One in five Canadians lives with a mental illness according to statistics from the Canadian Mental Health Association. In my experience, the rate at which people struggle with mental health issues of some kind is much higher. Most people suffer in silence. Statistically speaking, we are all connected to someone struggling with mental illness. While you’re reading this, look around you. I guarantee someone you just saw is struggling with mental illness and/or a mental health issue of some sort. It’s guaranteed. Are you surprised?
I remember the first time I knew what it meant to feel sad and not know why; and the time I realized that I felt this way a lot of the time, and still didn’t know why. I was six years old. It confused me deeply. I had loving parents, we had a house to live in and food to eat, I went to a good school, I had a good community of people around me. I still felt sad. A lot.
When I was a kid, nobody talked about mental illness, mental health, or anything in the middle. It simply wasn’t something that was a part of the dialogue. As I contemplated what I was going to write this morning, I realized that actually, I don’t recall any public conversations about mental health growing up, whether it was elementary school years, or high school. And while I like to joke that I’m getting old, it wasn’t that long ago that I was in high school.
It wasn’t for lack of experiences that could lead to a discussion either. I had friends who had very difficult home lives, knew people who lived through tragic accidents, I’ve lost friends to suicide, and more, never mind the statistics we now know about the rate at which mental illness affects the population as a whole. I’m not sure why it was not talked about, it just wasn’t.
Now that I’m older, and in the mental health field, I’m glad that there is more talk about mental illness and mental health management. What I find now, however, is that I can grow tired about simply talking about it and creating awareness, probably to a fault. Awareness is very important. I can only imagine the difference it would have made for me, or friends I now know struggled in childhood, if we could have heard about mental health and had discussions about it. The discussions, however, leave me asking the question, “So now what?” Many of the discussions I hear sound hopeless and don’t offer many solutions. As a professional, I’m also well aware that the solution isn’t simply more professionals and more mental health services.
Let’s Talk Hope
One of the things I’m known for, and is written all over my bios on various websites, is that I don’t believe in hopeless causes. It is one of my fundamental beliefs that there is hope in every situation, even if we can’t always see it when we’re in the middle of it. Last year, I connected with Connie Jakab who formed National Hope Talks and we collaborated on a conference in Calgary this past January. The conference is all about hope.
This time around, in January 2020, the conference will be hosted in Edmonton and Calgary, and together with 140 Sports, we’re bringing it to Delta. It’s time we went beyond talking and start acting like we believe that there’s hope.
What Is Let’s Talk Hope?
Let’s Talk Hope is a conference, or perhaps an unconference where we bring together students, teachers, parents, mental health workers, business people, non-profit leaders, and more to talk about Hope. We’ll have some speakers with lived experience and unique insight into mental health. This will set the tone for the day, and give some valuable information about what some of us are seeing in the community in terms of mental health. We’re also going to have workshops that incorporate different art forms and help build skills to manage mental health in our own lives, the lives of our community, and beyond.
The peak of the experience at Let’s Talk Hope are the incubator sessions. In these sessions, we get into small groups where people are mixed up to have at least one teacher, student, business leader, mental health worker, non-profit leader, etc. Each person gets 2-3 min to share their perspective and what they are noticing about mental health. Each group then writes down what was commonly shared and what could potentially be the solution.
We know we aren’t going to solve mental illness in one day. What we are going to do is create hope, and get creative, and talk solutions. Solutions that will come from every part of our community, not just the professionals.
Join us in Bringing Hope to Delta in January 2020
I can tell you that the first Let’s Talk Hope conference this year was one of the most powerful, encouraging, and hope giving experiences I’ve had in my work in mental health. It helps bring the message of hope in mental health forward, knocks down silos between providers, clients, and the community, and gives us a renewed sense of connection, of togetherness in this fight for mental health in our own back yard.
Does this sound like something you’d like to be a part of? We need to hear your voice and have you as part of the solution to bring hope to our community.
We’ve been receiving more questions about counselling appointments, and particularly appointments for children with a Registered Clinical Counsellor. So, we thought we’d write another article to address some of the things that are unique about counselling appointments for children. I won’t repeat the details of the last article, so you may want to read that one first, and continue here.
