FREDRIC SCHIFFER, M.D.
Back to questions:  Ask Dr. Schiffer, so what does he think?



HOMESTRESS REDUCING SUNGLASSES
OF TWO MINDSTo Order Of Two Minds (In Association with Amazon.com)
BRIEF_BIOGRAPHY of Dr. Schiffer scientific papers with some full text articles


What is the evidence that Dual-Brain psychology or the lateralized sunglasses are effective therapeutically?


    To date I have not done any randomized, controlled, blind outcome studies.  These are the kind of studies which should be used to test any form of therapy, and I have been trying for the past couple of years to get them going.  But to do these studies one needs significant funding and the cooperation from colleagues who run clinics or otherwise have access to patients who can be invited to participate in such a study.  At McLean we are beginning a study of children with Attention Deficit Disorder which might lead to an outcome study, and I have been attempting to set up outcome studies with a number of colleagues, but all this has been progressing slowly.
    I have reported in my book, Of Two Minds, about 20 case reports of patients I treated with the principals of dual-brain psychology and the glasses.  In my practice I have treated over 200 patients with these techniques, and I have been in correspondence with a number of colleagues who have reported cases of patients to me who responded very favorably to these techniques.  Still, this is anicdotal data, and is not controlled.  But, much of psychiatry has been founded on case reports.  Freud began with a few case reports, and psychotherapy and psychoanalysis have long been criticized for a lack of good outcome studies.  In the past decade there have been some good outcome studies of psychotherapy, and they have shown it to be effective, but for decades it was practiced without such studies.
    Interestingly, there are no outcome studies of antidepressant medications beyond 8 weeks, and those studies do not show the antidepressants to be much better than placebos. In the only large scale outcome study of Prozac versus placebo, the authors found that at the end of the 8 week study, the patients on Prozac had a 40% decrease in depression (as measured by the Hamilton Depression Rating Scale); those on placebo had a 29% reduction.  The study is published as: StarkR, Hardison CD: A review of multicenter controlled studies of fluoxetine vs. imipramine and placebo in outpatients with major depressive disorder. J Clin Psychiatry 1985;46:53-58.  Other controlled studies on antidepressants are also not very impressive.  (See: BLAMING THE BRAIN by E. Valenstein, The Free Press, 1998 and FROM PLACEBO TO PANACEA by S Fisher, Wiley, 1997; and THE ANTI-DEPRESSANT ERA by D Healy, Harvard Univ Pr, 1998).
    Of course, many treatments such as acupuncture, St. John's Wart, yoga, hypnosis, gestalt therapy have not generally been examined with blind, controlled outcome studies.  Nor have many treatments used in internal medicine.  Also, outcome studies when repeated often get very different results, but I am not advocating against good outcomes studies.  Quite to the contrary, I am strongly in favor of them, and as I just mentioned am constantly trying to get the funding and cooperation to do them.  But, I am asserting that in the absence of such studies, we should not be banned from discussing and using therapies which are not fully evaluated.
    My impression from my work with my patients is that Dual-Brain Psychology is very effective compared with the therapy I was offering before I began using these techniques.  Of course, this is a subjective opinion based only on my subjective impressions, but my impressions are very favorable.
    I need to point out that there is an important difference between Dual-Brain Psychology and people's responses to the lateralized glasses.  By Dual-Brain Psychology, I mean psychotherapy (supported with medications when the patient and I feel they are appropriate), using the theory of Dual-Brain Psychology as a framework for the treatment as described best in my book, Of Two Minds.  In patients who have emotional responses to the glasses, we can use them as an adjunct to the treatment.  Patients who respond to the glasses appear, according to a review of my cases, to tend to resolve their problems more often and to a greater degree than those who do not respond to them.
    But, the lateralized glasses can be used outside of Dual-Brain Therapy.  They can be used in experiments which test acute emotional and brain wave responses to the glasses.  Many of my patients wear these glasses between therapy sessions.  These patients report that the glasses are often remarkably helpful in reducing anxiety and depression.  The glasses can be used also by themselves without therapy.  Other people, not in therapy, use them simply as a device to reduce stress.  I have given the glasses to a number of people, not in therapy, and I have often found that when people respond to them, they are remarkably helpful.  But, I have no outcome studies, yet, only anicdotal evidence.
    What I do have considerable evidence for are the acute effects of putting on the lateralized glasses.  I have published two placebo controlled studies showing that the lateralized goggles affect people's emotional state much more than two pairs of placebo goggles.  We also have a study showing that the experimental lateralized goggles cause brain wave changes in the expected directions to a degree that is highly significant statistically.  The placebo goggles did not cause significant brain wave changes.  A colleague from another Harvard Hospital has replicated my findings. He found that putting the glasses on 37 very depressed patients caused changes in their level of depression in 35 of them, and 65% had fairly large differences between sides.
    Thus, we have three items which can get confused: 1. people putting on the glasses and having an immediate emotional response, 2. people wearing the lateralized glasses on a daily basis and finding that it helps them feel and function better, and 3. people using the glasses as an adjunct to their ongoing psychotherapy sessions.  There are placebo controlled studies only for the first condition.  But, there is a relation between the three conditions.  Those people who have reactions to just putting on the glasses are the same people who are likely to benefit from wearing the lateralized sunglasses in their everyday life and in their psychotherapy if they happen to be in therapy.  Having observed many hundreds of trials of people responding (often the same people using them on different occasions) to the glasses and being helped by them convinces me that they are remarkable.  Even to this day, I find that when a patient has an intense response to them, I am a bit taken by surprise all over again.  It's something that has to be seen or experienced to be appreciated.
Back to questions:  Ask Dr. Schiffer, so what does he think?



HOMESTRESS REDUCING SUNGLASSES
OF TWO MINDSTo Order Of Two Minds (In Association with Amazon.com)
BRIEF_BIOGRAPHY of Dr. Schiffer scientific papers with some full text articles