Shadow Syndromes : The Mild Forms of Major Mental Disorders That Sabotage UsA Monthly Summary of News and Events
Vol. 1 No. 5 - May 1998
This newsletter is sponsored by EEG Spectrum International, Inc.,
a leader in providing clinical service and training professionals.
Past issues are available at www.eegspectrum.com/newsletter/
Information on how to subscribe or cancel a subscription appear at the end.
The opinions related in this newsletter reflect those of the author only.
Copyright (C) 1998 by David Alan Kaiser. All rights reserved.
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Charles F. Stroebel, M.D., Ph.D., a biofeedback pioneer, died Friday April 10th.
Comments from his colleagues can be read at www.eegspectrum.com/html/stroebel.htm
Rick Kirkpatrick, LCSW 3065 N. College #164 Fayetteville, AR 72703-3417 (501) 44-2270 Bill Mitchell, MFCC P.O. Box 5826 Blue Jay, CA 92317-5826 (909) 336-0996 Stephen A. Kibrick, Ph.D. 4766 Park Grenada, #208 Calabasas, CA 91302-1546 (818) 222-2024 Biofeedback Institute of Los Angeles 3710 S. Robertson Blvd, Suite 216 Culver City, CA 90232 (310) 933-9451 Michael A. Backlund, Ph.D. 1979 Armstrong Ave. San Francisco, CA 94124-3303 (415) 822-6864 Email: backlund@scientist.com Jamie Winn, ACSW, LCSW Creative Counseling, and The First Step Sober Living Homes & Treatment 12315 Oak Knoll Rd. #130 Poway (San Diego), California 92064 (619) 748-6637 Email: Jamaxjon@worldnet.att.net |
Iva Crowley 9825 Shade Lane Wichita, KS 67212 (316) 721-3963 Dr. Stephen Jay Overcash Consulting & Clinical Psychologist 640 Philadelphia Ave. Chambersburg, PA 17201 (717) 263-9471 fax -5133 Email: sjo4@psu.edu James Reagan, Ed.D.; Julie Reagan 215 Wayne St. St. Joseph, MI 49082 (616) 982-7015 Email: jamesreagan@qtm.net Jim Callens, Ph.D. Highway C, Route 2 Box 201 Steele, MO 63877 (573) 695-3016 Edward M. Buda, Ph.D., Rice Clinic, S.C. 3398 East Maria Drive Stevens Point, WI 54481-1362 (715) 341-7441 Teresa Paine, Ph.D. 1601 1/2 Bland Street, Suite #1 Bluefield, WV 24701 (304) 327-8362 Ernesto Miselevich, M.D. 68 Hannasi Ave. P.O. Box 6490 Haifa 31064 Israel 9724 837 5748 |
The Surgical Model of (Mental) Health
EEG biofeedback refers to at least three separate therapeutic modalities, each associated with its own medical or mental health disorders and frequency range in the human EEG Spectrum International.
The first form of EEG biofeedback, which I would now call "Alpha biofeedback," involved conditioning of EEG activity between 7 to 13 Hz through visual or auditory feedback. Developed in the 1960’s by Dr. Joe Kamiya at the University of Chicago, early investigations focused on using brainwave biofeedback to facilitate entering states of deep relaxation and meditation. Many of the same people who embraced EEG biofeedback in these early days were proponents of mental expansiveness through less accepted techniques such as LSD and mysticism and such early associations greatly hindered EEG biofeedback acceptance in the mainstream scientific community (to this day, I should add).
A second form of EEG biofeedback developed out of operant conditioning of cats. Dr M Barry Sterman of UCLA found that cats could be trained to control their brain waves. Seredipitiously, he discovered that when cats were injected with toxic chemicals that usually induce epileptic seizures, those who had been trained in the middle to high frequency range (12-20 Hz) had far fewer seizures than untrained cats. These results were soon replicated in monkeys and then humans. This form is commonly referred to as SMR-beta biofeedback (or SMR-beta neurofeedback) and it reduces motoric excitability and restores cortical stability in general.
