I just went for my vision exam, and since it had been three years the technology had advanced once again in the interim. The bright flash that used to be employed to take a picture of the retina is not as fierce as it once was, and they hand you the trigger so that you even know when it’s coming. Efficiently one wends one’s way from one instrument to another, and it’s all done within a half hour. It is recommended that everyone have his or her vision checked on some schedule.

It is odd that we won’t, as a society, do the same for the brains of our children. Some simple tests every year during the school career could expose certain problem areas that should be specifically addressed. We really know a lot more about help for brain function than is being applied, and it’s not just neurofeedback. But whenever this does start to happen, the testing should be applied universally, not just to the child that is identified as a problem. And the helpful techniques should be applied universally, just as we provide education universally, because every brain can benefit to some extent or another.

And then there is nutrition. Numerous studies show that key nutritional deficits affect cognitive ability. Of course they affect much more besides, but why would we tolerate a situation in which school children are under-nourished for years, while at the same time we would not fail to change the oil in our cars on schedule?

The matter of nutrition is illustrative in another way. It has been pointed out that more money is spent on alternative health than on mainstream medicine (in terms of self-pay). The bulk of the $40B-$50B involved here goes into the nutritional supplement pipeline. This whole industry has been built up over the last few decades outside of the clutches of Big Medicine and of Big PhRMA. Medical research was involved all the way, but Big PhRMA does not own this field.

Most of us did not learn about Vitamin C, or E or Omega3 fatty acids or folic acid or probiotics or digestive enzymes from any family doctor. The awareness was spread in other ways. The same goes for dietary sensitivities and food intolerances, heavy metal toxicity, etc. Information about these is spread informally through other information networks.

The objection could be raised, of course, that the whole industry has sprung up like a field of weeds, devoid of any of the nice controlled research that is ordinarily demanded. And certainly the field has had its share of hucksterism. (Do I really need to worry about liver health, or can I just allow it to take care of itself the way it has done for 66 years already?) But it must also be agreed that there aren’t a lot of hazards there, for example with “supplement interaction,” “supplement side effects,” “habituation and dependency,” etc. At worst, it has been said, those who faithfully take all this stuff end up having very expensive urine. In the extreme, perhaps the kidneys are over-taxed. Also, just as Prozac is ending up in our rivers, so probably are some of our supplements. Such problems are manageable.

Our society seems to have come to terms with this “rogue” industry. When the government tried to clamp down on this burgeoning market with the FDA hammer, it received more mail than on any other issue, including the whole Viet Nam War. One key aspect, no doubt, is that nutrition has always been outside of the purview of medicine. It is subject to the accumulated folk wisdom. Nutrition has never been the business of medicine, so it intrudes only when necessary–as in the case of vitamin deficiencies, diabetes management, and cholesterol.

I see the supplement industry to a certain extent as a stalking horse for neurofeedback. “Medicine” does not own cognitive function any more than it owns nutrition. Deficits in cognitive function are not a medical condition. Poor intellectual function and low academic success do not spur the pediatrician into action. It is not his issue. As for the consumer side, would we not do for our brains what we have shown ourselves perfectly ready to do for our bodies with physical exercise and supplements, and for our vision with testing and visual correction?

So we confront two paths. The one brings neurofeedback into the Temple of Medicine as a new procedure for recovery from brain dysfunction, and the other treats it as part of a larger “Self-Regulation Discipline” where the competence necessarily resides within the person individually and within the society generally. Self-regulatory competence, by its nature, cannot be merely administered; it must ultimately be mastered. The person has to own it to have the benefit, and he has to walk out of the therapy suite with it.

Medicine has never been interested in the brain that heals itself. So self-healing has always largely been an amateur operation left to the end user. Now that such self-healing is becoming instrumentation-aided and formally understood, should that necessarily change? Of course one can point to hazards, but we accept these in the society at large. We moved from using coachmen for carriages to everyone driving their own car, even though we manage to kill more than 100 people every day that way in this country. Typically the worst that can happen with a poorly administered self-care model is that it fails in its objective.

