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I want to talk today about why it’s important for health care professionals of all kinds to learn about and use audiovisual entrainment (AVE) and cranioelectrical stimulation (CES) in their practices.
I and others have received pushback that professionals don’t have time, they’re busy, and that it’ll take hours and hours. I find this puzzling given that anyone who has a licence to practice in their field has to have been a natural learner in order to survive the long road to receiving it; furthermore, all licenced professionals must take educational credits every year in order to maintain their licence. Professionals know that in order to serve their clients or patients well, they must learn new information in the field and update their practice regularly. Why then would they find learning about neurostimulation techniques so anathema?
Neurostimulation can dramatically improve people’s brain function and thus their quality of life. AVE and CES are the most accessible, portable, and affordable means of neurostimulation. Depending on the issue, it can permanently heal a problem or, with regular use, allow a person to feel and think better, and to carry out actions or behaviours in line with who they are. I’ve been thinking about why neurostimulation, and these two techniques in particular, are not adopted widely, given how effective they are.
I believe there are three aspects to solving this problem: trust, overburden, and anxiety.
Trust
The relationship between health care professional and patient or client determines the course of healing. Alliance and rapport built up over time fosters trust; this trust leads to the person believing their health care professional and in wanting to carry out the instructions given to them. They’re more likely to learn from therapy as well because trust will have created a willingness to pay attention. Trust will also have given them courage to ask questions without fearing they’ll be discharged because they asked or challenged the professional’s opinions.
Trust only happens over time. A person will go into a relationship with societal trust: a doctor works to bring them back to health because that’s what doctors do. A psychologist provides a caring atmosphere complete with couch. But personal trust from alliance and rapport, the kind that leads to the best outcomes, only develops through regular personal contact and from believing the professional has gotten to know them.
Unfortunately, experience sometimes teaches a person with brain injury or a mental health issue that professionals don’t take the time to listen and don’t make the effort to provide the healing that they crave. And so when, for example, the trusted social worker suggests seeing an unknown psychologist for neurostimulation, the person balks. How do they know the psychologist will be trustworthy? Neurostimulation sounds woo-woo and not a prescription one wants to receive from a new professional that experience has taught will probably not listen. Receiving it from the trusted social worker, though, will foster assent. If they don’t trust them, they’ll find all sorts of reasons not to agree.
Burden
Brain injury requires seeing multiple specialists. Getting health care becomes a job of juggling appointments and prescriptions that range from exercises to daily activities of living to taking medications that don’t work well. One-off consultant appointments interfere with regular appointments that keep one going, and it becomes frustrating and despairing. And so when a psychiatrist, for example, suggests seeking neurostimulation with a psychologist, the person balks. It's one more regular appointment to add to an already onerous health care schedule. The psychiatrist providing it themself means it's physically doable for the person in their weekly life.
Anxiety
Because few have heard of neurostimulation, never mind understand what it is, the thought of using it creates anxiety. We all know about medications because we’ve been brought up with pills — acetylsalicylic acid for a headache, acetaminophen for fevers, vitamins, and minerals. And so taking a prescribed medication may create anxiety about what that prescription will do but not in the pill itself.
But that’s not true for neurostimulation.
Not only would the prescription cause anxiety, but also the technique as well. Thoughts might include: What does it look like? What will it feel like? How do you use it?
It’s not as easy as swallowing a pill. You have to choose the right session, remember to have water nearby, know how to put on the eyesets and headphones (something a person with brain injury can stress over when even brushing their teeth is difficult), and so on. A person with anxiety, including anxiety from brain injury, can become so anxious at the thought of this unknown technique that they’ll balk.
The only way to overcome anxiety at trying a new technique is by their health care professional doing it in office, regularly. Their trusted professional next to them comforts and alleviates anxiety, which leads to assent. In addition, by walking them through the sessions, asking how they feel and what they see, teaching which session they’re using and perhaps why, the professional helps the patient transition to using this novel technique at home.
The reasons of trust, of not overburdening a person with too many specialists, and overcoming anxiety are why every health care professional ought to learn about and use AVE and CES in the office and guide at-home use. Also, using AVE and CES during a talk therapy session can relax a person so that they talk more easily. So why not use neurostimulation in regular brain injury and mental health practice?
Copyright ©2021 Shireen Anne Jeejeebhoy. May not be reprinted or reposted without permission.
