We talked to Ms Alberta Hildebrand, head of the step-by course programme of the Child and Autism Foundation. In the interview she told us more about the goals of the foundation and about their experiences with Neurofeedback in ASD.

Dear Ms Hildbrand, thank you very much for taking the time to talk to us. What exactly does the Child and Autism Foundation do?

 

The Child and Autism Foundation is a competence centre for children and adolescents with autism in Urdorf in the canton of Zurich. It was founded on the initiative of affected parents who set up a day special school for children with autism in 1975. Since then, the organisation has continued to develop and has established itself as a nationwide centre of excellence with a wide range of services for families where autism spectrum is an issue. In addition to a school home with a day special school, a boarding and driving service, a counselling centre and the early intervention area, we also run an aids shop and the step-by course programme.

We maintain a lively exchange with professionally related schools, counselling and specialist centres in Switzerland and abroad. In addition, we raise public awareness about autism. 

The Child and Autism Foundation employs around 100 people. It is a non-profit organisation and our work is financed by contributions from the federal government, cantons and municipalities, through counselling and courses for affected persons, families and institutions, as well as through donations.

 

You have already mentioned the step-by course programme, of which you are also the director. Who is the training programme aimed at and what is the goal of the programme?

 

The step-by course programme was founded by our foundation in 2004 and offers a wide range of further education, training and lectures on the autism spectrum. It is aimed at professionals from the fields of education, agogy, therapy, medicine and - depending on the course - also at parents and accompanying persons who live or work with people on the autism spectrum. The offer is very well received and we simply notice that the need for further training on the topic continues to grow. We therefore also offer individual training and courses for schools, institutions and other foundations, which are specifically tailored to their needs and topics. With this offer, we also want to pass on some of our many years of experience.

 

What is your experience with Neurofeedback?
 

Autism manifests itself differently depending on its severity and expression and can include various symptoms. These include withdrawal into a world of one's own thoughts, avoidance of contact with the environment, disturbances in speech and motor skills, low empathy for the emotions and needs of others, stereotypical movements and behaviours, and avoidance of physical contact. Neurofeedback can have an amazing effect in treating these accompanying symptoms of autism.
Autism cannot be cured causally, but can be treated therapeutically to the degree of severity. The treatment must be adapted to the individual patient as flexibly as the effects vary. Neurofeedback can therefore be one of the building blocks of a behavioural therapy treatment plan.

Parents whom I advise and support tell me that Neurofeedback helps their child in everyday life. For example, anxiety or anger can settle down, the child becomes calmer, calmer or can feel himself or herself better. The child, the teenager, but also the parents, can develop more self-confidence and self-esteem. It helps them to relax mentally so that they can concentrate better and interact more positively with their environment. 

 

Once a year you organise the so-called Autism Forum. What are the contents and goals and what is planned for this year?
 

Our Autism Forum provides a popular platform on the topic of autism. We facilitate networking and exchange for professionals, institutions, decision-makers, people working in the autism field and interested parties. The programme covers a wide range of current topics from early childhood to adulthood. We welcome nationally and internationally renowned experts as speakers. This year's forum will take place on 11 November 2022. The programme and invitation will soon be published on our website www.kind-autismus.ch.

 

Neuroscientist Dr. Ned Sahin was a keynote speaker at the 16th Autism Forum and said "I think I see the amazing hope that the right technology, the right neuroscience and the right humanistic approach can have for this set of potentially 70 million people". Do you think Neurofeedback can make a contribution here?
 

We think so. Of course, there is still a long way to go. Of course, we are still a long way from providing comprehensive services for families, but on the one hand, public interest in the autism spectrum is increasing and families are finding places to turn to. We are also working on building more competences and networks through our courses. On the other hand, there are more and more scientific findings and also new technological approaches that support children and young people and also positively support their environment.
All these developments are intertwined. We also see potential in Neurofeedback and I hope that Neurofeedback, as a component of various methods and approaches, can support many people affected in their everyday lives. 

 

Thank you for this interview!

 

Of course, you can learn highly effective Neurofeedback with us. But above all, it is our lecturers who make our courses so special. Reason for that is, you won’t learn Neurofeedback from trained sales personnel in one day with us, but from enthusiastic Neurofeedback practitioners. All of them are experts in their subject and have been working successfully with Neurofeedback in their own practice or clinic for years, with a lot of empathy and sensitivity. So we sat down with some of the lecturers on our team and simply asked them why they love teaching and what makes our courses so special. 

 

"You can somehow do Neurofeedback, or you can do it really well" 

When we enter the online meeting, Meike Wiedemann, Doris Engels and Horst Schneider are already in the middle of the conversation. Just yesterday, a very successful course in Switzerland came to an end and the three of them are having a lively exchange about it. The feedback from the participants was very good and Meike and Doris also enjoyed the course. We ask the three of them, representatives for the many others of our lecturers, why they actually like teaching so much. Meike doesn't ponder long and says: "With our courses we want to reach people who are in clinical work, people who do Neurofeedback all day. And we want them to do Neurofeedback well with our courses. Because you can do Neurofeedback somehow, or you can do it really well." Meike PhD, PD in Neurobiology & clinician in private practice says about herself that she was infected with the Neurofeedback virus more than 20 years ago. In the course of her scientific career she came across Neurofeedback, was fascinated by the effects, educated herself, attended courses worldwide, worked with all methods, landed at ILF Neurofeedback and finally stuck with it, "Simply because it is best".

With every sentence said Meike, Doris and Horst carried over the message of how great enthusiasm and passion everyone puts into teaching. "After our courses, we want our specialist colleagues to go out and be well prepared to practice. And simply, the more therapists work with Neurofeedback, the more people will have access to Neurofeedback. That's what drives us." says Doris, an occupational therapist, design therapist, and systemic therapist, as well as the owner of several practices.

"I understand what people are saying about your courses now."

The motivation is genuine. You can sense that in the interview and the participants in the courses also notice that. "We often get feedback that there is such a pleasant atmosphere in our courses. Afterwards people often say, “I understand what people are saying about your courses now”, Doris continues. When asked where this special atmosphere comes from, all three immediately agree: there is simply a friendly relationship among the team and the collaboration is characterized by mutual appreciation. Horst, who holds a degree in biology and a doctorate in neurophysiology, adds happily: "The harmony in the teaching teams radiates to course participants and simply creates a feel-good atmosphere. And, of course, we all bring professionalism and a lot of experience to the table. You just notice that." 

Neurofeedback expertise from various disciplines

The lecturers cover numerous disciplines from occupational therapy to psychotherapy, (pediatric and adolescent) medicine and psychiatry, (sports) psychology, neurobiology, neuropsychology and more - all are professionals with a healthcare, therapeutic and/or scientific background. Meike adds "Especially the different orientations and professions we have in the team makes the teaching so exciting and we complement each other perfectly." The diversity of teaching can also be seen in the wide range of courses offered. In addition to the basic course and symposium, there are numerous indication-specific courses in which guest lecturers also provide new, up-to-date, specialist input. Doris adds, "We are always up to date in the industry and informed about changes. In addition, we also benefit from this close exchange in our daily work. As part of this network, I can always develop myself as an experienced therapist."

 

The importance of self-awareness in Neurofeedback

The focus of each basic course is on self-experience with Neurofeedback. Especially through practical training and working in different roles should enable all participants of the course to quickly feel confident in using Neurofeedback.
"We know that our participants learn a lot in the few days of training. Because of self-awareness, the basic course is very intensive. But our participants leave the course feeling good about themselves, so they are ready for practice," says Meike. 
During the internship, participants are closely supervised - whether in face-to-face courses or online. The internship usually takes place in groups of two, closely supervised by the lecturers. Experiences and results are discussed in small groups in order to jointly work out the next steps for the following sessions.
In addition, there is of course always the possibility to set focal points in the courses and all participants can bring in their concerns, ranging from therapy of complex traumatization over ADHD up to Neurofeedback in the area of peak performance. It's also important to the instructors to keep an open mind and think outside the box. "We teach ILF Neurofeedback, but our roots are in other approaches as well. Therefore, we are always open to learn more about other Neurofeedback methods as well," says Horst Schneider.

