Brain, Impulsivity, and Evidence — What to Do Next

The New Biological Brain

New scientific insights provide multiple keys that will release us from our collective impulsivity imprisonment. This recent sea change in brain and body science dramatically corrects previous, incomplete intervention protocols. It’s time to rethink old patterns.

Yes, many more options are available, and new ‘functional’ science discoveries provide improved options for different intervention strategies. With new biologically based systems, we can sprinkle on that ‘ounce of prevention,’ because we now know so much more about the ‘working biology’ of those who suffer with impulsivity.

Keen awareness of precipitating factors will encourage better questions, higher levels of predictability, more targeted interventions, and better resolution of behavioral regressions, — if impulsivity does get out of hand. Anyone can benefit from this new biological brain information at any level, — from parents, to physicians, to teachers, to all those in charge of groups on any level.

But isn’t this brain stuff way over our head? And just how does the new body based information, such as breakfast and sleep, fit into the puzzle? Let’s first set the stage.

Then and Now

At the outset, let’s take a quick look at the past ‘big picture’ to simplify the current complex situation.

When we were kids, about 40 years ago, the only way we could look at behavior and impulsivity was from the outside. Back then we suffered daily from an advanced case of ‘defensive label psychobabble,’ because we could only see the tips of impulsivity icebergs. Today, regrettably, psychobabble often persists as our only intervention strategy.

Psychiatry then, as it often is now, was caught up with labels and superficial diagnoses based on appearances. We had no tools to measure brain and body functions, so we had to guess a lot. Back then we focused on imagination and dreams, today we have remarkable modern tools to focus on biological reality. Back then impulsivity was considered ‘passive-aggressive’ — and now impulsivity is often simply described as ‘oppositional and defiant.’ And, to use those labels, ask yourself this question: just what does one do with ‘passive aggressive character disorder?’ What exactly is the utilitarian value of a marker like that?

The problem with labels: they imply a permanent condition, a fixed monolithic entity, and do little to address child, adolescent, and adult function over time. They are as superficial as the shirt on your back, and completely fail to address the person inside.

And by the way, did someone say we should use ‘structure’ for impulsivity? Is ‘structure’ the only tool in our kit? And just how do we apply structure? Often these old solutions are actually more complex than the new ones.

Beyond Structure

Since I was a medical intern in Grand Rapids, Michigan, I’ve been dwelling on the psychological and scientific limitations, and the real destructive potential, of labels — and I’m excited to report to you that we have come a long way since then. We now know more about brain and body physiology than ever in the history of humankind… but, surprisingly, many have not yet decided to use it!

I have been writing about troubles regarding label limitations, regarding imprecision with medications, and regarding superficial diagnosis since 1992.. The details for correcting impulsivity are about fixing function, not labels. If we move past the limitation of simply naming the behavior we can directly target the causes.

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