Perspectives on Placebo: The Psychology of Neurofeedback

Abstract

The application of operant conditioning with EEG variables to produce changes in behavior has been gaining increasing interest in research and application areas. However, the methodology has come under scrutiny and criticism for its potential placebo effects. This article will examine those issues from the traditional methodologies of demonstrating effectiveness (control group, sham treatments) as well as examine the possible biochemical and electrophysiological effects of a placebo response. Specifically, the role of endorphins and dopamine and their relationship to the alpha and beta frequency in the placebo response will be examined. The research addressing the diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI) correlates of the intervention will be examined.

Therapists’ Experiences With Integrating Neurofeedback Into Therapy for Complex/Developmental Trauma

“…The barriers and challenges mentioned most frequently by participants were the learning curve, others' perceptions or stigma of neurofeedback, and the investment of time and money. These challenges align with those referenced in existing literature (e.g., Chapin, 2016;Orndorff-Plunkett et al, 2017;Thornton, 2018;Weiner, 2016). Having additional guidance for clinicians starting off with neurofeedback will be beneficial for the field.…”

“…Existing literature supports participants' reports about skepticism that exists about neurofeedback, including attributing the effects of neurofeedback to placebo (e.g., Thibault & Raz, 2017;Thornton, 2018).…”

Effects of neurofeedback on the self-concept of children with learning disorders

“…The placebo effect of a sham-NFB treatment arises from the technological context (e.g., noticing the signals from the EEG in a computer) and the encouragement and verbal information from the researchers and parents around the training sessions ( Colloca and Miller, 2011 ; Schönenberg et al, 2021 ), which are factors that, by causing an expectation of improvement, end in a placebo response in the person. Moreover, the placebo effect could be linked to endorphin and dopamine increases that may affect the EEG alpha activity ( Thornton, 2018 ), a finding that could also explain the lack of difference between the NFB and sham’s theta/alpha ratio change, with both groups showing a significant ratio decrease. In the sham subgroup, the placebo effect seemed to have affected the academic performance and global self-concept, with larger improvements above the waiting-list subgroup.…”