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Joe Sanok 00:01:07 Practice of the Practice podcast with Joe Sarna. Accession number 1063. I’m Joe Sarna, your host, and welcome to the practice of the Practice Podcast. Joe Sanok 00:01:22 I am so excited to have you here today. You know, when it comes to neuroscience, I just love learning so many different things about the way the brain works, how to optimize it, how to think differently. and I know that the field is always growing so much faster than I can keep up with. And that’s why I’m so excited to have Doctor Andrew Hill with me today. Doctor Hill is a cognitive neuroscience UCLA, founder of Peak Brain Institute and a leading neurofeedback practitioner and biohacking coach for clients worldwide. At Peak Brain Doctor 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. Dr. Andrew Hill 00:02:14 Oh, thanks for having me, Joe. Appreciate it. Joe Sanok 00:02:16 Oh, man, I am so excited about this. when I was writing Thursday’s The New Friday, that was, from April of 2020, is when I landed, the the contract with Harpercollins. 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 and a camper, and I just want to be done with this thing. Joe Sanok 00:02:36 I was learning so much about kind of neuroscience, neurofeedback, optimizing the brain and applying it while I was writing the book. 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, we’d love to just start with Andrew. How did you get into neuroscience, neurofeedback, all of that? Dr. Andrew Hill 00:03:01 Yeah. Thanks. So I’ve been working in the field of neurofeedback for like 25 years or so. and before that I was working in mental health, doing psychiatric work inpatient. I was managing group homes for folks with multiple disabilities, you know, no language, impaired cognition and was working really across a different, you know, area of health and human services where people tended to suffer pretty hard, be it lock facility, inpatient or heavily structured residential. We didn’t have a lot of, what I saw was we didn’t have a lot of, ability to help people make change. Dr. Andrew Hill 00:03:38 So there was, you know, palliative stuff or helping people suffer less, hopefully. But in the inpatient environments, I’d see people come and go sort of revolving door style mental health where they’d 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 at 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 in the sort of trenches of mental health. And I ended up getting a job a year or two later, working in an autism center, an outpatient center. And 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, an autism population that were serving. I had some experience in that, and I was curious about them because they did this thing I’d heard about called neurofeedback. Dr. Andrew Hill 00:04:33 So I walked in, hopefully, you know, just to get an internship or some observational hours to figure out, you know, what this stuff was. And I ended up walking out with an actual job and spent a couple of 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, center. And what I saw 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 6 or 8 weeks, they were making huge changes in executive function, anxiety, seizures, 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. Dr. Andrew Hill 00:05:31 And so this again, 25 years ago or more, the field of neurofeedback was pretty niche. It’s still pretty small, but back then, you know, before the modern internet, even the 30 or 40 providers who were most active at the time, about a thousand people total in the field, everyone’s arguing on the on the Usenet to give 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. Mailing list based forums essentially, and lots and lots of vitriol was being slung back and forth between about three schools of thought in the neurofeedback landscape. You know, everyone argued that their way was the right way and everyone else was foolish. And, you know, the underlying theories about how this stuff worked, it wasn’t reconcilable. And so really, a lot of aggressive fighting was happening in the back end of the field at that point. And yet all of those approaches all had better impacts than traditional mental health psychotherapy and medication. So against that landscape, I sort of said, well, wait a minute. Dr. Andrew Hill 00:06:32 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 man and elephant situation, you know, everyone’s describing something right in front of them, but nobody really had a good sense of what they were doing at a high level. And so I went back to grad school. I went to UCLA, and spent some time there studying how neurofeedback works and how does the brain know that certain brainwaves are being applauded? how does, 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 performance, or a kid who’s screaming and stimming and flapping, they’re both going to have sort of an anxiety phenomena, maybe an executive function, maybe some sleep issues. So I started to see as I kept working in this field for years, 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 dysregulated in individuals and very different, you know, ways visibly, it’s often the same gross resources. Dr. Andrew Hill 00:07:46 We want to work on these big features of our brain that help us produce our mind. So I studied neurofeedback in grad school, and then as I exited grad school. decided to open up neurofeedback companies teaching people to understand themselves through brain mapping. And then, we provide brain training or neurofeedback all over the world at this point. So, yeah. Joe Sanok 00:08:09 Wow. So when you when you’re explaining neurofeedback, 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 specialist, a specialist. And, you want that person that’s, you know, doing the brain mapping and full on neurofeedback. And then there’s other times