Neurofeedback Practitioner Training

This module is an introduction and orientation to the course. We set out the course objectives, and give an introduction to neurofeedback, biofeedback, and some of the different types of neurofeedback. We also introduce neurofeedback software, in particular Mind-Body Training Tools, and give an overview of devices for neuro- and biofeedback.

This module is a course within a course. It's designed to get you up and running with neurofeedback as soon as possible, with only just enough content to get you started. By the end of it you should be able to run your first neurofeedback training session.

The rest of the course will then fill out the ideas you meet here in much more detail.

There are eleven parts, including this introduction (part 1).

• Part 2 gives us a basic overview of what EEG is, how it is quantified and analysed by neurofeedback software, and what it can reveal about brain function.
• Part 3 begins the practical instruction in how to measure EEG, starting with how to set up the device and sensor cables.
• In part 4 you learn how to attach EEG sensors (electrodes) to the scalp, and ensure you get a good clean reading.
• Part 5 introduces the 10-20 system of sensor site locations, and teaches you how to find your training sites.
• As mentioned already, the course focuses on Mind-Body Training Tools (MBTT) as the software system we'll use for both training and assessment. Part 6 presents an introduction to MBTT.
• In part 7 we consider what can go wrong when we measure EEG. Artefacts are features of our measured signal that don't come from the brain, and hence obscure the picture. You'll learn the sources of artefact, how to recognise them, and how to avoid them (as far as possible).
• Part 8 presents an overview of the training process, and introduces some key concepts: protocols, thresholds, and feedback.
• Part 9 demonstrates how to run a training session using MBTT. We'll start by using "simulator mode", allowing us to get familiar with the software and its operation, without the encumbrance of cables, sensors, etc.
• Part 10 is a first pass at one of the key factors in neurofeedback training: how to apply your mind. Neurofeedback is brain training more than it is mind training, so we'll consider how to get out of the way and allow your brain to do the learning for you. (This is a topic we'll return to in greater depth, in module 4.) Part 10 also touches on what to expect from the experience of training. This is important as unhelpful expectations can get in the way of the right mindset needed for training.
• The final part of module 1 looks at how to review your training sessions, and how to judge performance and progress. Again this is important to managing expectations, and finding the right mindset for training.

By the time you've completed module 1, you'll have run your first neurofeedback session(s). There is still much to learn, the rest of the course fills in the details of your neurofeedback working knowledge.

Module 2 is the least practical part of the course. It's designed to offer background knowledge of the neuroscience and neuorphysiology of the themes that neurofeedback addresses, namely mental and emotional functioning. You can skip over it if you wish, or continue with it as background reading while you continue with the course.

This module has three parts:

• The second part offers some reading material from my book "Mind-Body Intelligence: How to manage your mind using biofeedback and mindfulness". You can download this material for later reading on a device of your choice.
• Part 3 is a reproduction of a blog article on the theme of biohacking, which I define as the art and science of optimising your well-being and performance by measuring, tracking and optimising your biology. Biofeedback and neurofeedback fit well within the biohacking approach.
• In part 4 I again present more of my own material, this time a mini-course on the principles of optimising brain health. I created this set of videos for an old website which is now defunct.

The purpose of module 3 is to explain what EEG actually is, how it is quantified and analysed by neurofeedback software, and what the results can tell us about mental and emotional functioning. Armed with this knowledge you'll have a clearer understanding of what neurofeedback is doing. Two key methods used by neurofeedback software are digital filtering and spectral analysis. Understanding these is an important basis for working with the software effectively, and knowing how to configure protocols.

This module has eight parts:

• In the next part we'll gain a deeper understanding of what EEG is, or what is being measured.
• Part 3 covers some of the practical details of measuring EEG - the operation of a differential amplifier.
• Part 4 begins our in-depth review of digital signal processing (DSP). You'll learn the basics of how EEG is quantified.
• Part 5 gives more neuroscience background: you'll learn about the neurophysiological origins of EEG.
• In part 6 we return to DSP, and present an in-depth explanation of digital filtering and spectral analysis, the two main methods for analysing EEG.
• In part 7 you'll apply your understanding of DSP to the MBTT software. You'll learn how to configure filters, etc., so that you can fine-tune neurofeedback protocols.
• In part 8 we review some more specialised EEG parameters, including coherence and dominant frequency. We'll also look at some of the more advanced displays you can find in neurofeedback software.

The purpose of module 4 is to explain how biofeedback and neurofeedback work. The chief practical import is an in-depth examination of how to apply your mind, or how to make effort, in neurofeedback training.

