March 17 , 2003 |
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"Artistes and Autistes"Author: Siegfried Othmer Ph.D.“Not everything that can be counted counts, and not everything that counts can be counted.” Albert Einstein The debate continues on the various lists about the value of QEEG-based information to drive protocols. Whereas the fissures in the field are not as severe now as they once were, a divide still clearly exists, with people encamped comfortably on one side or the other. Each side claims to have science on its side, but if truth be told, we are each reinforced in our approach by what amount to a succession of dramatic case histories, plus a sprinkling of supportive studies. What matters in determining which side of the divide we are most comfortable with is not simply the accumulating data, however, but who we are as scientists or clinicians. It is our personal style in confronting new information that determines which kind of evidence we will attend to. When this orientation is then graced with clinical success, it is continually reinforced. With a technique as powerful as neurofeedback, such reinforcers are plentiful. We therefore have two or more evolutionary pathways for the development of the field, and these would tend to diverge if left to their own devices. Deliberate efforts then need to be made at cross-fertilization to keep these developments from further fragmenting the field. As the field matures, and as people begin to feel safe in their worldview, more honesty will also enter the discussion, and people will recognize the extent to which EEG phenomenology drives even mechanisms-based training, and conversely model-based thinking informs QEEG-based training. Whereas a bifurcation of the field into fundamentally different approaches is probably more damaging than helpful, there is also a danger in having one perspective entirely eclipse the other. The perspectives brought to the field by practitioners of both worldviews are somewhat complementary. They reflect one of the main divisions in the sciences, between the lumping and the splitting perspectives. Historically we see shifts in scientific orientation over the generations from a generalizing and a particularizing perspective. No stable equilibrium is ever reached, but rather there is gradual movement from one orientation to the other, and fashions shift accordingly. Only rarely are both perspectives kept in useful contention within the same person. Stephen Jay Gould was a paleontologist who devoted his life to the study of snails. But he also aspired to the most inclusive, general models that could be squeezed out of the data. E.O. Wilson was another such scientist. In this case the lifetime focus was on ants, but Wilson was also the author of the book Consilience, about the trend toward inter-disciplinary engagements in the scientific enterprise. Of course the best example was Charles Darwin, but it is better to draw on more contemporary examples. Most clinicians and scientists fall more specifically into one orientation or the other, and we may refer to these two tendencies as the artistic and the autistic. The artistic mindset is global and integrating, and allows itself to be somewhat intuitive, to follow up on hunches, and to take mental leaps. The autistic mindset is to confront the sensory overload of the clinical world by narrowing down to a few variables that can be well-characterized, and to define reality with respect to those measures. This is the buttoned-down world of the engineer and left-brained scientist. This is also the bias of the entire enterprise of science. One has a sense of inevitability about the fact that the thrust toward establishing validity for our work involves a bias toward what is readily quantifiable. That may end up narrowing perspectives, to the detriment of the healthy progression of this field. I recall a NOVA program on the mapping of India by the British. Simply the possession of the cartography of India gave the British enormous leverage. Similarly with the American Indian. When the American government decided to map Indian lands and to impose the discipline of individual ownership on those who had always said land was not for owning, it was another blow to the Indian lands. He who owned the maps ended up owning the territory. The history of this discipline is that mainstream science not only gave rise to this field at the outset, but it also nearly killed it right after. And even now there is a certain disdain for the clinically so very fruitful domain of alpha-theta training. The enterprise of science does not tolerate or cohabit well with soft-science phenomenology. This troubled relationship is illustrated well by the attempted replication of Peniston’s work by Ken Graap and David Freides at Emory University. To the one community here was a demonstration by legitimate researchers that evidence for alpha-theta training did not hold up. To the other community the effort proved only what practitioners already knew—you don’t entrust something like alpha-theta training to left-brained scientists. The nascent field---so promising for the field of psychology---was being killed off all over again. The subtlety of what can be at play in this work is illustrated by the Pandas at the Washington zoo. For ten years they tried to mate the pair and failed. Thinking them to be solitary in the wild, the pair was kept apart except during estrus. After ten years, someone came up with the idea to allow the pair to be together without restriction. Voila, offspring. We knew well the timing of estrus. We knew nothing about relationships among pandas. This to me is paradigmatic for the inevitable soft-science aspect of things, which are of course prominent in neurofeedback as well, particularly in alpha-theta. A few months ago the Economist warned that if people thought they had reason to be concerned about genetic engineering—of plants, animals, and man, then they should really be concerned about what was coming along in the neurosciences and neurotechnologies. Much of the questionable, discomfiting future that was painted involved things we are already routinely and proudly doing with neurofeedback---improving IQ; eliminating violent propensities; warming up the cold-blooded sociopath; etc. It was hard for me to share the pessimism. But then there is the small matter of control. Once this field becomes tethered to the plow of left-brain science a Gattica-like future becomes not only possible but perhaps even likely. What is now a beckoning opportunity for mental health may in the next stage of development just as quickly become a means of control—of individuals and ultimately of entire societies. To retain neurofeedback as a humane discipline two things are required: There is an inevitable tendency for techniques to gradually become more refined and more complex. This includes our own approach. Every once in a while one needs a reset operation back to radical simplicity, and that is what is promised by the above approaches. And it is such simplicity that facilitates human liberation from utter dependency on the priesthood of modernity, namely that of science and medicine. At the turn of the year the Economist reflected on the challenges to globalization—poorly articulated at this point though they are. Where are the alternatives, the editors asked? Well, don’t look for them any time soon on the front page of the Wall Street Journal. But neurofeedback is perhaps a paradigm for the future—a technique with a unique potential for human health and well-being; one that can be tailored to the individual; and one that can be mastered by the individual with respect to himself or herself. Neurofeedback could be a counter-point to the prevailing trend toward the centralized control of our lives. It is the larger themes mentioned above that hang in the background of the debate between the different schools of thought in the field. It is a matter of what we bring to our work; what vision we hold for the future development of neurofeedback; and where, ideally, we would like to see the “locus of control,” whether in a newly minted authority or, finally, within the individual himself. We are never just arguing about the data.
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