The Future of Neurofeedback and Research with Dr. Andrew Hill | POP 1063

hey there practice of the practice Community are you ready to take your private practice to the next level then mark your calendars for September 16th through 19th 2024 because level up week is back and bigger than ever insert rocket emoji here join us for 4 days of live webinars interactive panels and exclusive resources tailored just for counselors therapists and private practice owners whether you're looking to fill your case load hire your first clinician or scale your group practice we've got you covered this is your chance to level up While others give up don't miss out on this game changing event register now at practiceof thee practice.com LevelUp and get ready to transform your practice remember September 16th through 19th level up week your ticket to practice success register today and let's level up together practiceof thee practice.com LevelUp [Music] this is the practice of the practice podcast of Joe sanok session number [Music] 1,63 I'm Joe sanok your host and welcome to the practice of the practice podcast I am so excited to have you here today you know when it comes to Neuroscience um I just love learning so many different things about the way the brain works how to optimize it how to think differently um and I know that the field is always growing so much faster than I can keep up with um and that's why I'm so excited to have Dr Andrew Hill with me today Dr Hill is a cognitive Neuroscience UCLA founder of peak brain Institute and a leading neuro feedback practitioner and biohacking coach for clients worldwide at Peak brain Dr Hill provides individualized training programs to help you optimize your brain across goals of stress sleep attention brain fog creativity and athletic performance Andrew welcome to the practice of the practice podcast oh thanks for having me Joe appreciate it oh man I am so excited about this uh when I was writing Thursday is the new Friday um that was uh from April of 2020 uh is when I landed um the the contract with Harper Collins it was due like mid September but I wanted to get it out early because we were going to be living on the road during covid in a camper I'm like I just want to be done with this thing I was learning so much about kind of Neuroscience neuro feedback um optimizing the brain and applying it while I was writing the book um that for me it was just such a fun process to write the book and so I know today we're going to dig in way past any of the kind of surface that I scratched but um we love to just start with Andrew how did you get into Neuroscience neuro feedback back uh all of that yeah thanks so I I've been working in the field of neuro feedback for like 25 years or so um and before that I was working in uh mental health doing psychiatric work in patient I was uh managing group homes for folks with multiple disabilities you know no language uh impaired cognition and was working really across a different you know uh area of Health and Human Services where people tended to suffer pretty hard be it lock facility impatient or heavily structured residential we just didn't have a lot of um what I saw is we didn't have a lot of uh ability to help people make change so there was you know paliative stuff were helping people suffer less hopefully but in the impatient environments I'd see people come and go sort of revolving door style mental health where they' get stabilized leave and come back a few weeks later you know in crisis again and I worked in all these different aspects of mental health for about a decade and right the end of that time I was working in a really acute psychiatric hospitals and ended up getting injured and I couldn't keep doing the work that I was doing uh in the sort of trenches of mental health and I ended up getting a job uh a year or two later working in an Autism Center in Outpatient Center and uh this is after leaving the field of mental health for a little while and then I missed it so I came back in I found a local place that had uh an Autism population they were serving I had some experience in that and I was curious ious about them because they did this thing I'd heard about called neuro feedback so I walked in hopefully you know just to get a an internship or some observational hours to figure out you know what this stuff was and ended up walking out with an actual job and spent a couple years working at this clinic and helping people work on their brains for autism ADHD anxiety seizure a bunch of stuff it was a more kid- focused uh uh Center and what I saw uh in the first couple of months of working there just blew my mind it was really running counter to what I thought was possible I had spent you know over a decade working with people who had really severe challenges and I saw some of the same types of populations in this outpatient clinic but I was seeing people come in and within about six or eight weeks they were making huge changes in executive function anxiety seizure sensory social and I was really just kind of flabbergasted because from my perspective these things weren't especially changeable and yet they were getting better change in this environment than anything I'd ever seen and so this again 25 years ago or more the field of Nur feedback was pretty nichy it's still pretty small um but back then you know before the modern internet even the uh 30 or 40 providers who were most active at the time about a thousand people total in the field um everyone's arguing on the on the use net to give a a sense of how long ago it was for folks who were younger that was like the precursor to Modern forums in the internet where Ma mailing lless based forums Essen EV and lots and lots of vitriol was being slung back and forth between about three schools of thought in the neura feedback landscape you know everyone argued that their way was the right way