The Future of Brain Health - AI and Neurofeedback with Dr. Andrew Hill

welcome to another fun new episode of the life optimize podcast I'm Dr Neil Palvin where we speak about optimizing your health life business and athletic Pursuits and I'm excited for this really new fun episode with Dr Andrew Hill of the peak brain Institute who I've had the pleasure of participating at his Institute here in Manhattan and I learned a lot he was like the psychic mind reader literally and figuratively so we're gonna learn a lot more today about qeegs and neurofeedback how you can do it in the office or do it remotely and how you can use it from everything from Health optimization and optimizing performance so unfortunately if you're dealing with illnesses like long covet or other issues as well so thank you Dr Hill for coming on the podcast with us introduce yourself thanks Dr Palvin nice to be here thanks for having me I guess I'm just your friendly neighborhood brain training personal trainer who happens to be a neuroscientist essentially and then I moved into the entrepreneurial space to share you know this this neurofeedback stuff this brain training stuff I've of a platform a a soapbox about not being overwhelmed by your brain but like digging in and understanding it and starting to demystify some of the big features of you know stress attention sleep because they're actually things that are physiologically based that we often give sort of big giant scary labels to and diagnoses too but if you understand how they work you can start taking control of them and be as frustrated as you need but it's kind of hard to be ashamed when you understand stuff and how it works so that's that's the role I serve as a writing coach for folks and help them build transform transformation using tools like neurofeedback now you explained to me before we start here that you instead of going to the research realm you went into this round the entrepreneurial realm was there some personal motivation or some something that was missing in the landscape that motivated you to go this route it's probably both I worked in health and human services for a while before going back to grad school and I went into a cognitive Neuroscience PhD program which is sort of that mind brain intersection study a lot of how the human resources the human features and brain resources of executive function sleep stress we're organized in the brain and how the different systems are interconnected and how they operate how to test them and the tool I was using all all scientists have tools of analysis and you know things that frame the questions they ask the tools that I was using were EEG or brain waves because I went back to grad school to study neurofeedback at I think I was 35 when I started grad school so you know a little bit older than the average person starting a PhD in the U.S the reason I went back to grad school is because what I was seeing in the clinical environment for you know over a decade I had worked in clinical pretty acute environments inpatient psychiatric block facilities I ran group homes for folks with multiple developmental disabilities and without language and often with altered communication and you know vision and hearing and other other features too so really quite profound human sort of edge cases of brains both developmentally and then in acute psychiatric work I worked in addiction so I had a huge breadth of Human Services experiences and places that humans suffer and I got injured working in a psychiatric hospital from doing too many restraints back to back and it was understaffed Hospital in uh it was before 2000 like in the late 90s or something and Health Care was falling apart and insurance companies are pulling out of big Hospital systems and and I couldn't go do the work I've been doing the with the people so I went to high tech for a while and then the tech bubble corrected around 2000 and I went back into Human Services looking for something because I missed working with people I found a center that could use all of my experience with developmental stuff autism ADHD et cetera that did neurofeedback in Providence Rhode Island and after working there for several weeks I started to get pretty excited because I was seeing people make changes and these were complaints that I had been working with for years and when things are pretty extreme you know someone's got very extreme autism or you know pdbn OS where they're flapping and stimming and screaming and having seizures and there's very little language production and very little language reception you know pretty extreme stuff I was seeing people like this change and I had worked with environment you know people with extreme brain stuff for years and was like well wait a minute this is this is interesting this is very attention getting and it wasn't just change like 8 ADHD folks were getting a couple of standard deviations on tests of attention of improvement in a few months like one person after the next so this kind of got my attention again and I I had to figure out how we were what we were doing because then more than 20 years ago still now neurofeedback's a bit of an art you know it's very akin to personal training in that yes you have data and assessments and you can dig into actual real numbers of things but you also have to understand the whole person the system and brains are weirder than bodies so you get a lot more variability and a lot more unusual stuff is normal and typical even though it's unusual so when you move into the landscape of brain at least 20 25 years ago everyone doing it was kind of a guru in their space so you're an Autism Specialist or an eating disorder Specialist or a concussion Specialist or migraine et cetera and this stuff this neurofeedback stuff had efficacy in all these Landscapes of suffering in a way that I just did not think was possible after working for years in traditional environments so I eventually went and got a PhD to study this stuff to study neurofeedback and I worked in the zydel lab at UCLA which is Dr zidalaron zeidel was a great laterality neuroscientist when he was a grad student I think he worked for Sperry and Bogan doing some of the split brain research initially at Caltech and stuff way back in the day on the split brain epilepsy research in the 70s and 80s and things but I did laterality research at UCLA looking left during Hemisphere organization and then brought in the neurofeedback stuff and I think I may have done the first double-blind placebo-controlled study on neurofeedback for my dissertation work part of it anyways and I did that work in 2010. so the field of neurofeedback's been around since at least the mid 60s and I may have done the first double-blind placebo-controlled study demonstrating you know the sort of blind impact or the actual brain's response to neurofeedback without the sort of human judgment piece of it being involved and from that point I just I think you'll appreciate this I ended up working for oh I ended up being about 12 years at UCLA teaching a lot of what I taught was gerontology and Peak brain aging and I bet you would agree that the field of gero the field of Aging medicine is pretty tightly aligned with the field of Peak Performance biohacking and a lot of the stuff we use and we used to use for only aging meds are used these days by people trying to get an edge or squeeze out performance or recover faster things like the choline drugs you know acetylcholine and things used to only be geriatric medicine you know now they're you know used by students and Executives and things so that was my landscape it's a long-winded story my my journey from working in Health and Human Services through a PhD and then as I exit the PHD I started a company that had a mixed addiction and non-addiction focus you know two separate sort of brandings and then after a few years the non-addiction side just outgrew the addiction focused side pretty aggressively so we split off into Peak brain in 2015 at this point so we've been around for a while we have offices in New York and St Louis and la and Orange County as well as some Services popping up now in London and Stockholm so people can work with our coaches and get their brains mapped and dig in and learn how they work and push them around so neurofeedback is going