Psychotherapy Out of Bounds

PSYCHOTHERAPY Out of Bounds, continued
Lashley’s Mass Action Hypothesis flitted through Felicity’s mind creating a sense of despair. If the amount of impairment of functioning was indeed proportionate to the amount of damaged brain tissue, the massive loss of brain tissue should imply permanent and massive loss of functioning. Certainly, Lashley’s hypothesis was accepted by psychologists and, besides, who could doubt such an obviously correct hypothesis. Felicity’s ‘mind’ focused more and more on the word ‘hypothesis’ (which means ‘guess’), and he began to run over in his mind the contradictory evidence which he had encountered. Lots of patients exhibited huge amounts of impairment of functioning with absolutely no ‘visible’ brain tissue damage – this was true in many epileptic cases, for example. Also, there were lots of patients who had large parts of their brains removed surgically without any particularly apparent losses of functioning.
Perhaps a more accurate reformulation of the Mass Action Hypothesis might be that loss of functioning is proportional to the amount of existing brain tissue whose functions are interfered with by continuing irritative (that is, epileptic) brain tissue. That formulation appealed more to Felicity than the earlier one. At least it might justify trying to do something for Terry.
As in Chester’s case, Felicity started a biofeedback programme with Terry, using Sterman’s method to train increase in SMR, in order to increase the availability of neural inhibition to his brain. Two EEG electrodes were attached to Terry’s scalp near the C3-C4 sites – on the top of the head, about equidistant from each other and from the earlobes. The feedback EEG unit was set to recognize and respond with a whistling sound for all recorded occurrences of sensorimotor rhythm (SMR) activity – electrical activity from this brain site occurring at between 12 and 14 cycles per second and between 10 and 30 microvolts. The purpose of this whistling sound was to provide a ‘reward’ for Terry’s brain for producing the desired SMR activity. SMR is an EEG activity representing neural inhibition in the brain. Neural inhibition is one means by which the brain functionally insulates itself to prevent short-circuiting or epileptic or irritative activity from occurring. It was thought that if his brain could learn to increase its production of SMR, it might prevent both his epileptic seizures and any irritative electrical activity which might be interfering with the functioning of undamaged parts of his brain.
Meanwhile, galvanic skin resistance (GSR) electrodes were also attached to Terry’s right (that’s right, right) hand to measure changes in the amount of sweat of his hand. He was shown pictorial slides which were changed for each successive 1,000 ohms of increase in his GSR level. Quirk’s stimulus conditioned autonomic response suppression (SCARS) method, which was described in Sally’s case, was used here to train Terry to limit any intense autonomic- anxiety reactions. The purpose of this treatment was both to desensitize any traumatically-conditioned anxiety which might have been left over from the traffic accident, and to prevent the possibility that any autonomic storms might occur and erase any trained increase in SMR production which might be achieved. The EEG-SMR method and the SCARS method were used at the same time.

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