and everyone else was foolish and you the underlying theories about how this stuff worked it wasn't reconcilable so really a lot of aggressive uh fighting was happening in the back end of the the field at that point and yet all of those approaches all had better impacts than traditional mental health Psychotherapy and medic so against that landscape I sort of said well wait a minute we're all you know decrying our way is the best way and it must work this way or should work that way very much a blind men and elephant situation you know everyone's describing something right in front of them but nobody really had a good sense on what they were doing at a high level and so I went back to grad school I went to UCLA um and spent some time there studying how neuro feedback works and how does the brain know that certain brain waves are being applauded uh how does uh the basic you know aspect of of attention work in the brain because attention and executive function as well as big features of anxiety and sensory these were the complaints I was seeing across all kinds of populations be it a high level CEO who's super high performant or a kid who's screaming and stemming and flapping um they're both going to have sort of an anxiety phenomena maybe an executive function maybe some sleep issues so I started to to see as I kept working in this field for years um sort of convergence around different resources that we all tend to want to work on even if those things can kind of cramp up or get disregulated in individuals in very different you know ways visibly it it's often the same gross resources we want to work on these big features of our brain that help us produce our mind so I studied Nery back in grad school and then as I exited grad school um decided to open up neuro feedback companies teaching people to understand themselves through brain mapping and then uh we provide brain training or neuro feedback all over the world at this point so uh yeah wow so when you when you're explaining neuro feedback um to clinicians a lot of us you know heard that in grad school we've probably had some continuing ed here and there we have a basic understanding around it probably not enough to implement a lot in our practice now in any specialty there's times that you definitely go to a special a specialist and um you want that person that's you know doing the brain mapping in full on neuro feedback and then there's other times where there's aspects of it that are fine for the general population um I would love to hear kind of some of those definitions as to kind of where we're at in neuro feedback now um what are some of the I guess my question is what are the basic things we want everyone that's listening right now to know before we enter into more of this conversation so a couple things one is you're right there's a proliferation of devices and consumer stuff available it's unfortunately not a substitute because it doesn't do assessments and tailored work and people are weird I mean really weird so good job be weird but you can't train one brain like someone else's brain and expect to get the same result can't do the wrong workout in the gym and expect it to work and that does happen you either get weak workouts with the one size fits-all system or you actually cause side effects because you're training your brain in a way it doesn't want to be trained generally in neuro feedback the process is one as you learned in grad school it's associative learning this is not that special in terms of how it's actually working it's a little bit Technical and you know magical in that way but the way we actually create learning is no different than basic associative learning you know if a baby's flopping around and suddenly does a baby push-up and can see 12 feet oh my goodness the brain remembers next time it wants to see further away and get more information it remembers that unique confirmation of neurons that fired to produce the push-up so increase the you know amount you can see the baby wasn't thinking wait wait left arm wait right arm it just kind of did the thing and the Brain took over the complicated uh you know discovering the Mastery of doing uh that particular movement and that happens in in Broad resources too so what I would say in terms of where the field is now there's a handful about eight different things that are pretty much reliable across people um there's other stuff you can do there's a huge amount of things you can do to the brain and create experience but in terms of the lwh hanging fruit for neuro feedback the stuff we almost always uh work successfully with when I say successfully we make changes in the brain to the point where we actually eliminate the phenomena and things like ADHD and PTSD and OCD cravings for alcohol often sleep issues uh sensory anxiety and social anxiety those things are all visible in what's called brain mapping or quantitative EEG and then you can really think about neuro feedback a lot closer to the personal training into the pool than therapy most people that do this work are therapists um there's about 15,000 people in the world that do neur feedback professionally the vast majority of them are therapists who first became therapists or clinicians of some sort and then they discovered that neuro feedback was impactful for their population of interest you know autism or Eed disorders or trauma or or whatever and then they learn some neuro feedback for that population for that complaint and we have some incredibly gifted people in the field who work combining therapy with neuro feedback especially in aspects of uh care that involve trauma you know that's a place where you don't just want to help the brain move but you want to help the person integrate the new skills but if someone's got ADHD just get the ADHD out of the way or seizures you don't have to do Psychotherapy for seizures you know it's