International at this point which is great because it's like you mentioned it has really good utility both in health and wellness and also unfortunate patients with chronic enough so let's enter some of the questions that I always get when I mention the stuff to patrons where they look at me like I have three heads unless I see the funny picture with me wearing the Red Cap which we'll talk about in a couple minutes here so to get all the information that you need to get somebody started on neurofeedback you need to start measuring it getting some information and data somehow and that's usually done through a qeg so explain to people this is what a qeeg is is it similar to what people hear about in the hospital if you're getting a quote getting an EEG done for seizures where the difference were the similarities and uh we'll go from there the the field of EEG has a version of neuroimaging sort of a way of measuring the brain it's been around for a long time one of the first things we did for damaging was look at the brain's electricity and the eegs that we do today for most purposes are very similar to the eegs that have been done for 100 years because they started off really looking at things like sleep stages and so the particular grid of electrode you put in the head and where they are and what other what else you measure became a standard and you know the brain makes electricity electricity moves around and mixes and recombines it's hard to measure signals at a location so when doing EEG you have to always kind of match your measurement scheme on the head to the measurement scheme of whatever it is you're comparing it against some other research or in this case the the queue and quantitative EEG means you're doing a full head cap of electrodes in this case we use 19 standard electrodes plus ear clips and that's the same 19 plus years you might wear for a sleep study or for epilepsy long-term monitoring but in those cases you're wearing these things for hours and hours and hours you know overnight or for a few days in the case of a brain map or a qbeeg you may agree it's pretty straightforward you sit down put a cap on squirt it full of gel kind of messy but it doesn't doesn't hurt then we have you sit still for about 10 minutes with your eyes closed and 10 minutes with your eyes open and that is the assessment of your brain sort of resting fingerprint arresting resources and we also do an executive function test an attention test alongside it that's a good practice from a you know neuropsych perspective I'm a cognitive Neuroscience person so I always must put physiology and performance and contrast to outline things that's that's how you know that's my tool set but the brain mapping or the qeeg takes that resting EEG the eyes closed chunk and the eyes open chunk and after clipping out coughs and wheezing and movement and stuff like that you have several minutes of clean data you average those amounts speeds and connectivity patterns of different brain waves throughout the brain you can take an average across time and then I would compare your averages on both the brain mapping information the EEG recordings and the performance test to an age match sample and see how weird you are essentially but good job be weird as far as the brain maps are concerned we don't expect you to be average and we don't use a brain map to train your brain towards average we use a yardstick to hold up against you to see what sticks out and see what's interesting and unusual because people are unusual and the degree to which things are unusual does not track how much suffering there is or if something's even in the way at all but a lot of the stuff we call illness or psychiatric stuff or cognitive or emotional suffering an awful lot of it isn't really a disease process it's really a dysregulation of an existing resource that has different modes or ranges it can move through and it kind of gets stuck it's disregulated in one mode kind of like a muscle can spasmer or cramp up when it's very strong anxiety is the best example of this you've got circuits all over the place that do specific things for information processing evaluation switching your focus around at the intersection of like stress and attention to Big clusters called the singulate in the front and back switch your internal environment what you're thinking about in the front and the external focus and the orientation and the evaluation to the outside world in the back so the front of the head is helping you remember that you walked into the store to get bread without rehearsing it and the back mid liner that has helped you do things like watch the road heads up heads up oh okay didn't crash great and that orientation thing is necessary and useful and you're always is using it but when your brain has a tendency to get stuck this way because it's powerful or when you learn the world is not safe or predictable really acutely and strongly and quickly the brain will cramp up these resources these cingulates and when the one of the front cramps up you get features of perseveration or Obsession and when the one in the back cramps up you get features of rumination or worry or threat sensitivity so you're stuck on your head stuck in your gut but I don't know looking at one person's brain I can tell that like you're making a lot of beta waves and cingulates and say wow you're cingulates are pretty active but I don't know if the one on the front is representing an OCD complaint for someone or they're just a high-powered CEO who tends to get a bit rigid I can tell it's unusual until it's strong but it lets me sort of say hey here's a resource and it's operating in a way that is unusual here's a plausible interpretation what do you think is it is it interesting and the one on the back same thing it might be a lifeguard who's helping to evaluate the environment or it might be somebody who's experienced acute danger and threat and the Brain sort of experiencing a trauma response we help people walk through their you know data and then understand what's happening and sort of recontextualize in some way stuff from a disease label into the actual resources that are involved and then from there again the agency unfolds and they can start making changes so are you I mean as I mentioned I had one and first of all I want to say for anybody it's an experience it's definitely a different experience than I've ever had before but it's very enlightening and it's also something that things I was doing they were asking me do it seems very simple like how are they going to get any any information from this that is scientific and then when I got my results back I'm like okay now I see how you guys do it so it's something you may not expect to get these complicated answers where it explains how your brains working but you actually do which is really cool and amazing and again allows us to go into the treatment side of it so when you're looking at the results from somebody are you I guess it sounds like you're looking at a combination between how each area of the brain is functioning and then also you look at the inner connection between different parts of the brain as well yeah exactly connectivity patterns the amounts of brain waves and the speeds of brain waves essentially across the average person one second doctor um your camera is black yes we're there we're working on the tech we're just making sure you're new yeah they are for them to keep going or there we go I am back you're back we found it's totally fine just in case you didn't know I thought yeah I know I I they second I was gonna say something they found it yeah so we talked about the connection uh interconnection so that's for Pure listing and they're going to have these questions so let's say I am I want to be the most elite top executive of a Fortune 500 company yeah what are you are there characteristics a that you're looking for you mentioned one already can I be trained to opt to be a better executive is it something that you can make or is it just kind of inherent genetic and you're kind of you are what you are or somewhere in between that's an interesting question yeah I don't think we come out as little like high-powered CEOs who you know in a little business suit right you know who want to like be the man and and stamp on the person you know the