Dr. Andrew Hill is a well-known figure in the field of neurofeedback and brain optimization. As the founder of Peak Brain Institute, he’s focused on utilizing neurofeedback and other techniques to help individuals enhance various aspects of their brain function such as stress management, sleep quality, attention, creativity, and athletic performance. His background in cognitive neuroscience and his experience as a practitioner make him a prominent figure in the realm of brain coaching and biohacking. His work, including his podcast Head First and ongoing research, contributes significantly to our understanding of how to improve cognitive performance and overall brain health.

Unknown Speaker 0:04
So, um, today I’m talking to Dr. Andrew Hill. Welcome, Andrew. It’s really nice to meet you and I look forward to seeing where our conversation goes today. Thank you. Thanks

Unknown Speaker 0:14
for having me. Nice to be here.

Speaker 1 0:15
Yeah. So I thought it would be good for us to start by you telling people a little bit about yourself, but mostly how you decided to become a cognitive neuroscientist and specifically, what was attractive to you about neurofeedback.

Speaker 2 0:30
So cognitive neuroscience for folks that are wondering, you know, what that mad scientist kind of label is cognitive neuroscientists typically get something in the in the brain how it works by overlapping physiology, with performance in some way assessing both seeing where there’s an overlap, and then learning something about how something works like attention, or sleep or stress or anxiety. And I studied that in grad school. But the reason I went back to grad school to study this aspect of the brain was because I was working in this field of Neurofeedback and found that a lot of people were getting a lot of change. So I started working in health and human services many many years ago. And I’ve worked in every aspect, you know, inpatient crisis work, geriatric dual diagnosis with substance abuse. I ran group homes for several years in Massachusetts with folks that were multiple disabled, developmental, no language, motor issues, deaf or blind. I mean, just people that often these sort of edge cases of where human suffering can be across all kinds of stuff. And I got injured working in a psychiatric hospital, I was in charge of doing restraints and handing the heading up the teams that would show up in the sort of unsafe environment and try to get them to become safer. And the hospital system was in the process of sort of collapsing then the payments for inpatient mental health were going away. And this was a long time ago now in the in the 90s. And I left mental health for a little while because of that. And then when I went back into mental health a few years later, I ended up working in an Autism Center, I had a lot of experience with autism and ADHD and things. And it was a center that used primarily Neurofeedback to train the brain. And I had deep experience with kids with developmental a typicality, and all kinds of things. And I was blown away by what I was seeing happen in these clients this in this Neurofeedback environment, where folks with V or ADHD were having it regulated in a few months and folks without language or with dramatic sensory issues. We’re seeing shifts of those resources in a few weeks or months sometimes. And this really flew in the face of what I thought we could do. I mean, I spent so much time working in acute inpatient psych, where folks had this revolving door phenomenon coming in becoming stabilized and not really healing or getting better. For awhile, I worked on a latency age and adolescent unit where we had kids from Florida, il 10. And then from 11, to 16, inpatient psychiatric. And those folks, you take them out of the environment that’s just regulating them. And usually people rebalance, they become very resilient. But we I saw people going back out into their dysregulated environments with, you know, difficult socio economic stressors and disadvantages with regards to education and crime and poverty and all kinds of things that really got in the way of mental health management. And then when there were inpatient, it was just taking out some of the harm and then usually managing some suffering briefly before those people went through a whole nother round and repeated the same phenomena. So

Speaker 1 3:50
usually, it’s symptom reduction, not really long term growth and change, right? Yeah.

Speaker 2 3:56
And this was at a time when the average inpatient stay as paid by Medicare and Medicaid, another phenomenon. The big blues was 11 days on average, when I started working in inpatient Psych. And over two years, the average length of approval dropped to two days. Nothing. It takes three weeks for SSRIs to start working with someone’s acutely depressed sometimes. And when someone’s in crisis, you don’t even get the drugs to stabilize in two days. Right?

Speaker 1 4:24
Yeah, it’s it’s really criminal, I would say on some level, but I’m curious about Well, I think it would be useful to talk about what neurofeedback is exactly like how does it work? And what does that mean?

