What Is Neurofeedback? A Plain-English Guide for Chicago Patients
Reviewed by Dr. Joseph Shoshana, Licensed Clinical Psychologist, Chicago.
If someone has suggested neurofeedback to you — or you have found it while looking for options that do not start with medication — you probably have the same two questions most people arrive with: what actually happens in a session, and does it really work?
This guide answers both in plain language, including the parts that are less flattering. Neurofeedback is a legitimate, well-studied approach. It is also frequently oversold. You deserve an honest picture before you spend money or time on it.
What Is Neurofeedback?
Neurofeedback is a form of biofeedback for the brain. Small sensors are placed on the scalp to read the electrical activity your brain is already producing. A computer watches that activity in real time and gives you immediate feedback — usually through a film or music that plays smoothly when your brain produces the patterns being trained, and dims or pauses when it does not.
Nothing is sent into your brain. No electrical current, no magnetic pulse, no medication. The sensors only listen. What changes over a course of sessions is that the brain, given consistent feedback, gradually learns to produce more regulated patterns on its own — the same way you learn any skill through repetition and feedback.
The Biofeedback Certification International Alliance describes EEG biofeedback as a specialised application of biofeedback that uses brainwave data in an operant conditioning framework — which is a technical way of saying: the brain learns from feedback about itself.
A useful way to picture it
Think of an orchestra. When every section plays in time, the result is coherent. When one section rushes or drags, the whole piece suffers — even though every musician is technically capable. Neurofeedback is closer to conducting than to repair. It is not adding anything the brain lacks; it is helping the timing settle.
What Actually Happens in a Session
- Sensors are placed. They are applied to the scalp with a conductive paste. It is painless and nothing is broken or penetrated.
- You watch or listen. Most people watch a film. That is genuinely all that is asked of you.
- The software responds. When your brain produces the target pattern, the film plays normally. When it drifts, the picture dims or the sound drops.
- Your brain adjusts. Largely without conscious effort. Most people cannot describe what they are doing, which is expected — this is implicit learning, not concentration.
- You go about your day. Sessions typically run 30–45 minutes. There is no recovery period and no sedation.
Most protocols involve a meaningful number of sessions rather than a handful. Anyone promising transformation in two or three visits is not describing neurofeedback accurately.
Why Assessment Comes First
Neurofeedback is only as good as the picture guiding it. Training the wrong pattern is not dangerous, but it is a waste of your money and your time.
That is why a qEEG brain map matters. A qEEG records your brain’s electrical activity and compares it against normative data, producing a visual report of how different regions are functioning and communicating. It turns “something feels off” into something specific enough to work with.
It also gives you a baseline. Without one, there is no honest way to say whether anything improved — only impressions. For some people, the map is the most valuable part of the process, because it is the first concrete explanation they have been offered.
Where Neurofeedback Came From
It is older than most people expect.
In the 1960s, Dr. Joe Kamiya, then at the University of Chicago, showed that people could learn to recognise and influence their own alpha activity when given real-time feedback. Around the same time, Dr. Barry Sterman at UCLA was training cats to alter their sensorimotor rhythm using a simple reward system. Sterman later found, unexpectedly, that the trained animals were markedly more resistant to chemically induced seizures — a result that pushed the field toward clinical application.
Six decades of refinement followed. This is not a recent wellness trend; it is a long-standing line of research that became practical as computing became cheap enough to deliver feedback instantly.
What the Research Actually Shows
Here is where honesty matters more than enthusiasm.
ADHD is the strongest evidence base. In 2012, the American Academy of Pediatrics’ review of psychosocial interventions rated biofeedback and neurofeedback as a Level 1 — “best support” — intervention for attention and hyperactivity behaviours in children. A frequently cited 2009 randomised trial of 102 children compared 36 neurofeedback sessions against computerised attention training and found greater improvement in the neurofeedback group.
The picture is genuinely debated. Later research has been more mixed, particularly trials using strict blinding and sham conditions, where effects on clinician-rated outcomes have sometimes been smaller than open-label studies suggested. Researchers continue to disagree about how much of the benefit reflects the training itself versus the structure, attention and expectation that come with any sustained intervention.