little people know yes you can train resources almost anything you can identify you can measure you can change understanding the brain's pretty hard but changing the brain's not so the the mechanism the technology of biofeedback is essentially measuring something that's varying in real time and when it varies a little bit on its own in the right direction you applaud it in a way the body or brain notices and then you create learning and you steer that process so yeah anything you can measure you can change now there's not like a the best CEO the best athlete kind of brain necessarily but what I would say is that almost everyone has the capacity for profoundly amazing performance if there's certain bottlenecks that are lifted and I tend to think of this as resources and bottlenecks not as high and low performers because you'll see high performers with bottlenecks and they're still performing fine but it's difficult and effortful and they end up you know high-level CEOs end up burnt out and angry at the end of the day not not flexible and able to go into listening mode with their with our spouses or something that's a problem but it's a different kind of problem than you know somebody having seizures all the time but generally if you can work on the gross resources of sleep regulation executive function speed of processing and it's a stress sleep attention and speed essentially are the big things I mean IQ on an IQ test is not a real thing as far as the brain is concerned that's IQ decomposes into speed of processing working memory and implicit learning ability well you can tweak your speed of processing and your working memory a little bit so yeah you can actually create higher performers there's studies showing that IQ goes up by over a standard deviation when doing neurofeedback because you're creating resource changes so it's more about what you need you know what is your brain like or what particular resources would you like to you know move so again back to the cingulates if I saw someone single it in the back and and the I could tell their brain was likely sampling and evaluating the environment powerfully that might get in the way so I'd say hey does this thing you know do you ruminate are you stuck in your gut kind of a hard time putting things down that bother you oh that's true to you huh that's annoying you want to work on that okay great and that can be true if somebody who's experienced profound trauma and has classic PTSD it can be somebody who's just a little irritable has a hard time settling but you can again flip the relationship into one of like okay here's your brain here's your performance what would you like to do you know here's some executive function stuff here's some sleep stuff here's some anxiety features here's some speeder processing stuff and when I say these in a sleep stress tension speed these are actually resources that that can be both measured and as they fluctuate they make big changes across multiple things take speed for instance if I look at your Alpha Waves this your idling brain waves you can see the how fast they idle at most humans most adult humans about 10 times per second 10 Hertz so if you're idling about 10 Hertz it's typical but if your brain is not idling quite as fast as the average person your age or if the circuits are all kind of not synchronizing across the same speed and you're 30 or above I would say something like oh hey wait you're Alpha Speed your speed of processing appears to be a bit slippery and dragging are you experiencing delayed recall and tip of the tongue and hunting for names little short-term memory blips and you know most of the time someone's like wow yes and then if someone's 45 or 50 or 60 they're like and I'm worried about that being age-related cognitive decline by the way as an aside I think you'll appreciate this as a aging focused doc people are usually concerned 40s and 50s about dementia and big gero you know big big geriatric uh declines often very freeing and useful to know the first type of memory you lose when you have the big things the big Dimensions the first thing you lose in memory is episodic memory first person perspective on scenes things that happen to you that's what you lose first speed of processing words names tip of the tongue forgetting things you were just told that's actually not memory it's just speed and you notice it when reaching for memory because it's a very time intensive synchronization process but actual memory circuits first an age-related memory you lose episodic or things that happen to you or the things that start slipping away so if you're not able to find words you're probably not sleeping deeply enough or you've got some inflammatory stuff going on you had covid and your brain's walking around with lots of delta waves trying to rest and repair all the time and you feel half asleep like you've had a concussion and then when you go to sleep you don't go all the way down into deep sleep and make lots of robust Delta because the brain's been making it all day long so you see this like persistent metabolic rest you know Delta mode and anything metabolic in covid and chemo and apnea and restless leg and Mild concussions you see this persistent metabolic sluggishness and you can't tell it apart you can't tell an old concussion or two that's caused something apart from someone's post-covet brain fog that was six months ago it looks about the same at a high level but if you see it you don't have to know why it is this is why you're a doctor of medicine and I'm a doctor of psychology I'm a mad scientist for you and a coach is because I'm not necessarily trying to find the discrete intervention and I sometimes can't find the root cause in the brain because I don't understand them that well but we can spot phenomena you're experiencing and push them around it doesn't really matter if the fog you have is because you have had you know some old wear and tear here and there or because you've got dysregulated sleep architecture because you're anxious or because you had covid last year and you haven't quite yet recovered your deep sleep doesn't really matter why if you can spot the fog and fatigue in the brain and spot let's say the stamina issues and a performance test and go hey you're uh looking kind of foggy you feel you feel a little burnt out oh you are Ah that's annoying longer on that great now you're in a place of agency and again you can stop feeling once you understand your brain and look at data people have this experience of going oh oh okay yeah yeah I cannot be annoyed at it or frustrated at it but you just aren't really able to be ashamed or guilty when you see your brain and see your suffering see your ADHD see your anxiety see your sleep issue see your word finding issue if it's jumping out in big giant pictures it changes your relationship with it suddenly and then if we teach you to read your pictures Peak brain has this we give you a year membership with brain maps are free and your listeners will cut the membership in half it's usually 500 bucks but we'll cut it in half to 250. so folks can if they're near one of the offices unlimited access to come in map your brain learn about it dig into it and so we have people uh I know some of our mutual friends in New York City are doing things like mapping multiple nootropics and looking at caffeine and methylene blue and all kinds of interesting brain effects in performance and in physiology because you can tease things apart you don't have to use brain mapping for just neurofeedback guidance but if you do see brain activity clusters that are some resting in a weird way and do seem to get in the way that's why I like EEG mapping as a technology because it frames the intervention immediately it's like oh you've got a bunch of back midline beta and you're ruminating oh okay let's work on that let's see if we can make that you know change and it puts you immediately in place of making intervention because then this is neurofeedback it stick a wire back there on the scalp and a couple ear Clips on and measure the person's beta moment to moment and measure their Alpha which is the resting mode of that tissue moment to moment whenever the beta happens to go down and the alpha happens to go up for half a second you say good job brain and make a little game on the