Consent and Confidentiality in Counselling for Children
Consent to Counselling
One of the questions we get asked is, “Who can consent to treatment, and can my child consent?” This is a bit of a tricky question in some situations, particularly around parental separation and divorce. I’ll save the intricacies for another article, but in general, one or both parents need to consent for their child to see a Registered Clinical Counsellor. If there are no court orders involved, either parent can consent but we always like to get both parents to consent, and also to provide history and input because we believe it’s in the child’s best interests to operate this way in most situations. The more information we can get and the more support the child can get, the better off everyone is.
In terms of when a child can consent to their own counselling, there is no black and white line drawn in BC in terms of the age at which a child can consent. One of the most commonly-used ages is 14 and is generally accepted by most service providers. If, however, you can make an argument that the child is what is called a mature minor, the child can consent as early as age 12, or possibly earlier as long as they understand what they are consenting to. In most situations, we use the age of 14 as a guideline here at Alongside You.
Confidentiality in Counselling for Children
Many parents find it unnerving to send their child to counselling when they are not in the room to witness what is happening and being said. As a parent, I can easily understand this anxiety – I know I want to know what is happening for my kids all the time! Here’s the challenge – counselling relies on a safe, secure relationship between the client and the counsellor built on trust. If the child thinks the counsellor is going to turn around and tell the parents everything they are saying, what are the chances the relationship of trust will survive? Probably not very high.
Every Registered Clinical Counsellor at Alongside You is responsible for their professional practice and so there may be some variability in how much input from parents is sought. What I would suggest is that most counsellors will seek to collaborate with parents as much as possible, with the best interests of the child in mind. The degree to which information is passed, however, is going to depend on the comfort level of the child and the strength of the therapeutic relationship with the counsellor. It will also depend on the counsellor’s judgement of what information would be helpful to pass on. If there is a suspicion of imminent risk to the child, confidentiality can be breached without consent, but this is a judgement call on the part of the counsellor and up to their professional discretion. I know this involves a great deal of trust on the part of parents, and it is not lost on us as professionals. We want the best for your kids and will hope to strike the greatest balance between these needs to help your child.
Who Comes To The First Appointment?
The answer to this question really depends on the age of the child, or what the child wants. For younger children (i.e. approximately 12 years old or younger), it’s quite common for the first session to be with the parents alone to get some history and background and answer any questions or concerns. This first appointment can also be split between the parents and the child, at the counsellor’s discretion.
For older children, it’s likely going to come down to what the child wants. If the child wants the parents to come into the first session, then that’s likely what will happen. If, however, the child wants to come in alone, it’ll likely be just the child in the session. This is to build trust between the counsellor and the child and allow them to establish boundaries around safety and trust.
How Can I Help My Child While They Are In Counselling?
Encourage Your Child
Going to counselling can be scary for anyone, and it’s a lot to take in for a child. One of the best things you can do is to be encouraging. Let your child know that this is a time for them to have a safe place to talk about what is happening for them. Emphasize that this is an opportunity to work through some of the difficult things in life, it’s not a place to go to get fixed because there’s something wrong with them. They are wonderfully made human beings who sometimes need a little extra help.
It may also be helpful to let your child know that you’ve gone to see a counsellor before and share how it helped you, in as much detail as you’re comfortable with and as is appropriate for the age of your child. Common experience and reassurance can go a long way.
Avoid Interrogating Your Child After The Session
I get it – you want to know what happened. We all do as parents. But, it’s not going to support the process if the child then worries about being interrogated after coming out. Instead, a helpful question can be, “Is there anything you’d like to tell me about your time with the counsellor?” Realize that answer may be, “No,” and this needs to be okay. You want to give your child the opportunity to share their journey with you, not make a demand that they let you in if they’re not ready to do that yet.
Understanding The Reports You Get Back
We all love our children, and we want to believe everything they say. I remember when my parents would ask me what I did at school, invariably, my answer each time was, “I played and had a snack.” I, of course, didn’t do this, and this only every day at school. I was a very forthcoming child apparently. I also know, that what kids report back to parents isn’t always accurate (the same goes for adults), or the full story. This isn’t intentional necessarily, it’s just how our communication patterns work. I remember a client that I was doing EMDR with one time had gone home and told their parents that we had been doing ECT. Yes, that ECT that involves significant electrical charges to the brain in a hospital setting. Thankfully the parents called me to clarify and assumed that something got lost in translation. I’ve also heard clients tell parents, “All we did was talk about boring stuff,” or, “All we did was draw a picture.” While some of this may be true, there’s usually a lot more to the story.
