Book Review: The mind and the brain

The Mind and The Brain

By Jeffrey M. Schwartz, M.D. and Sharon Begley

This book was recommended to me by Russell Osguthorpe, author of Choose to Learn. I thought it was fascinating.

Schwartz begins by talking about his treatment of people with Obsessive Compulsive Disorder (OCD). Since I mildly manifest some OCD symptoms this was especially interesting to me. One of his keys points is that contrary to the belief that we are controlled by our genes, and basically predestined to certain outcomes, we have the power to make choices not only to override these predispositions, but to actually alter the composition of our brains. (For a quick and interesting read on this topic, see "Does Thinking Make It So" published in the most recent Harvard magazine).

Schwartz weaves the stories of several scientists and their experiments to show this thesis to be correct. One of his key ideas for changing the way our mind has to do with Buddhist practices of meditation. The four steps he suggests are to “Relabel their obsessions and compulsions as false signals, symptoms of a disease, they reattribute those thoughts and urges to pathological brain circuitry (“This thought reflects a malfunction of my brain, not a real need to wash my hands yet again”). They refocus, turning their attention away from the pathological thoughts and urges onto a constructive behavior. And, finally, they revalue the OCD obsessions and compulsions, realizing that they have no intrinsic value, and no inherent power” (14). [see end of this review for more on these “re’s”.]

Schwartz’s story of how he developed this theory is quite interesting. Previous treatments of OCD seemed quite strange (forcing people to do the behaviors that they hated) and the cure rate was very low. Piece by piece he put these four keys together and eventually began using them in therapy with great success. In fact he showed that there was substantially decreased metabolic activity in that part of the brain that is overactive in OCD patients. He stated that “This was the first study ever to show that cognitive-behavior therapy—or, indeed, any psychiatric treatment that did not rely on drugs—has the power to change faulty brain chemistry in a well-identified brain circuit” (90).

A corollary of this finding is that the brain remains subject to change and grow, not just in childhood, but throughout life. Additional evidence to demonstrate this comes from the Silver Spring Monkeys. A researcher named Taub experimented on these monkeys by altering a small part of their brain making one of their limbs unusable. Then he put the good limb in a straitjacket forcing the monkey to use the arm that it thought was useless. In time, the monkey was able to use the “useless” arm. In other words, the brain was able to become active and have other parts of the brain learn how to control its arm. This work with monkeys was later applied to stroke patients, and many were able to regain use of limbs that they thought they would never be able to use again. Taub says, “If a stroke knocks out your Broca’s region, I am suggesting, you can in effect grow a new Brocas’ region” (196).

Another interesting finding reported by Schwartz is that mental activity can have the same effect on the brain as physical activity. “Pascual-Leone…[had] one group of volunteers practice a five-finger exercise, and a comparable group merely think about practicing it. They focused on each finer in turn, essentially playing the simple piece in their hands, one note at a time. Actual physical practice produced changes in each volunteer’s motor cortex, as expected. But so did mere mental rehearsal, and to the same degree as that brought about by physical practice…merely thinking about moving produced brain changes comparable to those triggered by actually moving” (217). This shows that the mental processes of relabeling and so forth that Schwartz described have the potential to actually change the physical structure of the brain. This was also related to how dyslexia (Fast ForWord) and Tourette’s might be treated.

The part of the book that caused Dr. Osguthorpe to recommend it to me was the final third which focuses on volition. “Mental force acts on the physical brain by amplifying the newly emerging brain circuitry responsible for healthy behavior and quieting the OCD circuit” (295). In simple terms, you are not controlled by your genes or your brain. The things you do and think about can literally reconfigure your brain.

One insight that I found particularly interesting as a teacher was that we can choose what we pay attention to, and that the things we pay attention to changes the way our brain works. “Attention to shape and color pumps up the volume of neuronal activity in the region of the visual cortex that processes information about shape and color…in people, paying attention to faces turns up activity in the region whose job it is to scan and analyze faces” (329).

So when I as a teacher say something like, “Students read verse 8 and look for…” I am helping to focus their attention on a certain point. This will fire up certain neurons and brain activity in a way that would not happen if they were reading without looking for something specific. “The way an individual willfully focuses attention has systematic effects on brain function, amplifying activity in particular brain circuits” (334).

So the implication for me as a person trying to become better is that by choosing to pay attention to certain things, or looking for certain things I can literally change my brain. Perhaps “looking for the positive” actually changes neurons in my brain and helps me to be a happier person. As a teacher I can work carefully to help focus students’ attention in meaningful ways.

[More specifics on the “re’s.]:

Speaking of what he came to term relabeling he said, “To register mentally the arrival of each and every OCD obsession and compulsion, and to identify each as a thought or urge with little or no basis in reality, would require significant, willful effort. It would not be sufficient just to acknowledge superficially the arrival of such a symptom. Such superficial awareness is essentially automatic, even (almost) unconscious. Mindful awareness, in contrast, comes about only with conscious effort. It is the difference between an off0handed “Ah, here’s that feeling that I have to count cans again,” and the insight “My brain is generating another obsessive thought. What does it feel like? How am I responding? Does the feeling make sense? Don’t I in fact know it to be false?” (78).

On reattribution: “Relabeling and reattributing reinforce each other…by reattributing their symptoms to a brain glitch, the patients recognize that an obsessive thought is, in a sense, not “real” but, rather, mental noise, a barrage of false signals. This improves patients’ ability not to take the OCD thoughts at face value” (82).

For refocus he “developed a ‘fifteen minute rule.’ The patient had to use an ‘active delay’ of at least fifteen minutes before performing any compulsive act. Setting a finite length of time to resist giving in seems to help patients…the fifteen minutes should not be just a passive waiting period, however. Rather it must be a period of mindful adaptive activity intended to activate new brain circuitry, with the goal of pursuing the alternative activity for a minimum of fifteen minutes. This seems to be the length of time generally needed for most patients’ OCD urges to diminish noticeably” (84). “When patients changed the focus of their attention…the brain might change too” (85). “Refocusing is the step that, more than any other, produces changes in the brain” (86).

“Revalue is a deep form of relabeling. Anyone whose grasp of reality is reasonably intact can learn to blame OCD symptoms on a medical condition. But such relabeling is superficial, leading to no diminution of symptoms or improved ability to cope….revaluing went deeper” (87) “…[it] means seeing matters as they really are” (88).

Good stuff…I should practice it! :)