where there’s aspects of it that are fine for the general population. I would love to hear kind of some of those definitions as to kind of where we’re at in neurofeedback now. Joe Sanok 00:08:50 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. Dr. Andrew Hill 00:08:58 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. You can’t do the wrong workout in the gym and expect it to work. And that does happen. You can 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 neurofeedback, 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. Dr. Andrew Hill 00:09:41 But the way we actually create learning is no different than basic associative learning. You know, if a baby is flopping around and suddenly does a baby push up and can see 12ft, oh my goodness, the brain remembers next time it wants to see further away and get more information. It remembers that unique conformation of neurons that fired to produce the push up and so increase the amount. You can see. The baby wasn’t thinking, wait, wait, left arm, wait right arm. It just kind of did. The thing in the brain took over the complicated, you know, discovering the mastery of doing, 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. 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 low hanging fruit for neurofeedback, the stuff we almost always, works successfully with. Dr. Andrew Hill 00:10:40 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, 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 neurofeedback a lot closer to the personal training and to the pool than therapy. Most people that do this work or therapists, there’s about 15,000 people in the world that do neurofeedback professionally. The vast majority of them are therapists who first became therapists or clinicians of some sort. And then they discovered that neurofeedback was impactful for their population of interest, you know, autism or eating disorders or trauma or whatever. And then they learned some neurofeedback for that population for that complaint. And we have some incredibly gifted people in the field who work combining therapy with neurofeedback, especially in aspects of, care that involve trauma. And 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. Dr. Andrew Hill 00:11:51 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 neurofeedback. And maybe more germane 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 where the lines are, you know, what aspects of what the person’s experiencing or ADHD, what aspects are anxiety or trauma response? What aspects should because their sleep is dysregulated? 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 or the other, you can kind of look the same. Dr. Andrew Hill 00:12:46 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, well, 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 cingulate or peri aqueduct and help someone, you know, soften their amygdala 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 neurofeedback 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 versions of cognitive behavioral therapy, things like IFS, internal family systems, somatic therapy, I don’t know, a lot of neurofeedback providers doing those latter ones. Dr. Andrew Hill 00:13:50 But I do know a lot of somatic 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 guess 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 speed of processing, these are actually fairly germane 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 neurofeedback 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. Dr. Andrew Hill 00:15:05 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 neurofeedback. 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, the DSM are not quite as precise and 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 the stuff you’re seeing in the data becomes something you can go after. You can help somebody develop, you know, life hacks and other bio hacks. Dr. Andrew Hill 00:16:04 You can go after it with neurofeedback. If you’re somebody who uses mindfulness, some of 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 metta, you know, loving kindness stuff. You can kind of learn your clients better. I mean, the reason I do neurofeedback well is because I understand clients brains from their data, not because I’m like the world’s most amazing neurofeedback provider. It’s a little bit of 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 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 in working with physiology is not just to become yet another expert, yet another guru. Dr. Andrew Hill 00:17:05 And people with deep suffering 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 not providing my judgment on them going over brain data, instead teaching people to read their own brains and see the things they know it really does pull the stigma of diagnostics and move somebody into a place of like, oh, okay, this is my brain. Oh yeah, I’m gonna do some stuff, I’m gonna take some control. Dr. Andrew Hill 00:17:54 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, illness or medical trauma, medical interventions, often kids that have surgeries, you know, repetitive surgeries, we’ll have medical trauma from being just in that patient role for so long or, you know, you 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 and their brain map and go, wow, it’s really hard for you to pump the brakes, 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. Joe Sanok 00:19:02 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, telehealth, and e-prescribing incredibly easy. Best of all, they offer live telephone support that’s available seven 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. I’m 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 Therapy notes.com and receive a special two month trial. Absolutely free. Again, that’s therapy. No scam. 