Neurofeedback therapy (NF) is a non-invasive method that teaches individuals to regulate their own brain activity. During a session, sensors placed on the scalp monitor brainwave patterns using an electroencephalogram (EEG), providing real-time auditory or visual feedback to the client. This process is generally considered to have a low-risk profile, particularly when compared to pharmaceutical interventions. However, because neurofeedback directly influences brain function, negative outcomes are possible, and understanding these risks is important for anyone considering the therapy. The potential for adverse effects ranges from temporary discomfort to the exacerbation of pre-existing psychological or neurological issues.
Potential Transient Adverse Reactions
Some people experience mild, temporary discomfort as their brain adapts to the new training regimen, which is often analogous to the fatigue felt after a physical workout. These common effects usually resolve quickly, often within hours or up to 48 hours following a session. Reported reactions include temporary fatigue, headaches, or lightheadedness, particularly when training higher-frequency brainwaves. Emotional shifts can also occur, such as a temporary increase in anxiety, irritability, or difficulty falling asleep. These reactions often signal that the current protocol may be too intense, and reporting these symptoms allows for prompt adjustments to the training parameters, which typically resolves the discomfort.
Risks Stemming from Improper Application
Practitioner Error
The most significant risks in neurofeedback often stem from human error or a lack of professional expertise, rather than the therapy itself. Neurofeedback is a learned process where the brain is taught to adopt new firing patterns, and if the protocols are incorrect, the brain can “learn” a less functional state. An untrained or unqualified practitioner may use outdated or unvalidated protocols that are not tailored to the individual’s specific brain map.
Undesirable Cognitive Shifts
Incorrect electrode placement or training the wrong frequency band for a given brain region can lead to undesirable cognitive shifts. For instance, inappropriately reinforcing high-frequency brainwaves like Beta can induce a hyper-aroused state, potentially leading to racing thoughts, increased muscle tension, or panic-like feelings. Conversely, training for excessively slow brainwaves can result in a “spacey” feeling, brain fog, or impaired concentration. When these inappropriate patterns are reinforced over multiple sessions, the negative cognitive or emotional state can persist, requiring corrective training to reverse the effects.
Exacerbation of Underlying Conditions
Neurofeedback carries the risk of destabilizing pre-existing conditions if a thorough clinical assessment is not performed beforehand. Individuals with complex psychological histories or severe neurological disorders are particularly susceptible to having their symptoms worsened. Applying a non-individualized protocol to a patient with a history of severe trauma can unintentionally trigger emotional dysregulation or heightened anxiety. For patients with seizure disorders, the wrong training approach can increase epileptiform activity or worsen impulse control. Serious adverse reactions include the exacerbation of depression, the induction of manic episodes, or a general deterioration in cognitive functioning, necessitating extreme caution and personalization for high-risk populations.
Safeguarding Against Negative Outcomes
Mitigating the risks associated with neurofeedback begins with exercising due diligence when selecting a provider. It is recommended to verify that the practitioner is licensed within a regulated field, such as psychology or counseling, and holds specific certification in neurofeedback. A thorough initial clinical assessment, often including a Quantitative EEG (QEEG) brain map, is necessary before starting training. This assessment identifies the individual’s unique brainwave patterns and ensures the protocol is precisely tailored to their needs, significantly reducing the risk of an adverse reaction. Patients must also maintain open communication with their practitioner, reporting any new or worsening symptoms immediately so the protocol can be adjusted.