Transcript
[0:02] [Music]
[0:04] welcome everybody uh
[0:07] thanks for joining us for this
[0:10] one hour webinar and this is really uh
[0:13] designed as a
[0:15] a basic introduction and i think that
[0:18] was fairly clear in the description
[0:20] um but um i think it's good to say at
[0:23] the beginning just in case some of you
[0:25] have
[0:26] some sort of background and
[0:28] neurofeedback or or know a lot about it
[0:31] this is going to be a pretty basic
[0:32] approach
[0:33] of really kind of looking at uh
[0:35] explaining how neurofeedback works
[0:38] um what is it that we're measuring how
[0:40] do we measure things how do we determine
[0:44] approaches to use with things like adhd
[0:46] anxiety and depression
[0:48] and then um
[0:50] doing a little bit of a playback demo so
[0:53] i can show you what neurofeedback
[0:55] actually looks like rather than just
[0:57] talking about it
[0:58] um
[0:59] so a little bit of my background just
[1:01] briefly
[1:02] so my name is jeff tarrant i'm a
[1:04] psychologist
[1:06] in eugene oregon in the united states
[1:09] and
[1:10] i've been predominantly working in the
[1:13] neurofeedback
[1:15] field as a professional for about
[1:17] 25 years
[1:20] and the field has changed a lot in that
[1:22] time
[1:24] if you could see some of the technology
[1:26] that i worked with at the beginning
[1:28] uh compared to now it's like night and
[1:31] day it's totally different
[1:33] thank goodness it was it was very
[1:35] rudimentary uh at the beginning
[1:38] uh stages
[1:39] and uh
[1:41] is much more interesting and useful now
[1:44] um
[1:46] so the
[1:47] one of the caveats that i should sort of
[1:49] give you at the beginning is that
[1:52] there's actually a lot of different
[1:53] kinds of neurofeedback and a lot of
[1:55] different companies and a lot of
[1:56] different types of equipment
[1:58] and of course there's no way that we
[2:00] could cover all of those possible
[2:03] options in terms of how people might
[2:06] engage with neurofeedback my goal is to
[2:08] give you sort of a basic overview
[2:11] and uh
[2:12] that
[2:13] is probably going to be
[2:15] a piece of what you would see with just
[2:18] about any provider
[2:19] that's what i'm hoping anyway
[2:22] so
[2:22] starting out uh what is neurofeedback
[2:25] right that's the question so
[2:28] neurofeedback is really a specialized
[2:30] form of biofeedback okay well what's
[2:33] biofeedback biofeedback is really any
[2:36] kind of a system
[2:38] where you are measuring or monitoring
[2:42] some aspect of physiology
[2:44] and giving the person
[2:46] some sort of visual or auditory feedback
[2:48] about what's happening in their body
[2:51] so
[2:52] you can use biofeedback to measure skin
[2:56] conductance right which is sweat gland
[2:58] activity on your fingertips
[3:00] you can do heart rate variability
[3:02] measuring aspects of how the heart is
[3:04] behaving
[3:05] you can do muscle tension
[3:07] right little sensors that you stick on
[3:08] the body
[3:09] to measure how tight or relaxed the
[3:12] muscles are
[3:14] skin temperature
[3:16] brain blood flow all of these are
[3:18] aspects of biofeedback
[3:20] neurofeedback is just really taking that
[3:23] idea but applying it to
[3:25] brain waves usually brain waves
[3:28] sometimes you'll hear people use the
[3:30] term neurofeedback
[3:31] talking about things like brain blood
[3:33] flow or some other aspect of brain
[3:36] functioning it's almost always brain
[3:38] waves
[3:39] right which we're going to get into here
[3:40] in a minute
[3:42] so the idea with neurofeedback is that
[3:44] if you can monitor brainwave activity
[3:48] and
[3:49] in some way communicate that information
[3:52] in a useful way
[3:54] to the client or
[3:56] the person that you're working with they
[3:58] can learn
[3:59] to modify their own brainwave patterns
[4:03] now why would we want to do that well
[4:05] because
[4:07] the way that i tend to look at things is
[4:09] that one of the reasons that people tend
[4:11] to experience
[4:13] symptoms
[4:15] so whether it's anxiety or depression or
[4:17] something else
[4:18] is
[4:19] that the brain has become sort of stuck
[4:21] in a pattern
[4:23] that's no longer useful
[4:25] it started doing something
[4:27] maybe it's just the way the person was
[4:29] born but the brain has kind of developed
[4:31] a rhythm a way of engaging
[4:33] that is actually kind of rigid
[4:36] and so it keeps repeating the same
[4:39] processes even if they're not useful
[4:42] so what we seem to be doing in
[4:45] neurofeedback is creating more
[4:47] flexibility in the system we're helping
[4:50] the brain learn to shift out of those
[4:52] stuck patterns and learning how to do
[4:54] something different
[4:56] now we'll get into more of that in a
[4:58] minute because it gets to this idea of
[5:01] you know how do we teach the brain to do
[5:02] that
[5:03] and really
[5:05] it's actually fairly basic in some ways
[5:07] the principles are largely
[5:09] part of something in psychology that we
[5:11] call operant conditioning
[5:13] which is basically if you reward
[5:16] something
[5:18] it'll do it more right so this this
[5:20] applies to like training a puppy right
[5:23] if you have a puppy and you want the
[5:25] puppy to do certain things and not do
[5:27] certain things well
[5:29] when it does what you like you give it a
[5:30] treat
[5:32] and guess what it does it more
[5:34] and if it if it does something you don't
[5:36] like you can either ignore it or you can
[5:39] punish it
[5:40] in which case it will do it less
[5:43] so these this is the basic idea of
[5:44] operant conditioning
[5:46] and interestingly the brain responds to
[5:49] the same kinds of basic
[5:52] behavioral mechanisms
[5:54] so we're using that to our advantage to
[5:55] teach the brain
[5:58] now most of you on this call you i'm
[6:00] sure you've heard of neurofeedback and
[6:02] you've probably heard it in relation to
[6:06] being a treatment option for a variety
[6:08] of different
[6:09] conditions
[6:10] and that's true and we'll we'll get into
[6:12] some of that you can also use it to
[6:14] enhance performance so things like um
[6:18] enhancing cognitive abilities
[6:21] right or uh cognitive performance or
[6:23] being able to pay attention
[6:25] we we use it a lot at the moment to
[6:27] facilitate meditative states
[6:30] so we kind of know what the brain should
[6:31] be doing during different types of
[6:33] meditation
[6:34] and so we can monitor those brain wave
[6:36] patterns and help somebody find those
[6:40] states of consciousness
[6:42] okay now before i can kind of get into
[6:46] um
[6:47] you know the the nuts and bolts of some
[6:50] of this
[6:51] we need to talk a little bit about
[6:54] brain waves because this is kind of the
[6:57] basis of everything we're going to be
[6:59] discussing in this webinar and so if you
[7:02] don't know what we're talking about
