As everyone is aware, 2020 has brought forth the undeniable and prodigious challenges of the coronavirus pandemic, its ensuing economic devastation, and the insistent loud voices decrying continuing racism and social injustice. Things are coming to a head as the pressures of the “invisible” virus enemy, its financial fallout, and the ubiquitous consequences of oppression and discriminatory consequences escalate the effects on our population.
The clarion call that black lives matter is gaining momentum, the economy is cratering, and our society moves forth in a strange and tenuous frontier where the future is uncertain. Our leadership, even at best, reminds me of the proverbial substitute high school teacher who stays one textbook chapter ahead of his students. With the future uncertain, it’s play as you go, one step and one day at a time. I recently managed to get a haircut, but don’t know if shops will be open the next time I need one—and I can’t hoard haircuts.
The coronavirus is not done with us. We coexist with this scourge that is taking advantage. American individualism is showing its ugly side, as people flaunt their “rights and liberties” to excuse unsafe and selfish behavior. We eagerly await a vaccine in the desperate hope to end this pandemic. With the current trifecta of COVID, economic disaster, and social injustice, the underbelly of our society (and others) is exposed to the reality of massive biologic vulnerability, financial inequity and fragility, and human conflict and oppression.
Not surprisingly, the surge in mental health issues cannot be ignored or underestimated. Mental health impact is the “elephant in the room” that trauma and hardship have revealed in unrestrained flooding. Job loss, illness, helplessness, and sheltered restrictions are laying bare the anxiety and instability that afflicts a high proportion of our population.
The nature of human response to trauma is that situational events can trigger past traumas and spark an onslaught of symptoms. In addition to personal difficulties, natural catastrophes and collective hardship or uncertainty unleash mental health crises tied to brain instabilities and unresolved issues. When earthquakes, fires, floods, and other disasters arrive, millions of people besides those directly impacted become re-stimulated to experience mental and emotional difficulties. Similar waves occur in the wake of political or social turmoil: latent psychological and neurological disturbances erupt and often overcome with atavistic reactivation. Vulnerabilities are catapulted into the forefront, and distressing symptoms arise.
Like old sports injuries that recur under provoking conditions, we now have a plethora of individual mental health problems and a collective mental health crisis that’s hardly acknowledged and barely addressed. The shutdown, economic retraction, and general panic about health have rippling effects on the entire health care system, including its frontline providers.
What are we to do?
Notwithstanding the resurgence and intensification of symptoms and crises magnified by our current circumstances, the prevalence of mental health conditions is well known. Subsumed under the rubric of mental health are numerous emotional and behavioral disturbances with associated physical illnesses and dysfunctions. What qualifies as disease may be debatable according to the sources of scientific evidence and theoretical orientation. I would argue that all mental health deviations (as well as health itself) have biogenetic organic bases with the aberrant development and manifestations thereof comprising various categories of disorder.
The severity, disruptive persistence, and recalcitrance of conditions like schizophrenia, bipolar disorder, alcoholism and drug addiction give credence to the idea that these conditions are physiologically brain-based disorders. There is also reason to believe that many other “mental health” problems are physiologically brain-based as well.
We must avoid the erroneous extremes of foreclosing and dismissive views of mental health: saying that “it’s all in your head” belies attitudinal ignorance and also the irony that it may well be in your head in the form of dysfunctional neurological activity. The other side of this corrupt coin is the fatalistic view of a biological basis that casts a deterministic conclusion, excusing the person from responsibility and self-control while limiting autonomy, freedom of choice, and healthy functioning without interminable medical and pharmacological intervention.
Debates and beliefs about the etiology of mental dysfunction underlie treatment approaches along with professional and public opinions and emotions about “mental” issues. Stigmas attached to mental health linger and detract from more enlightened and effective professional and social treatment and inclusion.
Arguments about personal responsibility, choice, and the “will or ill” basis of dysfunction continue. I have ventured opinions on this fundamental matter in various writings:
Let’s Not Just Talk About It: Duality of Dysfunction in Mental Health
https://marksteinberg.com/webpages/articles/lets-not-just-talk-about-it.jsp
Different Responses to Mental Health Crises and Cancer Crises
https://marksteinberg.com/webpages/writings/different-responses-to-crises.jsp
In accord with disparate attitudes and judgments about physical versus mental afflictions, cancer elicits sympathy, whereas behavior disorders breed antipathy and rejection. Nevertheless, mental and brain disorders pervade and afflict many millions of people—perhaps yourself and those you know. The list of troubles is long and widespread:
The list of “mental disorders” is extensive. Separating mental or psychological dysfunction from physical or physiological categorization is arbitrary. Not only is there overlap, but many contemporary and traditional professionals argue in favor of a neurophysiological, brain-based etiology for a broad range of illnesses.
