🧠 Neurofeedback Q&A: ADHD, Medications, & Brain Mapping Insights | Expert Panel Discussion 💡

for some unknown reason YouTube YouTube won't let me do it I I just says oh there's something wrong it must be at YouTube I have no idea what they're talking about you can see it from inside streamyard though right got me on the right hand side in the studio is the chat I think that's how you have to enter it if you're yeah no I've tried I I've it says join the chat and it just gives me an error message every time I'll try it again connect there are no errors in this room Anthony Ramos why don't you kick everything off well hey there uh this is intended to be a live Q&A for uh anyone interested in neuro feedback I know that uh many clinicians listen but prospective clients people just curious are always welcome and we have a very and users and users so Joy L do you have a disclaimer we don't know nothing don't listen to any of us obviously this is this is more for information not Direction in your own personal treatment we are not interested in being your doctor or being your therapist we are just here to make sure that if you have questions regarding nuro feedback something about you and whether you're appropriate for neuro feedback we're happy to entertain that based on the experiences that we all bring today we are here to make your primary care physician uncomfortable not me we're here to make your your own expert in there a feedback if if you guys don't mind I I've heard Dr Hill mention that he's got a a few um ways that you can address the skepticism when they ask you questions about the research and some people say it doesn't work I don't know if you've discussed this before but I would be interested to learn more about it yeah I'm working on a more comprehensive review specifically for ADHD because I'm getting a lot of push back from people are saying but Dr Barkley says um and there's plenty of research out there for ADHD so I'm just trying to collect it in a prepare the apologist sort of perspective well before I share that piece of it um in general though there's a bunch of very sane and obvious reasons why the literature lags behind the clinical impact by what I consider decades um one is that most of the clinical work is done in an individualized way where you do assessments you start someplace and then as you do neuro feedback you iterate in a in a direction to do goal congruent impacts and you change what you're doing over time as the person has different goal priority progress and symptoms Etc and so what you end up doing is also varied and tends to be quite different one person to the next you two athletes walk into the gym with similar goals different personal trainers may have a different path to get you there and all of the research pretty much this there are a couple papers that have exceptions but pretty much they do the same protocols to groups of people they don't individualize as they go um there are a couple that do individualized alpha frequencies but for the most part it's uh small groups of people doing the same protocols you know maybe two groups reactive uh comparisons and then you have this short-term number of protocols too it often takes 30 40 50 100 sessions sometimes for making really big changes where you can measure them on a bell curve uh at the individual level and this just breaks down when you do the same thing across groups of people so one is the lack of indiv individualization meaning the research does not reflect what we call neuro feedback as done by clinicians mostly it reflects The Cutting Edge 1978 of neura feedback pretty much you know uh it's to your point Andrew it's it's the nature of science and I think there's a you know difficulty for the the Layman to understand that science if you're studying the effects of a medication you have to rule out as many possible variables as you can to to get an accurate testing of the effect of a medication makes sense in neuro feedback same thing you know Ruth lanus will do pz down because that's the protocol she's testing it doesn't take into effect what you're what you're saying is clinicians using their skill set to do different things with the same goal in mind to reduce the client's PTSD symptomology and that that is an I don't think it's a soluable problem not like testing discret you know AB protocols but you've already touched on the second question there which is you know studies are done for medications right you can do blind Placebo control you can do active Shams you all kinds of stuff the average size of a you know tier one level study these days gold standard about $5 million um and that's a fairly simple study with drugs well who owns neuro feedback who's going to spend five million to do the kind of studies even if you could do them with simple models which you can't so it's a very expensive landscape you know Hill decline in terms of the investment in the field a bunch of nichy software and Hardware providers all playing in their field with very little pressure to create at least historically you know the tools are relatively primitive in terms of computing it's starting to change a little bit but not not not rapidly um not landscape uh wide so we have the inability to do tailored work in some ways in the literature we have blinding Placebo control as a as a as a problem in the literature it's been very hard until recently to do sham controlled neuro feedback placea controlled I did what was the first or second study that wased a controlled for my dissertation work and did the research in 2009 2010 really recently for technology that's 100 years old for EEG 55 plus 60 years for neuro feedback just doing our first Blinded studies a decade ago really 15 years ago kind of old now but like that's pretty recent for this kind of stuff so that's three reasons four there was a lot of well poisoning that happened a lot right in the 70s and 80s sterman research was in the 90s kept going right it hasn't stopped hasn't stopped yeah right but initially there was a lot of push back from epilepsy uh Landscapes on sternman's work and then we got pushed back on ADHD medication Provider from medication companies on the Chad you know sending full sending two for a couple years they had full-time two Physicians being sent full-time salaries to Chad meetings to tour and just to poo poo know a feedback the ADHD meetings their friend Dr Barkley yeah well he may be outgrowth of that yeah and then I guess my last more common I'm sorry he was way involved in the 90 95 or so so you know he's now seen as the world