Neurofeedback for Attention Deficit Disorder

Attention Deficit Disorder is a common condition affecting children and adults. Symptoms include high distractibility, difficulty with sustained attention and poor task completion.  Individuals suffering with ADD generally experience great difficulty performing multiple tasks simultaneously. Hyper- activity often accompanies attentional problems . Symptoms of hyperactivity include fidgetiness, high distractability, difficulty completeing tasks and excessive physical over activity. The symptoms of ADD/ADHD may co-occur with a variety of mood instabilities.

ADD/ADHD, paradoxically, is a result of the brain being in an underaroused state. (Hyperactive children, of course, look anything but under aroused). However, when given stimulants, the child calms down and is more able to pay attention. This is because the part of the brain that suppresses unwanted physical activity and distractability is underaroused and is, therefore, unable to do its job. With the introduction of stimulants, the inhibitory centers come back “online” and perform their normal function. Neurofeedback (also referred to as EEG biofeedack) bypasses the need for stimulants by teaching the person to “up regulate” that part of the brain as well as “down regulate” other parts. Similarly, ADD persons without the hyperactive component, cannot resist new or novel stimuli and as a result, tend to be highly distractable. The training helps these children (and adults) marshal the internal resources that allow them to remain on task rather than becoming stimulation bound.  The result is that the person can remain focused and on task -leading to improved performance. See results below:



This graph represents the overall score on a Continuous Performance Test -used to assess degrees of impairment of attention, for 249 children and adults. The blue lines represent the pre-training score -ranked in order of severity of impairment. The red lines represent the corresponding post -training score. Note that those with the most severe deficits show the most improvement following neurofeedback training. 

Neurofeedback for Mood Disorders

Neurofeedback offers a new approach to managing and alleviating depression and anxiety as well as bipolar disorder. Neurofeedback training impacts the basic mechanisms by which the brain controls physiological arousal and mood management. Efficient regulation of arousal is generally restored with the training, resulting in improved self awareness and self management. Many clients who suffer with mood instability report that they simply don’t let themselves “go there anymore”. The sense of control they experience is implicit in statements such as these. Although we don’t measure neurotransmitters as part of the process (such as serotonin availability) the assumption is that if the person is feeling better, the neurotransmitters are titrating themselves properly. Much of the increase in mood stability is due to improved sleep regulation (i.e reductions in hypo or hypersomnia). Neurofeedback training appears to be effective regardless of the cause(s) of the depression -whether it is from a genetic pre-disposition, childhood trauma or  simply a physiological change of unknown origin. While doing the training, the client may find that anti-depressant or stimulant medication will no longer be needed or can be significantly reduced. The training also appears to be effective for several conditions that are often comorbid with depression, such as alcohol dependence and violent behavior. In treating anxiety, the training seems to reduce excessive activity in the sympathetic nervous system –the neurocircuitry of the fight or flight reponse. This can have a major impact on performance in multiple domains.


The above graph represents the decrease in depressive symptoms experienced by women in the military with PTSD during months of neurofeedback training (The EEG Institute -Camp Pendleton study)

Neurofeedback for Aviation Personnel

Over the past 30 years or so, researchers have demonstrated that teaching a person to deliberately alter their brainwave activity, or electroencephalogram (EEG), through such techniques as operant conditioning via EEG biofeedback, can be very effective in treating problems such as attention deficits, mood instabilities, and addictions. Additional benefits are consistently observed in sleep. The major advantage of such an intervention over the usual pharmacological approach is that the training is essentially without side effects.

EEG biofeedback has been used with particular success with attention deficits. The corrective mechanism seems to involve training of the subcortical regulatory centers in the brain that govern attention and focus. Attention deficits are often situationally induced through exhaustion and hyper-focus. In other words, normal brains, (i.e. those without any predisposition towards attention disorders) will begin to exhibit some of the EEG characteristics of attention deficit disorder if the person is exposed to an unrelentingly stressful situation that compels constant external vigilance and anticipation. Pilots and air traffic controllers often find themselves in situations of sustained high- performance demand. Such situations constantly challenge a persons ability to remain vigilant and shift from one task to the next. The common feature of persons in such high demand jobs is that they often find it difficult to disengage from the heightened vigilance mode -leading to poor sleep and exhaustion. The brain is often stuck in the slightly hyper-aroused state and will not disengage without difficulty (e.g. such as at night, when your mind starts to race after your head hits the pillow for sleep). Whether due to biological factors or exhaustion, the common feature of poor attention is an excess of low-frequency activity. Down-training these low frequencies and boosting the midrange activity seems to improve the brain’s regulatory activity and the attentional problems are resolved. Part of this is due to a normalizing of sleep patterns.

