ICONOCLASM:
Chapter 4 of “Beyond Biology” by Charles S. Yanofsky
Contents:
Neural Model
of Psychological Types
“If we evaluate a human being as a type, we need
not take the individual case into account, and that is so convenient. It is as convenient as evaluating an
automobile by its make or body type. If
you drive a certain make of car, you know
where you stand. If you know the
brand of a typewriter, you know what to expect of it. You can even select our breed of dog in this
way; a poodle will have certain inclinations and certain traits, a wolfhound
will have others. Only in the case of
man is this not so. Man alone is not
determined by his origins; his behavior cannot be calculated from the type. The
reckoning will not come out even; there is always a remainder. This remainder
is the freedom of man to escape the conditioning factors of type. Man begins to be human only where he has the
freedom to oppose bondage to a type. For
only there, in freedom, is his being--being responsible; only there “is” man
authentically, for only there is man
“authentic,”. The more standardized a
machine is, the better it is; but the more standardized a person is, the more
submerged he is in his race, class, or characterological
type, the more he conforms to the average--the more inferior he is from the
ethical standpoint.” [1]
ICONOCLASM
Every age has its own idols, its
“isms” for us, Mechan-ism or scient-ism. This is a systematized belief, that anything
understood deeply enough can be explained in mechanistic terms and is no
different from any other belief ingrained at an early age. Mental events comprise a subset of all
phenomena, by no means unusual, and thus can be reduced to physical processes
that take place primarily in the brain.
In its deepest sense this belief system implies that pure thought is
reduced to events that take place in matter. Experience is mechanical and
material. But foundations grounded in
matter in the palpable as opposed to the invisible, are beginning to crumble. There is evidence
that we find these old paradigms inadequate to begin with. For instance, in the
What makes you the person that you
are, determines your proclivities and behavior including reaction to positive
and adverse stimuli, level of happiness, productivity and whether or not you
have emotional problems? If we only knew! How much could we profit from such
knowledge! What of the age-old questions
of nature, the way persons are built, how we are vs. nurture, what our
immediate environment makes of us? Are people basically good or evil? Do we have only a thin veneer of civility and
control with evil kept constantly in check (We certainly get that impression in
Despite all of our scientific advances we have only a rudimentary idea about basic human motivation. It is all we can do to vaguely state that motivation may reside somewhere in the frontal lobes. The most advanced research has defined, only to a limited extent some of the influences that shape decisions in terms of anatomical substrate and perhaps more usefully, certain neurotransmitters as we shall see below. But where is the kernel or core of human will? When you decide to do something as simple as moving your finger, where is the ultimate source, anatomically of this decision? We do not know! Our tests, functional MRI or PET scans merely point out activated areas of brain that are implicated in such actions; they may show a pattern of activation that varies from subject to subject and between situations, but they will never show the ultimate source of even the most rudimentary decision. They do not show us from whence derives motivation, especially the drive to change one’s world or the direction of one’s life.
Two persons raised the same way, even growing up in the same household, can turn out different. No one has been able to predict how someone will turn out by looking at his or her environment, which frustrates social engineers. There is a lot of debate about what constitutes a healthy upbringing. Bad persons can be born under ideal circumstances and in many cases persons show tremendous resilience despite., or even because, of their being dealt a bad hand. There is little question that in our society we tend to trust the highly born. Most of our heroes hail from patrician lineages and we scoff at the lowly born. It's the self-made person who we truly should admire, but we don’t trust him. He is a nouveau riche. We seek a purebred highbrow who has had everything handed to him. Yet we all know of persons lowly born, who have achieved a great deal (even if this is not the usual case) and there is perhaps more social mobility in American society than most places around the world. Most of us don’t think very much of Rousseau’s concept of the noble savage.
We all know someone who grew up under adverse circumstances having to struggle against seemingly insuperable odds, and yet have achieved material, educational or ethical milestones beyond imagining, and of others whose lives were a disappointment despite their having all of the advantages of material comfort and close nuclear family. We enjoy citing these examples because they seem to prove that some persons have an inner fire while few others have any burning passions inside. Examples abound of persons born to limited means who become rich or famous by virtue of burning ambition. Bill Gates, the Intel guy, Clare Boothe Luce, Einstein and Freud, Faraday, and a host of others were born poor and to unknown families.
When it comes to human behavior
facile rules, break down, not always, but occasionally, and enough to make all
the difference. This slight infrequent
breaking of rules, this difference o
Momentum= Mass X Velocity, but rather,
Force = Mass X Acceleration.
Sometimes, perhaps not that often,
a person does the unexpected, fails to go with the flow, but instead, exerts a
force on his world which in turn, changes his course or his outer world. The
paradigm, o
Parkinson’s disease is caused by Dopamine deficiency in the basal ganglia of the brain, specifically in the substantia nigra or black substance which is less black in Parkinson’s brains because there is also less melanin, a metabolite of Dopamine. In his popular book, Awakenings, Oliver Sacks showed how there is spectrum from the Dopamine deficiency of Parkinson disease to Dopamine excess brought about by excessive Dopamine replacement therapy. Patients may run the gamut from immobile inertia, to aggression, excessive movement, and hypersexuality depending their Dopamine levels. Thus Dopamine is the transmitter of more than simple motor action acceleration or force. There is evidence connecting Dopamine with basic motivational processes, an inner fire, pleasure seeking, motivation.
Cocaine increases brain Dopamine by
blocking Dopamine transporter, the protein that transports Dopamine from the
synapse, back into the neuron, where Dopamine ceases to be active. Every
neurotransmitte
The D2 Dopamine receptor subtype is implicated in this process. Experimental Rats try to stimulate certain nuclei in the brain, that contain Dopamine, especially the nucleus Accumbens. Alcohol, Cocaine, and nicotine, increase the effect of Dopamine in the brain. The ventral tegmental area of the midbrain also has Dopamine secreting neurons that project to the nucleus accumbens. Other transmitters, serotonin, enkephalins GABA also get into the act, stimulating or inhibiting the ventral tegmental Dopamine containing neurons. The final common pathway though is the nucleus accumbens that has D2 dopamine receptors. Does an inherited alteration in Dopamine D2 receptors predispose a person toward alcholism and cocaine addiction, pathological gambling or other cravings?
Evidence is contradictory at this point but there is some support in work by Blum et al.[2] Have found an increased incidence of a certain gene type in alcoholics designated as A1 allele, which associates with the D2 Dopamine receptor. These associations are fairly weak if they exist at all, but are more convincing in more severe cases of alcoholism. For example, if the A1 subtype has a frequency of about 20% in normal Caucasian control group, there may be around a 45% incidence among Caucasian alcoholics, not a very convincing association, but enough magnitude to be statistically significant. D2 receptor subtypes seem to account for some susceptibility to alcoholism and also the A1 polymorphism connects with other disorders, motor tics, compulsions, attention deficit disorder and autism[3]. Others have found that alcoholics, as opposed to the rest of us, are simply not as sensitive to the effects of alcohol, that is may require higher doses, more drinks to become uncoordinated, high, or have changes on their EEG. In other words, future alcoholics may have an inherited decreased susceptibility to the acute effects of alcohol.
Figure
1: The nucleus accumbens in the frontal lobe. CCg=corpus
callusum, Ch=caudate nucleus, IC=internal
capsule, P=putamen, GP=globus
pallidus, AC=anterior commisure,
Fcol=columns of Fornix,
NA=nucleus accumbens, an extension of the putamen, part of the deep motor system in the brain.
[4]
What if alcoholism and other cravings were found to be true genetic based disease states? Does that absolve the alcoholic from responsibility for his own behavior? A more important practical consideration is that understanding drug cravings, which may have to do with an ascending tracts in the brainstem and Dopamine transmission, an internal reward system, may one day help us to find medical treatments for all sorts of cravings and addictions.
To me, the interesting part has to do with the weakness of the data. The statistical strength of Dopamine receptor subtypes in ethanolism is fairly minimal and even there, some groups reach contradictory conclusions. Under the best of circumstances it is far from possible to draw firm conclusions about a genetic or any organic basis for any specific human craving.
The best model of craving is Tourette Syndrome which is a study of the irresistible urge. In Tourette’s the patient has an urge to perform certain acts, ordinarily simple tics or mannerisms such as forceful eye blinks and shoulder shrugs, but also more involved activities throat clearings, vocalizations and other utterances, sometimes expletives, “coprolalia” ( from Greek, literally fecal babbling). Some persons have copropraxias (praxis, to do) and needing to touch themselves for example, even in public. The Touretter will be able to suppress his irresistible urge for a while, but the urge will always be expressed. He will try hold out until he is alone, but the act will always get done and there is no way to stop it. Not surprisingly, Touretters have various compulsions of all types, even to ritualistic behaviors and obsessive-compulsive disorders sometimes gambling. Dopamine is the major transmitter implicated in Tourette syndrome, as drugs that block Dopamine, the anti-psychotic drugs, are by far the most effective tic-suppressors, but other medicines, especially Serotonin-increasing antidepressants, seem to be most effective for compulsions. These medicines are effective at treating many secondary symptoms such as an addiction to gambling. An organic disease such as Tourette’s is the strongest argument in favor of the notion that humans are subject to predetermined irresistible urges that cannot be controlled, also that one may use organic means, namely drugs, to control these urges. But Tourette’s is a disease which says little about health and superlative ability.
In fact most information about neurotransmitters and psychiatric disease, the brain, behavior connection, is generated about what we know about the effects of certain drugs. Typically certain classes of medicines are found to be helpful for certain conditions, sometimes quite by accident, then it is up to researchers to find explanations for why this might be so. Thus isoniazid used to treat tuberculosis, was found, quite by accident, to diminish depression and cause in some, susceptible persons, a form of mania or excitation. From this observation, the first generation of antidepressants, known as tricyclics developped, amitriptylene and imipramine. These drugs were only later found to affect the transmitter brain norepinephrine. Tourette’s was at one time thought to be a purely psychiatric disease. Today, many of us doubt that such a thing exists as a psychiatric disease because of known physical concomitants. The first hint that Tourtette’s is actually neurological came from empirical observations about the effects of Haloperidol on the tics in this disorder. From clinical this observation, a Dopamine hypothesis about the causation of the disease arose. Why? Haloperidol was known to exert its effect, primarily through dopamine blockade.
