Client Stories from Neurofeedback 101
These are cases about Anxiety and ADHD and Attention from Michael Cohen’s book Neurofeedback 101, which has sold more than 13,000 copies.
Every person is different. What happened for one person doesn’t predict what will happen for another. Some took months. Some didn’t finish.
Anxiety, Panic and OCD
A Therapist Who Couldn’t Quiet His Mind
A mental health therapist came to my Neurofeedback 101 course. Each participant receives five neurofeedback sessions. When we discussed his training goals, he told me that his mind had been racing since he was young and that he endured non-stop conversations in his head.
For his first three sessions, we trained his temporal lobe (emotional calming), combined with his anterior cingulate (associated with a racing mind). Based on his feedback, we made some training adjustments for his fourth session. Toward the end of that 15-minute session, he reported a complete quieting of his mind.
We did the same training one more time before he left the course. He reported later that the effect had lasted for several days. He could not remember experiencing that kind of calm mind in his life.
These initial sessions showed him what he could accomplish if he trained more. He decided after his brief experience to include neurofeedback in his practice and to continue to train himself as well.
Too Anxious to Drive
A 40-year-old mother of three had anxiety caused by major trauma. It was so extreme that she was unable to drive. Even riding in the car as a passenger distressed her. She would stare at the floor the entire time the car was moving, just to endure the ride.
After 10 minutes of her first neurofeedback session, she reported feeling a little more anxious. I adjusted the training, and ten minutes later she said she felt calmer than when she came in.
After eight sessions, she reported being able to drive short distances and feeling far less anxiety. She wasn’t “cured” after eight sessions, due to the extreme level of trauma and the number of years she had been experiencing anxiety. However, five additional sessions brought her significant improvement and kept her from reverting to the anxiety level she had experienced for years.
She benefited from a combination of both neurofeedback and another type of biofeedback. Given her history, I expected her to need more sessions than she did in order to achieve this level of benefit.
A 14-Year-Old Missing School
An academically gifted 14-year-old freshman experienced so much anxiety at school that she sometimes refused to go. She frequently wound up in the nurse’s office complaining of severe anxiety or stomach distress. She was even fearful of using the school bathroom. She called her mother (a mental health therapist) at work five to 10 times a day, pleading for her to come get her. This was extremely stressful for her mom.
After eight training sessions, the number of times she called her mom had dropped to only a few calls a week. She stopped refusing to go to school and became comfortable using the school restroom.
As training progressed, the girl reported noticeably less anxiety, as well as improved ability to manage herself. In 14 sessions, the girl felt much happier and had only moderate, controllable anxiety. Her mom was thrilled for her daughter and thankful that the frantic calls had stopped.
Two years later her anxiety began ramping up, but before it got out of control, she returned for a “tune-up.” It’s not uncommon for someone to need an occasional tune-up. After four sessions, she got back on track and didn’t need to continue training.
Two Cases of Quick Anxiety Relief
A 45-year-old man came into our office with extreme anxiety. He had been seeking relief for over a year through a variety of therapies, including medications. Nothing had worked. After his first neurofeedback session, he reported feeling significantly calmer. He said he had not experienced anything that could calm him like that.
A 27-year-old woman came to us suffering from extreme anxiety that had begun four months earlier following an assault. Medications hadn’t helped. The anxiety had become so severe that she had to quit work. After her second neurofeedback session, she described herself as “feeling kind of normal,” which hadn’t happened since the event. She could not believe she could feel calm like that again.
Be aware that a single session does not solve a problem. Most of our very anxious clients notice significant calming within a few sessions. It can take more time for the benefits to produce lasting effects. Once we see this kind of positive response to training, it’s usually just a matter of time before it starts to hold.
It often gives clients hope when they experience a big change, even for a short time, particularly when nothing else has worked. Most of these clients have already been on multiple medications before they came to us.
As soon as someone’s anxiety kicks back in — the effects rarely hold for long during the first few sessions — they often believe that the neurofeedback didn’t work. In fact, it did work. Their brain was able to calm itself. It just hadn’t had enough practice yet to sustain its new habit. I point out that they saw a glimpse of what they can achieve with practice.
A Nurse With Panic Attacks
A 27-year-old client finally had her dream job as an R.N. in a hospital. The problem was, she was nearly crippled by anxiety and frequent panic attacks.