screen start to move and a few seconds later when the brain moves in the wrong direction for that workout that day the game slows down or stops and then the big trick is we move the goal posts every few seconds so this is operant conditioning but of an involuntary Behavior because you can't really feel your brain waves so you're watching a little game on the screen stop and start a puzzle pieces fill in or a pack many dots or music play in silence and you're like really this is doing something to me but your brain hears good job brain good job brain good job brain nope oh good job good job good job nope good job again and again and this is no different than a little baby flopping around who does a little baby push-ups suddenly and goes whoa I can see 12 feet instead of three feet this is so cool all this information the family remembers all the unique confirmation of muscles so it can remember the associative you know learning the states that produce the information flow and then since we're gently applauding not just an event in the brain but like the trend you may have over half an hour little runs of the brain waves brain goes hey wait a minute oh Alpha back there's making stuff happen huh okay cool and usually two or three sessions in the brain goes all right I I like the information I want that over no information sure and it reaches for in this case more Alpha and the person goes ah whoa I feel different huh remember my imagining this I don't think so huh it's a little weird and then it lingers for a few hours and wears off and you say coaches I might have noticed I don't think I noticed anything like all right try it again you try it again and you're like oh wait a minute and then your sleep your stress your mood will Flex after every session like you go to the gym and you kind of feel it the next day well you work your brain out and you get a little Flex in sleep onset or depth in energy and Clarity and stress and so you get to get a little transient effect grade it evaluate it talk to your coaches refine your plan and then gradually iterate and we map your brain again about every other month 25 sessions or so and that's enough neurofeedback to produce usually a full standard deviation of change especially if there's any need in executive function on you know classic CPT tests or on the same brain activity for ADHD or anxiety features you can move them to that degree pretty reliably across people so when you move that much on a bell curve it feels like an awful lot and if you do a few months of neurofeedback especially on the things of sleep stress and attention the stuff you're using all the time the brain is now practicing that stuff in a new mode all the time so it doesn't really wear off after a few months which is now your new brain resources and you get to sort of have that new stability and push them harder if you like after that but I have patients who have ADD and long covet and how do we how do you frame it for patients when they're dealing with you or one of your colleagues okay I have again add them along covid I have some memory some brain fog when am I going to feel some improvement when I start doing neurofeedback and what and the other question is so do they do you tell them what they should notice first like how do they know it's working what's the Magic in the in the potion here how do you how do we frame it because this is not okay here just take your antibiotic and you're going to feel better in five days they're putting work in and it's again like you said it's not a tangible it's not like your blood pressure goes down and your blood sugar goes down so how do we frame this for people listening out there to understand blood pressure does go down actually and you do get blood sugar stabilizations okay generally um you tell someone well the way that we work at Peak is you map your brain at the beginning and then a couple days later I go over data with you and I walk through a brain map and an attention test and teach you to pick out the stuff that seems to be interesting and say this thing here we think about it this way these brain waves this feature this part of the brain here's physiology does this seem valid does this seem important to you real to you and we trip over the big things people care about that way and so usually by the time they're starting neurofeedback they have this sense of agency like wait a minute I'm working on my executive function I'm working on my this and so I would build a plan of a little 15-minute chunks of workout do a couple a day or a couple three times a week more accurately we would say to them something to the effect of people usually feel it three to five sessions in and then you get a little transient effect for a couple of hours up to 24 hours after a recession based on what happens we want to know how you're feeling sleep stress and attention stuff shifting around other goals you have and so we send clients surveys twice a day every morning we send you a sleep survey saying how was your sleep and every afternoon how was your day so clients start making notes of their goals and we sort of Marco Polo our way towards success you know they Define what success is it's not a here's what's wrong with you client it's a hey here's what's weird and interesting and unusual which of these things might be oh that's what that one's important to you okay and success looks like okay gotcha and now we're you know keeping our eye on that trying to elicit subjective effects so after a few sessions you should buy this end of the second week five successions in you're getting a little lingering effect whenever you do neurofeedback and then when you do different neurofeedback the effect you get feels different so you can go whoa I was kind of wired after that one oh okay I'll change the frequency change the site oh super chill after that one that was weird I like that all right cool you know so you can kind of learn someone's brain gently as you try work out the way a personal trainer does and within a few weeks you're usually making some yeah tangible subjective benefits are emerging and then you go to the objective the resting brain is change about six seven eight weeks in you can see those changes so so we keep using the term neurofeedback so if we're doing it neurofeedback what's involved is another headset is it just so a game with some combination of both yeah so all neural feedback is a form of biofeedback and biofeedback is just a reflection a control uh system You observe things inside so you can reflect back what's happening unlike most forms of traditional biofeedback which involve things like hand warming and breath pacing and stuff like that neurofeedback is largely involuntary because you can't feel the central nervous system that's the definition of neurofeedback it's biofeedback on things that are in the central nervous system and for folks who are not quite so neurosavvy the central nervous systems all the stuff inside of bone if a nerve's inside of bone its central nervous system pretty much so you can't feel those you can feel the nerves in your peripheral nervous system you can learn to control like the the tension let's say in your body using peripheral biofeedback and they do things for pelvic floor or stability and incontinence and things that are biofeedback in the gut but for neurofeedback you're measuring something you can't feel you're measuring Behavior you're not aware of you know you're getting changed there's billions of things happening in certain specific ways in your brain all the time can't feel it you're kind of glad you can't feel your brain by the way we don't have any sensory nerve endings in our brain we can't feel the tissue itself ironically the thing that does all the feeling can't feel itself but you're kind of happy about that because it moves not quite as much as the heart does but it moves and it's full of like amazing amounts of electricity and acidic compounds and all kinds of stuff so if we could feel it it would probably hurt all the time because it's just so much going on so in the case of neurofeedback it was billions of things and you simply measure a parameter that's fluctuating moment to moment like the speed of your Alpha and if I play a sound or make a car go faster or make a pack made a DOT or anything in the outside