Igor Stravinsky was an early twentieth century iconoclast. His Rite of Spring explodes with energy, rhythms so earthy and complex Stravinsky had difficulty figuring out how to put them to paper. This was a heady time, in the days before the Russian Revolution, the Great War, in the years between Einstein’s Special (1905) and General (1916) Relativity, the victory of Quantum mechanics over a Newtonian Physics. Le Sacre raised more than a stir at its premier in 1913. By that time Stravinsky had already introduced two wonderful earlier ballets, Petrushka (1911) and Firebird (1910) whose music was influenced by his brilliant teacher Rimsky-Korsakov. But Le Sacre was different. Its offenses were sufficiently revolutionary, too much for his audience to take. The premier touched off one of the more celebrated riots in music history. It is hard for most people to appreciate how sometimes great art must offend, not fit neatly into the blueprint of previous works. Here Stravinsky literally helped create modernism. The ears and eyes of the musical public were not quite ready for this, but that is what must happen, once in a while, if we are to make any advance. It is emblematic in art.
Le Sacre is about a pagan ritual that welcomes Spring with the worship of the earth. The theme is a ritual in which a chosen sacrificial virgin whirls and dances herself to death under the watchful eye of sage elders. The music crashes through the gates breaking conventional romantic musical idols along a path of conquest. Great music and art is most of the time is simply validating and uplifting. Yet if Stravinsky’s sound is appealing, and though explosive and primitively advanced rhythm, it does not sound all that unusual to us today. We have heard so much since then that we hardly know what all the fuss was about back then. Its appeal is not to emotions primarily which is better done with melody than rhythm. Still the music finds new patterns of activation within the cortex, new patterns of arousal and mental exercise. Ironic that a break with the romantic past in the early twentieth century depicts pagan ritual – iconoclasm in the service of idolatry. Le Sacre may break idols, but the earthy primitivism of matter still wins out over mind.
The archetypal iconoclast was
Abraham. The Abraham in Biblical accounts,
broke all of the idols of his
father and idol merchant, Terah, and then
left the ancient
Iconoclasm. There are echoes of Abraham. The convention was to worship inanimate material objects, themselves the products of human hands “Why do you worship statues that can’t do or feel anything? How can these objects possibly have any control over your life?” you hear Abraham say. Chances are his father sympathized with him. Undoubtedly Terah sympathized with his son, but didn’t have the personal fortitude to leave his life behind, or perhaps he was by then too old. Chances are he merely made his living selling the dumb statues but didn’t believe in them. Abraham’s insistence on a non-material spirit who created and controlled the universe was the first iconoclasm. in history. That is not to deny that to this day we worship physical objects.
People still need to see something
tangible and real and churches have made peace with this human clamoring with
its extensive iconography that a lot of people require in thei
Idol-breakers accentuate humanness. They swim against the tide, eschew the conventional. they arouse hatred and alienate. This doesn’t mean that the outrageous is always good or valuable, nor that art needs to be outrageous in order to be good. Without form, or meaning, expression turns crude, vulgar. Formless meaninglessness is what we have in rap and rock music of a drug influenced new age. Recall that a whole political movement revolved about the sacrilegious Andres Serrano's "Piss Christ," a photograph of a crucifix immersed in the artist's urine. This drew criticism from Senator Jesse Helms that nearly did away with the National Endowment for the Arts. Innumerable articles were written about the subject. Finally the Supreme Court got into the act and supported a standard of decency as prerequisite to federal arts funding. Many persons recoiling from this outrageous art that offends sensibilities, have used this for a pretext to condemn the entire art world. Yet it is in the very fiber of art to swim against the tide, to challenge convention with the outrageous. Sometimes this simply offends and does so without substance with little regard for form let alone our deepest feelings. Such amorphous garbage does not express anything. Rather it tramples over us.
Adolescence is in part about the same rebellion, a declaration of one’s own identity, as if to shout to the world, “I’ve arrived! I’m here and in your face!” It’s the source of a youthful enthusiasm that to adults maddens and insults, but it is what an individual identity is about. At least in adolescence you can say that you are on the road to something.
David Gelernter in his book 1939, The Lost World of the Fair[5] gives us a poignant look of youthful enthusiasm and optimism, a post-depression world in the throes of a world war when one would think there was little reason for such optimism. Gelernter presents a young architect and his own unconventional visions for playgrounds, schools and buildings. A building as a vision can positively change lives and society and its institutions. Creativity begins well before you have been infused with the conventional, while you are learning in school, as you are flushed with the new, and a host of things you have yet to learn. After you have reached a state of high competence in a field, you begin to see things as others do. You lose that youthful creative spirit. Having established a line of thought in your youth it is usual that you are trapped in it, you will spend the rest of your years in that area. For one thing, you just have too much invested.
Unless, you are fortunate enough to be able to do something totally different in later life, a phenomenon well described in Betty Friedan’s Fountain of Age and in Gail Sheehy’s Passages.
Medical science has uncovered a large number of biological processes that profoundly affect personality and behavior. As more data accumulates we are finding that behaviors and internal personality structure are controlled by innate, genetic internal elements. These come less from Western literature and more from biology and chemistry. Controlling for environmental factors, intellectual, musical and athletic abilities are largely inherited. It seems to be no accident that abilities as well as diseases and disabilities run in families. It was more than the musical environment that made musicians in generations of Bachs, Mozarts and Beethovens. In retrospect, it is hard to believe how much we were taken in by arguments of the strong environmentalists anyway. All of us know of examples of children driven by some inner force though never trained in the field of music medicine or law, and never encouraged to enter into it were driven in a certain direction anyway. What determines such a drive is more than a mere talent. It is motivation and proclivity. Society functions best when it allows people to make their own choices.
Most of us tend to gravitate into the fields for which we are the most suited. Society would do best by not restricting this choice and basically leaving people to pursue their own dreams. One example is Richard Wagner a towering figure in music the greatest composer by far of German opera. Friedrich Wagner, a minor police official who died 6 months after Richard’s birth, was probably not his father. Richard was most likely the illegitimate son of Ludwig Geyer, an actor and singer who married his mother a year after Friedrich’s death and provided all important exposure to the theater while absolutely forbidding him to have anything to do with music. These facts are even more ironic since Wagner, noted for his later anti-Jewish sentiments was probably the son of Geyer a Jew*. But his paternity would go a long way in explaining his proclivity for both literature and music and his grand scheme to unify the arts in one magnificent operatic structure. Richard studied music on the sly and Geyer died in 1821 at any event. Hearing Beethoven’s Fidelio in 1829 was something of an epiphany for Wagner that awakened his own latent interest in music. Before that point his artistic interests were mainly literary.
More and more we are hearing about spectacular discoveries bearing on biological links to behavior. A genetic defect in MAOA, monamine Oxidase A, which is the enzyme that deactivates Serotonin in the brain was created in mice. These mice with an up to nine-fold increased brain serotonin are more tremulous as pups and more aggressive adults, exhibiting increased grasping in a clumsy attempt to mate, irritability, and a tendency to bite and attack. Two years earlier a Dutch kindred lacking MAOA was discovered with overly aggressive with males who would rape, commit arson, and brandish knives, try to run down an employer with a car. These men were also found to have elevated brain levels of Serotonin due to a deficiency in the Serotonin metabolizing enzyme MAOA.[6] We know personality and behavior can be altered in using drugs that increase or decrease levels of Serotonin and other chemicals, so why should veterinarians be hesitant to use the same chemicals in animals that are known to alter emotion and behavior in humans? Many of them do will give your pets with emotional disorders doses of antidepressants and tranquilizers such as Prozac and Valium.
Even more biological ammunition comes from ethology which looks at the innate behavior patterns of animals. Animals inherit much more than physical characteristics such as eye and hair color. Complex patterns of behavior are also inherited and have profound effects on maturation and mating. Some speciation is determined more on an inherited behavioral basis than any physical quality. Certain simple physical characteristics act as releasers of behavior. The famous example given by Konrad Lorenz a pioneer in this area of study is the propensity, expressed over a limited period shortly after hatching, of ducklings to follow a moving walking animal. Almost always this animal turns out to be the mother of the hatchlings but if a human should intervene and begin to walk away during this critical period shortly after birth then the ducklings will continue to follow the human who will be treated as the ducklings’ mother. This is imprinting. What is required is an inborn pattern of behavior, wired into the central nervous system, and a releaser that brings out this behavior often in a critical period. Earlier in chapter one the releaser of the male stickleback fish which is another classic example, was mentioned. The best example of imprinting pointing to the interaction of environment and inherited behavioral patterns is birdsong. Most birds are born with a simple limited repertoire of song patterns. These basic patterns are later blossom into their full complexity and diversity during a critical period of learning that occurs early in life. A bird’s song is endowed with a local species-specific dialect that is superimposed on simpler patterns and learned through contact with older adults who have fully developed song. The male utilizes song mainly to attract a female of the same species as part of a mating ritual. If he is raised in isolation from other males, the very basic innate unembellished song pattern is what remains. Therefore the song of the male bird is largely inherited and partly learned as well. Not only the basic song apparatus and wherewithal to produce the song, the vocal and neural apparatus, but also the proclivity to learn more complex song patterns during a specific period of the bird’s early life. Song, as much as any physical character, ensures that females only of the same species are attracted for mating purposes. Perhaps other closely related females might look almost exactly the same and mating might possibly occur, purely on the basis of morphology or appearance. But the specific male song, and heritable differences in actual mating behavior, help ensure that this will not occur. Male aggressive behavior is controlled by the same factors. The birdsong is sexual and has both attractant and aggressive repercussions. Other males, hearing conspecific birdsong that is part of the competitive mating ritual, if done in their own territory, might be inclined to attack so that a physical fight will occur. More often the song is a declaration keeping competing males away from females and out of the singing male’s territory. The male bird will sing more vehemently if deprived of sex or sexually excited. Aggression will be more vehement as well. While in birds with more complex brains some specific elements have yet to be worked out neurophysiologically, it has been possible to show in certain stridulating insects such as grasshoppers, that inherited song dialects, also used to attract females, translate into firing patterns of single neurons tuned to respond (fire) to exact frequencies produced. Thus there is a certain inherited lock and key when it comes to bird and insect sound production, a correspondence between the motor output, influenced as it is by internal states, and sensory response.