The third form is called Alpha-theta neurofeedback and it deals with the lower to middle frequency range (4-12 Hz). It has been shown to be effective in treatment of Chemical Dependency/Alcoholism, Depression, and Post-Traumatic Stress Disorder since 1989. Its effectiveness may lie in its ability to produce transient states during which physiological tone is quieted regardless of emotional content being processed by the client, thus providing a window of time and/or psychological capability that a client would not typically be able to generate on his or her own. (If you read an alpha biofeedback paper prior to 1989, or read one after 1989 and there is no prominent mention of theta rhythm, it is alpha biofeedback and not alpha-theta neurofeedback. )
Although the history of EEG biofeedback is replete with misinformation and problematic associations, the main hinderance to neurofeedback's acceptance in mainstream medicine is the conceptual model underlying modern medicine. And intrinsic to this model is the delivery system. If Neurofeedback could be administered in a pill, perhaps we would be "Talking Back to Neurofeedback" or living in "Neurofeedback Nation". But because an individual must do more than swallow a pill or have a piece of themselves surgically excised, the Surgical Model of Health cannot absorb or append this promising approach.
Neurofeedback transcends diagnostic (DSM-IV) categories, but this does not hinder its ultimate acceptance. The Surgical Model of Mental Health also does not hold diagnostic categories dear. For instance, Ritalin was originally used to treat narcolepsy, Prozac had its single target initially and whatever other chemical miracle soon to be devised will be sold to add hair one day and increase memory the next. Pharmaceuticals were quickly absorbed into the Surgical Model of Health as they are viewed as nano-scalpels or nano-prosthetics; they are no threat to the model; they in fact bolster it. The surgical/prosthetic view of mental health may sound primarily anatomical (add or remove functional units of the patient) but it pervades pharmacological approaches as well (add or remove functional molecules of the patient). Until the surgical/prosthetic paradigm is demoted and delegated to its useful niche in mental health, regulatory treatments (those that re-organize functional units of the patient) will remain on the outskirts of acceptability. And for mental health, the irony is rich, as we are all aware of the vast flexibility of our brain in learning and recovery. To not recognize that the one organ which controls all others to greater degrees cannot itself be trained to control itself more effectively is to miss the premise of psychology.
DK
Overview of cognitive neuroscience of attention. The thesis underlying this work is that attention is not a single entity, but a finite set of interacting brain processes.
Part IV of this book is dedicated to the discussion of normal and abnormal development of attention, including pathologies such as schizophrenia and attention deficit disorders.
For more information, see [www-mitpress.mit.edu/book-home.tcl?isbn=0262161729]
Shadow Syndromes : The Mild Forms of Major Mental Disorders That Sabotage UsThis book was recommended to me by a neurofeedback clinician as a must-read.
For more information, see [www.amazon.com/exec/obidos/ISBN=0553379593/]
An account of the use of these therapies in two California psychiatric institutions. Braslow, like most historians of medicine, is generally hostile to the early therapies that ushered in biologic psychiatry, such as malaria-fever therapy, insulin coma, lobotomy, and similar treatments that acted on the physical substance of the brain.
An upcoming issue Parade magazine will also feature a major article on EEG biofeedback.
The space shuttle Columbia returned to Earth on May 3rd after 16 days of orbital research primarily on the influence of microgravity on the human brain and nervous system. Shuttle personnel underwent 11 investigations and 15 other studies were performed on a collection of rats, mice, snails, fish and other animals. Researchers were eager to determine how the body re-adapts to Earth's gravity and the lasting effects of weightlessness on developing systems. During some of the investigations, astronauts had their EEG monitored. I look excitedly for reports on what was found in this domain.
For more information on the Neurolab Shuttle mission, see http://search.main.yahoo.com/search/news?p=shuttle+Neurolab&n=20
For more information, , see The Handbook of Psychopharmacology Trials: An Overview of Scientific, Political, and Ethical Concerns [www.nejm.org/public/1998/0338/0003/0203/1.htm]
The National Institutes of Health (NIH) will host a conference this autumn that will focus on Methylphenidate, better known as Ritalin, currently taken by millions of American children every day. Methylphenidate is in crucial ways similar to cocaine, and some experts fear it could encourage substance abuse in later life.