Speaker 2 4:37
Yeah. Neurofeedback is a process of training the brain training the central nervous system, it’s a form of what’s called biofeedback. A lot of folks hear biofeedback and think like relaxation where it can handle warming and breath pacing and things. And that’s a way of taking control of physiological stuff. But when you say neurofeedback, we mean this stuff you’re trying to control is inside the bones. It’s inside the central nervous system. And one of the biggest differences between peripheral nervous system and Central is you can’t feel your central nervous system. It has no sensory nerve endings, you can actually feel your brain ironically, because it’s doing all the feeling, you probably wouldn’t want to feel it, it’s kind of acidic and hot and moving, actually. So it’s probably a mercy we don’t feel our brains the way we can feel our heart and things because it would be way more painful. But the process of doing Neurofeedback broadly is just picking up something inside your brain that’s varying like the amount of brainwave the speed of a brainwave or some blood flow or something, and then reflecting it out in a way that is almost brought up to the level of not awareness necessarily, but the brain noticing because the brain itself doesn’t really the brain doesn’t do very good monitoring of its different parts. Part of the, the mechanisms of information flow in the brain require that the brain be very modular. And information that’s that’s being processed is kept apart from other bits of information. So, like glandular communication, endocrine communication, the body, you release endocrine molecules into circulation, and they act for a long time, at a distance, gradually, with very low timing, precision, but in the brain, you release neurotransmitters into the synapse, and not into circulation. The synapse is actually a closed space between two neurons, let’s say it’s sealed off, and a little a little opening area. So you’re controlling the concentration neurotransmitters in the little, little gradient. So the brain is very bad at knowing what other parts of it’s doing. There’s no like central management of the brain itself that can kind of go oh, wait over there. That’s kind of a seizure, I should probably pull back on that. There’s mechanisms for managing stuff but not no high level. So we take some basic features of associative learning and hijack them a tiny bit, take things that are happening and measure them so leave an example that’s sort of germane to neurofeedback, the the field was discovered in the 60s, the way it’s done now, because of a brainwave that was sort of trained it was it was exercised at UCLA, Dr. Barry Sturman was working with cats and found he could shape he could operatively condition this brainwave called SMR sensory motor rhythm. And we all make SMR. If you were to see a cat on a windowsill holding still and watching birds, you’ve seen the sort of pure case of it, where you get a lot of motoric, or body inhibition, and a stillness of your focus, which is literally the opposite of ADHD, literally, which is a low SMR state relative to theta or a lubrication or release state the brain can produce in its modules. So if you stick a wire on a circuit involved with not being impulsive, or with sustaining your attention when you’re bored, that’s the right hand central cortex or the left hand, you can measure a moment to moment the amount of these beta waves measure moment to moment the amount of things like thetas and alphas which can get in the way of control. And whenever your brain happens to move briefly in the right direction, the computer sees that and applauds your brain with a little bit of gameplay. So a game starts to move Pac Man needs dots or puzzle pieces fill in. And the next moment your brain moves the wrong direction. And the game slows down or stops. The brain says Hey, Mike, where’s my input? Where’s that stuff? I like stuff. Oh, and then it happens to move in the right direction and the game resumes. It’s a little Applause Good job, Brian. Good job. Good job. Good job. Good job. Nope, again and again. And the big trick here, the operant conditioning piece of it, is we adjust the goalposts. Every few seconds, we move the threshold, the criteria next to where you already are. So your brain gets applause for movement it makes in a certain direction from its own brainwaves. It’s not an active process, it’s usually fairly passive and most Neurofeedback and the brain goes, well, that’s interesting, bringing my theta down and SMR up does stuff cool. With the mind actually takes a few sessions of training to feel it. Within about 10 minutes, the brains actually picked up the information loop and is starting to echo and mirror what the outside world is telling you. It’s really kind of interesting. What’s in here, don’t feel it. Yeah,

Speaker 1 9:17
but we are so adaptive. And that mechanism is so sensitive to shift and change. Is there is there an effect of the act of being able to watch one’s brain like that?

Speaker 2 9:31
There can be especially for some of the the physiological parameters that you have control over like blood flow, you actually have a tiny bit of voluntary control. If you think happy thoughts or concentrate you get a massive surge of blood about two seconds later. You can wear an infrared sensor on your forehead. I have one here I do. Cover it in front cam on your four. Oh, yeah, of course they did right and measure waves of heat coming off your brain in real time as a vascular tone and concentrate or think happy thoughts and see it surge. Because

Speaker 1 10:03
the act of seeing that surge therefore then impact the physiology.