It’s also impossible to escape generalization of these same principles to human language dialects. Presumably with us, language is more a matter of learning with minimal genetic component (excluding the basic abilities to speak and to respond to language) but the effect is the same. Mostly by learning humans are “tuned” to respond to specific languages and dialects and mating and other social interactions are much more likely to occur among persons who are genetically, racially and linguistically similar. Our analogy also extends well beyond language over the whole gamut of ethnicity with its own biological and cultural and linguistic components. Ethnic linguistic variation, which is an evolutionary tree of sorts, largely parallels genetic differences. Human racial varieties parallel ethnic and linguistic ones.
Considering that almost all organisms have evolved methods for kin recognition[7] ranging from elaborate olfactory systems in paper wasps, tadpoles and sweat bees, to location of eggs in certain birds we should note that many of our ethnic concerns are biologically determined. Humans go out of their way not to breed with close family members. That would be a disadvantage in two ways. Recessive traits, many of them injurious, would be expressed doubly by mating with a close relativeF. Also mating with very close relatives would limit the store of genetic variation, so that making populations so homogeneous they would not have the basic fuel required to evolve. The fuel of evolution is individual variation. Organisms evolve when variations in individuals affect fitness.
On the other hand evolutionary forces limit out of group mating. This is true especially in complex social animals such as humans. Each large group or kindred is also a separate evolutionary experiment and there is pressure to mate within a group (ordinarily for man a common language or ethnic group) and fierce competition for survival between groups as well. The survival of the individual’s genes is married to that of his group. If the group is large enough, there will be adequate genetic variation to fuel adaptation. History describes kindreds conquered, displaced, obliterated. There are records of such total destruction since the invention of writing. When you consider it, it seems that language may have developed entirely to separate out different ethnic groups or, the biblical descriptions of such processes through marriage, and war are very likely highly accurate. Groups segregate after separation of a founding member into separate family groups or kindreds then continue to grow apart. Two related kindreds that separated only few generations ago may later make war against each other much as sons of Isaac and Ishmael who had Abraham as their father or Jacob and Esau (founder of the Edomites) who were both sons of Isaac. What this means is that we need come to some accommodation between mating with relatives that are too close (as exhibited by incest laws) and those who are too distant (the mechanisms of language, religion and war are instrumental here.)
Ethology
has shown that behaviors are inherited just as much as morphologic
characters. Behavior is the efferent
side. On the afferent, receptive side it
is very likely that we inherit a propensity to perceive the world in a certain
way. It is certain that a whole logic is
wired into the brain and that the origin of this logic or wiring system that
shapes our perception is in evolution.
We turned out this to view the world in our own specific way as humans
because evolutionarily that is what was most adaptive; that is what increased
our fitness in the world. All of us
wonder about what is truth, what determines out perception of truth debates
which we have today but which were fully shaped by enlightenment philosophers
by Hobbes, Hume, Berkeley and Kant. The
debate in epistemology, the origin of truth, how we know what we know, whether
what we think is true bears any relationship to an objective reality, revolves
about how our world is formed by the interaction of the inner workings of our
mind and perceptions and how this fits into a pattern that is our world
view. Is there a mental form or pattern
into which we fit our perception or a blank slate into which we place
individual raw perceptions to eventually make a mental model. The striking thing for me, is that all of these philosophical debates
were formed before
So the third aspect of the scientific examination of personality and behavior, after analysis, and behaviorism, is biology. And here we have made the greatest strides in the latter part of the twentieth century. Biology definitely explains a lot. Major objections to Darwin and evolutionism, far and away the most powerful biological theory before the revolution in molecular genetics, that we are in the throes of at present, have come from radical religionists, and they are armed with fundamental misunderstandings about a Christian and English speaking literal interpretations of their Bibles and little, if any, appreciation of other areas of enquiry.
Scientists have failed to inquire about whether it is possible for a mechanism of free will to be built into a biological system. Could it be that the brain is designed to be a repository of free-will? This would be contrary to our understanding of all other mechanical systems to be sure, but is a theoretical possibility that should not be overlooked. Of course it is contrary to our understanding of other mechanical systems and that is what makes it so interesting. We have alluded to examples of other systems, scientifically described, whose behaviors cannot be readily predicted. These include descriptions of sub-atomic quantum behavior where the uncertainty principle applies. Since we cannot know at time t0 the position and momentum of an elementary particle at the same time, the behavior of such elementary particles at time t1 cannot entirely be predicted. Also, in recent years, science has explored chaos theory which describes the relatively unpredictable, yet still deterministic in the wide sense behavior of such areas as weather prediction and the stock market, even EEG and EKG non-rhythmic patterns. It is even more probable that free-will will fall into the purview of chaos. Another alternative is that of new areas of inquiry about self-organization order out of chaos theories as described by Ilya Prigogene and Stuart Kauffman[8] for example. Or, we may be forced to admit the possibility of free-will built into neural systems via scientific principles that have yet to be defined.
Psychologists would like to be able to predict behavior and prognosticate on abilities. If nothing else this would legitimize their science by giving it predictive power. What if one could develop a test that would accurately predict school performance or find the best recruits for officer candidate school? Imagine if one could tell who among us are most likely to commit a crime. Parole boards could know which inmates to keep and which to set free. Our penal system would be turned on its head. For the first time one could come up with rational arguments, a high probability that a certain personality type would be at risk to commit a crime, to preemptively incarcerate or neutralize a criminal prior to his actually committing a heinous act.f . What if you knew which persons were more reliable, which ones had a tendency to steal, and the proclivities of all candidates, then you would have an idea what person could be hired and which to turn down. The Holy Grail of psychology is finding instruments that can predict future behavior. The history of such attempts is full of failure because behavior is willed and not determined.
The best that you might hope for is to be able to define abilities, proclivities, and more vaguely on emotions and motivation. You could make a statement about various influences then, but would be unable to predict behavior with any measure of certainty. A probabilistic model is all you could hope for. With those tools you might furtively enter the realm of prediction, knowing depending on the design of your test you may not be accurately assessing all you intended to measure.
In a certain sense it may not matter very much. For example consider the much-vaunted SAT test used for high school students. The Education and Testing Service has tried to design a test that can predict college performance, to provide an objective means to compare high school juniors from many different schools and backgrounds. We all know that a student with high grades from a mediocre high school may not be as academically gifted as one with lower grades from a more demanding or competitive class. The SAT seeks to correct for these deficiencies. The SAT test is very subject to a practice effect which means scores improve considerably on repeated testing because the questions from exam to exam are not that different. Consequently the SAT’s and other standardized tests have started a mini-industry of courses that essentially defeat these exams.
What about IQ tests which measure
intelligence and seek to stratify persons into prognostic categories predictive
of school and work performance? It is shocking
how little IQ testing is questioned in the lay and academic media
especially when you consider the checkered history of the tests and how they
have been used by pseudo scientists of all stripes in the past. In the early part of the Twentieth Century
these instruments, developed by such pioneers as Binet
and Terman,
administered to military recruits found a low general level of
intelligence, somewhere around the 13 year old age level. IQ tests administered to new immigrants on
Current research indicates that
about 50% of variation in human IQ is inherited. Common techniques used to
explore this interesting area include correlation coefficients of certain testees, identical and fraternal twins raised together and
apart, biological parents and their children whether adopted o
Starting from the seed of the IQ test, a whole branch of psychology has developed around the use of tests and instruments that seek to measure aptitudes and emotions. These consist of hundreds of tests and inventories many of which are all too familiar since we have all taken many of them. The simplest are the test administered by teachers and we all know how imperfectly such exams actually measure mastery of subjects we have taken in school. After you come out of an exam aren’t you always questioning whether you had a fair or and unfair test? In many cases you have not been tested fairly but at least a teacher’s exam does get you to study. The closest thing to an IQ tests are exams of “scholastic Aptitude” given to high school students in an effort to prognosticate on their abilities. You can improve your performance markedly on such exams through practice and a mini-industry has evolved just because students do improve their scores utilizing these courses and the test largely determines entrance into competitive schools. If you can improve your scores then the word aptitude is a misnomer, but at the very least, the test cannot be quantifying any innate academic ability and the exam is quite easily defeated. The problem is that there is no very good way of comparing students of diverse background and from different schools. Psychological testing has evolved into a whole specialty.
Many people are not aware how many
different tests there are. Tests measure
abilities and proclivities of all types.
