A Call to Arms
Author: Dr. Siegfried Othmer
It is now estimated that some 17% of
soldiers returning from Iraq and Afghanistan are plagued with
lingering mental health issues that are not being well met within
the VA system. Even if the intention were there to address these
issues, the capability is not---neither financially nor technically.
As we know, the reaction of the Veteran’s Administration to the
work of Eugene Peniston was to move him to a desk job in Bonham,
Texas, there to await his retirement. That is how management deals
with inconvenient facts, and how established power snuffs out
innovation. But we can help from where we sit.
There is an opportunity here for us, but
also a real challenge. Since medical care is supposed to be available
at no charge to our veterans, the government sets the bar on pricing
irrespective of whether the required service is actually available.
We have no choice but to meet the government’s price point. I
therefore suggest that we collectively offer to treat veterans
with neurofeedback at no charge. The most needy veterans right
now are estimated to number around 2,000. That’s less than one
per neurofeedback practitioner in the country, a number I estimate
at about 6,000. But perhaps only about a third of practitioners
will end up participating in this venture. On the other hand,
not every veteran in need will actually arrive at our door. I
expect that things will sort out in a way that each practitioner
may end up with one or a few soldiers to work with. A practitioner
may offer to treat just one at no charge, or perhaps just one
at a time. In that manner, excess demand can be handled with a
waiting list.
If there is interest in this among our readership,
then we will try to promote this offering through a national campaign
with paid news releases and notification on our respective websites.
I would also try to draw in sponsorship from the professional
organizations, the AAPB and the ISNR, and from the major practitioner
networks (Thought Technology, J&J, BrainMaster, NeuroCarePro,
Roshi, LENS, BioExplorer, ESII). Rob Kall at FutureHealth may
lend a hand as well with publicity through his OpEdNews website.
Let us know how you feel about this through
our on-line poll on the Bulletin Board:

A Letter from the Incoming President of the
AAPB, Richard Sherman:
Some excerpts:
Another issue we need to address is just
how much emphasis we want our association to put on "mind-body"
concepts. We have already included the statement "an international
society for mind-body research, health care, and education"
in the banner of our web site and all of our letterhead materials.
We are adding the ability for people searching the web for "mind-body"
to be directed to our web site. Suggestions on how much more to
do vary from offering more professional training and conference
time on the topic to actually changing the name of the Association.
Share your opinion with me.
Write to Richard at rsherman@nwinet.com
Through your answers to surveys, etc.,
you, our members, have declared your belief that applied psychophysiology
/ biofeedback is a profession. Until the profession is recognized,
it will be very difficult for its professionals to practice. Certainly
we won't be licensed and independent practice with reasonable
compensation is not easy. The question is how to proceed. Once
again, we need your ideas! Please send them to me so your board
can begin a program of implementation.
This brings up the topic again of the future
of the profession that I raised in the newsletter just prior to
the AAPB meeting, and again afterward. As it happens, the appropriate
place of home use of neurofeedback, and the necessity of supervision
of remote use, is a current hot topic on one of the public lists.
On this occasion, I would like to write about
the fate of unlicensed practice in the event that licensure in
biofeedback/neurofeedback were to come about. Will there be a
continuing role for the unlicensed practitioner even as the field
matures? This topic concerns me not only because of the significant
number of people in our readership who fall into that category
but because of the fear that the strait-jacketing of licensure
will hinder innovation. Finally, this represents for me an over-riding
civil liberties issue.
The theme of civil liberties draws me back
to the dramatic gesture by Mahatma Gandhi of placing a glass of
seawater over a candle in order to evaporate the water and extract
the salt. He did this in order to ridicule the British monopoly
on salt production in India. The British were not amused. They
had to mount a response to this insolence, so they hauled Gandhi
off to prison. But we know who won in the end. Self-regulation
is similarly accessible to the man in the street. One does not
need a license to instruct someone in the breath, in paced breathing,
in abdominal breathing, in over-breathing. One does not need a
license to instruct in the regulation of finger temperature using
common thermometers available at a gardening or hardware store.
One does not need a license to instruct someone in the regulation
of galvanic skin response using a cheap ohmmeter from Radio Shack.
Or the GSR-2 for that matter. These are surely matters that will
be part of the common property of all mankind. They cannot be
effectively restricted. Call this the “reductio ad absurdum”
argument for the unlicensed practice of self-regulation procedures.
There is also the Australian model to consider.
Last year the regulatory body determined that restrictions on
what licensed professionals could do with neurofeedback/biofeedback
were appropriate at this stage, but no such restrictions would
apply to individuals. So citizens of Australia were free to avail
themselves of this technology to their hearts’ content. This provides
a kind of escape route for us as well. Operation of the relevant
instrumentation could be left entirely to the client. This may
be particularly helpful in states such as Massachusetts, where
psychologists may not touch their patients as a matter of law.
It may also be an escape hatch in New York, where restrictions
on the practice of biofeedback are contemplated, or in Florida,
Texas, and Utah, where such limits are already established in
law.
We will shortly be in a position to deliver
neurofeedback services over the Internet, so that the clinician
need not be co-located with the client, or even in the same state.
This will allow a breach of all attempts at local regulation.
Licensure is at this point entirely a matter of State regulation.
Corporations registered in Delaware for their own convenience
can wreak mischief all over the country without impediment. And
credit card companies locate in Nebraska for the same reason.
Laws there favor them, and they are not hindered by other State
laws when operating in other states. Similarly, anyone operating
legally in California, where alternative health procedures by
unlicensed professionals enjoy legal protection, can serve the
entire nation without sanction.
We are also witnessing the breaching of the
boundary between therapy/training and entertainment, in the development
of SmartBrainGames. No one will insist on a mental health professional
standing by as the child plays a video game. Yet learning is taking
place, and functional adaptation of neurophysiological mechanisms
is being promoted. It does not seem likely that this development
will ever be reeled back in and strait-jacketed through regulation.
Finally, if all else fails there is the L.
Ron Hubbard remedy of embedding the self-regulation strategy in
a more encompassing model of religious or spiritual practice.
I suspect that Hubbard was well aware that he was beyond the reach
of the regulatory bodies if he placed his GSR instrument, the
E-meter, within an overtly religious context. So our final refuge
also lies in the free exercise clause of the second Amendment.
The largest potential applications of neurofeedback
will ultimately be outside of the clinical setting entirely—in
education, in sports, in the corporate world, in entertainment,
in optimum performance, and in enhancing spiritual practice. We
want to be at the heart of things, where things are flourishing
and unfolding, not merely at the margins where things break down.
This takes us entirely out of the realm of procedure, of diagnosis,
of reimbursement through conventional channels, even of established
norms of doing the work. We are only beginning to move down this
path. Our contribution will be in terms of knowledge transfer
and professional guidance and coaching rather than in terms of
being the gatekeepers to life-altering potentialities.
Comforted in the knowledge that such escape
routes exist now and will continue to exist, I can look at licensure
in terms of its positive aspects: enhanced stature of the field;
organized pathways of professional education; improved reimbursement
environment, etc. But the process scares me. The ISNR both here
and in Australia saw real fissures around the issue of professional
ethics, certification, and entitlement to membership. The battle
around licensure will inevitably fracture the community even more,
if that is possible.
The Internet flourished as it did because
it was a commons with easy access. Self-regulation is similarly
accessible to every man. It is not intrinsically costly. It is
a non-rival good. As Thomas Jefferson said, if you take light
from my taper, I have no less. Much of self-regulation consists
simply of knowledge that is easily promulgated. That is our role,
both as licensed and as unlicensed professionals.
Dr. Siegfried Othmer
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