Saturday, June 19, 2010

Peripheral Vision and Socializing

Peripheral visionImage by J'Roo via Flickr
One thing that has been bugging the crap out of me since I've become aware of it is my inability to follow people's interactions in a group.  If I am sitting at a table with 3 other people, I can really only talk to one person at a time which means I may, at times, have a tendency to hog the conversation and reduce the group interaction to a one-on-one talk instead of a round robbin discussion.  I am not clueless and uncaring about other people so I do periodically check in and watch the other people in the group.  When I am not overloaded. I am socially adept enough to try and bring in the other people into the conversation, However, especially in high-stakes discussions, I do take snap shots of  other people's reactions.  But when an interaction with another person is at its emotional peak, I stop watching everyone else as I am overloaded and focus on the key person.  When coupled with slow processing by the brain, this does not happen for me in a real-time feed like it does for everyone else.

I told Dr. Herzberg about this and she is starting to work on parafoveal stimulation to increase peripheral vision.  Decreased peripheral vision means I can't track what people sitting beside me are doing .
The fovea is a small spot near the retina's center filled with photoreceptors that allows the focal point of your vision to guide visual information to the conscious thinking part of your brain.The fovea receives only a small part of the visual information entering the eye. The parafovea is an area that surrounds the fovea and can take in much more. The parafoveal cells are connected to other areas of the brain that govern reflexive or"instinctive" responses.  Most of the visual information that hits the parafovea is subliminal information, below the conscious threshold, and the visual system in our brain alerts us to what's important, tucks it away in our memories (think about subliminal messages in advertising), or ignores it. Impaired peripheral vision also impacts the ability to sense incoming danger — such as cars running stop signs — and react instinctively.

We did a computer based exercises where I followed a dot bouncing from side to side last week.  This week during vision therapy,  I held a  piece of 8 1/2" x 11" paper with a dot in the middle and different letters sprinkled all over the paper at arms length and focused on the dot.  Marianne, her tech, called out words and I was supposed to spell them.  This was not too easy for me as I really could see only about a 1 1/2" diameter circle around the point. I tried hard not to cheat and look away from the dot but it wasn't easy.

Apparently, I have been going through life in a bit of a tunnel.  I noticed this biking through the woods and driving as well.  I wonder what the subliminal impact of all this is... when your brain and eyes aren't capturing all this subtext.

I  have asked Dr. Herzberg to start thinking about how my vision impacts higher order functioning.  She is a great person to have this conversation with as she started out in life majoring in psychology with an emphasis on perception, cognition and childhood development.  Dr. Herzberg became fascinated by the vision aspect of this and went into developmental optometry.  Unlike other specialists, she has retained enough of her earlier background to understand that her patients are more than a pair of eyes.  So we have been starting a series of conversations about what vision therapy can do to stop perseveration, slow processing, impulsivity and the impact my vision problems will have on career choices.  I know vision therapy is not a cure-all for all ailments; but there is evidence for interaction between the vision system, executive function and emotions. Obviously, I do get happier as my vision improves, generally speaking.  There are some times, however, when all these changes are a bit overwelming and I creep into bed and put a night shade over my eyes and listen to soft music or my sound oasis (my tinnitus can flare up) after vision therapy.  It's really interesting to see how my cognitive processes and emotional states will shift as my vision improves.  I am pondering what the inverse impact will be: i.e. how thinking and emotions impact vision.  Stereo Sue, a neuroscientist who famously recovered 3D vision through vision therapy, recently noted that depression after the death of her father seemed to decrease her 3D vision.  I, too, notice that if I am feeling a bit down or a bit tired, I start slipping back into old dysfunctions visually.

I know this is a bit of a stretch, but I am wondering if cognitive based therapy where you examine thought patterns for negative cognitions would impact vision: ie you can think your way into better eyesight.  I wonder what the effects of other psychotherapies are on vision, as well. EMDR gets very interesting with its emphasis on bilateral processing.

One thing that bothers me is that I really don't have an overarching framework that explains  my physical  and other dysfunctions.  I am going about fixing myself from the bottom up:  get the senses working and then start working on the higher order processes..  But, I wonder if there is something that ties all this stuff together somehow and if I get that something working, it will have a much deeper impact than patching up lower level, physical functions and working my way through the cortex to the higher level ones.

I do notice that I am thinking more clearly as a result of all the therapies that I  have been doing.  It's hard for me to say which one exactly has helped with which executive problems as I am doing many therapies at once.  Ideally, I'd being doing a neuropsychiatric assessment after each therapy, but there is a limit as to how much an insurance company will pay out and I don't want to push it.  But,  after I finish getting my basic body functions of vision, hearing, balance back in order,  that would be a good time for another round with a  neuropsychiatrist.
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