What's New in Neurofeedback

A Monthly Summary of News and Events

Vol. 3 No. 11 - November 2000

This newsletter is sponsored by EEG Spectrum International Intl, 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) 2000 by EEG Spectrum International Intl, Inc. All rights reserved.



  • Announcements  - Thalamocortical dysrhythmia online
  • In the Spotlight   - The Ritalin Controversy
  • News & Reviews - Books, journal papers, of interest
  • Events & Locations - Conferences, Courses
  • Last Word               - Reflections on a Retraction

  •  

    Announcements

     


    In the Spotlight

    The Ritalin Controversy

    by Siegfried Othmer, Ph.D.

    The Los Angeles Times editorialized recently on the lawsuits against the Ritalin industry. Titled "Detour for Ritalin Issue" (October 27, 2000), the editors said:

    "A polarizing debate over the growing use of the drug Ritalin to treat attention-deficit hyperactivity disorder in children has now been thrown to the courts. That is the wrong place to address this subtle medical issue. What's needed, for a start, is government research that might settle the dispute."
    Some comments: It is suggested that taking Ritalin to court, by analogy to tobacco, is not the right remedy for Ritalin overuse. Instead, answers should be sought in research. Considerably more parallelism exists between Ritalin and tobacco than just in this narrow legal arena. What has usually been left out of the discussion of tobacco is that it can often serve a medicinal purpose just like Ritalin. Attention Deficit Disorder takes many forms, and cigarettes are probably a remedy for some forms of the condition. "It helps me concentrate," is the common report. Others find that it helps with their anxiety; and yet others use it to stave off depression, or to suppress anger. Many report improved mental acuity. Cigarettes, therefore, are not merely delivery vehicles for a substance that induces dependency. They manage arousal and attention, as does Ritalin. If the role of tobacco as a primary resource for self-medication were recognized, it is doubtful that we would feel quite so good about taking this drug to the courtroom either. Of course the tobacco companies cannot claim this particular "high ground," because they don't wish nicotine to be considered a drug in the usual sense in any event.

    Now when it comes to research, it appears that cigarette companies significantly under-represented the health hazards of cigarettes over the years. The same can be said for the Ritalin industry. How is it that after more than forty years of Ritalin use no large-scale study as ever been performed to monitor the long-term effects? How is it that the recently completed "Multi-Site Study" did not meet the gold standard for research design in such studies? For example, there were no "no-treatment" controls, and there was no random assignment. Children who had already been on medication successfully for some time were introduced into the medication phase of that program. They were preselected! In the world of science, this is a scandal. Of course this biased the outcome of the study in favor of medications. The U.S. Government sponsored this study. Hence the NIH was a co-conspirator in this flawed design. In any research that could threaten Ritalin supremacy, these same researchers would insist on the gold standard being met

    This points up the difficulty in simply asking for more research on Ritalin. The drug companies control the whole process, even down to their acolytes within the NIMH. There is the same commercial interest in the case of the Ritalin industry as there is in the case of the tobacco industry. If flawed research and the misrepresentation of legitimate research helped make the case for taking tobacco companies to court, then the same argument can be made against the Ritalin industry.

    The primary complaint about cigarettes of course relates to its negative health consequences and associated death rates. Now we also have reports of deaths on Ritalin, and on combinations of Ritalin with other drugs. These are children dropping dead from heart failure. One autopsy showed what is commonly known as a cocaine addict's heart. These children cannot have been on the drugs for very long. There is every reason to believe that there could be long-term negative consequences that should be investigated. But the drug companies and the FDA are in denial. A couple of years ago, a prominent child psychiatrist at UCLA, Professor Dennis Cantwell, lamented this state of affairs. He said, "ADHD may be a terrible thing, but you don't die from it, and you shouldn't die from the remedy." He was driven to look for an alternative. He was about to launch upon a major study of neurofeedback, a very promising non-medication approach to ADHD, when he succumbed to a heart attack. Without his involvement, the study never got underway. The drug mentality still rules. Research under that mentality will likely only confirm what is already believed.

