Tracking Changes

So many people hear the stories of miracle responses to neurofeedback and assume that’s the norm. The reality is that consistent work over time is what tends to produce lasting results, not miracle reactions.

It’s always important to remember that the training is for the brain–not the trainer, and not the trainee’s mind. The brain is getting the feedback, which in many cases the mind can’t make head nor tail of–much less the trainer. When you do psychodynamic psychotherapy with a client who wants to break a habit, you recognize that you may have to change other things before the habit changes. Just telling the client to stop smoking, for example, or how bad it is for him, etc. simply doesn’t do the trick. So, if you measure the number of cigarettes he smokes each day, you both may get frustrated because the number doesn’t go down for a while. If you look at the larger picture, the client may notice that he is less anxious, that he doesn’t get irritated as easily or other things which are laying the foundation for the final result. What measurable changes (outside of plain old performance) would you see when someone was suddenly able to ride a bike who couldn’t before?

Using another example, a runner may check his heart-rate during exercise to see if he’s in the training range. That’s feedback for the heart. I don’t know of any runners who graph their heart-rates from session to session. They may graph how far they were able to run, how quickly they ran, etc., but those are again performances.

If you assume that there is a stable situation in your brain (unlike any other part of your body) and that if you checked in HEG the ratio of red/infrared blood and its relationship with infrared temperature in the same spot, even at the same time every day it wouldn’t vary, I think you’d be quite disappointed. It’s the same with EEG charting—you can presume the brain operates like a machine, but it does not. Even going to the gym or jogging you have probably noticed that some days it’s easy; some days it’s hard work. Thousands of things affect that relationship (which, by the way, is kind of a derivative), like how well you slept last night, when you last ate, how much you ate, what kind of mood you are in, what you’ve been doing for the last hour, etc.

The objective is to teach those brain areas to activate physiologically upon demand, from wherever they are when you start, and to be able to sustain that activation–improvement in stamina–over longer and longer periods. I’m not sure how you measure that over time except by saying, “I feel happier.” “I focus better for longer periods.” “I have greater control of myself.” “I’m planning and organizing more effectively when that’s appropriate.” etc.

An Assessment is a Snapshot

When you do an assessment, QEEG or whatever, you are taking a snapshot of someone jumping on a trampoline. You can probably tell if they look excited or scared, what they’re wearing that day, maybe what the weather is like. But you don’t know if they’re at the top of their jump or the bottom, going up or going down, if this was a really big jump or just a little one, what kind of trampoline it is, etc. Taking multiple pictures will likely give you a lot of images that don’t necessarily look the same–especially when they are separated by time.

If you have a client come to you and complain, “my theta/beta ratio is all out of whack; I want to fix that,” then you should certainly train that and track that and do pre and post, etc. Don’t hold your breath waiting for that person to arrive in your office. Much more likely the client will want to feel safer or happier, be able to recall read or heard material after one contact with it, get along better with others, play golf better, or whatever. Real world stuff.

I know it’s disappointing when the client has gotten better as he wished as a result of the training and you just can’t “see it” on the EEG. Even QEEG’s, with thousands of measures of brain activity, don’t necessarily show “improvement” in the EEG.

Sorry. You’ll just have to be satisfied with pleased clients. (BTW, imagine a situation where the EEG looks dramatically better after 20 sessions–and the client is still struggling as much as he did when he came to you–do you think he’s going to care much about the EEG graphs?)