Dr. Andrew Hill Founding Director Peak Brain Institute NeuroNoodle Podcast #40 8-5-21

welcome to neuro noodles neurofeedback and neuropsychology podcast featuring our neuropsychologist dr laura jansen's dr skip brynn and neurofeedback legend jay gunkelman our goal is promote options for better mental health specifically we focus on the objective data you can receive from a brain map and the positive results of training with neurofeedback this is an all-star cast that are more than happy to share their knowledge with you please give us five stars in apple podcast subscribe to our youtube channel hey and buy us a cup of coffee on patreon be a supporter of the show get early content behind the scenes action as well as partake in our members only neuro neutral network meeting hey if they can't hear us we can't help them again please give us five stars an apple podcast if you're not a subscriber visit neuronoodle.com to sign up for our newsletter my name is pete and today we have on the show dr andrew hill founder of peak brain institute thanks for hey thanks for coming on uh doctor now we we were introduced to you from uh dr sanderson out in california with miramar she does a lot of great work uh uh with dementia uh how do you know dr sanders sanderson i mean i think just tangentially the field of neurofeedback as you guys certainly know is pretty small and a little bit self-referential i mean i i doubt there's uh even five thousand people in the us who are sort of at a high level clinically doing this anymore um in fact from my perspective the field has been shrinking the whole time i've been in it i mean i'm i'm relatively young in the field a lot of my mentors are aging out and or dying and i'm sort of seeing the field shrink a little bit and and dr sanderson is another one of these i'm not sure when she's uh when she into the field but she seems to be the same sort of generation younger a little bit um like uh like i i am and i came into the field sort of being aware of her but uh just just a tangential professional relationship yeah got it and then uh jay we had the passing of joe castellano uh i didn't know him but you sure did i'm sure everybody else did can you can you touch on that sure he just had his birthday a few weeks ago turned 49. so it was a precipitous unexpected occurrence and um he will be added to the list of the remembrance event which is this friday at 4 15 pacific the 6 15 central time if you go to aapb dot org you'll be able to find a link you need to register for it to get a a zoom invite to the to the event but you know uh as andrews pointed out um the f1 generation of the field is uh long in the tooth and uh and you know it's an aging uh field we do have wonderful students the the field i've been fostering students as best i can for uh the last 20 plus years uh but i've auctioned off this beard to the total of 17 000 for student funds uh people shave it off into funny uh various forms but um just as an indication uh stu donaldson has passed stu was uh uh foundationally involved in the emg feedback he had added eeg as well later in his career but he was well known for emg biofeedback muscle biofeedback les femi uh who taught open focus uh alpha style training uh five channel phase sensitive uh feedback back in the 70s joe camilla obviously f1 himself um the the founder of alpha as a a thing that you could feed back uh and and uh be sensitive to as well as potentially control operantly or with systems theory there's arguments as to what the mechanism is larry klein one of the original manufacturing promoters in the field thought technologies uh co-founder uh started the biofeedback federation in europe the foundation over there which has been going as an educational body for many decades peter rosenfeld who a lot of people don't necessarily remember he uh he kind of departed from the eeg biofeedback into erp event related potentials in a very deep way um it involved in uh truth detection false detection uh using erp with um some of the and national security folks even um uh michael thompson um a clinical uh person and a a dear friend um uh he passed the add center in canada his wife linda still operates uh but it has been a tragic loss with him passing um um the heart rate variability her as a russian if it weren't for him hrv wouldn't be present in the united states he brought hrv that they had done with the cosmonauts and and peak performers high altitude climbers and things like that um and uh god i can't even say his damn name you know uh uh but uh uh avecny elsa bear who did uh frontal alpha asymmetry uh training uh for for depression uh nancy moss isn't a a person in the field but don moss is her husband and nancy just passed a couple days ago and now i hear from andrew that aaron zeidel a professor at ucla who was open to doing neurofeedback at ucla for grad students and um uh goodness maybe 20 years ago or so i referred andrew there uh as a potential spot for him to do his phd so um you know again there's a lot of people uh that have passed and the remembrance service friday is i think going to be um overflowing uh and obviously the most recent the tragic passing of joe castellano um and um anyways um it's a joyous to remember them uh it's tragic to have lost them yeah thank you thank you jake uh so so dr hill uh please tell us about uh uh your business peak performance uh how long you been in business uh give us a little background on that sure so um our company peak brain institute has been around for coming up on six years in a couple of months and we are um it's my second neurofeedback company i ran another one for a few years that was focused on addiction and as we outgrew the addiction space basically because we were working with all brains we sort of broke off into another company and peak brain you know i'm not a psychologist unlike almost everyone in the field has a therapeutic focus not everyone as you guys know but the the general field is therapists social workers psychologists nurses people working in a therapeutic context for the most part you know with the transference and the container so to speak with their clients and i sort of felt like a lot of what we do is closer to fitness and so i started a company who is trying to provide education and facilitation of the process of neurofeedback but without it being a therapy process so i call it functional neuroscience which sort of sits between fitness medicine and psychology and it uses tools from all three but instead of it being a process of you know brain mapping like many of us do and saying ah here's what's wrong i'll i'll treat you it's a process of great here's a brain map here's what they can show what do you think where are your goals what do you think is interesting and peak brain tends to provide education around qegs around brain mapping for the individual and teach them to understand themselves from the maps and from attention testing and then we can often help them achieve certain performance goals and because i have a broad experience clinically across different you know areas of complaint i've done a lot of work with autism a lot of work with addiction but over the past decade we've really moved more into peak performance and high level performers so you know i still have a third of my clients are kids with autism people with seizures people with brain injuries mold lyme covet i see a huge amount of post covered brain stuff these days but about a third of my clients are the highest performers in the world you know your favorite athletes your favorite tv stars who are you know trying to handle their stress and then of course the other third is all the rest of us those of us with brains that might need some support or optimization and sleep stress and attention but peak brain tends to do things a little differently because we operate outside of the therapy context for instance we provide free brain mapping after the first one for our clients ongoing without any charge so it's an educational you know it's your lab it's your gym it's your spa to