February 21, 2004 |
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Winter Brain NewsletterAuthor: Siegfried OthmerA quick report on the just-concluded Winter Brain Conference, while memories are still fresh. On this occasion, we offered a two-day Advanced Training Course before the conference, as a convenience to those wanting to conserve on travel costs. But it does add significantly to what is already a long conference, a burden on the attendees and on us. We will probably not do this again. Rae Tattenbaum also offered a two-day course on her Peak Performance program, which was the best attended of the pre-conference courses. A course on QEEG-based training by Jay Gunkelman and Richard Soutar, on the other hand, hardly had more students than faculty. That may be a sign of the times with regard to QEEG-based training, as well as a reflection on who comes to the Winter Brain Conference. Or people are just balking at too long a conference. On the Foundations Day, Rob kicked off the marathon with a historical review, and I started the technical discussions with 40 minutes of a firehose of data and models. The attendees were in for a long day…. The next day we were on a two-track schedule—left hemisphere on Track A to the left; right hemisphere on Track B to the right, where the Winter Brain Conference shared floor-time with the StoryCon. The audience voted with its feet, sloshing collectively between the two venues. The liveliest action, however, built up in the exhibit area, with increasing crescendo that even intruded upon the lecture halls. Val Brown was there with the latest version of his NeuroCarePro software, 1.86, which offers higher speed in execution and some additional features. We just received our own copy and will be trying out the new stuff shortly. There is also a new remote use version. Tom Collura showed a new product called Brain Mirror that implements the traditional Mind Mirror approach—used by Anna Wise—in new and elegant garb. The flowing compressed spectral array utilizes some signal processing (spline functions) for smoothing of the data in the frequency domain for a very pleasing visual effect, with a display update rate of twice per second. The mind races on. One imagines that in the future such smoothing in the time domain may also help make the display more intuitive and eye-friendly. The unit uses its own dedicated hardware rather than the existing BrainMaster amplifier. So one cannot just order up the software and use it with existing hardware. But then the whole thing is just under $800. Renting the unit out to a few people for home training for a period of time will quickly get it paid for. The obvious application is to use the unit just the way Anna Wise does, namely to monitor the person’s state either during psychotherapy or during neurofeedback, particularly of the alpha/theta type. The unit is oriented toward two-channel display, so that hemispheric balance is directly observable on the screen in a variety of display options. EEG Spectrum International was there in force with the new EEGer software, albeit with a design that was essentially put in place more than four years ago, with the objective of functionally replicating a design that dates back to 1985. Oh, the bane of backward compatibility! Nevertheless, it is a worthy step forward, and a scrolling version of the therapist display is said to be imminent. It should be a great platform for further developments. This was also the first year in which the “Wild Divine” autonomic trainer was on display. Word is spreading rapidly about this new and highly affordable product. I think that if practitioners made the option available of people using this program while they were waiting for their kids in the waiting room, the program would sell even better than our book. The software is well done, and provides for journeys that all involve aspects of physiological self-regulation that could last up to ten hours without repeating themselves. One is reminded of the earlier attempt in this direction, sponsored by George Fuller von Bozzay. That earlier design swallowed $6M in development, and then nothing was left for marketing. In the opinion of Len Ochs, the earlier product may even have been superior in some ways. For one thing, it provided for much more rapid response, which we have always considered to be part of good feedback. The Wild Divine is languid and fluid in response, but in feedback terms it may be like having vague steering in your car. In any event, more than 100 units of Wild Divine were sold right at the conference, mostly to people who had tried it personally. The QXCI people were also represented, just as they had been at SNR in Houston. They were fully booked for the whole duration of the conference with signups for people to spend an hour with the unit and with a practitioner to interpret it all. This could be considered a comprehensive physiological monitor, only it is mysterious how the monitoring is actually done. A band is strapped around the head, with an umbilical of cables running to the computer. OK, so something is being measured, no doubt. But the straps tied around the wrists and ankles are just rubber. Hmmm. And if necessary, the whole shooting match also works without any such gear, and even over the telephone. I went along for the ride. With some 1400 physiological