Neurofeedback and Society
By Siegfried Othmer, Ph.D.
One senses that incrementally we are approaching the time of general acceptance of neurofeedback. It is something we’ve been looking forward to, but just as it is difficult to picture any kind of heaven where one might actually wish to spend eternity, we have difficulty picturing that blissful future. The goal has been an abstraction, and as we think about it, we realize that even the greatest success for the field that one might imagine may still not represent a state of bliss—except possibly in the hearts of those who helped to bring it about.
Our complex human natures assure that as new turf opens up on which proprietorship can be asserted, there will inevitably be contentions about the new real estate, the intellectual property, the scientific pecking order, and the codification of right belief about the new discipline. We have already seen this at every point in the development of the field, and this tendency may only get worse for a time as economic enticements increase.
If we cast about for examples from the past that might help us here in the projection into the future, there are some breakthroughs that are epochal and singular, and there are other scientific breakthroughs that may be comparably epochal, but they are more universal and diffuse. An example of the former is the Salk vaccine, where we can identify a moment in time when our society transitioned from polio being a scourge for which there was no remedy to one that could be readily prevented. This breakthrough will always be attached to the man that produced it. An example of the second is the recognition of the importance of personal hygiene and sanitation in public health. No single factor was as significant in the improved health prospects of our citizenship during the past century than the movement toward sanitation, clean water, proper sewage treatment, etc. There is no famous name like Salk attached to this far more significant, but mundane development. At this point, we can no longer assign paternity.
Neurofeedback is in the latter category. It emerges out of an understanding of the brain that is going to become universal, much like the “chemical deficiency” model of mental illness is now, and this understanding will underpin so many new developments that it will rival the revolution of public sanitation in terms of overall impact. But just like with the earlier example, the idea will become so pervasive, and it will surface in so many guises, that paternity will become obscure. Our grandchildren will be unable to imagine a time when these ideas were not understood.
Given the universality of the concepts that we are appealing to in neurofeedback, it seems like a huge waste of effort, and a hindrance to progress, to keep putting up “No trespassing” signs on aspects of this emerging reality. Jonas Salk even thought that way about his own breakthrough. He saw himself as the fortunate scientist who had come along at the right time to meet this opportunity. “To patent the vaccine would be like patenting sunshine,” he said. Even I would disagree with him on that count when it comes to the Salk vaccine, but when it comes to neurofeedback, the sunshine analogy holds.
As a society, we would not dream of limiting sanitation access only to those who can afford it. It is a public good, for the benefit of everyone alike. Similarly, education is a public good, and one’s entitlement to it is not in question. Neurofeedback should be seen as a public good much like education. If there is a simple and accessible means by which people can make the central nervous systems more stable, functional, competent and serviceable, then this should not simply be dispensed to the elite on the basis of affordability.
We have a situation, unfortunately, in which the need for neurofeedback is not at all correlated
with the capacity to afford it. In fact, an inverse relationship more nearly applies. That is
where the society must step in to meet the need of the population at large.
There is still a role here for the private sector. The school system is a case in point. We still
have private companies serving the needs of the schools---construction companies, book publishers,
etc. But our society guarantees free access to education, and it should at some point also assure
access to neurofeedback.
This obligation may actually be more manageable than it might seem when we reflect on neurofeedback training programs costing thousands of dollars per person. At nominally $2000 per person, the national neurofeedback budget would be $600B, which would exceed the current budget for the national defense. We could actually make the case for that, but it would be pointless. Even a $2000 expenditure pales beside the public cost of educating a child through twelve grades of schooling (about $100K). A cost-benefit analysis of the social costs of addiction, of academic failure, of the prison system, of persistent unemployment, of eldercare, and of family strife because of emotional trauma and other mental health issues would make a universal neurofeedback program a bargain. But the argument would still remain pointless. Our society is not going there on the mere basis of a cost/benefit argument, even if it were to be convinced intellectually.
Universal access to neurofeedback will require an entirely different approach to the problem of service delivery than the current fee-for-service model. In thinking about this problem, my point of departure is the key word in biofeedback, which is “self-regulation.” Success in neurofeedback means that the competence has been transferred to the trainee. This must be true at two levels. Firstly, the brain owns its own acquired competence. But secondly, through the neurofeedback process the person also gains an understanding of the enlarged scope of our personal autonomy that may be gained through self-regulation. The technique raises one’s horizon on one’s own potential. Barriers to personal engagement fall away because of an enlarged sense of empowerment. It’s difficult to square this need to diffuse understanding broadly with the desire to compartment this kind of expertise within a professional cadre.
In order to reach its full promise, neurofeedback has to be framed not as a therapeutic intervention primarily but as a natural part of the educational process, in this case one targeting our own internal regulatory regime rather than our academic or intellectual potential. Our capacity to improve the self-regulation of our own biological functions must be part of the knowledge base of every child. With it will come an enhanced sense of responsibility for the self, something that has been undermined by our emphasis on genetic causation and utter dependency on medical interventions. The near-term benefit for our society and the world at large could well be comparable to the impact of the computer and Internet revolution. But the impact would be qualitatively different. We would be helping with the most intractable conditions that retard our societal progress, and we would be creating a more humane society.