come check your brain out it's not your doctor's office where every relationship is expensive and charged it's your resource and some people come in trying to work on their creativity other folks on their immune function other folks on their seizures or their you know getting off book on their play on one reading again or something if they're getting older um and so over the years uh you know peak brain launched in the fall of uh 2015 and we've grown we have an office in los angeles we have one in orange county california we have a big one in st louis missouri oddly enough and then we have some european centers one in london one in copenhagen but all of that is about 25 of our clients most of our clients at this point work virtually from home with leased equipment live staff and we do everything virtually for the most part um the pandemic of course accelerated this but even in 2019 we were about 50 virtual with our clients and so that's jumped about maybe 75 these days um but we send out brain mapping amplifiers we have live staff do your maps with you at home uh we use you know portable devices for training we use the clinical software eager with home clients now so it's a very seamless process it's very similar to coming into the office and working with the trainers or the coaches we call them as well as working from home directly and i've got everyone from you know high high level athletes and actors to people that are you know have 17 you know impaired kids they're trying to get some some relief from them so uh it's really quite a wide range of brains as i'm sure all you guys have come across as well when you get all kinds of things when you work with brains so i've stopped trying to specialize instead i'll help you work with whatever brain goals you want to work with uh the olympics uh what's your feedback on what's been going on with uh simone and naomi uh yeah is it is your peak performance business uh getting an uptick from it inquiries just curious we haven't yet um certainly simone of course being at bruin you know i got my phd at ucla i have a soft spot a sweet spot for you know for supporting her and would love to support you know her if she has any need but um my take on this and again i'm very tangentially you know i don't know what the olympic commission committee has done and i don't know what the limits are in japan but my understanding is that psycho stimulants are somewhat anathema in japan and they're kind of steered away from mostly for cultural reasons right because in was it world war one or two the kamikaze pilots would get seriously jacked up on on stimulants and you know commit suicide with bombs and the sort of cultural signification in japan i think is stimulants or that old thing that was a problem you know 50 years ago um and so stimulants are very very uh highly controlled in japan which my my understanding on this is that simone could not use her ritalin and the particular event that she withdrew from is one that requires an awful lot of sustained focus while you're spinning through the air and and i'm not a gymnast you probably can tell looking at me but uh i can't imagine trying to keep control of spatial relationships and that kind of things under even highly trained highly perfect i'm well rested i'm focused et cetera if you're also dealing with an attention system which is you know grabbed by high stimulus environments and tends to dip when you aren't focusing you know the sort of dopamine stuff that comes along with a little bit of attention trouble i mean forget performing under high stress on the olympics now you can try to do that without the support of your you know routine medication it seems a little bit uh you know it was an additional challenge she had to had to deal with um but you know i i from my perspective hearing that she was somewhat dependent on ritalin to perform my immediate thought was oh well she just should take care of that brain difficulty and i say that out loud sometimes on like a facebook group or randomly oh you got some made hdl let's take care of that and people get really angry at me generally often because they're like what do you mean you can't get rid of this stuff and they're often and when i point out that oh here's some you know research showing the change and here's some you know a thousand different brain maps i have a pre and post changes and i talk about the kind of changes we get in attention i mean we tend to get on attention testing at least a standard deviation against the average population every 20 or 25 sessions and neurofeedback so we do about 40 sessions minimum i tell people 40 sessions is the minimum for permanence and they may not get it but they'll get some some floor built up under them in that time frame so about three times a week for three months is 40 sessions and we tend to get a couple of standard deviations on executive function testing i'm sure all you guys do too this is not you know magic for those of us in the field we understand that it's a very large impact but when you talk about the magnitude you're taking people who are profoundly adhd and impaired and stuff's in the way and moving them to above average typically in a semi-permanent way and so when i just off-hand mention that you should take care of your attention difficulty or your anxiety or your whatever i you know i'm trying to be empowering sometimes i have to have to remember that people often have been suffering with this stuff for years and years and years and the idea that it could have been doing something for it is very very stressful i mean i had the same experience when i got control of my own adhd i worked in an adhd and autism center doing neurofeedback that's how i was trained up before grad school in a place in providence uh called the neurodevelopment center run by dr larry hershberg somebody else who's in the process of retiring now another f2 i guess for larry um but in in in starting there i was profoundly adhd like pick the most hyperactive hard to control 10 year old you've ever met in your life and multiply by a few and that's me at age 28 you know when i was thinking about grad school and trying to you know stress about the idea of studying and applying for you know different programs and of course when you're out of undergrad and into grad school so much more of your work is self-directed delayed gratification stuff so when you spend several years doing research and writing papers it's not the most adhd friendly environment because there's not much immediate reward that comes in to keep you dragging through this log and so i was you know working in the center and i started to see things like adhd and autism seizures change and i was shocked because i had been working in the field of you know mental health at that point for over a decade mostly in really acute mental health severely uh impaired adults in residential facilities with multiple disabilities cognitive and physical i was you know i learned tactile signs so i could deal with people you know in individual people i had learned different sign for each person because they had very limited you know pidgin language themselves and then i worked inpatient with dual diagnosis with drug and alcohol and i worked in gerontology units in psychiatric and just saw people at the absolute edge of human resources getting pinched and falling over and then the developmental stuff at the end of life the early of life would both you know be a inflection there and i started working in this place uh in providence and within a month was seeing adhd symptoms change and autism start to shift i was like wait a minute this isn't what i understood about the brain how are we getting eye contact and sensory changes in autism how are we getting executive function improvements in a month or two this is this is bizarre and so i was sort of uh excited to understand that we could actually make change and yet this is a while ago this is back in maybe 2001 or two and the field hasn't advanced that much in the past 20 years as i'm sure you know you