#neurofeedback #brainwaves #brainoptimization Awesome Health Podcast - episode 261 In the expansive realm of mental health and cognitive enhancement, neurofeedback emerges as a particularly promising approach to brain training. It offers exciting possibilities for optimizing brain function and mental well-being. But what is neurofeedback, and how does it work? Join us on a journey through the brain's intricate pathways, guided by insights from Andrew Hill, a pioneer in the field. In this podcast you will learn about: - Neurofeedback: Harnessing brain waves for optimal mental well-being. - EEG Insights: Understanding the brain's electrical activity for personalized training. - Tailored Sessions: Customized neurofeedback journeys for individual goals and brain patterns. - Overcoming Skepticism: Technological advancements pave the way for wider acceptance. - Future Frontiers: Remote programs and intelligent interventions signal a new era of brain optimization. And much more. https://bioptimizers.com/ahp/andrew-hill-261
Episode Summary
I joined Wade Lightheart on the BIOptimizers Awesome Health Podcast to talk about neurofeedback, what a QEEG brain map actually shows, and why a technology with real but uneven evidence still sits at the edge of mainstream practice. You can watch the original conversation. What follows is drawn from that discussion, in my own words.
What is an EEG, and what are brain waves?
The first human EEG was recorded in the summer of 1924 by Hans Berger, who spent five more years before publishing because he could not believe what he was looking at, and nobody else believed him either (Berger, 1929). We are still describing a lot of this in phenomenological terms. We know how brain rhythms behave and what properties they have. We are less sure what they ultimately mean.
Most of what your brain does, you are never aware of. The thinking, perceptual, emotional, and memory work you do notice runs largely on the cortex, the wrinkled sheet of tissue on the surface. Flatten it out and you find columns of tissue, six layers deep, repeated across the whole sheet. Each little block holds roughly 30,000 neurons and a larger number of support cells, and they fire together in a shared rhythm. One song emerging from thousands of cells. You have billions of these mini-columns, sending local connections to close neighborhoods and distant connections far away, passing information back and forth.
That coordinated firing is the EEG. Brain waves run from near zero cycles per second up into the thousands, measured in Hertz. Classically we read EEG from about 1 to 40 Hz.
- Delta (below ~2 Hz) is the heartbeat of the brain. It drives deep sleep, memory consolidation, immune function, and the mechanical wave that washes metabolic waste out at night (Xie et al., 2013). Feel it while you are awake and you feel foggy and deeply tired.
- Theta (4 to 8 Hz) takes the brakes off. Around 6.5 Hz sits the insight moment, the aha of memory access. Spread theta everywhere across the cortex and the brain gets squirrelly and distractible, which is one face of ADHD. Park it over the front midline (the anterior cingulate, the CEO that selects what you focus on) and you get nail-biting and songs stuck on loop.
- Beta is the gas pedal you use voluntarily, up in the teens of Hz. When beta gets stuck in that same front midline, you get intrusive, perseverative thoughts, the OCD pattern.
You can keep walking the architecture this way. The big hubs of decision-making and experience, the default mode network, the executive network, the salience network, plus the motor, sleep, and sensory systems, all show up as brain waves you can measure.
What does a QEEG brain map actually show?
QEEG just means quantitative EEG. We measure your brain at rest, cap on the head, gel in, ten minutes eyes closed and ten minutes eyes open, then compare you against a database of thousands of people your age. We plot amounts, distribution, connectivity, and speed of each brain wave, and we look at where you stick out.
You cannot diagnose off a QEEG. Nothing rises to diagnostic validity, and that is one of the real reasons the method has not gone mainstream. People are weird, and a pattern that is a problem for you might be a strength for someone else. What you can do is read the outliers. We pair the map with executive-function testing, go/no-go style attention tasks, which puts valid boundaries on the broader features.
When I walk someone through their brain map, I show them six or eight or fifteen things that are unusual. Your alpha is doing this. Your theta is doing that. Here is what that part of the brain tends to do. Most people say, "Oh my gosh, that's me, and I care about that." Now we are in the ballpark. You do not have diagnostic precision. You have a perspective on the system and, more important, you have agency.
How does neurofeedback change a brain wave?