variables ostensibly being attended to, no doubt something will come up that one will resonate with. Pupils will dilate. The person will lean forward or start asking questions. And the attentive and solicitous therapist will be aware that paydirt has been struck. For me it came up with “appendix” (I don’t have mine any more). It also came up with “right heart.” This reminded me of a cardiologist having mumbled something about “right branch bundle block” fifteen years ago when surveying my EKG. There were no doubt a bunch of misses, too, but one picks up on the hits. I had not really learned anything about either my appendix or my heart, but ineluctably my confidence in this little mechanical oracle was rising. It is the Las Vegas effect. Winnings and losses affect us differentially. Then there is the remediation. As the problem at issue is being held in thought, mysterious remediation is being effected. After a minute or so, the computer declares that a certain percentage of resolution of that problem has been achieved, and then the next problem is targeted. Or the program will ask for additional time to do its work. I cannot imagine a better way of mobilizing the placebo effect with a technologically sophisticated Western audience. Of course one leaves the experience lighter afoot, a number of obscure problems having been expunged painlessly out of one’s repertoire of chronic ills. Peter Litchfield told me at length about his investigation of the whole adventure. In the creator of this program we may be dealing with a modern L. Ron Hubbard, a genius of sorts, but perhaps one whom you would not invite over for dinner. It is best not to suspend critical faculties in the presence of this particularly awesome set of software. For the first time I also got to try the neurofeedback system built around the Sony PlayStation. This development was undertaken by Domenic and Lindsay Greco, and involves technology licensed from NASA (the attention trainer developed at Langley) as well as the interface unit built by Bruce MacMillan (the Pocket Neurobics). It was my first time on the Sony, so I felt very self-conscious as I learned to drive with people standing around watching. My attention was entirely on the driving rather than on the rewards and inhibits, but perhaps it is only to the good that the feedback recedes into the background. I found myself escalating in arousal level, however, as I gradually got the hang of it, and pretty soon I was crashing my vehicle into obstructions at 180 miles per hour rather than at thirty. What does it mean to have high SMR amplitude under such circumstances? I have not a clue. My sense of it was that the demands of the game dominated in physiological effect on me over whatever the feedback might be doing. Perhaps that will change once the “Fehmi brainstate” (the state of mastery) has been reached, to wit: “anything that is worth doing well is worth doing effortlessly.” I was far from reaching that point with the game, but I am sure that seasoned kids could readily work the game in that mode. At this point in the day I was having blurry vision from all of the excitement; my brain was fogged; I needed recovery from sleep deprivation; and so I repaired to the NeuroCarePro booth for rehabilitation. Sue Dermit Brown recognized my distress and gave me a soothing journey, then an energizing one at > 40 Hz, and then again a more middle-of-the-road piece. My brain threatened to go off into theta-land a few times, but after the session my brain felt like it had had the benefit of a few hours of sleep. The blurriness of vision was gone. I was ready for Swami Beyondananda that evening. I must share with you one sour note that for me will always cast a shadow over this year’s conference. When Chuck Davis came to exhibit his new ROSHI II+, he found that his—now former—partners were displaying a new product that ostensibly bypasses his particular technology but targets the same function. The unit is intended to be combined with a neurofeedback instrument such as the NeuroCarePro. Apparently Chuck had been offered a deal with a gun to his head---join the new venture on our terms or you will find yourself without anyone to build your product. In that new venture, of course, he would be playing no particularly useful role. The new product was already out. It is always hazardous to speak out when one only knows one side of the story, but the fact is that I have known Chuck now for many years, during which he labored incessantly, and against much ridicule and opposition, to get to this point. His technology is now in place with a Windows option (BioExplorer) to replace the Unobtainium Amiga for data display (not for processing—the ROSHI is autonomous). My impression is that Chuck was being short-sheeted just as his success was imminent. Obviously, this competitive product did not emerge fully-grown out of a lotus blossom. His partners had to have been on another agenda for some time, surely going further back than the last ISNR Conference, where they arranged for Chuck to receive recognition from all of the Roshinis in attendance. This is of course a classic story. In the January 2004 edition of Scientific American the history of the Curta mechanical calculator is reviewed. It tells of Curt Herzstark, who developed this elegant little calculator while in a German