“For over a year, each day that I went to work I had a panic attack,” she explained. “I thought, ‘Oh, my God, I can’t do this!’ It was so much responsibility. I had people’s lives in my hands.”
Daily Xanax and an antidepressant helped a bit, but she still struggled badly, even on medications. And she didn’t want to keep taking them. She feared her career could be in jeopardy.
“I reached the point where I had to do something,” she recalled. “I couldn’t go on like this. I was so anxious I couldn’t think straight. I knew I wouldn’t be able to continue to work in my profession if I didn’t get a handle on this problem.”
When a friend told her that neurofeedback might help, she decided to try it, even though she didn’t know much about it. Since I’ve worked extensively with anxiety and panic attacks, we went straight into training without a brain map. My approach included neurofeedback and biofeedback that targeted systems playing a role in her chronic anxiety and panic attacks.
She came once a week. After her first session, she noticed that she was notably calmer. Following her sixth session, she felt calm enough to discontinue her medications. After her tenth session, she decided she was done and discontinued her training.
“I was doing so well I didn’t think I needed any more training,” she said. “I was thinking much more clearly and had more confidence taking care of my patients. My panic attacks were gone.”
It could have taken much longer than 10 sessions to stabilize her level of anxiety and panic attacks, but she was young, physically healthy and ate well. It’s an example of how you can’t predict how long neurofeedback and biofeedback might take to produce results. We followed her for several months after her training. Without additional sessions, she reported her symptoms were still under control.
An OCD Carpenter Who Kept Restarting His Work
A 51-year-old carpenter had suffered from severe OCD since the age of 20. The OCD came a year after a car accident that had produced a significant concussion. He reported that he had had no symptoms of OCD before the accident.
The first time we met I asked him to describe his OCD. He said that within seconds, he noticed everything in my office that was out of order. There was a slightly discolored ceiling tile. The folders and pens on my desk weren’t straight. He detected a small string lying on the floor, plus about five other things before I stopped him. All of those really bothered him.
At work, when doing a job, if something wasn’t perfect, he would have to start over. Sometimes he could not complete a job after scrapping his work too many times. His OCD interfered seriously with his livelihood.
Because of his history of concussions, I started by doing a qEEG brain map on him. It indicated significant problems in his prefrontal lobe (decision-making, hyper-focus) and the anterior cingulate (stuck, obsessive thoughts, inflexibility, inability to transition) and some other areas. Some of his brainwaves ran too fast and others too slowly, at the same time. He was able to hyper-focus on details but couldn’t slow down to see the big picture.
After about 20 sessions, he reported he had recently hung some pictures in his house and saw the task “as other people did” for the first time. Instead of taking an excessively detailed approach to every aspect of hanging the pictures, which in the past would have taken him several hours, he instead was able to step back and be “OK” with getting them up in a reasonable way. He said it took less than an hour to hang them. This was remarkable for him.
He also noticed being far more relaxed and not “consumed” as much by details. Continued training was probably needed to help reinforce his gains but, unfortunately, he was injured in an accident and never made it back to training.
A note on OCD: many people we see with OCD have done everything, including medications, with very limited effect. I’ve heard similar reports from many colleagues, even though the research is limited. For severe OCD, my experience is that it can take numerous neurofeedback sessions, plus ongoing maintenance. Other factors can also play a role in speeding up the training, including exercise, diet and nutrition.
An Anxious Teenager
A mother brought in her 16-year-old daughter for help with extreme anxiety. She barely communicated with her mother. Due to the severity of her anxiety, she often stayed away from school, had difficulty making friends and eventually withdrew from high school to be home-schooled. She didn’t want to come for neurofeedback training.
Before the mom would consider a qEEG brain map, she wanted to see if she could get her daughter to come consistently. We chose a protocol that works in a high percentage of cases with extremely anxious people. However, after five sessions, we saw very little progress, and the girl was still fighting her mother about coming. A complicating factor was that she was on the stimulant Adderall. I suspected that the med might be contributing to her anxiety.
Her mom began to wonder out loud if neurofeedback was going to help her daughter. I knew it eventually would, once I came up with the right protocol, but I had to do it quickly or she might stop coming. Once again I suggested a map, and this time her mother agreed.
I adjusted her training protocols using information from the qEEG map. It worked. Within two to three sessions her mom felt things were better. Her daughter quit fighting her about coming for training, and from that point on, she made steady, gradual improvements.
