It is time to ask the question of what unifying theme or organizing principle will give impetus to a new liberal consensus. Whereas the disintegration of the conservative consensus is in view, a renewed liberal ascendancy is not yet assured. There are two possibilities in store for us. Either we encounter a crisis point in current economic arrangements that will compel a re-ordering of our economic relationships, or we will muddle on incrementally toward a new state of liberal resurgence. It is best not to hope for crisis, even if the outcome is likely to be favorable to the liberal cause. Such crises are essentially impossible to predict, except of course for their general likelihood, which is increasing ominously. And they are devastating in effect on the most vulnerable part of the population. If our national response to the global warming threat is any indication, we cannot apparently summon the will in our society to act in advance of potential crises. Politics drives via the rear view mirror. What gives rise to particular concern is that economic growth has been flogged over the years at the expense of stability in the system.
The only future we can really grasp is one that moves forward incrementally from where we are. And at the moment, we are still operating as a society on the “homo economicus” model, i.e. that the value of man is to be seen in his economic contribution, and that his happiness is to be judged in terms of material goods. We have all been recruited into the care and feeding of the “queen bee,” our economy, and no sacrifice is too dear for its continued welfare. In practice, this also means the coddling of the immediate custodians of the queen bee, our corporate CEOs. At the other end of the scale, we have come to harbor a stark pessimism regarding the lowest socio-economic echelons in our society. The prevailing view holds that it is best simply to cut our losses. The fewer resources wasted on the underclass the better.
Allow me to introduce an engineer’s perspective on this state of affairs. Engineers and physicists have perhaps a keener sense of the degree to which we are skirting on the edge of instability in our international financial systems, in our trade and other economic arrangements, and in our stressing of the natural systems on which we depend. All these systems can be analyzed as networks, and such man-made networks are not categorically stable. If networks are asked to become more sensitively responsive and quicker to react, they intrinsically also move closer to the edge of instability. And stability must be independently arranged for. It cannot be assumed.
When it comes to homo economicus, an airframe analogy comes to mind. In our single-minded focus on economic growth, all our economic engineering effort is expended on increasing engine thrust and lift in our craft, and little or no attention is paid to drag on the airframe or on the ballast that it is taking on. With increasing sophistication and complexity in our technological society, ever greater reliance is placed on the few identifiable engines of progress, with an increasing percentage of our public becoming inert at best, and a drag at worst.
The case can be made that even within the growth model of homo economicus it pays us to reduce the ballast and the drag on our virtual airframe. And if such a challenge were deemed both doable and worthwhile, we would see a pragmatic convergence of the liberal impulse toward egalitarianism and social justice with the cold-hearted utilitarian perspective of the Chicago School. Consider that our society has at present essentially written off the children who struggle through special education, unemployed black youth, the kids that end up in the juvenile justice system, the children who graduate out of foster care, the drug-addicted, those who remain on welfare, those who suffer from any kind of mental disability, and of course the homeless. Murray and Herrnstein’s book “The Bell Curve” gave absolution to the conservative impulse to refrain from throwing good money after bad. The folks in the nether tail of the distribution are simply a lost cause.
Even the utilitarians cannot ignore the fact that these non-contributors are not inert, but rather cost the society dearly. (Example: a juvie graduate in Utah typically costs the state $50,000 per year over the subsequent five years.) Suppose it could be argued that we now have a technological remedy for social and educational failure, as well as for the problem of addiction and criminality? Then both the principled liberal position and the utilitarian case converge to mandate that the remedy be implemented forthwith on a grand scale.
In what is assuredly becoming the biological century in scientific research, the most far-reaching developments will likely relate to brain function. Already it is clear that we are justified in having high expectations for the neurotechnologies over the near term. We don’t even have to wait for exotic new technological developments, as we do in the case of stem cells and genomics. We don’t have to wait for implantable chips or fancy new brain-computer interfaces. It turns out that our brains can be coaxed to function better with simple technology we have available today. The brain lends itself readily to training techniques that enhance its function, and these techniques turn out to be rather straight-forward.
