Obsessive-compulsive Disorder (OCD) is a condition where a person has persistent, uncontrollable, recurring thoughts and/or ritualistic behaviors that they repeat over and over. OCD starts in the subconscious brain with implicit memories, fears, and beliefs from the past. These intrusive thoughts make a person feel uncomfortable, anxious, or a sense of doom or dread. In an effort to ease the unpleasant feelings, they behave in automatic, habitual ways, like washing their hands, checking locks, or counting things.
OCD comes in many forms, but most cases fall into one of four general categories:
● Checking: such as locks, alarm systems, ovens, or light switches, or think you have a medical condition like pregnancy.
● Contamination: fearing things might be dirty or a compulsion to clean. Mental contamination involves feeling like you’ve been treated like dirt.
● Symmetry and ordering: the need to have things lined up in a certain way.
● Ruminations and intrusive thoughts: an obsession with a line of thought. Some of these thoughts might be violent or disturbing.
Brain scans show that people with OCD tend to exhibit one of two types of brain activity, either an overactive or a sleepy brain.
Contamination, checking, order and symmetry, and intrusive thoughts are generally the result of an overactive frontal lobe and basal ganglia. On the other hand, some obsessive behaviors, such as hoarding, can be the result of a brain that is underactive in some areas.
OCD is a vicious loop inside someone’s brain that has formed because of neuroplasticity.The more you think a thought or complete a behavior, the more firmly that pathway gets connected and etched into your brain, and it becomes easier for your brain to return to it. A brain region known as the striatum, which is involved in decision-making and motor control, is thought to play a key role in OCD.
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is a clinical diagnosis given to children who have a dramatic — sometimes overnight —– onset of neuropsychiatric symptoms, which may include OCD behaviors or things like severe food restriction. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a subset of PANS that appears in children following exposure to strep infection.
OCD and these other conditions do not have to control a person’s life. The answer to easing these compulsions lies in changing the brain. One research report showed that all 36 patients who received neurofeedback training for OCD showed improvement.¹ More than two years later, most people had maintained the improvements in their symptoms.
Frequently Asked Questions
About OCD, PANS, & PANDAS
We’ve gathered a list of commonly asked questions about OCD, PANS, and PANDAS, for your convenience. If you don’t see the information you need, please don’t hesitate to reach out to us. Simply click on the question that interests you to navigate directly to the relevant section.
It may be a helpful support for some people with OCD, especially when the brain is stuck in rigid, repetitive patterns. We do not present it as a stand-alone cure, but it can be a useful part of a broader plan that may also include therapy, medical support, and other interventions.
PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome. PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a subtype of PANS with a specific known trigger: strep infection. Both involve the sudden, dramatic onset of neuropsychiatric symptoms in children — severe OCD, tics, anxiety, emotional dysregulation, food restrictions, sleep disturbances, and behavioral regression — triggered by an underlying autoimmune response to infection. PANDAS is specifically strep-triggered; PANS can be triggered by other infections (Lyme, mycoplasma, strep) or sometimes has no identifiable trigger.
The hallmark difference is onset. Typical OCD develops gradually over months or years. PANS/PANDAS arrives like a light switch — one week your child is fine, the next they have intense rituals, refuse to eat, can’t separate from you, or won’t touch doorknobs. The severity is also different: PANS/PANDAS OCD is often dramatically more debilitating. And the triggers matter — PANS/PANDAS symptoms often flare with new infections, which is a pattern typical OCD does not follow. This is why accurate diagnosis matters so much; the underlying autoimmune process requires medical treatment that OCD alone does not.
Both. Neurofeedback does not treat the underlying autoimmune process — that requires a qualified PANS/PANDAS physician, typically using antibiotics, anti-inflammatories, immune-modulating treatments, and sometimes IVIG. What neurofeedback does is support the brain’s ability to self-regulate during and after flares. Families often report shorter flares, less severe symptoms during flares, and faster recovery to baseline after the acute medical treatment has done its work. It is a complement to the medical protocol, not a replacement for it.
We recommend coordinating directly with your PANS/PANDAS physician on timing. Some children do well starting during a flare because the extra regulation support is exactly what they need. Others do better once the acute inflammation is somewhat controlled and they can tolerate sitting through a session. For some families, doing a brain map during a flare and then beginning training as the flare settles is the right sequence. We tailor to your child’s situation and stay in communication with your medical team.
Most OCD clients do 30 to 50 sessions. OCD tends to need more training than anxiety or depression because the brain patterns driving compulsive behavior are deeply grooved — the rituals have literally become brain habits. For PANS/PANDAS specifically, the timing can depend on flare patterns and medical treatment progress. The good news is that once the new brain pattern takes hold, it tends to stay.
No. Neurofeedback is non-invasive and medication-free, so it combines safely with antibiotics, anti-inflammatories, steroids, IVIG, rituximab, supplements, dietary protocols, CBT, and exposure and response prevention (ERP). Many families find it pairs especially well with ERP — because when the child’s nervous system is calmer, they are more able to tolerate the challenging work of exposure therapy without being overwhelmed. We coordinate with your full care team and never make changes to medication.
Adults respond just as well, and in some cases more dramatically — because adult OCD has often been unresponsive to medication and talk therapy for years, there’s often significant room for improvement. Some of our most striking OCD outcomes have been with adults who had decades of compulsions, intrusive thoughts, and failed SSRI trials. Training the underlying brain pattern frequently reaches places that medication and exposure work alone could not.
This is, sadly, a common story. Many standard pediatricians are not up to date on PANS/PANDAS research and diagnostic criteria. If you suspect it, seek out a qualified PANS/PANDAS specialist — the PANDAS Physicians Network maintains a directory. We do not diagnose PANS/PANDAS ourselves, and we’re not a replacement for the medical evaluation and treatment your child needs. What we can offer is specialized brain training support that fits alongside the medical protocol and helps address the neuropsychiatric symptoms from a different angle.
The changes usually unfold in a specific order. Sleep tends to improve first, often within 5 to 10 sessions. Emotional regulation follows — less frequent meltdowns, faster recovery when upset, more flexibility. Then the OCD symptoms begin to soften: rituals take less time, intrusive thoughts lose some of their grip, avoidance decreases. Parents often tell us their child ‘has more room to be themselves’ partway through training. We also do a reassessment brain map partway through so you can see the actual electrical changes.
There is some promising research and clinical experience supporting neurofeedback for OCD, but the evidence base is still developing. We try to be very honest about that. For the right client, it may be a helpful tool alongside other forms of care.
Yes. Grey Matters Brain Training Studio in Carmel, IN serves PANS/PANDAS families throughout Indianapolis, Fishers, Westfield, Zionsville, Noblesville, and beyond. We are happy to coordinate directly with your PANS/PANDAS physician, speech-language pathologist, occupational therapist, or any other provider on your child’s care team. Call 317-215-7208 or book a consultation to learn whether your child might be a good fit.
Grey’s Plan — The Most Complete
Brain Training We Offer
If you want the most comprehensive, all-inclusive, guided solution for focus, behavior, and overall brain health—for your child or yourself, Grey’s Plan gives you everything needed to make the next 4 months the turning point.
Neurofeedback alone is powerful.
But when you combine brain training with gut testing, clinical oversight, and unlimited support, results come faster, smoother, and last longer.
Sources: 1. Sürmeli T, Ertem A. Obsessive compulsive disorder and the efficacy of qEEG-guided neurofeedback treatment: a case series. Clin EEG Neurosci. 2011 Jul;42(3):195-201. doi: 10.1177/155005941104200310. PMID: 21870473.