Neurofeedback

Applied Psychophysiology 

Dr. Imber is considered an expert in applied psychophysiology. He has doctoral-level specialized training and experience with QEEG assessments, Neurofeedback and Neurotherapy, Heart Rate Variability Biofeedback, Photobiomodulation, Cranial Electrical Stimulation, Audio-Visual Entrainment, Peripheral Nervous System Biofeedback, and Cognitive Optimal Performance. Dr. Imber’s experimental research dissertation was in the field of acute and chronic stress management https://www.proquest.com/docview/2267452548/16DD8607B1DA41F4PQ/3, and he is considered an expert in this area along with the therapeutic application of Neurofeedback and Heart Rate Variability Biofeedback for traumas, anxieties, fears, and phobias. Dr. Imber is Board Certified by www.BCIA.org in Neurofeedback and Biofeedback.

Applied Psychophysiology is a branch of clinical psychology focused on the psychophysiological treatments of some mental health issues and performance optimization applications in education, sports, business, and the arts.

Neurofeedback

Neurofeedback is a form of learning (e.g. operant conditioning) employed to modify the electrical activity of the brain. This method is used to treat clinical conditions, as well as to enhance performance. The equipment used at MindShift Psychotherapy is Mitsar, CGX Systems, Thought Technology, and NeuroGuide are FDA approved for off label use.

The activity in your brain affects pretty much everything you think, feel, and do. As a result, when its functioning is impaired and out of balance, you are impaired and out of balance. Problems with attention, memory, emotional regulation, learning, relationships, pain, sleep, and a myriad of other ailments all have underlying roots in your brain and nervous system.

Neurofeedback (also known as electroencephalographic [EEG] biofeedback or biofeedback for the brain) is a technologically-advanced type of brain training. It utilizes a brain-computer interface (that is, your brain activity is linked to a computer software) to train your brain toward healthier patterns of functioning. This allows us to not only receive real-time information about your brain activity but also communicate back with it in the form of audio and visual cues (i.e. two of the brain’s primary languages). Your brain can then utilize this feedback to make adjustments toward the achievement of set goals, such as an increase/decrease of activity within a particular region, a change in processing speeds, or an increase/decrease of connectivity between brain regions.

Basically, we are teaching the brain how to behave in a healthier manner. During the neurofeedback training session, the computer will monitor your brain activity from moment-to-moment and compare it against the goals we have set. It then entices your brain to produce more of the healthy activity patterns by rewarding “good behavior,” usually in the form of desired responses on the computer screen. For example, when the majority of your brain activity stays within the set thresholds, a movie zooms in and the audio gets louder; when it pops outside the desired range, the movie zooms out and the sound goes with it. Over time, the brain learns what it has to do to keep the movie playing and starts producing more of that activity. Then, the more your brain practices that new pattern of activity, the stronger the new connections become, leading to long-lasting effects.

Peripheral Biofeedback

Peripheral Biofeedback is also a form of learning used to modify the peripheral nervous system. This method is used to treat clinical conditions, as well as enhance performance. The equipment used at MindShift Psychotherapy Thought Technology and is FDA approved for off label use.

Types of Peripheral Biofeedback

  • Heart Rate Variability (specific breathing rate activating the calming nervous system)

  • Capnometry (breathing to optimize CO2 and O2 balance for anxiety and performance)

  • Temperature (technique to help with awareness and reduction of anxiety)

  • Galvanic Skin Response (technique to help with awareness and reduction of anxiety)

  • Surface Electromyography (technique to help with muscular pain)

Neurofeedback Modalities

There are many different modalities of neurofeedback training that have been proposed and developed over the years. Here at MindShift, we utilize a variety of modalities in accordance with what each client needs at each point in their training process. We are also one of the few locations that offers the latest, most advanced, and most targeted modality available: swLORETA z-score neurofeedback. More traditional forms of neurofeedback often use 1-6 sensors, which only allows the computer to read and train generalized, diffuse activity close to the scalp. This can be useful for learning to control specific brainwave frequencies in general brainwave regions, but is limited in terms of specificity and connectivity.

SwLORETA z-score neurofeedback, on the other hand, utilizes a 19-sensor EEG cap and an advanced brain imaging technique called standardized weighted low resolution electromagnetic tomography analysis (swLORETA). This allows us to visualize a 3D image of your brain activity and pinpoint specifically where activity is coming from deeper down in the brain. For this reason, the modality is often called “deep brain neurofeedback.”

We can then compare your brain activity against a database of “healthy brains” to identify regions and patterns that are outside these neurotypical levels. This gives us z scores (i.e. a statistic of how far the activity in a particular region is outside the “healthy” range. More often than not, the regions that are the farthest outside these neurotypical ranges are associated with unwanted symptoms. Thus, we can select all the regions and patterns that are suspected to underlie your symptoms and simultaneously train them toward healthier functioning.

