April 29, 2020  

Typical Neurofeedback (NF)

Typical neurofeedback (NF) implicates modifying brain behaviour by means of operant conditionuing

The brain is powered by electricity and produces electrical patterns called brain waves.

The frequencies of the waves determine the level of arousal of the brain.

A good balance in the level of arousal is important.

A brain that is over aroused may experience i.e. high tension levels, aggression, hyper activity and panic.

A brain that is under aroused may experience low mood or depression, fatigue and psychomotor delay.

Typical NF teaches trainees to make big things small and small things big in order to get to a point of state flexibility.

With typical NF training the trainee is rewarded when a frequency range is produced as indicated by the QEEG. (Mark Smith)

Infra slow fluctuation training ISF is a form of NF


      • A recent development in NF training is focussed on the lowest frequencies in the brain (0.1Hz). Infra slow fluctuation training is performed on DC amplifiers which allow the lowest frequencies to pass through unlike AC amplifiers that allow higher frequencies to pass through.

      • This training relates to what is going on in the cortex.

      • Infra slow fluctuation training focuses on emergent state shifts within a session. These shifts require adjustments that optimise a client’s response to the training in real time training.

      • The infra slow fluctuation training is related to state flexibility but the training is merely a display of the IFS signal.

      • No direction or quantity of the signal is desired, in other words, there is no goal to achieve.

      • It is a reflection of the ISF activity that causes the trainee to feel something.

    What happens during training?


        • The purpose is to find the trainee’s optimal frequency or the frequency where the trainee feels most relaxed, comfortable and alert.

        • The trainee responds with increased awareness of his or her physiological state as the state shifts.

        • The theory has to do with cortical activation, shifts in parasympathetic response and achievement of a new mental state, in other words, the main purpose is to reach a state of homeostasis.

        • At the start of the 1st session the ISF starts on 0.0030 Hz.

        • After 4 min the clinician asks certain questions with regards to the following:

        • Should there be any discomfort of any kind the frequency is then changed until the optimal frequency is determined and then repetitions of the training start.

        • The purpose is to change behaviour to a positive state by repeating ISF training on the optimized frequency.

        • The optimum frequency is reflected back to the client with 2 reward sounds. A higher tone is heard when amplitude increases more than 15 % and a lower tone is heard when the amplitude decreases more than 15% compared to a dampen average of the signal.

        • Listening to a tone during the session tells you that when the “infra-slow” brainwaves shifted 15% above or below, a trainee can be led into another state.

        • The brain is getting ready to respond to stimuli in a manner that facilitates self control and get to a state of homeostasis.

        • ISF is alternating current, which is small and measured in millivolt signals and adjustments are made according to how the trainee feels.

      How is ISF training conceptualised clinically?


          • It is largely symptoms driven.

          • The trainer and trainee focus on the symptoms experienced.

          • Three categories are included:

          • Homeostatic deficits of the brain state

          • Developmental disorders & trauma

          • Arousal and activation disorder

          • The Q EEG identifies the positions or placements on the head.

          • Treatment outcomes: the ISF training may impact hypothalamic/pituitary/adrenal activity.

          • ISF training has the purpose of reducing anxiety, promoting relaxation, regulating sleep architecture and maintenance, and reduces hyper vigilance or over arousal.

          • Autonomic regulation is observed during sessions such as body temperature and regulating heart rate.

        Deficits of homeostasis


            • Migraine

            • Vertigo

            • Seizures

            • Mood swings

            • Asthma, which is also an affective disorder

            • Panic attacks

            • Fibromyalgia

            • Paranomnias – night terrors, sleep walking or talking

          But what affects homeostasis?

          Answer: the autonomic nervous system (ANS)

          The ANS has 2 subdivisions:


              • Sympathetic division, which adapts the body in many ways for physical activity: increases alertness, heart rate, blood pressure, pulmonary airflow, blood glucose concentration, blood flow to cardiac and skeletal muscle.

              • But at the same time it reduces blood flow to the skin and digestive tract.

              • Extreme sympathetic responses called “fight or flight” reaction comes into play when the animal must attack, defend itself or flee from danger.

              • In our lives it involves exercise, competition, stress, danger, trauma, anger fear.

              • We do not always notice the sympathetic effects.


                • The parasympathetic division has a calming effect on many body functions.

                • It reduces energy expenditure and normal bodily maintenance, including digestion and waste elimination.

                • It is a more resting state.

                • The sympathetic and parasympathetic divisions are part of the autonomic system and act together, they don’t alternate.

                • The tone shifts according to the body’s needs.

              Developmental Disorders and Trauma


                  • Autism

                  • Attachment disorders (RAD)

                  • Personality disorders

                  • Addiction

                  • PTSD

                Arousal & Activation Disorders


                    • ADHD

                    • Depression

                    • Learning disabilities

                    • Tics and OCD, Tourette’s

                    • Anxiety

                  What is training about? To obtain the individual’s optimal frequency

                  Questions are asked at the start of a session to determine the trainees mental and physical state:


                      • With regards to headache

                      • Any feeling on the stomach

                      • Level of arousal – sleepy or alert

                      • Stress level

                      • Low mood/depression

                      • Frustration level or irritable

                      • Any pain

                      • Muscle tension

                      • The trainer also focus on non verbal cues: fidgeting, tense jaw or lips, excess blinking, poor engagement.

                    Training focus on 1 symptom and frequency changes are done on a 0.0001 Hz level after which, the trainee’s response is checked every 4 minutes.

                    There are clear indicators of too low or too high frequency, which are then adjusted.

                    It is therefore very important to get feedback from the trainee or parents within 24 hours. They have to focus on any changes that occur with regards to sleep, pain, alertness or drowsiness, as well as symptoms mentioned above.

                    (Infra-Slow fluctuation training. On the down low neuromodulation. Mark L Smith 2013).

                    Dr. Annemie Peché

                    Clinical Psychologist          PS 012149

                    EEG Technician E 001406

                    Neurofeedback & Q EEG  BCN BCIA E 5513