The Journal of the Astronautical Sciences, vol. 15, n° 2, pp. 92-96, mars-avril 1968
Sydney Walker III, M.D.1
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Cet article est bref examen de la chaîne critique des processus liés — anatomiques, physiologiques et psychologiques — opérant à déterminer la nature des observations faites par un individu, qu'il s'agisse d'un accident, d'une expérience prévue ou d'un phénomène extraterrestre tel qu'un "ovni". Un objectif d'un tel examen est de démontrer comment, à travers l'exploitation d'examens médicaux adaptés, l'integrité du système observateur peut être éstablie de manière à ce que la crédibilité du témoin occulaire n'ait pas a être laissée au type de spéculation où il se trouve si souvent aujourd'hui. Sans certains investigation de ce type, on ne sait pas si l'observateur témoin a, par exemple, des anormalités visuelles sérieuses, une tumeur au cerveau causant des hallucinations visuelles, ou une pathologie de caractère telle qu'être enclin à attirer l'attention sur lui en fabriquant ou mentant ouvertement sur ce qu'il a vu.
Que de telles évaluations de l'observateur n'aient pas été proposées auparavant est probablement dû au fait qu'une évaluation adéquate dépend de l'incorporation des approches et outils de plusieurs spécialités médicales, plutôt qu'une seule.
Le témoignage humain d'événements ayant été observés est crucial pour la science, la justice et la sécurité nationale. Cependant la crédibilité de tels témoignages est souvent laissée soit entièrement à la spéculation ou, au mieux, insuffisamment assurée.
Il suffit simplement de regarder la controverse et la confusion actuelle entourant la question d'objets volants non identifiés (OVNIs) pour apprécier le besoin d'une évaluation mineutieuse de l'observateur. C'est seulement après que la crédibilité de l'observateur a été établie que l'on peut extraire les "données molles" des signalements d'ovnis et contrôler leur intérêt scientifique [Manuscript soumis en février 1968].
Un recours, ou cours, est de ne traiter qu'avec les "données dures" et de simplement refuser de traiter de quelque manière que ce soit les rapports de témoins occulaires, en contenstant que de telles observations sont peu probables parce qu'étant trop bizarres ou n'ayant été rapportée auparavant que par des "gens dingues". Ce type de réaction reflète une étroitesse d'esprit scientifique. Ceci est susceptible d'être basé en préjudice ou peur de l'inconnu (en particulier lorsque cet inconnu, s'il est pris au sérieux, menacerait la sécurité ou la survie). Une telle attitude fait partie de celles dont le scientifique souhaitant être objectif veut se garder, dans l'intérêt de la vérité et du progrès. D'un autre côté, la position opposée de foi non remise en question dans les signalements de l'observateur n'est pas mieux.
Cet auteur suggère une attitude initiale de "scepticisme bienveillant" en raison d'une connaissance aïgue de la myriade de processus (et maladies) individuels déterminant ce qui a été observé et comment cela est décrit. De plus, et plus important encore il est proposé qu'une évaluation médicale spécifique et spécialisée des observateurs individuels est essentielle pour établir l'integrité du système observateur. En suivant une investigation clinique minutieuse, la plus grande partie de l'erreur humaine en observation peut être placée dans une perspective éliminant la "foi aveugle" dans le témoignage du témoin occulaire et confère aux données rapportées une confiance proportionnées à sa valeur.
Bien qu'il soit bien connu qu'une formation spécifique puisse servir à augmenter l'acuité observationnelle, la capacité de base individuelle est variable. Les gens diffèrent considérablement en termes de patrimoine génétique, intégrité neurologique et caractéristiques et dynamique de personnalité — tous expliquant ce qu'ils ont vu ou disent avoir vu. En appliquant des méthodes sélectionnées utilisées en médecine, en particulier en neurologie, psychiatrie et neuro-ophthalmologie, la crédibilité des observateurs peut être évaluée cliniquement, prédictive comme rétrospective. Une telle approche offre une évaluation à la fois quantitative et qualitative du système nerveux central fonctionnant comme il se reflèterait lors d'un signalement observationnel.
Adequate clinical assessment of an observer must involve cross-disciplinary integration because of the nature of the bodily processes involved in seeing and reporting an event. In the beginning, the event is perceived. Usually, this is basically a matter of seeing, although other sensory modalities can also be involved. The initial critical consideration, then, is the state of the eye (cornée, lens, rétine) and its connections with the brain (optic nerve, tract, temporal, parietal, and occipital lobes). A careful examination of these structures (both directly and indirectly) can establish whether or not it would have been possible for a particular individual to have perceived what he has reported or whether, on the sole basis of the state of his input apparatus, his observation was distorted.