Take that front-midline beta producing intrusive thoughts. We place a wire there, clip the ears, and measure the beta moment to moment as the brain makes it, along with the alpha, the neutral idling frequency that sits between the gears. Both of these wander on their own. Whenever alpha happens to rise and beta happens to relax at the same instant, the computer applauds. A little auditory and visual reward. Good job, brain. When alpha collapses and beta climbs back, the game dims or stops.
The brain notices this. Your mind does not, because you cannot feel your brain waves. This is operant conditioning of brain electrical activity running below conscious awareness, the well-established core mechanism (Sherlin et al., 2011). The trick is that we keep moving the goalpost, so we only reward change in the right direction for that workout.
After two or three sessions over a week or two, you start to feel it. A surge of alpha in that tissue gives you a few hours where you do not feel as stressy or obsessy. The next day you talk yourself out of it. Then it happens again. Around the third or fourth session you stop arguing and start noticing which protocols help, the same way you learn in the gym that your shoulder wants an incline press. You learn to tailor the workout to yourself and iterate toward your goal.
Every 20 to 25 sessions, roughly every other month, we remap and retest. Without big interventions or big life events, the research finds that QEEG and executive-function scores stay remarkably stable month after month. Add neurofeedback and, in the data I have read across thousands of brain maps, people typically push about one standard deviation, one z-score, every other month on executive-function performance, on the brain markers of executive function, or on anxiety features in the brain. This is my observation across that body of data, not a published effect size.
Why isn't neurofeedback everywhere if it works this well?
I have about six answers, ranging from completely reasonable to a little conspiratorial. They are all true.
It takes work. We know how to build great cardiovascular fitness as a culture, and heart disease is still the number one killer, because fitness takes effort and guidance. Changing your brain can be faster than medication for some features, but it still takes months and, historically, expensive gear. Twenty-five years ago a system cost twenty grand and needed two computers talking over a parallel cable. The hardware is a couple grand now, but the hard part is using it well.
The origin story carries a warning. Barry Sterman discovered this flavor of neurofeedback in the mid-1960s. Running a NASA rocket-fuel toxicity test on cats, he found that some of his animals resisted seizures far longer than the rest. Those animals had been in an earlier study where he had conditioned them to produce more sensorimotor rhythm (Sterman et al., 1969). SMR is a low-beta wave that behaves like an alpha, made along the sensorimotor strip ear to ear, the still-but-alert state you see in a cat on a windowsill. It turns out SMR makes the brain seizure-resistant. Sterman trained an epileptic patient in SMR, and her seizures came under far better control (Sterman & Friar, 1972). When his early seizure work reached publication, his federal grant funding was pulled, for reasons that were never made clear to him.
There was active pushback. Through the 70s and 80s, the method drew sustained criticism in ADHD parent circles even as neurofeedback was reducing executive-function difficulties in many people. Sterman's later review of the seizure literature reported an average reduction in seizures across studies, with a small fraction of people gaining complete control (Sterman, 2000). The reductions I have read about in the QEEG data I work with are often substantial.
The research is genuinely hard to do. You do something different for every person. There is no clean way to run a placebo-controlled trial of an individualized protocol, the same problem you would hit testing personal training for the body. A gold-standard NIH human study runs at least five million dollars, and nobody owns neurofeedback, so there is no commercial sponsor. Those pressures kept it nichey and fringe. For a fuller account, see whether neurofeedback is legitimate.
How do we know the brain is actually responding?
Most of my graduate work at UCLA went into the mechanism question, because twenty years ago the field had three or four loud voices on the early internet arguing that their method was the only right one, all of them getting strong results, none of their explanations reconcilable. Blind men describing an elephant.
So I ran one of the early placebo-controlled, double-blind studies of neurofeedback. Blinding EEG is hard, because the screen reacts when you cough or move, so the subject knows it is live. Working with one of the largest software vendors in the field, I built a sham module: take EEG samples similar to the person but not theirs, randomize them, scale them, stitch them, and blend them with the person's real signal so you still see them blink and clench their jaw, while every training variable runs off non-contingent noise. The brain reacts when you reward the real frequency you are targeting. It does not react when you reward random nonsense.
Is neurofeedback really just learning?
We are not doing anything exotic with learning. We strap on a measurement loop that feeds back data points you cannot otherwise perceive, and natural associative learning takes over. It is no different from an infant doing a first push-up, seeing fourteen feet of new view, and reaching to do it again. The brain remembers the configuration of neurons that produced what it wanted. The mind does not. We simply supply the reward only for associations moving in one direction.