really just the brain's ability to resist that phenomena so there are some gross things you can get access to what I would probably think maybe is more important than the you know landscape of neuro feedback and maybe more gerine to clinicians listening is that you can use brain mapping to understand your clients I mean you literally can look at a brain map and a performance test and figure out if executive function anxiety fatigue if those things are in the way and and where the lines are you know what aspects of what the person's experiencing or ADH what aspects are anxiety or trauma response what aspects are because their sleep is disregulated those things can all look the same in your clients you know you can't tell if someone's necessarily ADHD or has a trauma response unless it's really severe version of one of the other kind of look the same and a sleep issue really does come along a lot of the time with ADHD so it can be hard sometimes to tease apart the physiology and the psychology when we're working with people and if you're trying to do therapy for physiology guess what it's not going to move very well and yet you also might want to do the physiological interventions with the therapy you know pull the teeth of the posterior singulate or per aqueductal gray and help someone you know soften their amygdalar tone so they're not panicking and not in a threat sensitive mode but it's really part of the process you know you would work on that and then do the integration work around trauma so neuro feedback in a clinical context usually or often especially for anxiety and trauma you see a huge amount of combining these days with techniques like EMDR brain spotting DBT CBT and then some of the newer um versions of cognitive behavioral therapy things like ifs internal family systems sematic therapy um I don't know a lot of neura feedback providers doing those latter ones but I do know a lot of sematic and ifs providers because they send me clients you know essentially I help get the brain out of the way and then their therapy works so I I guess the the point is I'd like people to think about suffering and complaints and goals you know they are complex they're they're they're psychosocial but we've been teaching biopsychosocial for 30 years in grad school and sometimes I think that the the clinicians who were more therapy focused you know talk therapy focused often forget that the physiology the Sleep regulation the stress regulation the executive the speeder processing these are actually fairly main resources that may impact how you do therapy so I can show you your client's brain and teach your client about their brain in a way no one ever has I guarantee you and I can teach you to understand people through brain data in a way that will add to your practice if you're a clinician so you don't have to do neuro feedback for this to be useful but I encourage you to develop a physiological perspective on some of the complaints you may see especially if you're in a landscape of like working with impulsivity or burnout or sleep or you know these anxiety features because there's a physiological component and if you teach your clients how to think about this it just adds agency you know I'm sitting down often over brain map data with somebody and my goal is not to sell neuro feedback it's to sell agency it's to be like look it's just your brain what do you want to do you know and also people are weird so as you go over physiological data with someone you get to both validate stuff they already know because that's what you see in their data and you get to kind of lean away from a diagnostic framework because the diagnostic labels in the DSM are not quite as precise they're not as variable as individuals and when going over data with someone you're generally telling them stuff they already know about inattentiveness impulsivity anxiety sleep fatigue Etc and that's The Sweet Spot of brain mapping is when you're really just confirming things that the person's already quite aware of because then stuff you're seeing in the data becomes something you can go after you can help somebody develop you know life hacks other bioh hacks you can go after with neuro feedback if you're somebody who's is mindfulness some of the the the the brain signatures you would see would help you understand if this person would do better with you know present time awareness versus single point awareness kind of meditation practices or meta you know loving kindness stuff you kind of learn your clients better um I mean the reason I do neuro feedback well is because I understand clients's brains from their data not because I'm like the world's most amazing neura feedback provider it's a little bit of a a black art you know and I'm pretty good at it but the really really important part actually comes before you start interventions it's the perspective and it really does flip the script a little bit and it moves people from this place of being diagnosed and a top- down treatment perspective into one where they're being informed and educated and being given progressively more and more agency and I think that's really important working with phys iology is not just to become yet another expert yet another Guru and people with deep suffering and and and quirky suffering have often been poorly served by psychology and Medicine historically and they're often kind of braced against you know meeting a brand new provider they're waiting to like have to go through their story again they're waiting to you know have the provider be a little confused by what's happening because no one else has been able to figure them out I don't have to do any of that I simply look at their brain and say look here's a feature in your brain it often means X Y or Z does that seem valid and most of the time it is and so instead of you know by by not providing my judgment on them going over