Once it has been established that a visual image can be picked up and transmitted, unmolested and unaltered, along normal pathways to the back of the brain to allow for perception, the next question is how the brain codes it. This involves the ability to deal with detail, to make associations and spatial relationships, and to do other intellectual work, all of which occurs very rapidly and before the processed material is made available at the tempero-parietal lobe level for communication or for a reaction of any other kind. A great many pathways and a number of brain areas are operative in this critical coding step, and a number of problems, both anatomic and physiologic) can affect the process, either subtly or grossly. The responsibility of the clinician here would be to test cortical integrative ability with the various neurologic testing techniques available to him. He must also rule out (by careful history, general physical examination, and certain laboratory' measures) the innumerable disease states — toxic, infectious, endocrine, metabolic, deficiency, and neuropathologic — that can subtly alter cortical functioning and thus interfere with the coding of an observation.
The next step in observer evaluation is the psychiatric part which, if properly carried out, will probably be the statistically most fruitful for uncovering observer creditability gaps. This is in part because the same types of disease processes listed above for interfering with cortical integration (coding) also can cause such mental aberrations as frank hallucinations and delusions or lead a person to fill in with make-believe details (confabulate) the parts of a report that his brain condition no longer allows him to remember.
In addition, there are the purely psychological problems, based in background factors, which lead an observer to deliberately fabricate or unwittingly distort what he has seen. If consciously driven, his motivation may be fame, fortune, competitive strivings or some rather specific, complicated need which has been tapped by finessing the event he is reporting. If the distortion has its roots at an unconscious level, it is likely that it was triggered by something about the event in relation to the patient's remote past. In the case of a functionally psychotic person, the entire observation may be the product of his own intrapsychic life instead of having had anything at all to do with an external event. On the opposite end of the continuum is the normal or only mildly neurotic person whose "hang-ups" are such that they have either not substantially affected his report or have only very subtly colored a small detail. It may be just as important to ascertain this.
Other aspects of the psychiatric part of observer examinations are the matters of intellectual differences and language factors, both of which would have some bearing on the reporter's strengths and limitations as a creditable and adequate observer.
A sound systematic method for ascertaining observer creditability would have widespread application. People in the legal profession grapple daily with this problem [2337 Glendon Ave., Los Angela, California 90064.]. Eye-witness testimony determines individual life and death decisions in courtrooms. On an even grander scale, it shapes far-reaching diplomatic and military policy. In the laboratory or other scientific settings, when inaccurate, it can lead to an horrendous waste of money and professional man-hours. In all these situations, we should be demanding to know more about the likelihood of a crucial observation before acting on it.
Many people in science, technology and government perform basically observational roles. Some of these individuals are in such responsible positions that what they think they see or say they have seen, and how they respond to it, could profoundly affect the course of human events. (Such a statement will not seem overdramatic or exaggerated to those readers who have some knowledge of how, for example, our national security system operates.) The choice of these people on the basis of tenure, military rank or years of good conduct seems hardly pertinent, since these factors don't necessarily reflect anything about the state of their central nervous system. Given our extreme reliance on some of these individuals, it is suggested that they be screened for observational integrity prior to placement in key positions and that they also be given periodic follow-up evaluations.
All-encompassing medical assessments of observers have not, to this author's knowledge, been previously proposed. This is probably because developing the idea and applying the methods entails a working knowledge of at least three of those medical specialties which focus on the central nervous system. It also demands an eagerness to integrate certain aspects of each specialty, for purposes of problem-solving. The desired end, in this case, is a more complete understanding of the individual observer.
Rather than extensively elaborating on the necessary examination techniques, the following outline stresses processes, structures, and diseases that determine the nature of reported observations. The specifics of the material are intended mostly for the non-medical reader, since the question of observer creditability is so often his business and since he will be the one in the position to decide when to request the special assessment.
The initial phase of integrated eye-witness assessment is a general medical evaluation. This involves, besides the complete physical examination, a careful history and selected laboratory' studies. The rationale for beginning in this way is screening, since many disorders of other organ systems are well-known for their adverse effects on central nervous system functioning. Knowledge about the background and current status of the observer's general bodily health will alert the physician to which areas will need further investigation and which of the later, special examinations will warrant particular scrutiny [3]. When diabetes, for example, is known to be present, the physician will look for specific related abnormal findings when he checks the eye and does the neurologic and mental status examinations.
Since observations usually begin with the eye and/or some other sensory organ, the next step (once adequate general medical screening has been done) might naturally be a neuro-ophthalmologic examination. This would concern itself with the major structures of the visual apparatus and any of their abnormalities which might influence accurate reception of the visual images [4].