guys might agree in terms of basic technique it's kind of the same from my perspective but at the time there were maybe three or four different schools of thought who they had the truth they had the idea about how this neurofeedback stuff worked that was usually being driven by a particular vendor who had some ideas about how to implement stuff but the field was full of people with fairly vitriolic arguments about this is the way to do it no it works this way you have to use brain maps no you can't use brain maps and it was a growing you know schism across different aspects of the field about what was happening how it works if it was voluntary if it required you know all kinds of different techniques and you know i sort of struck me as a little bit silly because a there were lots of egos involved but b all of those schools of thought were getting good results better results than is considered conventionally possible in psychiatry so instead of you know any one of those schools of thought having the truth it sort of struck me as what i call a blind men and elephant situation you know we all got a little piece of truth worth describing it but no one really has the overall perspective so i hung out and did my own neurofeedback and did about 18 sessions and essentially eliminated you know what was fairly profound adhd for myself and that sort of gave me the freedom and the excitement and the encouragement and the resources to then go and you know get into grad school and of course i went to ucla and did some you know neurofeedback research there and tried to push the field a little bit but then the far side of that you know this was in uh the early 2000s when the grad school the grad student landscape was shifting a little bit you know when i started grad school in 2005 all my peers were getting postdocs and when i finished grad school in 2011 2012 none of my peers were getting postdocs anymore there's the competition was so high the funding was so low and so i decided to move into the business world instead of the you know sort of academic post-doc world and having a i have a cognitive neuroscience phd so i'm not a psychiat a psychologist i'm not a clinical clinician i'm a research scientist basically and i wanted to find ways to take the cog neuro stuff and bring it into the individual agency you know provide the person the the freedom the power the agency to take control of their brain mostly because i saw that neurofeedback was an agency building technique it took whatever the diagnosis was whatever the problem was and even if we don't understand brains perfectly looking at a brain map looking at symptoms looking at performance you can demystify these things to some extent in a way that's often not true in other aspects of mental health so showing someone their trauma their posterior cingulate up or their anterior cingulate being obsessive or their temporal junction being hot producing social and sensory issues was incredibly freeing for people to go oh my gosh my tinnitus you're seeing oh it's real people haven't been believing me oh my gosh it's real thank you and pete i started having this experience where clients would lose the stigma lose the frustration lose the guilt because something they could see it's like if i showed you your broken shoulder and an x-ray you know you understand it you wouldn't normally be angry at your shoulder before that though right you might be frustrated but you wouldn't be like oh my shoulder oh i'm so weak my shoulder's broken but we do that with our brains and so a lot of my my mission here is to teach people about these modular aspects of the brain that can support attention stress sleep mood in a way that is then tractable that you can then take control over so that's really the mission statement so to speak at peak brain is this agency providing thing and we draw from the tools of psychology medicine and fitness but we're kind of not really any of those things for people so i'm on the back i'm on the business side of things this is going to be my last question it's a question from the parents out there what do you tell the people who come in the peak brain the parents um because you know the olympics uh naomi uh simone you know they're like what what should i do for my kids uh do you suggest get it you know when they have to go in and get their physical do you suggest getting a brain map uh before this season every couple years like what what what do you tell the parents out there because once they get a you know a knock to the noggin uh right how do they know you don't have a baseline uh what what are your thoughts on that and then dr laura dr skip jay take over so i i tend to um talk to parents when kids are either in crisis or when the parents are focused on the kids performance you know so they're either a kid is a soccer player they are an athlete they are a gymnast or something or um they have some autism they have a seizure they have something else going on so either they're walking in with identified complaints oh my kid's having more seizures oh my kid is getting in trouble in school or they're sort of like coming in from a a broad perspective and the kid may have some history may have some concussions maybe a soccer player may have an eating disorder or whatever in the case of concussions in the case of wear and tear what i often tell people is you can't tell if there's a concussion in the brain using brain mapping you can tell this brain fog you can look at course phenomena you can say oh look there's extra delta oh your alpha waves are slow but you won't know if someone's built that way if they acquired that through wear and tear and you don't always know if it's a problem when i tell people when looking at brain maps you know it's plausible you don't know it's true and then if it fits okay well now it's actionable probably you can test it so i'm always about providing agency and ways to make intervention less about understanding what has happened i joke if you want answers go see a doctor you want questions uh i'll come see a scientist we have questions for you but doctor's answers aren't always legit or aren't always satisfying especially mental health people get categorized they get labeled they have the agency taken away and i often see people when they have these mysterious syndromes no one else can figure out and they've gotten lots of unsatisfying diagnoses unsatisfying medications unsatisfying interventions and they're finally trying something that's a bit more you know them taking control of it um so when it comes to concussion stuff if i have a kid client who's a soccer player or an athlete what i'll say is we should map early and often we should map now and since i don't charge for repeat brain mapping it's a very easy sell get one now and then they're free um and we're also way under price for the field we charge 500 bucks for a brain map you know so uh it's it's this access place we're providing and then i also tell parents and adults that you know your concussions will bloom they don't show up right away if you get a concussion car accident an injury come right in let's grab a snapshot probably won't show up if it shows up it's really bad and you should go to the er chances are concussion won't show up right away in eeg but it'll bloom it'll it'll emerge over a few months and that's what i want to watch for you client i want to watch your your delta waves creep up at the point of impact your alpha wave slow down as your sleep erodes if if it matters to you let's watch it so you can keep an eye on it if it shows up a few months from now let's say your speed of processing drops a little focal arises up that you bruised and we see it well you can just go after it now directly with some good sense of where you can apply pressure without having to develop these broad inflammatory states i mean post-concussion stuff is non-specific and tends to produce as i'm sure you guys know lack of sleep anxiety lack of stamina slow processing but it doesn't show up right away and half of all brain injuries