Interests, personality types, emotions, linguistic mathematical musical
abilities, character, honesty, frontal parietal lobe functions, are all
measurable with these instruments. Tests
are not used only to admit a student to a certain college but to help quantify
brain injury for court cases or to help decide whether or not to hire a
prospective candidate. As on all
measures you accept a certain limit of accuracy. Schools and employers are well aware that in
trying to find the best candidates some of the best students and employees will
be excluded while other poor candidates will be accepted and are willing to
take their chances that on the whole, in most cases they will find the fittest
candidate. Besides, in case anyone
inquires (or sues) they can always show that all comers no matter what thei
A few cognitive deficits are specific and can be localized to a given region of cerebral cortex. They localize to areas mostly because of lesion experiments that show when a certain area of the brain is cut out then these functions are impaired implying that the affected area must somehow be connected with performing the function. Contrary to popular belief, decreased function via lesioning does not necessarily infer that the area in question is responsible for the function. One situation is termed Gerstmann syndrome after the psychiatrist who first noted a curious combination of problems. The subject with Gerstmann’s is unable to write, recognize his own fingers, calculate, and tell right from left. He has in order of appearance above, agraphia, finger agnosia, acalculia, right-left disorientation. The lesion is in the angular gyrus of the dominant (usually left) parietal lobe. All of these problems, taken individually, can be caused by anatomical defects elsewhere in the brain, but when they occur in combination, they almost always point to a problem in the left angular gyrus or an area near it. This doesn’t mean that the angular gyrus performs these functions, far from it. However it is one area that is necessary for the performance of these individual tasks. Why?
The angular gyrus processes data arriving from many sources, the visual cortex, auditory areas etc. It helps to further process this data. It is one of the areas of the brain collating and operating on information from diverse sources. Some of the tasks are actually composites multiple subtasks. Let’s take the problem of acalculia. Before you are able to use and manipulate numbers you have to be able to recognize them properly through either an auditory or a visual pathway usually, i.e. you must be able to receive numbers and the problem. Then you must understand the operations, addition, subtraction etc. that you are expected to perform. You have to have some language function in order to know what to do to operate on the numbers. This language function is the same as what is taken care of by the left hemisphere of the brain and as such persons with some types of aphasia (see previous sections) may have a number language defect or a type of “aphasic acalculia”. Such problems in linguistic interpretation ordinarily localize to the dominant cerebral hemisphere.
What if you are confronted with a complex problem whose answer you don’t know by rote such as addition of more than two or three columns with carrying and place holding? Then if you have a spatial deficit such as could be caused by a lesion on the right side of the brain you could get into trouble. Hence such problems involving extended computation and place holding are trouble for those persons having right hemisphere deficits. Other folks have more a pervasive problem with calculations that do not involve place holding or language function. Those people ordinarily may have more extensive bilateral defects such as occur with Alzheimer’s disease and have “anarithmetria.” Therefore as we have found with some other cognitive deficits such as naming, arithmetic computation, calculation, is a composite function that is not entirely localizing since so many steps are necessary for it to be carried out correctly by the brain. But where it occurs in conjunction with other defects as listed above, it localizes to the left angular gyrus [12](picture) Complex mental tasks, even those as seemingly simple as naming and calculation involve many areas of brain that are all necessary for the completion of the act. Each of these areas do not perform a function that is sufficient in and of itself, nor is it specifically involved in doing the function in question, say to name or to calculate. An area of brain, if lesioned, may impair a certain function. Yet it is rarely possible to connect that particular cognitive function specifically to that area. The most you can say is that particular area is necessary for the performance of that function, not that it alone is totally responsible for performing it.
Cognitive functions are characteristically composite in this way, that is, they involve putting together simple tasks into a complex whole. The brain usually parses out each simple function to a specific zone. Therefore each of these possibly disparate zones may in fact be responsible for a deficit that we see when we examine the patient. The classic examples are with calculation as shown above where a simple spatial problem such as space holding may impair the function and that is localized to the parietal lobe, or there may be a problem translating numbers linguistically that has to do with the language areas of the brain and either of these two simple deficits is sufficient to cause the larger deficit of acalculia because each is a necessary prerequisite to calculations. Another classic example is with naming, i.e. anomia. In order to name an object you have to have some visual recognition which implicates the visual areas, ie the occipital lobe and connecting parietal lobe, and you have to somehow connect the language area of the brain with the visualized object, this involves white matter connections from the visual to language areas, and even after the language to visual connection is made, you still have to find the right word which involves in the language area choosing from a vocabulary repertoire of nouns from memory banks and then in Broca’s area of the brain, making the sound, either saying it or writing it. If any of these links is broken, the subject will seem to have an anomia. The clinician’s skill is in further localizing the deficit which is almost always done on the basis of accompanying deficits. For example a subject with anomia who has a visual deficit will have his lesion localized to the parietal or occipital lobes whereas an anomia that associates with a decreased speech production in general is located in the frontal lobe, near Broca’s area. Hence for brain localization we depend on the concurrence of more than one, hopefully two or even three deficits. A single task especially a composite task, often involves disparate areas that are each responsible for simpler functions but each is a link in the chain which is broken, a lesion in any of a number or areas will result in the single deficit.
Psychologists and neurologists too typically find certain deficits on behavioral test or on examination. On the basis of these problems they try to find a diseased area of the brain. A patient with a Broca (motor) aphasia is supposed to have a problem in the inferior posterior frontal lobe (Broca’s area). Usually we are correct when we try to localize problems in this way. Aphasias or brain-related disorders in handling language, are the easiest cognitive deficits of all to precisely localize. With a proper analysis of the specific dysfunction, the clinical impression of a lesion correlate very well with what is seen on a CT or an MRI scan. In a few instances we may find a patient with a Broca type aphasia does not have a lesion where we expect it, in Broca’s area but somewhere else, often in the deeper part of the left hemisphere or even in the thalamus and we are often wrong, because there are a number of other brain areas that are necessary for the performance of the function and any of these might be responsible. However we do a lot better when we identify a combination of problems as these localize to specific areas of brain most precisely. What if we have a Broca Aphasia and right sided weakness? Then we know where the problem must be, in the Left frontal lobe. It’s a lot like localizing with one coordinate compared with triangulation which is a lot more precise. For this reason one might in fact achieve deficit triangulation. A lesion in the brain is most like a radio transmission that is best localized along more than one axis. These axes in space are the specific deficits. Even a seemingly simple classic deficit such as naming turns out to be a composite function involving a number of brain regions.
It is most fascinating to compare changes in personality with alterations in the brain. Here we have to keep in mind how personality is on even a higher level of abstraction than even cognitive cerebral functions. Not only is the topic in question composite, culling together multiple brain areas but also there are much more subtle problems in recognition of a personality change. We are talking about seeing human patterns of response or characteristic style of response that each of us has to specific sets of like situations. How does a person characteristically respond to stress, for example? Does he worry and perhaps become immobile and withdraw, or is he a person who takes action. This requires at the very least, repetitive periods of observation before a conclusion can be drawn, or perhaps at the very least, self report.
One of the biggest problems with the materialist paradigm is the following: Why don’t people always behave in a way that is manifestly advantageous to their self-interest? Why do they persist with behaviors that are injurious to their interests? It is the stubborn tendency of persons to act against what is manifestly advantageous that thwarts attempts at social engineering and makes behavior unpredictable. Most of us, as a general rule, will conform to rewards and punishments of our society. Young persons see that lots of money is to be made in business. Therefore, our colleges are enrolling business majors who expect to make a killing when they graduate. When repressed by an immoral and corrupt dictatorship or crime boss, 99% of people will follow the rules. But eventually, evil will be thwarted by the few who are courageous enough to act against their own immediate manifest self-interest. How do we account for this phenomenon?
This poses a terrible problem for those who seek to control others by pulling strings and manipulating rewards and punishments. Not everyone will act as you expect them to. There may be no better way to preserve the language of a small minority than to forbid its people from speaking it, as the English did in the case of Scottish Gallic still spoken today, no better way to preserve a minority religion than the unfriendly suppression of its practice. Umberto Eco in his book, FOUCAULT’S PENDULUM writes, tongue-in-cheek, of the Templars, ruthlessly repressed by Philip IV of France in the fourteenth century, its leaders tortured into confession and burnt at the stake, yet whose descendants exist to this day as a sort of underground, precisely because of this repression. In short, what we have identified is a rebellious spirit, unexpected behavior among some, by no means all, repressed people, which makes life difficult for the despot or manipulator, makes behavior that much more difficult to predict, and in some ways defines what makes us human.
All kinds of persons seek to
predict your behavior and to profit from their predictions. Schools and teachers stratify their students,
in an effort to teach more to the quicker ones and less to the slower
ones. Presumably it helps to concentrate
on students that that they feel have more ability, but it also explains their failure to reach
the others. No one has proven their
prognostications to be correct.
Marketers of products are betting
they can create a demand for consumer goods.
Employers want productivity and the government demands a high level of
behavioral conformance to maintain the peace but also for less laudable
enterprises such as collecting taxes and
fighting wars. Politicians are
trying to find ways to control you, whether they be dictatorial and are seeking
means to get the populace to conform to thei
That makes persons somewhat less
subject to prognostications and manipulations. In
On the other hand is a behavioral determinant that you can more or less count on. This is the person’s character or ego structure. It consists of habitual behaviors that are somewhat mechanistic in their predictability and automatic nature, also of beliefs, points of view, that are part of personality structure. Thus behavior is composed of two contradictory elements, the unpredictable non-mechanical side and the characterological constant side.
At first glance it seems that
character is the more mechanistic and determined part of human nature and not
subject to human will and motivation.
The proper understanding of character and personality does make behavior
more predictable though to truly know a person,
to get past their masks and facades, is no mean task. But it is an error to suppose that the
unpredictable side of behavior is the part subject to free will. We are powerfully motivated to change our
nature and character as when we are transformed by work, by education or
efforts to improve our habits or ethical response. On the other hand what appear on the surface
to be random willful behaviors usually aren’t.
Persons without character fail to show up for work or commit random acts
of murderous violence, performed under
the influence of base tendencies,
resulting from forces other than free will. The supposed free-wheeling
murderer or crook is not acting as much with his free will, as collapsing before his baser
instincts. To fashion a character that
others can depend on, that will give a reliable response, this takes motivation, commitment, and
executive function, a higher more pervasive will. One builds character through premeditation,
motivation and will-power. This means
that people can count on us to show
up, give our best performance, do our
best work and also that our behavior is to some extent predictable, but in doing so we are exercising a stronger
human will than the slothful forsaker of work or
person who commits the random act of violence.