concentration camp during WWII, following up on ideas he had had since the late thirties. His keepers were intrigued, and the development effort clearly was responsible for Herzstark being kept around. If successful, the product would be made a gift to Hitler upon the triumphant conclusion of the war, they said. In any event, Herzstark survived the camps and was able to complete the unit in 1947, patent it by 1950, and then sell it in gradually increasing volume. The story continues: “The demand was there…and Contina expanded from the ballroom to a proper factory, ramping up production to several hundred per month. With this progress, the financiers behind the company pulled the rug out from under Herzstark---reorganizing the firm and annulling his stock. Like Edison, Tesla, and so many other inventors, Herzstark would be squeezed out of the profits of his own invention.” He survived the death camps only to be undone by his own investors…. The story now seems uncomfortably familiar. My suggestion is that people not rush to buy into the new instrumentation—attractive though it may be—until these disagreeable matters are satisfactorily resolved. Chuck will need a few months to get new developments to salable status. Anyone who has lasted this long without the ROSHI technology can also wait a few months longer. During the main part of the conference—in fact the opening talk—I presented on the need to unify the fields of biofeedback and neurofeedback conceptually. Our field cannot flourish the way it is currently split. On the one hand, all the diversity that is coming into the field is to the good. But the ongoing claims of uniqueness and global superiority are now largely unsupportable. There are quite simply many viable pathways to self-regulation, and the discussion should be about how these instrumentalities are best deployed. It is a question of clinical efficiency, not of clinical efficacy. Please pardon me if I find occasion to reinforce this message in the future. Sue presented on training the back half of the head, on the new findings for parietal and occipital training with the inter-hemispheric placements. In a workshop, Sue talked about applications to pain management, a timely topic since we are writing a book chapter on the subject. During a panel discussion on mechanisms, Hershel and I had a repeat of what we did at the ISNR conference. Sterman was to join us on that occasion, and Gunkelman on this one. Sterman was a no-show, and Jay came in late to this panel, and thus we did not have a chance to coordinate our respective contributions to the panel in advance. Unfortunately, Jay started to throw jabs in the middle of my presentation, which was not welcome at all under those very time-constrained conditions, where I was on a forced march through my material, building a web of argument. Hershel reviewed his model of HEG with his by-now thoroughly familiar slides. He had already been on stage for forty minutes before the panel even started. So we had more than an hour with HEG, and it was after ten at night when we transitioned into a more fruitful discussion mode. Hershel repeated is data compilation on HEG achieving quicker results on TOVA normalization, even though he is aware of my counter-arguments against those apparent findings. Hershel is gracious to point out that he is not really claiming that HEG is faster than neurofeedback. After all, his model is that HEG impinges on angiogenesis---capillary formation, whereas neurofeedback potentially influences synaptogenesis. There is surely no expectation that angiogenesis works faster than synaptogenesis, or that only one of these processes is needed to effect resolution of clinical syndromes. Instead, the case makes itself: If angiogenesis is the mechanism, then we should be using HEG to promote it directly. With regard to speed of response, Hershel is really saying that his results point to the relative advantage of training at frontal placements, not the intrinsically greater speed of response of HEG. Go where the problem is—that’s his message. We have of course known about his claims for years, and we have wanted to go to frontal placements for a long time. Dan Maust and Jonathan Cowan had been urging it even longer. But it was some time before we were able to do so benignly. By now we do have extensive experience training frontally and pre-frontally. The fact is that ADHD does not fully resolve for us using only frontal or pre-frontal placements. Using our approach, we cannot abandon the central strip at all. It remains dominant both in our approach and in our conceptions. In fact, we are seeing parietal training playing an increasing role, now that we have a pathway to using it effectively. And the importance of training the central strip is reinforced by what we find with migraines. Whereas Jeff Carmen makes the strong case for pre-frontal training with his pIR HEG, we find unambiguously that migraines are best addressed in our paradigm with T3-T4 training. Jeff has made forays to other placements than Fpz (such as Fp1 and Fp2) and has been rebuffed. Sue trains other sites as well, but finds that when migraines crop up again, one must repair back to T3-T4. Amidst all of Hershel’s old charts and SPECT scans, which are becoming very familiar, there was one gem. It was Hershel’s telling of the story of his son, who