are silent there's no symptoms initially but you get this five six year process of everything eroding and so you know the old football player was fine finishing their college football career but 10 years later they can't sleep they're burnt out in the afternoon can't find words they're irritable they're short they're they're frustrated and they're just you know full catastrophe stress and attention living here um you show them their brain and suddenly it makes sense so i've had more than a handful of people who the benefit i give them is simply showing them their brain i had a dad call me a couple days ago and i said oh i haven't i haven't talked to you in a few years i you know i talked to you a couple years ago and we've done a brain map on their son and the sun didn't actually start training which is a little unusual usually people see their brain they're like oh wow oh yeah let's let's work on that but this kid looked at his brain i sort of said well look there's some attention difficulty but look at how powerful you are look at all this amazing ability to see patterns and how fast your processing speed is and i gave i always give this like resource description not a diagnostic so i kind of broke apart the positives and the negatives in this kid's attention performance as he headed into uh college and it was enough of a validation that he decided it was time to organize his time and structure his life and everything else and soared successfully in undergrad simply by seeing that he had some resources on the ball that were changed his perspective on adhd for him away from the diagnostic you know uh category into the more nuanced resources he was actually dealing with and i gave him some coaching around oh look your auditory system doesn't alert very well what your visual system does sit in the front of the class when you're studying play loud music with no lyrics and those two things will hack around the weakness and help you activate your brain and he used these things to successfully then move through you know understanding himself and we never did narrow feedback it was enough to to point at the brain and educate people so i like doing that and in some ways my job is done once i teach you a little bit about yourself and then you can decide you know if there's interventions you want to pursue dr laura uh yeah hi uh good morning andrew i was um caught by one of the first things you said about seems like the field is shrinking or maybe not growing and um uh just curious about your your uh understanding of why that could be and then another kind of same question that if you were to start a neuro feedback practice now 2021 were post covered what would the approach be is there anything different you would do and i guess just kind of curious if you would speak to kind of the future of neurofeedback um i would say um to answer the first question i think the field is shrinking because the skill sets required to do neurofeedback are not trivial i mean my mentor in the field my first boss larry hirschberg he's a clinical psychologist you know a psychodynamic freudian type psychologist but he was also had to be a windows expert and an eeg expert and a brain mapping expert and taught some physiology at brown like by the time he was done his career and larry's retiring right now he had developed skill sets broad skill sets in a lot of different domains powerfully you know really deep knowledge and that's a little unusual for the clinical professional who wants to niche down and specialize in the population they care about with the tools that work for that population and then provide a lot of change and most people in the field of neurofeedback started off doing something different off as a trauma therapist or an addiction therapist or a autism person or an adhd coach or something and then they discover hey wait a minute this neurofeedback stuff seems to impact this population i care about ooh i'm gonna learn some and the way they learn it is in a four day workshop or a conference somewhere and they learn some basics and unfortunately the field is full of a lot of marketing information that obscures the science so there's platforms out there that use invalid language around what they are and then marking language that obscures what's happening and they say things that aren't true so people don't understand who use the tools what they do and so you have people who are sort of like punching buttons on black boxes and using recipe books in clinical lore and can navigate their way through one type of brain challenge successfully and effectively with one set of tools that's most of the field i would argue you know an autism therapist is really good at working with heg and specific right hemisphere stuff with you know dr cobins maybe a multivariate coherence let's say but you can't then work with trauma necessarily you know psychiatric trauma necessarily it's a different skill set so that's been a difficult adjustment for individuals in the field to develop enough skills what tends to happen is people will niche down into the skill sets they enjoy and work with clients they can make success with and that's it and then those people will scale up their personal bandwidth the way a therapist will which is like 20 people 30 people right that's that's the roster that's the that's the census of a therapist is 20 30 people when i was working for dr hershberg when we had when we had a busy weeks it was you know 50 to 100 sessions in the office that was a busy week a very busy week it's great but dr hirschberg center is one of one of the larger ones in the country with multiple stations running when i was working there we had eight stations running continuously it was amazing um and my centers my my larger centers have six stations running which is great but most people are running one station maybe two it's on one on one with their clinical population that they're seeing themselves once twice a week maybe three times a week and so those people get busy they have a mentee or two but they hit 60 years old 65 years old they're like oh i'm going to retire now and i guys i can't tell you how many times a month i would say it's at least once a week i get a call from a practitioner or an email or a sort of you know curious request from somebody saying you know i'm going to close my center would you like to buy it would you like to take it over every single week somebody reaches out and says oh i'm trying to figure out how to hand off my center to somebody i can't find someone who can do this i can't find a postdoc to train up i can't find a good psychologist who's interested and i think the other piece of that is when i train my staff or i train clinicians to do this it doesn't happen instantly i mean the skill set the hands-on piece of it can happen in a few days but i find takes about a year of looking at brain maps before they start to make sense and about two years of making decisions about neurofeedback protocols from brain maps before you start to systematize it with the people you work with that's been so i think that's a big ask for the the transfer of information and i think what ends up happening is you have the skilled nerf backers dwindling and you also have a burgeoning of the one-size-fits-all systems the non-tailored systems that i do not like i think cause problems and then also the sort of weak t versions of traditional neurofeedback the likes of the lightweight caps that have dry electrodes that have you know turnkey systems with fewer you know i don't want to name any brand names to avoid annoying people but um i do i think the process of neurofeedback is best done when it's heavily individualized when every person's brain is assessed and when the process that's done to the person is then tailored and iterative the way fitness is um and i think that there are some one size fits all some things you don't have to learn anything that work okay if you're average and that's diluting the quality of field and the other half of it is the skilled people are aging