Join Jess Arce, host of The Learning Disabilities Experts, as she welcomes Dr. Andrew Hill, founder of Peak Brain Institute and a leading neurofeedback practitioner. Dr. Hill, a PhD in Cognitive Neuroscience, shares his expertise on unlocking the power of your mind through neurofeedback. In this episode, you'll learn: • What neurofeedback is and how it works • The benefits of neurofeedback for cognitive optimization • How neurofeedback can help with a variety of learning challenges Bonus for Listeners! Use code 3DLE for $250 off at Peak Brain Institute: https://peakbraininstitute.com/referral/?ref=3DLE Schedule a FREE Consult with America's Dyslexia Expert: https://www.3dlearningexperts.com/consult 3D Learning Experts Official Website: https://www.3DLearningExperts.com 3D Learning Experts Facebook Page: https://www.facebook.com/3DLearningExpert 3D Learning Experts Parent Support Group: https://www.facebook.com/groups/dyslexicsupport Get to know more about AMERICA'S DYSLEXIA EXPERT: https://3dlearningexperts.com/jess-arce/
Episode Summary
I recently joined Jess Arce on The Empowered Parent to talk about how the brain trains, what neurofeedback actually does, and why a learning challenge often looks different in the data than it does on the worksheet. Watch the original conversation. What follows is drawn from that discussion, in my own words.
What made me trust that the brain can change?
My younger brother had a head injury when we were kids and spent a few months in a coma. He came out of it and rebuilt most of his function over time. Watching a small injury produce a dramatic shift in consciousness, and then watching his brain relearn what it had lost, taught me early that this organ adapts.
I spent years in acute mental health settings before I found neurofeedback. Inpatient psychosis units, dual-diagnosis units, locked facilities for kids, group homes for adults with multiple disabilities. I saw people who cared deeply, and I saw a lot of palliative holding. I spent one year teaching a man to use a fork. The next year his program lapsed and he lost the skill. Real durable change was rare.
Neurofeedback was the first thing I watched move people quickly. ADHD complaints dropping in a couple of months. Eye contact and vocal prosody returning in autistic clients. Seizures and obsessions falling away in weeks. That was not what I thought possible, so I went to UCLA for a PhD in cognitive neuroscience and ran placebo-controlled, double-blind work to understand the mechanism. Part of what my dissertation showed was how the brain registers the feedback signal in the first place.
What is neurofeedback and how does it work?
Neurofeedback is operant conditioning applied to your brainwaves. The behavior being conditioned is involuntary. You cannot feel your brainwaves and you cannot consciously drive them, so you are being exercised rather than instructed.
Here is the mechanism. We put a couple of sensors on the scalp and ear clips on. The software watches one region moment to moment as your brain naturally produces a variable amount of a given frequency. When the brain briefly shifts in the direction we want, the computer rewards it with sound and a moving image. A Pac-Man advances, puzzle pieces fill in. When the brain drifts the wrong way, the game stalls. We move the goalposts every few seconds, resetting the reward threshold to sit just past where the brain currently is, so you are only applauded for the shift we are training that day. Threshold settings matter a great deal for whether a session lands, and we adjust them constantly.
You can read more about the underlying method in my neuroscientist's guide to neurofeedback for ADHD and the research overview on whether neurofeedback is legitimate.
How fast do people feel neurofeedback?
You feel it inside three to five sessions for most people. About one in fifteen feels it the first time. About one in fifteen never consciously feels it, yet their sleep, stress, mood, and attention shift anyway.
Sessions run about thirty minutes, three or four times a week. Around the third or fourth session, you train a region, the brain produces a larger surge of the targeted frequency, and you notice it. People describe a calm, focused feeling and wonder if they are imagining it. They are not. It wears off, and the next day the impression is fainter. Train again and the effect comes back a little stronger. If we push too hard or pick a poorly matched protocol, you feel wired, struggle to sleep, and feel wiped the next day. That tells us to change the protocol, and we usually get a cleaner result. The work is iterative. It is closer to personal training than to a fixed dose for a diagnosis.
Which brain circuits are we actually training?
A circuit on the left side, between the crown and the ear, stabilizes whatever state you are in. It keeps you on a boring task and keeps you asleep at night. It runs on beta waves. A similar circuit on the right supervises attention moment to moment, also using beta. Both circuits can shift toward automatic by producing more alpha or theta. Alpha is the neutral idle between gears. Theta lifts the brakes and lets things happen.
On a QEEG brain map you can read someone's resting balance of these rhythms. Heavy alpha on the left predicts inattentiveness as tasks drift toward boring. A poorly supervised right side means any higher-intensity stimulus, good or bad, pulls attention toward the shiny object. For executive function complaints, you generally train beta up and bring theta or alpha down. The classic ADHD signature is a high ratio of theta (disinhibition) to beta (activation).
