A Year-End Reflection

by Siegfried Othmer | January 4th, 2007

An Inconvenient TruthThe film “An Inconvenient Truth” with Al Gore is a chilling example of what can happen when scientific findings clash with political objective and entrenched economic interests. The science can be made to disappear even when it is impeccable and even when unanimity has been achieved within the scientific community itself. We saw the same phenomenon at work when it came to the dangers of smoking cigarettes, and on numerous occasions over the years with various other environmental issues.

The controversy here is not about needing better science to resolve the outstanding ambiguities, contrary to what is claimed. The science will never be good enough for the critics because the findings will not cease to be inconvenient. Al Gore happened to have a ringside seat to Roger Revell’s early measurements of atmospheric CO2, which already raised caution flags back in the late sixties. The evidence has only gotten more solid since. The whole opposition is clearly policy-driven from start to finish.

Consider that as the evidence has mounted in favor of global warming, the debate has subtly shifted to the issue of whether the problem is man-caused–as if that somehow gives us an excuse for inaction. The proposition is divisible into two: 1) does increased CO2 in the atmosphere cause increased global temperature, and 2) are we significantly increasing the atmospheric CO2. The answer to both is unequivocally yes. So the problem is clearly man-caused. But it does not really matter operationally. We should undertake countermeasures in any event. Since the argument does not need to be settled, the debate is obviously diversionary. This becomes obvious the moment we apply the same logic to any other issue, such as the threat of a bird flu epidemic.

Now this has relevance to our field of neurofeedback. We keep being told that our lack of acceptance is traceable to the inadequacy of the research. But I suspect that matters are much like in global warming. Neurofeedback happens to be an inconvenient truth from the standpoint of rather major economic interests in the country. The last thing anybody up there would want is unequivocal research that favors neurofeedback. But it is not just Big Bad PhRMA that would be inconvenienced. The same attitude of fear and resistance to the “shock of the new” is to be found when we speak to people involved in the prison system, in addictions treatment, in school systems, and in universities. Radical change is threatening to anyone’s competence. Even when mental health professionals have essentially nothing to offer–as in the case of dementia or coma–they will put up their guard in alarm when neurofeedback is proposed.

The clamor for better evidence is a red herring, just as with global warming. This is apparent from the fact that the critics are not even interested in finding their way to an answer. Neurofeedback is an abiding inconvenient truth.

Another example along these lines comes from the other current documentary, “Who killed the electric car?” The evidence is pretty convincing that the auto companies had a change of heart with regard to electric cars. After first putting them on the market in response to California’s zero emission requirement, the automobile manufacturers discovered their grievous error and reversed course. They made sure that Californians would no longer have access to such cars, and instead they put a move on State regulators to shred the State requirement for zero emission vehicles.

The public was told that there was insufficient interest in such vehicles, when in fact quite the opposite was the case. Here is the current state of affairs, in the words of Dan Neil, resident dilettante at the Los Angeles Times: “Electric motors are clean, lightweight, maintenance-free and powerful. The latest lithium-ion batteries are energy-dense, durable, compact, and recyclable.” Electric drive gives us the energy equivalent of $1/gallon gasoline. Looked at purely economically, the 40mpg internal combustion engine becomes the equivalent of >100mpg transportation through this metamorphosis.

This promising future had to have been apparent some years ago already to the auto executives. The real danger, therefore, was of rapidly mounting public enthusiasm that would lead to the quick obsolescence of much of the economic infrastructure around automotive transportation in this country. The big auto manufacturers would be scripting and paving their own path toward marginalization. The doors would be thrown open to innovation that the majors could neither control nor be certain to dominate. The whole thing had to be throttled in the crib.

It might be argued that the existence of hybrids contradicts such a dark interpretation of events. In actual fact, it was US companies that initially sponsored research on hybrid technology, with considerable government cash infusion. This drew in the Japanese companies out of fear of being left in the dust. Then the Detroit majors abandoned the technology, by which time the Japanese companies were far enough along that they carried on to the goal line. It was a comedy of errors. Now it is but a small step to plug-in hybrids, and Detroit’s worst fears will be realized–at their own instigation. Meanwhile, they are sticking hybrid technology in SUVs, which is just putting lipstick on a pig.

