The references which Tom gives probably contains the "facts,"
such as they are, which Bill asks for in his post to me. I am
sure that they will not satisfy Bill because of his definition of
a fact which is, I think: A statement about people in general,
or about a person in particular, which is true almost 100% of the
time. Is this right Bill?
Would the following be a fact?: Using 20 variables of EEG
activity, Thatcher(1989) was able to correctly identify 94.8% of
the cases with respect to the question: Did this person suffer
from a mild head trauma? He was able to show this level of
identification in a number of replications across people,
research settings, different data collection equipment.
Even if this is not a fact, according to Bill's definition, a
clinician using this "false fact" could do a lot better than by
chance alone. A person in a work accident might be denied
benefits by an insurance company. The company might claim that
the person is faking or malingering. The 20 variables could be
collected in an EEG monitoring session which only needs to yield
60 seconds of artifact free EEG with eyes closed. The empirical
function which Thatcher found, which discriminates known mild
head trauma cases from known normals with 90+ % correctness,
could be applied to the data and might yield the statment: The
probability that this person suffered a mild head injury is such
and such. This "false fact" could be used to counter the equally
"false fact" that " The person has not sufferred a mild head
trauma." which the insurance companies make with no basis other
than a generalization such as: Our experts tell us that most
people who experience this kind of work accident to not take so
long to recover and do not experience the symptoms the claimant
is making.
Bill asked for the definition of cortical excitement. Thatcher
defines it as frequency of EEG. Someone showing "above normal
levels of excitement" over some particular scalp location is,
therefore, showing more components of the EEG in the higher
frequencey ranges.
In a recent workshop I attended given by Thatcher, he presented a
view of the origin of the EEG in the cortex in terms of
interactiions between the pyramidal and golgi cells. It was very
interesting, and included feedback concepts, but I need to firm
up my knowledge in this area more before trying to repeat the
explanation. Perhaps Tom or Andy will favor us with a brief
description of the origin of the EEG if they know it.
There are clinicians using EEG Neurofeedback whose clinical work
can be thouhgt of as providing a test of whether the
relationships between excitement and depression which I
summarized are correlational or causal. Sonders, a psychiatrist,
reports that 80% of the people who were given EEG Neurofeedback
based on these generalizations experienced meaningful reductions
of depression symptoms. He has not published his data at this
point to my knowledge. I will be attending a talk he will be
giving in December and ask if he has anything published.
I am sure that Bill will say: What about the other 20%? I don't
know the answer to this. Most clinicians would be happy with an
80% success rate. Clearly, if you are one of the 20% who did
not show improvement, this would not be satisfying. Bill's
attitude, which is technically correct I believe, can be
frustrating to "desperate clinicians" who are asked to help
people now, based on what we know rather than what we would like
to know.
Half joking, half serious, my father used to ask me when I came
home with a 95% on a test, which I was very proud of at the time
because most of the other children did not do as well: What
happened to the other 5%? Another favorite expression of his
was: That and 25 cents will get you on the bus. This is when
busfare was 25 cents. It was hard not to to react to these kinds
of minimizations of accomplishment with sadness and anger. I
know that he meant well, but it certainly did not feel good at
the time.
Perhaps, a person will try harder. Perhaps a person will give
up. Julian Simon conceives of depression as the result of
chronic "negative self comparisons" combined with "a sense of
hopelessness." I guess as long as we continue to have hope that
it is possible to have better facts about depression that we will
not become depressed about it. Bill's attitude about facts is "a
negative comparison." Is it a realistic standard in more
complicated circumstances? This seems to be an important question
to accompany Bill's question of Is it really a fact?
I would be happy to help 80% of the people who came to me.
However, I agree that 100% would be even better. Until I reach
the almost 100% standard, I will not fool myself into thinking
that I really know what is happening in the case of depression.
However, if I am helping a larger percentage than someone else,
I would like to entertain the fantasy that my "false facts" are
better than his "false facts."
I plan to read the references which Tom mentions. The best
single one that I am familiar with is:
Harris, J.E. (1986). Clinical neuroscience: from
neuroanatomy to psychodynamics. New York: Human
Sciences Press.
···
To: Bill, Tom, Ed, Avery, others interested in topic
From: David Goldstein
Subjection: depression
Date: 11/02/93