I saw a man who took a bullet to the face which went through one optic
nerve causing blindness. He heard a lady
scream and decided to help. The attacker,
a would-be rapist, shot him in the face.
Who was exercising his will at that time, the rapist or the man of
character? On the surface the rapist’s
behavior was not constrained by social mores.
The rescuer, on the other hand,
was a man of conscience and characte
The answer unequivocally is the ethical person. This is a paradox though only a superficial one, that we readily fall for if we fail to think things through. By dint of years character development and personal sacrifice, someone may finally be able to master immediate desires, to sublimate for a higher, less immediate reward never dreamed of by the person of little discipline. It’s the base part of our person, the pure biology that shackles us.
Recent work has shown that
murderers have a high incidence of brain damage and are deficient in frontal
lobe function. When tested by
neurological examiners or looked at with MRI and other imaging techniques there
is a very high incidence of frontal lobe dysfunction. More violent types also frequently have a
history of violence in their own life particularly as children[13]. An intact frontal lobe acts primarily through
inhibition. This we have seen in earlier
chapters that explored the ideas behind neurological control. It is a general principle in the nervous
system that certain motor paradigms are hard wired into lower centers, then
this moto
It’s a given that what is basic to
you will eventually be expressed. This is not just on the biological level and
there are many examples. Srinivasa Ramanujan, who is compared with the greatest of mathematicians in history, was born impoverished in
It is so easy to make the generalization that what is innate and basic will eventually come through. Even though the experimental evidence is lacking, it is reasonable to ask, how it is possible to describe a basic self, and having done so what do we do with the information? Life as a process can be seen as a constant battle between what we are, and a buffeting and erosion of what really matters. Most of us aren’t resilient enough not to make certain compromises and eventually what we are, our own personalities gets worn down. Most of the erosion takes place on the side of the individual person. Outside forces change us inside. Yet some other persons, relatively few of them, are capable of chiseling away at their surroundings and make a great change seemingly through sheer force of will. Those persons are larger than life to the rest of us. Albert Einstein was unwilling to make compromises with what he knew to be true, that nothing could travel faster than the speed of light. He was willing to live with the consequences even if they contradicted with common sense. If consequences caused time to dilate or to contract, he would still insist on what he knew to be correct. Semmelweis dealt with derision of his colleagues when he suggested that childbirth fever may be spread from patient to patient because examiners weren't washing their hands. His heroic insistence on what he knew to be true in face of ostracism by his colleagues cost him his mental health, but saved many women's lives.
Most of us are too willing to
compromise in almost every instance with what we know to be true. For material gain or success, we sacrifice integrity, a bit
at a time. Perhaps it's for a little
bit higher income, or more security for our family or the short-sighted
approval of a superior at a job, in
gradual small pieces, imperceptible
steps, we chip little by little at ou
The frontal lobe is an extension of the efferent and motor limb in the same way as are the basal ganglia, but functions at an even higher, more abstract, level in the task of motivation and planning and strategy. It will be recalled that the basal ganglia are needed for intact detailed motor function, provide acceleration that comes from force, a change in the inertia of constant velocity. The frontal lobes may be viewed as an appendage to basal ganglion function in some ways. To make a motor movement each system, the frontal lobes, the basal ganglia, the cerebellum, makes their own individual contributions. These integrate to create fine movements. As far as frontal lobe abilities we all know persons who excel in motivation and the force of will and others who will be taken up by forces that surround them. By sheer will, exert a force a change in their environment. Most of us just go with the flow of life and rarely have the chance, or I should say, take the chance, to alter it.
Just trying to get to what you are,
how you are basically built is a slippery process. Some things like religion are inculcated at a very early age
and so probably form some of this basic structure. Very early on most of us have a good idea
about ou
We all know of people who have been
forced to subsume their identity for various reasons. Perhaps a wife on marriage will throw her
training and career to the wind,
subsuming her entire identity, including he
Giving up of a piece of oneself, what is basic to our own personality structure inculcated at an early age, will eventually raise great anxieties. Anxiety turns up in a number of different guises, expressed in a variety of ways, subtly at first almost imperceptibly but eventually makes its appearance. This is seen in some free-floating cases that we eventually diagnose as anxiety disorders, what used to be called free floating anxiety and what is called today, panic attack disorder. Not surprisingly, these problems are especially common in women and occur I think as almost a fear of death which of course exactly what the problem is, the demise of the person, the death of the self.
For psychiatrists the personality, formed at an early age, is enduring almost by definition. Personality disorders, though not as overtly pathological as other forms of psychiatric disorder, are considered untreatable. Admittedly certain personality traits cause great misery and are maladaptive for the person afflicted, changing and even ruining lives. The sociopathic, histrionic, compulsive or “borderline” traits may be life crippling, but these are almost unalterable conditions. Better to be an overt neurotic, more obviously sick, but easier to treat.
The brain mediates personality, for it is simply a more enduring aspect of mental life. Character is mediated by the cerebral cortex in particular. Cerebral cortex is composed of numerous interacting, often conflicting elements that are mutually influential. This is unlike our discussions of other parts of the nervous system.
We have observed that as a general rule the nervous system is hierarchical, with higher centers controlling, modulating or inhibiting, lower more hard-wired responses. Not so in the cortex whose various parts interdigitate and interact. The cerebral cortex functions as a sort of committee structure. Anybody who has been on any committees knows how they work. The more members of the committee to spread responsibility out, the less gets done. Some members of committees assume relatively greater, some lesser influence. Usually committees meet endlessly, accomplish nothing, unless there is some executive to take control and commit it to act., yet as we shall see, the greatest problem will be in trying to determine how we have the illusion, if that is what it is, of some unitary control or aim in the entire structure.
In consideration of a neurological
approach to personality we have to come back to the lesion experiment. Lesions and their effects give us a powerful
and at the same time, incomplete look, at the workings of the brain. It 's important to remember that if a lesion
results in absence of a given function that merely shows that the part of the
brain is necessary to that function, not that the lesioned area performs a
given function, but that it is a necessary part of that apparatus for carrying
it out. Lesion Broca’s
area and the subject will be speechless for awhile, mute, then a non-fluent
difficult slow speech will emerge and frustration at not being able to use
language to get one’s ideas across. Your
first impulse is to conclude that Broca’s area in the
left frontal lobe, is responsible for
making speech. That impulse should be
resisted. As it turns out other lesions
far-removed from the left frontal lobe will also produce similar findings. This means that the subject needs Broca’s area in order to make speech, that it is necessary, but not that this is the function that Broca’s area provides.
It does not make Broca’s area a sufficient
producer of speech or language. As it
turns out, Broca’s
area intimately interacts with other
parts of the brain which work together in the production of language. These include Wernicke’s
area in the temporal lobe, the
supplementary motor area and othe
M-Marsel Mesulam made this point eloquently in a ground-breaking article, “Large-Scale Neurocognitive Networks and Distributed Processing for Attention, Language, and Memory[16]”. The brain described as a computational machine is non-sequential for the most part, massively parallel in structure. This point was made in the first chapter, “Inside the Neuron”, in pointing out how the brain differs from most modern computers. Slowly computer science has evolved to the point where Silicon-based thinking machines resemble brain functions and even anatomy. Cognitive science has benefited from cross-pollination between computer and brain specialists.
How does a modular construct differ from a network anyway? You can pretty much disable most desktop computers by removing any specific part or module. It almost doesn’t matter what the part is. Remove a board, or a disk drive, a monitor, the power supply, in other words any of a variety of modules, and the thing will stop in its tracks. We’ve already pointed out how the brain is different. You can removed an awful lot, even obliterate a hemisphere, and the person will make every effort to get around a deficit. All the parts interact, functions are widely distributed, and this goes especially for higher cerebral functions. Taking memory as an example, certain very important structures, the hippocampus, the mammillary bodies, limbic system and others, are responsible initially for laying down a memory engram. Destroy any of these paired structures on both sides and the person will suffer a severe impairment in learning anything new. What about old memories? These will be unaffected, because, they spread out, become very widely distributed over multiple cortical areas over time. They are over-determined. Thus old memories are extremely resistant to erasure, are far less vulnerable, than are new memories that are just now being laid down.
Thus we’ve evolved a more mature picture of cerebral function as we look straight at the cortex, a sort of network model. The single lesion will impair function, but only because every cortical area interacts as part of a network with other areas. Such basic functions as memory, language, focusing of attention, depend on neural networks.
Attention:
The process of attentional
focus will illustrate this point. Over
the years a number of neurological conditions have been described in which
there is an alteration of attentional focus. As it turns our attentional
processes pertain to such a wide array of disorders as: attention deficit disorder, schizophrenia, encephalopathy that happens inside
hospitals, strokes which cause “neglect”
of one side of the body and so-called disconnection syndromes, hyper and hypovi
Attention is determined not by any single brain structure, but through interaction of way stations. Probably the oldest observation having to do with attention has to do with the parietal lobe. Clinical neurologists long ago noted a defect called “neglect” that was especially prominent in patients suffering from a right parietal brain injury or stroke, something seen almost daily on the wards by practicing neurologists. A stroke affecting the right parietal lobe may cause the patient to ignore his left side. First of all data is not getting in to the cortical areas that subserve sensory function from the left body because these reside in the right parietal cortex, data about the position of a limb, sensation and so forth. A person may be so ignorant of his body, that he may come to the conclusion someone else is lying in bed with him not his own left arm and left leg. He may at first lose all contact and knowledge of his own left side as if it is alien to him belonging to someone else. And if this same region is weak or paralyzed, as it often is if the stroke involves more frontal areas as well, he will report that everything is normal denying all weakness, so-called anosognosia, unawareness of disease, a type of neglect mentioned previously. In extreme cases the poor patient will have no knowledge and be unable to focus on the entire left side of the room, will fail to acknowledge a person approaching him from his left, fail to eat food on his tray left of the midline, etc. Studies have shown that the right parietal lobe, is implicated in a spatial sensory ordering of one’s world. The parietal lobe, posterior or behind the central sulcus, performs this primarily sensory spatial function.