suffered a head injury some time back while transporting a sailboat. As is often the case, the symptoms did not set in until some time after he was declared medically fit. But then they set in with a vengeance. At one point he even considered suicide. Hershel had just gotten acquainted with a paper in Science that pointed to F8 as a site strongly involved with emotional processing, a site activating and de-activating in a kind of counter-point to the anterior cingulate. The relevant paper is by Naomi I. Eisenberger et al, in the October 10, 2003 issue of Science Magazine. It is titled “Does rejection hurt? An fMRI study.” And it finds that emotional pain registers in the same places cortically as physical pain. Hershel got a direct indication of the special nature of F8 when he was monitoring the HEG signal both there and at Fpz. There was a burst at F8 during a crying episode while his son was still in his depressed state. Hershel trained the F8 site on his son’s head, and after a few training sessions obtained complete resolution of all TBI symptoms. Any naïve observer would be inclined to think in terms of spontaneous remediation. And that of course does occur. But it does not occur on a timescale such as this, as those of us working with TBI for years are aware. What a heart-warming story, and how wonderful that Hershel was able to help his son in the same timeframe that Marjorie’s health is increasingly compromised. At the same time that Hershel and I were engaged with the mechanisms discussion, another panel was involved with the topic “To Q or not to Q,” a panel to which Sue and Val had both been invited. Both would rather have been part of our mechanisms discussion next door. As it was, there were more panel members than audience participants in that forum, which also says something about the declining hegemony of QEEG-based training. This panel was a set-up, in which a bit of information was metered out to the participants about the case, whereupon Bob Gurnee (whose patient was being discussed), could issue forth with the actual resolution of the mystery, which was of course based on some reading of the QEEG tea-leaves. Had the tables been turned, Sue could have shown a case that has been a clinical challenge despite the fact that the QEEG showed essentially nothing. Sue took this occasion to simply say how she would begin to assess this case. The information available to her was sufficient to serve as a reason to show up for training, not however adequate to define the protocol. The discussion was launched by Tom Brownback, who had organized the panel. He expressed his amazement that anyone could get good results without resorting to a Q to specify the training, but he was prepared to believe it based on reports from people that he has learned to trust. When it came Sue’s turn, she said by way of rejoinder, “I am amazed that anyone could get good results by relying on the QEEG alone, but I am prepared to believe it based on reports from people that I trust.” Symmetry had been restored. The playing field was being leveled. Incidentally, the critique that Jay leveled at our T3-T4 training was that there was no direct connection via the corpus callosum between those two sites. I was at the point of discussing the possible role of the corpus callosum in organizing brain timing. Jay and I have tangled on this subject before on the biofeedback list, and I was aware of Jay’s position in this regard. First of all, Jay argues that the corpus callosum involves transport delays that rule out a role in organizing simultaneity. Secondly, there was the argument above about the absence of direct linkage. His intrusion into the discussion at this moment was particularly unfortunate because I was at the point of arguing that indeed we cannot hold the corpus callosum responsible for the organization of inter-hemispheric timing, despite the fact that the CC involves some four percent of all cortical neurons. It has a role, obviously, but not any kind of exclusive or even exalted role. People still function without these connections, and in fact the resulting deficits are subtle. In particular they do not match up with the list of functional deficits that we remediate with inter-hemispheric training. On the other hand, the existence of transport delays does not preclude a role in the organization of simultaneity. Extensive modeling of complex coupled systems shows that synchrony emerges quite readily as long as some kind of coupling, delayed or not, is maintained. Further, the absence of direct linkages between T3 and T4 is almost entirely irrelevant by virtue of the very network argument that I was making. Following Paul Nunez, every point in cortex is removed from every other point in cortex by no more than three synaptic links on average. Direct linkage is not required in order to satisfy the conditions of a small-world network model by which large-scale timing in the brain is organized. It is the small-world network model that allows us to view timing in the brain as a distributed network function. Further, it is one in which the “hubs” play a central role. All of the relevant hubs are sub-cortical structures. The argument needs to be presented as a whole in order to make any sense at all. The upshot of all this was that Jay was forcing me into an unnecessarily adversarial position, one