What's New in Neurofeedback

Topometric QEEG Training Course All you need to know about QEEG... but were afraid to ask. Instructor: M. Barry Sterman, Ph.D., Oct 26-28, 1998, Highland Springs, CA (near Palm Springs) - www.eegspectrum.com/course/topomet.htm

Web Assistance Center - If you're new to the web or have a problem accessing the information you need, check out this new center. Soon to be added are a chat and forum. www.eegspectrum.com/help

New Neurofeedback Clinicians / New Offices

Bud Leikvoll, Ph.D.
Arrowhead Psychological Resources
11361 N. 99th Ave, #102
Peoria, AZ 85345-5469
(602) 974-0357

Patricia Jo Ryan, Ph.D.
2129 S. Tamiami Trail
Osprey, FL 34229
(941) 953-9060

Kent Kinzley, M.A., M.F.C.C.
180 N. Oakland Ave, #FPFS
Pasadena, CA 91101-1714
(626) 799-6391
Email: kkinzley@AOL.com
(new location)

Prudence Grand
Osgood St. Associates
10 Osgood St.
Greenfield, MA 01301
(413) 772-3775

Robert Egri, MA, CSW, MFT
Counseling Resources of Ann Arbor
2617 Peters Rd
Dexter-Ann Arbor, MI 48130
(734) 665-6924
Email: begri@umich.edu

John Anderson, MA
Minnesota Neurotherapy Inst
3040 Inglewood Ave
St. Louis Park, MN 55416
(612) 396-7029
Email:  jsander@fishnet.com
(new office)

Laura Birholz, Ph.D., Donna Cook, M.S.
Allied Clinical Services
222 S. Rainbow Blvd, Suite 117
Las Vegas, NV 89128-5340
(702) 363-3484 or 256-5151

NeuroDynamix
Domenic Greco, Ph.D.
4001 C West Lincoln Dr
Marlton NJ 08053
(609) 940-2233
Email: neuro1@netreach.net 
www.neurodynamix.com

Ross Quackenbush, Psy.D.
189 Liberty St NE Suite 201
Salem, OR 97301-3529
(503) 588-1010

Larry Hall, MS
Stirling Psychological
PO Box 622
Johnson, VT 05656
(802) 888-1136

Elizabeth Torrence, RN
4929 Heather Dr
Anacortes, WA 98221
(360) 992-2102

In a recent editorial in the Los Angeles Times, Health Alternate to Health Care, Andrew Weil opens with the following insight: "attacking alternative medicine in general and herbal remedies in particular [in a recent New England Journal of Medicine editorial] did little to restore confidence in practitioners of conventional medicine." Seventy percent of all patients have undergone one or more alternative therapies; and since 1990 visits to alternative therapy providers has outnumbered visits to primary care physicians in the U.S. Why is our confidence in conventional medicine lagging at the very midst of the biomedical revolution? What is driving this renewed and vigorous interest in alternative medicine?

First -- Weil would like to retire the term "alternative medicine" altogether. He would prefer the term "integrative medicine," an accurate label, as practitioners integrate standard and novel methods of treating a patient. Besides any negative connotations associated with anything "alternative", as a majority of patients seek out these forms of treatments, can we rightly call this treatments "alternative" anymore? Was Clinton, the major vote-getter, the "alternative" candidate in 1996?

What apparently spurred Weil into writing his editorial was the series of misrepresentations the authors of an NEJM editorial foisted on their learned audience. First, the authors argued about the "risks of alternative medicine". To support their claim, they cite three separate and isolated incidents. These rare reports of toxicity are obviously "anecdotal evidence", the same kind of evidence they denounced when it does not serve their purpose. They also neglected to make the obvious comparison: how much risk is associated with integrative treatments compared to the risk associated with standard practices. The risk of using prescription drugs involves as many as 100,000 deaths and 1.5 million hospitalizations yearly, according to Weil. The risk associated with warfare is often less lethal.

The NEJM authors believe that the increased interest in integrative treatments, beside being regressive and "irrational", may be due in part to the "harsh treatments that may be necessary for life-threatening diseases." Perhaps this is where the 100,000 yearly deaths factor into their argument. They also surmise that people resort to integrative medicine practitioners because they are disillusioned with the "often hurried and impersonal care delivered by conventional physicians." Possibly true for a handful of people, but I suspect that the manner of clinicians runs the spectrum from Mengele to Schweitzer in both camps. Perhaps the reductionism of conventional medicine, the reliance for treating the symptom and not the disease, which has made conventional so successful in so many diseases, does not always suit an individual's condition or state of mind. The increasingly tight relationship between organized medicine and the pharmaceutical industry may also contribute to a loss of confidence in the ivyed halls of medicine.