brain data instead teaching people to read their own brains and see the things they know really does pull the stigma of Diagnostics and move somebody into a place of like oh okay there's my brain oh yeah I'm gonna do some stuff I'm going to take some control and it's it's really lovely to be able to offer you know a clinical population that degree of agency and sort of it's a different mode to move people into especially if they've been medicalized or you know dealt with some trauma by being in a treatment environment for many many years you know with with uh illness or medical trauma medical interventions often kids have surgeries you know repetitive surgeries will have medical Trauma from being just in that patient role for so long or you know see see someone's tick or someone's you know impulsivity and that's something that they've been blamed for for the past 10 or 20 years and people you know sneer or lift an eyebrow or think it's their fault but when you show somebody their impulsivity their brain Map and Go wow it's really hard for you to pump the brakes huh the person's like yes thank you yes it's real it's a real thing so data can be really powerful as an agency builder in a mental health context without actually using it as a diagnostic as a therapist I can tell you from experience that having the right EHR is an absolute Lifeline I recommend using therapy notes they make billing scheduling note taking telea health and E perscribe incredibly easy best of all they offer live telephone support it's available 7 days a week you don't have to take my word for it do your own research and see for yourself therapy notes is the number one highest rated EHR system available today with a 4.9 out of five stars on trustpilot.com and on Google all you have to do is click the link below or type promo code Joe on their website over at therapynotes.com and receive a special 2month trial absolutely free again that's therapynotes.com and use promo code Joe on the website if you're coming from another EHR therapy notes will also import your demographic data quick and easy at no cost so you can get started it right away trust me don't waste any more of your time and try therapy notes just use promo code Joe at checkout what are you doing October 1st through 3rd I want to hang out with you just south of Nashville Tennessee down in Franklin I'm going to be keynoting the mental health marketing conference and I would love for you to be there we are also sponsoring the clinical track where there are going to be tons of amazing trainings All For You in private practice this is the national gathering for marketers and clinicians in mental and Behavioral Health you're not going to want to miss this awesome conference it's the one conference I'm keynoting this year and you can read more over at MH marketing.org also Steve over at mental health marketing has given 25% off to any practice of the practice listeners that want to come to this whether you're coming in person or online you're going to want to use promo code Joe at checkout to get 25% off I would love for you to come in person for my closing keynote on Thursday October 3rd at the mental health market marketing conference but if you can come online that works as well can't wait to hang out with you in Tennessee again that's mhm marketing.org and use promo code Joe at checkout to hang out with me October 1st through 3rd 2024 I would love for you to kind of walk us through so the average clinician has someone in front of them that is dealing with trauma anxiety something that they know that brain mapping you know neuro feedback could help like how does that flow work um they're they're in front of them is it then they go get brain mapping with someone like yourself and then there's data that comes back and tips on what they should do like walk us through kind of the some of the best practices and obviously it's going to be client specific in a lot of areas where it's going to be like full referrals versus partial referrals but like what does that typical collaboration look like for therapist that are going to partner with folks that are doing the brain mapping and helping with that kind of data yeah a lot of people that do brain mapping are also therapists so they're really just mapping their client base as they go but I have a certain um fraction I would say you know about half my referring clinicians are super excited to use the tools but don't want to necessarily become a brain gym and stop seeing their 20 25 30 client hours a week so instead they refer people out for mapping and maybe for brain training with us uh and my company Peak brain does brain mapping in physical offices we've got uh four in the US and a couple overseas you know uh New York City LA St Louis Orange County plus uh Stockholm and London but about 80% of our clients never see our offices so we're a little unusual in that we send equipment out to clients and we have live coaches walking you through doing brain mapping uh yourself from home uh or neuro feedback yourself on going from home so it depends a little bit on where people are let's say somebody was in you know New York or La near one of our big offices and they're interest in understanding their clients more you know I send emails every so often saying hey send your clients and I'll teach you and what they will do is they'll send somebody in uh the person will sit down and put a cap on the head squirt it full of gel they sit still for about 20 minutes half of that eyes closed and half of that eyes open because the brain is in a very different uh set of states and modes under those two eye conditions and we also have the person do the world's most boring executive function test 20 minute go no go style CPT um and all of these things the performance on the test as well as the two Baseline brain recordings uh we then compare to AG match samples and