world when your Alpha speeds up a little bit your brain goes hey wait that information seems to be contingent on me that's kind of interesting the mind doesn't usually the mind can't feel its own brain waves you're like why is that sound keep happening okay but the brain's like hey wait more Alphas making stuff I like stuff Hey where's my stuff oh there's my stuff I like stuff oh I could have more stuff when I make alpha I'm going to make some Alpha and then the Mind goes oh wait a minute okay I feel that so you get this involuntary exercise process going on essentially so train for half an hour three times a week and starting three four sessions in you feel different slightly afterwards like this little subtle lingering effect so the voluntary piece of it the work is goal setting and is reflecting on did the workout land did the neurofeedback produce the thing you're looking for in any way and if it did you can sort of Chase those effects and burgeon them and tune them to get better effects and that's that's the art of neurofeedback to some extent is that understanding the brain well enough understand the person well enough and communicating around their goals uh and around what they're observing to help design the next few days of workouts that they're going to want to push themselves around with it's amazing the brain is very simple and very complicated all at the same time and you gotta know how to play with it and manipulate it to get it to go where you want to get to so you keep it with goals could somebody come to you and say pretty much most goals who were guarding their cognitive performance and that's something that you guys come up with a plan with at least to opt to possibly help help them get there so yeah there's cognitive goals there are emotional goals a lot of anxiety stuff a lot of trauma stuff a really reliable work into our feedback for creativity I have a disproportionate a large number of actors in my client roster who often come in because they're getting Hound in the red carpet or super stressed or they're like not sleeping well enough to remember their lines well enough or something but the creativity boost that our actors our musicians even our athletes get is not insignificant it's a fairly dramatic and profound release of creativity so the creativity work which happens to bring up T cells the same end of the protocol pool people come in for T-cell boosts or for creativity boosts or for migraines or for seizures or for concussions they also come in something for Peak brain because we're not necessarily illness focused they come in to understand their brain and just be like I probably I would say something every year I get one or two clients that comes in who says yeah I don't know just uh what's up my brain and optimize me usually it's suffering that drives someone's you know or specific goal athletic goal a performance goal of something or some suffering you know go goals to me are irrelevant to some extent if they're suffering driven or performance driven goals they're just goals and I want to frame our work in spotting supporting changing things toward your goals but it ends up being a broad Network where a third of our clients are neuro you know the classic sort of neurofeedback population of autism and ADHD and seizures and migraines concussions and these days post-covet brain fog and other you know sort of neuro complications and then we have the other third of the pool which are ultra high performers at Peak a lot of extremely high athletes a lot of musicians for some reason like very very you know people squeezing the juice out of life uh kind of uh you know performers and then the last third is all the rest of us who are a little burnt out who may have missions with stress or drinking or little hint of ADHD or whatever and a lot of those people we started to get for the first several years we were in business we didn't first start pitching ourselves as you know broad brain optimization we were more focused on the populations of interest and neurofeedback when we first opened up but we kept getting like several kids in ADHD let's say and then their parents would see the change and sign on and get really nice transformation even without necessarily identified large goals or needs and then you get get people coming in I get a lot of these every year who say oh I have no problems at all essentially you know I sleep great no anxiety I'm powerful I run a run a billion dollar company yeah yeah Life's good but like let's let's get me more and they have a person for everything and now they're looking for a brain person to like just be a resource and you look at their brain and you're like wow this person looks really really anxious and Hyper focused oh my God they're not sleeping and you dig deeper and you find that they're using coke coke every so often and they're really kind of like a jerk to their wives and they get home and you're like okay and I don't care they don't identify that as a problem but when they show yeah I'm not as soft as I might want to be to my wife I can't be a good listener I'm still trying to solve problems when I get home I'm like all right let me do a little bit of work on their sleep and whatever else and then we slide in some Alpha Theta neurofeedback for creativity and I got a letter or a call from their wives saying whatever you did do more of it that was the best conversation we've ever had the therapy session was he brought me flowers because you can unlock stuff so it ends up being tailoring the stuff you're doing the workout possibilities towards the stuff the person's trying to accomplish and listening carefully and framing their goals in terms of their physiology whenever possible so you can then try to elicit a change in their physiology they notice subjectively in their goals so we really applied cognitive neuroscientists I call it functional Neuroscience because we're looking for you know this piece of it and I also do the functional you know habit hacking and biohacking piece of it where Peak brain coaches teach all of our clients how to you know manage circadian rhythm to the classic circadian tricks or to do macronutrient cycling to reset insulin resistance or a thousand other things that might be in someone's goal landscape and you know how you might teach someone to do Keta would be very different if they were a competitive lifter versus an eight-year-old with seizures you know so you have different criteria you might give them different management tools you know breath Ketone versus a blood Ketone meter let's say so we do a little bit more broad holistic biohacking for our clients but you know Maslow said to a man with a hammer every problem is a nail and gosh my first knee jerk is usually let's look at a brain map and because of that we make them very accessible and we teach and read them and you know get you excited about them so I am learning a much more big how big a scope this is so you can make new form better at work and improve my love life and I can if I have writer's block you can fix that too is what you're saying design protocols that are likely to create change to you and those those resources that you'll notice and that you will then be able to say oh I think I got something out of that protocol and together we can learn how to elicit effects in those directions usually yes yeah so brain map pretty much can help you with a lot the whole Spectrum here which is awesome which I love learning things right when I talk to experts so um I'd happen to deal with unfortunately a lot of patients either with some type of traumatic brain injury so I wanted to quickly highlight that I mean both either concussion or on or into like you mentioned in terms of you started the core of initially with things like Alzheimer's and add so how does the is that process any more complicated any slower I guess unfortunately long covered May kind of overlap into that now so is that the same process that again how does that work same process at a high level um it is a little slower yeah if you have a lot of tbis or wear and tear if you're an athlete who's collected a bunch of concussions and you're beat off in your speed of processing and you're chronically anxious yeah it takes longer like if you just quote unquote come in with major ADHD or PTSD and it's it's