Dr. Andrew Hill Founding Director Peak Brain Institute joins our Neuropsychologists Dr. Laura Jansons, Skip Hrin, and Neurofeedback Legend Jay Gunkelman Quotes: AH " A lot of what we do is closer to fitness" AH " 50 years ago there were no gyms to work out in like there is today, I see Brain Gyms as the next iteration" AH "Delta rhythm is the heartbeat of the brain" AH " We live in Delta, but we don't think in it" AH "Concussions bloom they don't show up right away" AH "Map early and often!" AH "if you want answers see a Dr. if you want questions see a scientist" Notes/Topics: - Joe Castellano Passing as well as other Neuro Feedback Legends Remembrance (see below) - ADHD - Autism - Post-Covid Brain - HEG - Regulatory Arousal Model - Functional NeuroScience - Tinnitus - Japan is very restrictive of stimulants/Ritalin/Simone https://peakbraininstitute.com/ https://peakbraininstitute.com/about-pbi/ **** AAPB Remembrance and Resilience Circle *** The culminating loss of several of the most foundational biofeedback/psychophysiology pioneers, AAPB leaders and friends gives us an opportunity to reflect, grieve and be there for one another. On Friday, August 6, 2021 at 7:15 pm ET/6:15 pm CT/5:15 pm MT/4:15 pm PT, we will honor our dearly departed and integrate meaningful conversation on loss at an informal virtual gathering where we will be: - Storytelling -- open sharing and anecdotes from those who knew our honorees best - Offering open discussion on loss and resilience - Facilitating an audience participatory Q&A session with our special guests who will entertain questions about these foundational figures - Providing guided group co regulation/ meditation session ** Note the time listed below is Mountain time as that is the location of the Zoom account owner) https://kellen.zoom.us/meeting/register/tJ0lceCrrTIiGdW2fvNPi1f8dHOtQP1XVhMg?fbclid=IwAR22O3N2KaYQTeKtT-gIRyrFXssSbhdpV-Y_eB5qDw_67krQsVHisX_aOpo Have a suggestion for a guest or topic? pete@neuronoodle.com Want to be part of the NeuroNoodle Network? Be a Patreon subscriber and enjoy subscriber ONLY benefits https://www.patreon.com/NeuroNoodle
Episode Summary
I joined the team at NeuroNoodle (Dr. Laura Jansons, Skip Hrin, and Jay Gunkelman) for a wide conversation about where neurofeedback sits in 2021, what brain maps actually show, and why the brain deserves the same kind of training infrastructure we built for muscles fifty years ago. This piece is drawn from my own answers in that discussion. You can watch the original conversation.
The episode opened by remembering several foundational figures in biofeedback and psychophysiology who have passed, including Joe Castellano. Jay carried that part of the conversation, and AAPB held a remembrance circle for the field's pioneers. I want to honor that and then turn to the work itself.
What is functional neuroscience, and how is it different from therapy?
Most people in neurofeedback come from a therapy background. Psychologists, social workers, nurses, addiction and trauma clinicians. They work inside a therapeutic container, with transference and a treatment frame. A lot of what I do sits closer to fitness.
I call it functional neuroscience. It lives between fitness, medicine, and psychology, and it borrows tools from all three. The frame is not "here is what is wrong with you, let me treat it." The frame is "here is your brain map, here is what these patterns can support, where are your goals, what looks interesting to you." At Peak Brain Institute we provide education around QEEG and brain mapping for the individual, teach people to read themselves from the maps and from attention testing, and help them work toward performance goals.
That reframe matters because it builds agency. When I show someone their anterior cingulate running hot and obsessive, or a temporal junction producing social and sensory irritability, or the slow alpha of poor sleep, the stigma drops away. If I showed you an X-ray of a broken shoulder, you would understand it. You would not be angry at your shoulder. We do that to ourselves with our brains, and seeing the modular structure on a map dissolves a lot of the guilt and frustration. People with tinnitus tell me the relief is partly that someone finally sees it on the data.
Roughly a third of my clients are kids with autism, people with seizures, brain injuries, mold, Lyme, and a large and growing group with post-COVID brain issues. A third are very high performers, athletes and actors managing stress. The last third are the rest of us, working on sleep, stress, and attention. Most of this now happens virtually, with leased amplifiers, live staff running maps at home, and the clinical software running remotely. The pandemic accelerated that shift, but we were already about half virtual in 2019. If you want to know how that works, I describe it in detail in our remote neurofeedback guide.
How much can neurofeedback actually change attention?
When people hear me say "you have ADHD, you could take care of that," they sometimes get angry. They have suffered for years and the idea that something could have helped is stressful. I understand that. I had the same realization with my own brain.