 

Neurofeedback as a life theme

Finally, we asked what motivates the three of them to teach in addition to their daily practice. After all, courses that last several days mean additional work. Meike answers immediately: "Neurofeedback is my life theme. I am convinced that it is good and therefore I want to teach it properly and thus help it to spread. When I started back then, I had to gather so much. Of course I took courses, the ones that were available at the time (laughs), but I still had to train myself for years and go deeper and deeper so that I could use it in a meaningful way. Until I arrived in the USA at EEG Info and after that it was clear to me what I would like to build up and pass on here. Now I am convinced that you can learn Neurofeedback faster and better with our courses than in the way I had to do it". Doris associates with Meike Wiedemann's response: "When I started teaching, for sure I thought about how I would do it alongside my practice. But I felt comfortable right from the start and had a good induction here. Mistakes can be made. And I always had experienced colleagues by my side at the courses. As I said, it's teamwork. No one is left alone. And now I have quite a bit of experience. Everything I've learned I can now pass on - that's something nice!". "There's nothing to add to that" adds Horst, also with a smile on his face.

 

Our training team

By following this link, you will find an overview of some profiles of our lecturers, including those of Meike, Doris and Horst. All of them have passed the certification at EEG Info Europe and are constantly training according to our quality assurance. And we are happy to see our team grow! You can find more info on LinkedIn or here.

 
Linkedin: BEE Medic GmbH | LinkedIn

 

Biofeedback describes a method that can offer the way to a better perception and regulation of one's own body. In biofeedback, peripheral physical parameters - also called biosignals - are used. These can be muscle tone, heartbeat or breathing rate, for example. Electrodes, which are attached directly to the skin, for example, or mounted in a chest belt or finger sensor, measure peripheral physiological parameters. These signals are then reported back on a screen - either simply as curves or in animations. 
Biosignals allow conclusions to be drawn about the current stress level - being able to perceive one's own physical reaction can be an enrichment for therapeutic work, or for training relaxation or concentration. Accordingly, biofeedback is used as a therapeutic component for mental and physical illnesses as well as in performance and concentration training - the so-called peak performance - or competitive sports. 

In this blog post, we would like to discuss the central parameters and functionalities of biofeedback and also shed light on the extent to which a combination of biofeedback and neurofeedback can be usefully designed in therapy. 

 

Pump it up - the heart rate and heart rate variability in biofeedback 

 

The pulse is a biological parameter that changes according to external and internal demands. Not only a steady pulse, but also the adaptability of the heart rate to different demands - the so-called heart rate variability (HRV) - is a central parameter in biofeedback. 
Heart rate variability is the variation of the temporal distance between two heartbeats (also: beat to beat interval). This is longer in times of relaxation than in times of physical or emotional stress. A high heart rate variability speaks for a good (peripheral) self-regulation, because it indicates that the organism is able to adjust the heart rate depending on the requirements and finds the optimal frequency for the respective situation. Low heart rate variability is often related to a problem in dealing with stressful situations, memories or stress in general. 

Especially for patients with anxiety disorders, depression or chronic pain, biofeedback with heart rate variability training can be helpful. Often these patients are not aware of the connection between their emotional stress and physical reactions and the perception of their own body does not work well, because they have permanently a very high stress level. Training here to perceive, influence and synchronize central parameters such as heartbeat and breathing and thus lower the general stress level can be a key experience in therapy and make patients aware that they do have control over their physical and mental state.

 

Breathe deeply three times - breathing in biofeedback 

 

You probably know the tip that lay literature and grandmothers like to give whenever someone is stressed: take three deep breaths. Does that really help? Here's a little experiment: put your hand on your stomach. Breathe deeply into your belly, feel how the hand rises, how your belly bulges, when the belly is bulging to the maximum, hold your breath for a moment and then breathe out again slowly and evenly. Feel the air flowing first out of the belly and then out of the tops of the lungs, over both lungs and out the airway. Repeat this three times. What do you notice? How are you conducting yourself? How has your heartbeat changed? 

The HEARTBEAT?! That's right - breathing and heartbeat are closely related physiologically. In a relaxed state, heart rate and breathing rate correlate, this is also what we call "respiratory sinus arrhythmia". When breathing in, the heart rate thereby becomes higher, the sympathetic nervous system is activated, and when breathing out, the heart rate becomes lower, the parasympathetic nervous system is activated. Breathing deeply in and out three times in stressful situations can thus help not only to gain better awareness and control over one's own breathing, but subsequently also to synchronize the correlation of breathing and heartbeat. 

 

Sweat Baby, Sweat - the skin conductance in biofeedback

 

The skin conductance is usually recorded via electrodes on the finger. The texture of the skin on the palm of the hand differs from that on other parts of the body - on the palm of the hand the skin has a particularly large number of sweat glands. These sweat glands, which are innervated by the sympathetic nervous system, react quickly to stress by increasing their glandular activity.  If the palm is dry and the activity of the sweat glands is low, the skin conductance is also low. Since sweat is a salty fluid, skin conductance - measured by 2 electrodes on the fingers - increases as sweat gland activity increases.

If the skin conductance is constant and low at rest, this indicates a relaxed state, but if it fluctuates constantly for no apparent reason, this may indicate that even stimuli that are actually neutral are perceived as stressful. If a stressor is then presented - sometimes the mention or thought of a stressful situation is enough - the skin conductance usually rises quickly. In healthy people it returns to its initial level after 1-2 minutes. However, in patients who have problems in emotional regulation, it also happens that the skin conductance remains at a high level for a long time after the stressor. Since the skin conductance responds quickly to stressful stimuli and is easy to measure, it is particularly well suited as a psychophysiological mirror in therapy - and reflects the change between tension and relaxation. It can also be used as a support in relaxation training or in learning various relaxation techniques.

 

It is getting hot in here - the body temperature in biofeedback 

 

Temperature is usually measured by a sensor on the finger. In a relaxed state, the smooth muscles in the walls of the blood vessels usually also relax, which leads to more blood flowing to the extremities - we often recognize this by the feeling of warmth in the hands. Thus, an onset of relaxation is accompanied by an increase in temperature in the extremities. Under stress or tension, the muscles in the vascular walls contract, the vessels become narrower and less blood reaches the extremities, often resulting in a drop in body temperature. The body temperature usually reacts with some delay, from the beginning of the stress reaction to a drop in body temperature in the extremities may well take 1-2 minutes.
 
The body temperature skin conductance can be used in therapy, for example, to demonstrate the influence of thoughts and ideas on physiology, because some patients succeed in achieving a change in temperature by imagining warmth/cold, and body temperature can also play a role in relaxation training. 

 

The combination of bio- and neurofeedback 

 

In symptom-based infra low frequency (ILF) neurofeedback, the patient's symptoms and state changes are the central components. Many of these symptoms also relate to correlates of stress and relaxation. Accordingly, the addition of biofeedback parameters can be a useful complement to ILF neurofeedback. This makes it possible for patient and therapist to include the physiological correlates of state changes in the therapy. Patients who are not able to perceive or verbalize changes in their stress and relaxation state very well will get another possibility to experience changes through neurofeedback. Even changes that are partially below the threshold of perception can be made visible by measuring peripheral signals and can find their way into the therapy. In the case of skeptical or tense patients, the inclusion of biofeedback parameters in the sense of psychoeducation can also help to make the connection between psyche and physiology visible and tangible, to familiarize the patient with the setting with electrodes and to gradually reduce the possible fear of changes through therapy, in order to gently introduce the patient to neurofeedback. 
The therapist can deduce signs of stress and relaxation in the physiological parameters and optimize the therapy accordingly, for example by changing the frequency.

