The Mind & The Brain; Neuroplasticity and the Power of Mental Force

The authors of this book are Jeffrey M. Schwartz and Sharon Begley, the former an M.D. and neuropsychiatrist and the latter a science journalist. I'll refer to Schwartz as a rule just to make things easier, and as it feels like his narrative rather than hers. 

This book is about a lot of different things, but a quick listing of the primary topics of discussion would include Neuropasticity (and the associated neuroscience to explain what that is to the uninitiated), Mindfulness meditation, Obsessive Compulsive Disorder, Cognitive Behavioral Therapy and Quantum Mechanics. Of course it is also about a bunch of other stuff, or at least other narratives, concerning the Silver Springs Monkeys and the birth of P.E.T.A., the "Quantum Zeno Effect", V. S. Ramachandran's research on phantom limbs, morality vs determinism, causal closure (or the possible lack thereof), William James' psychology, volition, and much else still. The distinctions possible to make between Mind and Brain figure largely throughout the text.

My intension is only to bring out a few things that I found interesting, but I do endorse the book itself as worth a read, if such things interest you. Or, somewhat more strongly, give it a try and if you don't find yourself hooked after a few chapters, I'll be surprised.

Ok, enough fluff. 

Schwartz works with patients that have OCD. He chose that disorder to study and work with because its sufferers are what is called 'ego-dystonic'. What that means is that if I am the one suffering from OCD and I am stricken time and again with a powerful feeling of dread, this overwhelming feeling that something is very very wrong and that the only solution is for me to wash my hands because they're filthy, infected, germ-ridden, etc… while I am thinking that "I must wash my hands!" I am also aware, in a quiet and less panicked part of my thoughts that they cannot possibly be unclean as I washed them vigorously a mere 20 minutes ago and have not touched anything at all since then. So this split in my self-awareness is what makes this disorder 'ego-dystonic'. 

So what he does, broadly speaking, is first to educate his patients about the neuro side of things, doing brain imaging on his patients, showing them how a part of their brain is rather overactive as compared to those who do not suffer compulsions, how the motive urgency of their feelings is due to phylogenetically older parts of the brain getting in on the act, such that the compulsion to wash my hands has an impact on me that ranks up there with fight or flight, making it extremely hard to just shrug off. Armed with this reconceptualization of their illness, they are then given a 4 step CBT strategy for dealing with these compulsions. I'll not go through these steps one by one, but again, in broad stroke, the patient is taught to immediately recognize the compulsion as a compulsion and part of their illness, they develop a variety of alternative responses, such that, rather than hand-washing, I might train myself instead to do deep breathing exercises for a few minutes or waters the flowers in the yard, or whatever. The issue being that the new activity is one that is not harmful to me or my surroundings. With an intensive therapy schedule and continual practice outside of therapy, Schwartz's patients are able to strengthen the effect, or perhaps resolve, of that other voice, the one that knows there is no reason for yet another hot soapy hand-washing to take place today.

If you know much about Vipassana meditation, or what you may have only ever heard of as Mindfulness meditation, you may have a hunch already about how it could be pertinent to the therapy discussed above. In this form of meditation, the goal is not so much concentration as awareness and centering one's awareness in the present moment. The basic introductory version of it asks that you focus on your breath. Thoughts will arise, but rather than becoming the active agent of their development, one tries to simply watch them arise and then fall again, without losing the focus on the breath. It seems that it would be simple enough but of course it is actually quite difficult. 

On a side note not unrelated to the topic at hand, I've been trying to get back into meditation this very week (I was a daily meditator off and on for several years when I was an undergrad) and it is every bit as difficult as I recall it being. When I was meditating daily in college I noticed a few things being very different for me. The 1st was that I rarely had to study very hard. Sounds a bit odd perhaps, but I paid attention in class and read the assigned stuff (usually in the morning right after meditating) and I tended to remember it all without any difficulty, so that for a time I never reviewed anything or studied beyond this at all while acing al my exams. The 2nd thing was that I slept better, falling asleep almost instantly and waking up as if a switch had been flipped rather than the sense that I have so often now of drifting closer and then further away from consciousness for quite some time before waking. 

So, getting back to the OCD stuff. By combining Mindfulness meditation, with neuroscience and Cognitive Behavioral Therapy, Schwartz has developed a very successful treatment for people with OCD which uses no psychopharmacological treatment, has a high success rate and low recidivism rate (and even when suffers do fall back into old compulsions, they tend not to fall all the way back to square one again). 