Even though the burden of self-care ultimately falls largely on the end user, that does not mean that health professionals are not involved. Increasingly, “integrative medicine” docs guide and advise on care comprehensively. But much of the burden of follow-through falls on the client. That’s true in medicine as well, as compliance with medication regimens is a huge issue. What’s different here is that a health partnership has to emerge in which the client buys into the process much more than in the old days of traditional medicine and pill-popping. We’re not just talking about a temporary procedure, but rather about how life is to be lived going forward.

We must, in essence, resist the wholesale “domestication” that Medicine has in mind for us, the coddling into dependency that we are now seeing as the Omega point of the Big PhRMA hegemony. As David Suzuki pointed out years ago, to a certain extent “civilization” is a process of domestication in which we agree to inhibit the public expression of some of our idiosyncrasies for the sake of the community. But the process can go too far into dependency, consumerism, and the relinquishing of our personal autonomy.

So, let me paint the picture of what we might expect to see with a self-regulation strategy seen as folk remedy and as folk wisdom. First of all, this would have to be taught in school, so that everyone is brought to a minimal awareness of their own ability to influence their own health. Children would be taught about breathing, about how they can control their own state simply by changing the breath rate and by shifting to abdominal breathing. They would have a chance to experience hand-warming, and some of the other biofeedback modalities like GSR and EMG. They would be exposed to Heart Rate Variability training. They would have a chance to see the CO2 level in their breath, and how it changes with breathing rate. They would get to see their own EEG, and to record how it changes when they close their eyes. All of this would be taught in a context of bringing understanding about the natural function of our internal regulation–about how dynamic it is, how interactive, how intricately devised, and how amenable it is to our own intervention.

The children would all be screened for Irlen Syndrome, and they would be screened comprehensively in terms of cognitive function. They would then be given opportunities for cognitive enhancement along with their normal schooling. Such cognitive enhancement strategies would include exposure to light/sound technology and HEG, and if that combination of strategies did not succeed, the children would be referred up to the next level of intervention.

Full clinically driven neurofeedback would be inserted at this level. All such children would be exposed to the conventional neurofeedback for enhanced self-regulation generally, and for the specific deficits in cognitive function would be screened in the fashion that Kirt Thornton has pioneered. Some of children might even get a SPECT scan at one of Doc Amen’s clinics at this point. All children would be given an opportunity for nutritional evaluation, and nutritional education would also be built into the curriculum.

The benefit-to-cost ratio for something like this would be out of sight. The cost of “maintaining” a failed child in our society is on the order of $20-50,000 per year. The difference between contributing $20-50,000 per year to the economy and being a drain on the economy to the extent of $20-50,000 is a swing of $40-100,000. Meanwhile the cost of such a comprehensive program should add no more than 1% to the cost of elementary school education, or nominally $1000 per child. The benefit for successful children can be quantified as an increment on life earnings, and estimated to be at the ten percent level. With lifetime earnings in the range of $500K at the low end, a $50K increment again dwarfs the cost of the initial investment. (By way of comparison, in the medical realm our costs of extending life through medical procedures averages out to $1600-$3000 per month of additional life expectancy.)

Compare this to the Teen Screen program that Big PhRMA has in mind to draw teens into permanent dependency. Compare this to the difficulty we seem to be having in getting the neurofeedback “virus” to take within the body of Medicine. And finally, consider how far down this path we have already gone: The neurofeedback field may only amount to one part in a thousand compared to pharmacology, but we are already at one percent compared to the nutritional supplement industry. And we are probably well beyond ten percent of other alternative modalities that are similarly labor-intensive, such as acupuncture and EMDR.

When we succeed in liberating someone from the constraints of their brain function, we tend to have a long-term impact. So in terms of lingering benefit going forward, our intervention is probably worth at least ten times that of ongoing medication and even of supplementation. Another way to make this point is in terms of amortization. If the benefit of neurofeedback is deemed to extend, say, for ten years post-treatment, just for the sake of specificity, then the cost of that neurofeedback should be amortized over ten years. By the same token, such amortized cost should be compared to the ten-year cost of a medication strategy or supplementation regimen.

So in terms of health impact we are already at the level of one percent compared to meds, and ten percent compared to the supplement industry. That’s not bad, given that the powers that be don’t yet know that we even exist.