There already exist a number of isolated initiatives in which school dropouts and juvenile criminals are systematically turned around with quite conventional means, and on a timescale of a year or less. The addition of the new technologies of brain training should reduce the time, effort and cost considerably and make the outcomes even more predictable. The addition of brain training to state-of-the-art addictions treatment has already increased the success rate from the nominal 25% level to some 75% (criterion: relapse-free after one year). The provision of brain training to violent criminals has shown reductions in recidivism from the typical 65% level to the order of 20% (over three-year follow-up). IQ increases of up to 40 points have been demonstrated among the mildly mentally retarded, although results in the range of 15 to 30 points are more typical. Mental retardation is simply no longer a life sentence. Down Syndrome children can be substantially helped, as well as autistic children.
It is now possible to target specific learning disabilities with brain training and essentially normalize performance in children and adults. Benefits are also being seen in the mental afflictions of the elderly—dementia and Parkinson’s. Postponing the onset of Parkinson’s symptoms by even two years would aid the national economy by $50B. If this service were privately delivered on a fee-for-service basis, it would cost more than $2B. On the other hand, if the service delivery were socialized, costs would be lower by perhaps a factor of two.
Many people are already availing themselves of these new capabilities on a private basis. We estimate that more than 100,000 people are undergoing brain training annually at this time here in the US, with a growth rate of perhaps 30% per year. But the larger societal need cannot be met in this fashion. There is a huge mismatch between those who most need the training and those who can afford it. The stressed-out, neglected, demoralized, and resource-poor underclass needs direct, subsidized, socialized intervention. The case for doing so can be made either on principled or on rational cost-benefit grounds, and it is compelling either way.
Just what has given rise to this breakthrough in brain-based therapies? It all goes back to one of the great historical controversies in the neurosciences, namely whether understanding is to be sought in “soups or sparks.” Is the brain to be thought of as essentially a neurochemical construct, or must it be understood in its bioelectrical functioning? The synergy between psychiatry and Big PhRMA has strongly biased our brain research in the direction of neurochemistry. The much more important frontier of what actually happens in our neural networks has been relatively neglected.
The success of psychopharmacology merely hints at what is possible when we also understand and learn how to influence the regulation of our neuronal architecture. As a Newsweek reporter put it poetically in discussing childhood depression: “The real goal of treatment is not to alter the brain chemistry but to repair its blighted circuitry” (Dec. 8, 2003, p. 69). So we are back to our favorite topic of networks….and of stability. Can our neural networks be trained to function better, and more stably? Apparently so. And if the answer is yes, then the implications are huge and they have immediate implications for policy. Even if the reader is inclined to reserve judgment on these early research findings ---which would be quite understandable---there is as much reason for optimism here as there is for stem cell research and genomics, for which there is even less tangible support at this time.
The emerging thrust toward “behavioral economics” has already revealed that our vast economic gains since WWII have not particularly made us happier. Our societal happiness has not improved since the late 1950's. This point is also charmingly made in Bill McKibben’s new book, Deep Economy. As we encounter natural and man-made limits to growth, we may come to terms most easily through an adjustment in our values. The material aspect here is actually the easy part. The quickest path to happiness is the practice of contentment with what one already possesses.
The harder part has to do with the more radical uncertainties we face in our modern lives—through family crisis, career-related uncertainties, or major health calamities. Cumulatively we seem to confront a more varied risk profile in our lives than did prior generations. At the same time, we seem to be living with less satisfactory “network relations” with family and friends. Remarkably, the British who lived through the London Blitz may well look back on that as the best time of their lives. That ordeal was the flip side of what we are living today, a life of material abundance on the one hand, and of stress, crisis, or dearth in relationships on the other.