That makes it an involuntary shaping during the session, followed by a voluntary check later. The next day you reflect: did I like that protocol, that stretch of my brain, that area? If yes, do more. If you do nothing, the effect wears off, because each session is an exercise, transient at first. That moves you out of a "find the diagnosis, fix it" stance and into an iterative, experiential one. For more on the underlying capacity, see biohacking plasticity.
What can you actually train?
About two-thirds to three-quarters of the work falls into familiar buckets. I divide brain features into two kinds. Some are primary and lock down early in development, like language production after age seven or visual fusion after six months. You cannot easily move those. The rest are regulatory. They are meant to shift and respond, and you can train them. There are about seven:
- Sleep, including sleep quality and brain fog
- Stress, meaning the whole anxiety family: rumination, perseveration, obsessiveness
- Attention
- Social function
- Sensory function and integration
- Speed of processing, your access to information and verbal fluency
- Brain stability, where failures show up as migraines and seizures
If a feature has shape, can change, and is meant to be exercised, you can move it. So the people who come to brain training often arrive with anxiety, ADHD, trauma, and drinking too much, kids and adults alike. Then come the neurological cases: concussions, migraines, seizure disorders, major brain injuries.
Lately I see a lot of post-COVID brain fog described to me. The signature shows up the same across people, vaccinated or not. What matters is whether you are symptomatic. It looks just like a concussion, like chemotherapy, like a mold or Lyme exposure, a non-specific brain fog pattern, sometimes with more temporal-lobe involvement. You find out it is COVID by asking. In the intakes I have read, roughly one person in three who has had COVID, even mild COVID, later shows neurological phenomena. Like a concussion, it often does not appear on an EEG right away. It blooms over the next two or three months as a neuroinflammatory and metabolic-load signature emerges. This is my observation across years of brain-map data, not a published finding. The encouraging part: unless something keeps hitting the system, the brain is built to rebuild, and these regulatory features respond well to being brought back toward an efficient, low-stress baseline.
How does the brain drift out of regulation?
Picture the regulatory system as having gravity. It wants to live in an efficient, safe, useful place, in an attracting basin, not rolled up the side into seizure, sleep-all-day, or depression. Immune toxicity, a stressful or traumatic event, a physical impact, a toxin, a medication, an environmental exposure, any of these can apply steering pressure away from that basin. One or two degrees off course leaving England decides whether you land in Greenland or Miami.
What keeps the metaphor honest is that gravity pulls you back toward port. You usually have to push hard on one regulatory mode before it cramps up. Consider the posterior cingulate, the back-midline Lifeguard that watches the road and stays heads-up. We all use it. Learn that the world is unsafe or unpredictable and it cramps up high, evaluating for danger constantly. Sometimes that is appropriate. Stuck in high gear in a safe environment, that is the PTSD pattern.
The biases run negative for good evolutionary reasons. The cost of missing a tiger is your life; the cost of missing something pleasant is small, you will see more tomorrow. So we over-weight threat and loss, and the regulatory modes become their own attractors. Your posterior cingulate learns sharks exist and starts hunting for sharks in an indoor pool. A lot of what we suffer from, anxiety, stress, sleep, attention, cravings, is regulatory, and you can reframe it, take control, and feel those circuits change.
Cross far enough out of the basin and you get the extreme events. You can dehydrate someone, or give them amphetamine or certain antidepressants, into a seizure far more easily than you can frighten them into one. You can startle someone into a faint, the vasovagal response, where the vagus nerve drives a huge physiological collapse, the same mechanism as a fainting goat freezing and falling over. Those edge states, an active seizure, the failure to come back to ground after stress, are where you move into dysregulation or illness. Still tractable, just harder to climb back out of.
Can neurofeedback build new capacities, not just fix problems?
Constantly, and more often than people expect. A lot of clients move from fixing into flow state and high performance.