leading expert in ADHD so I mean a lot of the people who are ADHD Barkley Barkley had a a researcher who he worked with Sandra Lou Dr L and Sandra Lou's done some very nice work um in metaanalysis uh on addadhd in neuro feedback and on medication and has shown that ADD ADHD treatments are equivalent to medication as far as the the the the efficacy power and um but a lot of what you've been saying is almost arguments against the field it's too small they're not the research isn't perfect and whatnot I started in the field before there was any efficacy proof of anything and um if the technique didn't have dramatic power I would have gone to do something else I've been in the field 52 years I've see it argument though when a parent comes and says I I can provide for ADHD I can provide briefs that were designed to take to insurance companies to demand parody the good news is that the administration at this point has uh set it up so that Health Care uh providers have to provide uh parody for mental health uh now it's going to be challenged obviously aggressively uh but now the standard is that they have to provide it and uh we can show uh uh efficacy level proof uh in uh in written material that's been peer reviewed and uh have it adequate to uh meet the uh guidelines for uh for Medicare uh but it it's it's going to have to be challenged and it's going be challenged basically uh uh as a class action circumstance where it won't it won't move forward why why is that evidence not percolated to the clients who phone us up they they're they're not find yeah they're not find I send it I send it to people all the time um I think I think if they go to Google Scholar they would be inundated but Santiago's point was like how can we make this to the public Andrew I have a question for you when you're putting together all this information for the families the parents right yeah do you have a sense that they're actually reading any of it um yeah because I don't give them a a a 20 paper review you know I'm trying to figure out right now the best way to do that in a way that is not me droning on you know and and some of that is like like how do I become an educator in Psychology better for this topic I'm trying to figure out the pedagogy here to like communicate some of the concepts that I don't see communicated well um but I mean just just to finish the last reason why I think we don't uh have adoption why don't we all have amazing cardiovascular health and abs I mean we kind of know how you know there's a there's a it's a process it's expensive it takes a minute it's Progressive with you know with some of the many of the things that we treat so to speak or train with neuro feedback there are medications for and so a shortcut or a pallative mechanism to not have to go through all the hassle and the stress and the effort for the sweat effectively so that's my last reason those are five I think reasonable reasons even if a couple are apologist about the quality of the field being a little bit yeah uh NY still so I would I would say bottom line for the people for the viewers and listeners is number one invite your friends to come to this live Forum if they're interested in learning about neuro feedback and they're on defense because I think this is important for people especially on defense about it it happens to me all the time I want to do Nur feedback but the jury is still out so you can get your answers here bottom line is does neuro feedback work yes it does is there research to support yes there is now I think that it's also important that we talk about two components to the neuro feedback one is um the conditions it can help so I think that we can all contribute here by talk by telling people people both from a research perspective as Jay says and then from the anecdotal subjective perspective because in my experience at least I have I remember many years ago Jay you helped me look at a case for cerebral PSY and they came I had never worked with it before I didn't find a lot of research I said to the family this would be experimental at this point we did work and the client got better you know got better it were they back to being quote unquote normal neurotypical no but the kid learned how to play the piano and and learned how to read and write and did a lot of magnificent things and so for all of us we've taken on cases in which we say this is experimental and we see good results and then we have the research so I think it would be important for people to learn what conditions that's neuro help neuro feedback efficiently help based on research and which ones we've seen anecdotally and subjectively where we can possibly help and people can have some glimmer of hope it may work it may not but at least they can take that leap of faith and try that's a nice context Santiago you know it's none of us are in the business of curing anything I think that's just you know something we should never actually say out loud doctors get to say that perhaps I'm not comfortable saying it I'm comfortable saying that I I am of faith that neuro feedback will have impact on almost anything that walks in my door that's brain-based you know I I I I I don't know for sure I probably can't prove it there may not even been a scientific research done into it I had a guy call me up with something I'd never heard of before and I'm going to mispronounce it of course and it's called um enph myelitis myaa H Jay Jay I think I may have actually asked you about this but it's that's crossed my path how would I it's an extremely rare brain disorder but do I have faith that the techniques that we apply to uplifting brain performance would have an impact for them I do I I don't know what to what extent and I and I said that to him clearly I have no idea it's worth to me it's worth a shot I've seen more mysterious things happen and I've heard anecdotes and stories from other clinicians about successes that they've had with seemingly intractable fill-in the blank so I I I just think the technique of neuro feedback is so profoundly uh General and specific at the same time that why not try it you know it's not a medication that's going to make you U you know break break out in hives there's there's not a lot of quote unquote negative effects to what we do here it's it's a it's a training it's a skill acquisition training platform give it a shot but John John you don't want to give an end result but the parent wants to hear an end result what end result can you give to a parent when you have a kid coming in bouncing off the walls and you go down a list