[00:00:00] Speaker A: Welcome to the Heart Rate Variability Podcast. Each week we talk about heart rate variability and how it can be used to improve your overall health and wellness.
Please consider the information in this podcast for your informational use and not medical advice. Please see your medical provider to apply any of the strategies outlined in this episode. Heart Rate Variability Podcast is a production of Optimal LLC and Optimal hrv. Check us out at optimalhrv. Com. Please enjoy the show.
Welcome friends to the Heart Rate Variability Podcast. I am Matt Bennett. I am here with a guest that I'm really excited to interview. I've got the June edition 2025 of the APB Journal. Always mandatory reading for me. And towards the end of the journal I found this Great article by Dr. Linda Thompson on the synergy between neurofeedback biofeedback and how it enhances therapeutic outcomes. And I just, I just fell in love and I'm so excited to be able to interview Dr. Thompson and talk about both the article and learn about her work in general. So before we move forward into your research, I'd love just to give a little bit of introduction on who you are and maybe what brought you to the neurofeedback biofeedback field.
[00:01:27] Speaker B: Right.
Well, in what brought us actually my husband and I, so really my late husband Michael and Thompson and I did things together and in 1993 we started the AD center or the ADD center and in we live in Toronto. So.
So it was pretty early days, but we found that the whole neurofeedback field was so welcoming and that you immediately had access to top people.
So we went off to our first meeting. We'd meet Barry Sturman, we'd meet the Lubars.
It was just an amazing welcoming field. And Michael's background was in psychiatry, mine was in psychology. And we both looked at each other and said these meetings are so much more fun than, you know, the American psychological or the Canadian psychological or the, or the, the psychiatry meetings.
So, so anyway, we felt it was a very welcoming field. We also felt that it had huge potential.
So we actually heard about it because I got a brochure that there was a non drug treatment for ADHD.
And my PhD thesis, 1979 had been on the use of methylphenidate for hyperactive children.
Self Concept and Locus of Control in Hyperactive Children was the title of that, of that thesis. And so anyway, it was a conference in a workshop in Florida in February. We live in Canada. February is very cold.
[00:03:10] Speaker A: Good time to go to Florida, you.
[00:03:13] Speaker B: Know, tossed a coin. Michael went down and he came back and said there is real science behind this. We have to look into this because, you know, he'd prescribed a lot of medications over the years and was very careful when he prescribed the Ritalin and other stimulants. But the non drug approach we thought was a terrific idea. And once we found out about it, we were hooked.
Awesome. Yeah, we spent a year going around to workshops and learning about it and training with the Lubars in Tennessee and, and was just, yeah, terrific. And started the AD center subsequently and yeah, never looked back.
[00:03:56] Speaker A: I love that. And I, I find adhd, having worked in school programs, you know, you know, throughout my career, it's, it's very interesting the time frame that we're in, you know, and I hear in the States, you know, one of our, you know, most popular podcasts is the Daily by the New York Times. And you know, they've recently released something on adh. How we're rethinking it. The role of medications. Is it genetic? Is it environmental? Kind of going back to the nature nurture arguments and everything. And I kind of left that, that podcast with we still really don't know. It's a label we put on something.
It, you know, it didn't get passed down as the 11th commandment to define what this disorder is, but it just seemed like a really interesting time. I wonder, was there anything that, that brought you to kind of focus in this area?
[00:04:57] Speaker B: Well, if you're starting a clinic, it's, it's the most common disorder in children. Right?
[00:05:03] Speaker A: Yeah.
[00:05:03] Speaker B: So, so obviously there's, there are lots of people who can benefit from the training and this. And when you mentioned their heritability, the heritability of ADHD is 0.7.
There's almost nothing that's as highly heritable as ADHD. It's. You inherited to about the same extent that you inherit your height.
[00:05:22] Speaker A: Wow. Wow.
[00:05:23] Speaker B: Height has the same heritability and that's well established through many, many twin studies and, and such. So it, it is highly heritable. Parents don't have to feel guilty that, that they caused it, except through their genes, which isn't their fault. And of course it can be worsened by the environment and currently it's worsened by the lifestyle.
So lack of sleep. Anybody who's sleep deprived is going to have impaired attention the next day. And that's about a third of the world.
Yeah, sleep deprived, right, exactly.
But our first publication was a case series of over 100 children and adults treated with neurofeedback and biofeedback for ADHD.
So we combined the biofeedback from the beginning.
So not just breathing, which is, I mean, these days it's heart rate variability that we do with every client. But. But in the early days there was breathing, but there was also electrodermal response, finger temperature.
So the whole range of biofeedback. Sometimes you have to do EMG on the jaws to get a person to relax enough so you don't have so much EMG artifact when you're doing neurofeedback.
But HRV breathing, of course, is hugely important and we're always learning new stuff about it. Right. So, I mean, I've got a couple of interesting tidbits that a lot of people doing HRV aren't so familiar with.
[00:06:58] Speaker A: Yeah, well, I'd love to hear some of those. And bringing that to one of my favorite concepts of the articles, the synergy that you talk about. Because going to meetings like APB or isn't our, like, you know, it kind of, we sort of existed. There's the neurofeedback, there's the biofeedback.