[7:04] it makes sense to get us all on the same
[7:05] page
[7:07] right so
[7:09] super basic overview
[7:12] what are brain waves well it's
[7:13] electrical activity made in the brain so
[7:17] every cell
[7:18] in your body
[7:19] and we're interested in brain in the
[7:21] brain cells but you know neurons but
[7:23] this is true with
[7:24] all of your cells
[7:26] uh
[7:27] you know it collects
[7:29] information from other cells
[7:32] through
[7:32] dendrites so dendrites are these little
[7:34] spines that are connected to the cell
[7:36] body and so this receives chemical
[7:38] information in the form of
[7:40] neurotransmitters
[7:41] things like serotonin dopamine etc that
[7:44] information gets received by the cell
[7:47] body
[7:48] and it uses that to make a decision
[7:50] about
[7:50] whether it's going to send its own
[7:52] signal or not
[7:53] and when it receives enough information
[7:55] that says yeah send a signal the signal
[7:59] it sends is actually electrical
[8:02] so the brain communicates chemically and
[8:05] electrically you got to have both
[8:07] so this electrical signal goes down the
[8:10] axon it goes down to these
[8:13] the axon terminals
[8:15] and then it releases more chemicals that
[8:18] get picked up by another nerve cell
[8:20] so
[8:21] brain cells communicate electrically and
[8:24] chemically
[8:25] um so what we're talking about is the
[8:28] electrical patterns
[8:29] now
[8:30] each brain cell
[8:32] is firing
[8:35] many many many many many times a second
[8:38] in some cases thousands of times a
[8:40] second
[8:41] right so
[8:42] what we are actually measuring when
[8:44] we're doing something like an eeg
[8:47] electroencephalograph this is where
[8:48] we're putting sensors on the scalp
[8:51] to measure electrical activity
[8:54] what you're actually measuring is large
[8:57] groups of neurons firing together so
[9:00] you're measuring patterns
[9:02] of electrical activity
[9:04] right it's too much to i mean you can go
[9:06] in and measure one elect
[9:08] one neuron at a time it's invasive of
[9:11] course you have to
[9:12] go into the brain and have highly
[9:14] specialized equipment and be in a
[9:15] research hospital
[9:17] um
[9:18] it's possible
[9:19] but what we're doing is sticking an
[9:21] electrode on the surface
[9:23] and looking at large patterns
[9:25] of electrical firing
[9:27] initially what we've got is this you
[9:30] know something that looks like this
[9:31] right so when you think of an eeg when
[9:33] you think of
[9:34] monitoring brain waves this is what many
[9:36] people think about because it's what we
[9:38] see in tv right and if you ever go to a
[9:41] neurologist for a sleep study or to look
[9:45] for seizures
[9:46] this is what they're largely going to be
[9:48] looking at it's called the it's called a
[9:50] raw
[9:50] eeg or a clinical eeg
[9:53] and what you're looking at is
[9:55] all of the electrical activity in in
[9:58] this case 19 locations on the scalp
[10:01] so there's 19 locations they all have a
[10:03] special name so we know where we're
[10:05] where we're at
[10:06] and you see the little squiggly lines
[10:10] that represent
[10:13] uh eeg activity as it's moving through
[10:15] the brain
[10:16] now
[10:17] this is all great except unless you're a
[10:20] neurologist
[10:22] this isn't going to mean much probably
[10:25] all these squiggle lines well what does
[10:26] this mean
[10:28] now if you're a neurologist you're
[10:29] looking for gross abnormalities you're
[10:32] looking for a seizure right or something
[10:34] like that you'll see that in this raw
[10:36] pattern
[10:38] now for us
[10:40] we need more
[10:41] finesse in terms of what we're looking
[10:44] at
[10:45] so what we do is we take a raw eeg
[10:48] something like this
[10:50] and then we run it through
[10:52] some filters a digital filter
[10:56] and what that does is allows us to see
[10:59] more of the nuance
[11:01] in the signal
[11:03] so the best way i can kind of describe
[11:05] how this works
[11:06] is by using an analogy
[11:08] right so if you've ever seen white light
[11:12] go through a prism
[11:15] out the other side comes
[11:17] a rainbow right a spectrum of colors
[11:21] and so if you think about what that
[11:22] means for a moment what it means is that
[11:25] all of those colors are contained in
[11:28] white light
[11:29] but you don't see them until you filter
[11:32] it
[11:33] so the prism acts as a filter
[11:36] because each of those colors is a
[11:38] different frequency
[11:40] red is a different frequency than blue
[11:43] right there's all of the colors have
[11:45] different frequencies so all of those
[11:47] frequencies are contained in the white
[11:49] light
[11:51] but again you have to filter it to see
[11:52] it
[11:53] so if we kind of go back to this image
[11:55] for a minute
[11:57] each one of these squiggle lines is kind
[11:59] of like a beam of white light there's a
[12:01] whole bunch of frequencies contained in
[12:03] here
[12:04] but you don't see it until you filter it
[12:08] so we run it through a specialized
[12:10] software program
[12:12] that
[12:13] pulls the signal apart so we can look at
[12:15] all the different frequencies
[12:17] right and by frequencies i'm talking
[12:19] about the speed of
[12:21] the electrical signal
[12:23] how many cycles per second are there how
[12:25] many repetitions of the wave are there
[12:28] per second
[12:29] so we can break it all apart
[12:32] and then when we do that
[12:34] we can see well how much activity is
[12:36] there
[12:37] in each of these frequencies
[12:40] right so there's two issues the speed of
[12:43] the brain wave
[12:44] how fast it is
[12:46] how many repetitions there are in a
[12:47] second
[12:48] and then how much of it is there how big
[12:51] is it so this is amplitude right or
[12:54] power
[12:55] and it's usually measured in microvolts
[12:58] so there's two issues that we have to
[12:59] deal with
[13:01] now most of the time we're not looking
[13:03] at individual frequencies we're not
[13:05] looking at one hertz two hertz three
[13:07] hertz four hertz
[13:09] what we look at instead are clusters of
[13:12] brain waves
[13:14] clusters of frequencies so when you hear
[13:16] these terms delta theta alpha beta gamma
[13:20] and there's other terms that you might
[13:22] hear as well
[13:23] for eeg bands
[13:26] a band is just a group
[13:29] all these are are clusters of
[13:31] frequencies
[13:32] so in general delta waves are going to
[13:35] be the slowest waves
[13:37] right so something like
[13:39] one to four hertz
[13:41] so one cycle per second two cycles per
[13:44] second so instead of looking at them
[13:45] individually they get put into a little
[13:47] group and we call it delta
[13:50] you can see the delta is also the the
[13:53] strongest it's got the most power it's
[13:56] the biggest
[13:57] right
[13:59] and so you'll see this pattern