After about 10 more neurofeedback sessions the girl, who had extremely poor self-awareness and self-insight, was able to report that she was feeling better and less stressed. She started having meaningful conversations with my staff, her mother and me. She was able to go places more easily with much less anxiety, even to visit the school. She still needed additional training to help her, but her progress was significant.
ADHD and Attention
An ADD Student Whose Grades Improved — and Who Said It Had Nothing to Do With Training
A woman brought her 15-year-old son to train for ADD. His grades had steadily dropped over the school year, and he was making C’s, D’s and F’s. He disliked coming to our office and said it was a waste of his time. He also said he didn’t have a problem.
When he arrived for his eighth weekly session, I asked his mother if she had seen any improvement. She said she didn’t think neurofeedback was helping at all. When I inquired about his grades, she responded, “Oh, he’s been making A’s and B’s in the last four to five weeks.” After pointing out this shift, she realized it had occurred since he had been training.
When I asked the boy if he realized that his grades had improved significantly in recent weeks, he responded yes, but that neurofeedback had nothing to do with it. He responded, “I just decided I wanted to make better grades.”
This lack of awareness of slow subtle changes from training is common.
ADHD and Too Easily Frustrated
Eleven-year-old John was a sensitive, emotional kid who could not handle frustration. His parents initially brought him in for ADHD and frequent meltdowns. He had been on stimulant medication for attention, but his parents took him off. They were concerned about side effects, including the possibility that the medication was stunting his growth.
He would cry and fall apart when things didn’t go his way, including at baseball practice. This didn’t go over well with his peers or his coach and caused significant stress on his parents.
During his first 18 sessions, we trained the temporal lobes to target emotions. After eight or nine sessions, he was having fewer meltdowns and emotional outbursts, but his improvements didn’t hold consistently. Then his parents pushed me to start targeting his attention symptoms. Every time I did, he became more emotional. I finally told his parents we’d get the emotions under control before doing any more attention training. That strategy worked.
After about 30 sessions, he was more consistent at managing his emotions. He no longer fell apart with frustration. He was much easier to manage at home, at school and at baseball practice. He clearly had gained more self-control, and his parents felt far less stressed.
We were then able to train attention, which no longer affected his emotions. We also suggested the mom focus on his diet and nutrition. She reported she thought that helped.
He completed about 60 sessions over the course of a year. He was able eventually to get off his stimulant medications, pay attention at school, finish his daily homework and keep his grades up. We tracked him months out, and he was still doing very well.
Why was this boy’s case complicated? One possible reason was that he had fallen and hit the front of his head hard at age seven. An MRI indicated no problem, but an MRI isn’t a valid measure of concussion. Years later, our EEG brain map revealed the presence of large, slow brainwaves over his right eyebrow compared to other parts of his head. That often correlates with attention problems. It suggested the possibility that his fall at age seven had resulted in a low-level concussion that contributed to his later problems.
A Student Who Discovered He Wasn’t Stupid
A 29-year-old man had spent most of the first 24 years of his life thinking he was stupid or, at the very least, had a severe case of attention deficit disorder.
From the earliest days, school was a nightmare. He was held back to repeat kindergarten. Diagnosed with ADD that same year, his doctor prescribed Ritalin, and he would take some sort of stimulant all the way through his school career and beyond. Then his school placed him in special classes for slow learners. He was bullied by the other kids and called “stupid” and other names. Throughout his school career he had tutors. When he received his high school diploma, he had a “D” average. College was out. The career he hoped for was out. He had low self-confidence.
At our center, we did a qEEG connectivity brain map. It indicated problems associated with significant learning disabilities. It also identified patterns associated with attentional problems, though that didn’t seem nearly as significant. Connectivity training targeted findings from the map, which I’ve found very helpful with learning disabilities.
The client did so well during the first three months of neurofeedback training that he was able to work with his physician to discontinue his stimulant medication and reduce his mood medication.
More importantly, he reported some major benefits. Within three sessions, he noticed he could read a map for the first time. He was able to write a check quickly, something that had been difficult for him because the lines on the check didn’t make sense to his brain. His chronic anxiety dramatically diminished. It was a big shift. I wondered how much of his anxiety was from being overwhelmed all the time.
