WillSpirit!

Where Will meets Spirit
∞ Love, Clarity, Balance, Peace, & Bliss ∞

A science, mental health and spirituality blog written by a physician.








  • Red_Exclamation_DotDisclaimer
    • Dear Visitors:
      Although I trained and practiced as a physician, my background does not include formal instruction in psychiatry beyond basic medical education. This journal presents ideas about treatment philosophy, but must not be considered therapeutic advice. Abrupt changes in one's psychiatric medications can trigger profound cognitive, emotional, and physical symptoms, including suicidal thoughts and actions. Consequently, pharmaceutical agents should not be increased or decreased without supervision by a mental health clinician.

    • ON THE OTHER HAND, your brain belongs to you, and your opinion counts. If you decide that changing your medication regimen will serve your best interest, then I believe your providers have an obligation to help you try to achieve your goals. I want everyone to be educated about their options, and do what will be most helpful for themselves. No one should feel pushed around by dogmatic and/or limited viewpoints, whether those of psychiatrists, anti-psychiatry advocates, or myself.


The Wrestling of Two Minds


In case anyone’s wondering about my near-daily posting, rest assured it will be over soon. I’m aiming to exceed my previous record for number of essays in one month, but after November 30th (my birthday), the pace will slow. I may even take December off to give everyone a chance to catch up.

Not long ago a reader emailed me a narrative of her struggles with mood issues and painful events. What impressed me most was her eloquent capture of something I believe characteristic of maturation: inconsistent embodiment of wisdom.

As we gain insight and self-awareness, our behavior doesn’t always keep pace. We may know better than to criticize our spouse, but speak harshly anyway. We may understand how obsessing about a friend’s failure to acknowledge a gift undermines our serenity, and why true generosity makes no demands, but feel resentful even so.

These lapses alternate with times when we find it easy to forgive others and graciously give of our time and resources.

Readers can track the unevenness of growth by comparing my posts with one another. Scrolling through my archives, I see essays that celebrate realization mixed in with tracts that whine about fate. Some days I can view my life from the distant vantage of wise detachment, and other days I get lost in a muddle of mediocrity. It’s as if there are two brains in my head: one aimed at self-realization and the other at self-gratification.

This dynamic interplay between the higher and lower minds seems built into the metamorphic process. Granted, some people enjoy a single mystical experience and are forever changed, like Saint Paul on his way to Damascus. But the majority, I believe, achieve grace in fits and starts.

Zen Buddhism is comprised of two schools that differ on this point. One faction believes satori happens suddenly, jolting the practitioner into permanent enlightenment. The other expects realization to build more gradually, through long practice. Observing myself and others as we stumble toward maturity (no doubt a lesser attainment than satori) convinces me that most people climb in stepwise fashion, and at first with many backslides.

Ken Wilber distinguishes between state and stage. A person can have a profound state experience, a mystical awakening, that leaves him or her feeling radiant and enlightened for days. But sooner or later the system settles back to its habitual stage of development. Brief spontaneous elevation may accelerate personal growth by showing what’s possible, but seldom effects immediate, sustained improvement.

In my own case, I was locked in a self-centered and materialist frame of mind at age 41, when a series of breakthrough experiences transported me to an enlightened state of being. For a time I felt and acted like a happier and more generous person. But eventually I sank back into pessimistic selfishness. Only after years of contemplation and meditative practice did I grow more consistently alive to my better nature, and I still suffer many days of impoverished attitude.

I’m currently reading A Universe of Consciousness, by Gerald M. Edelman and Giulo Tononi. Edelman is a Nobel Laureate brain scientist, and the book summarizes contemporary theories about the neural mechanisms underlying mental life. He explains that the millions of circuits in the brain intertwine and feed into one another in complex and rapid cycles. Each pathway competes with its neighbors, and the ones that so-called “value” systems highlight get strengthened, while others fade away.

If we never question our thoughts and behaviors, they get rated by instinctive value systems that crave immediate gratification. We gravitate toward food, comfort, sex, and aggression. But if we intervene as thought unfolds, we can encourage healthy attitudes and discourage negative ones. We can deliberately build up maturity and wear down selfishness. This is the essence of neuroplasticity.

But make no mistake, this is life and death competition. The egocentric circuitry fights tooth and nail for its survival. It has no interest in fading quietly and would sooner destroy happiness than face dethronement. So when we are tired, distracted, or agitated, the old pathways seize the day and we act badly.

This is no cause for alarm. Many addiction experts believe that relapse is part of recovery. Occasional napping is part of awakening. At first, our eyes may only open briefly and under the most favorable circumstances. But as we work and grow, they stay open longer and in the face of greater adversity. Finally, the day comes when depression howls as loudly as mine did yesterday, but we stay alert and open to the experience. We don’t close our eyes or turn away. We don’t hurt ourselves or anyone else. We just settle into our deep core of serenity and enjoy the storm.