 

Modern Biofeedback with the AliveⓇ Software 

 

Measuring the four central parameters - heart rate variability, respiration, skin conductance and temperature - separately and reporting them back in curves or animations is no longer necessary with our combined biofeedback solution of Combisensor and AliveⓇ software. The Combisensor - a finger sensor with electrodes - is attached to the index finger, derives biosignals and reports them back to the AliveⓇ software, which uses them to generate graphs and curves that are highly informative for patients and therapists.  The Combisensor can be easily connected to the NeuroAmp and the Cygnet and Alive software packages can be operated in parallel.

The AliveⓇ software contains a variety of animations, workshops and tutorials and offers versatile applications for the four peripheral signals. The Alive feedbacks are displayed on two screens - similar to Cygnet - and the therapist can also see the actual derived biosignal. This also allows the therapist to use the software simultaneously with neurofeedback and Cygnet. However, with AliveⓇ it is also possible to use the popular Cygnet animations such as Innertube, Tropical Health or Dreamscapes for biofeedback. However, Alive also includes specific calm feedback options exclusively for biofeedback, which are particularly suitable for anxious and tense patients. Detailed reports can also be generated through the software. 

With Alive, biofeedback can be used both as a separate therapy component and in combination with neurofeedback. 

 

Biofeedback in theory and courses - Our teaching offer 

 

Since biofeedback addresses peripheral parameters, there is no need for a compulsory beginner's course, unlike neurofeedback, which works with central excitation parameters. Biofeedback can also be a useful component in other therapy or training settings, for example in peak performance or competitive sports. 

To learn how to use the finger sensor and AliveⓇ and to try it out in practice, we are regularly offering an introductory course in biofeedback theory and practice. Please check our courses for more information.
 

 

Literature recommendation

For those interested in more intensive study of parameters in biofeedback, we recommend chapter 2, "Peripheral Biofeedback" in the following Springer textbook: Haus KM. et al. (2020). Praxisbuch Biofeedback und Neurofeedback. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59720-0_1 (in German)

The brain is a very complex organ and the interaction between anatomical and functional networks of the brain is a current topic in psychopathology research and therapeutic discussion.
Olga Kara is a neuropsychologist and neurofeedback therapist with a strong scientific and research background. From early on Olga was fascinated by neurobiological and psychophysiological foundations of cognitive processes as well as their specific patterns in various psychological conditions. Besides Infra Low Frequency (ILF) Neurofeedback, she uses different training methods in combination with neurotechnology to help patients in her practice in Tampere, Finland and clinic in St.Petersburg, Russia. Olga moreover actively participates in the development of the latest approaches for the integration of brain functions analysis in treatment.

 

Olga, what do we understand under brain functions analysis? 

 

The Brain - as any other organ - has a specific anatomical construction and we can measure the thickness of the cortical layers, or the size of the ventricles, or identify some unusual swelling. All this information is highly important for diagnostics. At the same time, our brain performs an enormous number of different functions. It allows us to read, speak, run, feel the environment, adapt, learn and so on. This complex repertoire of behavior is performed by functional brain networks, or networks that are activated and working together to allow us to perform.Psychological and psychiatric symptoms often cannot be linked to anatomical deviations, but we can identify problems within functional brain network communication. And this helps us to link the deficiency within a specific functional brain network to the patient’s symptom. 

 

How do you use brain functions analysis in your practice?

 

Brain functions analysis helps me in several ways. I conduct brain functions analysis as part of diagnostics to e.g. exclude pathological conditions that should be addressed to another specialist, or to better understand the symptoms of my client. I have found brain functions analysis to be useful, when standard protocols do not seem to help the patients - this is when maybe a severe underlying functional brain dysregulation interferes. So I use brain functions analysis for therapy planning but also for monitoring of therapeutic outcomes.

 

What further information does brain functions analysis provide for the therapist? 

 

In ILF neurofeedback our primary source of information are the patient's symptoms and symptom changes. By the patients’ state and the relations within and in between neurofeedback sessions, we get information about hyper- and hypo arousal and can e.g. adapt the training frequency. Me as well as my colleagues get great results by this symptom-based approach. But sometimes - in e.g. patients with inconsistent symptom profiles, severe comorbidities or with practically no ability for introspection and self-report - one would like to consider a second source of information. This is when brain function analysis, EEG and ERP recording can be beneficial. 

Therapists could use this method if they have concerns about client conditions, for brain training protocol construction, for monitoring of progress (especially if customers cannot see the difference between initial condition and post-training changes). In some cases, especially for medical doctors, this method can be used to predict the responsiveness to a specific medication. The information one gets out of brain functions is complex and one needs to analyze the data and have specific knowledge therefore. 

 

Is brain functions analysis a necessity before starting ILF neurofeedback training? 

 

It is not a necessity. ILF is a symptom-based approach with clinically validated standard protocols that perform very well without brain functions analysis. 
However, in case your client shows unexpected reaction to ILF or you have some concerns about client progress, you may want to add an additional assessment to support your idea about customer condition, exclude some neurological abnormalities, or simply use this as an evidence-based approach, which can help you to measure the effectiveness of the therapy on the functional brain state.I would recommend brain function analysis for those neurofeedback therapists who are interested in the EEG and want to add a further source of information - EEG and ERP related data - besides symptom changes to their treatment evaluation. 

Olga will also share her knowledge and give insights into brain functions analysis and neurofeedback therapy in an Expert Talk on October, 20th 2021 at 5 pm CET. Register right now for free and learn about how neurodiagnostics, EEG/ERP technology and brain functions analysis can be integrated into a neurofeedback practice. 

The demand for psychotherapy continues to grow unabated. Whereas practices were already at capacity before Corona, demand continues to increase. According to a survey conducted by the German Chamber of Psychotherapists at the beginning of the year, demand is already up another 40% over the previous year. For patients, this often means even longer waiting times. For practices, overload. But why it is worthwhile to start with Neurofeedback right now, we show in this article. 

 

1. First of all: Neurofeedback can help with many symptoms because it aims to improve self-regulation.

Our brain is constantly busy with regulation and always wants to work ideally. When we are well-rested, relaxed, stress-relieved and healthy, this self-regulation works well. It is then quite easy for the brain to work optimally and, for example, to go to work with concentration and vigor during the day and to be able to switch off well in the evening. In contrast, we often find it difficult to relax during particularly stressful times. We are not concentrated, irritated and surely everyone of us has already experienced depressive moods once. Sometimes we can get out of such phases on our own and not every kind of stress makes us sick right away. However, permanent stress, traumatic experiences or (mental) illnesses can disrupt this sensitive system of self-regulation in the long term. And often mental illnesses in particular go unnoticed for a long time, are ignored and favored by many factors. The consequences are then often severe and long-term with a variety of symptoms. This is where Neurofeedback comes in. It aims to improve self-regulation and thus to alleviate the symptoms of illnesses. This is why we call ILF Neurofeedback a "symptom-based approach". Depending on which symptoms patients suffer from the most, feedback and electrode position are individually adjusted. ILF Neurofeedback is therefore very effective. Successes and whether a patient responds can often be seen in the first few sessions. Mostly by an improvement in sleep, concentration, or the ability to relax better again. And often patients also report a feeling of well-being, that they feel more secure "and tidier in the head". Neurofeedback can therefore lead to rapid therapeutic success.

 

2. Neurofeedback is fun

Neurofeedback doesn't actually feel like therapy because of the relaxed therapy situation. Especially children and teenagers look forward to "their Neurofeedback training" with the computer game-like animations. Problems at school, whether they have ADHD or suffer from anxiety - all this does not play a big, noticeable role during the Neurofeedback session. During Neurofeedback, it's much more about relaxing, letting the feedback work on you, and, most importantly, experiencing self-efficacy. And even very performance-oriented adults who find it difficult to open up or are reluctant to talk about difficulties often find access to Neurofeedback very quickly. This is because Neurofeedback does not focus on problems and diagnoses and also simply feels good.