pure and simple and classic three or four months maybe five you know makes massive changes for almost everyone but if you come in with lots of wear and tear like my NFL players or NBA players have caught too many elbows and things it takes four to six months usually just to get you sort of where you want to be in stable or folks that have autism that you know with language issues and sensory stuff it's a bit longer than simple brain tuning like ADHD or sleep issues might be um this amount of severity doesn't affect how well we can work with things and some to some extent the worse things are the faster they move in brain training because you can see them and you can really be specific and the Brain hears your attempts to change when you're that specific but when you're using uh uh uh tools and neurofeedback for the metabolic stuff the wear and tear or the brain fog the postcovid the Lyme the chemo the apnea the sort of metabolic hit the person's taken which looks very similar again across causes we often include not just the brain mapping and the EEG training which is classic neurofeedback but we we do something called heg training passive infrared hemo encephalography so it's an infrared Camry strapped to the forehead pointing Inward and it measures waves of heat flowing off the brain as a proxy for metabolism and you learn to do a vascular pump by thinking happy thoughts and concentration and getting a two second later bold response essentially in the brain like the MRI would show a little blood blood surge second and a half two seconds after you concentrate so you learn to create vascular pumping in your brain and see waves of heat on a screen it responding to voluntary thought and effort so you're kind of doing this weird peripheral nervous system type biofeedback blood flow off but doing it on the central nervous system at least the support systems the vasculature so I'm not exactly sure what form of neurophyback or biofeedback that is but p-i-r-h-e-g is um amazing for migraines concussions and for some reason that technology that frontal lobe vascular pumping seems to work really well for accelerating social function when people have developmental disabilities especially in things on the autistic Spectrum so it's a blood flow tool essentially but yes we would do EEG and HED training and expect it would be four to six months for you know a lot of wear and tear and tbis but again the worst things are the faster you get changed so Dr Barry Sturman who sort of discovered the current form the modern form of neurofeedback in the late 60s he discovered it because um it reduces seizures like he just kind of discovered by mistake a little bit like sort of he was doing EEG uh Operate conditioning on uh his his population his animal population interest where he put a chicken broth sorry a eyedropper inside of the cheek of cats it would squirt chicken broth into their mouth whenever they made a brain wave the cats make a lot of as a reward and that brainwave you've seen if you've seen cats in a windowsill being liquid watching birds that physically relaxed State and and laser-like focus is called sensory motor rhythm in mammals and we use it to sit still we use it to stay asleep we use it to inhibit seizures so high SMR tone is literally the opposite of ADHD first of all but it has a very impact on stabilization of seizures so Sturman did this experiment with eight cats raising their SMR and proved he could condition it up and put them back in the subject pool and six months later pulled them out pulled 32 cats out and were exposing them to Rocket Fuel at the past of NASA to see how dangerous Rocket Fuel was it's the 60s animal research and uh air quote or air yeah air quotes animals every yeah everything there well I mean animal research you know we always try even today even back then we were we always try to do the least destructive thing possible and nowadays we can do more least destructive research it doesn't doesn't harm creatures um in the 60s computers there was less in silica less less known about basic science a lot more even ethical uh animal research was happening that that you know took took animal lives um this is one of those studies and stirma was EX for the purpose of NASA keeping astronauts safe was figuring out if methylhydrazine was quite toxic because people were reporting symptoms nausea hallucinating vomiting when they were near it so stimulus testing cats a safety study for NASA and he found that of these 32 cats 24 of them had a perfect dose dependent curve when exposed to methyl hydrazine Vapor where it was a taxi or a stumbling drooling crying seizure come of death a perfect dose-dependent curve but eight of the cats you know most the cats are having seizures 40 minutes in eight of the cats two and a half hours in we're just starting to show some instability events in the brain when the other cats were at the end of their dose curve response so to speak and Sturman couldn't really figure out why a quarter of the cats appeared to be super cats that were methyl hydrazine resistant until he remembered that these cats may have been part of other sub other studies and he looked and these cats had had their SMR brain waves trained up well his lab assistant was a medication uncontrolled epileptic on memorol Tegretol Dilantin huge amounts of it having tens of seizures every week complex partial mix tonyclonic just miserable they built her audio feedback machine to measure her SMR and play tones when she made more over the next year she went off all of all of her meds her main seizure free for a year wow that was the start of the field of neurofeedback in 1967. and from there it's it moved into sleep it moved into ADHD it moved into seizure because of SMR because it's it's Central to Executive function regulation we also call SMR sleep spindles or Sigma at night the thing that fires to keep you asleep on a car goes by you kind of notice it but don't wake up the suppression of the rousing instinct when that's appropriate so SMR helps with inhibitory tone helps prevent things from reacting when you don't want them to in the brain be that motoric impulsivity or a seizure or Waking Up throughout the night so again a calm cat in a windowsill literally the opposite of ADHD physiologically I'm going to image that the rest of the day my little cat just hang out a little cartoon uh so you mentioned something I want to get back to really quickly you mentioned by this uh addressing social behavior does that mean if somebody if you can help if they're they're I guess possibly helps somebody if they're introverted or shy is that something where there it may be a brain functioning issue that you may be able to help them or is this I mean again it also could be related to potentially some other issues that's something that could be addressed um if people or if somebody doesn't react well in social situations or the latter is more addressable than China shyness may be normal and natural and good for you and it works for you great but social anxiety social integration social cueing discomfort around people's voices and eye contact you know I see that in people on the autistic Spectrum a big cluster of tissue behind the right ear called the tempo parietal Junction I also call it the Princess and the Pea because it gets irritated at everything and you'll see it really hot in autism and they are just like a fire hose and you can't filter it you'll also see it really hot in people that have deep emotional you know the wounded poet who's like feeling all the feels and has all the thoughts and has all the resources with which to catastrophize and emote you see that tissue is wide open in people and so you can tell it's kind of hot you can tell there's some sort of like the same people you know they're gonna throttle their roommates when they're chewing too loud and you know they notice every person suffering on the street corner and yeah if that gets in the way and you want noise canceling headphones for social information or sensory irritability you put a wire there you measure usually the hot beta he lets an alpha come up to replace it and it's like getting a voluntary gain knob to turn things down and when I say volunteer I mean voluntary we don't take things away with neurofeedback usually we give you range so the CEO that has