Join us as we delve into the intriguing world of neurofeedback, a groundbreaking approach with the potential to transform our mental health and overall wellbeing. In this episode, we uncover the intricacies of neurofeedback and its profound implications for mood regulation, mental clarity, and emotional balance. Together, we explore how this innovative technique allows individuals to gain deeper insights into their brain's functioning and offers a unique opportunity for self-improvement. Through engaging discussions and insights, we navigate the landscape of neurofeedback, shedding light on how it has the capacity to revolutionize our approach to mental health and physical wellness. This episode invites you to embark on a journey of discovery, emphasizing the incredible potential of neurofeedback and brain mapping to empower individuals in their quest for improved mood, mental resilience, and a more balanced life. DR. ANDREW HILL Dr. Andrew Hill (Cognitive Neuroscience, UCLA) is the founder of Peak Brain Institute and a leading neurofeedback practitioner and biohacking coach for clients worldwide. At Peak Brain, Dr. Hill provides individualized training programs to help you optimize your brain across goals of stress, sleep, attention, brain fog, creativity, and athletic performance. RESOURCES https://peakbraininstitute.com/ https://peakbrain.co.uk/ https://andrewhillphd.com/ https://www.instagram.com/peakbrainla/ https://www.youtube.com/@drhill THE JORNI RESOURCES https://thejornipodcast.com for show notes https://thejorniblog.com for more holistic healing and mental health resources https://thejorni.com LIKED THIS EPISODE? Share this episode on social media and leave us a short review! https://thejornipodcast.com/episode-157-neurofeedback-with-dr-andrew-hill
Episode Summary
I spent years around acute psychiatric inpatient units, group homes, and crisis centers before I ever touched an EEG amplifier. What I saw there was mostly holding patterns. Revolving doors. People in deep suffering getting what amounted to palliative care for mental health, with little long-term change. The insurance environment was collapsing around us at the same time. In my first four years around inpatient mental health, the average paid length of stay for someone in acute psychiatric distress dropped from 11 days to three. Antidepressants and mood stabilizers were barely starting to work, often not working at all.
Then I walked into a center doing neurofeedback, hoping for an internship a couple of days a week, and walked out with a job. Within a couple of months I was watching things I did not believe were possible: seizures dropping away, anxiety and trauma easing, executive function and sleep changing in adults and in developing brains. I had to understand why. That search took me to a year of depression neuroimaging at McLean, then to UCLA for a doctorate in cognitive neuroscience, then to one of the first double-blind, placebo-controlled neurofeedback studies. This article comes from a conversation I had on The Jōrni Podcast; you can watch the original conversation. Here is how I think about neurofeedback now, after 25,000 brain maps.
What is neurofeedback and how does it actually work?
Most forms of neurofeedback are passive. You put a wire on the scalp, measure a brainwave feature (the amount of a band, its speed, its connectivity to another region), and watch it fluctuate. When the brain briefly moves in the direction you want, the system rewards it with a sound or a visual event. When the brain moves the wrong way, the reward is withheld or slowed. That is operant conditioning, technically instrumental conditioning, and the goalposts move with you. The computer chases your brain, sitting just next to where you are. Whenever you happen to shift, the brain gets new information: something happens when I drop my alpha. So it drops more alpha.
This is an involuntary exercise. You cannot really feel your brain, so you are not consciously steering it. The brain notices the contingency on its own.
My dissertation work pinned down the mechanism. I built a double-blind procedure inside EEGer, one of the gold-standard platforms, by pulling stored EEG clips off the disk, shuffling and scaling them to match a person's signal, and blending them on screen. Coughs, blinks, and unplugged wires still showed up, but the training parameters came off the stored files, not the person's brain. I then measured the evoked potential, the momentary brain event right after each reward. The brain reacts in the exact frequency range you are rewarding, and it does so within about five minutes, in everyone. You can watch the desynchronization or the amplitude burst shift over a few days of training.
The brain learns almost immediately. The mind catches up later. Most people do not report feeling neurofeedback until the third, fourth, or fifth session, and even then it is subtle: a few hours of feeling clearer or sleeping differently, dismissed as imagination, then noticed again. If you want the technical detail, the event-related spectral perturbations for the reward event are in the dissertation. They show how the machine yokes to the brain and where learning gets applied. If you train others, that signal also tells you in real time whether neurofeedback is actually happening or whether someone is too distracted or moving too much. More on the underlying logic in SMR Neurofeedback: Train Sleep, Focus, and Self-Control and the neurofeedback topic page.