of efficacy they want to hear what how long will it take what can it do or should I just take a pill I'm gonna step in yeah we already know the answer about the pill no no I I love I love the Pete I don't think I've ever had a phone call with somebody asking questions about n feedback that didn't say how many sessions will I need let me ask you a question have you asked your psychiatrist the same question how about your therapist how about your Gardener do any of those people have a hard and fast number for you there's very little in the world your orthodontists can't even tell you exactly okay so I approached that question from that aspect there is no reasonable answer I haven't met you yet I can't even take a guess what I do tell people because they have to have something if you come into my office and you have uh a garden variety limited to add situation it's going to take us somewhere around 40 sessions to get to the point where you've got your improvement but beyond that I'm assuming you want this to stay so then we're going to have to tit trate away from it and make sure that your brain can hang on to this new capacity so I'm doing numerical measurements every session of every frequency and I'm looking every time you come in did you hold on to that did your brain remember how to do that and are you getting the same gains because if you get those gains and your numbers look good and you're getting two weeks between sessions I can tell you confidently that 25 years from now you're going to send me a postcard or send say hey I'm still doing great so I think we have to be less shy about having to limit ourselves to how many sessions it will take you know i' I've started telling people the concept of 20 sessions 40 sessions is a myth you know don't read that and assume it applies to you so I don't know whether you're seeing the streaming screen we are yes are uh so um uh this document is let me I've I've got to go to the doc myself as opposed to the streaming in order to stream it but the document is uh from 2020 is professionally produced uh uh the um and uh this is essentially a a brief uh intended to be uh an argument for the use of neuro feedback and Behavioral Health and it's very well constructed Ed um uh I have a disclaimer that I've got a piece of this but you can see Martine ARS who publishes everything everywhere David caner who's you know brilliant and has been in the field as long as I have been um uh it and um Donna Jackson she she's the um angels and assassin author uh Fred schaer obviously bcia folks should know him and Mark who who is probably one of the key uh people to put this thing together uh so um the it it an executive summary but it's u a general introduction about neuro feedback um evidencebased for ADD ADHD uh they do a very nice job going through uh uh there there's a gigantic document here uh uh looking at the research uh how long does it last uh um how how can we get better access to it uh this is um details of how it works the this document is something that I hand out and in the appendages at the bottom uh you know basic stuff with different brain waves eug electrode placements Al this is a a great resource to hand to the doubting uh parent uh and it covers add and um and it covers it I think really quite well so um I would uh I would suggest um that we're not without resource to hand to folks it's just that a lot of folks in the field don't necessarily track all the documents that are available and again this is 2020 it's only a few years ago that it was produced um and it wasn't produced necessarily to be distributed to people in the field it was specifically to uh to to argue in front of insurance uh panels so anyway Jay I've never seen that before it looks amazing can I get well a can I get a copy B can can we distribute this freely yeah and yeah yes you know amaz amazing I I I I've never tried to bury stuff under bushels I I've tried to uh you know Shine the Light wherever we could uh including sharing it with folks uh on panels like this so yeah no it's it's is it on the andr homepage I haven't been involved in isnr since un able to travel so that was that was rhetorical you know I'm past president but I I I'm I'm amerus on everything I'm retired retired so right uh you can't expect me to be out there doing the lifting at this point my tissue won't take the heavy lifting anymore I've been on St for 35 years now uh hell u i i I tried to bump the screen door open a little bit I got a gigantic hematome on my forearm on the other side of it here uh just I just just touch me and I break so um you know I I can't do the heavy lifting but I'm I'm more than happy to kind kind of Point people towards some of the resources well please I'd love I'd love a copy think it's important Futures John the name of the company is brain I can go I can just go download this okay I'll I'll I'll email you a copy of half one very Pro neur feedback friendly it's not all they talk about but they are very friendly and supportive of neuro feedback yes awesome so somewhere along the way efficacy comes in there and there is an implication that there is an endgame to whatever the symptom is is and when a parent goes in and you tell them well I don't know what it is I understand from the clinician point of view but from the parent point of view we're being led in there because we think that hey for ad D ADHD there is 20 sessions or whatever it is there's a number in there and there's a book that you go to that says well you have ADHD here with a five and you have autism over here that's a two or a one one of them is easier to train easier one is harder than than the other how do you explain that to a parent by by not being tied to the diagnostic label and that also gets into John's perspective about not treating not being doctors in this role not being medical if we instead of talking about the DSM labels talk about the brain resources themselves which are underneath the level of diagnostic label they're still valid but I can talk about your rumination perseveration inattentiveness your impulsivity your speeder processing yada yada yada and valid and you can show someone that resource in data and what I tell them is we make about a standard deviation of change on the qegs on the performance testing on in the thing we train every 20 25 sessions on average and that actually UND shoots you know I give them a little that's a somewhat conservative guess and tell them if there's big brain injuries or maor illness or developmental stuff it can move half that slowly often schizophrenia lack