You know, me sort of being focused in the HRV biofeedback space. Like I've just become fascinating of a kind of can be the homework for neurofeedback.
You take that the step forward with the synergy. And I just think this is what we. You're giving folks. I think what we desperately need is kind of models of integration along with, you know, the talk therapy aspect of it as well. And I thought that was a really powerful thing in your approach.
[00:07:51] Speaker B: Right. Well, we always need a multimodal approach.
[00:07:53] Speaker A: Yeah.
[00:07:54] Speaker B: Like, HRV is fabulous for relaxation.
It's great for stress management, but it's not standalone.
[00:08:03] Speaker A: Right.
[00:08:06] Speaker B: So you have to have a lot of tools in your toolbox.
But HRV is one that has lots of research. And one of the reasons I think both neurofeedback and heart rate variability training are very powerful is that in both cases, you're training oscillatory systems, right?
[00:08:25] Speaker A: Yes.
[00:08:26] Speaker B: So in the brain, you're training a lot of thalamic cortical loops. And with the heart rate variability, you're training the connections between the heart and the nucleus tractus solitarius in the brainstem. Right. In the medulla. So everything comes together there in the medulla.
So it's also an oscillatory loop. Right. So you have an increase in blood pressure. The baroreceptors send these messages.
Vagal afferents and glossopharyngeal afferents up to the nucleus tract is solitarius. And then messages come back, you know, along the, the vagus back to the heart. And it slows the heart.
[00:09:13] Speaker A: Yeah.
[00:09:14] Speaker B: Because your heart would beat over a hundred beats per minute if it didn't have something slowing it down.
So it's an. It's also a loop. And here's the thing. When you train an oscillatory loop, your results last.
Right.
[00:09:31] Speaker A: So.
[00:09:32] Speaker B: So if you're training. If you're training.
So.
So the.
So if you think of regular biofeedback, there were a lot of biofeedback labs set up in hospitals in the 1970s. Right. It was the big new thing. And they could train people to lower their blood pressure, and it was amazing.
But there was a problem.
They do it in the clinic, they go home, the blood pressure goes back up.
That's a tonic system. It's not oscillatory. So when you train to reduce blood pressure, you got to keep it up.
[00:10:09] Speaker A: Yeah, right.
[00:10:10] Speaker B: But when you train for hrv, I mean, hopefully people will learn their breathing, they'll use it frequently, they'll calm themselves. But. But even if they don't, you've changed an oscillatory system, you've reset it.
[00:10:24] Speaker A: Yeah.
[00:10:24] Speaker B: And. And the same with Brainwood. Like, why is neurofeedback considered level 5 efficacy? That means efficacious and better than anything else. Right.
So it gets results equal to medications. How is it better?
No side effects and your effects last. Yeah, right. With drugs, as soon as you stop taking the drug, you're back to square one. With neurofeedback, you do your 40 sessions of training. I mean, it's not a quick fix.
[00:10:53] Speaker A: Right.
[00:10:54] Speaker B: But you do it and your results last. You got it for life because you've got a new set point.
[00:10:59] Speaker A: That is awesome.
So when we look at this from. Because I imagine there may be a few folks listening to us who may be interested in heart rate variability, maybe using some sort of device or integrating a little bit of HRV resonance frequency breathing biofeedback into their thing.
You look at it in my understanding, and please correct me if I'm wrong, of the neurofeedback world, is there's a big investment that needs to be made somewhere along the line. Because while you could do HRV for relatively cheaply, I mean, you can ramp that up to tens of thousands of dollars for in office equipment as well.
But if somebody's maybe doing talk therapy, a little biofeedback, where do you. How would you encourage people to look into the neurofeedback side because that seems to be the one with my experience at least at conferences, that there's a payment plan involved for somebody like me to get that level of equipment.
[00:12:06] Speaker B: Yeah. So that is a barrier, the hrv. I mean essentially you can do it free. Just teach belly breathing.
[00:12:14] Speaker A: Yeah.
[00:12:15] Speaker B: Right.
Hand on the, hand on the chest, hand on the belly. So with little kids who would just fiddle with sensors, we teach them belly breathing.
[00:12:24] Speaker A: Yeah.
[00:12:24] Speaker B: Right. So just, just do that, do that effortless diaphragmatic breath. Right. You can, we can and tell them to practice at home, put their teddy bear on their tummy and make the teddy bear go up and down as they breathe. Right.
[00:12:36] Speaker A: I was a second grade teacher. She, she does that in her classroom. So.
[00:12:40] Speaker B: Yeah, yeah, yeah, yeah, yeah. So, so the breathing practice is, you know, very, very reasonable in terms of cost.
And I mean you can buy an OURA ring and that's more expensive. You know, that's pretty pricey. But, but you have lots of, you have lots of apps. You have apps for the phone that use the, that use the, the light from the phone to, to do your pulse. So there are lots of inexpensive things. When you do neurofeedback. It's an investment in learning as well as in equipment.
Right. But the equipment is getting less expensive and, and you can do a lot with single channel. Like we started with single channel. You don't have to go out and get a 19 channel and learn how to do quantitative EEG. You can start with single channel and do a lot because the brain works in networks.