It’s helpful if we all start with the assumption that the counsellor has the best interests of the child in mind and that we may not be getting the whole story when we get it from our child. Be curious, ask general questions, and if you have any concerns, contact the counsellor to clarify.
Trust The Counsellor and Your Child
I know it’s unnerving to trust someone else with the care of your child. I get that on both sides, as a Registered Clinical Counsellor and as a father of two young girls. Again, trust goes a long way and goes both ways in the relationship between parents and therapists. We want what’s best for your child, and we’ll do whatever is possible to help. Sometimes this involves us not divulging information you may want to know, and sometimes that may be unnerving for you.
We want to include you in any way we believe will be helpful for your child and your family. This sometimes takes time to develop, understand, and plan for. Your patience is much appreciated, as is your commitment to a process that may have you feeling like you’re standing on the outside at times.
Thanks for reading to the end! I hope this helps with some of the questions you may have about the first appointment with a Registered Clinical Counsellor for your child, and a bit about the ongoing process. Sending your child to a counsellor for the first time can be nerve-wracking, and challenging at times. Please feel free to ask any questions you like as you’re booking, we’ll answer them as best we can!
I remember my first counselling session. I was pretty freaked out. I didn’t really want to be there. I didn’t know what to expect. I think that last part was what made the situation difficult – I’d never been before, I didn’t know anyone who had seen a counsellor before, so I was completely lost and anxious about it.
I saw a new client yesterday and this reminded me of my own first experience seeing a counsellor. This client had never been to counselling, had no idea what to expect, and I could see that there was definitely some anxiety about the whole situation.
While every counsellor will be different in their approach, I thought I’d write an article about what to expect and how to make your first session as successful as possible when you meet with your Registered Clinical Counsellor for the first time.
Here at Alongside You, your first interaction will be with our front desk staff who will explain much of the administrative details that you’ll need to know, give you recommendations on which of our counsellors might be the best fit, and help to book your first session. After that, they will send you our online intake form to fill out prior to your appointment. This helps us take care of the necessary paperwork ahead of time, and also helps our counsellors get an idea of what you’re coming in for and some details before you arrive.
When you arrive, you’ll enter the waiting room to wait for your appointment. We have a self-serve waiting room, so please feel free to help yourself to water, coffee, or tea and take a seat. We want you to be as comfortable as possible! If you have any questions before your appointment and it’s during our reception hours, feel free to wander toward the back and speak with our office staff, they’ll be happy to speak to you.
Once your appointment time arrives, your counsellor will come greet you in the waiting room, and invariably, probably offer you another drink. Feel free to get a refill, they’re free! Now it’s time for the main event. Your first appointment with a Registered Clinical Counsellor.
Each counsellor will have a bit of a different interview process to start out your work together, but remember, they need to get to know you and also, you need to get to know them for the relationship to work. The first appointment will be about building the relationship and getting to know each other.
Here are some areas that I usually ask clients about at our first session to get to know them and how I might be of help. Again, every counsellor will be different but a lot of these questions are fairly common to ask new clients.
Things A Counsellor Might Ask You At The First Appointment
Personal and Family History
I like to know what life was like growing up, and how clients got to where they are today. This can be a short or lengthy discussion. As a marriage and family therapist by training, I believe that our personal and family history have a strong influence on our development and I like to know how people came to be where they are now. I usually suggest that clients tell me their story – however, they want to tell it – in as much or a little detail as they feel comfortable.
Mental and Physical Health History
I like to know the history of a client’s mental and physical health. What has your health been like throughout their life? Do you deal with any chronic mental or physical health conditions? Does anyone else in your family deal with any of these conditions?
Another question I often ask is, “When is the last time you saw your family doctor? When is the last time you got a checkup and bloodwork done?” This may sound overly-medical for a counsellor to be asking, but it’s important. If you’re coming in because you’re feeling depressed, anxious, or otherwise, I want to make sure that there isn’t a physiological problem at the root of your symptoms. There are many physiological issues that have symptoms that can masquerade as psychological or psychiatric issues. If you are dehydrated, have a thyroid imbalance, your blood sugar is off, iron is low, etc., these can all cause symptoms that look like a mental health issue. The last thing I want for you is to treat something as psychological if there’s a physiological cause.
