Neurofeedback: What It Is, What It Does, What You Need to Know

Featured GeekMom Science

Scientific progress goes more than boink; it helps provide new therapies, such as neurofeedback, to help children and adults with mental health and neurofunctioning concerns. Although many doctors are quick to provide medication or cognitive talk therapies to help people better cope to their surroundings, scientific research shows that we have the ability to help negotiate these kinds of health problems in long term, non-invasive ways. However, the information about these types of therapies is lacking in the public consciousness.

With this in mind, I reached out to Dr. Roseann Capanna-Hodge.

Image: Roseann Capanna-Hodge

Having met Dr. Capanna-Hodge in the summer of 2015, I found her to be “one of us.” She’s smart, snappy, and approachable. Also, just like many of us, she has one of those “sparky” kids that we’ve discussed in the past. Talking with Dr. Roseann is like catching up with your old friend who lives far away but with whom you always feel that sense of understanding. She’s able to explain even the most technical aspects of her therapies in easy-to-grasp ways making her both the perfect practitioner and perfect advocate. With that in mind, I sat down with Dr. Roseann to ask her some questions about neurofeedback.

GeekMom: One article described it as non-conscious learning, like riding a bike. How does neurofeedback work? What is the science?

Dr. Roseann: What a great analogy! Neurofeedback works through a simple process of reinforcing the subconscious brain to change itself. Neurofeedback treats a variety of conditions in a safe and effective manner because it works at the subconscious level. It creates lasting changes in the brain by creating new electrical activity through a process of measurement and reinforcement. Quite simply, one is reinforced for changing their brain waves at a subconscious level through the use of computers. The brain learns to self-regulate, which calms the nervous system, reducing or eliminating symptoms. Almost any brain, regardless of its level of function (or dysfunction), can be trained to function better.

GeekMom: So basically, it works the same way the training a dog to ring a bell to ask to be let out works? By reinforcing the behavior as positive, we learn the better behavior?

Dr. Roseann: That is exactly right.  Your subconscious gets reinforced for changing its own behavior. It is like working out, your have to work out over time in order to build the muscle. With Neurofeedback, you change your own brainwaves over time through of process of reinforcement of the subconscious through computers; you get visual and auditory reinforcements that que the subconscious brain to change.

Without self-regulation, many problems of the central nervous system can result – Lack of Focus, Anxiety, Depression and Physical Symptoms, to name a few. Neurofeedback is successfully used to treat ADHD, Autism, Anxiety, Stress, Emotional Distress, Behavioral Issues, Mood issues, Pain, Lyme, PANS/PANDAS, Headaches, Concussion, TBI and a variety of other issues.  Almost any brain, regardless of its level of function (or dysfunction), can be trained to function better.

Neurofeedback is a scientifically-based treatment for a variety of problems that result from a dysregulated nervous system. There have been hundreds (or more) of research studies to prove the effectiveness of Neurofeedback in the last 45 years. Recent meta analyses document the effectiveness of Neurofeedback in the treatment of ADHD (Arns, de Ridder, Strehl, Breteler, and Coenen, 2009). In 2012, the American Academy of Pediatrics rated Neurofeedback/ Biofeedback is rated as a Level 1 intervention for ADHD – the same as medication! Despite all the positive research, allopathic medicine hasn’t embraced Neurofeedback from becoming mainstream due to a lack of education and training for physicians and mental health practitioners about its effectiveness in graduate school. Instead, there is a push for only medication in the treatment of mental health issues.

Arns M1, de Ridder S, Strehl U, Breteler M, Coenen A. Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis. Clin EEG Neurosci. 2009 Jul;40(3):180-9. (Research provided by Dr. Capanna-Hodge)

GeekMom: Speak to me of the different brain waves and parts of the brain. What do they do? How do they affect a person’s behavior? How does neurofeedback impact these?

Dr. Roseann: The brain is a complex organ that is made up of billions of brain cells called neurons, which use electricity to communicate with each other and is also divided in segments that have specific neuropsychological functions. For example, the frontal lobes are in charge of preparing for actions; they are the brakes of the brain so to speak. Our brain is made up of billions of brain cells called neurons, which use electricity to communicate with each other.

GeekMom: So, a few years ago my son got this “snap circuits” toy. If you snap the circuits in a square pattern, it makes a long alarm sound. If you move the snaps around and make it like two side-by-side rectangles, it beeps instead. Is that kind of what we’re talking about?

Dr. Roseann: That is a nice way to think about how neurons communicate with each other. Yes, our nervous system is highly connected and responsive to change.