And if you're training at the top of the head location called CZ or CZ in the U.S.
you're, you're over the emotional brain. You're affecting the attention networks which are very widespread. And, and, and you're also over the motor strip, so you can deal with, you know, hyperactivity. So it's a really, so single channel training which, and you can get good equipment for single channel training that, that's, you know.
Well, let's see. I think, I think it's around $5,000 to get some of the, some of the less expensive equipment. That's still good. Right. So, so, so I think people, people who aren't afraid of new learning.
[00:14:22] Speaker A: Yeah.
[00:14:23] Speaker B: Are, are going to give it a try.
[00:14:24] Speaker A: Yeah.
[00:14:25] Speaker B: Right.
[00:14:25] Speaker A: Because even for me it's like, boy, you know, like just learning and like becoming an expert. I'll put that in air quotes on. HRV has taken a second several years to get there. And I look at the neurofeedback side of things because I'll go to those workshops. I'm very fascinated in it. It's like, who. This is a, this is a mountain to climb as far as learning curve, which I always find very inspiring and you know, gives me energy too. But it is a little intimidating to go on that journey both price tag wise, but also, you know, just like, okay, what do all these mean, these different waves and what do they correlate to? And then I see the raw data and people can read that like people read like the matrix. Like I'm like, what's that? You know. But it's, it is a really powerful tool that I hope becomes more, you know, inexpensive, you know, but again that learning curve is there as well for folks.
[00:15:29] Speaker B: Yeah. But it's more accessible now because there are good online sources.
So Fred Shaffer has excellent online programs for both heart rate variability and biofeedback and neurofeedback, you know, at a reasonable price. So the entries, you don't have to spend a year like Michael and I did, traveling to different experts.
[00:15:51] Speaker A: So you brought up with adhd, you brought up the medication piece of this. And I know it's a, it's a topic that I know a lot of parents struggle with.
You know, I'm getting this feedback from maybe at school or another setting that the symptoms may exist. Maybe, maybe I've gotten an evaluation, maybe I haven't. But, but, but the hesitation around medication in a system, honestly here in the US at least that that will be, you can go to a general practitioner and walk out with, you know, a medication just with a 15 minute visit at times. So I'm curious how that plays in to, to your thinking. Because I think everybody would say, hey, if, if there's something where I don't have to do medication with side effects, that, that would be ideal. So I'd love to know with your expertise and you know, where, where that sort of fits into your thinking.
[00:16:55] Speaker B: Right. So having a non drug approach I think is very powerful.
Fact is most people haven't heard of it.
[00:17:02] Speaker A: Yeah, right.
[00:17:03] Speaker B: And the US with your direct to consumer advertising for drugs.
The. There was an article in the economist in February, February 11 economist and it pointed out that 1 in 9 children the United States is diagnosed with ADHD. Yeah, like that is a really high rate. Right.
And if you just go on parent report, it's about 10% of the population who would fit the criteria.
If you go on parent report in Sweden or Norway, it's 3 or 4%.
Right.
So.
So there's, there's a big difference in terms of awareness and also I think in terms of parents just maybe wanting quick fixes for their kids.
Yeah. And then, and then as I said, the lifestyle.
[00:18:00] Speaker A: Yeah.
[00:18:01] Speaker B: Like I think, I think the, the problem with screens is worldwide, but it's maybe a little more in the US And I think nutritional factors.
[00:18:09] Speaker A: Yeah.
[00:18:09] Speaker B: Play into it as well.
You know, US diets aren't so, aren't so great.
So there, yeah, there are a lot of factors. But hrv, we've, we've always combined, combined biofeedback with neurofeedback because I mean, those kids can be impulsive and if you can teach them to pause and give a breath before they blurt something out in class.
Right.
[00:18:32] Speaker A: Yes.
Yeah, my wife always appreciates that for sure. So.
[00:18:39] Speaker B: Yeah, yeah, yeah. I think, I'm curious actually. I'm, I'm co authored the first book to have a, to have a chapter on NeuroFeedback was the ADD book by Sears and Thompson.
So you may have heard of Dr. William Sears, Bill Sears. Yes, actually we can give a plug ask Dr. Sears.com is a, is a very helpful website.
So, so Bill and I wrote that book back in 1998 and we're, and it's still, it's still a classic. We were, we're actually talking about finally doing an update on it. But the latest books on ADHD by people who were already experts in the 1990s like Hallowell and Rady and their new book, ADHD 2.0 doesn't even mention neurofeedback.
[00:19:26] Speaker A: Oh, really?
[00:19:27] Speaker B: Doesn't even mention it? Yeah.
[00:19:30] Speaker A: Why do you think, why would you think if it's so highly, you know, indicated and researched back, why do you think that would be missed altogether?
[00:19:42] Speaker B: Well, back in 2012, the American pediatric association published, they published their guidelines and based on Cochrane criteria, they gave neurofeedback the same level of efficacy, the highest efficacy for treating ADHD as medications.
So this is 2012.
[00:20:06] Speaker A: Yeah.
[00:20:06] Speaker B: Okay.
2013, it was off their website.
And it seems that the drug companies are big donors to the Pediatric Association's annual meeting.
Yeah. So frustrating.
[00:20:26] Speaker A: Not surprising.
[00:20:27] Speaker B: Yeah, yeah, yeah.
[00:20:28] Speaker A: At the same time, I mean.