The brain is our control center; thus, it is responsible for the management, control, and self-regulation of mental and neurological states that correlate with and underlie physical, emotional, and behavioral manifestations.
So-called “organic” diseases have a basis in brain-regulated mechanisms. Alcohol and drug abuse often result in damage to the liver and brain; but, these addictions are intimately tied to brain function. The huge problem of diabetes and obesity—while caused mostly by diet—are also results of the brain’s poor management of body sensations, stress, and impulse and self-control.
From the prevalent mainstream practice of prescribing medications to treat mental and psychological problems, it is obvious that the medical mainstream considers the problem to be one of biophysiology and biochemistry. This treatment approach underscores the brain-based issue, though it attempts to solve brain management problems with a “cruise control” chemical approach. Unfortunately, this approach often falls far short of ameliorating the problem and its underlying cause: brain dysregulation.
Fortunately, we have (for decades) an elegant, natural, effective, and enduring solution to making the brain work better and ameliorating, reducing, or eliminating a host of disorders. This is the treatment of neurofeedback (also called EEG biofeedback). Neurofeedback is not new. It has been around since its inception in the U.S. space program, beginning in the late 1950s.
As computer technology has evolved, neurofeedback software and practice have advanced to more rapidly and efficiently address symptoms and populations more widely and effectively. I would estimate that over the past thirty years, my colleagues and I worldwide have administered approximately twenty million neurofeedback sessions. Practitioners collectively and conservatively report at least an eighty percent success rate.
Neurofeedback is the training of brainwaves: the EEG or electroencephalographic neural activity that represents the energy or fuel that powers the firing of nerve cells in the brain. In each of us, the EEG is connected with cognitive, emotional, and self-regulatory functions that allow the brain and nervous system to shift among states. As a blatant example, our brain state during sleep is different from our waking state. Although that is obvious, the brain must constantly shift between and among many states, some subtle and some more intense. The degree and ease with which we can do this routinely has substantially affects how we feel and how we function. Ultimately, our self-management and self-regulation habits affect our health, stamina, satisfaction, habits, and durability.
Many extreme, intractable, and upsetting conditions are caused and maintained when the brain routinely kicks into fight-or-flight mode. This syndrome underlies anxiety conditions, insomnia, post-traumatic stress disorder, and others. It’s as if the brain’s accelerator is constantly floored. This floods the system with cortisol and other hormones and reactions that normally are reserved for emergency survival situations. Continual flooding damages organs and systemic health, lowers the threshold for disease onset and progression, accelerates aging, inhibits healing, and leads to the formation of counterproductive habits, including self-medicating.
In short, when the brain is in overdrive or is otherwise imbalanced in its self-regulation, it makes life miserable. Aside from the major diseases that impair and shorten life—heart disease, cancer, diabetes—compromised self-regulation “nickel-and-dimes” people out of a satisfying and productive quality of life. A high percentage of the population is quite uncomfortable with their bodies, their stress management, sleep, weight, and eating habits. The inability to relax, headaches, anger, high stress, mood problems, and unbalanced inner responses lead people to excessive drinking, drug use (both prescribed and otherwise) and unhealthy habits.
Brain training with neurofeedback goes a very long way toward relieving symptoms and reversing problematic conditions.
In trying to understand how training the EEG can positively influence so many problematic conditions, it’s critical to consider the role of brain regulation in keeping us alive, healthy, resilient, and productive. When things go awry, the symptoms and dysfunction can often be traced to problems with the central organizing principle of disorder.
Fortunately, our malleable and adaptable brains can correct, restore, and normalize a lot of disorder when shown the requisite information pertaining to its own operations. This process is the effective ingredient in neurofeedback brain training.
It remains disheartening that, despite the extensive and mounting evidence for its efficacy, neurofeedback is still not endorsed (or even accepted) by mainstream medicine and the therapeutic and educational communities. It’s as if this “N” word is not to be mentioned in any legitimate conversation about appropriate health care or treatment for a variety of afflictions, symptoms, and conditions.