Meanwhile, they are diverting us with talks of the hydrogen future. The objective is to point us to a horizon that we are assured is quite distant. I apologize for the digression from our main theme, but I have some history with hydrogen. I used some liquid hydrogen in my Ph.D. research and we had to be awfully careful about how the stuff was stored so that it wouldn’t blow up Clark Hall, the then-new physics building on the Cornell campus. In England a hydrogen facility in a physics lab had exploded and taken some good folks with it. And the dirigible Hindenburg is still in our collective memory. At the same time, hydrogen offers very few upsides. One again suspects that the tactics around hydrogen are more defensive and diversionary than they are serious–it’s future is far enough away so as not to perturb the precious present.

Here then we have a case where the technology was already viable inside the big company, but was still put to death–even at great financial cost to the company and cost in goodwill with the public. What are the implications of such carnage for neurofeedback? The experience prompts one to ask whether we do or do not pose a substantive threat to Big PhRMA. Any hegemonic enterprise such as Big PhRMA will probably resist even minor intrusions into its turf. That is the nature of empire.

The closest we come to a relevant example is the reaction of Big PhRMA to the emergence of the supplement industry. It continues to amaze how differentially supplements and drugs are treated in the press both with respect to good news out of research and bad news in terms of negative impacts. Reporters aren’t making this up. A war against the supplement industry is clearly in full cry.

It turns out that the major prescription drug categories in dollar terms are not ones that we will directly impact on, or at least we won’t for a long time. Right at the top are the drugs for the control of cholesterol, for example. Lifestyle improvements do matter here, but the big factors are diet and exercise long before we ever get to neurofeedback. In second place is cytostatics for the treatment of tumors. We expect little impact there. In third place are antibiotics for the treatment of ulcers. Only then do we come to the anti-depressants and the antipsychotics. Not far behind these are the blood pressure medications, treatments for anemia, calcium antagonists for stroke, and medication for the management of diabetes. The latter is comparable to the anti-convulsants in market impact. The stimulants never even made the list.

We will have some impact on usage of over-the-counter pain medications, but people do show a clear preference for the simple medical remedy for most common pain issues. What it all boils down to is that the drug companies should not be too worried about us.

And then there is the other factor to consider: Effective neurofeedback strategies can also potentiate the appropriate medications. Compliance is a huge issue with many meds, and if the dosages could be reduced to the point at which side effects are negligible, more people would stick with their doctor’s advice in these matters over the long haul. It might well be that the potentiation of medication will be comparable to the abandonment of medication that our work makes possible.

All that said, it would be prudent for us to favor those conditions in our marketing where the tentacles of empire are not singed, i.e. where pharmacology is essentially irrelevant: the autism spectrum, traumatic brain injury, the dementias and the problems of aging, addictions, the personality disorders, learning disabilities, and optimum performance. The entire domain of trauma work–collectively probably the largest mental health issue–begs for our involvement.

The category of conditions where our work may serve to potentiate medication effectiveness include migraine, seizure disorder, the anxiety-depression spectrum, chronic pain, and Bipolar Disorder. Our work can be helpful to the health professions by dealing with dental phobia and the fear of anesthesia and surgery. We can help significantly with “chemo fog” and with recovery of cognitive function after general anesthesia. We can help doctors by working with their “heart-sink” patients and their “crocks.”

Still it would be in our interest to remain mindful of past attempts to stifle progress and to strategize around it. The decentralization of all aspects of neurofeedback helps to protect the field from decapitation. The field is already moving in the direction of multiple protocols, multiple modalities, and multiple perspectives. This is a healthy development. Certification, however, remains curiously and archaically monolithic. And the professional organizations still feel compelled to adjudicate between the anointed and the unwashed. What is almost entirely missing from the development of our field is outreach to the “near-neighbor” professions such as physical therapy, occupational therapy, social work, chiropractic, Traditional Chinese Medicine, naturopathy, and the nascent thrust toward integrative medicine. A clear mutuality of interests exists, as well as a synergy among our various approaches.

Finally, the unnatural breach between the fields of traditional biofeedback and neurofeedback needs to be healed. We need to be in a position to make the case that we are not just talking about one procedure or another, but about a multi-faceted approach to mobilize the huge potential for improved self-regulation. The most immediate way to do that would be to fuse our respective technologies into one combined enterprise, both conceptually and in practice. Then the war against one or another “procedure” would be reframed as a misguided attempt to discredit self-regulation strategies per se–an absurd proposition. If we are never doing only one thing, then one thing can never be blamed.

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