    One difference between tobacco and Ritalin is that the former induces dependency in its users, whereas the latter primarily induces dependency in its providers. In fact, most commercially successful drugs promote such dependency. Therefore one cannot depend on the drug industry to police itself. Even the FDA is ultimately the servant of the drug industry. Certainly the NIMH is captive. For a breath of fresh air, there must be outside intervention into this incestuous state of affairs. Hence, in the grand American tradition, a law suit.

    It is likely that good law will make for bad science, here as elsewhere. Science does not flourish in the adversarial climate of the courtroom. However, the courtroom is not a bad venue for shedding light on what may be a very rotten situation.

    According to the Los Angeles Times editorial, "[the plaintiffs] depict as conspiratorial common practices like drug company funding of a disease advocacy group." The reference is to CHADD. The editors agree that this is "somewhat troubling." It is no surprise that an organization like CHADD supports stimulant medication as a treatment for ADHD. And it is not blameworthy for doing so. After all, Ritalin does work for many children, and is a Godsend for some. Where the organization stepped over the line, it seems to me, is with the overtly hostile attitude it adopted to any alternatives to Ritalin, such as neurofeedback training of the brain. After all, there was no research evidence for such a position. All the existing research was favorable in its implications. The only valid criticism of the existing body of research is that it was not all that might have been wanted for such "large" claims.

    Here is where a case can be made that a conspiracy to suppress alternatives exists. The vigorous, even strident opposition to neurofeedback has the smell of intellectual dishonesty about it, not merely of self-interest. Here is where scientists stopped acting as scientists should, and were using the scientific method not to elicit the truth but to club emerging ideas into oblivion. CHADD was in thrall to its own scientific advisers, and turned out to be a willing pawn in the larger campaign to turn more and more of our children into lifelong dependency on the pharmacology enterprise.

    See comments in paper at www.latimes.com/news/comment/20001107/t000106656.html

     


    News & Reviews

    NEW BOOKS



    Dreaming Souls: Sleep, Dreams, and the Evolution of Mind
    by Owen J. Flanagan
    Why do we dream -- from an evolutionary perspective. Does dreaming convey any discernible adaptive advantage to the dreaming species? A review of current research on sleep and dreams and a new theory about the nature and function of dreaming.
    www.amazon.com/exec/obidos/ASIN/0195126874/top100/

    ADHD in Children and Adults
    by Paul H. Wender
    Update of Wender's classic handbook on the subject: more case histories, expanded section on adults, and new treatments.
    www.amazon.com/exec/obidos/ASIN/0195113489/top100/

    Chronic Fatigue Syndrome: An Integrative Approach to Evaluation and Treatment
    by Mark A. Demitrack, Susan E. Abbey, Stephen E. Straus
    The latest scientific findings about chronic fatigue syndrome from the fields of infectious disease and neuropsychology.
    www.amazon.com/exec/obidos/ASIN/1572300388/top100/

    Ethical Conflicts in Psychology
    by Donald N. Bersoff
    Chapters focus on substantive issues in ethics such as confidentiality, privilege, assessment, research, and the business of practice.
    www.amazon.com/exec/obidos/ASIN/155798591X/top100/

    Pathological Gambling: The Making of a Medical Problem
    by Brian Castellani
    More than two thirds of adults gamble on a regular basis and approx. 1.5% of adults gambles excessively. This book explains how pathological gambling has turned into a medical disorder in the US.
    www.amazon.com/exec/obidos/ASIN/0791445224/top100/

    Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage, and Meltdowns
    by Brenda Smith Myles, Jack Southwick
    Practical solutions to the daily challenges facing individuals with Asperger Syndrome and their families. Strategies to promote social skills, self-awareness, and calming.
    www.amazon.com/exec/obidos/ASIN/0967251435/top100/

    Storming Heaven: LSD and the American Dream
    by Jay Stevens
    The history behind the creation and popularity of LSD: from Harvard to nirvana.
    www.amazon.com/exec/obidos/ASIN/0802135870/top100/

    A Neurodevelopmental Approach to Specific Learning Disorders
    by Kingsley Whitmore, Hilary Hart, Guy Willems
    Explains how children are evaluated for learning disabilities such as dyslexia, dysgraphia, and ADHD. The normal development of the cognitive functions are described as well as the psychosocial and biologic underpinnings of these disorders.
    www.amazon.com/exec/obidos/ASIN/1898683115/top100/