Some health care providers (even some physicians) recognize the value of neurofeedback. However, the prevailing attitude and practice of prescribing medications and sometimes add-on talk therapy relegates neurofeedback as a “fringe” treatment that consumers may try at their own risk and expense.
Most insurers don’t cover neurofeedback, considering it “investigational,” despite over fifty years of bona fide research and clinical evidence attesting to its proven efficacy. Health insurers, of course, look for ways to not pay for services. The prevailing view by the medical establishment of disparaging or dismissing neurofeedback adds to the arbitrary justification by insurers to not pay for it.
Note that neurofeedback does have legitimacy. As one example, the American Academy of Pediatrics recognizes neurofeedback as a Level I “Best Support” intervention for Attention Deficit and Hyperactivity with studies showing it as effective as medication. There are many studies attesting to the effectiveness of neurofeedback for other conditions, including headaches, seizures, and alcoholism.
Neurofeedback was pioneered, researched, and proven effective for migraines and seizures and has been used effectively for over fifty years. Yet, it’s a rare physician who will even tell patients about neurofeedback (much less recommend it) for these conditions.
Ironically, insurers and patients pay for medications indefinitely for conditions that are ameliorated by neurofeedback. Over time, the cost effectiveness of neurofeedback is considerable and defrays mounting and continual costs of other treatment, including drugs. But, the longer view toward financial savings and the improvement and viability of brain functioning is subsumed under the need for a quick fix. Sadly, the pharmaceutical quick fix is often short-lived, habit-forming, and with substantial negative side effects.
The combined “spoiler” effect of lack of medical recognition, lack of coverage, and insufficient mainstream recommendation leaves patients to discover neurofeedback by themselves. There is a lot of information available, yet consumers must sift through the naysayers to find accessible providers. Consumers want to know why—if neurofeedback is so viable—they haven’t heard about it through traditional sources. And the answer, quite frankly, boils down to ignorance and denial on the part of professionals. We cannot entirely blame pharmaceutical companies. It’s the buy-in to drugs by physicians that sustains the routine and overwhelming glut of prescriptions.
Psychopharmacology offers little for the developmentally delayed, learning disabled, and traumatized. Tranquilizers and antipsychotics may subdue or quell aggressive behavior and overly noisy thoughts, but they do not heal, and they have horrible side effects.
In the world of science reporting and broadcasting, it’s also a mystery why neurofeedback is rarely mentioned in articles and documentaries about neuroscience and brain plasticity. Documentaries abound about brain studies illustrating new discoveries regarding areas of the brain that “light up” or fail to activate in response to different stimuli. Thus, we know increasingly more about brain responses and connections. Yet, the obvious and evidentiary leap to solving deficits and improving brain performance is curiously omitted across the board in public reporting.
There are likewise many media discussions and documentaries about treatments for trauma, phobias, abuse, PTSD, and victims of violence. Curiously, there is no mention of neurofeedback. It’s as if the new “N” word is unacceptable, just quietly used within a subculture of its acolytes and practitioners.
In addition to the impact of brain functioning on individual health and well-being, the precarious status of social harmony and economic stability depends significantly on how well people’s brains work to manage the complexity of the world.
Surely, the rampant greed, insensitivity, and injustice we suffer reflect the fear, anxiety, and lack of self-control exhibited by those in power. Tyranny is not the product of psychoses, but rather of brains deficient in compassion, composure, self-regulation, and self-control unleashed in an environment of collective frustration and deprivation.
We live in a culture divided by inequity, injustice, and historical oppression and marginalization. In this, we are not as different from or better than many other governments and societies we like to put ourselves above.
Our democracy and evolving enlightenment very much depend upon good brains to operate and sustain the system. Increasingly, it appears, we are vulnerable to the individual and collective traumas that erode sensibility, compassion, productive vision and planning, and the capacity to refrain from overreacting.
Individually and socially, fight-or-flight mode is increasing. Anxiety and depression are spiking. Collective social and economic traumas tend to trigger personal traumas and instabilities and to accelerate their symptoms. There’s much cause for worry.