Here we expand on the accounts given earlier of how biofeedback and neurofeedback create change. At the heart is the idea that the trainee learns to guide his neurophysiology away from a problem state and towards some solution state. What does it actually mean to learn? And crucially, how do we make learning as efficient as possible? What role does the conscious mind play in optimising learning efficiency?

It must be said that much of the content in this module is not part of most neurofeedback trainings. It's probably more relavant to peripheral biofeedback - indeed the ideas I present were formulated in the context of my peripheral biofeedback practice, and some of the material is recycled from other courses. There's no doubt that you can do effective neurofeedback without it, so please feel free to skip it if you so wish.

On the other hand, my personal preference is to precede EEG neurofeedback with at least some training in peripheral biofeedback. Much of the key research in alpha-theta neurofeedback incorporates some peripheral biofeedback, so if that is of interest to you, please stay with me.

Module 4 has seven parts:

• Neurofeedback is standardly presented as a form of operant conditioning. In the following part we'll consider what this means.
• Real-world human learning goes well beyond conditioning. In part 3 we expand our account of the science of learning. Much of my presentation here is based on the work of French cognitive neuroscientist and author Stanislas Dehaene, whose book “How We Learn: The New Science of Education and the Brain” I would highly recommend. We review his four pillars of learning: focused attention, active engagement, error feedback (which of course has particular relevance to us) and consolidation.
• In part 4 we take a more explicit look at the role of the conscious mind in learning, and in neurofeedback in particular. We try to reconcile the mainstream view of neurofeedback as having almost nothing to do with the conscious mind, with the roles of attention, motivation etc we just explored.
• Part 5 offers a more practical consideration of how to apply the conscious mind in neurofeedback and biofeedback. Even if you accept the mainstream advice, it's very challenging for at least some trainees to just do nothing. I think it behoves us to give more help. Here I recycle some of my teaching material from my biofeedback training courses.
• In part 6 I offer yet another personal viewpoint, that you won't encounter in most neurofeedback practitioner trainings. We explore the idea that neurofeedback works because it is a type of hormetic stressor.
• In part 7 we explore some principles of neuroplasticity as offered by author Norman Doidge, in his second book on the topic of neuroplasticity: “The Brain's Way of Healing: Stories of Remarkable Recoveries and Discoveries”. These ideas are perhaps not the most relevant from a practical point of view, but they do open up the idea of combining neurofeedback with brain stimulation technologies.

Selecting a protocol is one of the key decision points for the neurofeedback trainer. It's also one of the most challenging aspects for a novice practitioner. In module 5 you'll learn about an important foundation for that choice: EEG assessment.

The brain is an enormously complex system, and the EEG contains huge amounts of information. Relating this information to patterns of emotional and cognitive functioning is no easy matter. Furthermore, we need to remember the brain is a responsive and flexible system – it's activity should reflect context, or what the owner is doing. There is no one single healthy brain state. The brain state most appropriate to e.g. writing computer code, is different from the brain state when lying in bed ready for transition to sleep. (Flexibility and adaptability are ultimately the key goals.)

My approach here will be to work through layers of complexity in EEG analysis.

From the point of view of the arousal model (covered earlier), we would ask, is the brain over-aroused or under-aroused? (Or just, over-activated or under-activated?) The answer would point the practitioner towards using an activating protocol or a relaxing protocol.

Thus, a very basic neurofeedback system would include a means of assessing arousal, plus protocols for activating and relaxing. Such a system would have the advantage of being easy to learn for the practitioner. It would be a considerable advance over a system with a single one-size-fits-all protocol. And actually I think it is a viable model for doing neurofeedback.

Of course we can go to deeper levels of complexity in EEG assessment. At the far end of the spectrum would be a full-head QEEG brain map. In this course we don't go to that level but we will cover pretty simple assessment systems that are realistic for a beginning practitioner to learn and use. If you're working with stress management and performance improvement cases (as opposed to compex medical cases) these tools are generally quite adequate.

If you're a professional coach or therapist working with clients, you'll want to assess your clients in other ways besides EEG (e.g. by taking a case history). This topic isn't really covered on the present course, except that in module X on managing the neurofeedback process, we'll discuss ways of tracking clients' progress.

