We speak with neuromodulation expert Ben Spielberg about what got him in his field of work in the first place, how to identify undiagnosed cases of ADHD, and his thoughts on the ideal type of work for neurodiverse individuals. Read along for a true brain-tickling conversation.
Thank you so much for joining our interview series! Before we get started, we would love to “get to know you” a bit better. What is your ‘backstory’, and how did you get started?
I started working as a neurofeedback technician at a substance abuse treatment facility when I was about 22 years old. There, I learned how to use different types of neurofeedback software, and I was really exposed to this idea that these unconscious thoughts, feelings, and behaviors were ultimately controlled by rapidly firing neural connections.
Even though this was only a decade ago, the prevailing notion at the time was that your brain is fixed in adulthood—you don’t grow new neurons, your brain doesn’t change, and when you engage in behaviors that damage your brain (e.g., drugs), your brain is damaged for life. We know now that this is far from the case, and that your brain is always changing and reforming connections in a process known as neuroplasticity.
Neurofeedback is a way to actively change your own brain—and in the process, change your feelings, emotions, and behaviors—using conditioning. For instance, if you’re working on someone with ADHD, you may want to utilize positive rewards when they demonstrate sustained focus, so if they’re watching a computer screen, the screen may get bigger and brighter as focus is sustained for longer and longer. But after doing this for a few years while obtaining my undergraduate degree in Psychology, I realized that it would be helpful for me to have more of a “hard science” background, so I was accepted into Columbia University’s graduate program in Neuroscience. My focus then switched to other types of neuromodulation, including TMS, ketamine, and tDCS.
Can you share an interesting story or anecdote that happened to you, and which you think helped direct your career?
I’ll tell you a story about the origins of personalized TMS. We treated a young woman with Major Depressive Disorder, Generalized Anxiety Disorder, and Obsessive Compulsive Disorder for TMS. She did well on the first protocol (a commonly used, excitatory protocol to mainly combat depression), but her anxiety and sleep were still problematic. So we added a protocol that is commonly used to treat anxiety on the opposite side of her head. That protocol helped for a few days, but ultimately led her to be fatigued in her every day life. We then decreased the duration of that protocol by 50%, which helped slightly, but still slowed her down. So we finally continued to decrease until we found an optimal range, which ended up being less than 30 seconds of stimulation. To date, we’ve never heard of or seen a TMS clinic using such short protocols, but that was the beginning of how a “microdose” of stimulation was borne.
Excellent. Let’s now move on to the core of our interview. For many of us, the pandemic fundamentally altered the way we work. Most notably, many teams have started working remotely, which is very different from the more traditional office environment. In your experience, has this shift negatively impacted people living with ADHD?
It’s probably gone both ways, and it really just depends on the type of job and how the symptoms of ADHD impact each person’s life. Some people with ADHD need external stimulation to keep them focused on the task at hand. Being in an office setting can be helpful if that setting is providing a motivating type of stimulation. For instance, being in a high-pressure setting can be helpful—albeit stressful—because the adrenaline provides the “drive” to either avoid procrastination, or to excel at projects in general.
On the other hand, what are some significant benefits of remote work for neurodiverse professionals?
For some people, it could actually be beneficial—these are the people who have flexible work schedules, and are most likely salaried and exempt employees. Those employees are not “on the clock” so to speak, so they have more time to get things done and align with their internal schedules.
As some organizations make the move toward making these changes permanent, what are some recommendations that you would make for ADHD professionals, particularly those in positions of responsibility?
Switch as much as possible to project-based assignments as opposed to time-based. When employment is solely focused on time, people with ADHD are at a big disadvantage because they find it difficult to regulate their internal clocks and get things done in an adequate amount of time.
Drilling down a bit, a common quest among ADHD individuals is finding the ideal daily routine that provides productive focus without neglecting incoming responsibilities as they arrive. What do you think is a good baseline to start planning a good day at work, and at home?
You need to allot some time to engage in self-care, and some time to productively drown out the noise from work, school, and family life. For some, this can be meditating every morning (alone or using an app such as Headspace). For others, this can be putting on a pair of headphones and going to the gym every day. This helps structure your days, and it really helps with providing a space to be productive in, and a space for you to work on yourself and keep your head organized.
We are big believers in the power of prioritization. With what frequency do you think someone should review their day-to-day priorities? And what are some good tips for deciding what is your next task, when you can choose among literally hundreds of options?