 

3. Neurofeedback motivates

Initial improvements in symptoms can be seen quickly and after just a few sessions. This is very motivating. For both, patients and therapists. The effects of Neurofeedback are especially noticeable in everyday life and are also noticed - especially with children and adolescents - by parents and in the school environment. They can be seen in better concentration, balance, better handwriting, etc.  Such tangible successes are extremely motivating and mean that patients are usually very happy to come to therapy. Fewer sessions are canceled and you have fewer therapy failures and a higher planning reliability. 

 

4. Neurofeedback brings ease into the daily work routine...

When asked what they personally benefit most from Neurofeedback, almost all of our clients say sentences like these: "Neurofeedback brings ease into my daily work", "Neurofeedback makes my work much more relaxed", "You can achieve so much with little effort through Neurofeedback" or "A day of talk therapy can be quite exhausting and drain your strength. Neurofeedback also feels easier to me. I am less drained and also much more satisfied with what I have achieved at the end of the day".

 

5. ... and less stressful situations arise during therapy

Neurofeedback is very calm work. Of course Neurofeedback has to be accompanied therapeutically and the dialogue with the patient is important during the therapy in order to optimize the training frequency more and more or to adjust it according to the therapy success. But due to the relaxed attention while the patient does the Neurofeedback "automatically" and follows the feedback animations on the monitor, less tension and stressful situations arise during the session. This is good for patients, but most of all for you! You can also simply take a breather yourself during Neurofeedback.

 

6.Neurofeedback is efficient

Every day therapists tell us about very rapid successes and real treatment breakthroughs. Many patients can be helped faster by Neurofeedback. Neurofeedback is also very easy to plan and the treatment intervals lengthen with ongoing therapy. So while your waiting list may not necessarily get shorter, because you will notice very quickly that your Neurofeedback waiting list is growing. You will however be able to help more patients faster overall. Which of course can also have a positive effect on the reputation and economic success of your practice.

 

7. Every patient can learn Neurofeedback

There are only a few contraindications for Neurofeedback, such as particularly severe forms of epilepsy. In principle, however, Neurofeedback can be learned from elementary school age to old age. The brain performs the Neurofeedback training "automatically" and without any noticeable effort. Because it is suitable for such a wide range of patients, it can be easily integrated into any practice and many patients can benefit from it.

 

8. Neurofeedback is easy to use

Our Neurofeedback hardware is very handy. Therefore, it does not take much to get started with Neurofeedback. The Neurofeedback equipment itself is compact and also the software is easy to use. All you need is a small area - ideally a small trolley on which you can safely place the NeuroAmp and consumables. With a little practice, you can also apply the individual electrodes within a few seconds. All you have to do is select a suitable feedback together with the patient, set the training frequency very simply by using a slider and then concentrate fully on your patient and continue to optimize the training by observing and asking specific questions. We will show you exactly how to do this in our basic courses with a high practical component.

 

9. Neurofeedback is therapeutically attractive

Modern Neurofeedback is not solely oriented towards diagnostics, but above all towards the symptoms that patients suffer from the most. This is why at ILF Neurofeedback we speak of "symptom-based" work and why your role as therapists remains so central. With your expertise and based on your Neurofeedback training, you guide your patients through Neurofeedback. You make decisions about the right electrode position and the appropriate training frequency. The good interaction between therapist and patient is therefore still important and will not be replaced by technology. On the contrary. Neurofeedback is therapeutically appealing and varied. This is because you adapt the feedback individually according to your patient's needs, learn with each patient, improve your skills, become more and more experienced and can use Neurofeedback optimally.

 

10. Hygiene rules can be followed easily

And last but not least: Neurofeedback is non-invasive, painless and hygiene and distance rules can also be easily followed. 

Neurofeedback is so fascinating, is`nt it? But when you are not yet familiar with it is sometimes complicated. With our Neurofeedback ABC on Instagram and Facebook we introduce to you every week neurofeedback related terms. Compact and understandable. To learn and share with the #neurofeedbackabc and #beemedic. And if you are not on social media we will keep you up to date here at our blog.

 

A - ADHD 
“In a multicentre observational study 97% of 196 children and adolescents who received 30 sessions of ILF neurofeedback over a 15-week period reported a clear improvement in symptoms.”

About five percent of school-age children suffer from ADHD. But it does not only affect children. Many adults continue to experience additional problems such as anxiety or sleep disorders. For ADHD ILF Neurofeedback can be an effective tool to:

> Improve concentration
> Encourage relaxed attention
> Increase frustration tolerance
> Improve the ability to switch between different states of attention
> Improve sleep
> Relax the school and homework situation
> Reduce medication doses if necessary

ILF Neurofeedback also appeals to young patients in particular because of the broad range of feedback animations we have, which resemble a computer game

 

B - Biofeedback
“Biofeedback is a term used in behavioral medicine to describe procedures that enable us to make unconscious processes of our body and psyche perceptible and thus influence them.”

People can learn almost anything. The prerequisite is that there is a feedback between what is wanted and what is achieved. For example, we cannot learn to ride a bicycle if we do not feel any incline. Most of the functions of our body and psyche, on the other hand, we cannot directly perceive or consciously influence. They are controlled automatically, such as blood pressure, skin conductance, body temperature and many others. If such a function does not work properly anymore or even fails completely, there is hardly any possibility to train it, because there is no direct influence. This is where biofeedback comes into play.

Biofeedback can be combined in many ways with various methods of psycho- and physiotherapy. Just by measuring body signals, such as heart rate, muscle tension, breathing, skin conductance, the patient can be shown very well how the body reacts to certain topics, thoughts, inner images or suggestions.

 

C - Courses
We emphasise the importance of high-quality and well-founded neurofeedback training. Our courses are therefore exclusively aimed at mental health professionals and have a high proportion of practical training and self experience.

Excellent neurofeedback education has always been very important to us. So important that we offer our courses and those of our training partners with an own product brand: EEG Info Europe. 

There, mental health professionals will find basic courses as well as a wide range of advanced and indication-specific courses. And depending on your individual needs, you can attend live online or increasingly on-site courses again.

Our instructors are true neurofeedback enthusiasts. All of them are experts who work successfully with neurofeedback themselves on a daily basis in clinics and practices. 

Furthermore, our courses are characterized by

> Intensive practical and self-experience
> Excellent course organization
> Attractive venues
> Wide range of online courses
> Course equipment - during the training we provide you with high quality neurofeedback equipment
> Courses in several languages throughout Europe
> Indication specific courses for advanced users e.g. ADHD, PTSD, pain, peak performance, burnout
> Full technical support

 

D - Dreamscapes
Dreamscapes© is a collection of 27 feedback animations for neurofeedback with our Cygnet© neurofeedback software. It includes landscape animations as well as creativity and thinking games and puzzles for an individual neurofeedback experience.

Not all neurofeedback is the same. 

Feedback animations play a central role in neurofeedback. They visualize what is to be reflected back to the brain. 

The first neurofeedback animations were very simple. Mostly they were bars that changed their height depending on the EEG frequency. And even today - more than 30 years later - very simple animations are still common in some procedures, where for example objects simply move up and down. 

However, the technical possibilities are far greater. Feedback games such as Dreamscapes©, InnerTube© or Tropical Heat© make it possible to experience animations similar to a video game. With ILF neurofeedback, up to 14 parameters are sometimes hidden in an animation - from color nuances that change subtly to the speed and movement of objects in the foreground and background to the brightness. In addition, the Cygnet© neurofeedback software offers a particularly wide range of different animations, which allows an individual adaptation to the patient. This promotes motivation and anticipation of the neurofeedback sessions, the therapy is diverse and, last but not least, patients can actively participate in therapy decisions. 

