Volume 3, Issue 12, April 7, 2005

The AAPB Conference in Reflection

Author: Dr. Siegfried Othmer

During the pre-conference period I had a chance to attend Daniel Kuhn’s workshop on erasing symptoms fixated by traumatic dissociation, in particular PTSD. Kuhn’s presentation had appeal for me in various respects. First of all, he found his way to the method from an academic origin in psychoanalysis, so this work represents a significant departure from his own beginnings. That sounds auspicious. Secondly, he applies the trauma erasure method both to major and minor traumas, seeing them both in the same terms, and as subject to the same rules. He refers to the “spectrum of PTSD”. We have similarly used the term “the penumbra of trauma” to describe the extension of the PTSD model to even minor traumas. Thirdly, he employs the memory model to describe both the original establishment of the trauma and the subsequent resolution. Fourth, he recognizes that quick resolution of the traumatic impact of the original event is possible, and that verbal techniques focusing just on the causative event can have favorable consequences that then generalize. This is similar to our own observation of the transformative experience, in our case observed randomly during the alpha-theta process. Finally, Kuhn is aware that early traumas can energize and enlarge later traumas through a process of concatenation in the physiological realm, and leading to a progressive kindling of the trauma response.

Daniel Kuhn became a traumatologist by virtue of his experience in the 1973 Yom Kippur war, in which he volunteered to serve as a young psychiatrist. He had been born in Israel but had subsequently come to the United States, where he received his medical training. The war caught Israel in a state of relative unpreparedness, and soldiers found themselves woefully under-trained and unequipped for the battlefield. The resulting sense of betrayal and low morale probably led to much more PTSD than would be expected in a battle-ready force. For his part, Kuhn was also confronted with novelty. PTSD was not yet under discussion, although terms such as shell shock and battlefield psychosis covered the bases. Lengthy psychoanalysis was out of the question as a remedy. And the idea of brain plasticity was not yet available to lay the foundation for devising a remedy. Nevertheless, in the urgency of the moment, Kuhn developed his very efficient method of verbally exposing the radioactive material and of leading the person to drain the experience of its subversive grip.

A variety of simple techniques are brought to bear. The person may be asked to “unfix the viewpoint” from which the traumatic event is regarded, and to adopt a perspective outside of the event. If a person cannot separate the self from the experience, even “splitting” becomes a strategy. A person may also be asked to repeat emotionally charged words that define the experience, until a point is reached where they are reduced to mere nonsense syllables. A person may be asked to repeatedly bring up a traumatic image and then to destroy that image. A person may be asked to review the experience and to rescript it as it is envisioned. All of these techniques serve to alter the quality of the memory.

I see this technique as being most useful when one is dealing with specific, identifiable trauma events as opposed to extended trauma histories. In this regard, it is more similar to EMDR than to alpha/theta training. During the workshop nearly everyone had a chance to undergo the process, and unsurprisingly Kuhn found material to work with in everyone. There was only one real skeptic in the crowd who did not really want to go along.

When one observes how frequently people gravitate to events in their distant past, it becomes evident how universally applicable the trauma model can be. Kuhn not only describes PTSD in terms of a continuum, but dissociation as well. So in the continuing grip of trauma, we live at times in trance states that may have had utility originally but are now dysfunctional. But trance states are also on a continuum. In our own jargon, trance states are observable as patterns of coherence---of network resonances---that persist in time, and fail to adapt to behavioral contingencies. They remain rooted in past experience and available for recall during periods of extreme stress. Or they even intrude upon our ordinary livelihoods. I continue to be reinforced in the view that fear and the trauma response are key organizing principles for an understanding of our experience and of our respective patterns of physiological responding. (Because of the very personal nature of the discussions at this workshop, no tape of the presentation was made.)

One of the talks that caught my attention was by Laurel Mellin of the UCSF School of Medicine, with the title “The Solution Method; Turning Off the Drive for the Range of Excessive Appetites.” The talk had a commercial tinge to it, since Mellin has published more than thirty books on her methods, but the message rang true. She talked about the disregulated system equilibrating at new operating point of “allostasis,” one in which the person resorts to a lot of measures that may be adaptive in the short-term, but detrimental to health in the long-term. This may mean dietary indiscretions, smoking, drinking, or even obsessive immersion in one’s work. With high allostatic loading, a new homeostatic niveau is reached, one that is self-reinforcing but ultimately detrimental.

