Infra-low-frequency training

Domain IX · Biomedical, neuro & digital · Siegfried Othmer, Susan Othmer · 2006 · Los Angeles area, USA

What it is

EEG neurofeedback in which the clinician feeds back very slow fluctuations of the EEG signal. These lie below the frequency range that conventional EEG work usually analyses. The developers say it descends from frequency-band training (see 047 Sensorimotor-rhythm training and 048 Theta-beta…

Format

• Format: individual, seated sessions with sensors on the scalp and continuous visual and auditory feedback, often a game-like animation. The developers report session lengths of roughly 20 to 60 minutes.
• Course length: not fixed. The developers use a nominal session benchmark only to compare outcomes, and they say benefit is not exhausted by it. This guide gives no session prescription.

Who practises it, and how they are trained or regulated

• Goal: decide whether ILF training is appropriate, safe and within the provider's scope, and involve the client's physician or prescriber where needed (see 4.10).
• Goal: build a symptom profile organised by the developers' clinical model. The Protocol Guide's assessment headings are physiological arousal, instabilities, disinhibition, localised dysfunctions, and learned fears and habits. Its symptom-profile headings range across anxiety, depression, attention, sleep, pain, eating, attachment, developmental disorders, brain injury and seizures. The Institute has given capable…
• Stage C: Core ILF training with ongoing optimisation

Evidence status, as the guide reports it

• Status: contested. ILF neurofeedback is a proprietary, developer-led method. Its mechanism, its wide range of claimed uses and most of its outcome data come from the developers and their practitioner network. An independent systematic review (Bazzana et al., 2022) found a small, mixed and weakly…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• as for 4.8.
• risk rising during a period of symptom flare.
• expectations raised by testimonials or broad claims.
• clients who want to use neurofeedback instead of medical care.
• the client attributing every change, good or bad, to the device.

Problems the guide addresses

• "Does it work?": evidence status to give clients and referrers
• No change or a plateau
• Worsening or adverse effects after sessions
• Overwhelm and emerging trauma material
• Clients who cannot report states (children, alexithymia, dissociation, cognitive impairment)
• Non-adherence, missed sessions and cost
• Over-attribution and dependence on the device
• Medication changes and conflicting advice
• Ruptures and role confusion between therapist and provider
• DIY and home devices

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.