[00:20:30] Speaker B: Yeah, yeah, yeah, yeah. There are also some meta analyses that have been published that, that state that neurofeedback is, is mainly placebo effect.
That it. And however, if you look at the authors of those, they're all people who have links to the drug companies and their criteria.
They set their own criteria for the Meta analysis, and they leave out a lot of the studies that show efficacy, and they tend to include studies where people have used a set ratio. So there's. Anyway, that's a fine point in neurofeedback. But if you're lazy, instead of setting a ratio according to what that client that you're sitting next to needs in terms of how much reinforcement, you can set it to auto reward. So they'd always get like 80% reward.
[00:21:20] Speaker A: Okay.
[00:21:21] Speaker B: But then the brain doesn't really learn to distinguish between a good day and a day when they're, you know, tired and out of it.
[00:21:28] Speaker A: So, yeah, it's one of the things that surprised me of being. I guess I'd say I'm in the orbit of neurofeedback.
That that piece of it is the, the, the fight that's still going on against some of these preconceptions that it isn't a valid science, you know?
[00:21:50] Speaker B: Yeah. I mean, you have people say, I don't believe in it. And then you say, oh, it's not a belief system. This came out of research labs. This came like, do you know, do you know where they. When and where they first showed you could train brainwaves?
[00:22:06] Speaker A: I know I do not.
[00:22:09] Speaker B: Published in 1968, Barry Sturman in Cats.
[00:22:15] Speaker A: Yeah.
[00:22:16] Speaker B: Operant conditioning of Brainwaves in Cats.
[00:22:19] Speaker A: Fascinating.
[00:22:21] Speaker B: So, so if, if, like kids, will. Kids, when you give them feedback, whether it's HRV or, Or neurofeedback, they're, you know, they're used to sort of magic, right. You flick a switch and a light comes on. But adults always say, what am I supposed to do? Right. Kids just make it happen. They get the reinforcement. Right. They learn. But parents, but adults say, what am I supposed to do? And then you have to explain, it's not about doing something. It's about a mental state, being calm and focused. Right. So, and sometimes I'll say to them, you know, cats can learn this, so I'm sure your brain can learn this too.
And I have them. I have them read the little section in the ADD book about, about the research with cats.
[00:23:07] Speaker A: Love that. So I think a lot of our folks who maybe have a foot in one world or the other, when you talk about the multimodal sort of that synergetic approach, and I know it's individualized for everybody, so I'll give that up front. I'm just curious, like, what does your work kind of look like as you're integrating hrv, biofeedback, the neurofeedback, and Also the talk therapy as well as, as folks come in to work with you. I'm just kind of curious as general again, I know it's going to be different for everybody, but is there sort of a way you, you sort of would assess and then kind of proceed again knowing that you're working mostly on the ADHD piece of this spectrum?
[00:23:57] Speaker B: Yeah. Well, Matt, the assessment is crucial.
[00:24:00] Speaker A: Yeah.
[00:24:01] Speaker B: Right.
So you have to do a thorough assessment that, that includes the breathing and, and the. So we do questionnaires, we do computerized tests of attention, one called the tova, one called the IVA which has auditory and visual. We do, of course we do an interview with medical history and family history and, and all those things. We do computerized neurocognitive testing. We use something called CNS Vital Signs.
Very good value. It costs maybe about $40 in administration. But it gives you these standardized neurocognitive tests for you know, verbal memory and reaction time and executive functioning and like a whole slew of things.
And of course you do your EEG assessment and the breathing assessment and, and, and then we do 40 sessions of training and we repeat it all. So we've got pre post and I think pre post is really important.
Yeah. If we're doing 19 channel, we actually, we're very thorough. We triangulate. We have three different instruments for doing a quantitative EEG with 19 channels.
[00:25:21] Speaker A: Wow.
[00:25:21] Speaker B: And one of them is from a company in New York, Evoke neuroscience. Now the limitation there is they only sell to doctors.
So psychologists are social workers or you know, ours is a multi disciplinary field but they only sell to doctors. But in a 20 minute assessment you get your, your EEG, your quantitative EEG, heart rate variability stats and, and also Loretta. Loretta Source.
So and, and ERPs, event related potentials that tell you about brain speed.
Wow.
So it's pretty impressive. And then we use the one that's probably most widely used where you do your data collection and you use the neural guide for interpretation.
And then we have this neat equipment From Korea From ImediSync that has the EEG and photobiomodulation, so light therapy, light built into each site. So that's, that's the, the third thing we do.
So yeah. So we're, we're a little bit, we're probably more thorough than most centers.
[00:26:31] Speaker A: You may have probably the coolest looking office space in psychology. I'm imagining.
[00:26:37] Speaker B: Yeah. But, but you know, we learn from every client.
[00:26:40] Speaker A: Yeah.
[00:26:40] Speaker B: And so here's an interesting, here's an interesting thing to mention about heart Rate variability training that we learned from our clients. Right. So when we're doing a session, when we're doing a training session, we actually have people there for about 50 minutes. And we, we.
And depending on the person and how important the HRV is, sometimes we'll do HRV first just to get them calm.
Right.
So, but they're hooked up for their eeg as well as having a respiration belt on and, and a pulse sensor on. On a finger.