    Care of the Psyche: A History of Psychological Healing
    by Stanley W. Jackson
    A history of psychological healing, written by a psychiatrist and medical historian. The current trend toward biomedicine should not obscure the importance of human interaction in treating patients.
    www.amazon.com/exec/obidos/ASIN/0300076711/top100/

    Electroshock: Restoring the Mind
    by Max Fink
    Written primarily for patient education. The uses, risks, and technical issues associated with this treatment. When the electrical power of the brain is not enough...
    www.amazon.com/exec/obidos/ASIN/0195119568/top100/

    Ten Years That Changed the Face of Mental Illness
    By Jean Thuillier
    Was the development of psychotherapeutic drugs such as chlorpromazine and lithium the key advance in mental health of the past century? This book explores the history of these inventions.
    www.amazon.com/exec/obidos/ASIN/1853178861/top100/

    Youth Violence: Prevention, Intervention, and Social Policy
    by Daniel J. Flannery, C. Ronald Huff
    Should youth violence be viewed as a criminal-justice problem or a mental health issue? Includes neurobiological and pharmacological issues in the treatment of violent youth.
    www.amazon.com/exec/obidos/ASIN/0880488093/top100/

    Difficult Clinical Problems in Psychiatry
    by Malcolm Lader, Dieter Naber
    Thirteen articles discuss treatment of difficult psychiatric conditions, such as schizophrenia, manic-depression, treatment-resistant depression, OCD, anorexia nervosa, and CFS.
    www.amazon.com/exec/obidos/ASIN/1853175501/top100/

     

     


    JOURNAL PAPERS

    Is asperger syndrome/high-functioning autism necessarily a disability? : Does Asperger syndrome (AS) or high-functioning autism (HFA) lead to a disability or merely a "difference"? Two models summarize how these individuals are "different": the central coherence model, and the folk psychology-folk physics model.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11014749

    Neuroimaging in bipolar disorder: what have we learned? : Besides possible structural abnormalities associated with bipolar disorder, decreased activity of the prefrontal cortex is found for bipolar patients during depression, though it is not clear if these changes are reversed with mania.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11018223

    Global processing in high-functioning autism and Asperger's disorder. : Using a global-local identification task (e.g., a letter outline consists of smaller letters, same or different) the autism group made more global errors than controls (indicative of right-hemisphere dysfunction) whereas the Asperger's group did not.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11039689

    Effect of somatic comorbidity on alleviation of depressive symptoms. : Moderate somatic comorbidity has only a minor effect on recovery from depression.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11037361

    Structural and functional brain development and its relation to cognitive development. : Recent pediatric neuroimaging studies suggest that increasing cognitive capacity during childhood coincides with a gradual loss rather than formation of new synapses and presumably a strengthening of remaining synaptic connections.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11035225

    History, evolution, and diagnosis of premenstrual dysphoric disorder. : Premenstrual problems with mood and behavior have been widely known forever, but has been formally recognized since 1987. Its history and how it differs from other conditions are reviewed.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11041378

    Early maternal depression on infant-mother attachment : Infants of depressed mothers often lack secure attachment and occasionally exhibit avoidant and disorganised attachment.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11039686

    Effects of nicotine and caffeine on EEG topography : Nicotine increases EEG power in some higher frequency bands in some conditions whereas caffeine decreases EEG power across almost all conditions.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11037035

    Neuropsychological consequences of abstinence among older alcoholics : Memory and executive skills only slowly recover, if at all, with abstinence.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11045859

    Evidence of an amygdala hypothesis of autism. : A developmental malformation of the amygdala may underlie high-functioning autism. These individuals often show enlarged amygdalas and characteristics assoc. with amygdala damage (impaired recognition of fear expressions, perception of eye-gaze).

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11006968

    Discussion of developmental plasticity: factors affecting cognitive outcome after pediatric traumatic brain injury. : Discusses current research in the context of a model of the numerous factors influencing recovery after brain injury in children including brain plasticity.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11001160

    Neurologic evaluation of violent juveniles. : Argues for a systematic, meticulous neurologic evaluation of any juvenile who has acts violently. This evaluation should include tests of cerebral-cortical function and waking and sleep EEGs, and other neuroimaging investigations.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11005006

    Polysomnographic and spectral sleep EEG in primary alcoholis : Ethnicity interacts with alcohol dependency in prolonged sleep latency, loss of delta sleep, and short rapid eye movement (REM) latency. African-American alcoholic patients show more severe sleep abnormalities than Euro-American alcoholics.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11003203

    Interhemispheric asymmetry of motor cortical excitability in major depression : Major depressive disorder patients show interhemispheric differences in motor threshold due to lower excitability on the left hemisphere. Controls do not.