Why then does this treatment work? The answer to that, per Schwartz, depends upon neuroplasticity and quantum mechanics. To begin with, neuroplasticity refers to the potential for the brain to "re-wire" or "re-zone" itself. That is to say, in a situation where a patient has had a stroke and some portion of their cortex has "gone dark" and no longer functions, for the work that this now defunct portion of cortex had heretofore had sole change of doing, might be taken over by another portion of the cortex. We have long known that the infant's brain exhibited neuroplasticity, but it has only been in the last decades that another serious burst of neuroplasticity was recognized in adolescence and that beyond this, and apparently in Schwartz's telling, much against the orthodox beliefs about the matter in the scientific community, that the brain retains the potential for neuroplasticity throughout our lives. The way that Schwartz's therapy for OCD patients taps into this is through attention, a.k.a. Mindfulness and this leads us to quantum mechanics because when one is talking about processes at the scale of neurotransmitter ions emerging from the axons of neurons, we are speaking of particles on the quantum scale and not the familiar billiard balls of classical Newtonian thought experiments. 

So, what does everyone know about quantum mechanics even if they know nothing about quantum mechanics? Heisenberg's Uncertainty Principle whereby it is not until an observation is made that the wave function of a quantum particle can be pinned to any location, until that point there are only probabilities. But let's add a note about the Quantum Zeno Effect as well. This really deserves a fuller quotation, but I'm not in the mood to transcribe the book's discussion of this so here I go… So, if we start with Heisenberg's principle and recognize that our observation of a particle has an effect on it, Quantum Zeno basically shows that repeated observation has the effect of 'fixing' a particle in a particular state. Now this finding, which has been replicated many times in physics, nonetheless really fucked with some physicists' heads. They expected that observed once, the wave function would collapse and a particle would be found in a place - that they were used to already. But they assumed that when some time had passed that where it would be found next would again be up for grabs, one option out of a range of probabilities, but it wasn't. Instead the particle was exactly where the initial observation had "pinned" it. The more it is re-observed, the more is stays put and the more that violates the probabilities. 

You can probably guess how this relates to the OCD situation already. By increasing mindfulness on the part of the sufferer about their compulsions and by helping them to develop a new set of responses to the compulsion, it is in effect their very own attention (volition) which gives them a degree of control, much as the observer pins the particle to a location and via quantum Zeno repeating it "fixes" it there, Schwartz's therapy allows the patients to "rezone" a part of their own cortex in response to their repeated and mindful volition. & here again, I think of something I mentioned in a previous post - how John Cage, who had been a very heavy smoker for many years, quit somehow with an image, every time he thought of smoking he would laugh instead. 

Anyway, this is all I will say about this book, though it has a great many other things to offer and is well worth reading in my estimation.

Habits, kicking & cultivation

No wonder I wear a hat so frequently.

Habits. I've often thought about habits. About that which is habitual, reflex-like, automatic, etc. What we do with but a bare minimum of thought. Depending on what field of repeated action we're thinking of habits are always found, I can be quite negative or positive about them. 

With regard to matters poetic, I've tended to be quite suspicious and rarely positive, but that requires some qualification. I've no aversion to a daily writing regime or anything like that. I have a file always open on my laptop where I collect lines for a long-term project that I am working on, if this is a habit. The habit of writing or improvising poetry seems neutral to me in and of itself. Billy Collins, and perhaps even moreso Richard Kostelanetz, have a bad habit, and I wish they'd get help, but that's me and at root I don't much care if they do or don't. But when habits become slurs (my terminological adoption and possibly, if purposively, a misconstrual of what Harry Mathews referred to as "systems of low-level regularity", this being the phrase he used to describe the system of any given author's "inspired" practice of writing), I get increasingly negative in my baseline response. This, again, is me; my bias, and I own it without qualm. It just seems to me more worthwhile to break language habits and reflexes if one intends to surprise oneself, or simply avoid writing the same poem again and again. 

During the time when I was in analysis, I developed a habit that now and then got me into a bit of trouble, that of hearing the things people didn't intend. When one's analyst is incessantly echoing one's slips of the tongue, after a time they start to become almost glaring. I noticed them in my own speech a great deal, and used that to poetic effect when improvising. But when you repeat the slips of others to them, a funny thing happens. Not denial, that's predictable. The funny thing is that sometimes they get really pissed off. Ha ha. After awhile I learned not to repeat them, though I still tended to think about them and what they might suggest which differed from what the person was trying to convey. But analysis is, sadly, some years behind me now and that habit has diminished with time. Recently though I was spending a bit of time with someone and noticed that she, on a number of occasions noticed my own slips of the tongue or caught the implication which I was trying to, if not conceal, then at least not to blurt out. I told her she should become an analyst, which to my mind is high praise. Admittedly though, it didn't work very well as a technique of seduction. 