of lack of proper nutrition I'm less worried about diagnosis than I am about prognosis I mean right diagnosis you have to talk categorization and that that's that that's you've got to do something like that just to get paid but um and and uh EG qeg is not very specific so we're not going to have uh proven efficacy as well as we're going to have proven clinical utility and uh we have tremendous clinical utility in and managing brain function we can uh uh teach people to stop having seizures we can improve add we can improve attentional skill sets and affective skill sets um we have great clinical utility uh I I'm not worried about the diagnostic specificity because that's to match to a standard that's what parents are Googling when they're looking for stuff you know so and and the the doctors who are going I mean imagine being a psychiatrist and you've been told that the the the ground you've stood on for the last 50 years of your career is now not valid what how else are you going to work you know that oh well we're not going to do DSM we're going to do ICD the ICD codes well that's behaviorally based categorization of another categorization set it's it's no different so so I'd like to talk about what Pete asked about because that's what I do every day in my office I work with kids I work with families I work with people saying this is GNA make it so we can't have a summer vacation is it really worth it I mean that that's kind of at the end of the day what you want to know right Pete so here's what I tell people look um no one and and I do speak of over 30 years of clinical experience no one has ever said to me can you make the diagnosis go away I get that question all the time they're they're they're not interested in making the diagnosis go away I get that question all the time seriously and I have to backpedal and be careful with it but I get that question every single week weird every single week someone says is it possible he won't have this diagnosis in a couple years every single every single week some parent ask that question about their kid because they care it's got social status it's about tracking their the teachers stop calling me after school and complaining yeah make them have a reasonable report for me at the parent teacher conference make my kid go to sleep in less than three hours a night make them and they have specific life problems that they're worried about and that is something we can track because I tell them all right you need to pay really close attention how long did it take him to go to sleep last night and if you tell me it took three hours and that's typical okay but it has been my experience that a lot of parents need help with this because they're busy their lives are overwhelmed I had a family come to me their son was very add very over the top and we did 20 sessions and I'm thinking we're doing great they didn't have much to report because you know they have three kids and they're busy but I'm thinking yeah but walks in the room and he just sits down calmly and he sits in the chair this is progress I can see it okay they came in after 20 sessions and said yeah we really haven't seen much help so I think this is gonna be our last session today I'm like okay that's fair can we go over some of the things you told me in our initial evaluation sure we got to the question about sleep this kid made the whole family go upstairs at 8:30 at night and go to bed because he wouldn't do that by himself then he spent the rest of the night visiting everybody's bedroom one at a time waking the whole family up at some times another during right okay so I got to that question and she said just a minute my husband is out in the car with the rest of the kids we'll be right back turns out the kid wasn't making the 8:30 bedtime every anybody he wasn't visiting hous and he was just like they're like we forgot to notice that yeah a question again it really has to do with people being conditioned to to get a diagnosis people are so used to getting a label it's hard for them not to to comprehend that that's not the the whole point about this now what I would like to say for the listeners is when people ask why a brain map why your feedback is why do you want to get a brain map we want to provide a brain map service for you to help you understand why why are you feeling this way why are you acting this way why you behaving this way way and how that's impacting your life because people a client may come to us and say I have been diagnosed with ADHD I have been diagnosed with depression I have been diagnosed with generalized anxiety disorder I have been diagnosed with PTSD and you name the initials they will bring them to you I tell them okay let's take a step back first of all what is depression to you yeah I feel sad well a lot of people feel sad that's mean that everybody's depressed so let's see how it is manifesting in your brain for you I'm not comparing you to the rest of the population I'm talking about you okay we've all seen cases where people with depression have epilep form discharges in the EEG they've never had a seizure they've never had a convulsion but it plays into their symptoms and how do we address it we talk to the prescribing professional and we and the prescribing profession professional suggests an anti-convulsant it's very counterintuitive and a lot of people will say anti-convulsant for depression well that's why we do a brain map because that's how your brain is manifesting it and now we know what how uh what it will benefit from and so that's very important for people now the second thing is the price versus the cost the cost is how much money are you paying for our service and how much are you paying us for us to work very hard to help your brain so neuro feedback will cost you x amount of money and that's what people consider but people don't consider the price which is the price you pay for not doing anything about it how much will it cost you financially not to not to train your brain how much will it cost you emotionally behaviorally at how much will it cost your family how much will it cost Society for you not to take care of your brain how much will it cost your your siblings and your kids and your relatives and your friends that's what people need to consider here you're paying yes you're paying a lot of money because neur feedback many times is not cheap but you compare it Anthony go guys we have a question from trist and uh so once we agree on the efficacy of neuro feedback can we agree on the most efficacious form surface amp or zcore this was