So they're doing their. They're doing their nice training. We have screen that Michael designed that works with the thought technology equipment, and it shows mountains. So you've got a blue mountain that shows your breathing in and out and a red mountain that shows the heart rate changes.
So instead of the steps, which is the accurate way to show the changes in heart rate, we've smoothed it. So then they just have to get their mountains going up and down together.
Got it.
So they're. So they're watching this screen and it also gives all the statistics for the, you know, for, for it and, and shows their resonant frequency and things.
And they might do that for, you know, three to five minutes just working on that screen, getting nice and calm.
And then they go and do their neurofeedback, you know, probably reducing their tuning out waves and increasing their calm waves. It's called sensory motor rhythm. Have you ever heard of sensory motor rhythm?
[00:28:13] Speaker A: Yes, I have.
[00:28:15] Speaker B: Okay. And also decreasing busy brain, which is, you know, like associated with anxiety.
[00:28:21] Speaker A: Yeah.
[00:28:21] Speaker B: So, so this sensory motor rhythm, which is extremely important. It's what it. What led Sterman to look at the EEG and the cats.
Right. Because he saw these cats, these cats were being trained to wait for a signal and then press a bar to get a food reward to get some milk and chicken broth. And he noticed that while they were waiting for the signal, they produced brainwave activity that looked like sleep spindles.
[00:28:49] Speaker A: Interesting.
[00:28:50] Speaker B: And he's a sleep researcher, and he says, why are these cats who are so alert and still producing sleep spindles?
[00:28:58] Speaker A: Yeah.
[00:28:58] Speaker B: Right. So that's. Then he trained them to produce bursts of. And he called it sensory motor rhythm. Because he says, let's call it like it is. You only measure it across the sensory motor strip of the brain and it's rhythmic activity. The way it looks, it's like spindle, like activity.
So this SMR is very important for calming. Right. Because it's associated with being alert but calm and not moving. Right.
So we track everybody's data, right. Like you should be doing learning curves Right. With every client.
So our staff noticed that during that period when they were just doing their breathing, there were changes in brainwave patterns, even though we weren't giving feedback on brain waves. And what do you think the change was, Matt?
[00:29:51] Speaker A: I would assume more activation in the prefrontal cortex area and less.
[00:29:58] Speaker B: We're at the central location.
[00:30:00] Speaker A: Yeah.
[00:30:00] Speaker B: Sensory motor rhythm.
[00:30:02] Speaker A: Okay. Gotcha.
[00:30:03] Speaker B: Sensory motor rhythm. Right. So we're seeing increases in the amplitude of sensory motor rhythm when HRV training is being done. Fascinating, right? Yeah, well, it was fascinating. And one of our staff, the smart gal who had first observed this and brought it to our attention, and then we'd start looking across all the other clients. She presented it at an ISNR meeting in Carefree, Arizona, and then it got published. Got published in the Journal of Neurotherapy.
What year was that published?
I think 2002.
No, sorry, 2013.
So Andrea Reed is her name. So it's. It's Reed. And another of our staff, Stephanie Neon. So Reed, Neon, Thompson and Thompson. 2013. 13. Effects of heart rate variability training on sensory motor rhythm.
[00:30:59] Speaker A: Very cool.
[00:31:00] Speaker B: Yeah. Journal of Neurotherapy. So easy to access. So I. So that's kind of an interesting observation. And of course, it makes sense because we are a unity.
[00:31:11] Speaker A: Right?
[00:31:11] Speaker B: Right.
[00:31:12] Speaker A: It's.
[00:31:12] Speaker B: It's not like the vagus connects the.
You know, the brain and the heart and the gut and, you know, it all works together. It's. It is. It is truly synergistic. So this idea of just train the brain or just train the heart.
[00:31:28] Speaker A: Right.
[00:31:30] Speaker B: It's really ignoring all those links.
[00:31:33] Speaker A: And then do you then have folks do breathing exercises between sessions? Like, do you continue that? I'm just curious. What's, you know, what's going on? Kind of, what homework do you give folks?
[00:31:48] Speaker B: Yeah. Yeah. Well, actually, we have a little publication that we call what Bodes well.
So Bodes, B O D E S.
Breathing is number one. Right. And then some online exercises like brain HQ and diet and exercise, sleep and socializing. Right. So we want them. We say, you know, it's expensive to do neurofeedback if you want to get your money's worth.
[00:32:11] Speaker A: Yes.
[00:32:12] Speaker B: Think of these five things that. That, you know, bodes well for success. And reading's number one. So we encourage them to do it. We tell them about apps they can get, and we also tell them, attach a habit to a habit.
[00:32:26] Speaker A: I love it.
[00:32:27] Speaker B: You ever heard that?
[00:32:28] Speaker A: Yes, I have.
[00:32:29] Speaker B: A habit to a habit. Yeah. Yeah, so we say. So. I mean, there are some really successful practitioners who can convince Their clients to practice 20 minutes twice a day.
[00:32:39] Speaker A: Right.
[00:32:40] Speaker B: If you're, if you're a Leah Lagos, the charming Lea Lagos in, in Manhattan.
[00:32:45] Speaker A: Yeah.
[00:32:46] Speaker B: She'll get her athletes recovering from concussion to do 20 minutes twice a day of heart rate variability. I guess you know her book, right? She wrote a lovely book too.