out dying can't find people to men to mentor et cetera so i mean i joke there's probably you know between five and ten thousand people in the us that do this work at a clinical level pretty well there's probably more than ten thousand chiropractors in los angeles i had to guess you know so it's not a very large field and i have a lot of european clients there are way more neurofeedback people in the us than there are in europe way more it's just a wide west of people trying things and trying to build businesses and no one's having any support so i have i have as many clients in australia and you know copenhagen and denmark as i do in like canada for instance because there's so little neurofeedback happening in australia happening in denmark that i've got tons of clients in those countries send them gear it's just as hard by the way to send gear to canada as it is to australia i don't know why that is but it is it's annoying um but you know the short answer dr laura is that i think the skill sets required are not being well transferred to the individuals who might want to do this work tons of people want to do it i get calls from clinicians every single week oh would you teach me would you supervise me would you become my mentor and i usually say no because it's not a very scalable thing and i'm trying to open up peak brains not just you know create more people but um it's a need yeah yeah so how would we fix it and it's kind of a grandiose question but any any uh suggestions any thoughts i'm in the process of fixing it okay um your secret's safe here go ahead uh right this is just a podcast with tens of thousands of people listening um so one thing you guys i'm sure all know deeply especially dr guppelman but um brain mapping is a bit of a rigid and slightly awkward thing to use because brain mapping or qeg is driven by comparisons to normative i.e heavily cleaned arbitrarily average and not really typical databases the reason we do that compared to average is because we got to compare it to something to get a sense of the bell curve and how weird things are but people are a little bit variable day to day brain mapping itself qeg is stable month after month year after year if it's clean data is according to literature however that's because we heavily control it you can't be tired no caffeine first half of the day et cetera et cetera and what i'm doing um i'm doing something i'll explain in a minute to help that piece of it but also as i'm sure you guys know have all done neurofeedback a lot of the the critical skill or a lot of the critical thing that is required to do neural feedback well is the steering process well what did what happened after that session how did you feel how was your sleep how was your stress how was your trauma how was your drinking you know what happened because the impact of a single session tends to be about 24 to 36 hours then it wears off and so you have an opportunity to sort of burgeon that effect and build it or steer it or tweak it but that's predicated on the client being a good observer and a good reporter and a traditional psychology environment reporting and observing is really poor and we were lucky if we got a third of clients to report back what was happening with our sleep or something in the addiction space so i've built a system to ping people periodically about their sleep their stress their day their mood and aggregate that survey data back into their training logs so i have a cobble together software to collect all the neurofeedback sessions all the brain mapping data all the attention test data all the things we're trying for neurofeedback and all the survey results so that people like me who have the domain expertise if you will of brain training can look at the brain map can look at the result look at the history just like all the clinicians do but i've compressed it down to a very tight little bit of information and right now we're moving that to a mobile app so soon we'll have this round-trip information where the clinician can communicate with their client on the same software they're using to track this training sessions and track their sleep you know i'm wearing an aura ring for instance that'll get sucked into the to the system but what this will do is it'll provide me longitudinal you know day-to-day uh sense of people's changing states qeg is traits not states it's trait stability but against the states caffeine fatigue trauma medications whatever if i'm tracking that across a month of variability day to day month to a month to month week to week across people's different major subjective resources and then occasionally brain mapping what we're going to be able to do is essentially create a wild type database for qegs instead of a normative database so the norm of databases are several thousand people you have to hit about 3 000 people roughly to approach the shape of a normal population of an average population when it's heavily cleaned but if we had normal data so wild type data sleepy data caffeinated data data when i'm stoned data when i'm tired whatever and just track that for thousands of people we should be able to generate essentially a sense of a dirty brain map no matter what's going on for you against all of the variables we're tracking and so the power of the variability the variance the standard deviation becomes multi-dimensional against lifestyle factors which means suddenly we can start doing things like predicting how to change brains based on what we're seeing change so this becomes a round trip where the qeg becomes not just a tool to help you come up with ideas and apply pressure but then we round trip that back into how one individual you know one psychiatric complaint or one medication status is impacted like i know if someone's on a certain med what it looks like in their brain sometimes or i know if a certain med is on board how to work through it or around it like for instance um one of the meds i hate to work through is buspar busparone it's the only amount i hate to work through actually because lucerone's a non-typical non-standard anti-anxiety med in that it brings up it suppresses slow brain waves most ant anxiety meds make you more relaxed they bring up slow brain waves in some ways but buspar shuts down theta it suppresses right frontal theta and if someone's on boostpar and they have a lot of anxiety buspar hides the right frontal theta i can't see it on the brain map and i can't touch it with neurofeedback until the boost bar is out of the way now almost no other drug is like that you can see the patterns through the drug if you're you know maybe not fully but you can see them and you can train them but there's a few drugs that get in the way now if somebody had a history of guspar and anxiety the variable dosing the variable strategies the wild type variability of that right front theta i would have been able to figure that out ahead of time not just by not supporting one or two clients who are on boostpar and they're retrospectively realizing what happened later you know 10 years later i'd be able to do that in real time going oh this client responded to right front training not sure why and be able to get a sense of the oh that's a medication status thing and essentially doing machine learning out of the brain mapping and i mean all you guys are still clinicians you look at brain maps you look at reports you get goals you make a call oh let's do this let's try this version let's do this protocol but i want to take that out of the skilled heads of us because that is a dwindling resource i want to first persist people like us several of us side by side making good decisions and then my data system is capturing a few hundred data points per day per person basically and then over a few years of that we can start doing predictive neurofeedback oh this complaint this brain let's try this and we can start taking the the gifted people like us out of the equation to some extent it's wonderful we've been in you know building the field but i'm concerned that it's relying