My to-do list will often have an assortment of tasks, some vague and some defined, all with varying deadlines. My approach varies depending on the type of headspace that I’m in (am I tired? Is English not working for my brain right now?), but in general a good rule of thumb is that if a task takes less than 5 minutes, do it right away the second you sit down. Taking away the quick tasks first is a great way to get in the zone of whittling away your list, and before you know it, the day can become very productive as you chip away longer and longer tasks.
On a more personal note, how do you get yourself in the zone for productive work? Any tricks, techniques or aids that you can share?
My zone changes constantly. I have some days when I can write any email, do interviews, check in with staff, and/or work on future projects. But then I have other days when I need to focus my brain for a few hours and do research, or when I have to make impactful decisions with little to no data. In general, I have some things that are unavoidable: previously scheduled meetings, appointments, and any emergencies that may arise where my employees require my assistance. In between those appointments is where I take into account what zone I’m in. Am I in a zone where I can do research for a few hours, or is my brain going to be thinking too fast to pay attention? Am I in a zone where I can send out a bunch of emails, or am I tired and nothing sounds right?
At a systemic level, what do you think organizations can do to help employees with ADHD thrive at work, and contribute at the top of their capacity? What are some DOs and DON’Ts?
Being as clear as possible with goals is helpful, as is switching to a project-focused mindset instead of a mindset where employees are simply trading time for labor. In the latter scenario, organizations will almost always be disappointed in their employees with ADHD, because people with ADHD have the ability to be hyper-productive in a very short amount of time, while having longer latency periods where ideas are “marinating” and work doesn’t get done. But the best advice I can give organizations is to give your employees with ADHD a chance to succeed. People with ADHD can get a lot done, and many symptoms can be leveraged in an advantageous way. It would be a waste of talent to limit someone with ADHD to one, monotonous job every day.
What are some specific tools or techniques that you recommend in order to stay organized and productive? Can you give a concrete example of how to integrate them?
I have a few techniques that work for me. For instance, I have a rule with emails that if it takes me 60 seconds or less to respond, I will do it immediately. However, if I have to think about the email for more than 60 seconds, I’ll wait until I’m sitting down or until I’m in the right headspace to answer. My goal is to always have zero unread messages, so decreasing the number of unread messages every day is helpful feedback for me. Most of the time, I’ll have no unread messages at the end of the day, but sometimes I may leave a few emails unread for a week if I really need a lot of time to work on them.
Getting a bit more serious now. I read about lots of people who went through their young years thinking they were incapable of great work, only to learn as adults about their ADHD. This finding is often liberating, and it enables them to understand how their mind works, and how to best deal with it. What are some red flags for someone who has not been diagnosed, but who suspects they suffer ADHD?
The biggest red flag that someone who’s undiagnosed but suspects they may have ADHD is the inability to work on the same timeline as a neurotypical cohort. Are you doing work a lot faster than others? Is your getting done slower than others, because you’re getting distracted by different things over the course of the workday? Have you heard people tell you that you’re making “careless mistakes?”
For someone who ticks some of these boxes, what next steps would you recommend? Read more, or talk to someone? When is it a good time to seek professional help?
I always encourage people to do their own research and psychoeducation for ADHD. Read some articles and see if it’s something that resonates with your life experience. If it does, it’s time to get tested by a professional. A neuropsychological assessment would be considered the gold standard, although a psychologist or psychiatrist can certainly make the diagnosis without a comprehensive neuropsychological assessment.
Ok, we’re winding down now. Something I like to ask everyone: Do you have a favorite “Life Lesson” quote?
“Everyone has a plan until they get punched in the mouth,” by Mike Tyson.
Finally, my favorite part of the interview, the “rapid fire” session!
- In the recent past, what book has impacted you the most?
I haven’t been able to read a book since graduate school!
- Coffee or tea?
- What was your childhood dream job?
- What public figure do you admire?
Dr. Eric Kandel.
- What advice would you give to your younger self?
Believe in yourself and ignore the negative self-talk.
- What is something most people don’t know about you?
I have ADHD.
How can our readers further follow your work online?
They can check out my company, TMS & Brain Health. We currently have 4 offices across 3 different states in California, Arizona, and Nevada.
Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.
About The Interviewer: Pablo Diaz-Gutierrez is the founder and CTO of Appfluence, an award-winning software company that focuses on helping busy professional make the most of their limited time, better organizing emails, projects and meetings. Priority Matrix has been recommended by ADHD experts as a useful tool to help manage time, tasks and life priorities. Appfluence is producing this interview series to highlight the tools and techniques that top experts find most effective. If you would like to suggest a new topic or interviewee, please reach out to us.