    Further info: www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=11026958

     


     

    Events & Locations

    Upcoming Courses

    Comprehensive
    San Antonio, TX - Nov 16-21, 2000
    Encino, CA - Dec 7-12, 2000

    4-Day Beta/SMR - Los Angeles area
    January 18-21
    February 22-25
    March 15-18
    April 19-22
    May 17-20
    June 14-17

    2-day Alpha/Theta - Los Angeles area
    March 24-25
    June 23-24

    Sue Othmer's 2-day Advanced Practicum
    January 6-7 - Los Angeles area
    May 5-6 - East Coast


    More info at www.eegspectrum.com/course

    Conferences for Neurofeedback Clinicians & Researchers

    CONFERENCELOCATIONDATES
    Winter Brain 2001Miami, FL Feb 2-6

    The 9th Annual Winter Brain 2001 Neurofeedback and Brain Sciences Meeting, Feb 2-6, 2001 Miami FL
    Lectures on Peak Performance, QEEG, ADDHD, Transpersonal experience, and more. Selected speakers include Karl Pribram, Thom Hartmann, Jay Gunkelman, Robert Gurnee, Joel & Judith Lubar, Sig and Sue Othmer, & Barry Sterman. Includes 30+ workshops and an exhibit hall.


     

    Last Word

    Reflections on a Retraction

    by Siegfried Othmer

    A recent issue of Science Magazine (Volume 289,18 August, 2000, p1137) reflects on yet another report of research fraud. The editorial observes "So far, the incidents have been concentrated in the life sciences, particularly basic biomedical research." Why should this be so? Perhaps it is because of the proximity of the life sciences to the end product, which is not so much scientific knowledge as it is medical practice. And medical practice tends to lean on science much the way the priesthood relies on sacred text. In medicine, science is more about truth rather than process. For example, it has been said that "It is no longer true that neurons don't regenerate." Of course if it is not true now, then it was never true. The only way the statement makes sense is that in medicine we are dealing with a provisional truth, arrived at by concensus, that has a certain declarative validity quite independent of any true "scientific" basis.

    So, in biomedical research, there may be an undue primacy given to the collective body of declared "truth," and experimental science is simply marshaled in the service of this truth. If one can be more efficient in helping nature along in revealing its secrets, what's the harm, since we know what the answer is anyhow? The culpable scientist was surely not trying to rewrite the laws of nature. He was just being a good acolyte in helping the natural progression of research along its most efficient path.

    It is only on this basis that we can understand the visceral opposition to the claims of neurofeedback within the anointed (or self-anointed) scientific priesthood. It is not yet within the scope of what can be believed. The workhorse that is drafted in support of such thinking is, of course, the long-suffering placebo effect. In thinking further about the placebo effect, I realize that it serves the same function in biomedical research as the stork does in childhood. That is, it deflects the discussion from what is really being asked. The stork theory does not really answer the question of where babies come from. And the placebo model does not really provide an answer to the question of what might be going on. Both answers instead close the door on the intended inquiry. Just to bring this analogy closer, I think we should in future simply stipulate that all vaunted placebo effects are probably valid, and brought to us by that famous Spanish tenor, Placebo Degringo. Then we can get back to the real issue of what is going on. (A debt of thanks to Mark Steinberg.)

    It is time, I think to hold our critics up to ridicule for their position. In the late sixties, Richard Feynman gave his BBC lectures at Cornell, and the auditorium was filled with people from the Physics Department. After the end of one of the lecture, with the mikes presumably turned off, Feynman carried on. He said, "Physics is sex; and mathematics is masturbation." This brought down the house. Experimental science engages with the real world. To a man, our critics have distanced themselves from any experimental verification or contradiction of our claims, even though this could be trivially done. In this regard, then, they should be classified with the mathematicians.