I'll give you a rundown of my experience.
I've been in weekly talk therapy with this particular therapist for a little over a year. We started with just general talking about the abuse and current life issues, establishing safety, coping mechanisms, etc., in preparation for EMDR. Then we did EMDR for several months. I've posted about it here elsewhere, and by and large it went well but it is definitely very powerful and to be handled with care. Then later last year we switched to Internal Family Systems (IFS), which has also been very interesting and helpful. For me, that has been powerful as well as less jarring and upsetting than EMDR. I am going to do EMDR again at some point to really dig into some specifics, but not right now.
So currently we meet once a week for an hour of talk therapy (some sessions with more specific IFS work than others) and then I also go twice a week separately for the neurofeedback.
My neurofeedback has worked like this -- in the first session, you have all the electrodes attached (something like 20 of them) and they do a "brain map" on you. You have your brainwaves read with your eyes closed, and then again eyes open, while sitting quietly. No talking about anything. This process took about an hour. Then I went online and did a self-assessment as far as current emotional issues, trauma impacts, and that sort of thing. The next session we reviewed my online answers as well as what the EEG's software had to say about me, and it was almost scary in its accuracy. It's not like it can read your thoughts, of course, but they are able to compare nuances of your brainwaves to a database of others and from there predict how likely it is that you have a particular issue (difficulty sleeping, for example), but they're not able to predict a particular issue's severity or to use it for any kind of diagnosis.
In my case, the EEG results showed brainwaves indicating extreme levels of fear, hypervigilance, and associated issues; which were bad with my eyes closed but were off the charts with my eyes open. I'm oversimplifying because I'm not an expert when it comes to this, but the idea is you're trying to train your brainwaves to be like those of a "normal" or non-traumatized person. So there are alpha, delta, theta, gamma, and maybe some other waves that I'm forgetting, and they're all supposed to be present in different levels in different areas of the brain. The brain map shows where your brainwaves are out of sync with where they would normally be with a non-PTSD brain.
So, just to make something up, let's say my brain map showed that I have "too many" alpha waves in the frontal lobe, and not enough delta waves, or whatever. So now armed with this info, and knowing what needs to be changed, the software creates a custom program for me.
I go in for a session and I sit in a recliner in front of a TV monitor. We get started by doing heartrate variability (HRV) while she gets the EEG electrodes setup on my head. The HRV system directs me to inhale for 5 seconds and then exhale for 5 seconds, which helps to relax the brain and body. It uses an ear clip sensor to read my pulse, measure its variability, and see how well I'm able to achieve "coherence" this way. Lots more info about this online if you search, and there are smartphone apps that do the same thing in a more crude way. This goes on for 10 minutes. By then, she has everything ready with the EEG, and she starts a movie for me, which goes on for 30 minutes. Any movie, of my choice. They have many to pick from, or I could bring my own. Content doesn't matter, although I guess you wouldn't want something particularly violent or triggering. The trick is, the DVD player software is tied to the EEG system. So as I sit there and watch the movie, it's reading my brainwaves in real time. The movie is visible on the screen, it's watchable but it's pretty dim. Every time my brainwaves in whichever area we're training are what the software wants me to do, it "rewards" my brain by making the screen brighter for a second or so, before going back to being more dim. It also makes a simple click noise when my brain makes the desired waves. Unlike the HRV over which you have some control, the neurofeedback portion is totally subconscious and passive. All I have to do is watch the movie, I don't have to try to influence what I'm thinking or anything like that. The monitor with my actual brainwave activity is behind me, out of my sight, where the therapist can see it. But she's not really doing anything besides monitoring it while I'm watching, the software takes care of everything. As my brain responds and makes favorable brainwaves, the software recalibrates and it gets more difficult. This also happens in real time and it's totally transparent to me, I don't know when it's happening. So the subconscious has to work harder, has to be trained, to get the same bright movie reward. It's the subconscious desiring the reward, not me thinking about it consciously. The idea being operant conditioning, over time the brain learns how to not be stuck in fight-or-flight-or-freeze. Hopefully. After 20 sessions, you do another brain map to review your progress and then use that to plan the next steps. I haven't gotten there yet, but I will soon.
So to answer your questions: I don't watch the brainwaves monitor during the neurofeedback, although I've seen my own brainwaves on screen afterwards and in reports. There's no talking during it, you want to be as still and quiet as possible. You don't have to sit there frozen but it's best to try to just sink into the chair and relax. It's really nothing like EMDR since it's passive and trauma doesn't even enter into it.
I've seen some very interesting changes. It's difficult to ascribe whether they're due to the EMDR from last year, or the IFS/talk therapy that we're doing concurrently, but some things have definitely changed noticeably since we started neurofeedback. The big ones are: a better sleep schedule. I'm a night owl and I stay up late and sleep too late. I've tried to force myself to bed earlier for years, and I end up just laying there. I don't suddenly instantly fall asleep now, but it's 100% easier to go to bed at an earlier time like 9:30 or 10, without even trying, and I fall asleep much more easily. Feels totally effortless. I still wake up a few times during the night, but instead of being up for hours I usually go right back to sleep after a minute or two.
A huge benefit for me is a lack of rumination. I just don't worry about things or obsessively plan them out like I used to. This doesn't mean that I'm apathetic, but it's much easier to just take care of things and be done with them, or to plan ahead, and not worry about it or even think about it until the next step needs to be done. Whether that's work, personal life, whatever. I also rarely ever replay conversations in my head, which is something that I used to do constantly. I couldn't believe how much there was a running dialog of past conversations or situations in my head until it pretty much stopped. This alone is very helpful. I've been able to be more present, not feeling like I need to plan what I'm going to say ahead of time, less awkward, much less anticipatory anxiety. In-situation triggers are still a problem and I'm not sure if neurofeedback alone is going to help with that.
There's less "noise" in my head. Not that I was hearing voices, but there is just a lot more clarity of thought. Sometimes I leave and as I'm driving away I just can't believe how clear my thought process is. It's moved me to tears a couple of times.
I'm more patient with people and in situations. Not rushing around as much, not trying to think ahead to what someone is going to say, not completing their sentences, listening to others talk is much more pleasurable and interesting now since I can focus better, etc.
For me so far it's really all come down to, my brain is learning to slow down and chill. And it's not really a sedated feeling. It's just not in this super hurried frenzy panic all the time. So the 24/7 fight/flight/freeze response is diminishing, leaving more processing power to take care of normal life events. And the more I do it, the more I realize how, understandably, my brain was in a ridiculous state of overdrive and hyperarousal for years. And why this constant adrenaline surge has exhausted my adrenals. Hoping for more healing there as well as they get used to not being so taxed all the time. So while we're not working on the trauma specifically, we're training the brain into understanding that it's safe not to be stuck in the PTSD symptoms.
I know that was a lot -- hope that's some helpful info for you and everyone. Happy to answer other questions too.