It took another three months of training for him to improve his mood, his confidence and emotional resilience, and to feel more confident in his ability to learn. He started reading books that he couldn’t tackle before. His reading comprehension level increased significantly. He said he was disappointed that he spent nearly 30 years of his life struggling unnecessarily. He’s continued to do sessions periodically, which have resulted in continuing gains.
A 20-Year-Old Who Left College, Then Went Back
A 20-year-old client had always struggled academically. It took a lot of work to make B’s and C’s in high school.
At college, he earned a mere 1.5 GPA in his first semester at a prestigious college in the Southeast. He improved little in his second semester. He was working hard but didn’t test well. He struggled to be organized, stay on task, and complete assignments on time. He also had problems sleeping. He was placed on probation and sent back home to “get his act together.”
His parents brought him to our center for neurofeedback training. A brain map showed that his brain was inefficient in areas related to attention but also in areas related to processing, comprehension and organization. We used this information to customize his training protocols to target those problems, along with improving his sleep.
His sleep normalized fairly quickly. We continued to train once a week over about five months. A follow-up brain map showed significant changes in his brain activity compared to the first map, although there were still a few areas that needed targeting. We continued to train based on the new targets.
When he returned to school, his GPA zoomed up to 3.5. His test scores and productivity greatly improved, and he was better able to ignore distractions. One of his advisors remarked that to see that sort of turnaround after just one semester and one summer off was “quite amazing.”
“Doing neurofeedback was a turning point for me,” he said. “I was trying to figure it out on my own and wasn’t succeeding. Working with the Center enabled me to push back the blocks.”
An 11-Year-Old With ADHD, Speech and Sleep Problems
This 11-year-old boy came into the world with several strikes against him. His birth mother abused drugs while pregnant, and she lost parental rights not long after he was born. He was adopted at the age of 10 months.
He was a very “hyper” baby, but his new parents figured he was just energetic. However, when he began to speak, his language was significantly delayed. His earliest diagnosis was “anxiety,” but his parents suspected it was more than that.
He eventually received numerous diagnoses, including a sensory processing disorder, phonological dyslexia, dysgraphia, ADHD and profoundly delayed fine motor skills. He had meltdowns in school and at home.
He had severe sleep problems. Unable to sleep at night, he would nod off in school. A sleep study revealed he had an alarming deficit of REM sleep. Already taking medication for ADHD, his parents brought him to see us, seeking a viable alternative. Underlying sleep disorders can contribute to many different problems for children.
Our initial neurofeedback training focused on utilizing some common sleep training protocols. Within a few sessions, his sleeping and waking habits improved. His meltdowns reduced almost to zero. A follow-up sleep study conducted several months later indicated that his sleep patterns and REM sleep were completely normal.
After a year and a half of regular neurofeedback training, gradual but significant changes continued to occur. He began speaking better. Homework time went from a two-hour nightly battle with lots of yelling to calmly completing his assignments in 45 minutes every night.
A Six-Year-Old’s Meltdowns
We trained a six-year-old boy who had numerous, extreme meltdowns. Over the first 11 sessions, there were periods when he clearly had fewer and shorter meltdowns. At other times, he reverted to his normal meltdown pattern. Ups and downs are not uncommon. It can take time before a person’s brain stabilizes from training.
At his 12th session, I adjusted his training to see if we could speed up his progress. I anticipated he might have an exaggerated response because he had historically been highly sensitive to small changes in training. I instructed his mom to call my cell if that occurred.
She called early the next morning to tell me that he was having a full-blown, angry meltdown and didn’t think she could get him to school. I suggested she bring him straight to my office. When they arrived, and per his mother’s request, I picked him up mid-meltdown, carried him to our training room and placed him on her lap. She held him tight as he screamed, thrashed and tried to kick her and butt heads with her. Believe me, placing the sensors on his head was no easy feat.
I adjusted his training based on what I learned from the previous training. The first few minutes of training didn’t slow him down at all, so I adjusted again. After three or four minutes of the new training, he suddenly stopped screaming and kicking. He smiled at his mom, pointed to the movie I was playing and started laughing. He calmed down completely and reverted to a cheerful, happy kid. It was kind of amazing. The mom couldn’t believe it. She had never seen one of his tantrums “flip” like that.
After three more training sessions for reinforcement, his mother reported that his meltdowns had stopped. I suggested we stop training and wait until he melted down again before restarting. He never did. Since meltdowns were the only reason they were seeing us, there was no need to keep training him.
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