Wednesday, March 22, 2023

Comments by Ethan

Showing 4 of 4 comments.

  • Yes. Interesting. I have been pondering this very issue myself recently. One does observe that so many individuals suffering from depression or other “mental illnesses” stay on the psychiatric treadmill despite its manifest failure to help them in any way, even after years or decades of failed medication trials. They seem to resist any suggestion that they would want to try another approach. Why does it not occur to them that there might be a flaw in the system? I suspect that there is already something in the highly structured rigidity of modern life that induces a sort of passivity in many people that in turn leads to mental distress. Psychiatry further reinforces and exploits this passivity as you’ve laid out here.

  • I find this very interesting because I have some experience with neurofeedback both as a patient and as a practitioner. I want to make clear that “brain injury” (as mentioned above) is not an adequate explanation for whatever happened to you. “Brain injury” suggests organic injury and neurofeedback is purely functional in its effects. There is nothing physically impinging on the brain, no magnets, nothing, except the information that is returned to the brain regarding its own behavior, usually through some sort of computer display. It is a form of biofeedback. Also, the article posted above about adverse effects from neurofeedback does not describe anything similar to your experience. Without knowing more about your case it is very difficult to make any kind of evaluation of what happened here. Neurofeedback is an extraordinarily powerful modality that is underutilized relative to potential benefits. Yes, with its great power comes some risk. My fear is that some will take your cautionary article as a blanket condemnation of neurofeedback (as has already happened in this thread).
    Bessel van der Kolk who is an expert in the treatment of childhood trauma said this of neurofeedback’s effects “There’s nothing I know that can do that, When you see something like that, you pay attention. Can my psychoanalysis do that? Can my acceptance and commitment therapy do that? Can my friends who do EMDR or Somatic Experiencing do that? No. Nothing I know of can do THAT. Time to learn new things.”
    “Don’t hire just any provider. A neurofeedback practitioner with 1. Five-ten years’ neurofeedback; 2. A certificate from or; and 3. Familiarity with attachment issues, is a good place to start. A good neurofeedback therapist won’t do “one size fits all.” Ask to be sure that they carefully adjust it to each individual and keep re-adjusting.”

  • Interesting thoughts on systemic change. It occurs to me that insurance companies have 90% of the data you need for your mapping project. But having completed the mapping, where do you go from there? You say “We could then match their current practice to what unbiased research showed was most effective in the short-term and long-term outcomes.” What do you expect to find by this comparison? What is “most effective in the short-term and long-term outcomes”? You anticipate that “the actual costs and ineffectiveness of these drugs become apparent” but how will this happen? The mapping will show costs, but how will it show effectiveness or ineffectiveness? And even if the mapping can show relatively low cost-effectiveness, you would need to be prepared to present a better alternative. What would that look like? You say ” a strong case can be made for savings over the long term by a more conservative approach to using drugs”. What is this case based on, and could we not make the case without the mapping? I think the “map of alternatives of handling mental health problems” is going to be the key here. Do we have such a map?