 

E - Enthusiastic
Neurofeedback enthuses patients and therapists! Neurofeedback is not only effective and painless, but also fun and it brings ease into everyday therapy.

Modern Neurofeedback is user-friendly and highly effective. 

Our systems are easy to use and allow therapists to concentrate on what matters most - their patients and the therapeutic work. Neurofeedback sessions can be a way to bring more lightness and ease into the therapeutic daily work. 

But not only therapists enjoy the neurofeedback sessions! The rapid treatment success and symptom improvements motivate patients and therapists. 

During the session the patient can lean back and relax while the brain performs neurofeedback automatically and without effort. And due to our wide range of different feedback animations, the neurofeedback sessions can be individually adjusted to the patient which makes the therapy even more attractive. This makes patients look forward to their neurofeedback session! 

 

F - Frequency
Frequency is measured in Hz (Hertz). The frequency describes how fast a regular process repeats itself in a certain amount of time. We also measure brain waves in Hz and we know that neurofeedback with particularly slow frequencies down to 0.0001 Hz is extremely effective.

What was that about frequencies and amplitudes...? Don't worry! You don't have to be a neuroscientist or a physicist to use modern and effective neurofeedback.

But to understand where neurofeedback actually comes in, we need to understand that electrical signals are continuously produced by the nerve cells in the brain. Whenever nerve cells join and oscillate together, we recognise rhythmic patterns, the so-called brain waves. 

The psychiatrist and neurologist Hans Berger discovered this a 100 years ago and invented the electroencephalogram (EEG) to record brain waves. In the meantime, we know that there is a wide range of brain waves, from very slow ones over several hours or even days to over 100 oscillations per second, which are also summarised in the so-called frequency bands. And that these are related to certain states of consciousness and functions. Modern EEG amplifiers allow us to measure the different frequencies precisely. And with neurofeedback we can learn to influence them.

 

G - Growing Evidence
A randomized controlled trial from the year 2020 has shown that just one session of ILF neurofeedback leads to significant changes in the brain’s connectivity.

In the study “"Modulation of Intrinsic Brain Connectivity by Implicit Electroencephalographic Neurofeedback" (2020), Dobrushina and colleagues have been able to show that ILF Neurofeedback modulates significant changes in brain connectivity.
 
The 52 healthy subjects completed a 30-minute ILF Neurofeedback session (electrode position: T4/P4) in a double-blind, controlled experimental design. Before and after the Neurofeedback session, the activity of neuronal networks in the brain was recorded in all subjects using functional magnetic resonance imaging (fMRI) at rest showing significant changes in the brain’s activity and connectivity post neurofeedback.
 
Evidence like this is important to support the clinical effects we see in neurofeedback in a variety of indications. But what exactly do we mean when we speak of evidence? “Evidence based“ means that a method is proven to be effective by scientific outcomes.
 
Neurofeedback – which has been scientifically examined for more than 35 years now – shows growing evidence with more than 2.000 published studies. (Pubmed, 2021)
 
To find out more about the study, visit our blog or read the whole study

 

H - High Performance
Neurofeedback improves the self regulation of the brain. As so called high or peak performance training it aims to improve performance in situations where you are required to give your best. 

Usually, the main focus of Neurofeedback is the therapeutic treatment. But Neurofeedback can also be used to enhance performance and this application area has gained more importance during the last years.

High or peak performance training can be especially useful to improve performance in sports, leadership situations or as a musician. Studies have shown that Neurofeedback training can improve executive functions which can help deliver the best performance in special situations and under pressure.

 

I - ILF Neurofeedback
Infra Low Frequency (ILF) Neurofeedback works with very low frequencies of 0.1 to 0.0001 Hz. It allows us to work with the best individual frequency for each client.

The Othmers worked with the beta/SMR training first, but they soon developed the first improvement in the procedure. They decided to no longer simply reward exceeding a single threshold level, but to work with the dynamic of the reward frequency band. The clients were now given feedback of their brain activity from an animation in which a bar moved up or down. The bar represents the proportion of Beta/SMR frequencies in the Frequency Bands recorded from the EEG.
 
Working with dynamic feedback has been made possible by advances in computer technology, which, moreover, could increasingly reflect the EEG signals in ‘real time’, with almost no  delay. Using the dynamic of reward frequency bands as a feedback signal marked the first of many subsequent shifts away from the initial explanatory model because this neurofeedback was no longer based on operant conditioning.
 
If you are curious to learn more, you can read our blog article or download the whitepaper about the development of the Othmer method.

 

J - Joy
Neurofeedback is fun and motivating because it doesn't really feel like therapy.

Children and adolescents especially look forward to their neurofeedback training. Through the feedback animations, some of which are similar to a computer game, they find easy access to the therapy. They enjoy neurofeedback and often can hardly wait to go to the next session again.

But not only young patients can get enthusiastic about neurofeedback. Also very performance-oriented adults quickly feel comfortable with neurofeedback since the focus is not on problems or diagnoses. The brain performs neurofeedback automatically and without effort. It is a relaxing, less stressful therapy situation. This is good for patients and equally for therapists.

 

K - Key technology
Neurofeedback is a key technology in the field of mental health.

The World Health Organization (WHO) defines mental health as “a state of well-being in which the individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully and is also able to make a contribution to his or her community.”

Mental health is far more than the absence of serious long-term illness. We all have times when we feel down or stressed or frightened. Most of the time those feelings pass. But sometimes they develop into a more serious problem, which could happen to anyone of us.

Mental health is considered to be one of today’s mega-trends. No wonder – approx. 10 % of the population is suffering from mental health problems in a way that prevents them from participating in our post-industrial information-centric society.

As a result, the demand for help is rapidly increasing while the supply remains limited. As in other healthcare areas technology may be able to help close the increasing service gap.

BEE Medic is specialised in developing EEG-based technology for mental health. With our modern neurofeedback solutions selected parameters of the patient's own activity, which can normally not be perceived, are made accessible to clients via the senses, e.g. by means of an audio-visual animation. This helps to improve the self-regulation of the brain and thus many symptoms of mental illnesses.

 

L - Long-term
Neurofeedback therapy can help to increase patient well-being in the long term. Just a few sessions are often sufficient to achieve an improvement in symptoms.

Within the first sessions of Neurofeedback, patients usually already notice some changes. But this does not mean that the improvement is finished - also in the further progress of the therapy patients and therapists notice changes in their symptoms and everyday circumstances - sometimes even partners, parents or teachers see them more than the patients themselves. Therefore it is important, also for the relatives, to report such observations back to the neurofeedback therapist for therapy planning.

Several studies have proven that Neurofeedback can help to increase patient well-being in the long term. For instance the medical journal European Child & Adolescent Psychiatry published a study that found that children diagnosed with ADHD showed large and positive improvements after 6 months of Neurofeedback treatment. In the process their symptoms have even improved over time, without needing further Neurofeedback therapy. 
Another study examined the treatment of tinnitus through Neurofeedback. The results of this study show that the participants could significantly improve their tinnitus  handicap inventory and visual analog scale scores after 5 months of Neurofeedback treatment. 
Furthermore a study of experimental neuropsychologists at Saarland University showed that subjects of the study could improve both short-term and long-term memory after participating in Neurofeedback training compared to the control group.

It can be concluded that there is growing scientific evidence which proves that Neurofeedback can improve patients’ wellbeing not only in the short term but also in the long term. 
 

Details and referneces to the studies can be found in our blog.

 

M -  Mirror
Neurofeedback is like a mirror for our brain. Through this self-awareness, the self-regulating ability of our brain and therefore also symptoms of various conditions can be improved in the long term.

During Neurofeedback, EEG signals are derived from the surface of the head. Through the positioning of the electrodes and the feedback parameters, based on the symptoms of the patient, it can be determined which range of neuronal activity is presented to the brain visually, auditorily and tactilely.

