I do training, not treatment.
What's the difference and why does it matter?, you might ask.
The difference between training and treatment is diagnosis.
There are two kinds of diagnoses these days:
One type of diagnosis is prescriptive. Getting a specific diagnosis implies a certain kind of intervention. In this context, diagnosis can be useful (or not -- a lot depends on the quality of the diagnosis and the diagnoser. (Is that a word? Oh well, you know what I mean...) Example: a diagnosis of pernicious anemia means you need vitamin B12.
The second type is descriptive. Not very useful in my opinion, except as a shorthand communication between professionals. Descriptive diagnoses are simply jargon-ized labels for describing a set of symptoms that tend to appear together. They give little to no information about the cause of the problem(s) or the best intervention and, for our purposes in this discussion, we're going to ignore them.
In all honesty, before the new year, I wrote an article for this blog about "ADD" as a descriptive diagnosis that people think means a lot and actually tells very little except for its use as shorthand. Then I decided it was a bit of a rant and didn't post it. Who knew the New York Times would feature a similar concern in an article on 2 January 2007 called What's Making Us Sick is an Epidemic of Diagnoses . Here are some snippets from that article that mirror some of my own concerns quite accurately (I've added the emphases):
"This epidemic [of diagnosis] is a threat to your health. It has two distinct sources. One is the medicalization of everyday life. Most of us experience physical or emotional sensations we don’t like, and in the past, this was considered a part of life. Increasingly, however, such sensations are considered symptoms of disease. Everyday experiences like insomnia, sadness, twitchy legs and impaired sex drive now become diagnoses: sleep disorder, depression, restless leg syndrome and sexual dysfunction.
"No one should take the process of making people into patients lightly. There are real drawbacks. Simply labeling people as diseased can make them feel anxious and vulnerable — a particular concern in children. But the real problem with the epidemic of diagnoses is that it leads to an epidemic of treatments. Not all treatments have important benefits, but almost all can have harms. Sometimes the harms are known, but often the harms of new therapies take years to emerge — after many have been exposed. For the severely ill, these harms generally pale relative to the potential benefits. But for those experiencing mild symptoms, the harms become much more relevant. And for the many labeled as having predisease or as being “at risk” but destined to remain healthy, treatment can only cause harm.
"As more of us are being told we are sick, fewer of us are being told we are well. People need to think hard about the benefits and risks of increased diagnosis: the fundamental question they face is whether or not to become a patient."
But back to our main discussion....
A prescriptive diagnosis points to an intervention(s) that will address that disorder in particular. The most familiar model for this is medical diagnosis and medications. High blood pressure? Take blood pressure lowering medication.
You also see it in herbal medicine, homeopathics, acupuncture, and neurotherapy (i.e., neurofeedback used in a treatment model), etc. Different approaches are used for different disorders.
Neurofeedback, as I apply it, is not a treatment. I do not use a person's "diagnosis" to decide what techniques might be useful for them, to target specific brainwave frequencies, etc. I do ask them to make sure that there are no acute conditions they need to be addressing while we are working and I work with other professionals on their team to do that.
This means that I don't have "patients". I work with people who are interested in moving ahead in some area of their life. I do use the person's goals to help them decide which technique might be preferable to them. But if, for example, they want to develop better attention, I don't care whether their attention frustration is the result of "depression" or a "sleep disorder" or "ADD" or working as a flight controller that needs perfect attention, I will provide the training in the same way. (I work differently with every person, but that's a different thing.)
To grow and evolve is most often not a matter of finding out what's wrong with us...it's a search for what's right and how to increase that. And that's what I see as the opportunity of neurofeedback.