see how unusual somebody is and again brains are weird so good job be weird it's a little hard to interpret we know it's unusual but there's still a step to go through with the client and I'll get back to that but the bra but the performance testing is very straightforward if if you look impulsive or inattentive or your reaction times are off or you show stamina ISS issues during the test it's really obvious it's very valid good face validity in the CPT label so I can tell somebody very very discreet discreetly straightforward way look you've got some impulsivity or some inattention or auditory processing is off or visual processing is off and we're just measuring that and it's interesting and it's all in a bell curve so you really quickly get a sense of well how in the way is it is it more than a standard deviation off the mean well okay that's kind of in the way um but I will say that even at that first attention test step you know someone comes in with ADHD diagnosis you look at their attention test you're like well yeah you have some inattentiveness but it's because you're falling asleep in the middle of the test not because you're having any trouble the rest of the time and then you might look at their brain and see all these fatigue phenomena that are stronger than attention phenomena and that can start to you know change the perspective but what what would happen is someone come in for a couple hours or we send them gear uh to home and they work for a couple hours Gathering data and then it takes a couple days to process that data to do an analysis of one person's activity and performance against the average population and so after a couple days of work we've got a set of PDF files that really outline your executive function as well as you know dozens of features in your brain and I do a uh a review with clients on Zoom I spend about half an hour teaching them to read their data so it's not like I write a report saying here's your diagnosis it's more like go look here's your attention test let's walk through it and look for quirky things and I'll teach you what it might mean and then here's your brain let's find all the quirky things and I'll teach you the physiology of that re region and what's under there and what it often means when you have an unusual amount of brain waves in that region and by doing that I'm really modeling coming up with plausible ideas that are bound by the valid data in the performance test and that are really sort of suggested by the brain data and then of those big features I walk through all of them with a client and I sort of you know unpack the physiology at each one of those locations and usually most of what I identified is important to them they they already know about it it's rare that I'm like oh hey here's a plausible idea and they're like yeah not me that's a little rare you usually I'm finding between a half a dozen and about a dozen things in any particular person's brain data and it's usually like 95% of those are just valid like the person already kind of understands that and knows it and it's a goal for them typically um so I find these features in a brain Set uh a set of data both performance and Physiology and then we would send the client the review video and the raw data files after we do a review and sit down over Zoom so at this stage the client has now been pretty thoroughly educated about their physiology kind of like going to Equinox and doing a big dexa scan and a bone density scan and a you know history of your nutrition then you sit down with a personal trainer go through it all try to figure out where there's performance opportunities or bottlenecks that you might want to work on and you probably know about most of those already that's kind of what we do is I you know go through all the data and I find generally the reliable stuff you can see you can see executive function things pretty reliably whether or not they're you know ADHD or postco fog or a concussion you can kind of see it and you can see all the flavors of anxiety pretty much um perseveration rumination hypervigilance sensory social they all kind of show up pretty clearly uh speed of processing is your Alpha Speed that's pretty obvious um and then there's a few other things you can see that are a little hard to interpret you can see concussion type phenomena but don't you we wouldn't know if they're from an actual concussion or you know sleep issues or other know things causing brain fog unless it's very very acute um and after walking through all this data the person again generally feels pretty validated and is pretty happy even if it's suffering we found because if you see things on a brain map well then you know how they operate and that starts to give you ideas about how to change them so as I'm walking through data it's never a conversation where I'm saying I'm sorry sir here's something wrong with you it's more like oh hey here's a quirky thing in your brain this often means X Y or Z oh that's true for you is that important to oh that's important to you okay that must be frustrating okay well that's this is a thing that we can often change usually let's make a note of that and so it's agency providing because either I have a technique to reach in and push it around with n feedback or it's you know more systemic I'm like oh look at this your deep sleep is clearly poor all the time oh yeah you came in for Sleep issues yeah that makes sense oh you're eating before bed yeah stop that fast before bed two hours the reason it'll let your blood sugar drop and we need low blood sugar to have a release of growth hormone so sometimes you can spot something in physiology like the Alpha Speed being slow or spread out which will produce word finding issues and delayed recall the Delta speed being super fast which is the brain pushing into the foreground with its metabolic you know recovery mode and if