Both of those things are true at once. Neurofeedback has real evidence behind it for ADHD and is not a fringe practice — and it is not the settled, universally accepted treatment that some marketing implies. Anyone who tells you the science is finished, in either direction, is overstating their case.
For other concerns — anxiety, sleep difficulty, the after-effects of concussion, performance under pressure — the evidence is thinner and more preliminary. That does not mean it cannot help. It means the honest framing is “reasonable to try, with clear checkpoints,” not “proven.”
What Neurofeedback Is Not
- It is not a cure. Any provider using that word about a brain-based condition is overselling.
- It is not permanent by default. Some people hold gains well; others benefit from occasional follow-up. Individual results vary, and nobody can promise you which group you will be in.
- It is not a replacement for medical care. It does not diagnose or treat medical disease, and it should never be used instead of appropriate treatment.
- It is not a reason to stop medication. Any change to prescribed medication is a decision for you and your prescriber — never a decision made because a training programme is going well.
- It is not right for everyone. Some people are better served by therapy, by a thorough evaluation first, or by both.
Who Tends to Consider It
In our experience, people usually arrive from one of four directions:
- Parents whose child is struggling with focus, behaviour or emotional regulation, who want to understand what is happening before committing to a treatment path.
- Adults who have tried therapy or medication and found the results partial — better, but not resolved.
- People who prefer to start without medication, or who want to understand their options fully before deciding.
- High-functioning professionals managing brain fog, disrupted sleep or a sense of running on reserves.
Doctor-Led Matters More Than People Expect
Neurofeedback is delivered in a wide range of settings, and the quality varies considerably. Equipment can be purchased by anyone; the interpretation is what separates useful work from expensive guessing.
At Chicago Brain Health, the assessment is reviewed and interpreted by Dr. Joseph Shoshana, a licensed clinical psychologist with more than 25 years of practice. That means your results are read in the context of your history, your circumstances and your symptoms — not just against a database. It also means you may be told that neurofeedback is not the right starting point for you, which is information worth having.
Common Questions
Does neurofeedback hurt?
No. Sensors rest on the scalp and only read activity. Nothing is sent into the brain. Most people find sessions relaxing, and some find them dull — which is a good sign that nothing dramatic is happening.
How many sessions will I need?
It depends on what is being addressed and how you respond. Meaningful protocols are measured in dozens of sessions, not a handful. You should be given an estimate up front and a checkpoint to review progress honestly.
How is this different from TMS?
Transcranial magnetic stimulation applies magnetic pulses to stimulate brain regions directly — it does something to the brain. Neurofeedback sends nothing in; it provides information and the brain adjusts itself. TMS is FDA-cleared for specific psychiatric indications and is usually delivered in a medical setting. They are different tools for different situations.
Will my insurance cover it?
Coverage varies considerably by plan, and many plans do not cover neurofeedback. Related services such as psychological evaluation may be covered when medically necessary. We will tell you plainly what is likely to be covered and what is not before you commit.
Is it safe?
Neurofeedback is non-invasive and generally well tolerated. Some people report temporary tiredness or headache after sessions. As with any intervention, it should be provided by a qualified clinician who can recognise when it is not the right fit.
Can it help with autism?
Some families pursue neurofeedback as part of a broader support plan, usually targeting regulation, sleep or attention rather than autism itself. The research here is early and we will not tell you otherwise. If you are exploring options for your child, the honest starting point is a thorough assessment.
A Sensible Next Step
If you are considering neurofeedback, the useful first move is not to book a course of sessions. It is to find out what is actually going on — and whether this is the right tool for it.
We offer a free initial consultation to discuss your situation and whether assessment makes sense. If neurofeedback is not appropriate for you, we will say so.
Call (847) 670-8544 or send us a message. Chicago Brain Health, 1021 W Adams St., Suite 201, Chicago, IL 60607.
This article is general information, not medical advice, and does not create a clinician–patient relationship. Individual results vary. Always consult a qualified professional about your own situation.