the question no such thing I would like Tim to ask I like Tristan if you're still there I would like you to tell me what criteria we might use because at the moment this is a conversation that clinicians who've been doing this for a very long time are very interested in and we have zero research we have zero answers for you if you take Loretta zore um anything the stimulant the the lens all these if you take them all you're going to have to compare them let me reframe their question here does carpentry work well if carpentry Works what tool is best well it depends upon what you're trying to do uh and and sometimes a hammer will be the thing but sometimes the screwdriver sometimes the saw you might have a plane I mean there's there's a gout I mean there's so many things you know and the a a really good Carpenter will have a tool belt with lots of tools that they're very good at using and they can create masterpieces you can sometimes uh find these people in clinical offices uh not labeled with carpentry above the door but with neur feedback above the door and and the thing that they're working on isn't a block of wood uh it's it's an organic uh living being that has to be optimized and you know it it's going to take a a variety of different tools for different tasks so U you know uh find out whether the person that you're considering going to has experience in the area that you're uh considering having treated and what tools they might use and how did they get experience in that uh who's their supervisor or Mentor or Su you know you treat it like a a field like carpentry and the tools the that's basically what you're asking here and uh at this point depending upon what you're building you're going to need different tools sorry John but you also have to be mindful of the charlatans because there are people promoting things like neuro feedback that are not neuro feedback and they're very dangerous and we spoke about this I think two weeks ago so yes but you have to make sure that your clinician is credentialed and is doing ethical and responsible work and is using equipment that is state-of-the-art and is considered uh you valid clinically to work with you because you could work to anybody with a with a headband and they're claiming to do near feedback and they're charging you twice as much and you're falling for it and then you in the end you don't get any better or you're going to get worse I was going to ask if Tristan part of Tristan's question about efficacy are we looking for result are we looking for Speed are we looking for cost what are the elements that that prompt that you know it's a complicated conversation when when you ask about efficacy and Tristan if you're still on the line if you can perhaps elaborate on the on your the interest in that question what is what is the efficacy measure that you're looking for uh you know we still can't answer it Andrew was Andrew last I think it was last week or the week before was very eloquent about talking about in the hands of a good clinician tools just work they just work you know it's not a matter Master versus something else you know you can for many goals you can get a lot of impact with almost any tool set and there are a couple of you know ways where things can get easier for certain tools but I don't know all the good clinicians I know are have the ability to do work with whatever tools are in front of them you know given amazing musician a crappy guitar and it sounds great if somebody doesn't know how to play music An Elegant guitar and it sounds crappy so all right hold on everybody if if the hammer is neuro feedback and the nail is ADHD okay I Dr Hill with your scenario if it's a four cord song that takes not a lot of time to learn can't we go to somebody can't we go to a parent and say you know what if somebody has labeled your kid with that broad brush of ADHD ad neuro feedback the efficacy is a five right you should be able to alleviate the symptoms in a shorter amount of time compared to autism can't we say yeah I I that's true I don't say should be able to I tell people what I've seen it's slightly different and another piece that to use Jay's analogy of carpentry if neuro feedback was as old as the hills the way carpentry is we would have better answers but we're still we're still barely out of our toddlerhood and the fact of the matter is Tristan if you go to somebody and they say oh the um the the zcore training is the best thing in the world for depression they don't have a leg to stand on we don't know we literally don't know the best you can do is say that provider has seen great results using that tool for that particular presentation yep we we haven't done any research to show that the hammer is good here the screwdriver is there good we haven't we're still trying to figure it out so look like a toddler if if you if you rate our experience level and our knowledge level yes I wanted to get back to something Santiago was banging on a moment ago about costs and there's a bunch of data out there research actual research data on the costs of mental health it's in the trillions of dollars this is not a small matter so you know to make it personal about you got your family to consider I'm about to spend 5,000 10,000 $20,000 on neuro feedback treatment if I don't to to to to Santiago point if I don't deal with this what am I 40 years from now in my retrospective analysis of my life I'm going to lose 40% of my potential income I'm G to probably end up divorced there's a whole bunch of true hard statistics on people going to you know untreated mental disorders of All Sorts higher rates of incarceration higher rates of divorce higher rates of cardiovascular events it goes on and on and on it's not just the disease model I get people all the time that are Traders and that are like golfers and other Elite athletes where if you give them a slightly less reactive mode and more sustained Focus they make twice as much money that week exactly like literally oh thanks Andrew I just made an extra 100 Grand this week because I wasn't chasing my loss yesterday I feel so good oh awesome pay me more buy buy more Nery back you know y AB a good point is the flip side of that increased uh potentials that people are going to have if they do this they think they're fine you Peak performer you know the Peak Performing crowd you know Santiago's talked about that as well you know the delicate balance that has to be struck between I have a client right now who swears his success as an attorney is due to his methylphenidate and I'm sitting here going