Inhibition of Behavior

The Pre-Frontal cortex is responsible for controlling our behavior, modifying our reactions, and suppressing the more beastly thoughts of our primitive cortex. We all get angry, and, in certain situations it would be abnormal not to do so, but, it is a specific part our our brain - the Pre-Frontal Cortex - that filters out what is appropriate and what is not, what is ethical, moral and righteous, and what and how I will react in every circumstance.

If someone cuts me off in traffic, my first response may be to repay the behavior with some equal but opposite behavior. Though revenge may be instinctual, my choice to perseverate on such a thought, or worse, to act on one, is a choice. This choice is a decision of the Pre-Frontal Cortex. If my Pre-Frontal Cortex (PFC) is intact and working near 100%, it filters my gut response and chooses to react in such a way that is constructive, edifying, and graceful. If my PFC is functioning to a lower degree, the inhibition of impulses either is limited or diminished and reactions will be spontaneous and immature at best.

If someone steps on my foot in a crowded elevator, my PFC reminds me to forgive, back-up, smile and continue on. It keeps me for screaming, crying or kicking the perpetrator. As a parent I teach this control of behavior to my children which is engrained into their PFC.

Simply put: A specific part of the Pre-Frontal Cortex aids in:

Inhibition of inappropriate impulses
Suppression of primitive responses to stimuli
Control of anger and its motor reactions
Keeping perspective of the whole

Conversely: A decreased output, or what we call, a decreased frequency of firing (FOF) of the specific areas of the PFC can lead to:

Anger that is seemingly beyond one's control and often outside of one's rational thought. I often see patients who tell me that they 'blow up' and a loved one for no particular reason (though they justified the outrage at the time) and then wonder why they over-reacted afterwards. This anger can range from a "bubbling stew" to a screaming rage, may be accompanied by physical actions (abuse, throwing things), and is usually a sharp interruption of the status quo (it seeming came from no where).
Swift personality changes from calm to extremely upset.

The worse the PFC is functioning, the greater the swing of emotions. It is worse under stress (like the mother who yells at the kids when stressed), worse with chemical changes (like the husband who abuses his wife only when drunk), and worse when the person has less social pressure to keep his/her PFC activated (i.e. in public the father is able to put on a good face, but under similar circumstances at home, watch out).

Worse yet, and the most debilitating factor to receiving care: Since the PFC is the part of the brain that is responsible for making moral, ethical and socio-acceptable choices, the greater the problem the individual has with the PFC, the lesser their ability is to recognize it! (The abusive husband denies the actions; the hollering mother blames the kids; etc)

The solution: Behavior modification gives minor results at best. All the anger management classes cannot increase the function of the PFC. Brain-Based Therapy offers the only lasting solution - locate the area of the PFC that is functioning less than 100% and increase its functioning. Simple? Maybe. Easy? Not exactly.

What we do: Locating the cortical deficiency isn't the complicated part. Through Neurological evaluation and testing, the PFC problem is diagnosed. We then write a specific treatment plan to stimulate that particular lobe. This is the Brain-Based Therapy used by Functional Neurologists to increase the frequency of firing (FOF) into that deficient brain center. We also use techniques to stimulate fuel uptake necessary for neuronal activation as well.