I see that I can tell someone's not sleeping well has some brain fog and has delayed access for words and names and tip of the tongue um and if I posit that model and they're like oh gosh yes I'm always hunting for names and I'm always tired okay well that's not your memory that's your sleep your brain's not running fast enough to hand off information clearly look at this Delta sir or ma'am look at this Alpha yeah here's how you change that you fast before bed and that'll help your deep sleep and I give them the insulin metabolic uh description about the why you should do it also people often don't know why they shouldn't eat before bed and the growth hormone suppression is a big piece of it another big piece is the Melatonin signal that rises later in the day suppresses insulin release so as melatonin goes up insulin drops and starts to go away this is one of the reasons why we snack at the end of the day if we have evolutionarily if we have access to calories we better eat them and store them at the end of the day because they might not be there tomorrow in our modern world that doesn't work so well and we can just eat forever and you know have metabolic issues but if you do allow yourself to fast you get a pretty strong blood sugar drop and you also clear insulin so you have no blood sugar and no insulin which is great and then two hours after you fall asleep if you're you know uh 30 years older or above you get your only pulse of growth hormone if you're young you get a trickle all the time but if you're older you get one pulse of growth hormone once a day uh when you first get into deep sleep unless you've had food before bed and then you skim the surface of sleep all night long and wake up hungry and tired so I might the point is I might see biohacking advice I might see things around stress uh another example is uh the front midline the anterior singulate which gets disregulated in many things we uh treat so to speak or or as as as a you know Psy psychological landscape many of us listening to this uh show today work on phenomena that involve the anterior singulate the anterior singulate is the CEO or project manager of the brain it holds things in the mind the internal mind it also helps you do things like what you're valuing what you're thinking about helps you do temporal discounting like when you when you overcommit to the task that's two months away because you because you're like yeah I can do that that's temporal discounting or when you're like oh my God I can't do this thing right now it's too it's too intense it's too too much work well that's the other side of it and the anterior singul helps with that it helps with uh selecting from conflict if you're going to step into traffic when the walk signal flashes but at the same time a car comes screeching around the corner you have to select from competing uh uh demands and that's also front midline interior singulate kind of things so many of us will have an excess of theta front midline Theta it's called and that's like a disinhibition of the tissue and others are of us will have front midline beta excess and if you have lots of beta that tissue gets caught in high gear and we tend to perseverate or become obsessive and if it's very very strong it's full-blown OCD you can see OCD on a brain map really clearly for most people as a blob of beta you know three standard deviations excessive beta on the front midline and if they have Theta you know disinhibited tissue the mind is sort of looking for things to latch onto and you get like low-key tick type behavior in the brain so lots of front midline Theta can produce songs playing in the head all day long that earworm phenomena or it can produce nail biting you know you you like obsessively chew on things so it's kind of a Ticky and picky kind of signature when the the Theta is high so if you're dealing with somebody and you try to support them and treat them and they have strong OCD and you look at their brain and you see front midline beta uh well then that gives you ideas about how they're operating versus Theta you know and about the flavor of OCD they might have or the flavor of tick and then if you're smart you might look at the literature and go wait a minute this kid I'm treating has OCD and they haven't found any medication to work on it and yet the brain looks like it has classic OCD you dig a little bit deeper in literature you find that you can give kids that have medication resistant OCD a supplement called an acetal cysteine that pulls the teeth of intrusive thoughts because it's lubricating that interior singulate pretty quickly in about 40 50% of kids with medication resistant intrusive uh thoughts so again not doing neuro feedback from the data but suddenly having a perspective on that person's suffering and Resource Management crystallize in a way that's a bit more precise than the psychological models we use I mean a lot of psychology is models it's models about how attachment works or how um Drive reduction works or how you know value works or impulsivity but some of this stuff is not psycholog iCal model sometimes it's just a resource sometimes it's just in your head it's not in your head it's just in your head you know and and you can go after it that way and really give people a lot more control over their internal environment so I guess to answer your question after somebody did a revieww with me we send them data we send them PDFs to the raw data and anyone else on their team who wants to be informed can now have that so you know if a person comes in saying oh I have a therapist please send this off well now that's great I send it off and then I'm available to that therapist to go back through the data again if they need so the therapist can of course review the video and see the big features that we identified and also maybe you know it can be useful to hear me talk to your client