Archive for the ‘Professional Issues’ Category
Wednesday, January 4th, 2006
With the onset of the new year, I wanted to turn the page and start off on a new topic. However, the question of professional boundaries continues to occupy some of the lists. If discussions of this issue are intended to bring parties together, rather the opposite is happening. Arguments are being refined; lines of demarcation are being more firmly drawn; and the bulwarks are going up.
In my own observation of this field, there has been considerably more effort put into defending turf than in building the field in the first place. The number of lawsuits per capita must exceed that for any field of comparable size, and the money put into such law suits, patents, and patent defenses probably exceeds the cash invested in actual instrumentation development. It has availed essentially nothing for those who sought to restrict others. The patents succeeded at most in slowing down progress, or forcing developments underground, and at the same time the patents are most likely indefensible.
In my previous newsletter, where I discussed the issue of whether licensure actually serves to protect the public rather than the professions, I failed to raise an obvious point. If the public is at risk from a proposed new technique, then the risk to the public is surely greater if the technique is entirely fraudulent than if it is effective but may simply be poorly administered. If a technique is entirely fraudulent, then it injures by diverting an ostensibly gullible public from more effective remedies. If the public interest were truly at issue, then the promotion of an entirely fraudulent technique to the public should be of greater concern to the caring professions than the haphazard, sub-optimal administration of an effective one. In actual fact, we see the concern about the public welfare raised substantively only when it finally dawns on the professions that there is actually something here worth fighting over. The claim that this has anything at all to do with the public interest is the rankest hypocrisy. (more…)
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Thursday, December 22nd, 2005
The current newsletter is a continuation of a thought process initiated with the previous one. What is the pathway by means of which neurofeedback can enter the professions without unleashing a variety of turf wars among the varied mental health disciplines, and while respecting the rights of the public? I proceed into this discussion in the firm belief that neurofeedback cannot succeed except through professional tutelage, sponsorship, and management. It cannot, for example, succeed simply as a grassroots movement among end users or, to push the metaphor, as a prairie fire through a public suddenly sensitized to its need for neurofeedback and apprised of the benefits thereof.
The second proposition is that whoever controls the instrumentation controls the field; so in order to prevent a scrimmage around the issue of who controls neurofeedback, both the technique and the instrumentation must be made part of the commons of mankind. No football, no scrimmage. That in turn means that the professions must distinguish themselves by virtue of added value, incremental competence, and integrative perspective, not because they control access to the technology. There will be objections to this on the basis of the claim that only the licensed professions can be counted upon to act in the public interest, and to protect that interest. It will be my disagreeable burden to point out that the professions do not have a history of doing any such thing, and give no sign of doing so now. (more…)
Posted in Neurofeedback, Professional Issues | No Comments »
Thursday, December 15th, 2005
Sometimes an actual case history does more to establish a principle than mere enunciation. My mother-in-law is 94 years old, and is doing neurofeedback every day to maintain her level of function. Family members are pitching in as they can to keep her in good spirits. Among the family members is a son-in-law who is also a Harvard-trained psychiatrist. Recently it transpired in casual conversation that he had caused some medication to be prescribed for one reason or another. Since we are doing neurofeedback and have to judge any changes that occur with respect to neurofeedback strategies, it would have been nice to know that a medication was being prescribed.
An old-line doc, on the other hand, feels that this kind of information should not be shared with anyone. Besides, what can neurofeedback possibly matter to anything? We have no standing to know about the prescription, and no reason to know it. This, incidentally, is from a person who has known about neurofeedback since we first undertook the training with our son Brian in 1985. He was a witness to Brian’s progress. He was also aware that my father-in-law undertook neurofeedback for years in the late eighties for his dementia and Parkinson’s. Every time the man got away from the neurofeedback instrument for a few weeks, his wife would notice his decline in mental function. That function would then be nicely recovered once he was back on home on the instrument. (more…)
Posted in Professional Issues, Scientific | No Comments »
Thursday, December 8th, 2005
As we approach the year-end, my thinking goes to the big-picture issues as I look back on the progress the field has made over the past year and project forward to how the field of neurofeedback will likely progress in the coming year.
Several anecdotes tell the tale. At our recent training course someone commented on how frustrating it must be to be sitting on what we know and yet have the larger world just go by without any awareness of this field. Over time we have gotten used to the slow rate of “diffusion of innovation” that characterizes the health field in particular. But we also realize that the field is growing in a healthy way with the gradual but relentless accretion of new mental health professionals into the discipline.
Every new practitioner will benefit some 30-150 clients and their families over the course of a year through neurofeedback. Collectively we are helping well over 100,000 people per year in the United States. Eventually this “population pressure” will tell. They will eventually no longer just represent isolated individuals. Rather, they will encounter others who have similarly benefited. It will become a movement. (more…)
Posted in Diffusion of Innovation, Outreach, Professional Issues | No Comments »
Thursday, September 29th, 2005
It was back in 1968 that Garrett Hardin published his famous piece, “The Tragedy of the Commons,” in Science (162, pp 1243-1248, Dec. 13, 1968, American Association for the Advancement of Science). The example of over-grazing of lands held in common was given as an exemplar of a universal truth, namely that assets held in common by a large population inevitably end up over-exploited. This follows from the ineluctable workings of Adam Smith’s Invisible Hand, in which each individual acts in his own interest. He derives the whole benefit from his own exploitation of the commons, whereas the costs are distributed among all, so he bears only a fraction. As the population grows, the ratio of concentrated benefits to distributed costs only grows, and the incentive to exploit only escalates with it.
The sense in which Hardin uses the word tragedy is that of Alfred North Whitehead: “The essence of dramatic tragedy is not unhappiness. It resides in the solemnity of the remorseless working of things.” Of course such workings out of irresistible trends results in unhappiness, and we require unhappiness to give the futility of escape dramatic poignancy. Says Hardin, “Ruin is the destination toward which all men rush, each pursuing his own best interest in a society that believes in the freedom of the commons. Freedom in a commons brings ruin to all.” So, unhappiness portends–and not only unhappiness, but ruin as well. It would be best to take notice. (more…)
Posted in Application of Neurofeedback, Professional Issues, Software Related | No Comments »
Thursday, September 8th, 2005
With all of the disagreements outstanding in this field, the least we can do is clear the semantic hurdles that may stand in the way of synthesis. One issue that is still outstanding, but can easily be dispatched, concerns how we think about inhibits. In the past I have variously contrasted Sue’s largely reward-based training with Val Brown’s largely inhibit-based approach. The distinction is quite clear to me in my own mind, but Val Brown comes back to point out that his system does allow the promotion of amplitudes in particular bands as well. In his approach of box targeting there is both an upper and a lower threshold set for every band. One can choose to raise the lower threshold with an imposed offset, thus rewarding the brain for larger amplitudes in that particular band. That could then be seen as a reward strategy. (The upper threshold gets raised as well, in that the whole box is moved upward, but that is not of interest at the moment.)
Now in fairness it must be said that Val has moved away from the use of this terminology of augments and inhibits in his own chosen framing of what he does. So the problem is not his but ours, as we try to understand his approach in our traditional framework. On the other hand, Val also has an interest in not having his system misrepresented. So, why do I still talk of Val’s approach in terms of inhibit-based training? (more…)
Posted in Professional Issues, Protocols | No Comments »
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