[14:00] throughout the slower the brainwave the
[14:02] more power it tends to have
[14:05] theta a little bit faster still
[14:08] considered a slow brainwave
[14:11] alpha again a little bit faster
[14:14] so at alpha we're looking at like 8 to
[14:16] 12 cycles per second
[14:20] beta we're starting to get into fast
[14:21] brain waves
[14:23] right now sometimes you'll see high beta
[14:25] it's kind of the next category up
[14:27] and then gamma
[14:29] and for the most part gamma is about as
[14:31] fast as we look right now and that's
[14:33] typically around 40 cycles per second
[14:37] okay
[14:38] so the brain is making all of this
[14:40] activity zero hertz up to 40 hertz
[14:43] actually way beyond that
[14:45] it's making all these frequencies all
[14:47] the time everywhere
[14:50] right so it's a little bit of a mistake
[14:52] to think oh the brain is now making
[14:54] alpha
[14:55] well the brain is always making alpha
[14:58] it's just how much alpha is it making in
[15:01] relation to the other brain waves
[15:05] so
[15:06] the different relative
[15:08] amounts of the different brain waves
[15:11] has something to do with our states of
[15:12] consciousness so this is where things
[15:14] get interesting right
[15:16] so you can see the really brief
[15:18] descriptions under each of these names
[15:21] and this is kind of what they're known
[15:22] for right these particular eeg bands now
[15:26] again it doesn't mean like if you're
[15:28] asleep that you only have delta
[15:31] right of course you have the other ones
[15:32] but you might have a lot more delta
[15:35] you can think of dealt having a lot of
[15:37] deltas being sort of unconscious
[15:40] right things are shut off
[15:42] um
[15:43] you know
[15:44] you're in a deep sleep or you're
[15:46] disconnected you're dissociated or
[15:49] things are shut down for repair
[15:52] in theta we tend to be in that sort of
[15:54] like
[15:55] drifting into sleep that
[15:57] twilight state it can also be states of
[16:00] creativity
[16:01] right tapping into the subconscious
[16:04] dreams
[16:06] certain types of
[16:07] meditation uh involve theta
[16:10] alpha's kind of the middle tends to be
[16:12] more like an internal awareness
[16:16] and being more physically and mentally
[16:17] relaxed
[16:19] so everybody likes alpha in general
[16:22] alpha tends to feel pretty good
[16:25] beta we're getting faster if there's a
[16:26] lot of beta
[16:28] in all likelihood you're thinking you're
[16:30] analyzing you're processing your brain
[16:32] is doing something
[16:34] active
[16:35] right crunching numbers or figuring
[16:37] something out or planning for the future
[16:41] and then gamma gamma's the one that
[16:42] everybody's excited about right now
[16:45] because it's associated with some
[16:48] higher states of consciousness and
[16:50] heightened perception
[16:52] so sometimes it's associated with being
[16:54] like in a flow state or being in the
[16:56] zone
[16:57] these aha moments
[16:59] where you
[17:00] understand something without efforting
[17:03] without putting in too much thought too
[17:06] much conscious thought it's like
[17:09] the mind-body mechanism figures it out
[17:12] by itself
[17:14] gamma is also associated with certain
[17:16] types of meditative states it's been
[17:18] found with
[17:20] advanced
[17:21] meditators doing a compassion meditation
[17:24] this gamma you also see it in things
[17:26] like lucid dreaming you also see it show
[17:29] up in things like psychedelic states so
[17:32] gamma's kind of an interesting fun one
[17:34] but again for us the important thing is
[17:37] how much of each one of these
[17:39] is there in a given moment
[17:42] right
[17:43] okay
[17:45] so
[17:46] let's let's kind of get down to more
[17:47] practical issues right so we've got all
[17:50] these brain waves
[17:52] and i've already told you that the
[17:53] amount of each one has something to do
[17:55] with our state of consciousness
[17:57] you also start to see that the
[18:00] relationship of these brain waves how
[18:03] much they're there are of each one
[18:05] are also related potentially to
[18:08] different mental health concerns
[18:11] so one that's really well known it's
[18:13] been in the literature for a long time
[18:15] is something called the theta beta ratio
[18:18] and its association with adhd
[18:22] so you remember theta is a slow brain
[18:24] wave
[18:25] beta is a fast brain wave
[18:28] so if you measure the amount of theta
[18:32] and divide it by the amount of beta
[18:34] specifically at a location called cz
[18:37] right in the center of your head
[18:40] that ratio seems to be very predictive
[18:43] of whether somebody has adhd or not
[18:47] and so that simple ratio theta beta
[18:50] at cz
[18:52] you can see that from the research
[18:55] the effect sizes for
[18:57] research in this area are quite large
[19:00] right so if you're not a researcher that
[19:02] may not mean much to you but a 0.75
[19:04] effect size is huge
[19:06] if you were a researcher and found that
[19:07] you'd be very excited
[19:09] and just as an example i i put a
[19:11] citation from many years ago
[19:14] where when they looked at the theta beta
[19:15] ratio
[19:17] in a control group it did not have adhd
[19:20] the average ratio was 2.4
[19:23] right so you could imagine you measure
[19:25] theta and let's say it was uh
[19:28] 12 microvolts
[19:31] and you measured beta and it was
[19:34] 5 microvolts you do the math
[19:37] and i don't know what it is two point
[19:40] something right that's kind of normal
[19:43] so kind of a two to one ratio ish
[19:46] is about what we expect
[19:49] and then you see with the adhd group
[19:52] the average ratio was 3.7
[19:55] much higher there's much more slow
[19:58] activity
[19:59] compared to
[20:00] fast activity
[20:02] now that's contrary to what a lot of
[20:05] people think with adhd they think
[20:08] you know because adhd is characterized
[20:10] often
[20:11] by
[20:13] you know lack of impulse control
[20:15] difficulties paying attention all of
[20:17] this kind of stuff
[20:19] that it looks like things are running
[20:22] too fast
[20:24] and that's not always the case a lot of
[20:26] times the brain is actually running too
[20:28] slow
[20:29] and so what is happening
[20:31] is that
[20:32] it's making it difficult for certain
[20:34] parts of the brain to do its job
[20:36] effectively
[20:37] so if there's too much theta hanging
[20:39] around in the frontal lobes which is
[20:41] kind of what we're talking about here
[20:43] and you can actually see in the image
[20:45] below you see all that extra theta up in
[20:47] the frontal lobes what that means is
[20:49] that though that part of the brain is
[20:51] having a hard time
[20:53] being efficient and being effective
[20:55] and so
[20:57] um
[20:58] what do the frontal lobes do well
[20:59] they're involved in paying attention
[21:01] they're involved in inhibiting impulses