[00:32:56] Speaker A: Yeah, yeah.
[00:32:57] Speaker B: So. So Leah can get her clients to do it. I don't think most of my clients I've never heard set aside the time. So, so we just say, you know, it's okay to do it. Little bits. Right.
So what are some of your habits? Like maybe you brush your teeth.
[00:33:14] Speaker A: Yeah.
[00:33:15] Speaker B: Right. Could you think about your breathing while you're brushing your teeth?
Could you use your breathing to fall asleep? Because it's going to help. Yeah, right, right.
It's going to help if you do your six breaths per minute or whatever your resonant frequency is, it'll help you fall asleep. And then my favorite, which I use almost every day is driving and coming to a red light.
Right.
So I tell folks I used to come to a red light and I'd be annoyed and my shoulders would get tense and, and I'd have like six red lights on the way to work. It wasn't great. And now ever since I discovered hrv, I come to a red light and I think, ah, six breaths permanent. That means I can do three breaths.
[00:34:05] Speaker A: I love it.
[00:34:06] Speaker B: Right. So red lights typically last 30 seconds, right?
[00:34:11] Speaker A: Yeah.
[00:34:11] Speaker B: Or if you're at a main intersection, it might last a minute. So there's my red light, I relax my shoulders, I let the air in and three breaths later I'm through a green light and feeling relaxed. Right. And my attention's better.
And I've had so many people say breathing at red lights has changed my life.
[00:34:34] Speaker A: Oh, that's amazing. I love that and I love the habit upon how like you've got to work that. I've done a lot like with medical adherence as well and other parts of my work. And it's like, where can we put that medication? Where it's like, what do you reach for every day? Whether it's cup coffee and doing that with, you know, breathing as well, I think is such a crucial thing to work it in because you need to feel it to get the motivation in many ways to keep doing it. And that's what I love about your approach is, you know, get it at the red light and feel the difference in a. Maybe just a. I mean frustrating, maybe be a 2. An annoying thing when you get. Have to stop replacing that with A regulated nervous system is a great way to get that sensation and build motivation.
[00:35:26] Speaker B: Yeah, yeah.
[00:35:27] Speaker A: So I'm curious to where, where the, the kind of the talk therapy piece comes in. Is that, is it, you know, on one hand, I'm thinking about, hey, they come in, they, they get a little bit HRV biofeedback to regulate them. They do neurofeedback. Do they stay in the same office then for talk therapy? Is that a different practitioner?
[00:35:48] Speaker B: Actually, we, we don't typically do psychotherapy as part of our sessions, but what we do is metacognitive strategies. Right, okay. So.
So to do neurofeedback with the registered psychologist would be too expensive.
[00:36:05] Speaker A: Yes.
[00:36:06] Speaker B: Right.
So we have, we have a group of wonderful neurofeedback trainers who are the people who sit. I mean, early days.
Yeah, I sat one on one with everybody. Michael sat on one on one. But, but as the, as these ad center grew, then we hired neurofeedback trainers from very early on.
So we, we typically, I mean, we've had speech and language therapists, we've had teachers, We've had lots of different professionals. But what we primarily do is hire graduate student material.
So we get people who've, who've graduated in psychology or in neuropsychology. They want to get some clinical training and go on and do masters or PhD. We've actually had, we've actually had nine. Nine of our staff go on and do PhDs.
[00:36:59] Speaker A: Oh, that's so cool.
[00:37:00] Speaker B: So. And even more go on to, to do masters. So.
So there are people who aren't afraid of new learning, but they're not, they're not therapists. Yeah, right. But they're obviously, they're good people, nice people, and, and they coach in metacognitive strategies.
[00:37:21] Speaker A: Gotcha.
[00:37:21] Speaker B: So starting from the beginning, this is something that Judy Lubar used to do. The late Judy Lubar. She'd, she'd do some training on task.
So in our center, the first 20 minutes would just be like getting feedback, getting in the zone, and then they'll do. And maybe an HRV screen. We also have screens that have. Show both the eight, the breathing and the neurofeedback.
[00:37:49] Speaker A: Right.
[00:37:50] Speaker B: So we can, you can kind of watch and say, oh, yeah, look, look how your sensory motor went up nicely when you were, when your breathing was all in sync there.
[00:37:59] Speaker A: Yeah.
[00:38:01] Speaker B: And then, so once they're calm and focused, it's a time for strategies.
And that can be whatever that person needs.
[00:38:10] Speaker A: Yeah, right.
[00:38:11] Speaker B: Like there's a whole chapter in the neurofeedback book on metacognitive strategies. Yeah, I've got the neurofeedback book here. Have you ever seen the neurofeedback book?
[00:38:21] Speaker A: I probably at a PB maybe.
There we go. Yep. That's for our listeners.
[00:38:29] Speaker B: Neurofeedback Bible size Bible says. I don't know why. There we go. The neurofeedback. So it weighs 10 pounds?
[00:38:39] Speaker A: Yes.
Yeah, it looks heavy.
[00:38:42] Speaker B: And it's got a chapter on metacognitive strategies.
[00:38:45] Speaker A: Awesome.
