Dr. Andrew Hill is the founder of Peak Brain Institute and a leading neurofeedback practitioner and biohacking coach for clients worldwide. He has lectured on psychology, neuroscience, and gerontology at UCLA’s Department of Psychology where he received a PhD in Cognitive Neuroscience. 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. He is the host of the Head First podcast and continues to do research on attention and cognitive performance. You can connect with Dr. Hill via Instagram @andrewhillphd https://www.instagram.com/andrewhillphd/ and @PeakBrainLA https://www.instagram.com/peakbrainla/ Related Episodes: Ep 193 - Superhuman: Dr. David Haase on Unlocking your Brain’s Potential https://podcasts.apple.com/us/podcast/superhuman-dr-david-haase-on-unlocking-your-brains/id1019070179?i=1000518793962 Ep 78 - Lifestyle and Brain Health with Dr. David Perlmutter https://podcasts.apple.com/us/podcast/lifestyle-and-brain-health-with-dr-david-perlmutter-ph78/id1019070179?i=1000401587053 If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating or share your feedback on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every week. Disclaimer: This podcast is for general information only, and does not provide medical advice. I recommend that you seek assistance from your personal physician for any health conditions or concerns. iTunes: https://goo.gl/UFjY0q | Stitcher: http://goo.gl/xKMmiR | Spotify: https://spoti.fi/3aiTnBg | Google Play: http://bit.ly/2vrlTSD
Episode Summary
This article is drawn from my conversation on the Pursuing Health podcast with Dr. Julie Foucher Brown. You can watch the original conversation. What follows is my own framing of the science and the clinical patterns we discussed.
What is neurofeedback, and how does it train the brain?
Neurofeedback is operant conditioning applied to signals you cannot normally feel. Most learning we understand is associative: a light and food paired enough times makes the light alone trigger a response. That is Pavlov, classical conditioning. Neurofeedback is the other kind. It is Skinner's pigeons, reinforcement of something you are already doing.
Here is the mechanism. We measure a brainwave you produce on your own. When the wave moves in the direction we want, a game runs, music plays, a little applause happens. When the wave drifts the wrong way, the reward stops. Your brain notices the link before you do. A few seconds in either direction, and it starts to register that the outside world is tied to its own activity. The brain maps tools onto itself this way, the same way it maps a fencing foil, a bicycle, or a paintbrush as an extension of your finger once you get good with it.
You usually cannot feel the training while it happens. You feel the rebound later. Hours after a session, the brain says, in effect, I was getting interesting information with more alpha, and it raises the alpha briefly. That is when you notice something shift. The trick for the operant conditioning crowd is that we move the goalposts. We adjust the reward so that longer and longer runs of the target state become what pays off. After several days, one session no longer just swings out and back to baseline. The resources start to hold.
This is why I take neurofeedback out of the treatment-and-diagnosis frame and put it into a personal training frame. I want to teach you about your brain, give you agency, and let you push on your own circuits. You can read more about how this works at a distance in my remote neurofeedback guide, and the broader evidence base in Is Neurofeedback Legitimate?.
What does a QEEG brain map actually show?
A QEEG measures the amounts, speeds, and connectivity of your brainwaves and compares them against a normative database. The brain map is a tool to decide what to go after in training, not a diagnosis.
Being unusual relative to average has no automatic clinical meaning. People are weird, and the degree of unusualness does not determine how much something gets in the way. Oranges and reds mean lots of a brainwave or lots of speed or connectivity. Blues mean low amounts. We model the unusual features into plausible hypotheses, then we check those hypotheses against your performance testing and your lived experience. The findings that line up with something you already recognize are the most valid targets. Full detail on the procedure is in my QEEG brain mapping guide.
Brain maps are stable for one person. Map yourself month after month and the picture stays the same unless you are doing something to change it, or you have been acutely distorted by caffeine, cannabis, or a stressor. That stability is what makes a sudden change meaningful.
Which circuits drive anxiety, rumination, and sensory overwhelm?
Anxiety phenotypes are cramped circuits, the way your lower back can spasm to protect you after a car accident. Think of anxiety as a circuit that is out of shape or mildly sprained. A bad sprain hurts worse than a clean break, so this framing does not minimize the discomfort. It changes what you can do about it.
A few circuits come up again and again:
The posterior cingulate sits at the back middle of the head and evaluates the outside world to orient your attention. Watch the road, scan the ocean for the drowning swimmer, heads up for the frisbee. When the brain learns the world is unsafe or unpredictable, this circuit can stay cramped, producing a ruminative, threat-sensitive unease. The severe end of that spectrum is PTSD, but most people sit somewhere milder along it.