[21:04] right this is why with some of
[21:06] some
[21:07] kids and adults with this type of adhd
[21:11] stimulants often seem to work
[21:13] because the brain is under stimulated
[21:16] if you stimulate the brain
[21:18] it functions better
[21:20] right so it makes sense in this context
[21:23] yeah tyler just made a comment about
[21:25] could you speak to increased beta and
[21:26] distractibility yeah so here's where
[21:29] things get a little bit tricky right
[21:31] because a lot of people come in and they
[21:33] say i have adhd and you say okay let's
[21:35] do a brain map which we'll talk about in
[21:37] a minute what a brain map is
[21:39] but we measure their brain wave activity
[21:41] and we're kind of looking for this
[21:43] pattern this theta beta
[21:45] uh issue and it's not what we see
[21:48] instead what we see is a bunch of fast
[21:50] activity
[21:52] and so it's like huh okay what's going
[21:54] on here
[21:55] so
[21:57] if you have a bunch of fast activity
[21:59] what usually happens
[22:01] um if somebody's talking about adhd is
[22:03] that there's so much happening
[22:05] internally there's so much information
[22:07] coming in they're thinking about so many
[22:09] things at the same time
[22:11] that it becomes difficult to filter
[22:13] through all that information to just
[22:15] focus on one thing
[22:17] so it still looks like adhd it just has
[22:19] a different
[22:21] uh
[22:22] i don't want to say cause a different
[22:24] signature
[22:25] in terms of an eeg pattern
[22:28] whereas again oversimplified but to show
[22:30] the difference if somebody has a lot of
[22:32] slow brainwave activity
[22:34] the distractibility might because
[22:36] there's not enough information to keep
[22:38] their attention right so the stereotype
[22:41] of like the kid who's like spaced out
[22:44] and looking around the room
[22:46] you know rocking in their chair getting
[22:48] up to sharpen their pencil they're
[22:50] looking for more stimulation
[22:53] so it's kind of two different issues but
[22:55] from the outside it could look the same
[22:57] this is why we find that measuring
[22:59] somebody's brainwave activity
[23:02] uh is really useful because if we
[23:04] understand what the brain is doing it
[23:06] can help us make decisions
[23:08] about how to best serve that particular
[23:10] person so meredith asked a quick
[23:12] question could this potentially
[23:14] implicate research
[23:15] implicate research the use of stimulants
[23:18] for dissociation considering that
[23:21] is also slower waves
[23:25] uh that's interesting
[23:26] um so if i'm understanding you're kind
[23:28] of what you're saying is that could
[23:30] stimulants be useful
[23:32] to help
[23:33] uh kind of pull people out of a
[23:35] dissociative
[23:36] uh kind of a state because dissociation
[23:38] is also
[23:40] uh characterized by an excess of slow
[23:43] wave activity
[23:44] it's an interesting idea i don't know i
[23:46] don't know the answer to that but um
[23:49] i'm you know i'm sure somebody has
[23:51] looked at that you would think so uh but
[23:54] i but i haven't but it's a great
[23:55] question and then karen asks i'll take
[23:57] one more question here and then i'll
[23:58] save the rest until we get a little bit
[24:00] further in if that's okay
[24:02] uh so karen says can a brain map show if
[24:03] someone is a high sensing person
[24:06] um
[24:07] so um i'm assuming karen that what
[24:09] you're talking about is like somebody
[24:11] that's
[24:12] uh highly sensitive i think that's
[24:14] probably what you're saying a highly
[24:15] sensitive person
[24:17] and uh the answer is yes and no
[24:22] which is
[24:23] most of the type of answers that we will
[24:25] have here because the brain's
[24:27] complicated
[24:29] um
[24:29] and so what i mean by yes and no is that
[24:32] the back part of the brain the parietal
[24:35] lobes
[24:36] which are kind of this back quadrant
[24:38] have a lot to do with sensory processing
[24:42] and so if you see somebody that has a
[24:44] lot of
[24:46] very often fast brainwave activity back
[24:48] there
[24:49] it could be slow
[24:51] but basically
[24:52] some sort of dysregulation
[24:55] of that area of the brain it could very
[24:57] well be associated with sensitivity
[25:00] either being oversensitive or under
[25:02] sensitive
[25:03] now the the reason i said yes and no is
[25:05] because just because somebody has
[25:07] uh
[25:08] excess
[25:09] activity back there or
[25:11] or low activity back there
[25:13] it doesn't necessarily mean that they're
[25:16] highly sensitive
[25:17] um so it doesn't kind of go both ways
[25:19] right if we see the pattern it's not an
[25:21] automatic sort of diagnosis and that's
[25:23] true with anything
[25:25] uh in this field just because we see a
[25:27] pattern like even if i saw this pattern
[25:29] on the screen with all this theta in the
[25:31] frontal lobes now i'm gonna have a red
[25:34] flag out like oh i wonder if this person
[25:36] has some adhd symptoms
[25:39] um but they may not
[25:41] because people are tricky and that they
[25:44] may have figured out ways to compensate
[25:45] or to work around that or that slow wave
[25:48] activity may be showing up in a
[25:49] different way
[25:51] so
[25:52] you you never want to i never want to
[25:55] and i think as a field we shouldn't make
[25:57] diagnoses
[25:59] based only on the brain map
[26:01] we want the brain map and then we want
[26:03] other data to help us understand what
[26:06] this brain map means right why is there
[26:09] fast activity there our slow activity
[26:11] what does that suggest
[26:13] and
[26:14] you know what data can i gather to help
[26:16] me understand
[26:17] what's going more specifically with this
[26:19] individual
[26:21] let me give you another example
[26:24] so anxiety
[26:26] now again
[26:27] um
[26:28] i'm oversimplifying some of this for the
[26:31] purposes of of this webinar right
[26:33] because we can't cover everything
[26:35] um
[26:35] [Music]
[26:36] but one of the patterns that we
[26:38] frequently see with anxiety is
[26:41] too much fast activity so it's actually
[26:43] the opposite of what we just talked
[26:44] about with adhd with sort of a
[26:46] stereotypical adhd
[26:50] is too much fast activity and it can
[26:53] show up in lots of places but one of the
[26:56] places we often see it is right down the
[26:58] midline
[27:00] so
[27:00] the front so the midline is called the
[27:02] anterior cingulate when you
[27:04] dig a little bit deeper down to the
[27:06] brain not on the surface
[27:08] it's called the cingulate gyrus
[27:11] and the anterior cingulate this part up
[27:13] in the front
[27:14] is
[27:15] very much involved in
[27:17] a variety of emotion regulation
[27:20] responses
[27:22] and so when this part of the brain gets
[27:23] over active
[27:25] it's so beta high beta things like that
[27:30] almost
