All in the Head

Before neurofeedback "I spent a lot of nights really upset that he was never going to be able to do things like other kids, go to a sleepover or to summer camp," she said. Now, Paulding said, she is convinced her son will be able to enjoy as normal a childhood as his 2-year-old sister, who shows no signs of ADHD.

Craniosacral Therapy

In the 19 years since osteopath John Upledger opened his eponymous institute in Palm Beach Gardens, Fla., more than 50,000 therapists from 50 countries have taken courses he devised to treat dozens of ailments. Treatment is simple: Craniosacral therapists exert gentle pressure on various parts of the body where they detect pulse points in order to release what they say are blockages of cerebrospinal fluid that cause problems.

Upledger, now 72, dismisses the importance of randomized, controlled trials and the views of his critics. Proof of the effectiveness of his treatment, he said, lies in the testimonials of grateful patients who tell him they feel better -- like the woman who had sought treatment at 83 other places before a single visit with Upledger cured her temporomandibular joint disorder.

Standard scientific studies of his technique "can't be done," he said, because "no two patients are exactly alike and no two therapists are exactly alike. I decided that what I was feeling was what I could believe."

Stephen Barrett, a retired psychiatrist who maintains the Quackwatch Web site, has described Upledger's beliefs as being "among the strangest I have ever encountered." Barrett said craniosacral treatment is based on "fanciful claims" such as the notion that manipulation of the skull can affect levels of cerebrospinal fluid in adults or that blockages cause the problems Upledger describes.

A 1999 report by officials at the British Columbia Office of Health Technology Assessment found insufficient evidence to support the effectiveness of craniosacral therapy.

Physical therapist Ronald Murray of the Asclepeion Center of Silver Spring said he ardently believes in the treatment, which has a large following in the Washington area.

Murray, who was trained by Upledger, said that 80 percent of the people he treats tell him they feel better afterward. "The people I see have been to everyone else," said Murray, who charges about $110 per session and has a three-month waiting list.

Gail Zech, a 76-year-old writer in Gaithersburg, said she consulted Murray several years ago at the suggestion of a friend. Zech said three doctors, including a neurosurgeon, told her she needed spinal surgery to prevent possible paralysis caused by a deteriorating vertebrae that was causing constant pain.

After several months of weekly treatments performed by Murray, Zech said, her pain disappeared. A neurologist told her that the deterioration had also stopped; Zech said she never underwent surgery.

"At the risk of sounding like a goofy enthusiast, I am so grateful to Ron," she said, adding that she is now pain-free and able to move normally. "I consider this to be lifesaving treatment."

Upledger said that as word of his treatment's success has proliferated, so have patients. Currently, he said, he has a five-year waiting list.