Now, these areas not mutually exclusive conditions either. You may have a physiological issue and also be struggling with a psychological issue. We want to cover all of our bases.
What Brought You To Counselling
This may seem like an obvious question, but it’s also an important one. We all struggle with various things in life, it’s the joy of being human. I want to know what it is that brought you in today, what are the challenges, how did they start, and my favourite question, “Why now?” What made you decide to come get some help now, particularly if this has been an ongoing thing for a while. This question is important because it clarifies what is the key issue that you are experiencing, and what your motivation level is, and what is specifically motivating you to get help now.
How To Measure Success
I often ask clients, “If this works, what will be different?” I want to know what your goals are and how they’ll gauge if counselling is a success. This both handles the goal setting, and how to find out if the counselling process working. My goals and metrics may not be what my client is going to use. I want to know what your gauge is. This doesn’t mean I don’t have my own tools and metrics for the process (I do), but it gives us a common language to monitor the relationship and the process on an ongoing basis. It helps us answer the question I ask pretty regularly with clients, “How’s this going for you? Is this helpful?”
What Do I Need To Know About You For This To Work
We are all special little snowflakes. We have our idiosyncrasies, oddities, preferences, hot button issues, and more. I’m no different. I want to know what is going to help you in the process, help us build the relationship, and help you feel safe and supported while trying to avoid things that do the opposite. Some people need a very gentle approach, others need a straight shooter. Some are very wary of a particular gender because of past experiences, others aren’t. I want to know these things so I can be the best help I can be for you.
I remember my first appointment with my current counsellor about 7 years ago. As you might imagine, I can be picky about my counsellors, and I’m also pretty headstrong and assertive. I know what I need in a counsellor. So, I sat down in his office and said, “Here’s what you need to know about me if this is going to work. I need someone who isn’t afraid to call me out on my crap. I need that, and I respond well to it. If you can do that we’ll get on famously, and if you can’t, no harm or foul, I’ll give you your money for today and be on my way.” I know myself and know that if I’m matched up with a counsellor who is softer and non-confrontational, I’ll be able to get away with things and manipulate the conversation easily and this won’t help me. I need accountability.
Things To Know About Counselling As A Client
As a Registered Clinical Counsellor, I want your experience to be as positive and helpful as possible and I know I can speak for the whole team here at Alongside You on this one. It’s important to know, however, that counselling is a team effort. Counsellors aren’t magicians with a magic wand that can fix all that ails you. The process works through the development of a safe therapeutic relationship and a joint effort to move forward. Here are a few things to keep in mind as you start your counselling journey.
Your Counsellor Cannot Read Your Mind
Some of you who have been to counselling before may laugh at this, and I know that I’ve had clients who were relatively convinced I had this magical power based on some of my interactions with them. We have intuition, not mind-reading powers. What this means is, it takes two active participants in a counselling session to get to where we’re trying to go. If you’re not an active participant, the process is very difficult if not impossible.
Being Open and Honest Are Important
We know this is a big ask of you. It’s not easy to sit down with a stranger and talk about the difficult parts of life. The counselling process needs this, however. If we can’t be open with each other, we can’t work together and create a safe space to wrestle with life. It’s not all-or-nothing, however. It takes time, and you don’t have to be an open book from the first minute. Build the relationship, and share as you do so. We’re in this together.
Try To Know What It Is You Want From The Session
This is sometimes a difficult one. I know that I often struggle to know what I want out of a session with my counsellor, but part of that is because I have a standing appointment that I go to every month regardless of how I am feeling that day because that’s what works best for me. Some of the questions I’ve outlined above can also be used on an ongoing basis to figure out goals and focus points, but it’s always helpful when clients know what they want to focus on in the session. It helps keep the process on track.
Ask The Counsellor Questions
Sometimes clients are surprised when I turn the tables and ask them if they have questions for me! As I mentioned above, counselling is a two-person endeavour and process. If I need to get to know you, it only stands to reason that you should get to know me as well. Ask away! The fit between a counsellor and client is important and getting to know each other helps us figure out if we’re the right fit. I always encourage clients to ask whatever questions they want, with the caveat that I may choose to decline to answer questions of a personal nature if they go beyond what I choose to reveal to clients about myself or my personal life. Every counsellor is different in this area but feels free to ask. You may want to ask about experience, qualifications, approach, personality, or things like hobbies, etc. It’s up to you and your counsellor to navigate how best to get to know one another.