[27:31] again not always frequently it's
[27:33] associated with overthinking
[27:36] getting stuck on certain thoughts or
[27:39] feelings or body sensations
[27:41] uh rumination
[27:43] right all those kinds of things i know
[27:45] there's a lot of info on this slide
[27:48] but just to highlight a couple of things
[27:49] on the bullet points
[27:52] showing you know that multiple
[27:54] researchers and clinicians have found
[27:56] this pattern
[27:57] right so you see
[27:59] um
[28:00] you know the third bullet point
[28:02] so the eeg pattern most associated with
[28:05] stress and anxiety are increased beta
[28:08] and decreased slow wave activity so
[28:11] specifically alpha so a couple of
[28:14] different researchers have found that
[28:16] right
[28:17] um
[28:18] the fourth one anxiety is generally
[28:19] associated with an increase of 19 to 22
[28:22] hertz activity what's 19 to 22 hertz
[28:26] beta right so again you see this over
[28:28] and over again this pattern
[28:31] and so again it's one of those things
[28:33] that if somebody comes into the office
[28:35] and they say i have anxiety
[28:38] i i worry all the time okay
[28:41] and if we do a brain map a quantitative
[28:43] eeg that's what q eeg stands for
[28:47] and we see that there's a lot of fast
[28:49] activity
[28:50] right here on the anterior singulator
[28:52] down the midline
[28:54] those line up pretty well so now we know
[28:57] what to target with neurofeedback and
[28:59] that's the point of all of this is we're
[29:01] looking for patterns that make sense
[29:03] given the concerns so that we know how
[29:06] to best approach
[29:07] a neurofeedback session which we haven't
[29:10] even got to
[29:11] yet one more example with depression
[29:15] again a little bit of an
[29:16] oversimplification but this is a pattern
[29:18] that shows up consistently
[29:20] so there's a thing called frontal
[29:22] asymmetry so it used to be called alpha
[29:25] asymmetry
[29:26] now we more just call it frontal
[29:28] asymmetry
[29:30] if you look at activity in the right
[29:33] versus left frontal lobes
[29:36] what you will see is that
[29:38] if the
[29:39] left frontal lobe is a little bit more
[29:42] active
[29:43] that's usually a good thing
[29:45] so that tends to be
[29:46] uh
[29:47] you know more associated with things
[29:50] like positive feelings and more of an
[29:52] approach motivation meaning
[29:55] if there's something going on that needs
[29:57] addressing you move toward it to resolve
[30:00] it right so it's a proactive type of a
[30:03] feeling state
[30:05] if there's more activity on the right
[30:06] side
[30:08] that actually tends to be associated
[30:10] with more negative feelings
[30:11] right so more pessimistic attitude
[30:14] uh more of a cup half empty kind of a
[30:17] feeling
[30:18] and a tendency to more move away from
[30:21] challenges so withdrawal motivation
[30:25] so again if we if somebody comes in and
[30:27] they say i'm depressed okay
[30:30] and we do a brain map
[30:31] and we see we're looking at these
[30:33] frontal lobes and we see this pattern
[30:37] that's a pretty good indication that
[30:39] those things go together
[30:41] and you know not to get too
[30:44] too much in the weeds here but
[30:46] again there's a lot of research kind of
[30:48] supporting this idea that frontal
[30:51] asymmetry is associated with
[30:53] negative mood and depression in
[30:55] particular
[30:57] um so i don't need to go through all of
[30:59] those but just to show you that there is
[31:01] research in this area
[31:03] some of it actually was pioneered by
[31:06] richie davidson
[31:08] which some of you may know from the
[31:10] meditation world so he's a researcher at
[31:12] the university of wisconsin
[31:15] and does a lot of the work right now
[31:17] with looking at the tibetan monks he
[31:19] works with the dalai lama
[31:21] and uh anyway so he pioneered a lot of
[31:24] this work with frontal asymmetry
[31:26] so
[31:27] the idea right is that somebody comes in
[31:30] they've got certain kinds of concerns
[31:32] and then
[31:33] we are doing a brain map we're doing a
[31:35] quantitative eeg
[31:37] in an attempt to see if there are brain
[31:38] patterns that make sense
[31:41] with their concerns
[31:43] now and again just to reiterate
[31:45] the patterns that we've covered are only
[31:47] one of many options right there's other
[31:49] ways that things could show up for adhd
[31:52] for anxiety for depression but these are
[31:54] some of the basic patterns
[31:56] now how do we get this information how
[31:59] do we measure somebody's brain
[32:01] well we do an eeg
[32:04] and so this is an old picture of of me
[32:07] you can see my hair super short and
[32:09] that's my son because of course you
[32:11] can't take pictures of your clients
[32:13] that's usually frowned upon
[32:15] so um my son served as my
[32:17] um volunteer in this case
[32:20] and so you see we put this kind of
[32:21] elastic cap on the person that has 19
[32:26] active sensors
[32:28] electrodes sensors the same thing and
[32:30] then you've got little ear clips that
[32:32] connect to the cap
[32:34] the ear clips are there
[32:36] um
[32:37] to serve as a reference
[32:39] so the software needs the some sort of a
[32:43] reference point
[32:44] in order to calculate your brainwave
[32:46] activity and the ears tend to work well
[32:49] um so you get the cap on you squirt a
[32:52] little bit of conducting gel into each
[32:54] one of those little uh sensors so on the
[32:58] inside of the cap there's like a little
[33:00] plastic housing
[33:02] with the metal sensor kind of tucked up
[33:04] in there
[33:05] so we use a conducting gel that we
[33:08] squirt into the little hole
[33:10] that serves as a bridge from the from
[33:13] the um
[33:15] scalp
[33:16] up to the sensor because even though the
[33:18] brain's making electricity it's very
[33:21] very very small
[33:23] and we have to read it through your
[33:25] skull and through your skin and through
[33:27] your hair
[33:29] so the conducting gel helps
[33:31] bridge that
[33:33] so you can see there's a wire a ribbon
[33:36] connected to the cap
[33:37] that's connected to those 19 sensors
[33:40] you plug that ribbon into an amplifier
[33:43] an eeg amplifier
[33:45] so
[33:46] that's collecting the data the eeg data
[33:49] and
[33:50] amplifying the signal because again
[33:52] they're very tiny
[33:53] and then it's sending it to specialized
[33:55] software so you can see the data
[33:59] live record it and then use it later for
[34:01] analysis
[34:04] so i keep using the term brain map
[34:06] that's kind of a you know
[34:08] um
[34:09] that's not an official term but it's
[34:11] what all of us in the field call it
[34:13] because what we tend to do is we collect
[34:15] this eeg data
[34:17] and then we run it through some sort of
[34:19] a database
[34:20] a normative database and there's a
[34:23] variety of them out there on the market