Why does the field disagree about how neurofeedback works?
When I trained, the field was fracturing into three or four camps: regular EEG bands, slow cortical potentials, micro-stimulation approaches, each with its own theory and its own frequency targets. The providers were in real conflict. They all agreed neurofeedback worked, they were all getting effects better than the medications pointed at the same complaints, and their explanations were not reconcilable.
I call this a blind-men-and-the-elephant situation. Everyone has a piece that is locally valid, and nobody fully understands the thing they are working with. The field is only 50 or 60 years old, three generations of apprentices teaching apprentices, with a lot of clinical lore. There are maybe 15,000 providers worldwide, around 10,000 in North America. For an honest look at the evidence, see Is Neurofeedback Legitimate? A Research Overview and Neurofeedback for Anxiety: What the Research Shows.
Why does brain mapping come before training?
I do not love most off-the-shelf neurofeedback tools. They are one-size-fits-all, and that breaks down the moment a person is not average. There is no magic box.
Two things make neurofeedback good. The first is an assessment, a quantitative EEG, a QEEG brain map, that analyzes the brain so the work gets tailored to the individual. The second is understanding how the specific technique you are using works. When you have tools that push the brain around without that understanding, you can get side effects: feeling spacey, on edge, irritable, worse sleep. These are usually transient and wear off if you stop. Tell whoever you are working with, and just do not run that protocol again. Repeat it 5, 10, 20 times, though, and you build a stable pattern that may need professional help to undo. Neurofeedback is a place where moving toward worse regulation or more suffering is a signal to stop, not push through.
The map itself is exploratory, not diagnostic. I cannot look at a brain and hand someone a label. The research suggests a resource may look a little unusual and often tracks with a certain kind of pattern, and the regulatory systems read fairly clearly. ADHD shows up reliably in the QEEG literature, with the theta/beta ratio the most studied marker (Arns et al., 2013). The signatures associated with OCD and PTSD show up in the imaging and EEG literature too. See Biohacking with EEG Phenotypes for how those profiles read.
What can you change in the brain, and what is locked down?
Some tissue is hard to change after a developmental window. How you hear language, how your two visual streams fuse into one picture, these lock down. If you develop a strabismus and get your eyes realigned late in life, you usually see double for good, with rare exceptions.
The regulatory systems are different, and changing them is intrinsic to how they work. Sleep, executive function, sensory processing, social processing, speed of processing, the many flavors of anxiety. These are large hubs of tissue doing a job, and once you learn how a hub tunes, you can take control of it.
Rate of change is concrete in my coaching experience. You can move much of the cortex about one standard deviation against the population every 20 to 25 sessions of typical band training. People often arrive two to three standard deviations off the mean. On most human testing data the average is set to 100, with 15 points per age-matched standard deviation. Someone walking in with ADHD-type impulsivity, whether from ADHD, a concussion, or a post-COVID pattern, often scores in the 50s, 60s, and 70s instead of 100 or above. In the EEG you usually see why: the combined ADHD presentation tends to show elevated slow-wave activity and disinhibition, the squirrel; the inattentive presentation often shows excess alpha, a brain stuck in neutral, unable to shift gears. People are rarely one thing. They are a mix. More on alpha in Decoding Alpha Waves and on the attention work in Does Neurofeedback Work for ADHD?.
Is your brain pattern a disorder or a resource?
Look at the front midline, the anterior cingulate. When it is cramped up and in high gear, making lots of beta, you get perseveration and obsessive loops; lots of theta there can look like songs stuck in your head or a tic. You might call that OCD. It might also be an effective CEO. The posterior cingulate, the back midline, watches the road, the careful-careful circuit. It can light up in a lifeguard or in a parent of several kids running a chaotic environment well. That is a skill. It can also be a stress response cramping into rumination. Often it is both. The CEO can have OCD, and the same tissue is both a strength and something they cannot quite regulate.
You do not have to take it as either-or. You look at your own front midline, see the beta, and recognize, yes, I get stuck in my head, and this matters to me. Then you exercise that tissue.