I've also been at times persuaded by C. S. Peirce's position regarding habits. Basically, that they are necessary things, and that we'd be better off to choose them than to be chosen by them. I do some poetry most every week, whether it be writing, assembling, improvising. But, I doubt that I would in most instances describe my poetic activities as habits as they are usually quite volitional. I tend rather to use the word for activities like smoking, staying up too late, nose-picking, chewing at the corner of one's mustache and the like, and thus, as I wrote above, as things that we do, repeatedly, but with such a minimum of thought that it borders upon no thought at all. 

I have been reading a book called,The Mind & The Brain; Neuroplasticity and the Power of Mental Force by Schwartz and Begley. The subject matter of this text might surprise some of those who know my interests and stated biases, as the author is both a neuroscientist and a cognitive-behavioral therapist. But if you are one of my small elective family you might have heard me saying a number of things in the last year about wishing to learn more about neuroscience. My reasons for that interest are several, but the dominant one initially was undoubtedly that, as a psychoanalytic partisan prone to making arguments from that framework, the toughest counter-arguments it seems are coming from that neuroscience terrain. My intention was to read Damasio this year and I still hope to get to his work, but I ended up with Schwartz &Begley. 

I'm glad that I bought this book. The authors do make a couple of ill-informed references to Freud (ones that they are apparently so confident of that they felt no need to cite him to substantiate), but that is so commonplace in contemporary writing that I'm beginning not to notice, much. Ok, I do notice and it irks me, but I sense that I might have a better chance of dissuading Homeland Security agents from frisking anyone they think "looks muslim" than countering this trend, so I wish I didn't care (sort of). 

That pet peeve aside (& this book is nowhere near as dumb-headed than many others I could name), this is a very interesting book that combines the neuroscience with CBT and adds in some buddhist meditational material (mindfulness stuff essentially), all of which are coordinated in the treatment of OCD in Schwartz's practice. But a larger, more philosophically juicy aspect of this text's argument is that, contrary to prevailing wisdom (or at least, prevailing until recently) from the neuro camp, "mind" and even "will" are emerging as both therapeutically and empirically valid concepts. Oh yeah, there is also quantum theory on offer here and integral to the broader claims of the text. Schwartz is bucking the trend in neuroscience of refusing all discussion of "mind" in favor of "brain," and is insisting, with a great deal of citational support, that those suffering from OCD can learn to "rewire" their brains by force of will. My terms are sloppy, but they get at the claim made here, and I find that I am positively disposed toward it even as many aspects of the CBT framework still strike me as exceedingly problematic (I'll come back to that below). 

Everything hinges on neuroplasticity. Though there has been contrary evidence for some decades now, the general view in neuroscience was that, while the infant's brain exhibited great neuroplasticity, that in short order it became fixed and quite static, with this batch of neurons "hardwired" to perform these and only these tasks. But that conviction has been undermined by research which shows not only that there is a second period in adolescence when the brain, to borrow some of the metaphors that the author's use, does a great deal of "rezoning". That is to say, that parts of the brain which may have heretofore been engaged in specific actions begin to be involved with quite other actions. There are a great many studies described and explained here, as well as therapies, all of which demonstrate this. I was most impressed by the details of the work of a man named Taub and the therapeutic practice (CI Therapy) that he developed for stroke victims. Without going into the details, this type of therapy, though obviously very difficult, has been successful in allowing stroke victims who may have lost the use of an arm, to regain use of that limb by reassigning the work that the part of the brain which has gone dark since the stroke, to another area of the brain. The success rates of this approach are pretty impressive, with, in some cases, people who had not been able to use their affected limb for 15 or more years, regaining near total use of it. 