Speaker 2 10:09
Or not directly. I mean a little bit but no mostly involuntary training. Most neurofeedback is passive, involuntary the cats that Sturman condition, cats are really bad instruction followers. works if you’re unconscious, it works if you’re in a coma. Dr. Margaret Ayers, who died a few years ago was really well known for training people who were in comas and training people who are unconscious, quite a lot of getting changes in brain. So so

Speaker 1 10:35
then the feedback loop of watching one’s processes is not really impacting the process.

Speaker 2 10:45
No, well, it is because the other way around, actually, the process is adjusting itself to react what the brain is doing. So yes, it but the loops run the other direction, actually. What does affect you dramatically? Is not the training off? I mean, yes, the training impacts you quite a lot. For some numbers. If you train those circuits to the left and right, I mentioned, we typically get about two standard deviations of change in ADHD features in about three months, which takes severe ADHD and just takes it to the to the other side of the bell curve. That’s

Unknown Speaker 11:19
remarkable. It’s a big change

Speaker 2 11:21
and it’s very robust and it’s very replicable. And you see it, you feel it. So it’s not this mysterious process ultimately. Yeah.

Speaker 1 11:29
Well, I know there are different types of Neurofeedback systems. And I wonder about that, like, for example, brain paint was sort of all the rage around the mid 20. Teens ish. So just for people that are listening to this and getting excited about it, how would they go about choosing the right form of neurofeedback? Yes,

Speaker 2 11:52
good question. I’m brain pain. I have a lot of respect for Bill Scott UCLA who helped develop it. Brain pain is a semi one size fits system where you enter questionnaires about it and it’s sort of PIXMA set of protocols. And initially, at least, brain paint was picked up a lot by inpatient addiction centers, because you could do good neurofeedback, it’s very impactful for cravings for alcohol withdrawal for seizure. So you could do fairly good Neurofeedback for that population, executive function, sleep, stress, anxiety, all this gets in the way and creates dysregulated relationships with substances, you can do stuff with people very effectively with a sort of menu driven approach and that’s what brain pain has done. But it’s not especially well tailored to your like actual physiology don’t do an assessment of your brain. And I would say half the field two thirds of the field still works in this area called quantitative EEG or cue EEG. And that is where and this is actually I think what changes you when you engage the process the most is so if I show you your brain and then tell you a bunch of things about yourself that are already true and you know them now you see them if I show you the anterior cingulate kind of lit up in high gear, and I say you know that when this happens, sometimes people get obsessive or a little bit you know, stuck in their head for separate. Oh my gosh, wow, I have OCD. Okay, there’s your superpower getting stuck all your back. midlines kind of stuck. Are you kind of front sensitive? And are you are you ruminate, oh, some trauma history. Oh, I’m sorry, I experienced that. I was seeing it. You know, because now you have this opportunity to stretch it you can stick a wire on the back midline measure the posterior cingulate it’s like tendency to go watch the road, watch the road. And yeah, that is beta waves moment to moment and measure the Alpha tone, the softening of that circuit work and put his fists down. And you can teach your brain to stretch out the resource and it’s like, ah, subjectively, and you feel it happening. Yeah, it wears off a few hours later. And you talk to your coaches and say, Well, I think I noticed some really interesting calmness, right, try it again. And it builds up again. So the metaphor here for neurofeedback is personal training. But the real change starts even before you get changed once you sort of conceptualize your suffering as physiology as a label, not as things happening to you. You’re a therapist or clinical role you create transference is this is container, there’s relationships, expertise, this treatment. I’m a coach, I’m a PhD scientist. My job is to educate you teach you stuff and thrust agency back up on you. Go forth and transform here’s some tools come back and we’ll celebrate and cheer you on and nag you to do more and, and whatever else but it’s a very different relationship when you’re becoming your own expert. And that’s sort of our different play into Neurofeedback as the Yeah,

Speaker 1 14:44
I mean, that’s beautiful. It sounds like in a way from the metaphor would be a biomechanical approach where you’re stretching muscles. If they’re tight, and then they they’re adaptive so they go back to being tight again, but the more you stretch over time, the more nimble and loose they become. I’m so the system’s instead of being jammed up or looping over time start to relax that pattern. Is that an accurate?