[34:25] that have been well researched
[34:28] and
[34:31] contain data from a wide range of people
[34:35] from different age groups
[34:36] so the idea is i could do an eeg with
[34:40] somebody who is
[34:43] uh
[34:44] 21 years old
[34:46] and i
[34:47] collect their data and i run it through
[34:50] uh one of these databases so there's
[34:52] there's one called neuroguide there's
[34:54] one called qeg pro there's one called
[34:57] braindx there's actually a bunch right
[35:00] so you pick which database you want you
[35:02] got to pay for it of course
[35:05] and i
[35:07] upload my data
[35:08] and what it does then is it
[35:11] compares that person's eeg data to a
[35:14] normative group
[35:15] so if they're 21 years old it's going to
[35:17] compare them to other
[35:19] people that are around 21 years old
[35:22] and what it's going to do is give this a
[35:24] little map like this
[35:26] that shows us
[35:28] how much brainwave activity they have in
[35:30] each of these g bands
[35:34] based on a comparison
[35:36] so you know how much
[35:38] activity does a person have compared to
[35:40] sort of average
[35:43] now just because somebody has more or
[35:44] less activity than average doesn't mean
[35:46] it's a problem necessarily right
[35:49] um
[35:50] and we're looking for things that make
[35:52] sense you know given their concerns
[35:55] so this was just kind of a you know a
[35:58] semi-random brain map that i just
[36:00] grabbed you know just to sort of
[36:02] demonstrate right so you can see there's
[36:04] an excess amount of theta in the back of
[36:06] the head
[36:07] okay
[36:08] not sure what that might mean because
[36:10] not sure which client this was from
[36:13] and then you see this really sort of hot
[36:15] spots of high beta in a couple of
[36:17] locations it's a little bit of an
[36:18] unusual pattern
[36:20] now you also see these little hot spots
[36:22] here that is probably something that we
[36:24] call artifact artifact is stuff that's
[36:27] not a brainwave
[36:29] uh
[36:30] that
[36:31] uh
[36:32] that gets in the way that gets in the
[36:34] signal
[36:35] right so muscle tension
[36:38] is an artifact so when you use your
[36:40] muscles
[36:42] it fires
[36:43] muscle
[36:44] uh
[36:46] cells right so there's electricity
[36:49] and that shows up or if there's movement
[36:52] so if you're moving the eyes side to
[36:54] side or if the eyes are wiggling or
[36:55] something like that it's going to show
[36:57] up on here so sometimes that stuff kind
[37:00] of sneaks into the record and you just
[37:01] have to know what you're looking for so
[37:03] that you don't misinterpret something
[37:06] right now this is the the front page of
[37:10] uh this looks like it was a neuro guide
[37:11] report
[37:12] and this is the front page
[37:15] and
[37:16] literally you could have up to 30 pages
[37:18] of data from one recording
[37:22] so there's a tremendous amount of data
[37:24] uh that's in there that's available if
[37:26] you and you just have to kind of know
[37:27] what you're looking for so
[37:29] that's my job right you look at this
[37:31] you're trying to figure out what's going
[37:33] on here and how it makes sense with
[37:34] their symptoms
[37:36] so once we have that information so once
[37:38] we kind of have an idea
[37:41] um then we move into the neurofeedback
[37:44] portion right we know what we want to
[37:45] train
[37:47] and
[37:48] now we have to figure out how we're
[37:49] going to teach the brain
[37:50] to do something different
[37:53] so this is another just example using my
[37:56] son
[37:57] and
[37:58] so now the cap's gone
[38:00] and in this case we're using
[38:03] um four
[38:05] single sensors so it's a different way
[38:08] of hooking up now you don't have to use
[38:09] four sensors you could use one or two
[38:12] you could use a cap again for training
[38:14] it depends on
[38:15] how many locations you're wanting to
[38:17] train with neurofeedback
[38:19] what are the areas of importance
[38:21] right so for example if we go back a
[38:23] slide
[38:25] maybe you know we decide that
[38:28] these are the only two areas i'm
[38:30] interested in these two that have the
[38:31] big red
[38:32] circles on high beta
[38:35] well maybe i only need to put two
[38:37] electrodes one here so this location is
[38:40] called p3
[38:42] and this location is called c4
[38:45] right so maybe i only need two
[38:47] electrodes one at p3 one at c4
[38:51] right maybe i don't need the whole cap
[38:54] so we make a decision
[38:55] and then we create a protocol i'm gonna
[38:57] show you more what that looks like in
[38:59] real life in a minute
[39:00] so we put the electrodes
[39:02] um on the head this time we're using a
[39:04] different kind of a paste
[39:06] instead of the gel
[39:08] we're using uh something called
[39:11] 1020 which is
[39:13] it's a little bit of a stickier paste
[39:15] and so it kind of holds it onto the
[39:16] scalp for us but it's also a conductant
[39:20] and then the client is looking at
[39:22] usually
[39:23] a computer monitor that is connected to
[39:26] their brainwave data
[39:29] now let me show a different slide for a
[39:31] second for a different perspective so
[39:32] this is more like a typical setup
[39:34] where the therapist might be sitting
[39:37] next to or behind the client
[39:39] and they're looking at all the data so
[39:42] if you can kind of see my little
[39:44] computer screen on this image there's a
[39:46] bunch of numbers on there in fact this
[39:48] particular program i was using it kind
[39:50] of looks like the matrix there's all
[39:52] these numbers and they're kind of moving
[39:53] around and changing from moment to
[39:55] moment
[39:57] right
[39:58] and so i'm looking at that and i'm
[40:00] setting particular
[40:02] um goals for the brain waves
[40:05] so whatever i'm monitoring again let's
[40:08] use the example from that brain map
[40:10] there's too much high beta i want the
[40:12] high beta to go down
[40:15] so i might be monitoring the high beta
[40:17] activity
[40:18] and i set a threshold
[40:21] and i say okay anytime the high beta
[40:23] goes below this line
[40:25] you're going to get a reward
[40:27] right it's that operant conditioning i
[40:29] want to reward the brain
[40:31] for doing the right thing
[40:34] so i'm over there making little
[40:35] adjustments
[40:36] and the client is watching something
[40:38] else
[40:39] now in this case he's just watching this
[40:42] uh geometric pattern that kind of
[40:44] changes shape and changes colors and
[40:46] there's some nice relaxing music that
[40:48] goes with it
[40:49] and so what will happen on this
[40:51] particular way of using it
[40:53] is that when his high beta goes below
[40:55] that line which is what we want
[40:58] then the screen is all the way bright
[41:00] the volume is all the way up
[41:02] if the high beta goes above the line