Most of what we lump into labels, trauma response, the anxiety family including sensory and social irritability, OCD, PTSD, generalized anxiety, most sleep issues, executive function trouble, behaves more like regulation than like a disease process. It behaves like a muscle cramped and stuck in one position. When you do non-medication work, meditation, therapy, neurofeedback, you do not lose the strength of the cramp. You lose being stuck there. The hyperfocusing person with OCD keeps hyperfocus on demand; they just do not have to. The lifeguard stays able to keep people safe the instant things turn dangerous; they are not tranquilized, they just stop living in their gut when things are calm. That framing runs through Biohacking Anxiety and Biohacking OCD.
How do you find neurofeedback, or train your own brain?
Training your own brain is the easy part. You can stick a couple of wires to your head and run software. Knowing what to do next is the hard part. The accessible options have grown: the OpenEEG project, OpenBCI, BCI2000. You can roll your own hardware and software.
The cost has dropped dramatically. When I started, you needed two computers per person connected by a parallel cable, one running signal processing, one running the game, plus a technician. A system ran around $12,000. Now an EEG amplifier runs under a thousand dollars, software is a few hundred to a thousand, and brain mapping systems are five or six thousand. That is real money, on par with what a prosumer spends on a phone or a laptop, and the same entry point. If you are agonizing over which tool to build, get out of your own way and buy reasonably cheap hardware. The tool is not what matters. I can get you in shape with a Nautilus machine, kettlebells, or a heavy rock in a Scottish field. The kettlebell was never the hard part.
Match the support to what you want. If you are in a first psychotic break or first deep encounter with trauma, neurofeedback is a powerful resource, and you should find someone who is also a therapist. Dropping dynamite in a kiddie pool is a real risk; you do not want to monkey with your brain while running on tenuous coping. Most big metro areas have psychologists and therapists who do this. If you have done 30 years of your own therapy and you are well regulated but want more, you may not need that container, and you can lean toward becoming your own biohacker. At Peak Brain we pair neurofeedback with mindfulness as the two working pieces.
A note on credentials, because people ask. A clinical license or a board certification is not required to do good neurofeedback, and no research links specific neurofeedback credentials to better outcomes. Some of the best practitioners I know built their skill through years of practice, not a certification pathway. Treat credentials as a baseline-training signal at most. What actually predicts good work: the practitioner genuinely understands the technology and the neuroscience; they individualize from QEEG data instead of running one-size-fits-all protocols; they track outcomes with objective measures and adjust; they re-map every 20 to 25 sessions; and they are honest about non-response, which runs roughly 15 to 30 percent, and build in off-ramps rather than selling a prepaid package with no reassessment. On the money side, be clear-eyed: neurofeedback is predominantly out-of-pocket, many insurers classify it investigational or not medically necessary, and Medicare reclassified it in 2024 from experimental to not medically necessary and still does not cover it.
Why is agency the real point?
I get referrals from therapists who cannot draw the line between anxiety, ADHD, and a sleep problem, and how those are tangled and feeding each other. They are trying to sort what needs therapy, what might need a medication referral, what might be an old concussion. A brain map gives the provider agency too, not just the person doing the training.
Understanding yourself can shift your suffering before you change anything. Sometimes you see your own brain, recognize the pattern, and either know how to shift your behavior or give yourself permission to work through the discomfort. The agency alone became as important to me as the neurofeedback. Peak Brain runs an access model around this: an annual membership with unlimited brain maps so you can look at your brain under different conditions, your Adderall, your caffeine, your cannabis, your pre-workout, and learn how each one moves you.
This generalizes past the brain. Read your own triglycerides on an annual blood panel and adjust. Track your ketones on a breath meter rather than taking a keto guru's carb number on faith, because your insulin response and ketone generation depend on when you fast, how you exercise, your body mass. For sleep, an Oura ring is useful if you watch the right number. Most consumer sleep-tracker stages are imperfect. Deep sleep is the metric you can both measure with some validity and influence, so track deep sleep and ignore the rest. Biohacking Sleep covers that in more depth.
Brain mapping is painless, goopy hair aside, and it is over fairly quickly. Start there. Peak Brain has offices in Los Angeles, New York City, St. Louis, and Orange County, plus London and Stockholm, and roughly 80% of the work is virtual, with coaches available seven days a week. In the US we ship equipment and map you from your kitchen over a screen share.
A lot of what gets called a disorder is a regulatory feature with range, levers, and structure that is not hard to understand. Get a brain map, see what is actually there, then try interventions that fit.
References
- Arns (2013). A Decade of EEG Theta/Beta Ratio Research in ADHD: A Meta-Analysis. doi:10.1177/1087054712460087