As a result, swLORETA z score neurofeedback is one of the most precise, targeted, and individualized brain-altering tools available. Because it is fairly new, solid scientific literature is limited; thus, more studies are needed to better assess how it compares to traditional approaches. Preliminary evidence and clinical experience, however, suggest that this new modality is able to produce clinical outcomes in less time than other modalities.

Other Types of Neurofeedback that may be incorporated into your therapy plan:

  • Surface (surface cortical areas and functional networks)

  • Amplitude and Z-Score (electrical thresholds and normative comparisons)

  • Theta-Beta (protocol to neuromodulate ADHD and help with symptom management)

  • Alpha-Theta (protocol to encourage a hypnogogic state for trauma, creativity, addictions)

  • Sensory Motor Rhythm – SMR (protocol for attention, depression, anxiety, Parkinson’s, epilepsy, and other sensory-motor brain dysregulations)

  • Infra Low Frequency – ILF (brain injuries, fatigue, anxiety, depression)

  • Passive Infrared Hemoencephalograpy – pIRHEG (infrared signals from the brain based on blood flow dynamics shown to be effective for ADHD symptoms)

qEEG BRAIN IMAGING ASSESSMENT

We do a complete assessment of your brain function to determine where it could use some extra help!

An EEG cap is placed on your head to measure the electrical signals being produced by your brain. The brain activity picked up by the cap’s sensors can then be converted into brain “maps” (i.e. qEEG and swLORETA images) to more easily identify the specific activity patterns that are likely giving rise to your symptoms. Once we have determined the specific areas/patterns of concern, we can create an individualized program to help your brain become the best it can be. For example, we may observe that a specific brain region is hyperactive, or that two regions are not communicating as they should.

We then look at what brain regions are associated with your particular symptoms and/or goals. The regions that match up between your reported symptoms and less abnormal activity observed in your brain are then chosen for training. Often, we end up training multiple brain regions and patterns of functioning (i.e. amplitude, connectivity, etc.) simultaneously, leading to more rapid results.

A TYPICAL SESSION

For the training, you will wear an EEG cap (that looks like a swimmer’s cap) and sit in a comfortable chair in front of a computer monitor. You will select a movie of your choice and the movie’s activity will be linked to your brain activity through a brain-computer interface software. When the majority of your brain activity stays within the healthy limits we set, the movie zooms in and sound plays. When the brain activity pops out of this range, the picture and sound zoom out. The idea is this: the brain wants to see the movie, so it starts experimenting with its activity to figure out what works and what doesn’t to make the movie play. When something works, it remembers what it did and starts doing more of that.

Throughout the process, you may figure out some clues as to what works and what doesn’t. For example, you may find that relaxing and breathing slowly helps to produce the desired brain activity and thus keeps the movie zoomed in. Tensing up and thinking anxious thoughts, on the other hand, might make the movie go away and thus discourage that behavior. However, it is also important to realize that less than 10% of your brain is conscious; thus, much of the process is subconscious, in direct communication with your nonverbal brain. Over time, with repetition, these new activation patterns become stronger and more automatic.

IS IT SAFE?

Yes! Neurofeedback is a very low-risk intervention with very few potential side effects. It is first important to understand that it does not involve putting anything into your brain, or even into your skin. The sensors placed on your scalp simply read your brain’s electrical activities–they do not put any electrical or other forms of stimulation into your brain.

Another benefit of this approach is that we are not forcing the brain to do anything it doesn’t want to. It gets to pick and choose what it works on, when, and how much. We are enticing it to change because we are rewarding “good behavior,” but we are not inducing any activity ourselves. Using z score training provides an additional level of safety because your brain activity is constantly being checked through real-time comparisons to the “healthy brain” database. If your brain activity starts going in the wrong direction (outside healthy limits), the movie zooms out; thus, the brain is immediately notified and encouraged to come back within healthy limits. We are also training toward brain patterns that have been shown to exist in several hundred healthy individuals (i.e. no history of brain trauma, neurological impairment, or mental health disorders) while still leaving room for flexibility and individuality.

WILL THE EFFECTS LAST?

Just like a muscle, the brain operates on a “use it or lose it” principle; as new neural pathways are repeatedly used, they become stronger and more automatic while the older, less used neural pathways start to wither away. Another way to view this process is with the analogy of a path through an overgrown grassy field. You may have forged a pathway that you usually take even though it may not be the best route. When you try out a new path, it is not yet established and thus may be hard to find the next time. If you have a guide that knows that path, and can lead you down it repeatedly, the path will more established and become easier to find the next time. If this new path is more direct, involves less obstacles, and has a lower potential to cause you difficulties, you will have no reason to return to the old path and that old path will become less defined; the new path becomes the automatic route your brain will now take most of the time.

Neurofeedback will be your guide on this journey to find the new pathway until it becomes “established” enough for you to easily find it on your own. Although more research is needed, studies thus far have demonstrated that the effects of neurofeedack tend to last beyond the initial training. However, it is common to “refresh” the training several months or a year after the training is concluded.