The anterior cingulate, in the front midline, selects what you think about. When it gets stuck in a high idle, you get songs lodged in your head, intrusive thoughts, nail-biting, the obsessive-compulsive flavor. On a brain map this often shows as a hot blob of beta or an elevated alpha sitting in a high gear.
The right temporoparietal junction (TPJ), behind the right ear, maps the world into the mind and handles auditory processing. When it runs hot, the sensory filter stays wide open. The world gets literally too loud. I call this the Princess and the Pea phenomenon: you cannot ignore the background. It can drive social loading, irritability, and rejection sensitivity. When the anterior cingulate and the right TPJ light up together, you get a specific perseverative-plus-sensory combination that can show up as misophonia, where a specific sound makes you want to climb the walls.
The frontal lobes carry an approach-versus-avoid balance. I describe the left frontal lobe as the happy little kid on the porch who says, "Hi, want to play, can I show you something?" The right frontal lobe is the grumpy old man who says, "Get off my lawn." When the left front is not making much beta, it is hard to summon that drive and buoyancy. A cool project lands as a burden rather than as interest. When theta and alpha bloom on the right front, you get dread and a freeze, which can tip toward depressive patterns. More on these circuits in Biohacking Anxiety and Biohacking OCD.
The empowering point is the one I keep coming back to. If we find something real on a map, you can almost always exercise it and change it. The brain is hard to understand and easy to push around.
How do you measure attention separately from the brain map?
Before training I run a 20-minute continuous performance test. We flash a green 1 or 2 on a black screen and also speak the number, and the only rule is click the 1 and not the 2. The stimuli come slowly across about 440 trials. We are trying to bore you, because that is how attention bottlenecks reveal themselves.
The test splits into two sides. The left side, attention, measures how well you grab the target and fire the gas. The right side, response control, measures how well you pump the brakes and not click on the 2. Scoring runs like most population measures: 100 is typical, plus or minus 15.
The value comes from looking within one person. A psychologist scoring 107 might call it fine. What I look for is the spread. In one of the maps we discussed on the show, the visual focus sat near 118 while the auditory focus sat at 92, almost two standard deviations of difference inside one head. That gap, combined with elevated activity behind the right ear, pointed straight at an auditory-specific bottleneck worth training. After two rounds of about 30 sessions each, the weak auditory subscale moved more than a full standard deviation, and the overall scores leveled up and held. The performance gains showed up even while the brain map looked foggy from a viral hit, which tells me the training was protecting function through the disruption.
What does long COVID brain fog look like on an EEG?
Nine times out of ten, post-COVID brain fog looks like a concussion on a brain map. The pattern is consistent: alpha slows down, which degrades the quality of deep sleep and drags your speed of processing and word finding. Delta swells up, especially in the temporal lobes, so memory retrieval gets hard, balance gets wonky, and sounds and lights get too bright.
I use a metaphor for the delta-and-alpha picture. Picture your brain as an office building. A cleaning crew of twenty comes in overnight and resets the place, so you arrive to fresh coffee and a sparkling office. With long COVID, that crew is cut to eight, they are exhausted, and they are still there at 11:30 in the morning, spilling trash and getting in the way of the workers. That is the metabolic repair state of sleep leaking into your waking hours, running fast to try to catch up.
The timing fools people. Long COVID does not have to arrive with acute COVID symptoms, and it does not have to show up right away. Like a concussion, it can bloom over two or three months. You can have a mild cold-like infection in December and not feel the fog until March. That is exactly the arc we saw in the conversation, where a December infection produced a brain map at peak disruption months later, then improved over the following months of training.
In clients I have followed for years, I see another pattern. When the inflammation arrives, it latches onto old brain injuries first and lights them back up, like a second concussion doing the damage the first one set up. The mechanisms that make people sickest with COVID and the mechanisms behind long COVID seem to overlap around inflammation, clotting, and energy flux. That is why pre-diabetes, visceral fat, heart disease with low ejection fraction, and blood disorders act as precipitating factors.
What can you do to recover from brain fog?
Neurofeedback is one tool, and on its own it often does a lot for this picture. Several others stack well with it.
Hyperbaric oxygen can drop brain fog noticeably and shows a clean pre/post change on a brain map. On its own it does relatively little for the brain over the long run, but added to neurofeedback it often roughly doubles the impact of the training. When people ask my protocol, I point to ten 90-minute dives over two weeks at two atmospheres in a hard chamber breathing pure oxygen.
