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Keywords: Mental health, mental illness, neurotherapy, neurofeedback, bipolar disorder, brain waves, head injuries, memory problems, ADD, ADHD, depression, patient empowerment.
Citation: Linden M. Book review: A Symphony in the Brain. J Participat Med. 2011 Dec 21; 3:e52.
Published: December 21, 2011.
Competing Interests: The author has declared that no competing interests exist.

When my therapist recommended I read Jim Robbins’ A Symphony in the Brain, she had just returned from a week of training in neurofeedback and was excited about incorporating it into her practice. The book answered many of my initial questions regarding my treatment for bipolar disorder and is even more applicable to my life since my mother, a neuropsychologist at odds with the profession, had a stroke last year.

Robbins offers a historical account of biofeedback (from the 1970s) and of neurofeedback, recognizing the primary players and critical research. The research is slim, however, and because of that, new studies are not funded (a common catch-22); but people practice neurofeedback because they feel it works. It is a process by which a person learns to change brain wave frequencies by getting aural, visual, or tactile responses. People with a need to better manage the body and mind call upon neurotherapy. During training, a person is hooked up to a neurofeedback instrument that records the person’s EEG. The recorded brain wave pattern is shown to the client, and he or she is asked to do things or think things to alter the brain waves so they work better for him or her. People with memory issues, severe brain injuries, depression, ADD, and brain-derived behavioral problems report that they benefit greatly from neurotherapy.

Three main types of brain waves are manipulated by neurofeedback; which ones are largely determined by symptoms. Joe Kamiya and Richard Bach were the pioneers of working with alpha waves, 8 to 12 hertz, associated with a relaxed state. Theta waves, 4 to 7 hertz, are just above the delta sleep waves, and beta waves are 12 to18 hertz. Barry Sterman did the primary scientific research with neurofeedback in a large study with epileptics, which Robbins summarizes on pages 42-43.

“Epilepsy is an invasion of an unwanted frequency in the brain. When a person is walking, talking, and engaging in everyday life, the brain is operating in the higher frequency ranges, called beta…In epileptics a portion of the brain is unstable, or hyperexcited, and it can’t resist as slow theta waves start to creep in.”

Robbins later describes the distractions people with ADD and ADHD experience as theta waves interrupting beta wave activity causing such people to daydream, drift off, or space out. Further, depressed people have higher levels of theta waves. Now, when I lack motivation for any activity at all or experience my all-too-frequent desire to just stare into space, I envision populations of theta waves weaving through my brain’s crevices. In the above cases, with proper neurofeedback treatment, a brain is trained to lower the number of theta waves. Brain training can also be used to increase beta waves for enhanced memory ability and productivity or, in the case of anxiety, alpha waves. Sometimes only one side of a brain is trained. It sounds simple but is far from it.

Although I am on medication and my symptoms of bipolar disorder are far less prevalent, there seem to be some I cannot shake. I believe it’s why my therapist would like to use neurotherapy with me. As I read the book, I thought about the ways I could use this therapy. Could it possibly help me on days, like my most recent ones, when my motivation for anything suddenly drops and stays low for weeks? How about helping the memory loss I believe is associated with the medication I take? I wonder if it would help me curb my anxiety with regard to food. Robbins mentioned the word “bipolar” only about three times in the entire book; it isn’t included in the index. At one point, he said neurotherapy has not been very successful for people with bipolar disorder. My guess is bipolar disorder is too complicated and affects too many parts of the brain for it to work very quickly. Given the way my body reacts to medication changes (up the lithium, I go down. Add some Lamictal, I balance out… add too much and I go up), I imagine increasing beta waves would help depression while doing so during a manic episode might be less than constructive.

Unlike Robert Whitaker in his account of medication and mental illness in Anatomy of an Epidemic, Robbins, a journalist who has written regularly for several magazines on science issues, includes the pros and cons, the believers and the skeptics, and the highs and lows of neurofeedback. While success is plentiful, neurofeedback has its issues. Neurotherapy does not work for everyone. Specialists say it can be because someone doesn’t want to change or is fearful of change. Neurotherapy requires not only buy-in, but commitment from the client to change the brain. It is an active process. Talk therapy can be an active process, also. However, a person can simply talk without making necessary behavioral changes. Behavioral changes are imminent with brain wave training.

People also say positive thinking trains the brain. Could neurotherapy be an extreme version of that? Positive thinking takes much more dedication for it to work, as it must be done nearly every moment to keep negative thoughts at bay. Is neurotherapy just the easy way out? Plenty of questions come with treatment involving the brain. For example, alpha waves seem to be a natural Prozac. Is training the brain any different than taking medication? It probably has fewer side effects, but will it keep us from living a life more naturally? (What is a natural life?) Will neurofeedback become regulated (unlikely without scientific proof it works) and subsequently become harder to get or perhaps less expensive? What about people using it like steroids to increase retention and enhance performance? We are constantly forced to ask such questions as modern and ever-changing technology overtakes current modes of treatment. But I keep asking myself, “Am I willing to make and live with the changes that may come from it?” and “Do I have the determination to do it or will I rebel against another mode of treatment?”


Robbins, J. A Symphony in the Brain: The Evolution of the New Brain Wave Biofeedback. New York: Atlantic Monthly Press; 2000.

Copyright: © 2011 Meredith Linden. Published here under license by The Journal of Participatory Medicine. Copyright for this article is retained by the author, with first publication rights granted to the Journal of Participatory Medicine. All journal content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License. By virtue of their appearance in this open-access journal, articles are free to use, with proper attribution, in educational and other non-commercial settings.