Speaker 2 15:07
I think so. I think the metaphors sound because most things we suffer from anxiety because I get to function stuff sleep dysregulation is actually closer to a resource that spasm or gotten stuck in a certain regulatory regulation mode. It’s not really a disease process. There’s a lot of suffering involved with all kinds of psychological and physiological things. But an awful lot of the brain stuff is not really progressive disease things. It’s an over adaptation or an accommodation to something so.

Speaker 1 15:39
So um, so I think we answered the question about what eg does exactly like how EEG is different from biofeedback.

Speaker 2 15:47
Yeah, yeah. So biofeedback is an overarching term and then EEG neurofeedback is one of the forms of it on the brain, but you could also do EMG on the monotype muscle. Or you could do heart rate variability on the vagus nerve, which controls the heart, you know, beat to beat variability which integrates the arousal sympathetic versus parasympathetic balance. So you might differ a biofeedback we usually do as well. Peak brain is focused on integrating sort of programs for you towards your goals, because we’re not diagnostic. It’s all it’s all your goals. So we might include HCG or HRV. Biofeedback or EEG neurofeedback, mindfulness education, we might teach them to use a sleep tracker, or we might teach them to use an acetone meter to do macronutrients and functional neuroscience biohacking, where you learn to control like insulin resistance and sleep strategies to get better brain health. And then you see those things change on your brain maps later on,

Speaker 1 16:43
started hearing. So when you talk about biohacking, and peak performance, what are you talking about there? And I guess in part, what I hear you saying is that people have conditions that we consider pathological meaning problematic, whether it’s ADHD, or OCD or high anxiety and that this can help enormously with that. But what if somebody is pretty regulated? And they have strong executive functions? And they feel fine? How does that tie to what you’re calling peak performance?

Speaker 2 17:14
Yeah, well, first of all, people are weird. be weird. So I’m looking at your brain, like compared like population averages. It’s not like Why aren’t you average? Let’s make you average. It’s more like, Hey, here’s such a yardstick. Here’s how you stack up against it. Here’s a few things that jump out. And when it comes to executive function testing, we always do a classic CPTs which are very valid for executive function. go no go style tests. Those are looking straightforward compared to the average person your age, here’s where you’re impulsive. Here’s where you’re inattentive, you got some auditory versus visual, it’s stamina issues, whatever. But the value there is unpacking the physiology the performance below the level of the labels. It’s not ADHD it’s impulsivity or auditory processing issue or reaction time or something. Then you end up with like a particular set of all that’s the bottleneck interesting all mine. Wow, my My teacher says I’m really really ADHD and I can’t sit still and I’m always moving look at the person’s brain and their executive function is fine for the first 15 minutes of a test but it burns right out in the last five right dominate issue not really classically ADHD look at their brain, you don’t see ADHD, which is high theta instead, you see, lack of beta and draggy alpha waves, and the person is kind of anxious and you kind of figure out they have sleep maintenance issues, and they’re generally anxious and they’re have fatigue and stress kind of fighting each other all day long. And they’re brittle and reactive. Not squirrel, not hyperactive. But you can’t always tell the difference in a 14 year old who’s stressed out. So the maps and the tools can sort of give you this and not just like give you like a particular intervention of neurofeedback, but start to unpack, hey, wait a minute, here’s what’s going on. So if you see that your alpha speed is running slower for your age, and the average person is, if you’re above 30, or 35. You probably have word finding issues, delayed recall and tip of the tongue and hunting for stuff. But that’s actually not aging related memory, which everyone thinks it is. aging related memory stuff, which usually doesn’t happen before age, you know, late 60s, but age related memory stuff, the first thing you lose is episodic memory or first person perspective experiences. You don’t lose words and names and semantic information. If you have Alzheimer’s or Parkinson’s and dementia or LBD or something. You lose the semantic and word information well after you’re far gone, so don’t worry about it. Word finding delayed recall you’re reaching for loading stuff into your mind into working memory and you’re having handoff mismatches timing mismatches. you’re grinding your gears. So I can usually predict if an adult is having word finding issues because the office speeds are all desynchronizing. And if a kid is having that they run so fast that finding words is fine. They have trouble absorbing information from the out Side world. So I’ll say are you reading a book and discover 10 minutes in your mind’s been doing something else for eight of those minutes? Wow. Yeah. Because the intensity depths and the speed the there’s nothing to synchronize the information flow anymore. So when you see these things, it’s not like oh, and now I’m gonna generate feedback. I mean, yes, you can often do that. And if suffering if there’s a cute stuff, you got big goals, great. There’s a, there’s a hammer, we can hit some nails. But for other people, it’s like, here’s some agency. Oh, you just had COVID. Now I see Delta everywhere. Oh, that’s really uncomfortable. Good strategies, try keto. There’s a hyperbaric place down the street, really hack your sleep really, really watched this, you know, oxidative stress things. You know, let’s let’s see how you look. In a few months. You can now track metrics the same you might look at your lipid panel at the doctor’s and go better back off and the Ben and Jerry’s for a few months. It just agency, you just learn