I I'm not sure how to answer that you know is but it's not the only tool he can use to get there yeah well that's true that's number one but he has paid a cost for it on the other side his his interpersonal relationships are in a shambles because he's he's unable to disconnect from his workflow into his actual life flow you know that that that the Flow State Dynamics question of turn the light switch that can turn that is available to be turned off and on when you need it that neuro feedback can provide you the skill set to be able to do that that the methylphenidate cannot you're always on that was my question regarding cost you know I'm going to play Devil's Advocate uh back to Pete's question about if I'm a mom and Andrew Hill Dr Hill brought this up too um medication does work for some people you know and medication itself is as I understand it may not be that expensive so we're telling them you need this many sessions this is the cost why should the mom pick neuro feedback over medication that's being offered which medication yeah you know uh let Let's uh let's take a let's take a peak uh at at medication and we we also don't get a good picture of that today's GNA tell us about that kind of stuff so in 2005 Jack Johnstone arranged a day at UCLA Andrew you might have been there um of qeg and neuro feedback and the heads of many departments at UCL attended and one of the heads of the department was the head of the child psychiatry Department Ken and at the end one of the evaluations they were they were very cordial and they were all very willing to accept Nur feedback as a good tool but the child psychiatry group said look we need something beside these medications because it turns out none of these medications have an effective life beyond five to years and if you start using them when you're seven years old by the time you get to College they you're out and you haven't learned how to do any of the things that you need to do so part of the medication story is they'll take care of you for a few years and then you're stuck and there's studies showing that one which one of these medications might you respond to methylphenidate rlin is a dopamine reuptake inhibitor and it works if you have Theta prto centrally but viance and Aderall are amphetamines and they don't work for that frontal Central Theta they work for slow Alpha at the back of the head uh if the alpha is slow and you need an Agonist that's but if you don't need an Agonist if you're only slightly slow a stratera reuptake inhib might be working provigil works for people that have a primary disorder of vigilance they just can't stay awake it's like narcolepsy without a cataplexy and it's not the same as the other people that need the other kinds of stimulants some people have beta spindles and they need guanosine or clonidine to reduce the beta spindles or they might need something more potent for a worse beta spindle like Gabapentin which start to get into the antic convulsions and you might have discharges in the EG and need an anti-convulsant a third of the anti a third of the ADD ADHD population have epilep form discharges uh you might end up on a more potent anti-convulsant uh people sometimes are given uh lithium which reduces beta but it potenti discharges it's an antimanic compound um oxytocin reduces mu and enhances social bonding and then there's the people that actually have frontal Alpha and they respond better to an anti-depressant and SSRI um if it's just regular Alpha snri if the alpha up there is slow if the alpha is faster than 10 or so than a tetracyclic and beta can be reduced with um anti- psychotics as well but they potentiate discharges and if you have a third of the people uh with discharges you have to be careful handing out an anti psychotic based on the behavior of add simply or or maphil it's important to point out when you mention ADHD and M and on the same breath that that pigil has a dramatically increased risk of side effects in ADHD because of the histamin component if you look at the first paper on using mapol off label called something like approved investigational uses the dropout rate when used with ADHD was Triple that of non ADHD that's when you use it for the diagnosis as opposed to the right person if you have a primary disorder of vigilance that's what you need so it's not the same as having add that that's again people in a diagnostic category and being given a medication for the category when it's only appropriate for a small subset that's today if if if Dr Hill and I today whipped up a batch of meds in the tub like bathtub gin and it it brewed up really really good people would believe it from us that's the thing Jay we have to be careful like we are crazy iconic lasts with if it could fix 20% of the of the autism population perfect so that they couldn't be diagnosed at all with one dose how could we prove that it was work would work at all I mean 80% of the autism population wouldn't respond to it so what it's a waste of time no it's the right drug for the right subset now all we need to do is be able to find a pattern in the brain that tells you you need this bathtub gin batch not that bathtub gin batch and you you end up with matches to the patterns if Psychiatry examine the organ that they treat and they don't uh we'd end up having better outcomes and fewer side effects and U Less uh less problematic withdrawal uh it's it's it's an unfortunate circumstance but Psychiatry doesn't really look at ageg traditionally the few psychiatrists that are getting good at looking at EG even call themselves neurotherapist Jay you brought a bathtub Jen I'm want to ask the panel this question maybe Google will pick it up and we get a bunch of people to watch this your choice is beer weed silos cybin which is the best of the three for your brain GH makes the poison so it depends on what you're talking about are you driving well well are you taking it for an intoxicant are you taking it for plasticity booster are using it socially are you self medic if you if you ignore all the other stuff siloc and actually has some positive effects on lots of brains not all uh people that have epileptiform content in their EG or gigantic greater than 20 microvolt beta spindles need to be cautious of of entheogens the the the likelihood of a bad outcome with ketamine dmts psilocybin uh iasa which is DMT from a plant variety but any of those can end up having bad outcomes and you your likely of a bad outcome is potentiated with epileptiform content and beta spindles which also are the two features that predict medication