Concerns about Ritalin began to emerge in 1995, when Nora Volkow, director of nuclear medicine at the Brookhaven National Laboratory, published with "Is methylphenidate like cocaine?" in the Archives of General Psychiatry. Using positron emission tomography (PET) scans, she reported similarities between Ritalin and cocaine in how the brain dealt with the substance. For instance, the distribution of Ritalin in the brain was almost identical to that of cocaine, the subjective high was very similar, and the drugs' effects peaked at almost the same time--between 4 and 10 minutes in the case of Ritalin, and 2 to 8 minutes for cocaine. The only significant difference was that Ritalin took over four times as long--90 minutes--to leave the body. "We're dealing with a drug that does have properties very similar to cocaine."
For more information, see The New Scientist article, http://www.newscientist.com/ns/980418/nfocus.html
In 1993 American school children consumed some 5 tons of Ritalin; this quantity has since more than doubled. This gives rise to the suggestion that perhaps the Food and Drug Administration should start regulating Ritalin as a food rather than as a drug. For more information, see "More Frequent Diagnosis of Attention Deficit-Hyperactivity Disorder", James M. Swanson, Marc Lerner, Lillie Williams, NEJM, 333, # 14, October 5, 1995) http://www.nejm.org/public/1995/0333/0014/0944/1.htm
Follow the threads yourself at http://search.dejanews.com/dnquery.xp?QRY=neurofeedback
A number of those recent additions were Neurofeedback clinicians webpages; and most of
these were hosted by or associated with EEG Spectrum International.
These include:
The training also includes the all-important practicum section which focuses on actual operation and use of instrumentation. Additionally, opportunity is provided outside the formal curriculum for practitioners to experience training on themselves as well as discussing professional issues, marketing, and the particulars of establishing a financially successful practice based on this modality.
Faculty: Siegfried Othmer, Ph.D., BCIAC; Susan Othmer, BCIAC; M. Barry Sterman, Ph.D.; Nancy White, Ph.D. ; Julian Isaacs, Ph.D.; Pat Fields, Psy.D.; Martin Wuttke, BCIAC; William Scott, BSW, CCDP
| LOCATION | DATES |
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| Atlanta, GA | May 14-18, 1998
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| Encino, CA | Jun 4- 8, 1998
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| Toronto, ONT | Jun 18-22, 1998
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| Encino, CA | Jul 16-20, 1998
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| Seattle, WA | Aug 6-10, 1998 |
| TOPICS COVERED |
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| EEG Biofeedback Theory: Neurophysiological Basis; Research History |
| Clinical Applications: Assessment, Protocol Selection, Practicum & Case Review |
| Specialty Applications: For Behavior Modification & Performance Enhancement |
| COST (5-Day Course): $895.00
Additional Attendees from Same Facility: 30% discount Reattendees: $200.00 |
To enroll, contact Dennis Campbell
or call EEG Spectrum International at 800-789-3456 or (818) 788-2083.
Please include your name and phone number in all email messages.
Conferences for Neurofeedback Clinicians & Researchers | ||
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| CONFERENCE | LOCATION | DATES |
| Assoc. for Applied Psychophysiology & Biofeedback (see below) | Orlando, FL | Apr 1-5, 1998
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| Australian AAPB | Sydney Australia | May 23-24
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| Society for the Study of Neuronal Regulation (see below) | Austin, TX | September 10 - 13 |
The most interesting talk I heard, one which deal only indirectly with neurofeedback, was Roger J. Broughton, M.D.'s talk titled "Daytime Variations in Alertness/ Sleepiness: Effects, Pathology and Mechanisms." From a wide range of physiological and psychophysiological data, it become clear to me that humans are creatures of the sun: Much of are bodily system are regulated by its daily appearance and disappearance. The absolute and relative amplitude of EEG frequency activity also exhibits significant daytime variations and these variations must be compensated for if training time varies for a client.
For more information about daytime EEG variations, see my past presentation to UCLA Sleep workshop [ www.eegspectrum.com/articles/kaiser94.htm]
A common statement I heard many times at the conference was the realization that qEEG assessment
was vital and within economic reach with Aquathought's inexpensively-priced 16-channel Mindset
[http://www.aquathought.com/alab/products/mset/mseteeg.html]. Alan Gevins in a newly published
book talks about the time when we all have our own personal brain scanners. The Mindset may
become the Altair of Personal Imaging ("a PI on every scalp!" to misquote Bill Gates)
Another interesting presentation:
Effect of neurofeedback on attentional and cognitive symptoms of ADHD children by David Kaiser, Ph.D.