Can the new brain technologies be helpful here? Indeed that appears to be the case. Brain training can directly train our emotional capacities and hence build and reinforce our propensities toward relationship. The first thing that happens with the brain training is the emergence of a more secure and grounded self. The self makes peace with itself, so to speak, and that more confident and secure self is then more capable of engaging in and sustaining relationship. We will have trained the brain toward an intrinsic, genuine, and inalienable happiness…
The most obvious application of this kind of training is to the sociopath who is insensitive to the needs of others, or to the psychopath who is completely incapable of feeling remorse. Imagine if these characteristics were essentially aspects of neuronal network dysfunction, and that such dysfunction could yield to targeted brain training! Imagine if these features were not the true manifestation of the self at all. Our entire criminal justice system would be revolutionized. We would be oriented toward avoiding failure rather than merely adjudicating after the event.
Even going back all the way to the McNaughten Rule our Anglo-Saxon jurisprudence recognized that one cannot hold a person of diminished mental capacities fully to account for his criminal behavior. What happens now if the diminished capacities are directly observable in the emotional realm? Intellectual capacities turn out to have very little relevance to the capacity for moral judgment. Our emotional capacities have everything to do with it. What then do we do with the person who can think but who cannot feel the pain of his fellows? The one is just as much a matter of brain function as the other.
Consider the Salem witch trials. The women were challenged on moral grounds when in fact they had been poisoned by ergotamine contamination of rye. We now look back on their treatment with considerable revulsion. If truth be told, however, in most of our system of criminal justice we remain in a Salem-like state of mind. We hold people morally responsible for what in many cases is the consequence of brain-based dysfunction. The moment our society appreciates this new finding, the burden shifts to the society to help the emotionally crippled as well as the intellectually handicapped. This does not mean that we turn more criminals loose. It does mean that we must help them, if for no other reason than that most criminals will be released sooner or later in any event. If we have a good shot at aborting a criminal career, we should make the attempt. We are developing the tools to do so. The moment a remedy for such catastrophic dysfunction becomes available, it creates a moral obligation for us all---one that happens to align nicely with our clear self-interest.
The most common application of brain training, however, will be to the ordinary family subject to the common stresses of ADD children, out-of-control adolescents, the burden of the failing elderly underfoot, parents at the edge of burnout, domestic violence, excessive drinking, and suble mental health issues. Once brain training becomes a possibility, it should become as readily and universally available as education for our brains. The issue of brain function should be antecedent to the issue of brain content. We should cultivate the capacity to learn before we attempt to teach. For the first time in our human history we are in a position to have a meaningful discussion on these topics. The whole field of education will finally be ushered out of its pre-scientific age.
A lot of social issues satisfy Pareto’s rule, which observes that for many phenomena a small fraction of a population accounts for the vast majority of the impact. The concentration of wealth fits this pattern, but also the distribution of crime, and the cost to society of the homeless. Only a small percentage accounts for the bulk of the social costs. In a remedial strategy, we would know on whom to focus. Matters are different if our strategy is preventive. Since we cannot predict who the bad players will be in life, we must simply offer everyone the opportunity to train their brains. This is just another way to argue that moral considerations, high principle, and sober cost-benefit analysis take us to the same pragmatic place. Brain training should be made universally available, even if public resources are required to bring this about.
The marvelous growth of our domestic economy during the nineties was most likely due in large measure to the fact that our huge investment in computer technology finally paid off in productivity. The breakthrough was in network connectivity, as provided via the Internet starting around the mid-nineties. We now face the prospect of an even greater leap in human capacities through the targeted training of our internal neuronal networks. Again, the issue can be seen as the management of connectivity, and this appears to be accessible to us in brain training.
The well-tempered brain can hold its state; it can deploy its resources at will; it can direct its attention; it can manage and contain its emotions or, on the other side, readily express them; it can summon the will and reign in its unruly impulses; it can easily commit things to memory and have them accessible to subsequent recall. All this is now becoming directly trainable.