response most likely in any medication so it's not surprising that they predict bad outcomes in inoc L and cocy and everybody because I don't know I'm just the guy that edits this thing but the closest thing to neuroplasticity is you're trying to reroute things isn't LS and psilocybin the closest thing that can help your brain versus beer and wheat there's an assumption there though that you need more plasticity you don't generally you're making plenty of cells every day the cells can move around every day you need to shape your plasticity but a lot of my biohacker clients I back off on doing all of the things all at once because you you create too much plasticity you know I I get clients all the time showing up with side effects from having done too much uh Lion's Man Mushroom because it jacks up bdnf so high they get side effects depersonalized sexual anhedonia stuff because of the plasticity so high without shaping the system reorganizes into a blunted state and this can happen with like you see this with Elite athletes or Elite musicians With A fine grain skills you can over practice and lose your skill because of the plasticity just wiping away the acquired deeply learned skill happens in very very elite overtrained people where The Pianist can't play anymore when she hits 16 because she's been playing four hours a day for her whole life and suddenly the brain's like screw you I'm just wiping away all the learning and this can happen so the plasticity is never that constraint unless you're dealing with an acute phenomena I think there could be cases where it's worthwhile using but I would say for psilocybin people are better used the better the better use of it might be in the heroic shamanic exstatic landscape not the micro do every day to boost my plasticity dude sit and meditate like take 10 minutes go for a walk do some neura feedback if you want to get fancy you don't need to Source risky psychedelics and dose every day it's just not a reliable way to control your plasticity that's my Singapore what do you gotta say it it all comes down to I think uh since we're speaking about medication is which one is healthier for you but you have to pay the price for versus which one it's unhealthy for you down the road that means if you think about you want to gain muscle which one is healthier for you lifting or shouldn't have the steroids of course weightlifting is going to take a long time you you have to work hard you have to earn your way you can do steroids but what's the risk that you're running by doing that it's more dangerous to me in the neuro feedback real a lot of people do need the medication but the way I see it for many people is they opt for the medication because they want the easy way out neuro feedback takes time it takes hard work and most people well I wouldn't say most people a lot of people today want to circumvent the hard work any which way possible you know I want to I want a bioh hack with by listening to uh to Ping sound so I want a bioh hack by you know submerging myself three minutes a day in ice cold water doing this type of breathing you know you have to understand that for you to get better mental health it takes hard work you go up and down you have to sacrifice things okay take the medic ation down the road like Joy says is not going to work for you anymore you're going to need a higher dosage you're going to experience side effects are you gonna be happy then is there is there are medications necessary yes long long term longterm no for what for what question no okay no no no I'm with you I'm with you I would be dead without meds no no no no no no no okay living through meds used to be the phrase now simply living through meds I you know okay but in that scenario J let's say some a kid with ADHD do they need reading for the rest of their life right that that's anxiety depression but wait but John okay go back you're you're assuming that if I take this medication if I'm 10 years old let's be ridiculously reasonable wait till they 10 um am I go am I still going to need it when I'm 25 well if you depend your behavior on that medication you're still going to depend on it when you're 25 the problem is you will not be metabolizing it the same way your brain will go that's not impressive anymore I don't see any difference so you'll probably end up with more side effects Less Pleasant kinds of aspects of it this is just the Simplicity of the medication that we're dealing with for ADD and ADHD quite honestly what do we have you know we have people walking around I I get this a lot people have been on their anti-depressants for 12 or 13 years and they're but they're not really happy with it it's better than it was but it's not great so they come for neura feedback and during the course of nura feedback before I caught on these people suddenly decide they're much better and so they just stop the anti-depressants and the consequences of doing that suddenly are often so bad that the people go right back on them because they cannot tolerate it exactly so it has to be tight traded it has to be done very carefully with a prescribing physician but you ask about medications okay John your new client who's coming in tomorrow has been told that unless their kid learns how to behave in 10 days they're getting kicked out of school you're going to do neura feedback for him no you say take him to pediatrician get some medication on board now understand that the medication will not have to be used for a long time once we've taught his brain how to shape that plasticity into more effective and usable ways you will be able to gently have a little bit less live a little until the brain takes over and they don't need the meds anymore but that's not the message that's sent out there Russell Barkley is out there barking to every he used to sell riddling to from cagi he took a lot of money from cagi so saying the chemical imbalance Vince manaster did a very nice study in a school and the kids that had high Theta beta ratios were diagnosed with ADD uh half of them were randomly assigned into also uh not getting just the riddin which was provided for the Theta beta ratio being high uh but half of them were assigned to also get neuro feedback 6 months later the meds were discontinued the ones who are in meds only reverted to their add ways behaviorally the ones who had had neuro feedback remained okay so uh it's possible to be put on them short run and take them away uh carefully uh to good effect and withdrawing the wrong drug too fast is really quite problematic you might think well