type of patients do you see?

I treat clients with ADHD/ Executive functioning skills deficits as well as clients suffering from Depression and Anxiety. Neurofeedback can help alleviate symptoms such as lack of focus/ concentration, sleeplessness, inflexibility, impulsivity, inattention, irritability, headaches and various symptoms associated with depression and anxiety. The age range I work with is ages 8 and above.

When will I notice a difference?

Many clients begin to see results after 10-20 sessions, as the brain reorganizes, readjusts and healthier brain wave patterns emerge. For some clients, it is so gradual that they may not see it until other family members/ friends point out changes. Most clients report an improvement of symptoms halfway through the neurofeedback training. I can give a better estimate after I conduct a thorough assessment, which includes the brain mapping and evaluation.

Are the results long lasting?

Generally, once dysregulated brain waves have adopted a new pattern of healthy brain wave activity, the results should be long lasting. However, if you experience an unexpected life situation that affects the brain (trauma, brain injury, death of a loved one, extreme stress), you might need maintenance sessions or "tune-ups." These might involve only two or three sessions to get the brain re-stabilized and back on track.

Can I use neurofeedback if I'm taking medication?

Yes. Neurofeedback works if you are taking medication.

Can neurofeedback lead to a reduction of medication?

Yes. After neurofeedback training, you may find you need less medication or are able to discontinue it altogether. These decisions would be made in conjunction with your doctor.

Can I do neurofeedback if I'm also undergoing mental health counseling?

Definitely yes! Neurofeedback can be a powerful addition to psychotherapy treatment. As the brain begins to improve functioning through neurofeedback training, emotional and behavioral issues can be easier to resolve with psychotherapy. We encourage all our clients to seek the best care available for their individual situations.

What is remote training or at-home training? How does that work?

Remote training or at-home training is exactly what it sounds like: you do your neurofeedback training sessions at home. It is cost-effective, convenient and you can get results faster by being able to do 3-5 (or more) sessions a week instead of twice a week in the office. A brain map and initial evaluation will be conducted in person and protocols will be set up tailored to your needs.

You will be trained to run at-home neurofeedback sessions. There is a monthly cost that includes unlimited neurofeedback sessions, equipment, supplies and a review/ analysis of each session. Please call the office at (703) 644-8039 or email paige@paigefishel.com for more information