In the social sciences the phenomenon of resilience has received considerable study since WWII. Even children raised in dire circumstances often go on to success, whereas most of their cohort succumbs to failure. The key factors accounting for the successes have been identified. The successful children have “good enough” looks, “good enough” intelligence, “good enough” academics and reading, an outgoing personality, and most importantly, the capacity for establishing and maintaining a significant adult relationship that anchors their self-regard. The relevant factors are largely accessible to us now for remediation.
One key impetus to the current happiness research being conducted by psychologist Martin Seligmann and others is that the mental health industry has to date really been oriented toward mental illness. It is not about mental health at all, but rather about the absence of overt mental illness and related dysfunction. In application to, say, suicidality, the thrust toward brief therapy means the process ceases the moment the person stops actively trying to kill herself. There are clear problems with this health care model, but the most obvious flaw is that most individuals will resist being labeled and hence most mental dysfunction remains untreated unless the person does, finally, spiral down into crisis.
Not only will the returning soldier from Iraq resist being seen as a mental case, but even the homeless person on the street, though floridly paranoid, will do so also. We must turn this around and work out of a wellness model, since this corresponds with how people generally see themselves. Everyone must be given the opportunity to train the brain. They should not have to qualify by personal failure. The technique must not be seen as predominantly remedial. This can only occur through incorporating brain training into our education much as we incorporate gym class. This is brain training, not brain medicine or psychotherapy.
What can the society hope for in the near term if what we currently know were to be immediately exploited? No more prison over-crowding in California; a vast reduction in medical expenditures by the Detroit major auto manufacturers for their large pool of retired and active workers; a reduction in special education costs for warehousing our learning-disabled children; a reduction in the growth of Medicare expenditures; a decline in the closeting of our elderly in nursing homes; and substantial inroads into the problem of addiction. The continuing decline in the mental health status of our children can be reversed. Major impact is anticipated on the epidemic of autism among our children.
On the more positive side, we would see a real increase in perceived personal happiness, and in the quality of our social relationships. Barriers to personal productivity would be lifted, with a payoff for on-the-job productivity. Improved cognitive function would mean people could work productively into their later years. People would live their lives in a state of fuller awareness of themselves and of their significant others. Those who posses a spiritual impulse or lead lives of faith will likely find their religious practice enriched and their spiritual experience deepened.
The very existence of this capability of brain training changes the terms of debate. It alters the political landscape because it brings in train a compelling mandate. It underpins a liberal agenda to deploy the powers of government benignly and positively to enhance personal efficacy and to secure the potential for happiness for our citizens and ultimately throughout the world.
Those of us who have had the privilege of working with these techniques over the last few years often encounter clients who regard their own recovery with some trepidation even as they are grateful for it. They know that their new functionality will alter the expectations of everyone around them. New demands will be placed, and expectations will ratchet up. There is something just a bit unsettling about the fact that so much of what we know about ourselves turns out to be so malleable and so subject to our own will and discretion. As therapists we have come to accept this kind of ambivalence when it surfaces as a natural part of the process. But we hasten to reassure people that what emerges is a matter of growth and fulfillment, not of alteration. Brain training is not the neurological equivalent of cosmetic surgery. People are put in a position to exploit their potential; they don’t alter their essential natures.
A word, finally, about how this all actually comes about. We observe the dance of the neuronal assemblies through our EEG. We reward the brain for its good behavior, and we cue the brain with respect to slippage into adverse behavior. All is done with straight-forward reinforcement strategies. This amounts to nothing more than behavior mod at the level of the brain, only we work at a level far below where these brain events have obvious behavioral fallout. It’s the equivalent of teaching our children table manners so that we don’t have to make bail years later. The most prominent technique among the emerging neurotechnologies is known as EEG feedback, or neurofeedback.
I hope that this article radiates the optimism with respect to our human potential that is continually reinforced in us as we pursue this work. Such optimism may be helpful to revitalize the liberal agenda into an encompassing, comprehensive deployment of our governmental resources for such a positive societal purpose. And even the most cold-blooded and heartless of utilitarian capitalists should be pleased with these developments as well.
Siegfried Othmer, Ph.D.