Recent EEG research by UCLA psychologist Barry Sterman and others, indicates that performance is highly correlated with certain EEG patterns. Ten years ago several pilots at Edwards AFB were studied for the purpose of examining the EEG correlates of peak performance while engaging in flight simulator tasks that required intense and sustained mental focus. It was discovered that those pilots whose brains produce more 8–12 Hz activity between tasks perform significantly better than those whose brains produce less. The subjects who produced the greatest amounts of this activity also showed less fatigue and greater endurance. Most importantly, research indicates that such desirable EEG signatures can be trained through biofeedback. In addition, those persons who have received such training report reductions in anxiety and depression as well as improvements in attentiveness and social compatibility.

Peak performance and Neurofeedback

Although many world class athletes say that athletic performance is predominately mental, the vast majority of athletic programs at our colleges and schools do not emphasis any sort of mental fitness training. The same could be said for the performing arts departments. We have all heard performers describe states of peak athletic prowess in such terms as “being in the flow” or “time having slowed down”. Fran Tarkenton, the former quarterback for the Minnesota Vikings, used to describe how everyone would appear to “move in slow motion” when he would drop back to throw a pass –as if he had all the time in the world. These descriptions of peak performance clearly reflect states that are within the mental domain.

The Martial Arts have always recognized the connection between the psyche and the physical. As such, practitioners and teachers of the martial arts place great emphasis on strengthening this relationship as a critical part of their training. Physical agility, accuracy and endurance are predicated on discipline and focus. Top athletes strive for an “energetically economic” (or ‘ergonomic’) performance through the maximizing of a sense of “oneness” with the body. Achieving such oneness involves mastery over the nervous system through the development and refining of inner awareness. Although exercises such as meditation can certainly take a person part of the way there, modern technology allows for the development of a much more panoramic inner awareness through biofeedback.


Biofeedback can be thought of as a window on the inner workings of brain and body which serves to complete the mental to physical awareness loop. Biofeedback essentially involves the measurement of a certain aspect of physiological functioning, something that is ordinarily beyond the person’s awareness, and then mapping it into a video display for easy observation. In bringing the unobserved into the realm of the observed, a person is able to alter physiological functioning. Peak performance training involves altering brainwave activity, or the EEG (electroencephalogram). Research has shown that altering the brainwave activity can have very beneficial effects on a person’s ability to focus and maintain attention. In addition, EEG biofeedback can improve mood disorders, such as anxiety and depression, as well as sleep –all of which can affect the quality of performance whether on the football field or the stage. Although a certain amount of arousal is necessary to perform optimally, every athlete, singer or dancer knows that anxiety can cripple any performance. In order to understand this more fully, one has to realize that anxiety is a survival trait that evolved into existence because it was conducive to the preservation of the human species. Anxiety serves as the first line of defense against threats to survival. It is essentially, the sentry for the “fight or flight” system. For it is fear that drives an organism (human or otherwise) to either fight or flee. Anxiety compels us to anticipate the immediate future. However, that which has served so well in protecting and preserving the human species, can become a major liability in the arena of performance or competition. This is because a performer has to be totally present “in the moment”. Anxious persons are forever anticipating the NEXT moment and, consequently, lose their connection with the present. The results can be catastrophic …or at the very least embarrassing. “Choking”, “crashing” or “forgetting one’s lines” are all examples of the lack of focus that can result from runaway anxiety.

Neurofeedback is not a new technique. It has been used for nearly 40 years. Clinical use of brainwave training began in the late sixties after research psychologist M. Barry Sterman of UCLA found that operant conditioning of the EEG activity was very effective in resolving seizure disorders. Over the past several years EEG training has found application in treating an ever widening array of problems and disorders. One of the most well researched applications of neurofeedback is for the remediation of attention deficits (Attention Deficit Hyperactivity Disorder, ADHD), related behavioral disorders, and specific learning disabilities. Subsequent clinical research has demonstrated its effectiveness in dealing with mood disorders such as depression, mania and anxiety.

neurofeedback’s primary purpose in peak performance is to reduce anxiety; increase attention and focus; normalize arousal levels; reduce misdirected muscular energy expenditure; and improve the body’s normal circadian cycles –particularly with regard to sleep. In addition to the physiological normalization, there are psychological benefits. Anyone who has ever studied stress management knows about the powerfully counterproductive effect of something called “negative self talk”. Persons with self esteem issues tend to lacerate themselves whenever they make a mistake. “Perfectionists” tend to punish themselves in this way and in doing so, virtually eliminate any chance of even approaching perfection. Nothing destroys focus and guarantees failure more effectively than beating yourself up in mid-performance. In our experience, neurofeedback has been shown to boost a person’s sense of self worth due, in part, to the gaining of mastery over one’s own central nervous system. In addition, an individual learns how to hold a narrow focus and at the same time maintain a widened awareness –a necessary precondition for the peak experience.


High achievers in any field are often described as having an inner bearing characterized by confidence, calm and an ability to focus under pressure. Such qualities have physiological manifestations that can be trained and refined. Thus, in order for performers to maximize their potential, a training regimen must include exercises that improve the brain’s regulatory efficiency. EEG biofeedback offers such an exercise.