Brain Dysfunction: we've all got a little something

What we now know as ADD/ADHD was originally called MBD, minimal brain dysfunction. Many of us in the mental health profession, along with teachers, were aghast: normal kids who had some problem sitting still and paying attention were being labeled as having defective brains! The ‘cure’ to this problem was to be found not in better schools, smaller classes, better diets, more physical exercise, but Ritalin, a form of speed that appeared just in time.

I’ve now come full circle on this issue. The identification of ADD/ADHD as a problem residing in brain dysfunction, not in the psyche, that is, not having psychological causes, was the beginning of what I now see as an entirely new understanding of our selves. Previously it was thought that the kid who wouldn’t sit still was ‘acting out’, that is, there was some psychological meaning and origin to his behavior. The advance represented by the MBD label was the recognition that not all behavior originates in the psyche, that is, in the realm of thoughts, feelings and experiences derived from childhood.

Next was autism. Originally it was thought that this originated in some problem interacting with the mother (as did all psychological problems in psychodynamic theory). Now that the rate of this disorder is far greater than it used to be, it’s also generally accepted that it represents a systemic breakdown, not a psychological problem.

In my opinion, neurofeedback reveals that this recognition of a non-psychological realm, a realm of systemic order and disorder, needs to be vastly expanded. Anxiety, panic attacks, enuresis, nightmares, stuttering, obsessive-compulsive disorder, to some extent depression, all thought to have psychological causes represent systemic dysfunctions that may not have their origin in the realm of the psyche.

While I welcome this recognition of ADD and autism as representing this systemic realm, the problem is that the prevailing understanding has taken the form of what I call the microbial theory of disease. Behavioral and psychological disorders are seen as specific disease entities and as requiring specific medications for their ‘cure’. Images are invoked of the scientist in the white coat holding test tubes. One has the pathogen, some microbe, the other has the cure, e.g. penicillin.

But is ADD something you ‘have’ in the same way as you might ‘have’ mononucleosis or strep throat Some experts think so, but I think the data tell us otherwise. If we chart all the symptoms that go into making up ADD, we would see that on each dimension there is a continuum of people who don’t have it at all to people who have lots of it. This is not true at all with ordinary diseases.

I would like to set out the first principle of this new science of systemic disorders. They all appear on a complex nexus of intersecting continuums; they do not appear as disease entities.