As all of you know, Heartfulness Psychotherapy is offering a Mindfulness-Based Cognitive Therapy (MBCT) group this spring and has also recently been involved in offering neurofeedback treatment. As such, I was asked by some very clever clients the difference between the two treatments and the associated benefits to be gained from MBCT versus neurofeedback, which I thought was a really interesting question. So let’s get into it.
Research has shown that MBCT has been beneficial for treating numerous concerns, such as:
- Postpartum depression
- Bipolar disorder
- Chronic pain
- Eating disorders
- Fibromyalgia and chronic fatigue
- Sleep difficulties
- Compulsive behaviours
- Acquired brain injury (ABI & TBI)
- Sexual difficulties
- Relationship functioning
- High blood pressure
- Stress factors in heart disease
- Increased self-awareness
- Genetic resilience from illnesses, including cancer
- Increased control of thoughts & emotions
- Emotional dysregulation, thus having beneficial implications for borderline personality disorder
MBCT is a particular type of mindfulness-based approach. It’s a manualized 8-week course that teaches techniques to manage difficult thoughts, feelings, emotions, stress, and pain to promote health and relaxation using guided meditation exercises. It’s not a therapy or support group per se, but rather an experientially focused group that encourages participants to try exercises and share their experience in group.
Mindfulness is a practice. This is good news and bad news for some. It means that it offers life-long skills to manage life’s challenges, which is empowering! It means if you practice these tools, you’ll have access to long-term resilience and skillfulness for the rest of your life, and once you know the practice, it effectively becomes free (you can practice it on your own), or with minimal follow-up/ “booster sessions” required. It also means that it’s most effective if it becomes part of a lifestyle (i.e. if it’s done on a regular basis), which some people aren’t willing to do consistently.
Neurofeedback uses EEG (electroencephalography) to get a baseline reading of the brain’s electromagnetic frequency waves such as delta, theta, alpha, beta, and gamma which may be over or under active in various brain regions, consequently affecting a range of functions. Based on the baseline reading of one’s neural activity, and based on their subjective reports about the symptoms or complaints they’re experiencing, a recommended treatment protocol is generated by the system. While neurofeedback systems may differ slightly, the overall premise behind their effectiveness is that they provide stimulation [in the form of auditory, visual, or tactile rewards (less commonly used)] to help the brain “train” or learn how to function at the healthier brainwave frequency for that particular brain region, as determined by the particular system. Every system is different. The technology I worked with compared each individual’s brain reading to a vast normative database, which has pros and cons in itself (e.g. some systems employ technology that only trains the brain in comparison to itself, since some people prefer not to have their brainwave frequencies modelled based on a normative sample, while others don’t mind).
Based on the preliminary research I’m familiar with, neurofeedback has received empirical support most commonly for stress-related concerns such as:
- Sleep difficulties
- Acquired brain injury (ABI, TBI, & post-concussive syndrome)
- Enhancing cognitive performance
- Chronic pain
- Eating disorders
- Learning difficulties
- It has been used with some benefits in Alzheimer’s disease
MBCT Vs. Neurofeedback (My Pros and Cons List)
Neurofeedback is purported to have lasting effects that are produced within 10-40 weekly treatments. It is often extremely costly but beneficial results can be seen relatively quickly, although the experienced benefits differ between individuals.
MBCT also has lasting impact but requires maintenance for best results. While the 8-week course can cost generally $600 -$975, it tends to be considerably more economical than neurofeedback and/or individual psychotherapy. However, neurofeedback might appeal to those looking for a ‘quick fix,’ which tends to be attractive in our fast-paced society.
Neurofeedback reflects new technology and all the benefits and limitations that come along with it, while MBCT has its origins in ancient Eastern traditions, thus carrying a sense of tried and true organic wisdom.
Mindfulness empowers individuals to cultivate internal skills and self-control, whereas neurofeedback requires that patients be dependent on the skillfulness of the practitioner and the particularities of the technology being employed, thereby relinquishing personal agency. Because of this, it is also possible for neurofeedback to occasionally train brainwave frequencies that yield less desirable outcomes (e.g. increased fatigue versus mental focus).
MBCT is an entirely non-invasive approach with mostly beneficial side effects. Participants are in control throughout their practice and the most adverse side effect of mindfulness ever reported (that I’m aware of) is increased awareness of difficult mental, emotional, or physical events (which is a benign side effect that can be supported and coped with). Thus, MBCT has few (if any) contraindications and to my knowledge has not been known to cause harm to anyone. Neurofeedback on the other hand is contraindicated for various conditions (e.g. epilepsy), and can be harmful if the clinician implementing it is not properly trained. While neurofeedback is marketed as a non-invasive approach because most systems do not introduce instruments or matter into one’s body –with the exception of Neurostimulation, which does input a mild electrical current into the brain– it is still possible to experience considerable adverse side effects during the course of neurofeedback treatment. These side effects may be intense enough in sensitive individuals to require time off work (e.g. symptoms similar to post-concussive syndrome have been reported for several days following treatments, or the possibility of increased seizures early in seizure treatment).
Neurofeedback is intended to result in lasting neurological change. The number of brain regions “trained” or targeted during a 10-40 session treatment protocol largely depend on the particular system being employed. The neural regions selected for training are often partly determined by the clinician and partly by the treatment protocol generated by the technology. Therefore, while there is greater ability to individualize which brain regions (and which associated symptoms) will be addressed, there are often a limited number of options of which regions and conditions a particular course of treatment will address. Of course one could pay for subsequent treatments and train additional regions. Mindfulness meditation (and MBCT) affect significant beneficial brain changes too, (see Psychology Today’s listing and Harvard’s recent study) they’re just less individually customizable. Such practices affect the brain’s electromagnetic frequencies as well; again, they’re just less individually customizable than in neurofeedback treatment.
Since MBCT is manualized, it should theoretically be offered in a consistent manner irrespective of the group facilitator and facilitators are expected to be experienced meditation practitioners. Neurofeedback, however, may vary depending on the technology employed and operating clinician.
Both approaches require prolonged sitting (20-60 minutes). Both approaches can make people feel slightly sleepy afterward. MBCT requires approximately 1.5 – 2 hours a week commitment for an 8-week period, while neurofeedback generally requires a one hour assessment, a 30-minute report reading, and 30-60 minute subsequent training sessions a week or twice a week for a minimum of 10-40 sessions, thus, neurofeedback is more time intensive. And it involves hair gel that may hamper your plans if you have a date scheduled after your appointment. Just saying.
MBCT is offered amongst groups, while neurofeedback is offered individually, thus providing a greater sense of privacy during treatments. While some may shy away from groups, I’ve received a surprising amount of feedback suggesting that the group atmosphere helped individuals learn from one another, normalize their own experiences, and feel part of a supportive community. (Note that speaking in group is only voluntary). Nevertheless, it’s up to personal preference.
I prefer MBCT over neurofeedback because I like the self-empowerment, life-long skill acquisition aspect of it rather than feeling dependent on yet another service provider. It helps me feel greater alignment with my spirituality, (note: this component is NOT taught or required in MBCT groups but may be a pleasant and optional byproduct). It also supports my yoga practice since it incorporates some gentle yoga postures. Overall, both approaches are great non-medical alternatives, and both treatments are known to be helpful for a variety of concerns, so it all depends on the treatment outcome you’re looking for. Ideally, we should be so lucky to use both treatments!
Please note that this is my professional opinion on these practices based on my experience with them; feel free to offer your feedback if you feel I’ve missed something; I’m happy to start a dialogue. Happy brain health everyone!