What's New in Neurofeedback

• John Gruzelier on BBC about neurofeedback - http://www.bbc.co.uk/radio4/progs/genre/genre_scitech.shtml

• ISSSEEM Quarterly Magazine Winter 2000 features article on Kansas prison system's use of neurofeedback."

How does the human mind function? What are the rudimentary rules of mental health? A 100, 150 years of psychological investigation and nothing approaching an answer...

The field of neuroregulation and the field of psychiatry share many common elements -- similar patient population, similar office protocol, similar practitioners -- and recently I was reminded of one characteristic in particular, a property that they both share which weakens them. I am refering to conceptual pluralism. Both neuroregulation and psychiatry suffer from conceptual pluralism, the lack of a single overarching paradigm to unite investigation. When paradigmic hegemony is absent, as it is in these fields, competing and often incompatible models coexist. In such an environment, any theory, however irrational, can demand equal attention. And they do.

Conceptual pluralism may be a necessary stage of all disciplines. In fact the existence of clearly defined models competing against each other may be a positive thing. It may reflect a necessary stage, the passage from formative upstart to mature science. But such competition is just as likely to hinder advancement in some domains as it propels it in others. Too much competition can keep everyone in the dark, out of the know, with too little data and too much interpretation spread thinly across too many models. A field can wallow in its own Dark Age. With too many Kings. Too many Popes.

Paradigms force us to make decisions, early and often. Paradigms drive scientific and clinical investigation; facts are collected selectively, studies devised entirely to refute or support one aspect of a model. The opposite is happening in (neuro)psychiatry today. Data are not being gathered selectively, but indiscriminately, atheoretically. Nearly every reasonable study from the past 30 years is being re-run nowadays, with an fMRI machine attached to the project. Will new insights be gained from all the billions of dollars spent? Had those resources been applied more cleverly, more discriminately, who knows?

Competition is at the root of creativity. In the middle half of the 20th century, two promising theories competed for the hearts and minds of physicists-cum-cosmologists: either the universe started with a Big Bang or it never had a start, always was, and always would be in a Steady State. They were opposing theories, contrary to the exclusion of the other. Whenever and wherever possible, data was collected and technology was developed in order to refute the other model. Sometimes it's not clear what data is relevant in the real world, what observations should be made. But with competition one's eyes are often widely opened, one's priorities become crystal clear. So was the case with the young field of cosmology. And from this structured antagonism arose many unanticipated bounties, from advances in radio telescopy to the theory of stellar nucleosynthesis.

Yet too much competition can bring on melee, a free-for-all, and the subsequent state of chaos and anarchy. Reviewing the upcoming SNR conference, the list of speakers and disparate philosophies behind their talks, I was reminded of a team of horses strapped together, all sweating at the bit, all pulling in every direction at once. The cart may lurch out of the muck every moment or so, but in which direction is anyone's guess. It has been 30 years since SMR conditioning was invented (or was it discovered?) and it seems like now it is the best of times and the worst of times. Everyone thinks they have the answer, everyone's technique and experience outtrumps all comers. This field does not have a single voice as some do, but instead makes a cacophony, a jarring, rarely attractive sound to the outside world. Can this be solve? Or is this unresolvable? Will brain sciences forever be like sausage or the law: to appreciate them, avoid attending their creation?

So what can be done? What might speed the process from gawky adolescent endeavor to mature and respect discipline?

I suggest that we set up a tournament, a joust of sorts: a contest enacted through a series of edited books. In each joust, in each edited volume, two models of protocol selection go head to head, lance to lance. Dedicate half a dozen chapters to each. All other contending theories wait on the sidelines for the next contest. The winner of the first contest is paired with the next most promising challenger in the next volume, etc. Like any fair contest we allow rematches, especially when past outcomes are unclear or new data demand it. Very quickly we should be able to sort this thing out. Perhaps in five years of jousts we'll whittle our models down to two or even one.

For Joust #1 I recommend behavioral (or symptomatic) models of protocol selection (e.g., inattention improves with such-and-such training, etc.) goes head-to-head with EEG-based protocol selection (EEG normalization), and let the better model win! Who knows? We may have a mature scientific discipline on our hands in no time.

DK

Related reading:

Dunbar, R. (1995) The Trouble with Science. London : Faber & Faber.

McGuire, M. & Troisi, A. (1998) Darwinian Psychiatry. New York : Oxford University Press.

News & Reviews NEW BOOKS

Understanding Other Minds: Perspectives from Developmental Cognitive Neuroscience
by Simon Baron-Cohen

Newest edition of this book includes numerous studies from neurobiology and other disciplines on the theory of mind from perspectives of normal development and autism.

The Life of a Bipolar Child: What Every Parent and Professional Needs to Know
by Trudy Carlson

Describes life a bipolar child, newest research on this condition, including medications, comorbid disorders, screening, and ways to anticipate and prevent suicide.

Handbook of Alcoholism
by Gerald Zernig

Alcoholism remains a major worldwide health concern. Comprehensive handbook addressing underlying psychological problems of alcoholism.

Clinical and Neuropsychological Aspects of Closed Head Injury
by John T. E. Richardson

Reviews the epidemiology, causes, and structural neuropathology of closed head injury and its impact on cognitive function.

From Neuron to Brain
by John G. Nicholls

Comprehensive introduction to the field of neurobiology.

Addictions & Substance Abuse: Strategies for Advanced Practice Nursing
by Madeline Naegle

Describes strategies for identification, assessment, and management of dependency problems. Includes study questions and case histories.

American College of Physicians Home Medical Guide: Epilepsy
by David R. Goldmann

Clear and concise information in accessible format. Includes recent advances in diagnosis, treatment, and preventative measures.

Management of Stress and Anxiety in Medical Disorders
by David H. Barlow

Edited interdisciplinary volume: State-of-the-art procedures for the assessment and management of stress and anxiety, including diagnostic and treatment considerations.

Children of Addiction: Research, Health, and Public Policy Issues
by Hiram E. Fitzgerald

Recent textbook examining the biological and psychological effects of addiction on the children.

Autism in History : The Case of Hugh Blair of Borgue
by Uta Frith

Examines Hugh Blair, an eighteenth century Scottish landowner, whose arranged marriage was annulled on the grounds of his mental incapacity; he was classified a 'fool' but was in fact autistic.

Psychiatric Management in Neurological Disease
by Edward C. Lauterbach