Another Inconvenient Truth

by Siegfried Othmer | May 1st, 2007

Plant Truth ComicJonathan Chait, a senior editor at the New Republic, reports that when the National Journal asked Republican senators and members of the House last year “…whether it’s been proven beyond a reasonable doubt that the earth is warming because of man-made problems,” only some 23% said yes. Since that time there has been a further strengthening of the scientific evidence, and the UN Intergovernmental Panel on Climate Change (IPCC) released a study signed by 2000 scientists to the effect that the likelihood of man-induced global warming now lay at the 90% level. When a similar question was asked of the Congressmen this year, the percentage assenting had surprisingly dropped to only 13%.

This depressing development should be a cautionary tale for those who believe that the acceptance of neurofeedback is just going to be a matter of putting forward better and larger scientific studies. This might just possibly be true in an environment where entrenched interests are not involved. But when real economic interests or basic belief systems are threatened, the skills of scientists in making evidence disappear or look unconvincing are brought into play. Moreover, even if the scientists are of one mind, as they are on the matter of global warming, yet other interests can still manage to confuse the picture.

Take another example. The FDA has just issued a stern caution with regard to the use of accutane: “Isotretinoin is a drug approved for the treatment of severe acne that does not respond to other forms of treatment,” the FDA said in a statement. “If the drug is improperly used, it can cause severe side effects, including birth defects. Serious mental health problems have also been reported with isotretinoin use.” Accutane has also been implicated in inflammatory bowel disease.

The FDA caution is straight-forward enough. What’s more interesting, though, is what isn’t being said by the FDA, such as:

“Serious mental health problems have also been reported with mercury-laced vaccines.” “Serious mental health problems have also been reported with the MMR vaccine.”

Etc.

These statements are equally true, and the obligation is just as cogent for the FDA to come forward with those cautions. These are simple factual statements that no one can contradict. If objections are raised to picking out thimerosal or the MMR vaccine in particular as a hazard, the simple statement that “Serious mental health problems have also been reported with childhood vaccines” would be a default position. Yet there is silence. We are up against another inconvenient truth. The decision has been made to submerge individual risk for the sake of the larger public good.

Another example that also involves the FDA is the sordid history of mad cow disease. This is a prion disease for which there is no known cure. First it was declared to be Britain’s problem, not ours, and when a mad cow showed up in this country, its significance was diminished. Then a second one surfaced, but again the system closed ranks. The problem is being managed. We had finally stopped feeding offal to herbivores, so the problem was deemed to be a temporary one.

The story may not be over, though. Just because the cows are healthy, and the death rate of the British from Creutzfeld-Jacob variant has been declining since 2000, does not mean that humanity is out of the woods. The cannibals of Papua New Guinea are a study in nature of a prion disease named kuru, and it appears that the incubation period of kuru can be as much as 45 years. So we may have more to look forward to. In the meantime, everyone is once again eating beef. This story is another illustration that when large commercial interests are at stake, the science either disappears or it is harnessed in the service of prevailing interests. This also illustrates the comfort we all take from being part of a shared community of belief. Surely we are not all going to die from eating beef, are we? *)

Contrast this with the FDA’s reaction to a single batch of bad L-Tryptophan out of Japan, an example we’ve cited before. In this case, the public needed to be protected from rogue competition for the newly patented Prozac. The sale of L-tryptophan in the United States was banned.

Some years ago it was considered prudent to set about to monitor the heavens for any celestial body that might be hurtling toward the earth on a trajectory bound for impact. If we find these dark objects while they are still some ten to thirty years away, we have time to go into action with countermeasures. All the unknowns are well known in this regard. That is to say, the probabilities are well bounded. No one can deny that we face a non-negligible risk of a catastrophic event. Now it is revealed that plans have changed, and that NASA is instead turning its resources to Mars, at the price of an uncertain Dance with Death for our whole human existence. A decision this irrational can only have been reached collectively.

It has been said that “All Truth goes through three stages: First it is ridiculed; then it is violently opposed; finally, it is accepted as self-evident.” With respect to neurofeedback, we have had the ridicule phase with Russell Barkley and John Ratey. There would have been even more ridicule, but few other people were paying attention. We are probably only now moving into the second phase, where neurofeedback is finally recognized as a threat. So it should be no surprise that resistance to our ideas should increase in some quarters even as the evidence improves and as the field grows and consolidates.

In the midst of this untidy state of affairs, some people have accused the various rogue pioneers in the field of actually hurting the cause of acceptance by the brashness of their claims and their general militancy. Surprisingly, I have actually developed some sympathy for this point of view. In fact, I agree with it. It is difficult for any outsider to directly influence mainstream thinking positively. It is much more likely that the challenge from the outside will just build up an immune response on the inside, and that is probably what has happened over the years. We have succeeded in increasing resistance to neurofeedback among the scientific elite as much as we have paved the way for its acceptance.

