*** The Role of Consciousness Discipline in the Cultivation of Well-Being in Persons with Injury of the Brain ***
A. Medications are helpful, but they are not cure-alls. They have side effects and are costly. Most importantly, not every condition responds to a pill or an injection. Medications have shown only modest success in the treatment of many, if not most, conditions arising from injury to the brain. When you prescribe a medication for a condition that is only marginally responsive to medications, not only do you fail to treat the condition, but a more appropriate – and potentially more effective – treatment goes unused. Prescribing a medication gives the illusion of active treatment, but is often an expensive distraction. Over time, the prescription of medication has received an overly important focus in the interaction between patient and physician. A visit with the physician involving only the exchange of words and ideas is too easily viewed by both parties as a failure.
B. I am particularly interested in practices which do not involve medications, cost nothing, have no side effects, require no equipment, and are universally accessible. These practices – such as meditation, mindfulness, regulation of the breath and regulation of bodily movement – are not only effective, but they give the person with brain injury a degree of control over their situation, so they are also empowering. They may be considered “consciousness disciplines”, since they are concerned with the disciplining of the mind through the habitual focusing of consciousness.
C. These consciousness disciplines have been studied scientifically and rigorously and meet the same evidence-based criteria as many medication trials. While some may view these practices as “alternative” or “complementary” since they fall outside the traditional purview of standard medical practice as taught in residency programs across the country, I view them as fully compatible with traditional medical therapeutics and see no need to label them as “alternative” or “complementary”. They are alternative only in the sense that they are relatively unknown or unpopular as therapeutic options. In my mind, they are quite simply good medicine.
D. Physicians may be aware of the value of non-medical therapies, but often lack the standardized route to administer them to their patients. There is a well-worn pathway from the doctor's office to the pharmacy. Physician are well-trained in the dispensation of medication. We have even devised a standardized form for the delivery of medication from the physician to the patient. It is known as a prescription. Physicians generally don't consider writing prescriptions for anything other than medications, and even if they did, the patient would not know where to have it filled.
E. The purpose of this presentation is three-fold: 1) to survey the research of several consciousness disciplines 2) to consider their potential efficacy in the rehabilitation of persons with brain injury 3) propose a system for the education of physicians and patients in the use of these techniques.