The brain uses those reported signals like a mirror. That is because our brain constantly tries to relate impressions from the environment to itself and analyze its own influence on it. During Neurofeedback, it is important for patients to realize that their brain influences what is happening on the screen. Through this self-awareness, patients can learn to improve their self-regulation skills.

For instance, stress symptoms, sleep disorders or disturbances of the attention and concentration spectrum, which often accompany mental illness, can thereby be significantly improved.

 

N - NeuroAmp
The NeuroAmp EEG amplifier with the integrated Cygnet neurofeedback software  is the core of effective neurofeedback.

You don't need much for neurofeedback. Most practices today value making patients feel comfortable anyway and have already comfortable seating, monitors and a laptop. For the neurofeedback itself you need the NeuroAmp EEG amplifier. The NeuroAmp is a compact, portable device which can be easily placed on a desk or a trolley. And well... the software just runs on a laptop or PC ;)

In our EEG Info Europe courses we provide the complete hardware and software for the practicum. You will see there how easy it is to use. And of course we also equip our education partners with our systems.

 

O - Online Training
Our Neurofeedback courses are also offered online in an effective and educational way.

Since the beginning of the Covid-19 pandemic, a large part of our lives has been taken place online. This also applies to our courses. We offer both webinars and basic courses online - with succes! With our online courses we have already convinced numerous participants who now even want to learn only online. Surely, this is also a type question, but nevertheless online learning can be fun and effective.

Online basic courses offer you planning security. The courses can take place, completely independent of possible regional or national travel or assembly restrictions as well as quarantine requirements. You also minimize your risk of infection. 

Through user-friendly software and varied course content we make sure to offer you a pleasant course experience. Of course you can also borrow and try out a complete Neurofeedback system for free of charge for the duration of the course. 

All course dates and more information can be found on our EEG Info website https://eeginfo-europe.com/de/lehrangebote.

If you are interested in some course insights you can read about the personal experiences of two of our colleagues, who participated in an online basic course, on our blog. 
https://eeginfo-europe.com/de/wie-funktioniert-das-eigentlich-mit-der-neurofeedback-selbsterfahrung-bei-den-onlinekursen
 

 

P - Patients
Neurofeedback is suitable for all patients from young to old. Due to its playful character and various feedback animations, neurofeedback is also perfectly suited for children and adolescents.

Neurofeedback is suitable for all age groups. For instance studies show that Neurofeedback can be an effective therapy option for children and teenagers diagnosed with ADHD. Neurofeedback sessions are often not perceived as therapy in a classical way and therefore provide a pleasant experience that young patients are actually looking forward to. Neurofeedback can however raise many questions. How does it work? Is neurofeedback safe for my child? How much does neurofeedback cost and how do I know if the therapist is well trained?

We at BEE Medic know that modern, effective neurofeedback is a powerful tool and therefore only train professional users with medical background in our EEG Info Europe courses. In addition, it is of course important to us that patients are well informed before they decide on neurofeedback. So in Germany we have supported since 2011 the “Neurofeedback Netzwerk” a website which gives information about the different approaches, costs and what to look for when choosing a neurofeedback therapist.

 

Q - QEEG
Anyone who deals with neurofeedback will quickly stumble across the term QEEG. Why we don't like to use this term and prefer to talk about brain function analysis, we explain here.

QEEG (quantitative EEG) is a method of EEG analysis. It describes procedures where spontaneous, resting EEG activity is recorded, broken down into individual frequency ranges and then graphically displayed in the form of so-called "brain maps".

But in order to make accurate conclusions for diagnostics and therapy from the observation of brain activity the comparison with a normative database is required. Here it is essential that in addition to the self-organization processes of the brain determined by analysis of the EEG in awake resting state (“resting EEG”), also the information processing processes are analysed. These are determined from the observation of the activation of different brain regions (“evoked potentials” – ERPs) during the repeated solving of standardized tasks.

This is the reason why we prefer to talk about brain functions analysis because it is necessary to look also at the ERPs. In the field of QEEG research, we therefore work closely together with HBImed AG. They have the largest and most accurate database of self-organization and information procession processes of several thousand persons.

 

R - Relax
Neurofeedback is a relaxed form of therapy - for patients but also especially for therapists.

During a neurofeedback session, the focus is not on problems and diagnoses, but rather on relaxing and letting neurofeedback work on you. Patients do neurofeedback "automatically". This results in less tension and stressful situations than normal. Thus, both children and often performance-oriented adults quickly find access to neurofeedback. 
But also especially for therapists neurofeedback is a relaxed form of therapy. Neurofeedback brings ease into their everyday life and allows them to simply take a breath.

 

S - Self-regulation
In neurofeedback therapy, the brain learns through self-regulation to find the optimal arousal frequency for itself in order to avoid over- and under arousal and associated symptoms.

In neurofeedback the brain's ability to self-regulate is trained. During neurofeedback therapy EEG signals are derived from the surface of the head. Based on the patient's symptoms, certain frequency ranges of brain activity are measured and evaluated in order to control feedback in the form of an animation on a screen in real time. Through this continuous process patients can learn to improve their ability to self-regulate. Particularly in the case of mental illnesses, accompanying stress symptoms, sleep disorders or disturbances of the attention and concentration spectrum can often be significantly improved in this way. 

What is important to know is that there is no one optimal frequency that is the same for every patient. Instead, the optimal frequency is very individual and depends on both the person and the given situation. In ILF neurofeedback, very low frequencies are used and the therapist determines the training frequency for the neurofeedback session depending on the patient and his response.

 

T - Trauma
In a sample of therapy-resistant PTSD patients, neurofeedback was able to produce a significant improvement in symptoms.

Post-traumatic stress disorder (PTSD) arises as a delayed response to an threatening event that would cause deep despair in almost everyone. Typical is the repeated experience of the traumatic situation in the form of flashbacks or nightmares, the social and emotional impairment. PTSD is often accompanied by indifference towards the environment, sleep disorders and avoidance of activities that could evoke memories of the trauma. 

In a sample of therapy-resistant PTSD patients, neurofeedback was able to produce a significant improvement in symptoms. One of our research groups was successfully involved in a rather large research program with U.S. veterans five years ago. It was immediately apparent that neurofeedback has a positive influence. 

Note: If you are struggling with PTSD, please be aware that Neurofeedback is not a substitute for medical treatment and a medical diagnosis.

 

U - You
ILF Neurofeedback is all about you! The so-called treatment protocols are are personalised to you. Depending on the symptoms and goals of the neurofeedback therapy.

Different neurofeedback approaches are available today, differing mainly in which parameters are fed back from the EEG and how these control the feedback. It is always debated whether a "one-size-fits-all" approach, such as classical frequency band training (in which we also have our origins), or an individualized approach, such as ILF neurofeedback, in which primarily changes in patient symptoms should guide neurofeedback training, is preferable.
The first neurofeedback protocols in the 1970s were nothing more than classical frequency band training. Since this has been around for a very long time, it is also well researched. The advantage is also clear: a "one-size-fits-all" approach is quick to learn. Certain frequencies are considered good and you train to reach them.
Individual neurofeedback, such as ILF neurofeedback, is more therapeutically demanding because the training parameters, i.e., primarily the electrode position and training frequency, are individually adapted to the patient's symptoms.
But no matter which type of neurofeedback professional users choose: at BEE Medic we have solutions for frequency band training, ILF, alpha-theta and synchrony neurofeedback as well as for tomographic neurofeedback or even with virtual reality, which are modular and no matter which type you want to start with, you can always expand your repertoire of treatment protocols.

 

V - Virtual Reality
Research shows that three-dimensional neurofeedback animation can lead to improved therapy outcomes and higher patient motivation.

Virtual reality (VR) usually refers to computer-generated environments. Through real-world movement users can navigate through the virtual world. The VR glasses enable users to enter the virtual world and interact with it. VR is often compared with video games, although the difference consists in the fact that users do not only control a character, but are the character. VR consequently offers possibilities to simulate experiences in protected spaces, including therapeutic uses.