for half an hour about different aspects of brain resources and what their experience is and where they find things most annoying sometimes therapists haven't gotten that information from the client because they're a you know psychodynamic therapist who never thought to ask about sleep regulation or you know or or a tick or something and it's a very different landscape but it can really inform things you can then jump on yourself psychologically especially because a lot of Psych that's you know we tend to have our individual therapy approach but also I would argue that a lot of psychologists and therapists are also coaches where the therapy they're doing is not so much about the particular intervention model it ends up being a lot closer to like motivated interviewing and you know goal setting and helping people identify where the stories are they're telling themselves but you can do that with physiology so if someone's like my sleep is fine and you're like um your alpha waves are super low and your Delta is really fast and you just got through complaining for the past 10 minutes about how you always wake up tired in the morning hey maybe we should try an experiment in sleep tracking and sleep hacking and see if over the next two weeks changing when you eat changing when you work out maybe buying a sleep r a ring tracker for your sleep or something you know you can start figuring out where there's some really important things to work on so you wouldn't need to be a neura feedback expert for that or even a brain mapping expert because you know I can be that for you but you would need to be able to have like a physiological perspective on someone suffering the bioc psychosocial method and perspective not just the psychosocial method here so awesome um well we've got time for one more question just a couple minutes left the final question I always ask is if every private practitioner in the world we're listening right now what would you want them to know that sleep is probably in the way for most of your clients sleep is usually a big deal and it's you know modern humans do not sleep well be it children or adults um there was a study several studies in the 80s and 90s on neuro feedback looking at brain mapping being able to diagnose ADHD and the statistics were high worked by Vince manastra Dr manastra very very strong stats like 94 95% uh uh sensitivity to sort ADHD and non-adhd into buckets and every year after that the replications got weaker and weaker and a decade later Somebody went back and realized hey wait a minute the Adolescent and college age populations were're doing research on got progressively more sleep deprived and the sensitivity of EEG analysis cannot tell apart ADHD from sleep dep and I would say that of the you know I do I do a thousand new people every year roughly and I see you know five or six thousand brain Maps a year and and 90% of them have sleep issues maybe more so it's really common ADHD anxiety chronic stress burnout sleep is a much bigger deal the only thing you could add into physiology is some sleep coaching some sleep hacking um it would make a huge difference in many of our practices if you just got people to pay a little more attention to their sleep and start to move in the right direction on that so awesome Andrew if people want to connect with you if they want to follow your work where should we send them yeah so you can check me out on socials at Andrew Hill PhD I've just started doing a YouTube live stream every week where I do Nur a feedback on myself and kind of like an AMA answer questions and there's a new topic every week as well um you can check me out there uh youtube.com Hill d rh- i l l and then my company's Peak brain Institute uh.com uh you can check us out all over the web and you know come ask us your brain questions or come on into one of our locations and get a uh and get a a discount you know normally we charge we're we're pretty affordable as the field of neuro feedback goes our brain mapping is only 500 bucks once a year for as many as you need you know brains change kind of slowly so that's maybe two or three or four uh would be the most you'd need but for for listeners of this podcast if you want to send people in we'll cut that in half so you can have a lowcost client uh access where your clients can get a brain map 250 and that includes repeats and that includes me going over data a couple times with them and sharing that with you so come ask me your brain questions or send your really hard clients to me I really like getting the hardest clients those people that you're really confused by because I can almost always add some value and help you unpack what's going on a awesome thank you so much for being on the show oh my pleasure thanks so much for having me Joe what a great show uh we are going to be hanging out uh down just south of Nashville in Franklin Tennessee at the mental health marketing conference I'm going to be doing the closing keynote on Thursday so if you want to head on over to mhm marketing.org just use promo code Joe at checkout you're actually going to get half off your ticket so um come hang out with me and all the folks that are down there also we couldn't do this show without our amazing sponsors today therapy notes is our sponsor they are the best electronic health records out there uh check them out over at therapynotes.com use promo code Joe at checkup to get a few months for free thank you so much for letting me into your ears and into your brain have a great day I'll talk to you soon special thanks to the band silence is Sexy For That intro music and this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered it is given with the understanding that neither the host the producers the Publishers or guests are rendering legal accounting clinical or other professional information if you want a professional you should find one