The regulatory features you can read reliably on a map cover about eight things: executive control of attention, processing speed, sleep regulation, the stress response, sensory processing, social processing, and the brain's stability against seizures and migraines. For more on the rhythms themselves, see decoding alpha waves and the phenotype approach to reading an EEG.
Why does sleep deprivation look like ADHD on a brain map?
In the late 1990s, Vince Monastra published work showing you could sort thousands of kids into ADHD and non-ADHD buckets with high accuracy on the theta-to-beta ratio alone (Monastra et al., 1999). Over the following years the effect got weaker on replication. Nobody could explain it until someone analyzed sleep across those cohorts. The adolescents had grown progressively more sleep-deprived across the decade, and sleep deprivation in a kid's brain produces the same disinhibited, scattered, emotionally reactive picture as ADHD. The decline of the theta-to-beta ratio as a population marker over time has since been documented directly (Arns et al., 2013).
If your child sleeps badly, you have seen this. Poor sleep makes them less self-controlled, more scattered. On a map you can also spot when someone is not managing energy well even if you cannot name the specific dysomnia.
What does slow processing speed mean for a kid with a learning challenge?
Many kids with learning differences carry a processing-speed or internal-language drag. The brain is not handing language between regions efficiently, so reading is slower, absorption is slower, and retrieval is slower. This used to be called slow cognitive tempo. It is largely the alpha rhythm, the idle of the machine, running draggy.
That drag can be developmental, or it can come from disrupted sleep or concussion. Any adult in their middle years who notices more tip-of-the-tongue word-finding is feeling the same alpha-speed hitch from worse sleep and a slightly slower brain. When you feel that, you have a window into what your child feels when text will not quite go in. Information feels sticky and slippery at the same time. Research suggests these patterns are trainable.
How does seeing your own brain change how you relate to your struggles?
Most weeks, I sit down with someone's data and walk them through how their own brain works rather than hunting for the right label. Again and again, a person looks at their map and says, "Oh, it's real, I'm not imagining my anxiety, my distractibility, my sleep." Once you see your physiology in data, your relationship to it changes. People feel frustrated about a broken shoulder on an X-ray, but they rarely feel ashamed of it. We carry shame about anxiety, inattentiveness, impulsivity, and rumination because they feel like they are happening to us and they come wrapped in stigma.
I look at thousands of brains every year. People are weird, and that is a good job. The goal is to find the things you already know about and decide which ones matter to you, the way you would read a blood panel and choose what to act on.
How can a brain map separate ADHD from an auditory lag?
A common find: someone's visual attention is excellent, their self-control is excellent, most of their auditory processing is fine, but the alertness for new auditory information shows a timing lag. A psychologist asks, "Do you have trouble paying attention?" The person responds, "Sorry, what?" and gets a check mark for ADHD. It is an auditory onset lag, and you can see it in the data.
The takeaway is concrete. An adult can ask their partner to call their name, give a half-second beat, then continue. The brain only needs that half-second of orienting time to lock in, and both people feel less ignored and less talked at. For a kid, that one feature gives parents advocacy ammunition: lectures recorded, instructions written down, the IEP modified because an auditory lag is sitting in the way of attention.
Can you train several brain patterns at once?
You can. We rarely isolate a single target, the same way you would train a bicep and a shoulder together at the gym. We balance protocols across executive function, energy, and sleep while managing the stress response. Sleep, stress, and attention form the foundational machine, and they all flex a little whenever you do classic neurofeedback, the way a deadlift works most of your body. How those three shift in the hours and the night after a session tells me how the training landed. Once that base stabilizes, we bring in trickier secondary goals in an order of operations.
How does neurofeedback work for trauma?
Classic PTSD tends to respond well. In someone who developed in a safe environment and then experienced trauma, you can see the cortex cramping up against it, and the research and my own observation suggest you can often ramp down major PTSD over a number of weeks. I have done a lot of this work with veterans.
Complex PTSD, which is developmental trauma, is a slower-moving condition rooted in insecure attachment rather than a single event. The drivers sit deeper: the amygdala, the periaqueductal gray, and the posterior cingulate. Because some of that is subcortical, it is harder to read on the surface and takes longer to shift, though the impact can still be large. Sebern Fisher's Neurofeedback in the Treatment of Developmental Trauma is the field reference here (Fisher, 2014). A study showed that a single session of amygdala and posterior-cingulate-targeted training using real-time fMRI and EEG reduced the abnormal connectivity between the posterior cingulate and the amygdala in patients with dissociative PTSD (Nicholson et al., 2017). Most neurofeedback is a gradual workout, but some of these protocols move fast.
What does the seizure research show?