[41:04] which is not what we want then the
[41:07] screen dims out and the volume starts to
[41:09] drop
[41:11] so this is the feedback
[41:13] not just for the client
[41:15] um consciously but also unconsciously a
[41:18] lot of this process takes place
[41:21] below the level of the conscious mind
[41:24] the brain's trying to figure out what
[41:26] the game is
[41:27] you know it understands operant
[41:28] conditioning without you having to
[41:30] manipulate anything
[41:32] and so the brain will start to make
[41:33] adjustments trying to figure out what do
[41:35] you want me to do
[41:37] and so it will try to figure out the
[41:39] game
[41:41] and in which case when it starts
[41:43] figuring it out and getting good at it i
[41:45] can make it a little bit harder
[41:46] right okay good oh you started to go
[41:48] down good can you go down a little bit
[41:50] more
[41:51] right so it's this dance
[41:54] between
[41:55] kind of the therapist
[41:56] and the client
[41:58] of trying to encourage the brain in the
[42:01] right direction
[42:03] so
[42:04] i'm going to try to show you a demo real
[42:06] quick so what we're looking at here this
[42:08] is a very simple
[42:10] protocol and again for demonstration
[42:13] purposes we want to keep it simple and
[42:15] so this is only looking at one location
[42:18] right so we're looking at one location
[42:21] it's just at pz this is the back of the
[42:23] head and this is the raw eeg
[42:26] right so that's everything it's like
[42:28] that white beam of light that contains
[42:31] everything
[42:32] and then we have it filtered a little
[42:33] bit so if you want to just see the alpha
[42:35] or the theta and you know we could make
[42:37] this a little bit
[42:38] uh boost
[42:40] the the signal if you want to see more
[42:42] definition
[42:43] right so you can see that theta there's
[42:45] fewer repetitions
[42:47] it's a slower wave how many repetitions
[42:50] are there between each red line and you
[42:53] can see with alpha there's a little bit
[42:55] more it's a little bit faster right
[42:57] now this is just this slide is uh or
[43:01] this uh screen is really just to make
[43:03] sure that we have
[43:05] um
[43:06] enough
[43:07] of a good signal that's all that we're
[43:09] using this screen for
[43:11] if i go to this
[43:12] screen this is where i'm actually doing
[43:14] some training so this is the therapist
[43:17] screen right
[43:18] and again it's very simple because i'm
[43:20] only doing one thing i'm measuring one
[43:22] location
[43:23] and i'm measuring one eeg band in this
[43:26] case alpha
[43:27] so this protocol that we're looking at
[43:29] is an alpha down protocol we want alpha
[43:32] to be decreased
[43:33] at the back of the head
[43:35] with the eyes open this is actually a
[43:37] really well known well it's becoming
[43:39] well-known protocol
[43:41] that was created by
[43:44] are really made famous by
[43:45] a researcher in canada named ruth lanius
[43:49] who was using this with post-traumatic
[43:51] stress disorder and getting really good
[43:53] results this is actually real data from
[43:56] somebody that i've been working with
[43:58] recently
[43:59] and
[44:00] uh what we're looking at on this screen
[44:02] you see the light blue line
[44:04] that represents the alpha activity
[44:07] at that location that pz and you can see
[44:09] it fluctuates it goes up it goes down it
[44:11] kind of moves around a little bit
[44:14] so my job is
[44:15] to help that activity decrease
[44:18] now you can see where i've got this
[44:20] white line that's the threshold
[44:23] okay right now it's too hard they're not
[44:25] ever getting below the line
[44:27] so i need to bring it up a little bit so
[44:30] i'm going to raise the threshold up a
[44:32] little bit
[44:35] so that
[44:37] hopefully they can figure out where it's
[44:39] at and start figuring out how to get
[44:42] below that line
[44:43] now realistically the client could
[44:46] actually watch the screen and use this
[44:48] as their feedback literally they're
[44:50] seeing their brain waves
[44:52] and
[44:53] part of the feedback is is it above the
[44:55] line is it below the line right
[44:58] so they could use this but it's kind of
[45:00] boring
[45:01] right although to be honest i do have
[45:02] people who kind of like this they kind
[45:04] of like
[45:05] seeing the more direct type of
[45:07] information
[45:09] okay so i've got it in a place right now
[45:11] where
[45:13] it's above the line some it's below the
[45:15] line sum
[45:16] and you know we'll kind of like
[45:19] play with this and see if they can find
[45:20] it
[45:22] now
[45:23] this is pretty boring
[45:24] so this might be what i have on my
[45:26] screen but this probably isn't what i
[45:28] want them to be watching i want them to
[45:30] have something else that's more
[45:31] interesting so what we might do
[45:35] is
[45:35] open up something like a youtube video
[45:39] so now you can see that
[45:42] you know they're getting all this
[45:43] positive feedback and it's dimming a
[45:44] little bit right oh what happened so in
[45:46] this case if we're looking at alpha down
[45:48] at the back of the head what we know is
[45:50] that when alpha um when your attention
[45:53] is internal when you're in your own head
[45:54] alpha goes up which is not what we want
[45:57] when your attention is external
[45:59] alpha goes down so as long as you're
[46:01] keeping your attention on what's on the
[46:03] screen and what you're seeing
[46:05] then
[46:06] you
[46:07] will keep the alpha down you'll be
[46:08] successful as soon as you get in your
[46:10] own head and start thinking which is
[46:11] usually not a great thing
[46:13] then it dims out so it can draw your
[46:15] attention to your own state of awareness
[46:18] a couple more just real quick things
[46:19] we've already talked about this but how
[46:21] does it work
[46:22] how does neural feedback work well
[46:26] operant conditioning you reward
[46:27] something it does it more you ignore
[46:29] something it does it less
[46:31] so this idea of use it or lose it
[46:33] brain cells that fire together wire
[46:35] together so through repetition
[46:38] usually we're doing these sessions twice
[46:40] a week
[46:41] and uh that repetition
[46:44] is
[46:45] um
[46:47] then kind of rewiring the brain
[46:49] literally you know because that's the
[46:51] way the brain works if you use something
[46:53] it gets stronger if you don't use
[46:54] something it gets weaker so trying to
[46:56] provide
[46:58] new information for
[47:00] the brain to be more efficient and
[47:02] effective
[47:04] you can use neurofeedback for a whole
[47:05] bunch of things
[47:07] the evidence
[47:09] for
[47:10] different conditions
[47:12] has been evaluated and published um
[47:15] uh there's probably an updated version
[47:17] but i don't think i have it because this
[47:19] one's all the way back from 2008.