Caught in this state of high allostatic loading, it is difficult to re-establish a more appropriate homeostasis. If the attempt is made to shed one of the little addictions or another, others may take their place. Thus many of those plagued with being overweight got that way only after quitting smoking, and others after quitting alcohol. Prisons are full of smokers, and AA meetings are full of people gorging on sweets and soft drinks laced with aspertame. Mellin appeals in the fact that she sees all of these problems of the minor addictions as related, and that she is motivated to address the core issues. Mellin became interested in attachment theory some 26 years ago, and has developed a technique of achieving “limbic homeostasis” as a key component of her program. I am tempted, of course, to see neurofeedback as a shortcut to such elaborate remedies, particularly since lifestyle changes are so difficult to establish early on. It is easier if lifestyle changes follow neuro-regulation rather than bearing the burden of being the agent of change.

The highlight of the conference was no doubt the talk by Naomi Eisenberger, titled “Why Does Rejection Hurt? Exploring the Neural Mechanisms Underlying the Experience and Regulation of Social Pain.” Unfortunately this talk followed Paul Lehrer’s, and I took that as my moment of opportunity to engage Paul Lehrer on the matter of asthma remediation, and the utility of neurofeedback in addressing it. By the time Paul and I concluded our discussions, Eisenberger was finishing her talk. Fortunately, the work is already out in print, and a tape of her talk is also available. The key message is that both physical pain and emotional pain involve the same pathways. This helps to explain the high correlation of chronic pain and emotional trauma. It also helps to explain why the lower tier of sites has more import for us for emotional regulation. In our mode of inter-hemispheric training, that means F7-F8 in first instance, but also T3-T4 and OF1-OF2 (beneath the eyebrows directly under Fp1-Fp2).

I was looking forward to the talk by Robert Garchel titled “The Major Paradigm Shift from the Biomedical to the Biopsychosocial Model of Chronic Illness,” but often the most basic truths are undone by their banality. The words did not stir the audience. One also wonders how the health delivery system could adapt, tethered as it is to established ways of compartmentalized functioning.

My own proposed talk had been relegated to the Poster Session, for which it was entirely inappropriate. Nevertheless, I had massaged the material into a suitable poster. Alas, the attendance at the whole session was relatively poor. In frustration, I cornered Barry Sterman on a later occasion to show him Leslie Hendrickson’s data. Of course Barry wondered whether I had been selective in my data presentation, but in fact I had excluded only those who did not receive a lot of training. I saw the data not as a statistical sampling of what could be done but rather as an existence proof that the inter-hemispheric training is capable of yielding good results. Barry indeed allowed that the data looked impressive, but then he went on to say that there was also data that looks impressive in proof that healing prayer at a distance works, and of course we pay no attention to that…. I was suffering whiplash from the mental leap.

Those who are also on the EEG Associates list server will recall my anecdote last week of the former graduate student of Dick Gevirtz who had assimilated her mentor’s prejudices against neurofeedback. She related an incident in which another one of the biofeedback gurus criticized an EEG talk by saying at the end, "I don't believe your data, and I wouldn't believe your claims even if I did believe your data." This was shockingly prejudicial even to her, and so she was compelled to reassess what she had been told about neurofeedback in all other respects as well. Significantly, this neurofeedback skeptic was even rejecting the early work of Sterman and Lubar, the whole ball of wax.

Here Barry was likewise saying effectively, “I don’t believe your data, and I wouldn’t believe you if I did believe your data.” Or something close to that. Rejection of the data on prayer is another illustration that, as Einstein said, “It is the theory that tells us what we may believe.” Even disregarding the celestial pathway that science cannot, by its very nature, admit to the discussion, there is also the evidence from telepathy and remote viewing for the interpersonal transfer of information. So why not through prayer? Similarly, once one has rejected inter-hemispheric training as a viable approach, data become irrelevant.

So much for fealty to the experimental method. So much for the admonition that “if you clinicians would just collect some data along the way, we would find that helpful.” It’s not worth jumping through their hoop, because then they just keep moving the hoop. Of course they are being objective about it all the time. Incidents like this just reinforce my thinking that science does not actually make progress this way when it comes to a radical new departure. Data tend only to persuade if they largely conform to our expectations.

Dr. Siegfried Othmer