We know that feedback animations in form of a video game lead to more effective outcomes than audio-visual content alone (Hafeez et al., 2019). Studies using virtual reality neurofeedback indicate greater learning success as well as better attention and impulsivity control than two-dimensional neurofeedback (Berger & Davelaar, 2018; Cho et al., 2004). And also relaxation can successfully be trained with VR neurofeedback (Gu & Frasson, 2017). VR neurofeedback can furthermore increase patients' motivation, interest, and also their sense of control during therapy.

The use of virtual reality in a therapeutic setting can therefore be helpful, especially for patients with anxiety disorders and phobias, but also for post-traumatic stress disorders, ADHD or chronic pain.

Cygnet® Virtual Reality combines state-of-the-art virtual reality technology with neurofeedback. The virtual worlds simulated in this feedback animation provides an unprecedented audio-visual neurofeedback experience to the patients.

 

W - Webinar
Our free webinars with experienced instructors are the ideal introduction to neurofeedback. 

Neurofeedback can be a therapy component in the treatment of numerous mental illnesses. But "healthy" people can also benefit from neurofeedback - this is referred to as peak or high-performance training. At our neurofeedback info days and webinars, you will get an overview of the current status, mechanisms of action and what characterizes modern neurofeedback methods and makes them so effective.

During the two-hour events, an experienced lecturer will give you a well-founded overview of the development of neurofeedback, the areas of application and what possibilities neurofeedback opens up today, thanks to modern signal processing. We will introduce you to the neurofeedback setting and there will be enough room for all your questions about neurofeedback. And all of that for free!

 

X - x23/x39
With our x23 / x39 QEEG device  the NeuroAmp is a up to 39 channel EEG amplifier for EEG and ERP based diagnostics. For research purposes, clinic and neurological practice.

If you are working with our Neurofeedback solutions you know that the NeuroAmp together with the Cygnet Neurofeedback software ist the core of our products. It enables effective and  powerful 2 channel Neurofeedback.

But did you know that the NeuroAmp can do even more than that? It is developed in such a way that it can be expanded modularly at any time e.g. with our x23 / x39 QEEG device. The NeuroAmp can then be also used as a 23/39 channel EEG amplifier. For neurodiagnostics, EEG / ERP Research or EEG biomarker development.
 

Y - Y neurofeedback?
 Y (Why) neurofeedback? There are many reasons for neurofeedback. We will show you a few very personal reasons

"If someone had told me a year ago that my son would grow up to be a bookworm, I would have shaken my head in disbelief."
- Mother of an autistic boy

 

"Neurofeedback brings ease to therapy."
- Gunnila Radu, Nordic Center of Neurofeedback

 

"The nice thing is that neurofeedback brings an ease to therapy and successes show up quickly. Sleep and mood improve and many patients report a sense of well-being after just a few sessions, feeling more confident and tidier in their minds."
- PD Dr. rer. nat. Meike Wiedemann

 

"Although I knew a lot about the process and effect of neurofeedback beforehand, I was totally surprised how quickly you notice an effect or a change. It only takes a few minutes and even minimal frequency differences have a completely different effect. And that's despite the fact that you don't have to actively do anything at first and basically just look at a screen."
- Participant of one of ouf online basic courses in 2021

 

Z - Zero
0,0001 Hz

In ILF neurofeedback we work with very low frequencies. ILF stands for Infra Low Frequency and especially neurofeedback with frequencies down to 0.0001 Hz is particularly effective. In the meanwhile German standard book "Praxisbuch Biofeedback und Neurofeedback" ILF Neurofeedback is also called "bridge between the original frequency band training (...) and the training of slow cortical potentials (SCP training)". 

 

EEG Info lecturer Dr. Roxana Sasu and Matthew Fleischmann, PhD from the Neurofeedback Advocacy Project have been working successfully with ILF neurofeedback for years.

In the US American podcast Mindstories with Dr. Josephine McNary, they explain what makes neurofeedback so special. Why it is so helpful in the therapy of ADHD, anxiety disorders and trauma and why it is particularly pleasant for patients. They also discuss current findings.

On the mindstories website you can listen to the complete episode

 

"Put your glasses on and dive into another world" - Virtual Reality (VR) is often advertised in this or a similar way. And especially the therapeutic benefit and use arouses the interest of science and research - especially in combination with neurofeedback. Recently, a sensational case study was published. According to this study, a patient suffering from chronic pain showed a 40% improvement in her symptoms after only 20 sessions with ILF VR neurofeedback. More details and why VR can also be so interesting for neurofeedback are covered in this article.

 

What does “Virtual Reality” even mean? 

Virtual reality usually refers to computer-generated environments. What makes them so special is their interactivity. The user can navigate through the virtual world with the movements he or she makes in the real world. Virtual reality is created through VR glasses with an integrated screen. Unlike 3D glasses, which only allow certain animations to be perceived more vividly through special filters, VR glasses allow the user to "enter" a virtual world that opens up right before his or her eyes and with which he or she can interact. 
If you lift your head, for example, the image section changes, just as it would in the real world. With additional controllers and sensors that detect movements and transfer them to the virtual environment, it is also possible to walk through the virtual world, climb stairs and even solve more complex tasks. VR is therefore often compared to a video game, except that you are not sitting in front of a screen and controlling a character via controllers, rather you ARE this character. Application areas for VR therefore open up in all areas that concern the simulation of experiences in protected spaces. For example, VR is already used for flight simulation training for pilots, for visualizations in medicine or for virtual training. Therapeutic use is also the subject of numerous studies, mostly under the term "virtual rehabilitation".

Feedback animations in Neurofeedback - more than just video games

 

Feedback animations play a central role in neurofeedback. They visualize what is to be reflected back to the brain. 
The first neurofeedback animations were very simple. Mostly they were bars that changed their height depending on the EEG frequency. And even today - more than 30 years later - very simple animations are still common in some procedures, where for example objects simply move up and down.

However, the technical possibilities are far greater. Feedback games such as InnerTube© or Tropical Heat© make it possible to experience animations similar to a video game. With ILF neurofeedback, up to 14 parameters are sometimes hidden in an animation - from color nuances that change subtly to the speed and movement of objects in the foreground and background to the brightness. In addition, the Cygnet neurofeedback software offers a particularly wide range of different animations, which allows an individual adaptation to the patient. This promotes motivation and anticipation of the neurofeedback sessions, the therapy is diverse and, last but not least, patients can actively participate in therapy decisions.

But not only the optics of the games and their graphic implementation have changed. Neurofeedback with images and sound has become established over time. By adding tactile feedback, for example the Brummi©, which passes on vibrations, the three senses of sight, hearing and touch, are already included in feedback processing. VR now goes beyond this and enables three-dimensional feedback.

 

VR in Neurofeedback research

 

Already at the beginning of the 2000s, first studies showed that three-dimensional neurofeedback animations can lead to an improved therapy result and also to a higher patient motivation. The following thesis applies: the more modalities are addressed by the feedback animation, the more effective the neurofeedback intervention can be (Othmer & Kaiser, 2000). 

Thus, the type of feedback has an impact on the quality and outcomes of therapy. For example, studies have also shown that feedback animations in the form of a video game lead to more effective outcomes than audio-visual content alone (Hafeez et al., 2019). Studies using VR neurofeedback indicate greater learning success as well as greater success in improving inattention and impulsivity than two-dimensional neurofeedback procedures (Berger & Davelaar, 2018; Cho et al., 2004). Not only attention, but also relaxation was successfully trained with VR neurofeedback (Gu & Frasson, 2017). 

VR neurofeedback can therefore increase patients' motivation, interest, and also their sense of control during therapy. Of course, this is only possible if patients have a confident and open-minded attitude towards this technology (Kober et al., 2016). 