Here is the magnitude. On attention and executive function testing we tend to gain about one standard deviation against the average population every 20 to 25 sessions. We run a minimum of 40 sessions, three times a week for about three months, which is the floor I quote for durable change. Across that course we commonly see a couple of standard deviations of improvement on executive function testing. That takes someone who is profoundly ADHD and impaired and moves them to above average, in a semi-permanent way.
I came to this directly. Before grad school I was as hyperactive and hard to regulate as any ten-year-old you can picture, except I was 28. I did about 18 sessions of neurofeedback at a center in Providence and watched my own ADHD largely resolve. That gave me the room to apply to grad school, and I did my cognitive neuroscience PhD at UCLA. If you parent a child with this pattern, the daily reality is covered in why your ADHD kid makes you yell, and the evidence base for training it is in my neurofeedback for ADHD guide.
Why couldn't Simone Biles just push through without her medication?
The conversation turned to the Olympics. I do not know the specifics of the Olympic committee's rules or Japan's restrictions, so treat this as informed extrapolation. My understanding is that psychostimulants are heavily controlled in Japan, partly for cultural reasons that trace back to wartime stimulant use. If an athlete relies on a stimulant like Ritalin to sustain focus, and the event demands sustained spatial control while spinning through the air, removing that support is a real handicap.
An attention system that gets grabbed by high-stimulus environments and dips when focus is required is a dopamine-regulation issue. Performing under maximum stress at the Olympics is hard enough rested, focused, and medicated. Doing it without your routine support is an additional load that most people underestimate.
What does a brain map actually tell you, and what doesn't it tell you?
QEEG is a measure of traits, not states. A clean brain map is stable month after month and year after year, which is exactly why we control the recording conditions so tightly: no caffeine, first half of the day, well rested. That control is what gives the normative comparison its meaning.
A map cannot tell you whether a pattern was built in or acquired through wear and tear. I can see brain fog. I can see extra delta. I can see slow alpha. I cannot tell you from the map alone whether you were born that way or earned it. So my language with clients is graded. This pattern is plausible. You do not know it is true. If it fits your experience, then it becomes actionable, and you can test it.
That is also why I joke: if you want answers, see a doctor; if you want questions, see a scientist. Doctors give labels, and in mental health those labels often strip away agency. I would rather hand you a question you can act on.
Why do concussions "bloom" instead of showing up right away?
Concussions bloom. They do not appear at the moment of impact. If you get a concussion in a car accident or a fall, come in right away and we will grab a snapshot, but the EEG probably will not show much yet. If a fresh injury shows up dramatically on EEG, that is bad and you should be in an ER. The usual course is that the injury emerges over two to four months.
The mechanism is neuroinflammation, and there are several injury types. A crush or impact injury bruises a patch of tissue and changes the regulation inside it. That tissue often drops back into delta, the slowest brain rhythm. I think of delta as the heartbeat of the brain. We live in delta but we do not think in it. It runs autonomic function and cell metabolism, and during sleep it drives big washes of cerebrospinal fluid through the brain, an agitation cycle that clears toxins and resets metabolism. When you do not sleep, the brain makes delta to try to compensate. When a patch of tissue is concussed, it can drop into a delta pulse because it no longer knows what else to do.
A shear injury is different. If tissue gets pulled away from tissue in a spinning or ballistic injury, you break the inhibitory interneurons that act as brakes between modular regions. Remove the brakes and that tissue runs fast, so you see little blobs of beta where there is shear damage. You also see the coup-contrecoup signature, a diagonal stripe of abnormality through the head, a delta blob in one front corner and the opposite back corner.
In that first month after a hit, people feel worse, not better. Sleep erodes, anxiety rises, stamina drops, processing slows, word-finding fails. They describe being half awake when asleep and half asleep when awake. On the map I watch alpha slow down as sleep degrades and delta climb at the sites of injury. Half of all brain injuries are silent, with no symptoms initially, and then five or six years of slow erosion. The old football player finishes his college career fine, and a decade later he cannot sleep, burns out by afternoon, loses words, and lives in full-catastrophe stress. Show him his brain and it finally makes sense.
So my advice to athletes and parents is simple: map early and often. A single soccer heading drill, done once by one teenager, produces GABA signatures in the brain that look like a brain injury for 48 hours afterward. Because I do not charge for repeat maps, my clients map frequently, and I can watch the same delta kernels over years. When clients return after a few years away and the small delta blobs have swollen, I will ask if they had another concussion, and often they did. These blooms tend to show up on the sides of the head, over the temporal lobes, and anywhere blood flow is heavy. Delta tracks vascular changes as much as tissue, so shifting perfusion drives big delta changes.
What are you seeing in post-COVID brains?
The same answer as concussion, because it is the same conversation: neuroinflammation. People show up reporting the same post-concussive picture after COVID. Poor sleep, anxiety, low stamina, slow processing, word-finding trouble. I see it after infection, sometimes after second and third infections, and occasionally after vaccination. I have also seen a handful of people whose post-COVID fog cleared after a vaccine, presumably because the immune response addressed the inflammatory milieu.