The cornea, the most external structure, accounts for visual distortion through scarring and clouding. These changes are caused by such insults as trauma to the eye, exposure to toxic fumes, infections, and deficiency or degenerative diseases. Inspection with an ophthalmoscope and/or slit lamp will positively establish corneal integrity.
The lens of the eye is the main structure for directing light rays from external phenomena to the retina. It has a wide range of possible variation, on both a genetic basis and, like the cornea, as a result of aging, trauma, deficiency diseases and infections. The configuration of the lens, as it is suspended in front of the eye by delicate muscles, accounts for the sharpness (and shape) of the image known as refractive ability.
The aqueous humor which bathes the lens is of particular concern because of the pressure it exerts on the rest of the eye. Increased pressure changes in this medium, measurable with a goniometer) are responsible for glaucoma which can result in serious impairment of visual acuity. After a period of time, the increased pressure will also lead to a characteristic constriction of the visual fields, which can be established by examination (perimetry).
The vitreous humor fills the eyeball and is the other fluid through which the light rays of a visual image must pass before they reach the retina. This medium is subject to clouding and other signs of early inflammation. "Floaters," which are abnormal proteinaceous particles in the vitreous humor, are sometimes mistaken by people as moving objects that are in their outside environment. Again, ophthalmoscopic and slit lamp examination will serve to determine the status of the vitreous humor.
The retina is the structure on which the visual image is actually received; loosely, it can be likened to camera film. Located in the posterior eyeball, it is the beginning of the neural perception linkage which eventually reaches the brain and consciousness. The retina is subject to many and varied abnormalities which can severely disturb both visual sharpness (acuity) and range (fields), as well as color perception. Retinal pigment accumulation, inflammatory, and other exudates, vascular problems and other types of pathology can come between an otherwise observable event and the retina, such that part or all of the event is obliterated or distorted in various ways. Ophthalmoscopic inspection will yield a great deal of information about the anatomic integrity of the retina, but a complete assessment must also include detailed mapping of both visual fields by perimetry, with attention to the size and shape of the blind spot. The observer's ability to perceive color at the retinal level may be challenged with Ischihara charts, which are most popularly used for detecting color blindness. These charts also will pick up abnormalities in color perception which are due to drugs, other toxic conditions, and higher, cortical integrative problems.
The head of the optic nerve (disc) can also be easily inspected with the ophthalmoscope, as it sits bare at the back of the eye. The optic nerve is subject to similar pathologic processes as those mentioned above: i.e., developmental, inflammatory, metabolic, and toxic. The color, texture and anatomic configuration of the nerve head indicate not only the integrity of the optic nerve at this vital point but also offer highly suggestive inferential information about the state of the rest of it, which is not directly visible. In addition, when there is increased intracranial pressure due to any type of brain abnormality, it can be reflected in the appearance of the optic disc.
The optic nerves from both eyes join in the area of the pituitary gland and then redivide in such a way that fibers from both eyes are represented in the optic tracts that form. Each tract then travels along either side of the brain (medial aspect of parietal and temporal lobes) via optic radiations to the occipital cortex. These pathways, although not directly visible, are accessible through the use of several maneuvers. Composite findings on neurologic examination, including visual field results, are traditionally used, but opticokinetic studies should also be done because of the abundance of information they can give about the integrity of the optic radiations. This involves the use of a moving, checkered tape which the patient watches and to which his eyes should involuntarily respond with rapid, rhythmic movements (nystagmus) [5]. If, on the basis of these studies, some kind of local pathology or other interfering process is suspected, the physician can then make use of special x-ray procedures (pneumoencephalography, arteriography) for looking at the areas in question.
Once the examining physician has satisfied himself as to the status of an observer's visual apparatus (to the point where the cerebral cortex takes over), he will want next to proceed with a detailed neurologic examination. His index of suspicion about the presence of absence of pertinent central nervous system disease had already been altered by his findings on general physical evaluation, as well as from the eye examination.
There is a clinical format for doing a complete neurologic examination; it is well-known to neurologists and other interested physicians. Certain of the maneuvers, particularly those which test cortical integrative function, are extremely important in the evaluation of an eye-witness. This is because they will indicate the ability of the observer's cerebral cortex to process what his visual apparatus has fed in -- to differentiate various kinds of sensory input, process detail, make associations, and integrate spatial relationships. More specifically, those tests that reflect cortical sensory status are particularly pertinent for eyewitness assessment. This is because there are numerous medical disorders that cause neurologic disruption at the cortical sensory level, resulting in hallucinations, delusions, distortions, and confabulations [6].
