Psychful

I (re)learned a valuable lesson yesterday involving the importance of good communication between therapist and patient. It’s humbling to have to relearn things that you know intuitively as well as learned through long professional experience. The humility should serve me well. Humility has a way of doing that. 

After training a seven year old boy with severe ADHD for about 12 sessions with neurofeedback, I was discouraged by the lack of progress that was reported by his mother. My solution was to change the reward frequency I had been using in his training. Instead of remaining in the infralow frequency range (.0001 Hz), the current iteration of the Othmer Method of neurofeedback, I raised his reward to 7 Hz based on the recommendation of a colleague who reported success in many cases of treating ADHD with this intervention. The youngster was unaware of the frequency change and continued to sit comfortably watching “Barnyard” on the computer monitor with the EEG leads on his scalp.

This particular boy had been on Concerta for the last 2 1/2 years, and as is often the case, the effectiveness of the prescription medication had waned to the point where he had regressed to engaging in dangerously impulsive behavior. That is what triggered the call for my neurofeedback services from his mother.

I knew I should share my intervention with his mother so that she could be attentive to any symptom changes or possible side effects from the change in reward frequency.  I told mother about the change and explained my reasoning was based on the lukewarm treatment progress she had reported to date. Mother replied with an apology. She had not intended me to interpret her reports of progress as being limited in scope. This was her first experience with neurofeedback and she had no basis for comparison.  She had only my initial presentation of the possible treatment outcomes for training away symptoms of ADHD using neurofeedback.

I decided to inquire a little deeper to better assess her report of her son’s treatment progress.

(Me) I understand that when your son began using Concerta he quickly showed a tremendous positive response to the medication.  What percentage of that initially great medication response was lost by the time you called me for neurofeedback?

(Mom) About a 75% loss. It was so much that he was engaging in dangerously impulsive behavior, like riding his bicycle out into traffic at major intersections of busy streets without my knowledge. This was happening even when he was taking the medication.

(Me) Since we have been training him with neurofeedback, what percentage gain would you estimate he has made towards that originally good response he got from the medication?

(Mom) 60-75%.

(Me) Your saying that in these 12 sessions of neurofeedback your son’s symptoms of ADHD have remitted to nearly the point he was at when he first started the Concerta?

(Mom) Yes.

Glad I asked! I had been interpreting her someone stoic appearance and cautious reports of treatment progress as being lukewarm and needing an intervention to increase the effectiveness of the the neurofeedback.  But making a 60-75% improvement in symptom reduction with a few weeks of neurofeedback training was hardly lukewarm!

Mom had tried withholding the Concerta on a weekend day and her son, quite naturally at this point, responded by becoming wholly undisciplined. His treatment progress while on medication reveals the fact that significant measurable changes are possible in treating children with ADHD using neurofeedback even while they are on prescription medication.

Now I will need to evaluate the merit of changing that reward frequency. We weren’t doing so bad after all!

Whether you’re aware or not, we are all drowning. The world is drowning, in information. The once remote ice caps of knowledge are melting and oceans of information are rising across our planet. As our friends at ShiftHappens report in their videos Did You Know? 2.0 and 4.0:

One million books are published worldwide each year.

130 million blogs and one trillion web pages now exist on the Internet.

More exabytes of unique information will be generated this year than in the previous 5000 years.

It is impossible for anyone, or any organization, to distill the collective wisdom from this unyielding flow of information. It’s more than Wikipedia can handle.

We cannot stem the tide of new information. For our very survival, as individuals, nations and as a planet, we must do what humans have done for millennia; we must adapt. Adaptation in this information-rich environment requires learning new skills.

Learning these skills means our process of education must change. Memorizing selected data points from the waves of evolving knowledge can no longer constitute “education.” Education must place less emphasis on mental data storage and more on data discernment, developing the cognitive skills to separate informational wheat from chaff. When faced with oceans of data, two skills are essential: the ability to find needed information, and the ability to assess the value of the information. Google may facilitate the search, but discerning the value of information is the skill of critical thinking.

Critical thinking has been defined as “reasonable, reflective thinking that is focused on deciding what to believe or do” (Ennis, 1995), and “the art of analyzing and evaluating thinking with a view to improving it” (Paul & Elder, 2002). Both definitions emphasize a conscious cognitive skill developed through practice. The mental sloth of uncritical thinking is often biased, uninformed or prejudiced. To be educated today, to avoid drowning in the data, we must literally learn to think, to develop the cognitive discipline of critical thinking.

One of the simplest ways to begin critical thinking is to ask questions, and one of the most basic questions is, “how do you know”? How do you know what is accurate and reliable information? How do you know if something you read on the Internet or see on television is free from bias? If you are unfamiliar with a topic, how do you know who to trust in reporting that topic? You may be able to readily access information, but how do you know that it is good information? To better understand the critical need for critical thinking, consider just one area of concern; the effect of media bias on politics.

Media Bias in Politics

All of the information we attempt to understand today is presented to us through various media: newspapers, magazines, books, blogs, radio, television, You Tube, etc. None of these media are free from bias. All media have a target audience, and in order to be popular with their target audience, all media naturally focus their news and information towards their audience demographic. In the political domain, liberal or progressive media focus their “news” to those on the left, while conservative media slant their information so that it is palatable to consumers on the right.

Walter Cronkite was once considered the most trusted newsman in America. Now it’s Jon Stewart. Television shows like Fox’s O’Reilly Factor and MSNBC’s former show Countdown with Keith Olbermann have abandoned objectivity for advocacy. They purposely provide passionate news with a slant their audience finds appealing, stimulating their base much like a football team stimulates the passion of its fans. The goal of advocacy journalism is less to inform, more to overwhelm, to beat the other side in a news ratings contest.

Even mainstream journalists tend to focus their assumptions, point of view and conclusions to fit a narrative consistent with the perspective of their audience and culture. At one time in our history the media discussed slavery in rational, naturalistic terms. The same U.S. media that repeatedly condemned Nazi atrocities in World War II barely mentioned the 200,000 civilians killed in Hiroshima by a U.S. atomic bomb. As Paul & Elder note, all journalists intuitively select terms to reflect the perspective of their audience:

“We plan…they plot. We have convictions…they are fanatics. We build weapons to defend ourselves…they build weapons to threaten us. We intervene…they invade. We are freedom-fighters…they are terrorists.”

If journalists failed to provide this familiar sociocentric perspective, their audience would accuse them of being tainted, biased, or unprofessional. It appears that in our capitalistic system, media bias is here to stay. Now there’s a critical need for critical thinking.