The Dubin Clinic | Los Angeles, CA
Direct Neurofeedback is an extremely low-strength electromagnetic current that can improve the sense of well being associated with diminished anxiety, depression, traumatic brain injury (TBI), PTSD, addiction and ADD/ADHD.
Direct Neurofeedback sends a tiny, imperceptible signal to the brain that causes a slight fluctuation in brainwaves. This fluctuation allows the brain to reorganize and get out of rigid, stuck patterns. It is like re-booting a frozen computer.
Despite such a weak signal, Direct Neurofeedback produces changes in brainwaves and greater self-regulation without any effort from the client. Direct Neurofeedback is not a treatment for any specific disorder. It is a general process that relaxes the nervous system and optimizes brain function.
However, as self-regulation occurs many problems arising from central nervous system dysfunction seem to improve.
“This can manifest as mood improvement in people with feelings of anxiety and depression, less distractibility and impulsiveness with ADD, greater clarity in TBI and less craving with addiction. Direct Neurofeedback may also benefit people who are already healthy and interested in peak functioning and greater resilience to stress.”
Excerpt from: Child Adolesc Psychiatric Clin N Am 14 (Jan. 2005)
Initial improvements are temporary, lasting from a few hours to a few days. With additional sessions clients report that improvements endure. An average of about 20 sessions is typically needed. Ongoing treatment is usually not necessary. Changes tend to be enduring.
Although the conditions that improve have very different causes, there is one common denominator: they are stuck in dysfunctional patterns. Direct Neurofeedback causes a “disruption” of that pattern regardless of origin, and allows the brain to either return to its “factory specifications” or begin creating new, healthy patterns. This coincides with the tremendous amount of research demonstrating a newly discovered “neuroplasticity” in the brain.
“We find the percentage of our clients who report benefit from the relaxation and reorganizing of stuck brain patterns with Direct Neurofeedback is upwards of 80%.”
In traditional neurofeedback, electroencephalographic measurements are taken from sensors attached to a client’s scalp. Those measurements are transmitted to a computer monitor, and a person is “rewarded” by results on the screen to increase or decrease certain brainwave patterns.
Our more recent form of neurofeedback, called Direct Neurofeedback, is very different and more efficient form of neurofeedback. With Direct Neurofeedback, information from sensors on the scalp is fed to a computer. Based on a person’s brainwave patterns a tiny, imperceptible signal is sent back to the brain from the computer. This signal causes a slight fluctuation in brainwaves, allowing frozen, dysfunctional brainwave patterns to be disrupted. Freed from these frozen patterns the brain reorganizes itself. Unlike traditional neurofeedback, which trains the brain, Direct Neurofeedback disrupts those aspects that are stuck.
Disorders That Can Benefit from Direct Neurofeedback
Anxiety and PTSD
Direct Neurofeedback diminishes the “fight or flight” response. The nervous system is less reactive. Direct Neurofeedback is exceptionally effective at reducing the symptoms of anxiety. Ninety percent of clients begin to experience improvement in the first or second session. Direct Neurofeedback also improves resilience, the ability to handle stress, and helps create a sense of calm in difficult situations.Anxiety Treatment
Depression: Monopolar & Bipolar
The under-aroused nervous system energizes—mood lifts, energy and motivation return. Direct Neurofeedback helps lift depression. Mood lifts, energy and motivation return and a client may once again experience a positive sense of wellbeing.Depression Treatment
Because so much of addiction is self-medication for anxiety and depression, and Direct Neurofeedback is so effective for both, maintaining abstinence becomes much easier.
A great deal of addiction results is self-medicating anxiety and depression. Because Direct Neurofeedback is so effective at treating anxiety and depression, this modality can be tremendously helpful for people withdrawing and recovering from addiction.Addiction Treatment
Concussions, Traumatic Brain Injury (TBI)
Headaches diminish, concentration returns, hypersensitivity lessens, and the fog lifts. In mild and moderate TBI, clarity, concentration, memory, multi-tasking and energy often rapidly improve.TBI Treatment
ADD and ADHD
With less distractibility and more concentration, organization improves and tasks are easier to complete. Direct Neurofeedback decreases impulsivity, distractibility and hyperactivity. Organization improves. The world becomes easier to navigate. Life becomes less of a struggle.ADD/ADHD Treatment
The potential range of clients is enormous. Direct Neurofeedback is very helpful in autism. Anxiety, impulse control and an over reactive nervous system, all of which are very common in autism, respond very well to Direct Neurofeedback.
