Brain Implants and Biofeedback are Big Money, But Ignore Social Causes of Distress
Targeted treatments are a consumerist way to address suffering.
The most popular psych story last week was about a woman named Sarah who found relief from a device implanted in her brain that sent an electrical pulse every time she had an irrational thought. It was supposed to be a breakthrough, but I couldn’t read about it without sci-fi dystopias playing in my head.
Granted, on an individual level, this implant — technically called Deep Brain Stimulation — could be helpful. All the articles I read said she had been suffering for years. While none explained anything about her life or her context whatsoever, they did quote her saying she was relieved.
Ars Technica’s take says:
“When it detects neural activity associated with irrational thoughts, which previously triggered depressive obsessions, its electrodes deliver a short, corrective electric pulse and ‘poof… the cycle stops,’ as Sarah put it.”
The researchers have hope that this could help alleviate an epidemic of depression, which is the leading cause of disability worldwide, currently afflicting one in five 15–24 year olds.
The brain implant is specifically for people with treatment-resistant depression, which usually means they don’t respond to anti-depressants. But this isn’t exactly rare, if you look at the data — in his book Sedated, James Davies writes that, in other areas of medicine, pharmaceutical advances resulted in better outcomes throughout the population over time, as you would expect if the medicines worked. But this hasn’t been the case for psychiatry.
Mental illnesses have actually gotten worse alongside the development and widespread prescribing of psychiatric drugs. Robert Whitaker wrote an entire book about this, finding that in any country where prescribing went up, the rate of people on disability for mental illnesses went up with it.
If the drugs treat depression, why haven’t rates of depression gone down? Why do studies actually show worse outcomes — more depressive episodes, for longer — when people stay on antidepressants long-term? And why are we still sinking money into changing individual brains instead of looking at ways to change the context out of which depression grows?
I think it has a lot to do with the fact that you can’t monetize structural changes like you can new drugs, electrical brain zappers, and video games that subconsciously train kids not to express their anger:
“The game, called Regulate and Gain Emotional Control (RAGE-Control)…trains kids to stay calm during stressful or frustrating situations. In the game, players try to shoot virtual asteroids while avoiding friendly craft, while a pulse oximeter on their wrist monitors their heart rate. If they remain calm and keep their heart rate down, they do better in the game. If their heart rate goes too high, they lose their ability to shoot.”
RAGE-Control doesn’t make kids less angry — when they surveyed the participants, they reported the same levels of anger — but their parents and clinicians rated the severity of their anger lower, which means, this game is just teaching kids how to mask their feelings. It’s another way to make them more manageable, like psych drugs do, without actually dealing with any of the root causes of their distress.
Games like RAGE-Control are attracting big funding — Mightier, which is a part of Boston Children’s Hospital, just snagged a $2 million grant from the National Institute of Mental Health to study the effects of biofeedback video games on kids diagnosed with ADHD, anxiety, Oppositional Defiant Disorder, and autism.
Partner company Magellan Health has received a total of $10 million to date for their own biofeedback game development, and a company called Akili Interactive just launched the first FDA-approved prescription game for treating ADHD.
Akili’s prescription game, EndeavorRX, costs $150 a month, which they say is “in line with what parents are used to paying” for stimulants. These are not cost-effective alternatives, but new, comparable revenue streams that can capture consumers who don’t want to or can’t take medication.
Magellan’s VP said in a statement:
“By teaching children how to navigate daily challenges through visual technology they learn how to cope and properly manage their stress in a meaningful and fun way.”
No mention of where their stress comes from, though. Just that it exists, mysteriously, and all we can do is throw millions of dollars into games that subconsciously alter their brains. It’s also not really teaching kids skills or coping strategies, or giving them any kind of meaningful release for their emotions, just teaching their bodies to contain them.
We know that bottling up anger has serious physical health consequences down the line, like raising your risk of heart attack, chronic migraines, muscle pain, ulcers…if the games are not reducing anger, but simply teaching kids how to hold it in, what kind of serious illnesses could this cause them as they grow up? Do we care about that, or is the goal just management, correction, and social control?
Davies writes that a targeted intervention like this, “by claiming to remedy so-called individual deficits, also subtly acquits new capitalist ideas, institutions, and policies of any causal responsibility.”
They are part of a “marketised vision of mental health” that “has stripped our suffering of its deeper meaning and purpose”:
“While each industry offers its own profitable elixir for emotional success, they all share and promote the same consumerist philosophy of suffering: your central problem is not that you’ve been mis-taught how to understand and engage with your difficulties (your ageing, your trauma, your sadness, your anxiety or grief), but the fact that you experience suffering at all — something that targeted consumption can address.”