that I did not wish to be in. Also relevant to this discussion was a presentation earlier in the meeting by Richard Soutar, on the EEG consequences of inter-hemispheric training. Richard had migrated fairly strongly toward QEEG-based training over the years, and had been rewarded for doing so, but as a result of our joint training for Stress Management Solutions (Tom and Terri Collura), Richard got a heavy exposure to Sue’s protocols. His wife Barbara, who is also a psychiatric nurse, resonated with this approach and thereupon used it with a number of clients whose problems were not resolving as expected with Q-based training. Dramatic results were achieved, and this needed to be understood. In particular, one severely depressed person they had been working with for a couple of years, and who had graduated to moderately depressed with QEEG-based training, had his symptoms essentially remediated in about seven sessions of the inter-hemispheric training, and was now minimally or mildly depressed. Richard was therefore motivated to do some pre-post QEEG evaluations around the inter-hemispheric training, as well as to monitor the two channels while training was actually occurring. In the latter test, he found a gradual decrease in coherence linking mainly to T3 as the session progressed. Presumably this renormalizes after the training session, something that would be nice to confirm. After all, we are not trying to achieve a disconnect syndrome at T3. Richard also showed a number of his pre-post QEEG data sets, exhibiting trends toward normalization of amplitudes in the problematic low-frequency end of the spectrum. Such normalization had not occurred with the prior QEEG-based training, even though these very same markers were being targeted. Clearly the effects of the training were non-local both spatially and in terms of frequency, and beyond expectations in terms of their magnitude. On the downside, Richard also saw increases in amplitude in the beta range in a couple of cases, and there was residual anxiety to match. Sue suspected that the reward frequency had not been lowered enough to avoid the excursion into anxiety. It is difficult for anyone schooled in the conventional models to comfortably take the reward band down into the low-frequency regime. It is just not done! The irony is that Richard obviously had shared his findings with Jay, and yet Jay still remained in a state of deep skepticism with regard to the inter-hemispheric training. Nothing more tellingly contradicts all of the assumptions of QEEG-based feedback than good old T3-T4 training for nearly all comers; the absence of frequency uniformity with such training; and the peculiar frequency relationships that seem to prevail with training of the frontal, central, and parietal sites. Even our traditional arousal model is stretched by the new findings. The inter-hemispheric training breaks all the rules. Nothing more convincingly strikes out as a new departure from all of our past thinking in terms of sensorimotor rhythm training, of amplitude training, and of the remediation of deficits and normalization-of-function training. Nothing more convincingly illustrates the “Regulatory Challenge Model” of neurofeedback. Perhaps Jay understands only too well that with this protocol his whole worldview sinks out of sight in the sunset. (And it may be no comfort to him that our own model is similarly over-hauled.) It was also reported back to us that Joel Lubar had warned in one of his lectures that inter-hemispheric training risks kindling seizures in those who are susceptible. Some twenty-five years of work by Douglas Quirk with seizure-prone violent criminals proves otherwise. Our findings are consistent that this training resolves instabilities. It does not create them. It is certainly true that in the most volatile of the instabilities, training at the wrong reward frequency can exacerbate the instability or even trigger it. Absent suitable tutoring in the method, therefore, a hazard of sorts does exist. So if Lubar means that the technique should not be used absent suitable training and instruction, then we would hasten to agree with him. The next morning we had the panel discussion on migraines. Even though the session got underway before dawn, an audience had assembled. This presentation could be seen as a first draft of our upcoming Symposium on migraines at the AAPB meeting in Colorado Springs. Deb Stokes talked about her data on 15 cases of migraines with both EEG and HEG, and I summarized the data on Jeff Carmen’s 100 cases with HEG, along with presenting our own data and that of Jean Cohen, a chiropractor in upstate New York who has become an enthusiastic neurofeedback practitioner. Martha Lappin talked about EEG phenomenology of migraines. This is coming to be a very comprehensive story. We also included discussions of autonomic training for migraines, and for that purpose Keith Sedlacek, MD joined the discussion. One of the highlights of the conference was a talk by Alan Shore. He was supposed to talk at our CIC at Lake Arrowhead a few years ago, but had fallen ill. He has two new books out that flesh out his theories on early attachment. (“Attachment is dyadic emotional regulation.”) He has latched onto EMDR with some enthusiasm for the remediation of disorders of early attachment, and he has also been aware of