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 right away. Trust me, don’t waste any more of your time and try therapy notes. Just use promo code Joe at checkout. Joe Sanok 00:20:06 What are you doing October 1st through third? I want to hang out with you just south of Nashville, Tennessee. Down in Franklin. I’m going to be key noting 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 keynote 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 Marketing Conference, but if you can come online, that works as well. Joe Sanok 00:21:02 Can’t wait to hang out with you in Tennessee again. That’s MH marketing. Org and use promo code Joe at checkout to hang out with me October 1st through third, 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, neurofeedback could help. Like how does that flow work there 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 therapists that are going to partner with folks that are doing the brain mapping and helping with that kind of data? Dr. Andrew Hill 00:21:57 Yeah. You know, a lot of people that do brain mapping are also therapists, so they’re really just mapping their client base as they go. Dr. Andrew Hill 00:22:04 But I have a certain 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 2025, 30 client hours a week. So instead, they refer people out for mapping and maybe for brain training with us and my company, Peak Brain, does brain mapping and physical offices. We’ve got four in the US and a couple overseas, you know, New York City, LA, Saint Louis, Orange County, plus, Stockholm and London. But about 80% of our clients never see our offices. So we’re a little unusual in that we send equipment and out to clients, and we have live coaches walking you through, doing brain mapping, yourself from home, or neurofeedback 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 and you’re one of our big offices and they’re interested in understanding their clients more. Dr. Andrew Hill 00:23:01 You know, I send it 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, 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 size clothes and half of that size open because the brain is in a very different, 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. and all of these things, the performance on the test as well as the two baseline brain recordings, we then compare to age matched samples and see how unusual somebody is. And again, brains are weird, so a good job. Be weird. It’s a little hard to interpret. We know what’s unusual, but there’s still a step to go through with the client. And I’ll get back to that. But the brain. But the performance testing is very straightforward. Dr. Andrew Hill 00:23:54 If you look impulsive or inattentive or your reaction times are off or you show stamina 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. 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 and 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. Dr. Andrew Hill 00:24:50 But what would happen is someone come in for a couple of hours or we send them gear, to home and they work for a couple of hours gathering data, and then it takes a couple of 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 of 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, 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, oh, look, here’s your attention task. 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 region and what’s under there, and what it often means when you have an unusual amount of brainwaves in that region. Dr. Andrew Hill 00:25:44 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 as important to them, 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 know, usually I’m finding between a half a dozen, about a dozen things in any particular person’s brain data, and it’s usually like 95% of those are just valid. Like the personality kind of understands that and knows it. And it’s a goal for them typically. so I find these features in a brain set, 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. Dr. Andrew Hill 00:26:43 So at this stage, the client is 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, and then you sit down with a personal trainer and go through it all and 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 post-Covid fog or a concussion. You can kind of see it and you can see all the flavors of anxiety, pretty much. perseverance and rumination, hypervigilance, sensory, social, they all kind of show up pretty clearly. speed of processing is your alpha speed. That’s pretty obvious. and then there’s a few other things you can see that are a little hard to interpret. Dr. Andrew Hill 00:27:37 You can see concussion type phenomena. But don’t you know, we wouldn’t know if they’re from an actual concussion or, you know, sleep issues or other, you know, things causing brain fog unless it’s very, very acute. 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? 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. Dr. Andrew Hill 00:28:21 And so it’s agency providing because either I have a technique to reach in and push it around with neurofeedback 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, and if I posit that model and they’re like, oh gosh, yes, I’m always hunting for names and I’m always tired. Dr. Andrew Hill 00:29:16 Okay, well, it’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 slash metabolic, 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. Dr. Andrew Hill 00:30:06 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, 30 years old 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 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. Another example is the front midline, the anterior cingulate, which gets dysregulated in many things we, treat, so to speak. Or as a, you know, psychological landscape. Many of us listening to this, show today work on phenomena that involve the anterior cingulate. The anterior cingulate is the CEO or project