Over the last 20 years our clinical model of neurofeedback has evolved through a cycle of changing clinical approaches, changing clinical results, and a changing clinical model. This presentation outlines our path from simple beta and SMR training to a more client-centered and individualized approach to learned self-regulation. Significant clinical and theoretical challenges are discussed that have led to breakthroughs in clinical approach and results. We also discuss our evolving appreciation of each individual’s unique experience of neurofeedback, and how we can observe subtle shifts in brain state that allow fine-tuning of the clinical approach. We continue to be challenged by the power and specificity of neurofeedback and our evolving understanding of how the nervous system responds to this simple yet profound functional challenge.