Neurofeedback practitioners are among the people more entitled to be optimistic than most, because we are aware that the problem of mental health is largely an issue of dysregulation. It’s more than that, of course, but the part that has been intractable, that keeps people in bondage to their condition and keeps them from bootstrapping their way out is the dysregulation component, particularly if that took root early in the person’s life. So, we are in a position to intervene with a tool that is finely attuned to the problem, even while the rest of the world has yet to appreciate the problem.
Now, we also recognize that the brain and the nervous system are not as isolated as we first thought. The dysregulation is system-wide, and much of it impinges on the brain—the microbiome, inflammation, toxins, and autoimmune disease, to name a few. This kind of system-level dysregulation is the dominant issue in autism, and in the decline of mental function among the aging. So, we cannot expect to intervene unilaterally and solve the problem—despite the power and efficacy of improving brain function through neurofeedback to resolve many pressing ailments and afflictions.
It is going to take collaboration across health disciplines, though, unfortunately, that is not the way the system is geared to work.
There is yet a third level, which is that we are living in a pathological society. The warmth that one might see at the level of an extended family or church group does not exist within a supportive environment on the larger scale. The analogy that comes to mind is living in the Arctic in winter. If you have to live there under those conditions, you would want to do so with a lot of friendly company. The cohesion that is a pre-condition for warmth on the societal scale—the sense of belonging—is no longer available. We live in a society that is perniciously split vertically into political factions and horizontally in terms of wealth versus subsistence. We have the credible foreboding that this monstrosity is about to go critical—as it often has in American history. We’ve been here before, and it has always been messy.
We are living in a society that is future-blind. It has no large-scale aspirations; it has scant credible heroes as models; it has no faith in our institutions—mostly deservedly so. The only people who have future consciousness these days are the technologists. But they also lean toward hegemony, and like others before them, they believe their power and influence is entirely benign.
Imagine if the future-oriented technologists could join a bandwagon of those who understand that flexible, self-regulated, compassionate brain function is in their interests; that versatile healthy brains employ more technology in better ways and contribute to the bottom line of technological innovations.
What if the people who drive the world’s economies and politics would take a stand that brain lives matter?
Let’s envision a world in which the importance of better functioning brains is given priority—an environment where neurofeedback is recognized, promoted, made accessible, and funded.
What if:
The incredible and stark value and truth underlying the Black Lives Matter movement is that the systemic injustice and racism that oppresses black people pervasively undermines the lives and freedoms of all of us. In a society that coddles selfish human nature to care about and protect “Me and Mine,” the problems of “others” can be held at arms length intellectually and emotionally—until one connects the dots and realizes that the very system that degrades and destroys a race is insidiously attacking and robbing the rest of us, as well.
When police disproportionally harass and harm black people, it’s a direct (though not always obvious) reflection of the same system that reserves wealth for the few in a country where most cannot earn enough to subsist; where laws and attitudes discriminate against immigrants and refugees; where even many of the “privileged” also cannot access or afford adequate health care; where education and housing are becoming increasingly out of reach; where mistrust of authority abounds in the face of governmental incompetence and corrupt leadership.
The statistics on illness, death, and incarceration tell only part of the story. The iceberg below that threatens us all is pervasive dismissal, discounting, and lack of care for the integrity and biological well-being of what makes us human: our brains.
Those of us who seem “well off” consider ourselves victims when those underserved clamor of justice and equality. When we are not suffering from “their” symptoms, we view them as potentially taking away from us in order to get well or ahead. In a climate (mindset) of insufficiency, the gain of others is seen necessarily as personal loss if it’s assumed there is not enough to go around.
But insufficiency is a fallacy, covertly spread through fear and deception, co-opting mindsets socially and individually. Taken at the level of mental health and brain functioning, the symptoms and offensive behavior of “others” is their problem (and perhaps their fault and responsibility) rather than our problem and one progressively bound to afflict all of us in both individual and community dimensions.
The system that drugs and incarcerates psychotic people and that ignores the desperation of the homeless and mentally ill is the same system that prescribes addicting medications for people who can’t sleep or calm down (including those with financial resources). It’s the very system that largely ignores humane and effective treatment of anxiety, depression, and trauma.
This is the system and culture that allows brain dysregulation, frustration, and fear to fulminate to levels that unreasonably justify and express beliefs about the inferiority of others.
When we as a society recognize that brain lives matter and act accordingly with goals, priorities, policies, and resources, we will, as a natural consequence, develop and practice better health, compassion, fairness, and equity.
— Mark Steinberg, PhD