[00:38:46] Speaker B: That, that. So those are strategies that. It's all about learning how to learn and what you know about what you know. Metacognition. Your, your wife, the teachers, I doubtless heard about metacognition. So the reason we've done that from the start is that neurofeedback takes time.
[00:39:03] Speaker A: Yeah.
[00:39:04] Speaker B: Right.
So if you want them to have some immediate reward, give them a strategy that they can use the next day in the classroom. Yeah, right, exactly.
So our strategies will range from reading strategies, listening strategies.
If you've got a child with Asperger's, like on the spectrum with Asperger's, we'll teach them social skills. Or we might let them watch a little, A little, A little vignette and then talk about it. Right. Social stories.
So, so if you're dealing with an executive, it's usually time management.
[00:39:39] Speaker A: Yeah.
[00:39:40] Speaker B: Right. Adults with Asperger's. We have this book by Temple Grandin and it's. We'll look at it. Let them.
[00:39:48] Speaker A: Hi, Colorado. She my neighbor, so to speak. I don't know her personally, but I'm proud to call her. I call her fellow Coloradoans. So.
[00:39:58] Speaker B: Yeah, yeah, yeah. So like there's a chapter in that book called People Don't Always say what they mean.
[00:40:03] Speaker A: Yeah.
[00:40:04] Speaker B: Right.
And that's something you have to share with an adult with Asperger's. Right.
[00:40:09] Speaker A: Yeah.
[00:40:10] Speaker B: Because they'll be socially naive. So, so this. So we match the strategies to whatever the person needs.
But that's different than doing psychotherapy.
[00:40:19] Speaker A: Yeah, right, gotcha.
[00:40:20] Speaker B: There is. There's the occasional client who does their. And. And you'd be surprised at how many conditions improve just with their neurofeedback. Like there's, and, and, and our heart rate variability. Like there's a self efficacy.
[00:40:35] Speaker A: Yeah.
[00:40:36] Speaker B: When a person learns to regulate their emotions with breathing.
Right.
Like they just feel like a more effective person.
[00:40:44] Speaker A: Yeah.
[00:40:45] Speaker B: And they're probably going to be more cheerful.
[00:40:47] Speaker A: Yeah, yeah, yeah. Well, I love the lifestyle part on that. On top of that, which is I think way.
And I did Too, As a young psychotherapist, never talked about sleep, nutrition, movement, like, healthy breathing has made my list now. The top. The top four, like, didn't talk about that. And now what do I know? That nervous system I was trying to help regulate through talk therapy. I was. They were dysregulating the work that we were trying to do together. And really difficult workaround, especially when I was doing trauma work, because they were getting, like, five hours of sleep at night and.
[00:41:31] Speaker B: Right.
[00:41:31] Speaker A: No matter how good a therapist I was, I wasn't gonna. I wasn't going to maximize our impact or outcomes if. If that was going to. If I didn't talk to them about those aspects.
[00:41:45] Speaker B: Yeah, yeah. You've got to get at least seven hours of sleep. Yes. Five bad things happen if you don't get seven hours of sleep.
But.
But speaking about breathing, I don't know, like, maybe because of Michael's medical background, we always tracked some other literature, too, so.
So there's a very recent article in a journal called Current Biology that was reviewed in. In Medscape, because Medscape is something I still look at regularly. And you were talking about mood. So this. This was a really interesting study where they took a hundred people and they just measured their breathing using a cannula.
[00:42:24] Speaker A: Yeah.
[00:42:24] Speaker B: And then. And then had this sophisticated software to analyze all kinds of 24 different measures. Right. So they were looking at things like, you know, how you shift from one nostril to the other.
[00:42:35] Speaker A: Yeah.
[00:42:35] Speaker B: When you breathe. So they actually have charts that show that, you know, left nostril, right nostril, you know, how much breath in each one, et cetera.
But they also looked at some other things, not just that airflow. And they showed, for example, I mean, they were all. They were healthy.
Healthy. 100 healthy.
[00:42:54] Speaker A: Yeah.
[00:42:54] Speaker B: Subjects. Right. But they also gave them measures like Depression Inventory.
Right.
So nobody was depressed, but some people were happier than others.
[00:43:06] Speaker A: Yeah.
[00:43:07] Speaker B: And what do you think they found in terms of breathing rate and mood?
[00:43:11] Speaker A: Uh, I would assume the slower the breathing rate, the better the mood.
[00:43:17] Speaker B: Yeah, they. They actually. They actually, the chart that they produced showed that the faster breathing rate was associated with higher rates of depression. Right.
[00:43:25] Speaker A: So. Yeah.
[00:43:26] Speaker B: Yeah. Just what you said. Right.
[00:43:27] Speaker A: Yeah.
[00:43:28] Speaker B: Well, not depression, not depression.
[00:43:30] Speaker A: Breathing versus nose breathing, all that stuff. So fascinating.
[00:43:34] Speaker B: Yeah, yeah, yeah. So there. So there are a lot of interesting things about breathing and new research that's happening and people who are, you know, way outside of our field. Right.
So also, larger volume of air is typical of the respiration of people with a higher bmi Body mass index.
[00:43:52] Speaker A: Yeah, right, yeah.
[00:43:54] Speaker B: And that kind of makes sense because they've just got, you know, a bigger cardiac system because they're a bigger person.