Schwartz's primary work is with people who suffer from OCD. He noted that, though those who suffer greatly from this malady, and who are compelled again and again to wash their hands such that they stay chapped and bleeding also know at the same time that their hands are not filthy and covered in dangerous germs. That is, while potent and difficult to deny compulsions are screaming an alarm about the germs and freighting that alarm with great emotional weight (described as dread, among other terms) which the sufferers often cannot resist giving in to, they also know very well that their hands are clean and that the washing is both unnecessary and harmful. It was this 'split consciousness' (referred to as 'ego-dystonic') which drew Schwartz's attention. Again, glossing a great deal of material into a few sentences here, his innovation was to recognize how this is not unlike the situation that a meditator faces when trying not to get caught up in thinking his own thoughts rather than just watching them arise and dissipate. There is no reference has made to the classic line by some venerable buddhist so and so (who I have forgotten), of the moon and the clouds in the pool, but I will as I've always like that image. If one imagines looking at the reflection of the moon on the surface of a pool as the analog of meditative awareness, then stray thoughts would be like the clouds which now and then cover the moon. The 'trick' of meditation then would be not to follow the clouds but simply to attend to them as they pass by and then return one's attention to the moon. Schwartz, through a four step method, teaches his OCD patients to listen to the voice inside them which knows that these are compulsions, that they are just their brains sending dark clouds out to cover over that awareness and distract them from their awareness that these compulsions are expression of their illness and not what they in fact know to be the case. There is of course more to the therapy that this, but that is how it starts. Subsequently they learn to substitute other actions for those which the compulsion had driven them to previously, actions which they have the chance to choose and which are not self-damaging. 

It's a very interesting book and I'd like to post a bit more about it in the future. But getting back to habits…

Some months ago my dear sister Rah read a book about stopping smoking, she'd been given it by a lifelong friend and fellow smoking buddy, L, who read it and quit. Then Rah read it and quit. Then Tony read it and didn't, though I must admit I haven't seen him smoking much at all. I'm reading it now. I had intended to wipe the book out this passed Sunday but I didn't. In part it may be because of the "threat" to my habit. & in part it may be my annoyance with the text's repetitive nature. But whatever the author advisers his readers to smoke while reading it, so I've bought a couple of packs since then. I also have some difficulties with one of the basic claims the author makes, that what keeps the smoker smoking is fear. Actually, many of his claims about what "all smokers" think and feel about smoking strike me as questionable. But whatever. I found while reading it and have noticed afterward that parts of analysis seem to be, for me at least, accurate. I'm thinking of the feelings leading up to the moment when one lights the next one. & thinking of how it is the nicotine addiction itself which produces this unease which leads to lighting up sort of pisses me off, in a similar fashion to, if less pissed off, when I notice while listening back to a series of my improvised poems that I've found a slur, a repeated word or series of sound choices. I nonetheless intend to read some of the book today and try to finish it tomorrow. Stay tuned for details. 

Amusingly, an image search for "CBT" also brings up images of
& devices for "cock and ball torture" 

Now, to return to the uneasiness that I have with CBT as a therapy. When I hear about how it is pursued I cannot help but think of The Power of Positive Thinking, a text which I think gets much too much positive regard. Look around for fuck's sake, the world has serious problems from the macro to the micro level. Deciding to just 'stay positive' feels like an ostrich strategy. I also can't help but to recall an argument I got into with a High School history teacher who was incensed that I was reading Mao's Little Red Book and was interested in Marx. I was in High School remember, and not quite the argument monster that I can be these days in classroom settings, but I tried to account for what I found convincing in Marx, the alienation of labor, exploitation of workers, etc. This teacher did something quite similar in structure to the CBT response to a patient's self-understanding of their suffering. He re-labelled and refocused and so forth. Thus it is not exploitation of labor but a free system where your work was rewarded depending on how hard you worked. It was not alienation at all, but part of the process of cultural development, etc. Capitalism was not an economic system that only emerged fully in the last few centuries which is dependent upon somebody somewhere getting exploited and which cannot exist otherwise, it was the natural outcomes of rational choices and the best way that we can have to satisfy basic human needs and wants. Here that business about how in Texas no student in public school will ever learn of any economic system other than Capitalism from birth to end of High School and whether this isn't depending upon the very strategy in play here, though applied in advance of any deviation.

Now one could obviously just reverse the process here and relabel again, so perhaps this isn't the fault of strategies like CBT. But I have to wonder as well. There are moment's in Schwartz & Begley's book when I question from who's perspective this or that behavior is deemed better. & this would lead to the larger question of whether in the situation of this or that person, feeling miserable and hopeless might not be an entirely rational assessment of the situation. But let us assume for a moment at least that there are ways in which we are, as social subjects, quite thoroughly fucked, as in disempowered. I cannot believe that re-labelling this situation in such a way as to naturalize it, or make it entirely up to the individual rather than a systemic issue, or any such thing is adequate. How many guards at the concentration camps had qualms which they quashed in this fashion? 

Google>Images "Habit" - tho obviously I chose it for looking like the Borromean Knot