you know the opiates or something you have to be very careful but even serotonin ssris serotone withdrawal is extremely severe so you you've got to be very careful with any of the meds that you're on you heroically just stopping them cold turkey is sometimes the worst thing you can imagine doing Dr Andrew Hill 80% of the people that you deal with are remote yeah what what are you I don't want to say treating what are you training or like when people when you get that email inquiry yeah I need help with what what are you responding with what can you help with 80% of the people you talk so I'm reframing what we do into resources in the brain instead of Diagnostics so I'm talking about six to eight regulatory features of the brain attention not ADHD stress response not anxiety and then within that you have the perseverative the ruminative the social ins sensory or the hyper vigilance um sleep issues for onset or maintenance not you know dysomnia di agnostic the resources are the same but I'm more interested in hey can we find the resources you care about not what is that label hey let's maybe drop below that label and figure out what success looks like so I'm framing it into what resources are we operating with which goals we pursuing for you and by doing that especially with a brain map open it's hugely supportive of agency and a shift in perspective and people start reporting day-to- day progress towards goals or not not the symptom level stuff the same way it's not they're not thinking of it as applied to them so people might find out about neur feedback because of ADHD or seizures or or anxiety or trauma but when they start talking to us we're like oh wow that trauma really sucks oh it might be your posterior singulate caught in high gear if you look at a brain map what you might see is posterior singul it's lit up in beta because your lifeguard is going ah watch the road and of course it does that because the cost of missing danger is so high so your brain liner learn the world wasn't so predictable and you validate the experience you validate the physiology you don't say they don't have PTSD but you're not necessarily buying into that tight DSM landscape and people come to us I would say usually even when they're kids the parents come to us educated they know what they're experiencing they know what people have called it already they know the symptoms they're experiencing and so if you just break it down into the resources that you want to work on and what is success and goals look like not eliminating diagnostic but what is you know over that resource look like that's what we work on and it's the same stuff it's these regulatory things these these eight things that we all end up working on when working on the diagnostic labels they actually show up across labels shockingly phenotypes are not as precise they're buckets the same buckets as the DSM is you know they're they're they cross those labels so where where you where where are you performing next what I'm trying to do is we're at the end if anybody wants to stay past we got a couple minutes left in the hour whoever wants to stay past I will stick around but Santiago you're in uh Singapore what you have uh so many more advertisements coming up you are all over the place what's next for you I fly I fly next week I'm going to to Texas to to teach uh with the my good friends of in mind out so I'm going to be teaching a a neuro feedback and a q class there and then from there I go to Chicago to the isnr meeting where I'm teaching a half day workshop on wait you're coming by my house I am coming by your house all right a barbecue and everything yeah um right so yeah I'm going to isnr I'll spend I'm doing a half day workshop on on looking at Roy tracings and then from there I jump to Romania where I'm teaching for three days with the people from IM sync and then back to California for the susen summit quite with the Koreans anybody you got anything to say before you pop out U regarding the Koreans I met Ayn yeah yeah well they I just finished that lecture for them on uh ADD ADHD and EEG uh attended basically by psychiatrists and about 100 people attended uh the uh the uh it included some people there was a cluster from Canada because kro uh the the psychiatrist who presented with me because I can't present by myself obviously uh I'm I'm just a tech so I've gotta I've got to have a a name on the Marquee other than me so uh there was a Canadian group but the largest group is actually from Brazil and we had a portuguese translator that did live uh translation and she kept up with me that was AI Jay I believe that was AI they they actually have I'm serious I think they have a a woman who who does the the Portuguese translation uh for medical she's specifically good at it okay I was I was in that talk I was convinced that those those different language translations were actually coming via AI based on the the way they were paced but I could be wrong my my Portuguese is super rough I I only knew that they had the Portuguese I didn't know that there were any other languages other than English and Portuguese you could even select on that so j i anytime you want joy if you want to hop in go ahead uh I I I want to just finish that that um uh the the the talk went well enough that uh I end up with a a cluster of folks who uh wanted to uh contract with me on the EG stuff and I basically tell them hey I I agreed to do this but I'm retired you know I can't I can't uh sign on to a whole bunch of other new projects and um the the Koreans have other resources other than me obviously and there uh folks that are excited and they want to jump in have other portals than coming through me because I'm not a way in anymore so all right we're we're at the hour Anthony John meot uh do Andrew Hill Joy what anybody want to stick around Jay I'll see you in the morning I I am not gonna stick around today because bye this is this is 911 and in my house it's my son's birthday so we celebrate today while we knowledge just what took place on this date years ago so I'm off to pick up a birthday cake congratulations mom happy birthday to yourself thank you yes thanks was quite a day oh yeah I bet especially in 2001 well yeah he was born in 86 so he had to date first hey everybody thanks for showing up and thank you uh peace out whoever wants to stick around I'll be here I got nothing else to do and and when you say I'll see you in the morning Pete that has so many weird connotations I don't even want to touch it not saying anything another time all right byebye all right