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.
A couple of newsletters ago I mentioned
an anecdote told by Nancy White, but even as I wrote about it, I
was uncertain as to the source. It could also have been told by
Lynda Kirk. I first approached Nancy White at the conference, and
she did not recall the tale. So when I saw Lynda Kirk I asked her
if she recalled the anecdote of the guitarist who played for people
in vegetative states. She did not immediately recall the story either.
I asked her if she would recall it with certainty if she had ever
told the story, and she answered, not necessarily. Now a very interesting
thing happened. As I told the story back to her, my own recollection
became reinforced to a virtual certainty that it was in fact Lynda
who had told the story originally, not Nancy. Seeing Lynda there,
and hearing her voice, served perhaps as more powerful cues to my
own recollection, so that I could almost picture Lynda telling the
story on stage, and I could even hear her words. At the same time,
Lynda found the story gradually becoming unearthed in her own mind,
and she began to reach her own certainty on the matter. Of course
it is also possible that our minds were at that moment in resonance,
and that our respective memories were abetted by that shared experience.
Surely someone in our readership will have heard the anecdote as
well, and can confirm our observations. Dr.
Siegfried Othmer
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