Hormetic stressors work well and cost little. Sauna, ice baths, contrast showers, and sun exposure all apply a mild stress that the system adapts to. The rule: if you feel worse afterward, like you got hit by a truck, you drove inflammation up too far. Back off, go gentler, and try again when you are less fragile.
Photobiomodulation (red light) is one I use and recommend, while staying honest that I do not fully understand whether it closes the loop on recovery. It is doing something. More in Brain Biohacking with Photobiomodulation.
Passive infrared HEG (hemoencephalography) measures the brain's blood flow with an inward-pointing infrared sensor while you concentrate, so you learn to drive frontal blood flow up. It works well for COVID brain fog, migraines, and frontal-lobe development, and it costs far less than a hyperbaric chamber, which makes it a practical directed tool.
For most people, this picture improves over time, especially with high-quality nutrition, some fasting, and lower carbohydrate intake to manage the inflammatory and metabolic load. See Strategic Fasting and Biohacking Brain Fog.
Why is metabolic health the foundation for brain health?
Nutrition is the most accessible biohack most people have. The thing I watch is what I call ectopic energy: storage that spills where it does not belong. Fatty liver, fatty muscle from circulating triglycerides, and visceral fat packed around the organs under the abdominal wall. That visceral fat is glandular, hormonal tissue that dumps inflammatory cytokines and drives blood sugar swings and hunger, and it responds to the same levers you pull for brain health.
The goal is metabolic flexibility. You want enough energy and a strong immune response without too much inflammation, and you do not want to fall apart walking past a donut shop because you caught the smell of sugar. How you fast should follow your reason for fasting. A child managing seizures needs serious low-carb, high-fat ketosis. A competitor prepping for the stage drops both carbs and fat to shred. If you are just staying healthy, the workable range is much wider. Aggressive fasting suits middle-aged men and postmenopausal women dealing with insulin resistance; young women have real pitfalls to watch with caloric restriction. Run it as iterative self-experiment with data, not as membership in any guru's church.
Most diseases of brain aging, the dementias, diabetic complications, Parkinsonian conditions, even much of cancer, are driven by glycation and oxidation, fatty acids and cholesterols reacting in the presence of oxidizing sugar. Controlling that flux is what I mean by functional neuroscience: hacking the body to support the brain up top.
Where is neurofeedback headed?
The field's best practitioners succeed by carefully trying something, learning from how your brain responds, and getting you a little further each time. People are variable enough that this iterative, personal-training approach is the most reliable across a population. It carries a real craft burden, and that craft is the bottleneck in the field.
Where it goes next is quantified self plus prediction. Tightly integrate your daily state and trait data, sleep, stress, heart rate, wearable metrics, with your brain map and your training history, and you can drop interventions onto graphs and see what is working. Build enough of that across thousands of people and the unusual brains, the ones who respond strangely and number maybe one in a thousand, finally have a database large enough to predict for. Eventually that becomes intelligent avatars: a model of your brain you can test interventions on before you ever feel wired or tired or lose a night of sleep, which is what neurofeedback side effects look like. It also frees us from the static normative QEEG database. Map yourself caffeinated, stoned, or stressed, and each one is just a labeled data point in a wild-type database, which solves much of the diagnostic limit of EEG.
What does a healthy life look like?
For me the daily foundation is three things. I get up very early, often before four, asleep by around 8:30, because locking in the circadian rhythm lets you get away with less sleep. I keep a minimum viable practice, a short Ashtanga sequence I do 28 days out of 30, to burn off the cortisol and glucose that woke me up before I go sedentary. And I cycle periodic fasting, playing with time, calories, and macros across 22-, 44-, and 66-hour windows.
I do not do much neurofeedback on myself anymore. I made large changes years ago, three and a half standard deviations of improvement in my impulsivity scores from 18 ADHD-focused sessions, and you change less once you are well regulated, which is part of why most people need only 30 to 60 sessions for the gains to stick. The thing I struggle to implement is resistance training, which I coach others to do and skimp on myself. It matters more for someone trying to drop body fat and restore insulin sensitivity than it does for me, but it still matters.
A healthy life manages demand and still finds fulfillment. You need pressure, the desirable difficulty, because we fall over without it, and relief is sweeter for it. The point of the self-care, the sleep, the meditation, the nutrition, the training, is to keep you resilient enough that a missed meditation or a short night does not topple you. When you have built that buffer, you can spend your energy on what you actually find fulfilling.
The first step, if you want a starting point, is data. A brain map gives you a stable picture of your own circuits and the agency to push on them. You can map in person in New York, St. Louis, Los Angeles, or Orange County, or run the whole process remotely. The goal is to make you your own neuroscientist.