The use of virtual reality in a therapeutic setting can therefore be helpful, especially to facilitate the transfer of learned skills from the therapeutic situation to everyday life (Blume et al., 2017; Hudak et al., 2017). While this is not the focus of neurofeedback, as self-regulatory skills training strengthens personal resources across situations, it can be beneficial for patients' self-efficacy to try out acquired skills in virtual realities accompanied by therapy. This is especially true for patients with anxiety disorders and phobias. Here, for example, a step-by-step approach with the fear-inducing stimulus can take place in virtual reality; or also in post-traumatic stress disorders. It can also be useful for ADHD, for example, to be able to work specifically with situations from the problematic learning environment in therapy.

 

ILF VR Neurofeedback for chronic pain

A recently published case study in which a 55 year old female patient with chronic pain was treated with VR ILF neurofeedback is currently receiving special attention. After 20 sessions of ILF VR neurofeedback, she reported a 40% improvement in her pain. The patient's rating of subjective pain decreased even further over time during therapy and in follow-up surveys. One year after completion of therapy, the patient reported an 80% improvement in pain perception. Similarly, she reported improvements in general well-being and coping with activities of daily living. In addition, symptoms of depression and anxiety as well as sleep quality improved (Orakpo, Vieux & Castro-Nuñez, 2021) . 

 

VR in Neurofeedback Practice

 

VR ILF neurofeedback is a very promising approach. Depending on the individual aspects of the patient, preferences, needs and of course therapy goals and symptom elevation, it can be a very interesting additional option for patients.
Many people still associate VR goggles as something that is only suitable for technical enthusiasts. But the application is simple. And with our neurofeedback systems one can easily get started with this exciting technology. The Cygnet Neurofeedback Software already has a VR module with great animations for VR. And also the use in exposure therapy or the transfer of learning into everyday life, where especially the combination with neurofeedback opens up opportunities, is spreading more and more.

 

References

 

Berger, A.M. & Davelaar, E.J. (2018). Frontal alpha oscillations and attentional control: A virtual reality neurofeedback study. Neuroscience,378, 189–197.
Blume, F., Hudak, J., Dresler, T., Ehlis, A.-C., Kühnhausen, J., Renner T. & Gawrilow C. (2017). NIRS-based neurofeedback training in a virtual reality classroom for children with attention-deficit/hyperactivity disorder: Study protocol for a randomized controlled trial. Trials,18 (1), 41. 
Cho, B. H., Kim, S., Shin, D. I., Lee, J. H., Min Lee, S., Young Kim, I., & Kim, S. I. (2004). Neurofeedback training with virtual reality for inattention and impulsiveness. Cyberpsychology & Behavior, 7(5), 519-526.
Gu, G. & Frausson, C. (2017). Virtual sophrologist: a virtual reality neurofeedback relaxation training system. In International Conference on Brain Function Assessment in Learning (pp. 176-185). Springer.
Hafeez, Y., Ali, S. S. A., Mumtaz, W., Moinuddin, M., Adil, S. H., Al-Saggaf, U. M., ... & Malik, A. S. (2019). Investigating Neurofeedback Protocols for Stress Mitigation: A Comparative Analysis of Different Stimulus Contents. IEEE Access, 7, 141021-141035.
Kober, S. E., Reichert, J. L., Schweiger, D., Neuper, C., & Wood, G. (2016). Effects of a 3D virtual reality neurofeedback scenario on user experience and performance in stroke patients. In International Conference on Games and Learning Alliance (pp. 83-94). Springer.
Hudak, J., Blume, F., Dresler, T., Haeussinger, F. B., Renner, T. J., Fallgatter, A. J.,... & Ehlis, A. C. (2017). Near-infrared spectroscopy-based frontal lobe neurofeedback integrated in virtual reality modulates brain and behavior in highly impulsive adults. Frontiers in human neuroscience, 11, 425.
Orakpo, N., Vieux, U. & Castro-Nuñez, C. (2021). Case Report : Virtual Reality Neurofeedback Therapy as a Novel Modality for Sustained Analgesia in Centralized Pain Syndromes. Frontiers in Psychiatry, 12, 3-7. 
Othmer, S. & Kaiser, D. (2000). Implementation of Virtual Reality in EEG Biofeedback. Cyberpsychology and Behaviour, 3 (3), 415-420. 

 

The article appeared in the "VdK Zeitung" on 06 May 2021. With over two million members, the VdK Deutschland e.V. is the largest and fastest growing independent social association in Germany. With 1.7 million copies per issue, the "VdK Zeitung" is the highest-circulation member magazine in Germany.

You can read the full article in German on the VdK website

The article briefly discusses how neurofeedback works and how it can be used for dementia, migraine, tinnitus, ADHD and autism.

"If someone had told me a year ago that my son Andreas would become a bookworm, I would have shaken my head in disbelief," says Susanne Lenz* from the Munich. The 13-year-old has a reading and spelling disorder. "Andreas is dyslexic. He has difficulties in quickly grasping the words of a text correctly. His brain builds in mistakes somewhere," Susanne Lenz explains. Before the boy started with neurofeedback training a year ago, reading caused him great problems. Today, the mother experiences her son as a real avid reader.

Thanks to computer-assisted neurofeedback therapy, Andreas who is autistic is making progress not only in reading, but also in his social life. "I observe that he has become more open towards people," says the mother.

 

Neurofeedback is a therapy method that - similar to biofeedback methods - is based on measuring physical body functions and reporting them back through appropriate signals in real time. Since neurofeedback is about the brain, EEG signals are used for feedback here. Neurofeedback is mainly used in therapy to improve the self-regulation ability.

Biofeedback

In biofeedback, body functions such as pulse, skin conductance or muscle tension are measured by sensors and made tangible in real time through sounds, images or animations. In this way, incorrect postures that lead to painful tension can be avoided if the muscle tension is continuously measured and, as an example, a sound reminds the user to adopt the correct posture again. Over time, the patient is trained to maintain body functions at a certain level of activity or to specifically change this level.

 

Neurofeedback – Improving the self-regulation ability of the brain

 
In neurofeedback, not muscular bodily functions, but the brain's ability to self-regulate is trained. For this purpose, EEG signals are derived from the surface of the head. Based on a thorough survey of the patient's symptoms, certain frequency ranges of brain activity are measured and evaluated in order to control feedback in the form of an animation on a screen in real time. For example, an animation might move faster, the image becomes clearer, or a melody becomes audible. Through this continuous process patients can learn to improve their ability to self-regulate. Particularly in the case of mental illnesses, accompanying stress symptoms, sleep disorders or disturbances of the attention and concentration spectrum can often be significantly improved in this way. 
 
Neurofeedback is successfully used for a wide range of indications, from epilepsy 1 over ADHD 2 to anxiety disorders 3, migraine 4,5, tinnitus 6 or autism 7. This is only a small excerpt from a long list of possible application areas. 

 
Reference to further articles

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Arns, M., Ridder, S. de, Strehl, U., Breteler, M. & Coenen, A. Wirksamkeit der Neurofeedbackbehandlung bei ADHS : Auswirkungen auf Unaufmerksamkeit , Impulsivität und Hyperaktivität : eine Metaanalyse. Dtsch. Verband der Ergotherapeuten (2010).
Moore, N. C. A Review of EEG Biofeedback Treatment of Anxiety Disorders. Clin. EEG Neurosci. 31, 1–6 (2000).
Walker, J. E. QEEG-Guided Neurofeedback for Recurrent Migraine Headaches. Clinical EEG and Neuroscience 42, 59–61 (2011).
Stokes, D. A. & Lappin, M. S. Neurofeedback and biofeedback with 37 migraineurs: A clinical outcome study. Behav. Brain Funct. 6, 1–10 (2010).
Güntensperger. Treatment of chronic tinnitus with neurofeedback. (2018). doi:10.5167/uzh-158283
Holtmann, M. et al. Neurofeedback in autism spectrum disorders. Dev. Med. Child Neurol. 53, 986–993 (2011).