So many on the spectrum are hypersensitive to stimuli, are anxious and over-reactive, have poor impulse control and have difficulty maintaining emotional stability. Because Direct Neurofeedback is so effective at treating all the symptoms, there can be a dramatic improvement.Autism Treatment
Obsessive Compulsive Disorder (OCD)
While anxiety does not cause OCD, anxiety drives it. As anxiety decreases, so does the intensity of the OCD. Clients often say that intrusive thoughts are now in the background and much more manageable.
We now know that with chronic pain, changes in the brain frequently take place. Furthermore, many of these patients have chronic anxiety and/or unconsciously tighten their muscles to limit discomfort. With Direct Neurofeedback the frozen, stuck changes in the brain are effected in a positive way. There is diminishment of the “fight or flight response”. Anxiety improves and muscles relax. Chronic pain patients benefit significantly.
Other areas where we have quite a few reports but no systematic review are for strokes, which are a form of traumatic brain injury. We think this may become one of the biggest areas of use for Direct Neurofeedback.
The applicability of Direct Neurofeedback is very broad. It includes the military (for both TBI and PTSD), schools, addiction centers, stroke and rehab centers and so on. Nearly everyone either has or knows someone who has anxiety, depression, addiction, OCD, autism, traumatic brain injury or chronic pain. As one of my colleagues said, the only person who might not benefit from Direct Neurofeedback is the Dalai Lama.
“EEG biofeedback meets the American Academy of Child and Adolescent Psychiatry criteria for clinical guideline for treatment of ADHD, seizure disorders, anxiety (OCD, GAD, PTSD, phobias), depression, reading disabilities, and addictive disorders. This suggests that EEG biofeedback should always be considered as an intervention for these disorders…”
Sufen Chiu, MD
Psychiatry and Behavioral Sciences, UC Davis
Direct Neurofeedback FAQs
What Happens in a Typical Session?
The skin on the forehead is prepared so that there will be a good connection. Then a few sensors are placed the scalp. The client sits still for about 30 seconds at a time while her brainwaves are recorded and a very weak signal is sent back to the brain. Other than that there is nothing the client has to do. In a few minutes the client generally feels calm and relaxed. The session is over in less than half an hour.
How Effective Is Direct Neurofeedback?
The success rate is very impressive. Over 85% of clients benefit significantly, often dramatically. And the changes are enduring. Once enough sessions have been completed (typically 15-20), most people have completed their treatment. There is no need to receive Direct Neurofeedback on an ongoing basis.
How Weak Is the Signal Going Back to the Brain?
The strength of this signal is far less than a cell phone and cannot be felt. This signal is 1000 times weaker than simply holding a AA battery against your forehead.
Does Direct Neurofeedback Affect Only Negative Patterns?
Only frozen and stuck patterns are affected by Direct Neurofeedback. Healthy brainwave patterns are flexible and resilient. When there is a tiny fluctuation in their pattern they automatically spring back to that healthy state.
Is Direct Neurofeedback Safe?
Direct Neurofeedback is extremely safe. In over 100,000 clients treated with Direct Neurofeedback there has not been a single reported case of someone being worse off. Direct Neurofeedback has been used by practitioners for over 20 years. Direct Neurofeedback is not experimental, only relatively unknown.
What if I Am on Medication?
Medication does not diminish the effectiveness of Direct Neurofeeback. There is no need to stop or reduce your medication, which should only be done in conjunction with your healthcare provider.
Is Direct Neurofeedback Covered by Insurance?
Direct Neurofeedback® is often reimbursed as a form of “biofeedback” using CPT code 90901. You should check with your carrier. We will provide you with a “super bill” which you can submit.
How Many Sessions Are Required before Improvement?
Most people notice an initial change within 3 sessions, occasionally a little longer. The average number of sessions for most problems is 15 to 20. Once treatment has been completed, additional sessions are usually not necessary. Occasionally someone needs a “booster”.
Do You Work with Children?
Yes. A large part of our practice is devoted to children, adolescents, and teens.
What if I Live Far Away?
Clients sometimes come from out of town and stay for 1-2 weeks. They receive daily treatments and generally experience very rapid changes.