that front midline hotspot might have some OCD and after you train down the excess bait on the front midline they can still turn it up and they need to hyper focus and then put it down at 5 30 pm and not hyper Focus as another viable mode to be in so that's the gift of neurofeedback honestly is flipping you out of this perspective of suffering and overwhelm and stuff not working for you and into like a okay got some brain resources what do you want to do they're not at 10 all the time they can go between a one and a ten when they need it and you know if you're always on it's more like you're always on an eight and a half and it doesn't ever feel good but if you learn to turn it off to a one or a two you can go flexibly between you know one and eleven no problem it feels good but if you're always at an eight it feels horrible and you can never quite actually push as hard or as soft as you might need to that's true of perseveration rumination social and sensory cueing um you can see executive function things pretty clearly so ADHD for instance is not just a low amount of SMR it's usually a high amount of theta which is lubrication and you can tell based on which side of the brain it is if it's left side then you have issues with things like the spotlight being bright enough and clear enough and stable enough we call that attention or focus and then the right side of the brain usually is the supervisor to know if you're paying attention or if you're going to go squirrel and it helps uh shut off the Theta and bring up the beta the SMR beta as a way of directing the machine so you don't end up with inattentiveness in the left or impulsivity or disinhibition from the right failure of that sort of motor tissue to create SMR tone which lets you sit still be still internally that kind of stuff so I'm gonna have you helped me answer a question I get all the time for my patients so why QE G because they hear about all these things on social media Reddit whatever it happens to be now there's so much I get too much information we have to filter it down here but at qeg there's functional MRI there's spect is qig play well are there differentiations that you can make simply to say look this is yqe J q e g is better than spec or function yeah where's everything play in the playground here sure uh I'm very biased but we should know that however um EEG is so much cheaper than an MRI machine so you can get an EG for a few hundred bucks you know it takes a grand an hour to run an MRI machine because of the helium and whatever else so spect very expensive MRI fmri very expensive also one of the big issues with using Imaging like specter fmri to understand you is there's no reference point so when Dr Ayman looks at a spec scan he can make a judgment call and say oh this part of the brain this little divot of activity that's this part and you're experiencing this but the only people that can do that are people who work for the amen Center who use spec who've been trained in that way no one else can do it brain mapping qeg takes the resting brain activity and then age matches the comparisons so you get a graded heat map of what's unusual out of the database instantly so that's one way in which you know the 10 000 people in the US who do neurofeedback they all can kind of read the same brain map the same way and come up with a similar perspective on the tools so that's useful more importantly you then have an EEG solution sort of suggested you know if you go into a spec most folks that do Specter functional medicine doctors so your spect is the the place of Speck I find is unbelievably useful is the really really squirrely mysterious diagnosis you need if you don't know what's happening if no one can figure it out the spect is unbelievable at that but the interventions are medical interventions or functional medical interventions lifestyle drugs supplements you know great but it's the diagnosis you're getting the value from when it comes to something like a spec scan or even an fmri and you need the person who knows how to read those the neurologist who knows how to read blood flow in the anterior cingulate or something and knows what it means because there's no database of blood flow across 10 000 people that you can look at a bell curve and go wow that's an unusual amount of blood flow for you doesn't exist so you have to only have the rarified neurologist making those calls about what is true for you or qeg there's five or six or eight commercial products thousands of cases all the shape of data in them approaches that of the real population in the world so you at least have a yardstick and you have some sense of what it means and then again okay it's an EEG phenomenon you're seeing you can now push on that particular EEG phenomena and see if you notice anything you're you're given agency instantly to start taking control of it and since it's a pretty non-invasive transient gentle way to push yourself around it's very low risk a couple sessions and you can try it oh wait a minute I'm feeling something great if you don't like what you're feeling don't repeat that neurofeedback protocol and it wears off the next day or so you have to repeat something 5 10 15 20 times to really get movement in the brain um so you have this freedom to like see the stuff in a brain map or QE G and go I would like to manipulate that and then use neurofeedback EEG training to go right after the stuff you're seeing and use the same tool sets to watch things change over many many months so there we I like that it's an N1 versus the N of many and a little more again more more understanding is of qeg versus spec and the other studies that are out and I can teach you the features if I showed you your Alpha Speed wasn't as fast as the average person your age and I said hey you experiencing some delayed recall and tip of the tongue and you're like yeah and then we trained your brain and three months later looked at it and it was up to speed and you felt smooth it had good liver fluency then yes I kind of know what it means but guess what you know what it means better than I do because I've taught you to look at the Alpha Speed I've had you watch your internal word finding you've transformed it you felt it change to me that is as valuable as the change is this perspective you get starting to take control of some of these resources and iterating through like Progressive agency instead of being overwhelmed by what is happening so that's my soapbox very well said on your soapbox thank you thank you now you can jump off and as as we move into the future here I know you're bringing your feedback not only to across across the world now now go to London Stockholm but now letting people like you said people do it at home that's the start of the future of neurofeedback in your Institute what do you foresee now in the next two three five years coming down the pike I mean you've already told me I can fix my love life and also uh maybe be like the next uh Steve Jobs here but what is the future I'm sorry I can't uh I haven't figured out how to turn on hair growth I know both of us for me that would that would be like the home run there there you go you know right like I have a long line of Executives out the door that come that come back for secondary training if I could very again that you fix testosterone and uh you be you you have need 30 000 centers but I have some good tricks for middle-aged dude libido they're not they're not Nursery back tricks but I got some good tricks that are non-invasive so there you Gotham I often share them all folks you know and full of Tricks where where are we heading with the neurofeedback and where do you see your Institute going so Peak brain is about 80 virtual now um most of our clients don't see offices the ones that do just come in for brain Maps usually um you know we have physical uh staff in London Stockholm uh Wellington uh we're probably partnering with somebody in Australia and Sydney shortly and then we have the four offices in the U.S so if you're in one of the countries where we have a physical location we can rent you equipment send stuff out very quickly and if you're not in one of those countries we actually work with clients in 30 or 40 countries already because clients will just buy a set of hardware and software for themselves