I see this with high-powered, type-A CEOs in their mid-fifties: successful, obsessive, anxious, sleeping poorly, a bit rigid and brittle. We work on sleep, anxiety, optimization. Six or eight weeks in, with the primary goals looking good, I blend in some access-to-consciousness and generative-creativity work using Alpha-Theta and alpha-synchrony training. Then their spouse emails me: what did you do, he brought me flowers, he made dinner, we had the best conversation. If you could not put your emotions into language, that resource starts to come online. I have had some success coaching around aphantasia too, the inability to visualize, which affects something like one in twenty to one in thirty people in some form (Dance et al., 2021); alpha and visual-tissue work during a technologically assisted nap can unlock a little visual experience and softness.
I do not chase states. Neurofeedback does produce state shifts, and you often feel a little different right after a session. One client described her first Alpha-Theta session as "uncomplicated joy." The state is nice. The trait change is the point. I would rather train across weeks and months and build multiple standard deviations of durable change as a resource, slowly enough to consolidate it, than create a one-time experience.
I also work with a lot of athletes, NHL, NFL, UK footballers, divers, usually after injury and an out-of-play protocol. You can see the concussions, and you also see the stress, executive load, and poor sleep underneath. Clear those and a player tells you he feels better than he has since before his first high-school concussion. Part of why the whole brain improves is that a single session of EEG self-regulation has been shown to enhance subsequent procedural learning, with research linking neurofeedback to a window of heightened plasticity (Ros et al., 2014), so the specific circuit you are shaping gets sharper and everything else you do lands harder too. The work touches on memory, intelligence, and learning for the same reason.
Can you train from home?
Yes, and most of our clients do. My goal is to sell you agency, not necessarily neurofeedback. I want you reading your own brain map and taking some control.
Peak Brain has six locations, four in the US (two in Southern California, plus St. Louis and Manhattan) and two overseas in London and Stockholm. Those offices see about 20% of clients. For everyone else we ship the equipment and run remote brain mapping, the cap-on-the-head part few people do remotely. Coaches run your gear with you over a private channel that stays open seven days a week, staffed by actual coaches, not a bot or call center, ready to place a wire, troubleshoot software, or develop a protocol for a new goal and have you report back on what you notice.
The fee structure runs lower than therapy rates, about half the average therapist, in your home. In the countries we serve there is nothing to buy; you run a service program for a few months and we send whichever gear fits the goal, blood-flow training for migraines, heart-rate-variability training alongside EEG for anxiety. People ask whether it works as well at home. The quiet advantage is that we encourage four sessions a week at home rather than the three we run in office, so you can complete around 55 sessions in three months and go further than you would in an office, at no extra charge. For the money side, see neurofeedback cost in 2026. Be honest with yourself about the money, too: 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" while still not covering it.
Where is neurofeedback heading?
Everything depends on the brain map, and the map today is an artificially static snapshot: one person, one morning, no caffeine, compared against thousands of others. People vary more than that.
The first step is longitudinal tracking, a fitness tracker for the brain. Index your alpha speed, your cannabis use, when you took your Adderall, all against brain measurements over time. That gives us a wild-type database of real variability instead of an illness-versus-the-middle-of-the-bell-curve model. I have software in progress on exactly this.
The next step is intelligent avatars. Between generative models, machine-learning models, and what we now understand about the brain, I think we are close to standing up a model of your brain and test-driving interventions on it. Give the model Adderall and watch how its executive function reacts before you put anything in your body. Research has shown that QEEG can help predict antidepressant response, with frontal EEG changes appearing about a week into treatment that forecast later clinical response (Arns et al., 2016). The frontier is testing the intervention space against a rich personal data set and modeling your transformation before you run it.
If you are on the fence about brain training, go do it. You learn how your own system works, you get the data points, and you take control. Start with a QEEG brain map so you can read your own outliers, then train the regulatory features you care about and remeasure every couple of months.
References
- Xie (2013). Sleep Drives Metabolite Clearance from the Adult Brain. doi:10.1126/science.1241224
- Sterman (1972). Suppression of seizures in an epileptic following sensorimotor EEG feedback training. doi:10.1016/0013-4694(72)90028-4
- Sterman (2000). Basic Concepts and Clinical Findings in the Treatment of Seizure Disorders with EEG Operant Conditioning. doi:10.1177/155005940003100111
- Dance (2021). Something in the air: gathering dust that's crossed an ocean. doi:10.1038/d41586-021-03706-w
- Ros (2014). Mindfulness and emotion regulation--an fMRI study. doi:10.1093/scan/nst043