Speaker 1 20:51
what that’s like. It’s really a holistic approach that you’re looking at the whole person uniquely as they are because everybody’s so different.

Speaker 2 21:00
They are people people are weird, lovely, lovely. People are quite weird. Yeah.

Speaker 1 21:04
That is mindfulness. Practice fit into this process, because you mentioned that also, or how does it complement these processes?

Speaker 2 21:13
Yeah, so mindfulness. Of course, for folks who are familiar, it’s getting ready all the rage. So I probably not telling anyone new but I consider it. So the classic definition is I think this is maybe Jon Kabat Zinn said, paying attention in a particular way to the present time on purpose. The act of meditation, or mindfulness writ large is actually one of executive function, which people often don’t realize until they do a bunch of it. It’s not an act of relaxation, you don’t go to the gym and be strong, you go to the gym and be weak. And later on, you’re strong, you got to meditate and you’re distracted as heck. And your mind is wandering and your knee hurts, and she’s cute, and oh, my stomach’s rumbling. That’s what happens when you’re meditating or doing mindfulness. And many forms of mindfulness are an anchor or an executive anchor and take the prefrontal cortex, they help you direct executive function on single point of awareness on present time flying by on a feeling tone, they’re an active executive anchor. So executive systems are one of the big three things that tend to want to have a beautiful foundation for sleep, stress and Attention, attention being the executive, as things that scaffold all the other higher level human things. There’s no mood thermostat in the brain. But there are measures for sleep quality, and executive function, maintenance and things like that. So train those and the whole system tends to resolve so it’s foundational and fundamental. It’s also something you can do voluntarily, most neurofeedback is involuntary, you get to choose what to work on and then see if it works. As you as you iterate, you don’t get to make it not work. You can’t make it not work in the chair, your brain gets moved, right and you go, Well, I can I feel or Oh, I feel a little weird, and that wears off and tell your coach. But it’s an involuntary exercise. So we want this voluntary piece of it. Well, the neurofeedback is like the coach in the gym, helping you build resources, the mindfulness becomes the coach on the field, helping you realize you’re dropping your your shoulder or something when you’re trying to execute and you learn to navigate and integrate the voluntary resources. And we make that a big piece of it, you know, all of our clients get mindfulness training, if they if they wish, or if we can talk them into it. And we have weekly groups as well that are both online and in person. Since since we are working with your mind and your brain, I feel that that’s the sort of minimal piece we should be doing for clients who might have others particular cognitive and you know, deeper stuff they want to work on. Often when people come in with diagnostic language based things. They’ve also got other team members, which is great. So I’m not going to work on schizophrenia without a psychiatrist on board or something. But when someone comes in who has a lot of desire to transform and change their brain, I feel that some guidance with that and some structure, some community can be very, very useful. So all the clients get some direct instruction, but then they get this weekly group. So you can do that during neurofeedback, although I often recommend it, especially with anxiety or mindfulness later on. Oh, you finished the program feeling great. Oh, don’t forget, have these mindfulness private sessions available this weekly group? Oh, yeah. And then we create follow on healthy habits and behavior in a sneaky way. And we also are physical offices, we have four in the US and a couple popping up overseas. Now, our physical offices are set up with a membership set up so that people pay one time and they have access throughout the year for brain mapping. So they often do this thing where they work on their ADHD or their post COVID fog or their seizures or migraine or their creativity or whatever. And get through it in a three to six month timeframe and transform pretty deeply and then we want to provide this longer amount I would have continued agency continued habit hacking and doubling down on things so that fixing your sleep issue translates into better sexual performance a few months later, when your cortisol drops, for instance, you know, like, these things are foundational. We don’t want to just stop when you’re done the problem for