[47:21] there's got to be an updated version by
[47:22] now
[47:23] but uh
[47:24] published by the applied association for
[47:26] applied psychophysiology and biofeedback
[47:29] and they go through all the research for
[47:31] all the different conditions with
[47:32] neurofeedback and biofeedback
[47:35] and say whether there is how much
[47:37] support there is
[47:38] and interestingly the highest level
[47:42] uh is with adhd and epilepsy
[47:45] seizure disorders
[47:47] uh level four which is you know the next
[47:49] highest there's a whole bunch of stuff
[47:51] anxiety pain headache etc some of this
[47:54] is biofeedback specifically and not
[47:57] neurofeedback but nonetheless the
[47:59] evidence is pretty good
[48:01] um for a lot of these different
[48:03] conditions and there's getting to be
[48:05] more and more evidence for ptsd
[48:07] not just using lanius's protocol but
[48:09] also
[48:10] uh some other protocols that uh
[48:13] seburn fisher uh has used in conjunction
[48:16] with vessel van der kolk and so there's
[48:19] more research coming out with that as
[48:20] well
[48:22] so i know we only have a minute or two
[48:23] left i always use all the time but um
[48:26] are there any
[48:28] additional questions before we wrap this
[48:30] up anything else on anybody's mind i
[48:32] tried to hit most of the questions as we
[48:34] were going
[48:35] i think i might have missed one
[48:36] somewhere
[48:38] there was a question about ocd is it a
[48:41] treatable condition actually uh
[48:44] yes
[48:46] and it depends right
[48:48] so there's always going to be
[48:50] um
[48:51] successes and not successes but it's
[48:55] interesting because a lot of times with
[48:56] obsessive-compulsive tendencies you see
[48:59] that same pattern that we talked about
[49:00] with anxiety that the anterior cingulate
[49:03] gets really kind of overheated or in
[49:05] some ways it's kind of not behaving the
[49:07] way we would like and so people tend to
[49:09] get fixated
[49:11] and so if we can get that part of the
[49:12] brain to relax or to loosen up a little
[49:14] bit
[49:15] then it uh it works much better another
[49:18] question here is the nucleus of the
[49:20] vagal nerve involved at all
[49:23] um
[49:24] so
[49:25] we can't really get to the vagus nerve
[49:30] through neurofeedback specifically
[49:32] there's other technologies that we can
[49:34] use
[49:35] to
[49:36] activate stimulate the vagus nerve
[49:39] so vibro acoustic technologies work
[49:41] really well
[49:43] heart rate variability biofeedback seems
[49:46] to activate the vagus nerve
[49:48] um so there are ways that we can get to
[49:50] the vagus nerve using other tech
[49:53] just not really specifically
[49:55] neurofeedback maybe there is but i just
[49:56] i'm not aware of it
[49:58] um i keep clicking the wrong button
[50:01] uh how does someone start doing this
[50:03] therapy i'm starting grad school in the
[50:05] fall to get my mft uh john great
[50:08] question that's a longer one send me an
[50:11] email and i'm happy to kind of give you
[50:13] some additional info
[50:14] how many sessions does it take to notice
[50:16] improvement oh great question
[50:18] uh adhd and anxiety in general with adhd
[50:22] if it is a typical
[50:24] theta
[50:26] excess pattern you can get some
[50:28] significant results in about 20 sessions
[50:32] again it varies sometimes you get that
[50:35] earlier sometimes it takes a little bit
[50:36] longer
[50:38] i'd say to say about the same is true
[50:39] for anxiety
[50:41] although honestly with anxiety i'm
[50:43] likely to use additional approaches
[50:46] so using other types of biofeedback with
[50:48] neurofeedback using some of that stuff
[50:50] we just talked about
[50:53] some vibro acoustic technology to kind
[50:55] of drop the nervous system down
[50:57] activate the the vagal nerve so there's
[51:00] um
[51:02] you know combining technology
[51:04] interventions is a um can often be a
[51:07] really
[51:08] powerful way to kind of move things
[51:09] quicker
[51:11] help regulate mania or hypomania i'll
[51:14] take this as last question and then
[51:16] we'll we'll drop it here uh thanks erica
[51:19] um
[51:20] so
[51:20] mania and hypomania there's less
[51:23] research behind that with neurofeedback
[51:27] i would say again
[51:29] in some cases i think yes
[51:31] especially if you're using a more
[51:32] stabilizing protocol so there's an
[51:35] approach called z-score training which
[51:37] is beyond the scope of what we can get
[51:40] in here to today it's a little more
[51:41] complex
[51:43] but it's really looking at
[51:45] systems networks in the brain and try
[51:48] and helping the whole networks kind of
[51:51] work in a little bit more organized and
[51:54] um structured way
[51:56] something like that or something like
[51:57] smr training
[51:59] can potentially help just relax the
[52:02] nervous system so that it's not over
[52:05] responding
[52:06] so i think that's our best
[52:09] chance
[52:10] with something like mania or hypomania
[52:12] but again there's just not a lot of good
[52:14] research at the moment
[52:18] yes heart math is great elizabeth um
[52:21] it's a great way to train heart rate
[52:22] variability i use it all the time
[52:25] um
[52:26] chris what forms of feedback are best
[52:27] besides dimming yeah games are great
[52:31] uh i particularly like using a game from
[52:33] a company called zoo core
[52:36] so they've got a software called zoo
[52:37] core air
[52:38] so you're you know you have an avatar of
[52:41] a creature flying around in the sky or a
[52:44] bird or a plane or something and you're
[52:46] flying through targets
[52:48] in the sky
[52:50] and so it's great especially for
[52:51] something like adhd or that alpha down
[52:54] approach where there's something very
[52:56] clear that is the goal
[52:59] and your mental state
[53:01] uh directs how accurate your flight path
[53:04] is so there's games like that
[53:07] in general the games need to be
[53:09] fairly
[53:10] um
[53:11] simple if you make them too complicated
[53:13] then there's gonna be too much cognitive
[53:16] extra going on that's gonna interfere
[53:19] with the training
[53:20] um so but there's lots of good games out
[53:22] there um and most of these companies
[53:24] have games built into their systems that
[53:26] work as well
[53:28] okay i gotta wrap it up there
[53:31] thank you all for showing up uh there
[53:33] will be a replay on youtube in a few
[53:35] days check out our neuro meditation
[53:37] channel there
[53:38] and uh thank you all so much