I never tell these clients what is true. I tell them what is plausible and let them make the meaning. They land on it themselves: that is my COVID, that is my old football injury, let's lean on it and see what changes. If you want the broader picture on clearing cognitive haze, I cover it in biohacking brain fog, and the theoretical case for HEG in post-COVID recovery is still speculative but worth understanding.
Why is the neurofeedback field shrinking, and how do you fix it?
The skill set is not trivial. My first mentor, Larry Hirschberg, was a clinical psychologist who also became a Windows expert, an EEG expert, and a brain-mapping expert, and taught physiology at Brown. That breadth is rare. Most people enter neurofeedback as a trauma or addiction or autism specialist, learn the basics in a four-day workshop, and end up running one or two stations with a roster of 20 or 30 clients. They master one set of tools for one population and never cross into the others, because trauma and autism and seizures each demand a different skill set.
Then they age out. Every week someone emails me asking if I will buy or take over their center because they cannot find a postdoc or psychologist to train up. Training takes time. The hands-on piece can be learned in a few days, but it takes about a year of looking at brain maps before they start to make sense, and about two years of making protocol decisions from maps before you can systematize it. Meanwhile the one-size-fits-all systems and the lightweight dry-electrode caps proliferate. They work fine if you are average, and they dilute the quality of the field.
I am building the fix. Brain mapping is rigid because QEEG compares you to a heavily cleaned normative database of a few thousand people. You have to control the recording precisely to make that comparison valid. Separately, the steering process is where neurofeedback succeeds or fails. The effect of a single session lasts about 24 to 36 hours, so you have a window to build on it, and that depends on the client being a good observer and reporter. In a traditional clinic, reporting is poor.
So I built a system that pings clients about their sleep, stress, mood, and day, and folds that survey data back into their training logs alongside the session data, the maps, and the attention tests. We are moving it to a mobile app, and I pull in wearable data like an Oura ring. Over time this produces longitudinal, day-to-day state data against trait-stable QEEG. The goal is a "wild type" database instead of a normative one. Sleepy data, caffeinated data, fatigued data, medicated data, captured across thousands of people. Then the variance becomes multidimensional against lifestyle factors, and we can start predicting how to change brains from what we see changing.
Here is a concrete example of why that matters. Buspirone, the anti-anxiety drug, behaves unlike almost any other medication on a map. Most anxiety meds bring up slow brainwaves. Buspirone suppresses right frontal theta. If a client is on it and has significant anxiety, the drug hides the right frontal theta, and I cannot see it or train it until the buspirone is out of the way. You can usually train through other medications. Buspirone gets in the way. With a wild-type database tracking variable dosing across many people, I could recognize that pattern in real time instead of figuring it out retrospectively years later. That is machine learning on brain maps, and it would take the dwindling supply of gifted clinicians out of the bottleneck.
What kind of neurofeedback do you actually run?
What I do is mostly regulatory arousal model neurofeedback, the older arousal model rather than the newer one, mixed with alpha-theta and HEG. As a laterality scientist trained under Eran Zaidel at UCLA, I reframed the arousal model into a laterality model, left and right hemisphere, with a developmental psychologist's lens on autism and ADHD. I built methods to measure attention in each hemisphere separately and validated some of that work. Anyone who has trained SMR and beta knows there are hemispheric differences; I built a whole assessment and balancing system around them, the way a personal trainer balances relaxation and focus work.
I am not trying to be the single most cutting-edge protocol for one person. I am regularizing SMR, alpha-theta, and HEG into 30 or 40 protocols that address 30 or 40 classic brain-pattern goals, so it scales to as many people as possible. Right now we have around 175 active clients training. I could never see a tenth of that as a one-on-one therapist. My remote coaches each carry a roster of about 20 and check in with me daily for case management.
A little movement in a domain where someone has felt out of control for years feels like most of the work to them. I give free service to veterans through a homecoming program, and guys with severe trauma will tell me at session 20 that they feel great and ask if they are done. I am glad they feel great, but I still see trauma in the brain and their sleep is not there yet. That sense of progress is what taking control of your own brain produces.
Why the brain deserves a gym
Fifty years ago there were no gyms. You went for a walk, you lifted hay. Now there is a gym on every corner. I see brain gyms as the next iteration of that. Trauma response, processing speed, impulsivity, these are tractable for change, just like your back pain or your abs. The point is to give people the same degree of control over their cognitive and physiological health that they already expect over their bodies.
If you want a baseline before the season starts, or you just took a knock to the head, the move is the same. Get a map now while you have something to compare against, and watch the delta over the following months. The brain you are tracking is the one you can train. <<<END>>>