on us and it should not rely on us this is getting rigorous enough that we should be doing predictive analytics and machine learning to do neurofeedback protocols we should not be just having oh i have access to this gifted person who knows how to work with trauma or seizures i'll talk to them that's a bit of a concern for the growth of the field so i'm trying to democratize it all from the point of view of fitness but then take the science out of the mystery place and bring it to the more rigorous place dr skip thanks pete andrew so you mentioned not being a clinician and and kind of steering away from maybe the more therapeutic aspects of it and this is a little tongue-in-cheek but your description of that conversation you have with folks when you show them how their brain works my experiences that's that's incredibly impactful and profound for people to see that almost a paradigm shift right and that's therapy right so so you're doing it uh at least in those moments but but more to my point is that that is such a powerful experience for people to conceptualize this unseeable and and because of the way our brains work unconsciously you don't have to think about it for it to work you got to kind of concentrate on moving your leg a little bit you know to walk up steps etc it can really be a changer and i guess the the therapeutic end on my end not to you know rope into this therapeutic world but it it uh instills agency and folks have a buy-in and that changes things whether you're doing your feedback or not my experience right once you get folks you know invested in doing this whatever this is that's that's an agency for change too right it just affects people's involvement in things but so just to comment but the question i had a couple and if you can get both that's fine but man i was intrigued by this idea of concussions blooming and what you might be able to tell us from your experience and even you know literature that you guys are collecting on your end and then if you have time what the hell are you seeing with post-covet brains i know it's probably not one thing but if there's any oh it is how it is oh shoot yeah please please share um and it's the same question it's the same answer actually about concussions it's the same conversation um the short answer is all we're dealing with is neuroinflammation as far as i can tell and there's lots of reasons to have neuroinflammation subacute or acute you know a lot of us it's shocking to what extent we see indications of brain fog or injury in everyone or many people i joke that there's no safe level of impact half of injuries all have uh you know have no symptoms but do produce difficulty later and so i think that's what we're seeing in terms of the blooming is that 50 of injuries do not show any symptoms right away and yet there's a structural change in the cases of injury types uh crush injuries impact injuries tend to produce a bit of the brain that's pushed on it's bruised and that changes the regulatory within the tissue and it will often drop back into delta waves the slowest brain wave i kind of think of delta as the heartbeat of the brain it's uh we we live in delta we don't think in it and it runs your autonomic stuff your cell metabolism it's running big surges of csf of of sugar's monofluid through your brain like a wash to machine agitation cycle in your sleep to plot toxins and help metabolic reset but if you end up not sleeping your brain makes delta to try to compensate for that lack of sleep if you end up concussed a bit of tissue if it's specific will be like oh i'm not sure what to do anymore and it drops back into a delta pulse basically the heartbeat of the brain and what i will see when working with concussions is often uh crush injuries is often delta blobs and um if somebody has a a a ballistic or a shear injury if they enter in a bicycle or a motorcycle accident or they're in a car that's been spun or something the injury is often different if you pull tissue away from tissue you break the neurons that come that connect regions called inhibitory interneurons and those are mostly shutting down activity the breaks for different modular bits of tissue so if you break the if you remove the breaks between bits of tissue you have little spots where the tissue is running really fast so you see little blobs of beta waves when there's shear damage and again i don't know if these are from damage when i see them but if i see oh look at all that blob of delta you have on the back left and you also tend to see the coup contra coup patterns you see the stripe the diagonal stripe through the head so if someone's got a blob of dealt on the right front corner and back left corner i wouldn't know it's from an injury but i might say oh hey this tissue in the back right is social and sensory you deal with sensory irritability oh you are okay that's probably valid no and for some people this kind of pattern might represent a line of force to the head oh that sounds plausible it might be i don't know it doesn't matter the fog is what matters and we can work on it whether or not it's an injury so i'm not trying to get to the diagnostic label i'm always in fact i'm always trying to shy away from it i joke to clients that it's their job to make the meaning and to have the experience and i will help them understand some ideas and they'll help me understand what is actually true uh so whatever sorry to interrupt therapist well that's the thing i have to be ethically and therapeutically appropriate even if i'm not doing therapy right i know i have an ethical line to walk um and and i worked in so many crisis environments and inpatient environments that i have i have a therapeutic and a therapy skill set that is actually more practiced and more experienced than most therapists i know who are actually psychologists just to be frank but i don't want to be a therapist for you i'm not in the process of developing transference safe containers and and and becoming part of the you know done with you agency thing i'm in the process of like the coach saying all right here's how you ski i'll meet you to the bottom of the mountain see how bruised up you are and help you to affect your technique you know that's the kind of coach i am go try that oh that hurt huh try that oh you like that okay great and i joke to clients yeah you know it's kind of like i send you the gym and you work out later on you're like oh my my shoulders are sore i'm like oh they must be taller than i thought i'll move the seat height on the machine try it again oh you like that okay and yet i don't know what height is here we're often kind of trying to guess about what's going to work well for somebody so um back to the concussion question you know you'll see little kernels of delta little little signatures of a stripe of beta or something and if it's plausibly an injury great you know it's worth working on but if it's recent it doesn't show up that often maybe you'll see something but not dramatically um and since i work with people for years and years and years and they often get free brain maps i have this luxury there's no cost involved beyond goopy hair for getting a brain maps my clients map with wild abandon and frequently and often and it's great and so i've got like maps and maps and maps and maps and maps for thousands of people and you know someone called me um at christmas time he said oh andrew i just got a concussion i'm like why are you skiing why are you skiing you had a concussion last month yeah i know but i decided i could probably take it easy and then i my son got me out in the slopes and yeah i got injured again oh well come on back let's see what you look like and he had a concussion it had been doing really well it was reactivated so you'll see that and people that have concussions who are athletes it's not their first one you know kid or adult athletes you tend to see the repetitive wear and tear stuff especially because it's often sports driven you know a single single soccer heading drill done one time by one person