Give The Counsellor Feedback
I always tell my clients, and then remind them periodically, that I need their feedback. Going back to my inability to read minds, I need feedback to know if we’re on the right track, if I’m focusing on the right things, and if things are helpful. Sometimes clients are afraid to tell the counsellor if they feel the process isn’t going in the direction they want or isn’t working. I absolutely want to know these things. I’d rather find out that something is off than continue believing all is well only to find out after the fact that it wasn’t helpful. I also want to know what is working so we can do more of that!
Counselling Is A Journey
I know that going to see a Registered Clinical Counsellor for the first time can be anxiety-provoking. I promise it’s not as scary, and we’re not as weird as you might think. We’re just regular people too, who have some training and experience to help you through some of life’s challenges. If we keep some of the above in mind and are open with each other, we can find a path through the challenges and help you thrive!
Feel free to give us a call or send us an email through our contact form if you have any more questions. We’re happy to answer them! Have you been thinking about taking the first step in seeing a counsellor? There’s no time like the present – take the first step, that’s the hardest part. It gets easier from there.
I never thought that I was a perfectionist growing up. The state of my room at any given point in time seemed to be an indication of my lack of perfectionism. As I grew older, however, I started wondering about it. At the same time, I also didn’t really know what it was. So, I continued on and forgot about it.
Fast forward to the present day, and again I’m wondering about it. Anyone close to me knows that I’m pretty particular about things, and often have a specific idea of how things need to be. If you visit our office, you’re likely to see some of that in action. As I worked on my car this morning, I noticed it creeping in. My fun car, a 1997 BMW M3, is now 22 years old. It has squeaks and rattles. It’s well maintained, but even so, if I’m working on the engine and I notice a sound that doesn’t seem quite right, it’s incredibly easy for me to obsess about it, rather than accepting that it’s a 22-year-old car that is going to have some strange sounds at times.
It even creeps into work. Shocking, I know. When we first started, we set out to fill gaps in services, particularly in counselling in Delta. The reasonable person would know that we were flying by the seat of our pants many times, trying things that didn’t work, and revamping again. Truth be told, as we’ve expanded and branched out far beyond counselling, we’re still figuring it out as we go along. I think this is actually a good thing because we’re trying to figure out how to help people in new, creative, and needed ways. It just doesn’t sit well with my perfectionism most of the time, and as I’m writing this, I also think this has a lot to do with the anxiety I often feel around work.
My counsellor and I were talking about this last week, and he gave me a really helpful handout on perfectionism that he’d come across, which you can read here. Addressing the full topic of perfectionism would take far longer than this blog post, so I want to give you some bullet points that I’ve noticed in my own life with perfectionism, and also what has helped me – and I hope that it helps you!
Three Signs That You Might Be A Perfectionist
You care deeply about everything, even things that really don’t matter much.
Don’t get me wrong, caring is a good thing. Particularly as a counsellor, caring is important! Here’s the thing though – we need to care about things at an appropriate level. The difficult part is knowing what that appropriate level is, especially if you’re a perfectionist.
You have unrealistically high standards, in almost everything you do.
High standards are a good thing. It’s something that I actually appreciate about myself, and usually, something people appreciate about me. The problem comes when our high standards become impossible One of my battles is that it is impossible for me to know about, account for, and control all of the details in a rapidly growing clinic. It was much easier when it was just me, Meg, and a couple others at the beginning. If it goes on for too long, it’s easy to get frustrated and just stop caring about anything, which doesn’t help either!
You have a difficult time with criticism.
I don’t know anyone that likes criticism and coupled with the fact that most people suck at giving constructive criticism, it’s a difficult thing for many people to handle. It’s very difficult for perfectionists because it flies in the face of their standards, their view of themselves, and their views of their accomplishments. How do you feel when someone offers constructive criticism? Does your body respond in revolt? Do you immediately go to justification and finding ways to fight back?
These are only three of the many signs of perfectionism you may notice in yourself if you’re indeed a perfectionist. If you’re interested in getting a quick sense of whether this might be a thing for you, you can try this screening tool as a way of finding out if perfectionism should be on your radar.