[00:44:01] Speaker A: Right? Yeah, yeah, yeah. Absolutely.
[00:44:03] Speaker B: Just like, just like kids and women will breathe a little more quickly than, than men, so a tall man will usually have a, a slower breath rate just because, because your, your optimal breathing rate is also related to your total blood volume.
[00:44:21] Speaker A: Yep, exactly.
[00:44:23] Speaker B: Yeah. Yeah.
[00:44:23] Speaker A: Very cool. So I one is, I can't recommend your article enough. I, I think we only scratched the surface. I, I love the kind of, the case studies work throughout there. It's, it's really like I felt like after your article I had read a book, to be honest with you, that I got so much great material and I always love to ask folks that I have the honor, like yourself of interviewing who is, who's been a pioneer in this field and watched it grow over time and evolve over time is, you know, with all that experience, where do you think we'll be five to ten years from now? As you look sort of into the future, you know, of neurofeedback, biofeedback, you know, the synergy that you've been, you've been talking about, where do you, where do you see us going with this? Or, or maybe just where you wish we would go with it. I'll let you take either of those.
[00:45:26] Speaker B: Well, I think we'll see more of the combined approaches.
[00:45:30] Speaker A: Yeah.
[00:45:30] Speaker B: Right. And. And like from the beginning the ISNR was started. Well, it just SNR at that time was started just a year before Michael and I got in the field.
So we always attended both meetings, the AAPB and the what's currently the isnr. And also my favorite is the Biofeedback Federation of Europe.
[00:45:51] Speaker A: Yeah.
[00:45:51] Speaker B: Like if you get a chance to go to the Biofeedback Federation of Europe, it's amazing.
[00:45:56] Speaker A: There are usually people from next year, I think is.
[00:45:59] Speaker B: That's right, that's right.
[00:46:01] Speaker A: Fingers are crossed to get there.
[00:46:02] Speaker B: Yeah, yeah, yeah. It's a great meeting. And the Europeans are so much more open to non drug approaches, so.
And they're doing very innovative things that. Yeah, yeah. And a lot of hrv. And of course the reason HRV got so, so big was because the research got so solid.
[00:46:23] Speaker A: Yeah.
[00:46:23] Speaker B: And that's because of the Villos coming from Russia.
[00:46:27] Speaker A: Yeah, yeah.
Such a fascinating story.
[00:46:31] Speaker B: Yeah, yeah, yeah, yeah, yeah, yeah, yeah. So we, we have to be very grateful to, to that couple for sharing their expertise because it was just. Yeah. Because they really got everything going in the US and, and I. So I think we'll see more combined approaches in the future. And also like the wearables market, right. It's grown so quickly. Like we should be, we should be growing quickly because now we don't have to tell people what biofeedback is anymore. Right? Because they are, they're wearing their rings and their watches and their whatever.
So, so the concept isn't new to any, to anybody. The concept of neuroplasticity is no longer new.
[00:47:16] Speaker A: Right.
[00:47:18] Speaker B: But I would say that, you know, as a society, self regulation isn't necessarily getting better.
So I think, I think we're needed more than ever.
And, and I think if we embrace some of the new technologies, like Eric Pepper always has good reviews on, on new, on new technology and breathing and posture and, and such.
So I think, I think the, I think our field should be growing.
In fact, it's been declining. Like there used to be AAPB meetings that were like regularly over a thousand people, right. And now there's, you know, it's more like 300, 350 for the different organizations. So.
Yeah. So, but I think it should grow. And, and here's my hint.
It's fine to write the textbooks, it's fine to publish the articles, but usually I'm preaching to the choir.
What grows the field is articles in everyday, in everyday magazines and in these days, podcasts.
Because like the Lubars. The Lubars, their practice thrived in, in, in Tennessee after a woman in an article in Women's Day magazine.
[00:48:40] Speaker A: Yeah, yeah, right.
[00:48:42] Speaker B: And then they were flooded with referrals because if people know there's a non drug option, right, Whether it's heart rate variability or neurofeedback, if they know there's a non drug option, they're keen to use it.
And so get into the local media and let people know about what you do.
[00:48:59] Speaker A: I love that. Well, I hope we at least like said with our focus on the podcast with heart rate variability. You're not by any stretch the first neurofeedback practitioner we have, but it's one of those. Your articles really does a just beautiful job of really integrating the synergy. Sometimes it's an overused word, but when you use it, I thought it was like I couldn't think of a better word to use. So.
Dr. Thompson, I just appreciate your work. I know probably I'm here today and part of folks like you 30, 40 years ago bringing this science in and setting the stage for us to have these conversations now. So I just appreciate you appreciate your work and the door is always open.
I bet there's another topic or two.
We could have fun discussing it at a future date. So you're always welcome back on the show, but thank you so much.
[00:49:56] Speaker B: You're welcome. Matt and I look forward to seeing you at the Biofeedback Federation of Europe next March.
[00:50:02] Speaker A: Me, too.
Hopefully maybe share a meal in Poland. That sounds like a great opportunity.
So thank you and thanks for our listeners. As always, you can find show notes, information about Dr. Thompson's work. We'll link to the
[email protected] and as always, everybody, have a wonderful week and we'll see you next week.
[00:50:23] Speaker B: Okay?