one teenager will produce gaba signatures in the brain like a brain injury for 48 hours after the heading drill so you see lots of stuff in people but what tends to happen is over two to four months the injury will show up the person's brain fog will also get worse in that first month usually so they feel horrible but as they recover from the hit the daze the fatigue the anxiety the sleep erodes anxiety goes goes up stamina goes down we see the alpha speed go down we see the amount of delta go up or down depending and the regulation of delta go fast or slow depending and the person reports being half awake when they're asleep being half asleep when they're awake having no mental stamina having no word finding being kind of anxious all the time and you can track those things as little blobs showing up in the brain the the delta waves usually getting worse sometimes it's the beta waves but it's usually delta um you know slow not fast and then i have clients who have worked through major brain injuries who've worked through major developmental changes and and are amazing you know highly performing individuals after some neurofeedback and i haven't seen them for a few years and they're all coming back now and i'm seeing them and i look at their brain i'm like oh wait did you have another concussion because these little blobs that were tiny of the delta mostly dealt with have blown up so what i'm seeing is the existing old stuff mostly is what will swell up and so usually on the sides of the head temporal lobes typically or where you see there's a lot of blood flow so the top of the head for delta and the edges are where the delta's kernels are showing up and deltas of uh also tends to not distract the brain tissue but the vascular or the blood flow so when this blood flow changes you see big delta changes as well so we tend to see those things on the sides of the head and any place else where there's been a delta blob historically it blooms again and i'm pretty sure the sides of the head are just like the temporal metabolism dropping because of some broad inflammation it's not probably from the temporal lobes but people are reporting all the same post-concussive symptoms they report you know from concussions after covet now so and even and even after vaccines and even and sometimes people having second and tertiary infections and having the same kind of brain fog afterwards so it's very strange phenomenal i have seen a couple folks have gotten vaccinated and have their post covered fog go away with a vaccine too which is interesting the action causes uh the brain to deal with the the inflammatory milieu and it addresses it sometimes so but it just gives people some perspective on this stuff like i'm never telling them here's what's true i'm saying here's what's plausible what do you think and they tend to make the meeting oh yeah that's my covid okay oh yeah that's my old football injury okay let's see let's see what happens if we lean on it and so they end up having the second third fourth brain map that's the place where they make the meeting and that's what they get excited and they've made some change and et cetera so thanks yeah andrew uh we we've got an agreement that the old people in the field are getting old and retiring or passing uh that that's obvious but um i have a little bit of a different perspective uh in that i do think that the field is expanding back when i referred you to ucla as a location to go to do a phd that wouldn't kill your career by asking to do a phd dissertation in neurofeedback now i could point to a dozen here in the united states i can point to them all over the world there there are major universities uh doing neurofeedback studies uh now salzburg austria the consciousness and sleep lab graz austria your fur chillers lab on event-related synchronization decentralization uh grazelier is retired but uh you can get a phd in the area of neurofeedback in london open university and uh royal college of med of medicine you know the opportunity to actually enter the field is uh burgeoning uh the number also not i mean number of people who can actually you know execute and do it well isn't is it increasing um i i would say i agree though i was in grad school ucla arguably the best psychology school in the world arguably um penn state that way uh and my first year there as i was applying to grad school you had the conversation i had to be careful mentioning the words biofeedback and neurofeedback or i got eye rolls in interviews um and the same thing happened to ucla but i got in and my third year there something weird happened all these really famous scientists doing cognitive neuroscience in learning and language and autism started saying hey you're that neurofeedback guy hey can we do some studies together and i wanted some more feedback with my population or my test can you add your tests to your grads to your dissertation work now and suddenly all these serious scientists who are not that interested in this wu stuff were very interested and there seems to have been a sea change since so not to say the field is not elaborating and getting better and there are people who are pushing the technology better but i would say the field itself is not changing and improving technology much at all individuals are they're people taking stuff erp training mri training scp infraslow and for low all the different techniques i'm very excited about them all but i couldn't train somebody up effectively in half those things and have them know how to do them so i tend to focus on it's what i call the peak brain way a replicable way of going after basic brain resources of sleep stress and attention and you guys will understand uh this language what i'm mostly doing is regulatory arousal model neurofeedback what we might consider the old school other model not the new school one mixed with alpha theta mixed with heg and then i'm a laterality scientist of course working with dr zeidel so i have a laterality left right hemisphere and a developmental psychologist's perspective on autism and adhd so i took this arousal model that the authors helped promulgate and i reframed it into a laterality model while working ucla essentially and then i test that you guys can remediation if you're curious i tested how to measure attention each hemisphere the brain separately and validated some of this ideas i mean you've all trained smr beta and you know that there's some hemispheric differences well i built a whole system of neurofeedback around those differences both assessing them at the actual hemispheric level as well as you know balancing the things we do the way you do in personal training you know you do some alpha and some beta to get you relaxed and focused kind of thing you know but i'm not trying to be the absolute 100 percent cutting edge most impactful bit of neurofeedback for one person i'm trying to be the most accessible most impactful neurofeedback for as many people as possible and to some extent i'm i'm regularizing smr alpha theta and heg into a set of 30 or 40 different protocols to address 30 or 40 different classic brain pattern goals and then people end up becoming more nuanced within that relationship themselves and it you know they often have a therapist they're often dealing with their anxiety or trauma with their therapist while working on their brain but it gives them a tool set they can bring to bear and i can do that for i mean i think right now we have 175 clients or something active who are actively training um i can i could not do 175 people as a therapist in an office couldn't come close to that 10 of that but you know i'm going to spend a half an hour after this podcast doing all the case management for the day for my los angeles office and my remote coaches will be touching base with me each for half an hour today with their own individual rosters of 20 clients and they'll then go forth and say oh hey joe doctor hill today and we thought you might want to do this protocol set this week we adjusted these protocols and let's