Neurofeedback: Fact or fiction?

Psychiatrists disagree about a lot of things, but one thing they almost all agree on is that psychiatry is a branch of medicine. One implication of this belief is that stigma against mental illness or seeking treatment is unjustifiable. Just as there is nothing embarrassing about having pneumonia or rheumatism, there is nothing to be ashamed of when you seek help for anxiety or depression. That’s all to the good, but it’s also the case that conceptualizing psychiatry as a branch of medicine has the effect of legitimizing psychiatrists as a profession. Just as when you have a problem with your heart, you go to a cardiologist, when you have a problem with your mind, you go to a psychiatrist. Trust us, we’re the experts.

The problem is that in certain respects, psychiatry is radically different to any other branch of medicine. Look at the parallel I made in the first paragraph: cardiologists look at the heart, psychiatrists look at the mind. We’re so used to this kind of comparison that we forget there is a massive difference here. The heart is an organ: you can find it, measure it, and, in surgery, you can touch it too. The mind … isn’t. So, when we say that psychiatrists treat the mind, what we probably mean is that they treat the brain, but there’s a reason we don’t actually say that: they don’t. As the controversial telepsychiatrist Daniel Amen puts it, psychiatrists ‘remain the only medical specialists that rarely look at the organ they treat.’ Dr. Amen’s brain scan methods are controversial, but there is no doubt that he has identified a clear problem with the mental health industry today.

The talk therapy – medication dichotomy

The reason why mental health lags behind other areas of medicine is that it is split into two wings, which approach the mind-brain dichotomy from two different angles. Talk-therapists work very much on ‘the mind’ using conversation to uncover how the client’s thoughts are interacting with each other and find ways to change distressing or destructive thought patterns. There’s no doubt that talk-therapy has come a long way over the past hundred years. However, there’s also no doubt that it is as much an art as a science. Success in therapy depends on highly subjective factors like how well the therapist’s personality meshes with his or her client. There are, literally, dozens of ‘therapeutic modalities’; some seem to work better with some people than others, but there’s really no way of knowing which will work for you until you try them. Successful therapists rely as much on their intuition in deciding how to proceed as scientific considerations.

The other side of the coin is medication, which is supposed to go right to the heart of the problem in the brain. However, when psychiatrists prescribe medication they may be affecting the brain, but they are still treating the mind. No-one who is prescribed antidepressants has a brain scan first. Instead, the normal procedure is to answer a series of questions about how you are feeling, which add up to a ‘clinical evaluation’. Moreover, even if psychiatrists started using brain scans it wouldn’t help them choose which pill to prescribe because while pharmaceutical trials indicate that they work, it remains entirely unclear how they work. Many people have heard something to the effect that antidepressants work by fixing a chemical imbalance in the brain, but, after decades of trying, research has not demonstrated that any such thing exists. Once billed as the scientific revolution in psychotherapy, the truth is that prescriptions are more like a calculated stab in the dark. That might be less concerning if it weren’t for the long list of serious side effects known to be caused by psychiatric medication, including weight gain, impotence, insomnia, and even suicide. Unsurprisingly, many wonder if there isn’t some alternative.

Neurofeedback: the next generation?

Neurofeedback is a relatively new technique, which can bridge the gap between existing forms of mental health treatment by working on the brain directly, but non-invasively. At the start of a session, the therapist will place electrodes on your scalp. That might sound intimidating, but they are just there as sensors – there are no electric shocks to worry about. These sensors then transmit information about your brainwaves to a computer, which displays them on a screen. As you watch this ‘movie’ play out on the screen in front of you, you are also interacting with ‘brain training’ software. Your therapist will guide you through the different stages of the software, adjusting the reward settings as you make progress.

At the end of the first session, you won’t feel much of a difference, but you will feel a little tired, as if you had gone for a medium-length jog. That’s because Neurofeedback is essentially structured exercise for your brain. Just as with physical exercise, you’ll start to notice the effects after a few weeks of keeping up the routine. Positive results include feeling less anxious, reduced stress, being able to cope better with adversity, and a more cheerful mood. Neurofeedback is used to treat a range of conditions, including insomnia, depression, and memory loss. It has been found to be particularly effective in the treatment of learning disorders, anxiety, autism, and ADHD.

So, does Neurofeedback point the way to the future of mental health treatment? Only time will tell, but one thing for sure is that more and more people looking for a safe, effective alternative to Ritalin, Prozac, and Xanax will be giving it a try.

Jennifer WillemsenJennifer Willemsen, MA, LMFT provides therapy to children and adults in Los Angeles, Miracle Mile, North Hollywood, and Corona, California. Visit her website, enjoyabletherapy.com, to learn more about how she can help you and your family.

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