A standard pattern of improvement was seen for attentional components as a result of neurofeedback training regardless of age (children or adult), diagnosis (ADHD or other/non-diagnosed), or even ADHD subtype (inattentive vs combined/hyperactive). The typical pattern is significant improvement in sustaining attention, controlling impulsivity, and response consistency; with little or no improvement in speed of processing.
Mean standard scores for TOVA subtests before and after approx. 20 EEG biofeedback sessions for 128 children and adolescents with ADHD.
PRE POST Change
Inattention 81.0 93.0 12.0
Impulsivity 83.9 100.8 16.9
Response Time 81.6 84.5 2.9
Resp. Variability 70.6 84.5 13.9
For more information about the AAPB Conference , see www.aapb.org
"CALL FOR PAPERS": The Society for the Study of Neuronal Regulation (SSNR) is seeking original research papers for presentation at the 1998 SSNR Conference in Austin Texas, September 10 - 13.
Research papers will be given either as a forty minute presentation, twenty minute presentation, or poster presentation. We are also seeking workshops for the conference of either two or three hour duration. Presenters should submit abstracts of under 300 words, indicating the type of presentation desired (40 minute, 20 minute, or poster or workshop). Entries need to be submitted by via e-mail, fax, or regular mail to David Trudeau, M.D., SSNR Program Chair (see addresses below) as soon as possible (deadline by 1 August 1998). Earlier is better, as last year we quickly filled all our presentation and workshop slots.
David L. Trudeau, MD SSNR Program Chair #4402 168 E. 6th St. St. Paul, MN 55101 Fax 612.725.2292 Voice 612.298.9773 trude003@maroon.tc.umn.edu
All submissions will be reviewed by the program committee and those accepted will be assigned to the program. The program committee will determine the type of presentation for research papers (40 minute, 20 minute, or poster) based on the content of the abstract, the judgement of the committee and the preference of the presentor. Every attempt will be made to notify presentors of their position/time on the program by August 15.
In 1935, Fulton and Jacobson reported early experiences with primate behavior following ablation of frontal cortex -- the precursor to the human frontal lobotomy. Shortly thereafter, Egas Moniz named this technique "psychosurgery" and received the Nobel Prize in Medicine and Physiology for his advanced trephination procedure in severely ill patients, the prefrontal lobotomy. Walter Freeman became a major proponent of this work and trephination, under further Latinized monikers, soon became acceptable treatment in the U.S. for "intractable psychoneurosis," schizophrenia, OCD, anxiety disorders, and, as late as 1969, severe depression.
Perhaps there may still be some reason for doing frontal/subcaudal/limbic trephinations for severe, chronic, disabling and treatment-refractory forms of depression (or anxiety conditions or OCD, etc). The critical ethical issue surrounding psychosurgery is the final of these four criteria. The first three criteria are constantly evaluated with institutional funds. One year, severity must be a Beck Depression Inventory score greater than 30, say; another year it must also include a high suicidal index score. Chronicity equals two years in which a major depressive episode was suffered, or five years, or better yet three. Disability equals a Global Assessment of Function score, etc. But where is the yearly institutional funding for following-up Sterman's epilepsy work? Why does injecting pig cells into a unstable brain (an inverted form of trephination with a prosthetic flavor) become front page news?
To determine whether the criteria of treatment-refractoriness is met, a patient must undergo any and all treatments which have some chance for success balanced with the emotional and physical cost to the patient. If neurofeedback is excluded from the list of treatments, as is often the case, how can we ever know whether cutting the frontal neural circuitry is superior to training them?
Joseph Bogen, M.D. likes to joke that in some epilepsy treatment centers, you were lucky if they didn't slice your corpus callosum as you're walking through the door. Approximately 1500 temporal lobectomies are performed in the US each year and some doctors advocate that this number is nearly 100 times too small. I am ignorant of the ontological truth in this matter -- how many people each year can improve with psychosurgery and nothing else. Regardless of this unknowable truth, nearly every patient awaiting psychosurgery should be informed of neurofeedback, an alternative treatment to intractable epilepsy which has been documented for nearly 30 years. Why would medical institutions allow such an omission, such a breach of ethics? But the future is ever-shiny in our minds and in years to come, perhaps in 10, perhaps 100 years from now, I am confident that psychosurgery will join less noble ventures in the dustbin of history.
David Kaiser, Ph.D.
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