schedule some time later on to find insight in your head so they can do that and the client's experience of it is very different than having it done to them if they've actually been sticking wires to their head and to your point you know if you take someone has trauma or anxiety or tinnitus or something that's really overwhelming and really disempowering you give them a little bit of change that they've accomplished 10 of their goals let's say that 10 of movement that they have worked on in a domain that they've normally typically historically been out of control in is sometimes like you've done most of the work a little bit of change in trauma a little bit change in ocd or ptsd and it's like oh my god i'm a mate i feel so good now yeah but you've only done a month and a half of training like i give free service to veterans you know as part of the homecoming veterans program and these guys come in severely traumatized sometimes and 20 sessions in they're like hey doc i'm feeling great am i done i'm like well i'm glad you're feeling great but i'm still seeing trauma stuff in their brain and their sleep isn't great but it's it's come so far in a couple of months from where it used to be they think they're you know all better so to speak and that happens when you start to take control of your own brain i'm not sure what the metaphor is but you know those gym bros who get so swoll they can't drop their arms once they realize how easy it is to get big pecs and arms they just do it and that happens with neurofeedback sometimes when it's not a therapy modality when it's more under your control and so i joke if you walk into equinox or gold's gym you know everyone's got their abs hanging out all the staff is you know flexing and pumping but if you walk into a peak brain office they all have their good listening skills and kindness hanging out it's really weird um all my 20 something and 30 something staff have this vibe like they're 95 year old meditators they're super well adjusted and calm and low key because they sit around and train their brains for fitness and performance not because there's anything wrong with them per se and i think that we're you know doing a disservice to the most of people who don't do neurofeedback you know i i point out sometimes people that 50 years ago when our parents were you know younger there were no gyms there were no gyms in the country you couldn't go to the gym in the 40s couldn't do it what do you mean a gym a gymnasium what do you mean place to workout huh go for a walk go for a run lift some heavy things with some hay well nowadays we have gyms in every single corner well i think the brain gym taking control of cognitive and physiological mental health so to speak is the next iteration of that and that's what i'm trying to do is give people the same degree of control that they might have with their abs or their back pain [Music] over their trauma response or their speed of processing or their impulsivity because as you guys know those things are completely tractable for change so amen dr hill thanks what's the what's the best way for uh people to get a hold of you uh is a peakbraininstitute.com is that the best url geekbraininst.com is the website um all of our socials are at peak brain l.a uh like uh l.a is all the social media and if folks want to watch my baking adventures that's just andrew hill phd it's mostly just food i just baking adventures got it okay uh any recommendations for somebody to come on the show next uh dr sanderson tag view uh don't need the answer now you email me later we'll let you go but uh we the west coast has been giving us some great uh content you guys rock out there yeah you might want to talk to dr lacada actually um i mentored him i trained him up and near our feedback uh vital head and spine v-i-t-a-l vital head and spine in pasadena dr john carlo la cata l-i-c-a-t i think j you know him right you were talking yesterday um he's a sweetheart uh i train him up initially and eager and brain mapping and then he's you know now off learning from better people like jay um but he might be a good person because he's a nuka practitioner upper cervical guy who came in to neurofeedback from that direction and has doubled down and just earned your feedback now so he might be a nice person one of the chiropractor types who's come in and discovered this and then essentially become now full a full brain guy instead of a chiropractor because of what he sees with the brain injury populations he works with it's a very different relationship when it's neurofeedback instead of the nuka stuff so uh he might be a good uh uh person he's really very well well spoken so good well dr hill thank you so much for coming on the show my pleasure to folks nice to see you all today thanks for having me uh and uh jay doctor uh hill you guys can split or hang out we're gonna do some housekeeping here and then uh we're gonna bring you back dr hill you're you're definitely uh every three months at least happy too and you know there's other things i don't know what kind of content you guys do but um i have a lot of uh touches into the nootropic and biohacker world kind of a minor celebrity in that world so all the nootropics all the all the weird stuff that all the weird people are doing is stuff that i didn't touch so if you wanted to talk about hacking the glucose to ketone index for brain injuries dr skip for instance or other stuff like that i tend to do a lot of those things and it might be other content that isn't just another you know neurotherapy right right right right right oh yeah so feel free to tap me for other things just let me you know give me something oh don't worry don't worry look look in your junk file someday all right we'll do it we'll do it all right nice nice all have a great day take care all right andrew bye-bye thank you dr laura you got a yes what's that little bottle you got there yeah speaking of neuro hacking neurotropic things ars koso sent us out a bottle of pre post biotic and my job a couple weeks ago was to try it out okay so what did i do i did not try it out and i'm here to try it out right now i'm gonna pour it's 15 milliliters which apparently is a half an ounce and so pour that in with some sparkling water it's pretty viscous it is the color of whiskey but smells like uh vegetables fruits it smells like raisins i guess so i'm gonna take a sip and i'm waiting for the uh to the end of the show to try this because um it's it's designed to be cleansed so okay yeah so if we see running away from the screen no no emts standing by or anything it has nothing to do with this but yeah actually it tastes really good you want to act like you're drinking it again because you kind of froze out there so viscous flavor yeah it's viscous it's kind of the um viscosity of motor oil but it tastes like raisins so it's actually a very good uh drink so highly recommend the taste of it and i'll um try to keep that too much tmi next time but um all right all right well you know let us know how it all comes out your screen froze but i don't see you turn green or nothing [Laughter] all right that's our uh ours koso uh report i think dr laura had to go to the bathroom [Laughter] it'll unfreeze your insides okay [Laughter] did she spell it on her computer i mean it's frozen there you go your system froze up there for a moment oh you're assumed you're you're good we thank you all for listening nerd noodles neurofeedback and neuropsychology podcast the contact info for everyone is located in the podcast notes below you have an idea for a topic reach out to me pete at neuronal dot com or leave us a voicemail with the lincoln podcast notes please give us five stars in apple podcast subscribe to our youtube channel our youtubers get to see all this fun stuff because i don't edit any of the youtube stuff little secret between us girls smash that like button on facebook instagram and follow us on twitter and hey if you really really like us you can always buy us a coffee on patreon slash neuro noodle cue the band