Effective treatments to heal brain injury include the following aspects: neurostimulation, supportive guidance by professionals, intense and frequent brain training, and objective testing before, during, and after to assess and individualize treatment and progress toward the person’s goal. Specialists who effectively heal brain injury have in common:
- they understand the neurophysiological basis of brain injury;
- they understand damaged neurophysiology is what needs to be treated;
- they understand brains support brains, that is, the phenomenon of a person in proximity to another having an enhancing effect on the other’s brain function, whether that be reading, conversation, focusing, and so on; and
- they listen to the person, really listen, so that their treatment(s) will meet the person’s goals as best as possible.
Medication — The Traditional Approach
Unlike medication, effective treatments rewire. repair, and/or reset. Medication is the main modality used to treat mental illness: Ritalin, Prozac, Abilify, Clozaril, etc. But brain injury is not mental illness. And medication is for symptom management. Medication does not cure. People with brain injury are looking for a cure or as close to one as current treatments can get.
Retraining brainwaves, neurostimulating neurons and neural networks are as close to a cure as we have today.
Dr. Norman Doidge wrote in the chapter “The Stages of Neuroplastic Healing,”
“In almost all the interventions in this book, some kind of energy-based neurostimulation of the brain cells is required. Light, sound, electricity, vibration, movement, and thought (which turns on certain networks) all provide neurostimulation. Neurostimulation helps to revive dormant circuits in the hurt brain . . . Some forms of neurostimulation begin from an external source, but other forms are internal.”The Brain’s Way of Healing, page 109.
Concerns About Medication
More and more, I hear patients being concerned about medicine in tablet form, how chemical-based medicine is used, and how physicians abuse prescribing medications as a way to not see patients regularly. A person I follow tweeted this video by Jonny Benjamin:
Although I disagree with his idea that the pharmaceutical industry is using drugs to numb the masses*, he is bang on in the rest of the video. Side effects or negative effects are a huge issue for most kinds of medications, psychoactive or not, yet too many physicians dismiss these concerns – to their patients’ peril. (Some don’t.)
Patients suffering from negative effects will either doctor shop to go off the drugs or stop them on their own; or they will stay on, and gradually the negative effects will become worse than the mental illness. I chronicled my own decision to get off atenolol, without telling my doctor, because of the increasing number of problems that worsened my physical and cognitive health. We don’t tell our doctors because we know doctors will not listen to us and will argue with us until we feel defeated. We feel we have no choice but to do it on our own.
Neurochemical Bias in Standard Care
This got me to thinking about why standard medical care believes we can only treat the brain via a neurochemical modality. Physicians have gotten into a thinking rut that the only way are chemicals that affect neurotransmitters or other chemical interactions in the brain. The tablet is the modality; the ingredients in the tablet are the specific action of treatment.
This modality leads to both beneficial and negative effects because tablets/pills/caplets/gelcaps/liquids are like a blunderbuss. The chemicals go everywhere in the brain and the body, not just in the injured or malfunctioning area of the brain.
Our Brain: More Than Chemical, It’s Electrical
But the brain – our entire body actually – is also an electrical organ. The brain produces brainwaves. While neurotransmitters work locally in the synapses between neurons, brainwaves are generated along the axons of single neurons or as synchronized activity among many neurons. They are still not fully understood, but then neither are neurotransmitters. Yet physicians and pharmaceutical companies have no problem blindly playing with those. Then patients end up being prescribed medications for the side effects from the original neurotransmitter-influencing medication.
Brainwaves can be associated with particular neurotransmitters. Learning about the association between the neurotransmitter GABA and gamma brainwaves is what lead me to working with the ADD Centre on enhancing gamma brainwaves. In 2020, I experimented with audiovisual entrainment of them. (See Concussion Is Brain Injury: Treating the Neurons and Me for the original research.) In other words, one can potentially increase a desired neurotransmitter by enhancing a particular brainwave in a particular region of the brain. Neurostimulation does this.
Neurostimulation: Brain Injury Treatments
Neurostimulation is the method of retraining to effect permanent healing. The training must be frequent and intense to the point of exhaustion in order to move the brain to heal itself. Thus brain injury treatments that heal require regular rest periods and social support. All the person’s energy must go towards healing the brain during this intense period of treatment. And even after the treatments are over, spontaneous healing will occur and require increased rest.
To use the tablet analogy, neurostimulation like brain biofeedback is like a tablet; the protocols are like the ingredients in the tablet. The protocols of targetted brainwaves and electrode placements are the specific action of treatment. That’s why it may seem like an unrealistic one-size-fits-all panacea, whereas it’s really individualized medicine that works.
Direct stimulation of the brain via tDCS (transcranial direct current stimulation) includes the additional ingredients of time, current, location on the scalp, and activity during simulation. This kind of direct stimulation relies on batteries to power it. Unlike ECT (electroconvulsive therapy) or rTMS (repetitive transcranial magnetic stimulation), tDCS doesn’t overload the brain with electrical current many times greater than its own. tDCS works on the same micro-voltage as the brain’s brainwaves. The brain is both resilient and fragile. It doesn’t take much to change its electrical activity. Overwhelming it with electricity as in ECT and rTMS with all its nasty unwanted effects will, in my opinion, be seen as a relic that pointed the way to cheaper, more effective, and brain-saving neurostimulation.
Unlike medications that flood the brain, neurostimulation targets specific locations and/or specific brainwaves. Low-intensity light therapy can produce a systemic effect when placed on the neck and brainstem regions. In this case, the systemic effect is one of enhancing the body’s ability to heal instead of changing symptoms in the way medications do.
Principles of Treating the Brain
Three principles guide most techniques of neurostimulation or brain training. Most take time to see results.
The first principle is to reboot, repair, or rewire the brain.
The second principle is to train the brain to the edge of its ability through intensity and frequency of training over time with rest breaks. When training begins to become easier, increase the difficulty so as to continue to train to the edge of ability. Reassess regularly through feedback and progress discussions with the client and by using the same objective tests at the end of the treatment cycle. Exhaustion is a given, and so build in rest in between brain training sessions. Research shows learning works best with breaks in between.
The third principle is to engage in desired activity during or immediately after neurostimulation in order to stimulate rewiring of the neural networks involved in that activity.
I have observed the contrast of medications versus neurostimulation. I have met people with brain injury functioning at a much higher level than me and had done so for years. But they were being treated via the tablet and/or the strategies plus rest standard of care. After I re-started brain biofeedback for gamma enhancement, I flew past them and am now functioning significantly better than they are. We must change the current standard of care so everyone with a brain injury is offered and has access to neurostimulation.
We must change the idea that brain care is medication, surgery, or ECT only. We must advance the healing of mental illness and brain injury and improve the quality and functionality of our lives.
*It may look like numbing the masses, but I believe it’s more about physicians so familiar with medications that they cannot conceive of other ways of treating the human body. Many seem to not like being made uncomfortable through being forced to think differently. For the industries involved, there’s a profit motivation to also turn healthy variability in the human condition into diseases needing pills.