Historically, all of medicine in Eurasia used to be a matter of folk remedies, with the essential knowledge broadly diffused and much else carried forward by “wisdom people,” largely women who were responsible for propagating civilization forward. By contrast, in the tribal tradition of Africa there was a conjoining of medicine with tribal authority within the medicine man. Significantly, the medicine masks never signaled health but rather power. They were always fright masks, ever over-sized. What the medicine man needed from his charges was recognition of his power and submission to his will. The man’s healing influence was contingent upon an awesome asymmetry of power.

At some point a transformation occurred in Europe in which through the male priesthood not only the ecclesiastical but the secular wisdom became the province of the male, of the hierarchy, and of the cloister. Wisdom people, the witches, were redefined as bad people that were a threat to the new regime and had to be put to death. The pejorative of “old wives’ tales” survives vividly to our day. (A few decades ago a study was done at the University of Birmingham in which the key folk wisdom regarding colds was examined. All of the folk wisdom was found to be supported in the study.)

Some hundreds of years later, European man threw off the yoke of ecclesiastical dependency. The new tradition of religious freedom also informed our own national politics. Yet it has taken another 500 years for us to become aware that with respect to medical freedom, we have tolerated a dependency and regimentation that would be unthinkable with respect to religion. When it comes to the wisdom of our bodies rather than of our souls, we remain as a society in a pre-Reformation phase, and the new day is just beginning to dawn.

In retrospect (because this Reformation is as inevitable as the previous one), it will be seen that the one dependency is as destructive of our full humanity as the other. We must, as individuals and as a society, move beyond dependency on the medical wizards. So the natural outcome of this development will be a reassertion of the rightful place of folk remedies and of folk wisdom, and a regaining of our respect for the wisdom of the body. But that new folk wisdom will now be continuously informed by the very latest of scientific findings, just as is happening in the supplement industry. The information flow will simply go directly, without intermediaries, in a manner reminiscent of the earlier translation of the Bible into the vernacular.

In our clinical work, we have observed both the “new man” and the old domesticated one. Over time, it became clear that we did not do nearly as well with people who were referred to us from traditional docs. These people came to us the same way they had come to their doc, namely to have health administered to them. The whole idea of working for it, and of being responsible for monitoring one’s own status, was just too much. Can’t you just tell me how to do this? Well, no…

The successful client is much more likely to have been to one or another alternative practitioner already. They know the drill. They expect to participate fully in the process. They have already assumed primary responsibility for their own care, or at least are prepared for the message. They do not ask: “Where are the controlled studies on this?”

Years ago our son Brian kept a California king snake, a constrictor. Every once in a while, it needed to be fed a mouse from the pet store. At one point we caught a field mouse in our house, and we served it up to the snake. The mouse mounted such brilliant evasive maneuvers, and was so perpetually vigilant, that in time we could do nothing less than give it back its freedom. I had always been in conflict about all this in the first place, as our natural allegiances align more with our fellow mammals than with the cold-blooded snake. But this plucky mouse had put us entirely in its corner.

The comparison of this mouse with the phlegmatic ones one gets from the pet store, who only know about food being sprinkled into their cage, illustrates for me what David Suzuki was trying to say. The forces of domestication, the trend toward hegemony and regimentation, can go beyond facilitating our civilization into their own oppressive excess that saps our vitality both individually and collectively. The antidote is an informed folk wisdom that resists easy propaganda, buttressed by the formal recognition of our right to medical freedom as much as to religious freedom. Both need to be unconditional. One should not have to qualify for it (except in the extreme case) by way of a competency test.

Medical freedom, however, offers little more than the absence of constraints. It is a mere precondition for what has to emerge affirmatively through recognition of our potential for self-healing. Again the parallelism with the religious sphere is striking. In both the realm of religion and of medicine, we perceive a frontier of unbounded possibility for both a vital health regime and a vibrant spirituality, while at the same time facing a return to a cramped fundamentalism.

This entry was posted on Friday, September 29th, 2006 at 6:44 pm and is filed under Application of Neurofeedback, Paradigm. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.