Integrative medicine "has not been scientifically tested and its advocates largely deny the need for such testing." Obviously they are not members of the PsyPhy listserver -- where members constantly assert the need for more evidence, more rigorous testing, more scientific publications. This misrepresentation irritates Weil the most. As he states, "Give those of us who support such methods the money and means to conduct research, and we will do it." National Institutes of Health opened the Office of Alternative Medicine in 1992 and since then only a single study in neurofeedback has been funded, to the paltry sum of $30,000 (i.e., rounding error in multi-site pharmaceutical studies).

The NEJM authors claim that what distinguishes integrative treatments from standard medicine is "an ideology that largely ignores biologic mechanisms, often disparages modern science, and relies on what are purported to be ancient practices and natural remedies". Operant conditioning is ancient? (B.F. Skinner attended Plato's Academy, didn't he?) When did the thalamocortical circuitry enter the "non-biologic" realm? That neurofeedback is either excluded from their characterization or unknown to the authors reveals the limits of their research into this topic.

The NEJM authors conclude that "Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional treatments." One of the most interesting features of this editorial is that just a few pages away, another author (Avrum Bluming, M.D.) arrives at the exact same conclusion -- but with greater objectivity. "We must continue to insist on the painstaking accumulation of evidence in the scientific testing of each new breakthrough." The same turf is explored with reason and clarity. Patients want an increasing role in the decision-making process. Bluming argues that as patients sort through all the therapeutic options, responsible clinicians must be equipped to assist them. Patients are consumers -- conventional medicine has ignored this fact for 400 years. Consumers require inclusion in the selection and decision process. But ironically, at the one time when patients request more control over his or her healthcare, other developments (HMOs) have added another voice to the process, one infinitely removed from the patient.

- DK

Health Alternate to Health Care by Andrew Weil www.latimes.com/HOME/NEWS/HEALTH/MEDICINE/t000093119.html

Alternative Medicine -- The Risks of Untested and Unregulated Remedies by Marcia Angell, M.D. & Jerome P. Kassirer, M.D., NEJM, Sep 17, 1998, Vol 339 (12), www.nejm.org/content/1998/0339/0012/0839.asp

Book reviews of two Alternative Medicine books by Avrum Bluming, M.D., NEJM, Sep 17, 1998, Vol 339 (12) www.nejm.org/content/1998/0339/0012/0855.asp

The Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary Therapies By Barrie R. Cassileth. www.amazon.com/exec/obidos/ASIN/0393045668/

Alternative Medicine and Ethics. Edited by James M. Humber and Robert F. Almeder. www.amazon.com/exec/obidos/ASIN/0896034402/

NEW BOOKS

Essays on the ethics of alternative medicine, including insurance coverage, legal liabilities (for healing prayer, for instance), and how organized medicine's tight relationship with pharmaceutical companies influence healthcare.

For more information, see http://www.amazon.com/exec/obidos/ASIN/0896034402/

The Alternative Medicine Handbook : The Complete Reference Guide to Alternative and Complementary Therapies
  by Barrie R. Cassileth
  340 pp, W.W. Norton & Company, $17.50

Cassileth summarizes a wide range of therapeutic approaches, from shark cartilage to shamanism. For each she describes its history, the beliefs on which it is based, and the therapeutic claims made for it, and any research evidence for these claims.

For more information, see http://www.amazon.com/exec/obidos/ASIN/0393045668/

Divorce Casualties : Protecting Your Children from Parental Alienation
  by Douglas Darnall
  288 pp, Taylor Publishing, $12

This book assists parents into recognizing the subtle causes of alienation and teaches them how to minimize their damaging effects before divorce permanently impacts one's children's mental health.

Click title for review. To order, [http://www.amazon.com/exec/obidos/ASIN/0878332081/]

JOURNAL PAPERS

Electroencephalographic biofeedback methodology and the management of epilepsy.
  Lubar JF
  Integr Physiol Behav Sci 1998 Apr-Jun;33(2):176-207