So, what if you are indeed a perfectionist? What do you do? Here are three things that help me keep my perfectionism in check, and I hope they’re helpful for you!
Three Ways To Combat Your Perfectionism
Question your level of care about things.
If you are caring about everything very deeply, then there’s something goofy in your meter. This one can be difficult, especially for something high on the emotional spectrum. Caring deeply about fellow human beings is a wonderful attribute, although it too needs to be kept in check. Caring deeply about whether the Kleenex boxes match the wall colour, or the specific noise your car is making is exactly as it should be when everything is running fine, or other such things may be an indication that your level of care is off.
One question I ask myself frequently is, “What is my level of care on this one, and is that reasonable?” I find this question to be especially helpful if my stress, or anxiety levels are high – because if they are, then that lovely limbic system is going to shut off our frontal lobes, which is the area of the brain that helps us determine reasonability.
Question your standards and expectations.
Working hard is a good thing. Being disciplined is also a good thing. Having no boundaries on either of these is not. It was pointed out to me when I did my Birkman assessment during my certification training that I will never expect anyone else to do something that I wouldn’t do myself. I’ve found this to be very true. The problem is, I expect extremely high standards from myself, and thus, it’s easy for me to pass all of those onto others. My own standards are often impossible to meet.
A question I use to keep myself in check on this one is, “If someone else were doing this, and it had nothing to do with me, would I think this standard was reasonable?” This integrates a little bit of the mindful self-compassion that Kristin Neff has developed and I find very helpful. We often expect things of ourselves that we would never expect from others. It also helps us give our brain a break, reduce anxiety, and increase the chance of having a reasonable perspective.
Have key people in your life whom you trust.
This is perhaps the most important of these three. I cannot overstate the value of key people who know you well, care about you, and are able to speak truth into your life, even when it’s hard. The trust part is key, because you’re going to have to trust that they’re doing it for your benefit, and it’s not because you’ve failed.
I’m fortunate to have a number of key people like this in my life who keep me in check. First and foremost is my wife, Meg. She knows me better than anyone else in the world, loves me despite my inadequacies, and also isn’t afraid to speak the truth to me when I need to hear it. I know that when she calls me out, she’s doing it for my own good, and I need that.
I also have my Registered Clinical Counsellor that I have a standing appointment with each month. I’ve been seeing the same counsellor since 2014, and I still remember our first appointment. I sat down and said to him, “Here’s how this works. I have impossible standards, I care deeply, and I don’t always have perspective. I need someone who isn’t afraid to call me out when I need it. If that isn’t you, that’s ok and I’ll thank you for your time. If it is, awesome, and we’ll get on famously.” He said he had no problem with that, and true to his word, he’s still supporting me, pushing me, and calling me out when I need it 5 years later.
Perfectionism can be a difficult thing to manage. It’s part personality, part anxiety, and wholly exhausting at times. I’ve been dealing with it for many years, but through some of the strategies above, and thanks in great part to some key people in my life, I have learned to manage it well, most of the time.
I know that my counsellor has played a key role in my ability to manage this part of myself. If you’re struggling with perfectionism and would like some help, we’re here. We’ve all got our stuff, and sometimes that outside perspective can be really helpful.
One of the questions I sometimes get asked is whether we do qEEG and linear neurofeedback here at Alongside You. Invariably, my answer is, “No, we use dynamic neurofeedback.” Understandably, people wonder why that is, so I thought I’d take a minute to explain why we use dynamic neurofeedback vs linear neurofeedback training. Before I continue, let me be very clear on one thing – both linear, and dynamic neurofeedback work, they are simply different approaches with different upsides and potential downsides. When we looked at our clinic and practice, the dynamic is what fit best for what we do.
A Very Brief History of Neurofeedback Training
Although many people still have not heard of neurofeedback, it has been around for decades, going back as far as the 1950s and 1960s and to research performed by Dr. Joseph Kamiya from the University of Chicago, and Dr. Barry Sterman at UCLA. Since then, there has been an amazing amount of research on, and development of neurofeedback with a wide variety of clinical applications.