This pattern should be familiar to anyone who has mastered a skill of any sort. At first one executes clumsily, but as time goes on performance becomes better. And at first quality is uneven, but with practice consistency improves. When I learned oculoplastic surgery, my early cases were slower and less skillful than those that came later. And in between the beginning and expert phases passed an interval when some of my operations looked brilliant and others amateurish. Eventually, however, I acquired the ability to reliably perform procedures of high quality.

This is how we learn, whether to be surgeons, musicians, athletes, or yogis.

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Sculpting Happiness

cortex2

Today I am filling in at the local Suicide Hot Line. Since this time of day tends to be slow, I’ll probably have time to complete a post. As I planned this essay, knowing where I’d be writing it, the topic of suicide naturally suggested itself to me. But after giving it more thought, I decided to write about something a little less depressing.

In the book Buddha’s Brain, Rick Hanson explains that dwelling on negative memories and feelings strengthens them. If we habitually focus on unhappy topics, and especially if we simultaneously harbor unpleasant emotions, then we increase the neural circuits that promote misery. The converse is also true: dwelling on happy topics and pleasant feelings leads to brain changes that foster contentment.

My goal these days is to improve my mental balance, and spend less time obsessed with depressing topics. Since my childhood was loaded with trauma and my adulthood has brought huge disappointments, negativity is already well entrenched in my brain. It will take the rest of my life to build in enough positive memory and feeling to counterbalance that burden of loss. Reliving my suicidal feelings and remembering the suicides of loved ones seem like counterproductive exercises. They can wait for some future day; no doubt depression will eventually descend despite my best efforts, and such subjects will be on my mind already.

Two readers have requested posts about neuroplasticity; since I’ve already introduced the idea by mentioning Hanson’s book, I might as well develop it further. Neuroplasticity has become a hot topic in neuroscience, but it is actually something we make use of every day. If we wanted to be less technical, we could replace the fancy jargon with the word learning without losing much meaning. Both terms refer to long-term changes in the brain.

One of the first and most striking demonstrations of neuroplasticity came from the research of V.S. Ramachandran. He showed that after an amputation, the brain regions that used to handle the sensory input from the lost limb do not simply go silent. Instead, adjacent functions spread into the unused area. So if an arm is amputated, the sensory system of the face expands into the area that once served the severed limb. As a result, people have odd phantom limb experiences, such as touch to the cheek causing ‘feeling’ in a hand that no longer exists. More elegant examples include the expansion of brain representation of fingers in musicians, or the larger memory modules of London taxi drivers, who have to memorize maps of the entire city.

The outer and most evolutionary recent part of the brain is the neocortex. In effect, it is a flat sheet of nerve tissue that has been folded and balled up to fit inside the skull. Although different parts of the cortex have somewhat different structural details, in every region the sheet is layered. In the visual cortex there are six layers, with some receiving input, some primarily performing internal processing, and some creating output to other regions. The number of layers and the specific appearance varies from place to place on the neocortical sheet, but one is struck by the overall uniformity. Regions that handle functions as diverse as vision, language, touch, movement, and judgment all look more or less the same, and areas with similar functions can appear identical. Thus, the sensory area serving the arm is indistinguishable in appearance from that serving the face.

This makes it easy for cortical regions to take up new functions. In people who are blinded, and especially those blinded from birth, hearing functions encroach on the visual cortex. This expands the processing space for auditory signals, and probably partly explains why people who are blind often hear better than those with sight. Enlarging the cortical space for fingers in musicians presumably increases manual dexterity.

These are large-scale changes that demonstrate the brain’s impressive ability to reorganize itself in response to need. Restructuring on that scale takes time, but smaller shifts in brain structure and function happen every instant. Every thought is accompanied by a ripple of neuronal activity that forms an organized ensemble and then dissipates. Every time a memory is created, new connections are established between nerve cells. The brain is changing all the time as we learn new skills, see new things, and think new thoughts. As we live we learn, and as we learn we change our brains. This is the essence of neuroplasticity.

We should feel both sobered and empowered by the fact that everything we think and do sculpts our neurons. Sobered, because every single thought leaves traces that accumulate; a lifetime of negative thinking strengthens the neural foundations of stress, fear, and sadness. If we clumsily allow our minds to obsess on whatever attracts attention, no matter how discouraging or counterproductive, we will develop brains prone to unhappiness. Empowerment comes from recognizing the opposite principle: fostering positive thoughts, memories, and feelings will gradually increase our ability to remain contented.

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