The combination of millions of neurons sending signals at once produces an enormous amount of electrical activity in the brain, which can be detected using sensitive medical equipment (such as an EEG), measuring electricity levels over areas of the scalp.We all have the same brain waves but we do not have the same pattern of brain waves. Certain patterns are associated with specific conditions. For example, people with ADHD often have too many slow brain waves frontally (theta) and not enough fast brain waves (beta) which would mean staying focused in non-preferred areas is hard (aka, their brain is bored!).

Neurofeedback impacts brain waves because one is reinforced for changing their own brainwaves. Typically a person pushes down a brainwave that they have too much of and increases one that they don’t have enough of and this results a person’s symptoms reducing. Each person’s protocol is different based on what their issues are and their brain wave patterning.

GeekMom: Talk to me about the types of disorders that can benefit. From my research, there seems to be a lot of research about ADHD but not as much on other types of disorders, such as Generalized Anxiety Disorder and Post-traumatic Stress Disorder. What is the research out there supporting some of the different types of mental health and educational disabilities that are aided through the use of neurofeedback?

Dr. Roseann:  Just about any issue that impacts the Central Nervous System (CNS) can improve from Neurofeedback; ADHD, Autism, Anxiety, OCD, PTSD, Stress, Emotional Distress, Behavioral Issues, Mood Issues, Pain, Lyme, PANS/PANDAS, Headaches, Concussion, TBI and a variety of other issues.  

Researchers love kids with ADHD because their issues are so easy to measure so that is why there as so many research studies.  There is a considerable amount of research that proves the efficacy of Neurofeedback with anxiety disorder and PTSD. One of the leaders in the trauma field, Dr. Bessel van de Kolk, has been a huge proponent of Neurofeedback. What a fantastic physician and passionate speaker he is. He doesn’t mice words when he says it is boloney to not be using Neurofeedback for those with PTSD. He is working hard to get funding for a large scale NIH research study to prove how effective it is. (Research provided by Dr. Capanna-Hodge))


GeekMom: How is neurofeedback different from using medication to control behavioral deficits?

Dr. Roseann: Neurofeedback is so completely different because it serves to calm the nervous system and at the same time enhance positive qualities. It gets that CNS to self-regulate so that negative symptoms dissipate. One often feels calm yet focused, sleep improves, and one’s overall mood is enhanced. One mom called her kid, “Johnny 2.0” after doing Neurofeedback because she said the Neurofeedback just made him a better version of himself. I love what she said because she articulated so beautifully what I see happening to adults and kids after Neurofeedback all the time. The other major benefit of Neurofeedback is that there are so few side effects where as with medication there are many!  One third of all hospital admissions are due to medication side effects. How horrible is that? Money wasted and all that suffering isn’t needed.


GeekMom: What are some of the side-effects of neurofeedback?

Dr. Roseann: There are few if any side effects of Neurofeedback. One can temporarily become over-stimulated (hyper, have a headache or become irritated) or under stimulated (tired). A simple protocol adjustment will stop any temporary side effects.


GeekMom: How do you measure the effects of neurofeedback? Explain the science behind how you know the treatment is working.

Dr. Roseann: Every practitioner measures in different ways, but most typically collect data after every session. At our office, we monitor progress in three ways: 1) Through QEEGs at regular intervals to objectively look at brain functioning.In very simple terms, a quantitative EEG (QEEG) is a computer analysis of the EEG data. It is a visual way to see brain functioning in terms of brain waves.  2) Through data collection at every Neurofeedback session.  3) Through regular customized symptom checklist progress monitoring.


GeekMom: Are there different types of neurofeedback? How do parents know what’s best for their child or themselves?

Dr. Roseann: Neurofeedback or type of equipment is really better than the next. What makes one treatment better than another is the quality and experience of the practitioner. Look for a practitioner that is a licensed mental health or medical provider and ideally who is also Board Certified in Neurofeedback (BCN) ( If you are taking a child, going with someone who is a pediatric expert is the best way to support your child. They can help you with all aspects of your child’s wellbeing and can assist with home and school issues too.


GeekMom: When children have “setbacks” – how does that work? Parents need to know what the reality is.

Dr. Capanna-Hodge: As we discussed before, negative side effects are rare. Certain types of a brainwave patterning is associated with a higher rate of temporary reactions and your experienced practitioner should know how to address that. In addition, an experienced practitioner who is doing their own QEEG’s can alter the Neurofeedback in real time to address any overstimulated responses.


GeekMom: Talk to me about how to deal with skeptics.  A 2013 article in Psychology Today argued that the real effects came from “believing the technology worked.” Since this article was written by a PhD and in a reputable psychology source, it has some informational validity.