their family and we have seven day a week Live support coaching the way we're set up we do the first two weeks of neurofeedback live with you we teach you to the basics of traditional neurofeedback so where we've really taken an advance is we've taken the process of doing traditional tailored careful individual wire placement neurofeedback and made that scalable to a virtual environment but there's still a bottleneck in the process of neurofeedback which is knowing how the thing you've tried it feels and the round trip of here's the brain map here's the thing you've tried here's what how it felt here's what you're planning on trying how do you adjust it that's the personal training circuit we have a cobbled together a back-end platform to kind of create this perspective on clients you know their stage their transformation where they are what their goals are you know the unknowns and their uh their changes thus far et cetera and what I would expect uh where we're going not just in neurofeedback but in I would guess in health and wellness I would guess in finance I would guess in all kinds of domains in life I think in the next three to five years we're going to see intelligent agents you know AI transforming everything AI is everywhere it's everywhere and I you know a lot of what I do the reason that my colleagues that exist in the field know you know no one's doing this High scale neurofeedback it's really hard to do and since the field existed people have tried and failed again and again and again and I might have the largest you know uh uh footprint of of clients for neurofeedback and I have around 200 active clients at a time or something which is an awful lot for a single neurofeedback you know provider essentially but I'm doing that because I've got all kinds of domain expertise shoved into my head you know a cognitive Neuroscience PhD in 20 years of working with brands at the extreme and teaching people about brains for 20 years it's an awful lot and it's a hard thing to replicate for neurofeedback but if I can use you know the past 10 years of peak brains skill decision making around clients with the complaints with the outcomes to start training intelligent avatars to say hey client with this brain map this complaint these goals you know what will what what have we done in the peak brain way historically over time I can start separating the sort of giftedness of clinicians in the field from the need to do that that level because you know Peak brand has pretty competitive pricing in North feedback especially in New York City where you are our prices are disruptively competitive all my colleagues very powerful I am yeah they love how vocal we are but they kind of hate our prices um essentially uh you know for folks who are wondering with that little cheese it's about 5k for a three-month program which you can get 50 sessions in so we're under that hundred dollar you know threshold basically for for pricing and in New York City you know it's therapists are charging 3 400 bucks a session same in La so it's getting a little bit ridiculous because it's a brain drain you know when I was in the field initially being trained by like a second generation person since it started I think there may have been more people in the field 10 years ago than now the technology is getting easier the amount of it's out there the costs the bearish to entry are lowering but the number of skilled people who can do it might be fewer because of this sort of like the first Dr Sturman is still like Emeritus faculty at UCLA still does some neurofeedback but other people in second and third Generations have been dying and aging out of the field the guy that trained me Dr Larry hershberg on the East Coast amazing autism psychologist he retired last year you know um and that's happening again and again so the skill of like the high level personal trainer is also kind of neuro Savvy who's also kind of like able to coach you that's been a hard thing to replicate and Peak brain does it has done it by replicating the coaching piece with our um sort of direct coaches we have worked with you and the sort of personal trainer you know head coach uh working with you that way that kind of high-end gym model but where I want to bring it is where the the phone app in your in your pocket tells me what your ordering says and your coach goes on notices that new protocol you tried wasn't great for your sleep maintenance makes a small tweak and you get a pop-up saying hey thanks for the report uh tomorrow's protocol is different here's why essentially I want to do that thing round trip without the in some ways really time intensive and labor intensive and you know a lot of it's just pushing numbers around so people can can can have everything right there where they can make domain expertise be that the wellness coach or the individual or the therapist I want that like Fitness tracker for the brain but with not just all the information aggregating like a fitness tracker but with intelligent predictive stuff Hey Joe you um you're drinking every Thursday night you're kind of a jerk every Friday you notice that as a feature what the Avatar says or hey you're experiencing this and these Trends are happening here's three Health involved interventions you've done before that helped your circadian rhythms off uh you may want to start fasting before bed again because last year when you were sleeping this poorly and you did that you got back on track quickly you know that kind of stuff is I think where we're going because I mean when you and I were growing up I'm not sure how old you are but there weren't a lot of gyms on every corner in the 70s that really happened in the 80s and our parents didn't have gyms in every corner but you and I can look at a lipid panel and go whoa better back off in the Ben Jerry's and and take agency you know and I think the brain piece of it is the next piece of it but it's not as knowable um it's it's more mysterious still and it's also more variable across people so the information is less discreet it's like genetic information it's not as discrete it's additive and and it builds up in systems so that's where I think we're going is having something you know the next health and wellness iteration is going to be something that can model interventions against it and say ah give them this brain given this complaint structure given this recent experience data Dimension is not going to work but that one plausible might work so at that point the cost structure of neurofeedback the cost structure brain preventions of self-assessments of Health and Wellness starts to do this from the point of view the consumer and the access and agency play goes way way up even more than I think it started to with technology becoming accessible that that would be perfect that'd be very again something one of these apps that's usable and gives you on instantaneous information be incredibly helpful so where can people find out about the peak brain Institute and learn more how you guys could help them so we're at Peak braininstitute.com uh as far as the website most of our socials are at Peak brain LA because that was our first office so you can find Peak bernella and Twitter and Instagram Etc um but I would say look us up and come on in uh and we will give you guys a listen who mentioned this show a discount to the 500 a year membership drops the 250 that gets you unlimited brain maps in all the offices or you can use the same discount towards a remote program if you aren't near an office and we have uh uh longer you know multi-month programs for folks that aren't near the offices too so greatly appreciate that we'll put that in the notes and also on all when we post this on all the social media sites and again thanks Dr Hill for hopping on he's always a Bastion of knowledge and uh as a wave I think you've done this before you have these all these analogies and ways of explaining what you do now so I think you've done you've done this a couple times already does it come across this pattern can you tell yeah yeah you still feel spontaneous good I appreciate that although folks have heard me go over their brains we'll recognize a metaphor or two that I've used today probably so um it's all it's all good so thanks for coming on on life optimized and we'll see you guys soon