What of the motor component? This has been connected with the frontal eye fields, which are known to be necessary to direct visual attention to objects on the opposite side of the visual field, left frontal eye field throwing the eyes, directing visual attention, to the right, right frontal eye fields directing attention to the leftf . The frontal eye fields located in the inferior part of the frontal convexity, direct more than visual attention to the opposite side. A lesion placed there will result in motor inattention. A third, somewhat more mysterious area that is necessary for attention is the cingulate gyrus, referred to previously as part of the emotional part of the brain, the limbic system. Most probably the cingulate adds some emotional or motivational value to directed attention. So we have described three areas, the parietal lobe (area referred to as “PG”, the frontal eye fields (“FEF”) and the cingulate gyrus.) Destroy any of these three regions and a deficit in attention to the opposite side of one’s world will result. They interact as a networky which is not tantamount to saying that any of these three areas functions as a separate module, that alone, any of these areas, PG, FEF, or Cingulate, is thought to perform the function of focusing attention. They all work as an interacting committee or network for performance of this function. PG and FEF most likely impose a spatial map on the outside world, at least the opposite half of the world, in the words of Mesulam, “…areas PG sculpts the attentional landscape, while the FEF and surrounding areas plan the strategy for navigating it.” and, “…the cingulate component could introduce a value system into the perceptuomotor mapping of the extrapersonal space.”
Understanding attention from a systems approach will provide the first step in describing conditions, mentioned above in which there is a pathological alteration in attentional abilities. Some conditions are more disabling than others. For example akinetic mutism features markedly decreased verbal output and movement, “abulia” total absence of drive and motivation. In the passive form the patient has the wherewithal to move, that is he is not paralyzed, nor is there a lesion that alters his ability to receive sensory input, yet he sits like a barnacle attached to the bottom of a boat, inert and unresponsive, his condition resembling quite a bit a sort of catatonic state. The akinetic mute may have a lesion in the medial frontal lobe, an area that attaches drive and motivation.
It’s tempting to view Attention deficit and hyperactivity disorder as a frontal lobe deficiency. A functional imaging (PET) study showed the frontal lobes of adults who had been formerly diagnosed to have Attention Deficit Hyperactivity Disorder (ADHD) and had children with this diagnosis, are not as active as the frontal lobes of controls without that diagnosis[17]. This implies that the disorder may run in families, as a deficiency of frontal lobe activation, that persists into adulthood. Thus children aren't the only persons with pathological hypofunction of the frontal lobe that requires treatment. Adults have a similar disorder as well. This early 1990 study performed by NIMH researchers and published in the prestigious New England Journal of Medicine, made it into the news media and had great impact on thinking about the disorder, reasonably estimated to affect between 2 and 4 percent of school children. For the first time, an objective test had shown an abnormality in the brain, some functional pathology, supportive of an ADHD diagnosis. The study was done on adults because of ethical concerns about doing a test involving radioactivity in teens who could not give informed consent. But a 1993 follow-up study by the same lead author was barely noticed. Here he finally was able to do PET scans on ADHD teens. This study showed no difference in frontal lobe metabolism in patients vs. controls.
That data is sparse at this point has not stopped practitioners and patients from jumping in headlong and spawning a mini-industry in the diagnosis and treatment of adult attention deficit disorder. Patients are lining up to be "diagnosed" by specialists. Some of them read descriptions in advertising literature or in magazines and "discover" that this is the problem they've had all of their lives, only it was unrecognized by their teachers and doctors. Among schoolchildren, especially boys, large percentages get treated with Ritalin a stimulant medicine used to improve behavior and performance in a windfall for the manufacturer of this drug. If parents and adults who are queuing up to be diagnosed realized the full implication of the disorder perhaps they would be less anxious to be diagnosed!
ADHD is a conceptual descendant of the former “minimal brain dysfunction”, MBD, a term that has now fallen by the wayside, but MBD is still a useful concept. The idea was that the condition was caused by some perinatal brain insult. The period of prenatal development, up and including birth, is a terribly vulnerable one for the brain. Genetic defects, alcohol and drug use by the prospective mom, infectious diseases, high risk situations, especially diabetes, and a host of other factors, adversely affect brain function. Severe perinatal cerebral injuries cause cerebral palsy, a condition caused by an injury at about the time of birth that remains for a lifetime. More subtle brain insults might cause “MBD”. Instead of observing an obvious palsy or weakness there could be lesser signs such as a cognitive deficit or mild problems with coordination, for example what is termed mirroring of movements, the obligate automatic movement in one hand while the other is supposed to move alone. Also specific learning deficits were frequently diagnosed in such children while, others presumably mediated by regions of unaffected brain, were left intact. The bottom line is that although there were abnormalities and delays in brain development, there were not deficits pervasive enough to cause either a global decrease in mentation - full-blown developmental delay, or cerebral palsy.
A combination of learning deficits and trouble sustaining attention with behavioral problems made a diagnosis of MBD. Today's point of view with ADHD is a bit more restrictive, although it has to be admitted there is a very high frequency of learning disorders as well. The triad of inattention, hyperactivity, and impulsivity defines ADHD with a set of examples and criteria in and out of the classroom to confirm each of these subcategories. A few subjects may be inattentive and impulsive but not overtly hyperactive and still have the problem. Checklists for parents and teachers have evolved to make things appear objective. As it turns out if a child seems to be doing poorly at school but yet should be able to master the subject matter on the basis of properly done IQ and ability tests, ADHD is often thought of. Generalized emotional and motivational problems, sicknesses such as chronic illnesses and epilepsy, lead exposure, even sleep or perceptual problems, also need to be ruled out. Given the above a child functioning below his ability especially a disruptive moto-perpetuo, is very apt to get this diagnosis. Children with ADHD tend to be adventurous and physically uninhibited. They are the first to hang upside down in playgrounds, to jump off furniture, may be especially prone to injury, and if they don’t have a gross developmental delay, may acquire gross or lower extremity motor skills earlier than their normal peers. One even gets the feeling that perhaps one day they might grow up to be brave intrepid warriors due to a lack of inhibition.
Often they do display what are often considered deficits of frontal lobe function. They tend to be uninhibited in social situations, to misbehave and disrupt their classes. Some are class clowns, stealing center stage from their quieter colleagues. They move about constantly and get distracted by any stimulus, being unable to concentrate on the task at hand, especially a reading task, and follow it through to completion. In milder cases the hyperactivity may be masked for a while in a doctor’s office so that the diagnosis may be more difficult. Some display imitative behavior or what is called utilization behavior. If an object is present in the room, they won’t be able to stop themselves from using it, even if they know it isn’t theirs and they are not supposed to touch it. Another child might be more inhibited, but these kids will pick it up. Behavior is, in other words, less restricted by usual norms and mores that inhibit others. Ritalin and d-amphetamine, stimulants, calm these kids down and help focus them on the task at hand. With a higher degree of activation they are able to focus better and there is the paradox, because you wouldn’t think of using a stimulant on a person who is hyperactive. The paradox is that a stimulant seems to calm them down and focus them. But it all is not so surprising really. Most of us have seen that a good rich cup of coffee will focus our attention and allow us to do our work, one reason why coffee is such a popular drink. Without it we are tired in the morning and our activity tends to be aimless and non-productive. Coffee rouses us into productivity and gives our work direction. Perhaps without coffee, our higher centers activate incompletely and we are aimless. Ritalin and amphetamine do just the same thing for these young kids. When a child has ADHD the effect is very dramatic, so much so that the teacher who hasn’t been forewarned, will notice if the child skips but a single dose. In fact the acid test is an unequivocal response to medication, -does or does not the child respond to Ritalin - indicating that what we may be dealing with a defect in nerve transmission.
Simply put, ADHD is a defect in brain activation. Properly activated, the brain functions normally and the student concentrates, completes his assignments and does well in school. and he doesn’t have to deal with the failure that would have occurred otherwise. The teachers are happy too. A diagnosis made. The child is classified, pigeonholed. He fits into someone’s rubric or model. All is well. But we have a deficit in studies that show how these persons do longitudinally. How long does Ritalin need to be continued? Is ADHD a maturational defect that recovers? Is it then possible to stop medication for the child to live happily ever after? We don’t know. No one has really looked into the matter.
Seeing a lot of these kids the
subset in whom Ritalin “works”, (What I really mean is that it helps, the student is better. Teachers and parents wouldn’t be without it.)
something far more pervasive affects these kids, some, not all, of them, and it is at least a deficit in what are
classically considered to be frontal lobe functions, proper inhibition, social grace, planning for the future, delayed gratification (strategizing for some
future instead of immediate satisfaction), patience, motivation - in short all
of the things that we typically admire in and which mediate “success” at least in our own society. Some of these kids have all the ingredients
built into their very nature of sociopathy. They want what they want now. There is little conscience o
The sociopath or common criminal is extremely interesting in that guilt and remorse seems is amputated from the personality (absent from the criminal's mental structure). Thus among persons convicted of rape, murder and violent crimes sentenced to death none express any remorse for their crime. This is a remarkable and universal finding frequently remarked upon by experts who deal with these personalities. It is not that they are unwilling to admit to the crime. Remorse is totally foreign to the sociopath's way of thinking.
Jesse Timmendequas sentenced to death of raping and murdering
young Megan Kanka
in
You can’t reduce the problem of ADHD merely to a chemical deficit in most cases. The problem is more pervasive. It gets into areas that are hard to quantify such as directed sustained attention, motivation, planning, social intelligence, inhibitions, appreciation and fear of consequences of one’s actions and generalized executive function. In many cases that first consultation for ADHD is but a harbinger of a lifelong maladaptation, at least for our own societal mores, may be the first sign of generalized sociopathy.