"Organic" hallucinations and distortions often seem very real, even afterwards, to one only transiently afflicted and are apt to be reported as witnessed events. They can occur in people suffering from acute infections, adrenal insufficiency, brain tumors, chronic pulmonary disorders (respirator acidosis), complications from vitamin deficiencies and alcoholism, abnormal calcium metabolism, low blood magnesium levels, epilepsy (for several reasons), and Sydenham's chorea. In addition, there are scores of commonly used drugs which will produce hallucinations if taken in toxic quantities or, by certain people, in prescribed amounts. These include antihistamines, meprobamate ("Milltown"), dephenylhydantoins (antiepileptic agents), atropine (found in many non-prescription sleeping pills), and bromides (as in Bromoselzer). The report of an eye-witness who has been scrutinized for these possibilities alone (by history, examination, and necessary laboratory data) will understandably assume more creditability.
The possibility that an observation may have been influenced by an "organic" delusion should also be investigated. Frequently, as with the hallucinations, there will be clues to this situation from the observer's history or from some examination findings. Among the underlying medical causes of delusions are trichinosis, syphilis, hypothyroidism, calcium disorders, various blood disorders, encephalitis, and pellagra. Some of these same disorders can, of course, also influence observational reporting through other channels.
Confabulation, as a neurologic sign, is particularly important to rule out in the eye-witness report because it can be so deceiving. In fact, it serves as a cover-up for memory impairment by filling in the gaps with sundry (but inaccurate) details. Typically, confabulation is seen in association with peripheral neuropathy (careful examination is thus apt to alert the physician) and is the result of either a blood) disorder or, more commonly, exposure to toxins [7].
Many gross mental aberrations, such as hallucinations and delusions, are not associated with abnormal physical or neurologic signs and can be causally traced to underlying psychologic disorders. These are likely to be recognized and so labeled in the neurologic phase of the assessment where, as in psychiatry, a standard mental status examination is used for ferreting out emotional disorders, as well as memory and other intellectual impairment. For example, the schizophrenias and psychotic depression (which are the more frequent functional disorders associated with hallucinations and delusions) usually have well known clinical characteristics and will be obvious to physicians doing formal mental status testing [8].
It is because of the less florid kinds of psychopathology that a thorough psychiatric evaluation should be part of an observer creditability assessment. The complexities and vagaries of the human personality can lead to some gross distortions and fabrications around an event, particularly when finessed by people who are borderline psychotic, paranoid, sociopathic, hysterical or inadequate personalities. Some of these people, when stressed, have brief, episodic breaks with reality in which they are frankly psychotic and hallucinate, yet then resume previous functioning.
During a sophisticated psychiatric evaluation, the physician would be likely to recognize a propensity for such episodes. His main job, however, would be to gather enough information about the observer as a person to be able to check him out generally, psychologically, for creditability. This would involve complete developmental and psychosexual history, studying family relationships (past and present), assessing intellectual ability, elaborating on areas of major conflict, assessing for characterologic make-up and evaluating for ego-strength or weakness.
In instances where an observer is being retrospectively evaluated (i.e., he has already reported an event) there should be an intensive effort made to explore the observer's feelings about what he has seen and described. Such discussion, when properly guided, is likely to uncover inconsistencies and other helpful clues, in the case of the noncreditable observer. Unconscious motivational forces that have led to inaccurate reporting can sometimes be uncovered by exploring the observer's fantasy life, listening for slips of the tongue, or attempting free association. In an occasional observer, where substantiation of his creditability is crucial and there is vague reason to suspect it, a pentathol interview may be indicated.
In instances where frank lying about an event is suspected, the observer can be questioned while monitored by a polygraph. This machine measures some of those bodily responses that are under the control of the autonomic nervous system which is, in turn, partly regulated by cortical centers. If the observer being studied is truly sociopathic and has never developed a super-ego, or conscience, the polygraph will not be able to pick up his lie, since he will have no associated conflict on telling it. The lying will be picked up, however, when the polygraph is used on other personality types.
Up to this point, this paper has focused on the many factors that interfere with observer creditability. There is as well, an obvious positive application for these assessments. The psychiatric evaluation, for example, can be useful for further screening for the strengths of observer candidates who have already been ruled medically and neurologically intact. In addition to making some sound predictions about accuracy of reported observations, the psychiatrist could also explore the candidate's ability to appropriately respond, under stress, to what he has seen. This aspect of an individual's make-up is of grave importance (as implied earlier) in some military, security, and other key positions.
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