There are similar examples from other fields. It turns out that we are having the driest winter on record right now in Los Angeles, and this occurred after the National Oceanic and Atmospheric Administration predicted a wetter than normal winter because of a resurgent El Nino. The weather we are having was correctly predicted by Bill Patzert, climatologist at NASA’s JPL, who said that the El Nino would be a no-show. In fact he contradicted NOAA’s last four predictions of an El Nino and was correct in all cases. One might ask, why is it that he has been right for a decade when they have been so wrong? And why is NOAA not paying attention to this man and his computer models? Alas, his counsel is dismissed because he is an oceanographer rather than a meterologist; in other words, an outsider when it comes to weather prediction. One would think that when it comes to predicting El Ninos, being an oceanographer would be an advantage. Nevertheless, Patzert remains an outsider.

Even insiders can be marginalized. Ransom Myers was a Canadian government official warning of the dangers of overfishing the Atlantic cod. His own department tried to squelch his papers, and instead blamed the 1992 collapse on “voracious seals” and rising ocean temperature. He was eventually proved right. Fortune Magazine selected him as one of the top ten people in the world to watch. Tragically, he just died at the age of 54, with the latest paper of this prolific author just coming out in Science.

This issue has been argued before in these pages, at which time I recalled the case of Freeman Dyson, who wondered whether it was better for an individual to influence the course of the Viet Nam War from the inside or the outside. He personally stayed inside as a member of the Jason group. He observed that it was really impossible to vector the ship of state from inside the Department of Defense, where criticism would inevitably be muted, buffered, and ultimately smothered. And he thought it impossible from the outside as well! One might have the necessary independence on the outside, but not the access to the levers of power. Daniel Ellsberg chose the outside route after realizing the futility of influencing policy from within the system, and he ultimately made a difference. But it took a long time, and he sacrificed his career to the cause.

We’ve also previously mentioned the case of Alfred Tomatis, who was ushered out of the French Academy of Arts and Sciences for his strange ideas about hearing. Even insiders cannot gain a hearing for ideas outside of mainstream thinking.

The reason that neurofeedback is now on such an unorthodox path is traceable to the fact that Barry Sterman did not succeed originally in persuading the scientific community at a time when research funding was available for his studies. But does one blame Barry for this? It was really a matter of a discovery happening before its time. There was no way for the science of the day to digest what was being discovered. So it was simply ignored. The truth of the matter is both simple and mundane. Barry’s work did not integrate well with the science of the day.

Plate tectonics would have had a much easier time getting accepted in the sixties if it had not been for Alfred Wegener going about lecturing on continental drift in the twenties. Once the idea was discredited, it was almost impossible to revive. We are up against the same thing now. If neurofeedback had been discovered last year, it would be all over the science magazines. As it happens, it was discovered forty years ago, so now we find ourselves in a slog. Things would be different in an ideal world, but there is no reason for Alfred Wegener to regret his pioneering work; there is no reason for Barry to do so; and there is no reason for us to yield to our critics now.

The obtuseness and rigidity of mainstream thinking is just something we have to live with. The explanation cannot be on rational grounds. One must look to the “culture of science” more than to its formal structures to understand how intrusive ideas are dealt with. Some months ago we had the crash of a Comair flight that had mistakenly taken off from a closed runway. On subsequent investigation, the mystery was never resolved as to why the two pilots did not notice the various indicators that they were off on the wrong track. One pilot even said to the other, “That is weird with no lights…” Yet no inquiry to the tower followed. My guess is that this miscue could not have happened if either pilot had been flying alone. The two were giving each other comfort in their non-decisions, even non-verbally. Silence meant assent, or at least acquiescence.

Something like that is going on within each part of the scientific enterprise. There is a community of shared belief, the integrity of which should not be challenged too readily. A key part of inculcating new members into a particular scientific discipline is the adoption of the shared belief system. To paraphrase Barry Goldwater, “ardor in the service of right belief is not a vice.” For the sake of minimal comity, there must be resistance to the intrusion of radically novel ideas simply to allow the process of research to move smoothly and for the community to function. Science largely moves incrementally, where it is at its best. Novelty intrudes randomly, and almost never by design.