First ADHD does seem to cluster in families. This conclusion is drawn from clinical observations, as again, there are no very thorough studies. This does not necessarily mean that a problem is entirely genetic. A variety of physical and adaptive disadvantages derive from being raised under adverse social circumstances, toxin exposure perhaps even lead exposure, and infectious diseases, poor self-esteem and most importantly, a vacuum of values and passing down of maladaptive work and social habits.
Then ADHD is associated with other brain conditions, especially learning disorders of various types, such as dyslexia, but also Tourette syndrome. The correlation of ADHD with other neurological conditions indicates that the problem is physical, and that ADHD may be significant for a more widespread disorder of cerebral function.
In fact, though we may loosely
classify ADHD as a type of frontal lobe hypofunction,
we can’t isolate such an integrated part of the brain in this way. We are indebted to such great neuroanatomists as Ramón y Cajal,
Lorente de No,
Walle Nauta and many
others, men of patience and
foresight, who felt the importance of
their work and painstakingly mapped innumerable tracts and interconnections in
the brain. Utilizing stains and making
gross and microscopical observations, these men were able to show us how exactly
how the cortex of the brain relates to lower centers, and how specifically different cortical
regions with varying microscopic architecture,
relate to each other. They laid
the groundwork for the modular and network conceptualizations that we rely on
heavily for understanding brain function.
Great men and women of later generations, it is impossible to name them
all, have followed in their footsteps
and have confirmed using more modern techniques just about all of the earlier
observations. The only thing is that
over with time and furthe
The frontal lobe is in a unique position to serve as executive. It connects with virtually every important neurological structure. Connection with the limbic system (limbus for edge) lying below the cortex (see “Beginnings”) are strong. Recall that the limbic system is involved with emotion and affective color, the hypothalamus and amygdala connected with high emotion and rage, and how these areas connect to the hippocampus and anterior thalamus and are heavily involved with memory formation. The frontal lobes interact strongly with the thalamus. In fact in many ways the entire cortex, but the frontal lobes most specifically, can be seen as a further development, an embellishment of the thalamus which acts as way-station to the brain. Finally the frontal lobes connect and interact strongly with other cortical surfaces, most particularly and interestingly the parietal lobes to which it connects via the superior longitudinal fasciculusY . Such strong connection implies integration in a network and control and places the frontal lobes in a central executive position.
The "pre-frontal" areas of the brain, that is the part of the frontal lobe not having a precise function in movement, that portion that lies in front of the motor strip on the border of the central sulcus (Figure 2) in man are the best developed of all other animals comprising some 30 per cent, of the brain more than in any other animal. This prefrontal region has an alternative definition, that volume of frontal lobe projected to by the medio-dorsal nucleus of the thalamus. (thalamus figure) because the thalamus projects widely over this whole area and to all of it.
Figure 2:
Comparison of the size of prefrontal areas in mammalian species.[18]
In a sense, the cerebral cortex as well as the frontal lobe may be viewed as embellishments of the more ancient thalamus. The thalamus is a way station intimately applied to the cerebral hemispheres (Figure 3). All sensory input, somesthetic, touch, vibratory sensation, pain, hearing and vision project from the periphery via thalamus to the cortex. Efferent (outgoing or motor) function also needs to go through the thalamus on its way to the periphery.
Figure 3:
Projections of the thalamus below the cortical level. The Thalamic nucleus designated
"medial" projects to the prefrontal cortex (dark).[19]
The most posterior portion of the frontal lobe and the most ventral or inferior part have a specific purpose, motor control and olfactory reception, respectively. Cut out the very back of the frontal lobe in any animal including man, and the animal will be paralyzed, the inferior part of a man’s left frontal lobe and he will be unable to speak. Similarly the sense of smell or primary olfactory cortex seems to be connected with the rear and interior of the frontal lobe where anatomically you can see nerve fibers coming from the olfactory nerve. These are the obvious functions of the frontal lobe but this leaves a very great mass of tissue in humans completely unaccounted for, the prefrontal cortex. The function of the prefrontal area is far from obvious and hints to its function have only been forthcoming in recent years. The defects caused by lesioning large sections of the frontal lobe are subtle and entirely human, connected with such soft areas as personality and executive function. Indeed, at a time when American neurologists and doctors were heavily involved with cutting out sometimes vast regions of the frontal lobes earlier in the twentieth century, many of them were surprised about how much tissue could be removed from human brains. The method used for frontal lobotomies at that time was to jam a sterile ice pick through the inner aspect of the orbits where the eyes are and wiggle it about knocking out a good portion of the medial frontal lobes, likely causing a good deal of bleeding and tissue loss. Sometimes electroshock therapy was the only anesthesia. As if this methodology were not surprising and frightening enough, experience showed that deaths were very rare, and even more surprising neurologic deficits were difficult to appreciate. Intellectual defects were not detected using standard instruments and personality changes, being hard to measure, went undetected. In the meantime this surgery had a therapeutic effect in that patient’s behavior became more tractable and less resistant. It became possible to talk with the patient and communicate perhaps for the first time in a while. It appeared that large portions of the prefrontal lobe were not necessary at all for day to day function, large portions being lesioned but causing no profound deficit. What we are talking about here is the very obverse of the topic at the beginning of this chapter. What you find in lobotomized patients is not an obvious deficit[20]. Instead you notice that the patient suddenly becomes more conforming, tractable, less threatening, easier to manage. It’s the kind of stereotyped conformity made famous in “One Flew Over the Cuckoo’s Nest. That was not the original intent of this procedure at all.
It had to be admitted, as first noted by the Portuguese neurologist Egas Moniz in 1935, winner of Nobel prize, and pioneer in the operation called frontal leukotomy on psychiatric patients and others, that such lesioning had a therapeutic effect on severely affected patients with psychiatric disease, especially those afflicted with types of schizophrenia causing violent behavior or severe obsessions. These symptoms could be relieved even doing crude procedures that obliterated part of the frontal lobes even as in those days was the case if the lesioning was not visible and you could not do the surgery under guidance of the imaging techniques we have today such as CT or MRI scans which would be used decades later. The procedure decreased the need for forceful restraint in the days when there were no very effective drugs to combat certain mental illnesses. Recall that major tranquilizers such as Thorazine and antidepressants first appeared in the 1950’s and antidepressants at about the same time, also minor tranquilizers such as Valium appeared later so that the only drugs in the psychiatrist’s armimentarium were barbiturates like Phenobarbital, and Meprobamate or Miltown which were merely very sedating. These drugs offered nothing in the way of specific treatment of specific symptoms of schizophrenia, delusions and hallucinations.
When you took out even large portions of the frontal lobe, you had a more tractable patient, who, in the long run, was a lot happier, needed less restraint, need not struggle against his caretakers could now walk about in freedom and yet there was no measurable change in cognition his ability to talk and function, in fact he was improved! What a marked therapeutic effect such an organic approach to mental illness had and it made the psychiatric ward into a much more therapeutic milieuF . In the days before doctors had effective specific medication, such surgery was undoubtedly a godsend and it was very popular too, not only performed on many indigent wards of the state, for in those times patients tended to be cared for in huge state run mental hospitals, but even in a few famous cases involving well-to-do subjects such as Rosemary Kennedy, sister of the John Fitzgerald.
Every
advance, even such a primitive advance
by today’s standards as frontal leukotomy, is a two-edged sword. Not every one who employed the operation was
thinking of the patient. You can imagine
how such surgery must have been misused especially in such regimes as the
Stalinist Soviet Union and
But little by little some pieces of subtle information began to emerge. There were in fact changes in such subjects, not at first apparent using any psychological testing instrument, but present nonetheless. The first hint of such change was, of course, the therapeutic efficacy of the surgery which was done to make resistant even violent behavior more placid and tractable. Certain patients seemed to be struggling constantly and were prisoners of extreme emotional states. Many of these persons could be helped by amputating this troubling part of their personality.
After lesioning large areas of the frontal lobe, psychologists had a difficult time finding any deficits on their psychological test instruments. Certainly classic tests of cognitive function, namely IQ and achievement tests, turned out to be normal as did tests of verbal memory, concentration and planning. Few tests showed any abnormality at all, except one rather simple-minded test which is now frequently cited the Wisconsin Card sorting test. Yet in the crucible of real-life situations many patients with frontal lobe lesions turned out to be dismal failures. They could not judge their own behavior or objectify themselves and frequently were inappropriate in social situations. They could not hold a job, maintain social relationships or appreciate the big picture in their lives, perfectly content to live dependent on other person’s largesse and not caring about not having their own identity. They were insensitive to other’s feelings as well.
Psychological testing shares some methodological flaws with objectivist behaviorist psychology of which it is a relic. Psychologist’s instruments test for external behavior, above all attempting to objectify human potential and personality, but ignore internal states which are valid study phenomena. The ignorance of internal states which early psychologists, particularly American psychologists, could not agree was a proper subject of scientific inquiry, is a major pitfall that still poisons the field of psychological assessment. I have often been impressed by psychologists reports sometimes involving eight or more hours of comprehensive “objective” testing. These are long impressive looking reports that can take up sheaves of paper, yet most fail to see the big picture and miss major deficits in patients. The subject may be a dismal failure in life and be unable to function, yet perform adequately on psychological profiles or a minor basically irrelevant deficit may be focused upon in the meantime missing the big picture. A physician’s assessment is free to look at internal states and thus has a tremendous advantage in patient assessment. On the other hand, it has to be admitted, the doctor’s assessment may not be quite as “objective”. If, on the other hand you mean by objective that conclusions are can be agreed upon by multiple observers, psychologists who perform these psychological assessments, then alas, these reports suffer from the same deficits that physician reports do i.e. there is a great deal of disagreement between professionals.