Module 5 content:

• In part 2 we explore how EEG relates to brain metabolic activity (energy consumption) which is what several brain imaging modalities including fMRI and PET are really measuring.
• In part 3 we take a more in-depth look at the standard EEG frequency bands, which we first reviewed in module 1. Our principle aim is to relate these bands to mental and emotional functioning.
• In module 3 we encountered spectral analysis, one of the key methods for analysing EEG. In part 4 we learn to interpret in broad terms features of spectral analysis charts.
• Part 5 reviews key patterns found in the EEG that correlate with mental and emotional problems. In considering these patterns, we begin to make reference, either explicitly or implicitly, to databases. In other words we compare what we find in the EEG to patterns that emerge from EEGs recorded from large numbers of people.
• In part 6 we relate EEG patterns to stress. We consider the different phases of the stress response, and how the EEG can be expected to change as the brain progresses through these stages.
• MBTT offers us software tools for recording EEG for assessment purposes, and generating reports that present the data in amenable ways. Parts 7 and 8 introduce these tools.
• In part 9 we consider a system for quick, easy but relevant assessment of EEG, developed by Dr Paul Swingle, which he calls the "Clinical Q". The review the markers used in the system.
• In part 10 we review some similar systems that are available to practitioners.
• The purpose of EEG assessment is to derive an appropriate choice of training protocol. Not all neurofeedback practitioners base their choice of protocol on a formal assessment recording, but may instead go by presenting symptoms in the trainee. Symptoms are typically interpretted according to the arousal model. We review this in part 11.
• In the final part we briefly review some adjunctive non-EEG assessments relevant to mental and emotional functioning, mostly office-based, and including HRV assessment, which tells us something about autonomic nervous system function.

To recap, one of the key decision points in neurofeedback is what protocol to train with. Protocol means the decision of:

• what particular EEG parameter or parameters to train
• whether you want to enhance it or suppress it (i.e. train up or down)
• where on the head you wish to train it (including how many channels of EEG to use in training).

Across the whole field of neurofeedback, there is a huge number of protocols in existence, ranging from very simple to inordinately complex. Selecting the protocol that is most appropriate to achieving the trainee's goals and resolving his brain inefficiencies, is one of the most important parts of the neurofeedback process, and also one of the most challenging to new practitioners.

This module will cover some simple but effective protocols, and how to select a protocol.

This being an introductory course, we'll focus almost entirely on amplitude training (i.e. the amplitude of some frequency band).

The simplest protocols involve training a single parameter. The examples we used in module 1 were like this, i.e. alpha-up and squash (broadband-down). We'll cover more in this module. More complex protocols have two training parameters, e.g. you can train beta up and theta down at the same time. We'll also look at two-parameter protocols in this module.

At this time, module 6 content is not yet finished.

This module covers in depth two key aspects of neurofeedback software, namely thresholds and feedback, which were briefly introduced in module 1.

Feedback is what is presented to the trainee, to see or hear, and aims to reward the trainee in some sense, for achieving the desired brain state. Feedback can take different forms, ranging from a simple bar graph to video feedback. Feedback can also be auditory (allowing for eyes-closed training) – e.g. a simple tone, or a soundtrack with variable volume.

Thresholds are the means of controlling what level of the feedback parameter is enough to trigger rewards. Setting thresholds appropriately, so that achieving rewards is neither too hard nor too easy, is key to optimising learning efficiency, and thus the success of neurofeedback.

In this module we look at how to configure thresholds and feedback effectively, primarily using MBTT software, but the principles should be extendable to other neurofeedback products.

At this time module 7 content is not yet complete.

Module 8 looks at how the neurofeedback process unfolds and develops over time, across multiple sessions, and how the practitioner should manage that process.

This module has n parts:

• In part 2 we present an overview of the client journey from start to finish.
• Part 3 covers client intake and assessment.
• Next we look at how to coach clients in neurofeedback so that they can apply themselves effectively.
• Continuing the theme of how to work with feedback, in part 5 we explore how periphral biofeedback training can support neurofeedback.
• In part 6 we look at how to plan and structure a neurofeedback session, and how to prepare for it
• Part 7 presents the important topic of progress monitoring
• Following on from this, part 8 looks at how and when to reassess your training plan and adjust or change the neurofeedback protocol.

Here we offer introductions to some special topics in neurofeedback, including:

• Alpha-Theta Neurofeedback
• HEG (Hemoencephalography) Neurofeedback
• Slow Cortical Potentials (SCP) Neurofeedback
• Optimal Performance Training
• Brain stimulation techniques as adjuncts to neurofeedback
• Neurofeedback & Meditation

While this won't be in-depth training, we will cover how to work with the Mind-Body Training Tools applications for alpha-theta, HEG and SCP neurofeedback.