Speaker 1 25:19
Yeah, so again, I keep hearing the holistic approach to brain health and well being and speaking of sexuality, because I am a clinical sexologist, I wanted to ask you about how these processes might help to optimize people’s sexuality or not their sexuality, but their sex and their sex lives, specifically, inhabiting

Speaker 2 25:41
your own sexual identity, nature expression, joy, pleasure is really complex across people. And honestly, while there are some things specifically we do that have sexual sort of targets with neurofeedback, I treat a lot of sexual complaints and people come in sometimes performance complaints, or sleep issues, or, I mean, often a sexual problem when I’m hearing about it is anxiety landscape, or it’s a parasomnia or dyspnea, someone has like an middle of the night arousal phenomena that wakes them up, that actually happens to some men, where they can’t fall asleep, because an erection wakes them up. And they are like, have a like, it seems like a tic essentially. Yeah. So I see that those people, I see people for whom performance has become very stressful, and it’s like any other flavor of anxiety. And I see folks, the other big thing I see is folks, women, in their late 30s, and 40s, who are trying to do everything they can to get pregnant. And cortisol gets in the way of that. So someone’s got dysregulated sleep, and they’re stressed and they will, you know, their their fertility doc will say, you know, addressing your anxiety or sleep issue would do as much as the hormones were doing. So you should probably, you know, hey, biofeedback, and they find us that way. So I tend to see the sort of the sexual piece of it for folks in the larger goal landscape. And, you know, for folks that are anxious, the goal tends to be about different flavors of anxiety, or separation, or maybe social anxiety, or maybe trauma history, you know, and it’s about detachment stuff. Now, not really about the sexual part, the attachment, perhaps, you can do amygdala type, you know, massaging essentially. And then for other folks. You know, you have these quirky weird brain things like night arousal phenomena, or sometimes you get folks with post SSRI, depersonalization and Anhedonia and low sexual tone. Because of that, and not all these things are super tractable in the neurofeedback landscape. But now, you can really get good impact on anxiety, sleep quality and plasticity in the brain, which can do a fair amount for helping then, you know, narrow the landscape of things you’re trying to work on. And then you can be a little more specific, and you can be a little more, you know, targeted with trying other interventions as you need working with that person on the posts that are I working with the fertility doc on specific interventions, because you’re no longer trying to drive cortisol down because your deep sleep is suddenly regulated or, you know, whatever. So yeah. All

Speaker 1 28:22
right, great. Well, that’s really interesting and useful to certainly those people who come to center for healthy sex for treatment. So, Dr. Hill, where will people find you? I know, you said, you’re in Culver City right now. But where else are your offices around the world? And how can people locate you wherever in the world they are? Yeah,

Speaker 2 28:40
so we’re in West LA, of course, in Culver City. We’re also in Southern California, and down in Orange County, and custom mesa. We also have big offices in St. Louis, and we have one in New York City in Manhattan. We are right now opening up we have concierge technician in London, and we have somebody in Stockholm. And there’s a few other cities we’re in, but actually 80% of our clients never see our offices, I say send them equipment. And our coaches do brain mapping virtually, and we give them amps. And we have live people seven days a week to teach you to do Neurofeedback on your brain and troubleshoot what you’re doing and hold your hand as you set up wires and Chris windows for having done an update just then, because it does that same test, right. So we are going a personal trainer type of phenomena. So we tend to support you know, we have these physical office network and folks coming up to brains and have fun with it. But you don’t have to be near the offices to work with us. If you want to find us on the socials. We’re at peak brain la almost everywhere. But our website is peak brain institute.com. So come check us out and share your brain with us and we’d be happy to show you all that stuff. That’s

Speaker 1 29:49
great. Well, it sounds like you’re doing really cutting edge and exciting work. And so now everybody knows where to find you. So it’s been my pleasure to talk to you today. And if Anybody has any questions? Please feel free to either write to us at Center for Healthy sex.com Or you can find Dr. Hill at peak Brain Institute. All right. Thank you.

Unknown Speaker 30:11
Of course. My pleasure. Thanks, guys. Take care of those brains.