Dr. Roseann: Ah the skeptics!… and there are many!  There are four decades of research that demonstrates the effectiveness of Neurofeedback. In 1973, when Neurofeedback was in its infancy, research was conducted to look at the effectiveness of Neurofeedback versus medication in treating Vietnam veterans with PTSD and substance abuse. Within a matter of days the Neurofeedback was clearly eliminating symptoms and the drug company made the hospital pull the study. And here we are 45 years later and medication is still being pushed by Western Medicine as the only solution for mental health issues. Somehow people have been convinced that medication is more effective and safe, but that couldn’t be further from the truth. Even therapists recommend medication when they should recommend a multitude of other therapies (Neurofeedback, Biofeedback, EFT, EMDR, hypnosis, meditation, yoga, etc) that calm the nervous system in a manner that creates space for people to experience their emotions. There really are few therapies that have has so much positive research yet hasn’t become mainstream. People need to think and ask themselves, “Who gets a financial benefit to keep people unwell and on medications?” Neurofeedback produces lasting changes that puts people on a path to wellness and people need to see it for what it is: a research tested, valid and safe option for improving brain functioning and mental health.


GeekMom: Some parents who see their children’s diagnoses as “flaws” to be fixed which is considered by many self-advocates as one of the problems with how society views disabilities. How would you respond to those advocates in terms of using neurofeedback?
Dr. Roseann: I have some families who bring their children to be “fixed: but most come in just looking to help alleviate some level of stress or suffering. Our American culture is a tough one; high levels of stress, little down and play time, many structured activities, poor diets, social stress, excessive media usage, and intense academics. If you have any level of a processing, attentional, behavioral, cognitive, social, or learning issue, it become tough to keep the academic pace. Neurofeedback optimizes brain functioning of anyone, which is why athletes and executives use it for peak performance optimization. So if we look at it as a tool for brain optimization (like nutrition and exercise) then we see that Neurofeedback is simply a wonderful way to improve sleep, level mood, improve focus, and improve processing speed.

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6 thoughts on “Neurofeedback: What It Is, What It Does, What You Need to Know

  1. You mentioned PTSD: The Psychophysiology Lab and Biofeedback Clinic at ECU uses biofeedback and psychophysiology to help Americas wounded warriors heal the emotional wounds of war.

    Carmen Russoniello, PhD, LRT, LPC, BCIAC was the President of the Association for Applied Psychophysiology and Biofeedback. He is currently Associate Professor and Director of the Psychophysiology Lab and Biofeedback Clinic at East Carolina University. Dr. Russoniello teaches undergraduate and graduate biofeedback courses through a first of its kind global classroom initiative and directs a biofeedback program for Wounded Warrior Marines at Camp Lejeune. The novel biofeedback intervention involves EEG and heart rate variability feedback and includes the use of virtual reality. Dr. Russoniello is himself a former Marine machine gunner and decorated Vietnam combat veteran.

    1. Carole,

      Neurofeedback (NFB) is a more advanced branch of biofeedback that focuses on the central nervous system. Neurofeedback, sometimes called neurotherapy, neurobiofeedback, or EEG biofeedback (EEGBF), gives users information on their brainwave activity. Brainwave activity is measured using EEG technology through sensors placed on the scalp and ears of a client. The information is relayed to the client and trainer by sound and a visual display (video). Here’s a video explaining more:

    1. Carole – I apologize for the late response. My understanding is that neurofeedback is a TYPE of biofeedback. Biofeedback incorporates actions on the part of the the individual. (In other words, you have to respond to the stimuli.) Meanwhile neurofeedback works on a subconscious level. I apologize for the delayed response!

  2. Thank you for this article! Glad that neurofeedback is getting more recognition. It can bring so much relief for so many people. We’ve had great results for clients training with the NeurOptimal Neurofeedback system for various symptoms from ADHD, brain injuries, migraines and anxiety. The NeurOptimal we use work directly with the central nervous system and is 100% non-invasive. Watch our success stories here: and a video on how this system works.

  3. EMDR is an effective treatment for trauma. Most addicted people have trauma because substance abuse is a coping strategy for unprocessed trauma. In order for a person with unprocessed trauma to be able to remain sober, it is critical that an individual process past trauma. Because EMDR effectively treats trauma, it is not at all surprising that it helps treat addiction – the coping mechanism for the trauma. I’ve been doing research on EMDR treatments, how it helps and exactly what the pros and cons are.

    Should anyone else be interested to see how this would help others here’s the page I looked at

    Hopefully, this information can assist someone (friends and families) in choosing the best treatment for someone they love.

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