Neurofeedback was discovered in the mid-1960s through a serendipitous finding that training a specific rhythm reduces seizures (Sterman & Friar, 1972). Every human brain balances on the edge of a seizure the way a walking person is always nearly falling and somehow does not. Drop the threshold a little, with a fever in a small child, and a seizure slips through. A meta-analysis across many studies found an average seizure reduction of about 50%, with a small fraction of people gaining complete control (Tan et al., 2009). In my experience the results have generally been better than that average. The more severe the pattern, the more clearly it shows in the map and the faster it tends to move.
Why does an ADHD kid train you to yell?
This is the most useful thing I can hand a parent. The ADHD brain, under high stimulus, shuts off theta and brings up low beta with no problem, often hyperfocusing and dropping into flow better than average. Under low stimulus, that ability is nearly absent voluntarily. So the brain seeks intensity.
Your kid will seek high-stimulus situations, which most parents already know. What parents miss: the brain will also train you to yell. When you tell them to take out the trash and they say "I'll get to it," and you escalate, the conflict supplies the higher intensity their brain was craving. It is high salience over low salience, conflict as engagement. They are often not aware they are doing it, and parents tell me, "I don't know why I yell at my kid so much." You are being reinforced. The ADHD brain is excellent at directing resources in response to the outside world and poor at staying internally directed on its own. If you notice your kid poking the bear, that is why. I cover the loop in more detail in why your ADHD kid makes you yell.
What is the sleep spindle's role in ADHD?
Most ADHD brains struggle to stabilize sleep spindles, the bursts of sigma activity that fire when you hear a sound in your sleep and keep you asleep. The awake version of that rhythm is sensorimotor rhythm, or SMR. Picture a cat on a windowsill watching birds: body liquid and still, attention laser-locked. That state is the functional opposite of ADHD. Awake, SMR lets you sit still and stay on task. Asleep, it keeps you from waking and helps pump the brakes against seizures. Martin Arns's work frames at least some classic ADHD as a problem of sleep-onset regulation tied to this rhythm (Arns & Kenemans, 2014). Train SMR and sleep spindles up in someone with ADHD and you tend to see reduced ADHD complaints and improved sleep at once. More on this in SMR neurofeedback.
It is rare to have ADHD without some sleep dysregulation. I now see a steady stream of women getting a first ADHD diagnosis at 47, because menopause disrupts sleep enough to surface a pattern that had been subclinical, and because we pay less attention to girls' behavior in the first place.
How does the program run, and what about cost?
Most of our clients train from home. We have offices in Los Angeles, Orange County, St. Louis, Manhattan, London, and Stockholm, but only about 20% of clients visit one. We ship the equipment and teach you to set the cap, apply gel for the assessments, and place a couple of wires for training. Coaches run live sessions with you for the first couple of weeks, then you have a private chat channel open twelve hours a day, seven days a week, plus short surveys twice daily. The morning survey covers sleep, the evening one covers your other goals, and the coaches adjust your plan in response. Some days that means pushing harder, some days it means a calming or palliative session.
For typical patterns, including ADHD, the research and our own tracking suggest you can see roughly a standard deviation of change every other month on attention testing and on big features of anxiety. A couple of rounds, three to four months, will often move severe ADHD from two or three standard deviations off the mean up toward or above the mean. The effects tend to hold: the ADHD literature shows durability at six and twelve months and out to several years in children and adolescents (Van Doren et al., 2019).
Insurance coverage is limited; I cover the details in is neurofeedback covered by insurance and what neurofeedback costs. At Peak Brain, two months runs around $5,000 for 30 sessions plus two brain maps, dropping to about half-price when you extend, which works out near $100 a session out of pocket. Our brain-mapping membership is $500 a year for unlimited assessments in the offices, where most maps in the field run $500 to $2,500 each. Listeners of The Empowered Parent get $250 off a package or the mapping membership with the show's referral code.
If you want to watch the method in real time, I run a live stream on YouTube at Dr Hill (drhill) every Monday at 6pm Pacific, 9pm Eastern, where I set myself up on neurofeedback and take questions. Old episodes stay on the channel. The next step for any parent reading this is the same one I take with every client: get the brain mapped, look at the data together, and decide which one or two regulatory resources are worth training first.
References
- Arns (2013). A Decade of EEG Theta/Beta Ratio Research in ADHD: A Meta-Analysis. doi:10.1177/1087054712460087
- Nicholson (2017). The neurobiology of emotion regulation in posttraumatic stress disorder: Amygdala downregulation via real-time fMRI neurofeedback. doi:10.1002/hbm.23402
- Sterman (1972). Suppression of seizures in an epileptic following sensorimotor EEG feedback training. doi:10.1016/0013-4694(72)90028-4
- Tan (2009). Meta-Analysis of EEG Biofeedback in Treating Epilepsy. doi:10.1177/155005940904000310
- Arns (2014). Neurofeedback in ADHD and insomnia: Vigilance stabilization through sleep spindles and circadian networks. doi:10.1016/j.neubiorev.2012.10.006
- Van (2019). Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. doi:10.1007/s00787-018-1121-4