manager of the brain. Dr. Andrew Hill 00:31:08 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. It helps you do temporal discounting, like when you when you overcommit to the task that’s two months away because 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 much work. Well, that’s the other side of it. And the anterior cingulate helps with that. It helps with, 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, demands. And that’s also front midline, interior cingulate 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 of us will have front midline beta excess. And if you have lots of beta that tissue gets caught in high gear. Dr. Andrew Hill 00:32:04 And we tend to perceive overrate 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, where you obsessively chew on things. So it’s kind of a ticky and picky kind of signature when the fate is high. So if you’re dealing with somebody, 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, well, then that gives you ideas about how they’re operating versus theta. You know, an idea about the flavor of OCD they might have with a flavor of tic. Dr. Andrew Hill 00:33:01 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. If you dig a little bit deeper in the literature, you find that you can give kids that have medication resistant OCD a supplement called Acetylcysteine that pulls the teeth of intrusive thoughts because it’s lubricating that interior cingulate pretty quickly. In about 40 and 50% of kids with medication resistant intrusive thoughts. So again, not doing neurofeedback 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 drive reduction works, or how, you know, value works or impulsivity. But some of this stuff is not psychological 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 you can go after it that way and really give people a lot more control over their internal environment. Dr. Andrew Hill 00:34:10 So I guess to answer your question, after somebody did a review with me, we send them data, we send them PDFs of 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 us off. Well, no, 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 experiences 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’d never thought to ask about sleep regulation or, you know, or a tick or something. And it’s a very different landscape, but it can really inform things. Dr. Andrew Hill 00:35:02 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, your alpha waves are super low and your delta is really fast, and you just got through complaining for the past ten minutes about how you always wake up tired in the morning. Hey, maybe we should try and 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, a ring tracker for your sleep or something. You know, you can start figuring out where some really important things to work on. Dr. Andrew Hill 00:36:03 And so you wouldn’t need to be a neurofeedback 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’s suffering, the biopsychosocial method and perspective, not just the psychosocial method here. Joe Sanok 00:36:19 so awesome. 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 were listening right now. What would you want them to know? Dr. Andrew Hill 00:36:31 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. There was a study, several studies in the 80s and 90s on neurofeedback, looking at brain mapping, being able to diagnose ADHD, and the statistics were high. The work by Vince ministre. Doctor, ministre. Very very strong stats like 9,495% sensitivity to sort ADHD and non ADHD into buckets. Dr. Andrew Hill 00:37:00 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 we’re doing research on got progressively more sleep deprived. And the sensitivity of EEG analysis cannot tell apart ADHD from sleep deprivation. And I would say that of the, you know, I do a thousand new people every year roughly. And I see, you know, 5 or 6000 brain maps a year. 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. 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. Joe Sanok 00:37:52 So awesome. Andrew, if people want to connect with you, if they want to follow your work, where should we send them? Dr. Andrew Hill 00:37:57 Yeah. Dr. Andrew Hill 00:37:57 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 neurofeedback on myself and kind of like an AMA answer questions, and there’s a new topic every week as well. you can check me out there. youtube.com slash Doctor Hill, Dr. Hill, and then my company’s peak Brain institute.com. You can check us out all over the web and, you know, come ask us your brain questions or come on in to one of our locations and get a, and get a discount. You know normally we charge we’re we’re pretty affordable. As the field of neurofeedback 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 two or 3 or 4 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 low cost client, access where your clients can get a brain map for 250, and that includes repeats, and that includes me going over data a couple times with them and sharing that with you. Dr. Andrew Hill 00:38:58 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 are awesome. Joe Sanok 00:39:10 Thank you so much for being on the show. Dr. Andrew Hill 00:39:12 Oh my pleasure. Thanks so much for having me, Joe. Joe Sanok 00:39:22 What a great show. We are going to be hanging out 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 marketing org, just use promo code Joe at checkout. You’re actually going to get half off your ticket. So 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. check them out over at Therapy notes.com. Use promo code Joe at checkout to get a few months for free. Joe Sanok 00:39:57 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 Silences Sexy for that intro music, and this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. 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