Category: Scientific

Professional Boundaries, Scientific Models, and Hemispheric Specialization

Sometimes an actual case history does more to establish a principle than mere enunciation. My mother-in-law is 94 years old, and is doing neurofeedback every day to maintain her level of function. Family members are pitching in as they can to keep her in good spirits. Among the family members is a son-in-law who is also a Harvard-trained psychiatrist. Recently it transpired in casual conversation that he had caused some medication to be prescribed for one reason or another. Since we are doing neurofeedback and have to judge any changes that occur with respect to neurofeedback strategies, it would have been nice to know that a medication was being prescribed.

An old-line doc, on the other hand, feels that this kind of information should not be shared with anyone. Besides, what can neurofeedback possibly matter to anything? We have no standing to know about the prescription, and no reason to know it. This, incidentally, is from a person who has known about neurofeedback since we first undertook the training with our son Brian in 1985. He was a witness to Brian’s progress. He was also aware that my father-in-law undertook neurofeedback for years in the late eighties for his dementia and Parkinson’s. Every time the man got away from the neurofeedback instrument for a few weeks, his wife would notice his decline in mental function. That function would then be nicely recovered once he was back on home on the instrument. Continue reading “Professional Boundaries, Scientific Models, and Hemispheric Specialization”

The Scientific Appraisal of Psychotherapy…and of Neurofeedback

The November 5 issue of Science News features an article by one of the regular contributors, Bruce Bower, on the encroachment of the Evidence-based Medicine juggernaut onto psychotherapy and its practitioners. The impetus was a policy statement on the subject issued by the American Psychological Association back in August. Despite the finality of a pronouncement of policy, the issue seems far from being put to rest. There does not appear to be much unanimity even within the committee of the APA which propounded the document about how such research on efficacy of psychotherapy should proceed, and whether weight should be given to clinical judgment along with more quantifiable scientific findings. Basic disagreements about the operative models survive: “Do treatments cure diseases, or do relationships heal people?” asks John Norcross, a member of the committee.

When it comes to testability for efficacy, neurofeedback would certainly seem to be in a favored position with respect to psychotherapy, for example. Why should we not relish this extraordinary opportunity to put some daylight between our methods and those that are less easily reducible to a procedure? It’s the arbiters of reimbursement who are pushing these standards, and if we meet them, do we not win? Perhaps. But then why is the hair on the back of my neck standing up in anticipation of such a win? Isn’t the problem that acceptance of neurofeedback on these terms would mean a kind of domestication that would rob it of its wild and boundary-breaking essence? Neurofeedback does not fit well in the above dichotomy: It is neither a treatment that cures disease, nor is it a mere appendage to talk therapy. Continue reading “The Scientific Appraisal of Psychotherapy…and of Neurofeedback”

A Critical Appraisal of Inter-Hemispheric Training

In newsletters #40 and #41 we showed cumulative data on clients for whom the dominant protocol consisted of inter-hemispheric training with single-channel bipolar placement. The results have proved to be generally better than what we were able to do with our prior lateralized placements. The reality is even more compelling than what is shown by the data, for two reasons that have been previously mentioned: 1) the clinical populations are much more challenging now than they were a decade ago; and 2) more of these difficult clients are brought successfully to the point of re-testing, so that they actually appear in the data set. Dropouts from training were more commonplace years ago, particularly of course among those for whom our conventional ministrations were not the appropriate remedy.

With this state of affairs as a background, the bar is inevitably raised (in our heart of hearts if nowhere else) for expectations that we hold for new cases coming in the door. Increasingly, there is a fairly established expectation of some significant clinical success for what has become an inclusive set of clinical challenges. It has reached the point where we might hold out the eventual goal of “zero-defect neurofeedback,” the expectation that we can through neurofeedback move nearly everyone to a more functional place, and more particularly, come close to having the assurance that no one will be worse off for the experience. Even if the initial experience with neurofeedback were to be negative in a particular case, protocols exist that would allow recovery. These protocols aren’t just postulated to exist in principle–we actually believe that we know what they are. So, given the opportunity, we should be in a position to benefit nearly everyone who comes for our services with the relevant clinical complaints. Continue reading “A Critical Appraisal of Inter-Hemispheric Training”

Investment in Beliefs

The other day I was buying a shirt for myself, and because mine is a popular size, I often encounter the “donut hole” in the selection, namely that my size is in short supply. I rummaged at length and found my size at the very bottom of the pile. Just at that moment, my eye was drawn to the shirts on the adjacent pile, and I decided at once that I actually liked the new one better. Not only that, but my size was right on top. I was done with my male shopping experience–beeline for the goods and get out. But then a surprising thing happened. I walked off to the sales counter with the shirt that I had spent some effort in locating. It already had my name on it more than the one I had just discovered. I had made an investment of time with this shirt, and the return on that investment lay in the purchase.

This relatively trivial vignette might not even have gotten my own attention were it not for the fact that I am enjoying the book “Blink” at the moment, which speaks about such “instant” judgment formations. But I am not going where Malcolm Gladwell went with “Blink,” which is perhaps grist for another newsletter. Yes, the decision was made in the “blink”-ing of an eye, and its basis was obscure at that moment. However, what really interests me here is the role of that sense of investment in our decision-making. Consider some other examples. Continue reading “Investment in Beliefs”