The resistance to novelty is not even restricted to the kind of paradigm-breaking thrust discussed by Thomas Kuhn in his famous treatise, “The Structure of Scientific Revolutions.” The recent death of Paul Lauterbur, inventor of Magnetic Resonance Imaging, reminds us of the difficulties he encountered early on with an idea that was entirely within the accepted science of the day: the mere addition of a magnetic field gradient would give us spatial resolution in nuclear magnetic resonance. Yet his initial paper was rejected by Nature, and his university law firm did not regard the idea worth patenting! Joked Lauterbur acidly, the history of modern science could be written from papers first rejected for publication by academic journals.

The resistance to new, off-beat ideas has a fractal property. That is to say, it is observable on every scale of social human activity. Even within the field, and even within a particular organization, we have observed how every substantial new departure is first met by opposition rather than with forward-leaning curiosity. This means that the defense of the existing belief system is an obligation assumed by nearly everyone that has been inducted into the community of believers.

In science we are part of a community in which “prejudice” is a virtue rather than a vice. An open mind, quite frankly, is either an untutored or an undisciplined one. The educated mind, on the other hand, is exquisitely aware of the boundary between what is acceptable and what is considered beyond the pale at any time within a particular scientific cohort. The boundaries keep moving; truths are acknowledged to be provisional truths; hence the use of the word prejudice is justified. We have a solid vantage point from which unproven propositions can be legitimately “pre-judged” to a degree. Entire study groups are organized within the NIH to render just such pre-judgments.

So it is the social dimension of the scientific enterprise that we must look to for an explanation of the resistance to paradigm-breaking novelty. And the larger the community of belief, the more difficult it is to step outside of it. In large groups, we scientists look more and more like locusts. It is possible for the lone engineer at Thiokol to insist that the Challenger should not launch outside of its thermal parameters. It takes a group at NASA to anesthetize each other’s concerns. The social dimension even dominated at a group size of two in the case of the Comair pilots. So when it comes to the acceptance of neurofeedback, it is not daunting to me at all that the community of science at large pays us no heed. With respect to any question outside of their expertise, one should think even of scientists as having the group mind of a swarm of locusts.

This is not intended to be either frivolous or insulting. The behavior of locusts, and of schooling fish, has recently been modeled quite effectively using only minimal assumptions. The group behavior emerges even with only near-neighbor interactions, as indeed is also the case with phase transitions in physical systems. And such casual interactions probably account for the conventional wisdom on the matter of neurofeedback. Scientists are inclined to orient to their colleagues when it comes to issues that are seen as peripheral to their core interests.

As soon as issues rise to a certain level of significance, as they must within the field itself, fragmentation ensues. So we are stuck with the unattractive combination of a highly Balkanized field embedded within a larger scientific community that is not yet engaged on the issues. It has also been shown that even a large flock of migrating birds can be effectively led by just a few knowledgeable leaders. That too translates well to our situation in neurofeedback. A few self-appointed arbiters can raise the alarm about neurofeedback and redirect the entire swarm of casually engaged scientists into passive opposition. Within the field, such strong advocates just succeed in further fragmenting the discipline.

At this point it is, however, far too late for neurofeedback to be sponsored into existence by the NIMH via the usual pathway of funded studies—operating on the fictitious assumption that we don’t yet know what we already know. All that’s left now is for neurofeedback simply to be discovered, much like the Mid-Atlantic Ridge was discovered, by mainstream funding agencies. All that is left to do is to acknowledge the reality that already exists, like hastily arranging a wedding after the pregancy test came up positive. Sooner or later someone at the NIMH will realize that a mature discipline has emerged while they were otherwise engaged.

Attachment theorists will come to realize that they don’t have to invent somatic technologies all over again. Biofeedback has already left its footprints. The military will discover that the answer to the conundrum of PTSD and blast injury lies in neurofeedback. Addiction treatment will cease to be a statistical embarrassment. Criminology will be overhauled, and rehabilitation will cease to be a joke within the Department of “Corrections.” The field of education will emerge from its pre-scientific state. And the anti-aging discipline will come into its own through maintenance of brain function. We know how to do all of this already. The validity of neurofeedback is simply no longer at issue, and the formal scientific enterprise can continue with what it does well–sort out the details; refine and solidify what we know; and lay the groundwork for further progress.

3 Responses to “Another Inconvenient Truth”

  1. Rory Strama says:

    Once again I find myself reading a very well written article here on this blog. It’s so hard to find articles written this well on other sites. Nice job on your dedication and writing style and thanks for being here.

  2. Your comment is appreciated.

  3. Andrew says:

    Mr. Othmer, while you are correct that citing research to get the larger organization on board is a problem, nevertheless, a fee basis approval for biofeedback is currently possible if one can convince the VAMC of the benefit of such care. I would find it helpful if you could provide a bibliography regarding efficacy of biofeedback in PTSD treatment (or a link to same). Thanks!

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