The most well-known form of linear neurofeedback these days involves the use of qEEG brain imaging and mapping. From this, it is thought that diagnostics can be derived, and specific areas treated to relieve specific symptoms. Many people have used qEEG and the different linear neurofeedback protocols with great success. This method appeals to our rational brains as well, because it gives us an image, with a diagnosis, and a specific form of treatment based on protocols.
Why linear neurofeedback is both appealing and problematic
I’ll admit, this approach appeals to my scientific, rational brain that likes numbers, graphs, and black and white answers. The problem is, the science of linear neurofeedback isn’t, in my opinion, as black and white as it may appear. While linear neurofeedback favours training at specific sites, research suggests that at any given site on the scalp, sensors will pick up signals from across the brain, both from under the surface and across the scalp. The complexity of brain signalling cannot be overstated, and it may be problematic to assume that training at a certain site will affect all individuals with specific problems in the same way. This problem is made greater when we use DSM diagnoses to guide methods because they are defined by behavioural characteristics of individuals vs specific behaviours as defined by neurologists. There are also multiple subtypes of EEG with reference to DSM categories, including 11 subtypes of ADHD determined by Chabot (1996), for example.1
qEEG is still a helpful tool, and linear neurofeedback does work, it’s just not as black and white as it may appear. General groupings of EEG have been shown to correlate to specific DSM categories, but training based only on qEEG doesn’t guarantee results. Training at specific sites also does not necessarily permanently alter brain activity at that site, but it may in fact do so – we just don’t know and can’t predict that.1
Why dynamic neurofeedback is both appealing and problematic
Let’s be unconventional and start with the problematic part of dynamic neurofeedback – it’s not a specific treatment for a specific symptom. While I’ve briefly highlighted how this is not altogether completely different from linear neurofeedback, linear does have the ability to potentially be more specific to symptoms. So why do we do dynamic neurofeedback training then? What’s the upside? I’m glad you asked.
Dynamic neurofeedback is diagnostically agnostic What this means, is that the protocols do not depend on a specific, accurate diagnosis from the DSM. Dynamic neurofeedback trains the brain as it is, in its current state of being. It constantly evaluates the brain (at approximately 256 times per second) and bases the training on this evaluation, outside of diagnostic categories.
It trains the whole brain, not just part of it The downside is that we can’t specifically say we are treating a specific symptom. The upside is that we can say that we are training the entire brain to function at its best. Thus, anything we are experiencing as a negative symptom that is related to the brain not functioning at its best, we can hope to see improvements in. We can’t guarantee that we’ll see relief in specific areas, but as I’ve already mentioned above, qEEG and linear neurofeedback protocols can’t truly guarantee that either.
There is no chance of clinical error With linear neurofeedback, an evaluation of the brain is done, and a treatment protocol put in place based on the assumption that the brain is showing activity on a certain wavelength, and should be behaving differently. Thus, the brain is manipulated in a particular direction to produce the desired change. If the assumption is correct, we see positive results. If, however, the assumption is wrong, it can introduce negative results, side effects, etc. With dynamic neurofeedback, we don’t manipulate the brain. We present the brain with information about what it is doing in real-time and allow the brain to make the adjustment itself. From current research, we know that the brain is perfectly capable of changing itself and adjusting based on neuroplasticity (you may have heard of The Brain That Changes Itself). Dynamic neurofeedback works on this principle and provides the information the brain needs to make its adjustments. Thus, there is literally no chance of clinical error in this form of neurofeedback.
It helps us reach those who may not be able to access neurofeedback otherwise Because our type of neurofeedback and its protocols are housed within the software, it does not require the same level of training that most linear neurofeedback does. This allows us to be creative in how we deploy it in our clinic. As a Registered Clinical Counsellor, I do all the assessment work involved in tracking for in-clinic neurofeedback. We have trained technicians who run the in-between sessions to keep costs down. We are also able to offer rental units for people to do at home, which allows those who can’t get into the clinic to access it, and also further reduces the per-session costs. This aligns with our mission to provide the best care possible and fill in gaps in service.
I hope this helps explain some of why we use dynamic neurofeedback training in our clinic. It’s an approach that works, produces results, and fits us and our clients best. If you’re curious to know more, check out this page on our website with more explanation and answers to common questions. You can also read more on our blog here.
If you have further questions or want to give it a try, please contact us or give us a call. It’s an amazing technology that we can all benefit from (myself included!).