neurofeedback for some years. His presentation was largely read from his materials, so it might be just as well to read his books. His talk was followed by Sebern Fisher, who told the story of the pregnant mother who went with FPO2 training from not wanting her baby to a rather benign birth and a well-regulated baby. The mom was quite convinced that her own training had in turn influenced the development of her child. It would be hard to disagree with that. Moreover, the mother did not go into post-partum depression as she had done in her prior two pregnancies. This is not the first instance of neurofeedback training during pregnancy, and leading possibly to a more benign birth process and an emotionally healthier baby, but it may well be the first such use of FPO2 training. As part of track B of the conference, Thom Hartmann gave several talks and also a workshop. Even at my age I am still looking around for my elders for moral and intellectual support. But among our generation, there are few people as keen-eyed about the challenges we face, and as ethically well-calibrated, morally fine-tuned, and spiritually sensible as Thom Hartmann. His every book is a worthy read, increasingly delving into larger issues of our society and our age. His latest book is Unequal Protection: The Rise of Corporate Dominance and the Theft of Human Rights. The book examines the fundamental reasons for the threats to our democracy (except as pageantry and as a distraction from the actual exercise of power). It is the rise of corporate power allied to the instrumentalities of the state. It’s difficult to call that by its real name, namely fascism. By virtue of global projection of influence, modern corporate power transcends the nationalism of historical fascist movements. So Thom poses another model. He sees us as being inveigled in a return to feudalism. It was feudalism, more so than King George, that the American revolution was mounted to resist. The protections that were built into the system at the time are gradually being dismantled. Thom also touched on one of my favorite themes: instability. He pointed out that we may be at the cusp of a major transition in our climate. We have suspected for some time that the transition to an ice age could be frighteningly quick. I recall joking in graduate school about the mastodons found frozen in Siberia with buttercups in their mouths. So the ideas has been around for a long time. But the science is firming up the model that the descent into an ice age could happen over as little as a three-year period. We have also learned in the last few years that climate warming was always associated with the start of an ice age, suggesting that warming may be the trigger. And we are beginning to tease out a possible mechanism for triggering the instability: It is the Gulf Stream, which is singularly responsible for making Europe habitable. With increasing melting of Greenland ice sheets, thus diluting the salt content of nearby waters, major shifts in the course of the Gulf Stream could occur that might quite suddenly trigger that instability and return Northern Europe to the deep freeze. The point is that the corporate dominance of our political institutions can never lead to a timely appraisal of such global issues. Corporate power asserts itself at immediate policy points, such as killing the Kyoto Treaty. Many other policy issues could further illustrate this point. Politics driven by corporate interests reduces to the tactical promotion of narrow self-interests, when strategic remedies are obviously and urgently called for. Given the overall quality and diversity of the program at the Winter Brain Conference, it is a shame that the price of entry is so high. Academics in particular are priced right out of the picture because they are not accustomed to such high fees. Also, a lot of the meat of the conference is to be found in the workshops, and they are priced separately. One wonders what the attendance might be if the conference were more affordable. The ISNR Conference this past year probably exceeded the Winter Brain Conference in attendance, and that may have a lot to do with the difference in fees. There were very few EEG Spectrum affiliates and EEG Associates in attendance, yet the overall attendance was the largest ever, judging by the fact that the group spilled over into other hotels. Right now, the opportunity exists to purchase attendance at next year’s conference at discounted rates. To anyone with a functioning credit card who is planning to attend next year’s conference, this option is to be recommended. It is the equivalent of >100% return of investment in a one-year period ($349 vs. $749 on-site registration fee next year. This price is available until March 15. This year’s attendees are offered an even more attractive price—I don’t know for how long.) Next year’s conference will be at the same site. That will do nicely, until such time as the field is discovered and the crowds arrive. For those who missed this year’s conference, there is the option of audio tapes or video recordings. The taping was done professionally again this year, so good quality is more assured. The service used was the same one that covered the Biofeedback Society of California meeting last November. Additional Notes: |
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