This abandoning of internal states due to a bias against inquiry into non-behavioral elements in personality has been eloquently addressed from the philosophical perspective by John Searle in his book The Rediscovery of The Mind. In it he presents forceful arguments that are valid, pointing to our lack of attention to internal states[21] which are, to be sure, a proper study of for scientific inquiry. Admittedly internal states are more difficult to objectify or even to get at but that does not mean we should stop trying to understand. Perhaps our understanding needs to ascend to a new plateau, maybe we need new tools before we are able to understand internal states and phenomena, but let us keep trying.
Moreover it was already known that there were cases of frontal lobe damage that had caused real effects. Many authors had published cases on war and other injuries and profound alterations in personality not the least of which was the celebrated nineteenth century case of Phineas Gage who described by his physician Harlow in 1868. Phineas Gage was a previously highly responsible and with a “well-balanced mind” and fastidious and dependable personality who working at his job as a foreman on a railroad had a rod blasted through the inner part of medial frontal lobe through his upper orbit (eye) on the left side mostly. This produced a marked alteration in his personality. Whereas he had been a “God-fearing, family-loving, teetotaling, and scrupulous honest working man”
Figure
4: Path of missile into the frontal lobe of Phineas Gage (compute
“The equilibrium or balance, so to
speak, between his intellectual faculties and animal propensities seems to have
been destroyed. He is fitful, irreverent, indulging at times in the grossest
profanity, manifesting but little deference for his fellows, impatient o
The greatest likelihood Is that these effects of frontal lobe lesioning that are so well-known now were not even known to
the Moniz or at least most of the original purveyors
of frontal leukotomies
and other similar procedures. Otherwise such widespread use of psychosurgery as
it was then called might have given them a lot more pause. Brain areas
inferior to the cortex in the human perform little integrative function. Lower areas are quite specialized leaving it
to the cortex to put it all together.
The Thalamus, in particular, receives inputs from lower centers. Sensory input from the spinal cord and cranial
nerves arrives at thalamic way-stations, mainly the ventral posterolateral (VPL)
nucleus. Motor inputs also converge on
their own separate thalamic nuclei (ventral anterior, ventrolateral
VA, VL) from many areas including but not exclusively from the spinal cord,
cerebellum, and basal ganglia. You'd
think that some final processing must occur within the thalamus, being that so many sensory and motor inputs
converge upon it. Within the structure, however, motor sensory and other
processes are kept separate. While there
is extensive communication, (cross talk) between all of these modalities motor function, auditory and sensory, areas
that converge upon thalamic nuclei, there is virtually no dialogue between
these modalities, between motor and sensory inputs inside the thalamus itself. The thalamus is
pretty large but not really large enough to perform this highly complex,
multimodal integrative function. Therefore the great bulk of correlative and
integrative work is left to the much greater developed cerebral cortices. Individual sensory and motor modalities are
separate in the thalamus. Why?
Humans
reserve this integrative function,
interaction between sensory and sensory and motor, finally associative function, pretty strictly for the cerebral cortex. This is still another piece of our uniqueness
puzzle. Integration is a cortical function.
The cortex is that anatomic substrate for what is distinctly us. The cerebral
cortex embellishes the thalamus the great way station complex of nuclei on
which so much data converge. VPL will project to the primary sensory parietal
cortex which will take things from there.
Then in the cortex this sensory information will first ramify widely,
extensively link, to other cortical regions and link with motor function as well. This means that up until the level of the
cerebral cortex there is no solid singular integration of disparate neural
functions that will define a single person.
In some lower vertebrates there is very little cortex, there is very
little beyond the thalamus. We see as a general rule in lower animals that
higher integrative functions are performed in more peripheral areas of the
nervous system, while in man such higher functions are reserved for more
central regions. For example, in lower animals a lot of visual integration is
performed right in the retina.
As
far as the phylogenetically new prefrontal area is
concerned, it is not silent. More recently we have only begun to appreciate
some of its functions. In a general way, one could see that many patients
subjected to prefrontal lobotomies seemed almost to be less human, less
themselves, although this procedure often did serve to make their behavior more
tractable. You could see that many of them seemed to be less spontaneous, more
docile, even zombie-like. We see patients with frontal lobe lesions who seem to
lack any spontaneity. Words such as aspontaneity, abulia, mutism, are used to
describe them. Some of them have various tumors or strokes that affect this
front part of the frontal lobe. Even processes that affect other areas of the
brain primarily such as diffuse increased pressure in the head, closed head
injury etc., seem to affect the frontal lobe preferentially. The anatomically
newest area, or developmentally "highest" area seems to be the most
vulnerable and likely to malfunction.
There
is little initiative in these patients and like lifeless physical objects they
are subject to the laws of inertia. It's hard to motivate them. They have no
initiative. But once they start something, they can't seem to stop it either.
They can't terminate a hand grasp. When you can finally get them to start doing
something they have trouble ending the task. Ask one to draw a cross and he has
to be cajoled. If you stick to your guns and finally get him to draw a cross,
he'll keep doing it, in other words perseverate. Ask
him to draw a circle and he may do so only continuing to put in a cross as part
of the figure. This happens with damage to the convexity in the dorsolateral frontal lobe. It is interesting that this are
is more or less contiguous with the motor areas of the brain, with a region in
the frontal lobe known as the supplementary motor area. The supplementary motor
area is basically contiguous with the still more primitive primary motor area,
which we've seen has a more precise,
motor homunculus on its surface. It's thought that motor movements are
basically initiated in the supplementary motor areas but that more abstract
motor plans and strategies come from the prefrontal area, also to some extent
motivation and drive.
Lesions
in prefrontal areas closer to the midline also occur, for example, in patients
who have had rupture of blood into the brain from anterior communicating
aneurysms. Here the problem is a mirror image to the aspontaneity
referred to above. Patients are hyperspontaneous in a
shallow way with a lesion in this orbitofrontal area.
They have "oscillating affect" that alternates between shallow rage,
depression or euphoria. They may be involved in such petty crimes due to social
disinhibitions as shoplifting, sexual assault etc.
Because of the seemingly contradictory ways that the dorsolateral
as opposed to the orbitofrontal lobe seems to work,
the eminent neurophysiologist Karl Pribram suggested
that the dorsolateral frontal lobe activates whereas
the orbitofrontal region inhibits[24].
The opposite of perseveration at
least superficially is called Field Dependent Behavior which also occurs as
part of a frontal lobe deficit. Here the person seems to take all his cues for
behavior from the environment. If he sees a cup he will have an irresistible
urge to drink from it even though it is empty. I've noticed many children with
attention deficit disorder seem to pick things up in the office, for example, a stethoscope, tuning
fork, or hammer and use it no matter who tells them to stop. This is
essentially the same as so called "utilization behavior" [25]. While perseveration seems to signify behavioral stability, field
dependent behavior evidences instability, both relatively higher orders of
behavior subserved by the heretofore clinically
"silent" prefrontal area.
We've established that so called "higher" or more
advanced brain areas are evolutionary
embellishments of lowe
Figure
5: Depicting the Central Sulcus
flanked by primary motor and sensory cortices. As one travels away from primary
cortices, there is a higher level of abstract processing.
As
the rear portion of the frontal lobe is responsible for initiating motor
activity, the cells comprising the area bordering on the central sulcus are designated as the primary motor area. As I
talked about in chapter electrical stimulation of this region would result in
movements or combinations of movements in a limb on the opposite side of the
body. In the 1930's Wilder Penfield at the Montreal Neurological Institute, was
interested in excising areas of the brain that were thought to be responsible
for generating epileptic seizure discharges. In striving to avoid lesioning the language areas of the brain, he began
utilizing the technique of electrical stimulation of the cortex in an awake
patient. Surprisingly he found that he could map out a little albeit slightly
deformed caricature of one side of a person over the surface of the motor
cortex, a figure now called an homunculus. Stimulating an area would often
cause a specific movement on the opposite side of the patient. The area
representing the feet was at top side of the brain, the head toward the bottom,
rather like an upside down man hanging by his feet. Certain areas of the body
were ove
On
an electroencephalogram certain electrical rhythms ove
A
similar homunculus could be constructed along the posterior edge of the
central sulcus for sensation corresponding to the
primary sensory cortex. Secondary motor and sensory areas also exist in the
frontal and parietal lobes representing larger less specific body areas and
more complex movements and sensations. Finally the surrounding areas also
segregated as to sensory vs. motor function deal with the initiation and action
and reception of sensation on still a more highly integrated and abstract
level. These are the association areas of the brain.
Touch, pain and position sensation may be organized according to the locus on the body stimulated, just as movements involve single or multiple body areas. For other sensory modalities such somatotopic organization is inappropriate, i.e. for auditory processing and the sensations of taste, smell and vision. For the auditory system in the area designated as primary auditory cortex that resides in the temporal lobe, reception is organized according to specific tones i.e. is "tonotopic". Certain cells within the primary auditory cortex react to sounds of a given pitch. The organ of Corti in the ear is organized in a similar manner with the apex of the organ resonant to lower pitches and the base vibrating more to higher ones, so that one can easily see that axons projecting to the brain conserve the same essential organization. Other brain areas that surround primary auditory cortex bring about a more integrated appreciation of sound. Some of these areas for example if stimulated, may cause a person the recall a certain melody or even a memory attached to a musical theme.
What we see from the above is that
there are areas of the cortex that are homogeneous with respect to sensory
modalities, be they hearing, vision, or touch sensation. Within these specific regions, located in the
temporal lobe for hearing, the occipital lobe for vision, the parietal lobe for
touch sensation, and so forth, is further specific organization. The best example is somatotopic
organization of body parts in the parietal lobe that subserves
touch and position sensation, the so-called sensory homunculus. There is a similar topical localization in
the temporal lobe, as we have seen, for specific tones, and in the occipital lobe for parts of one’s
visual field. All of these cortices have
surrounding, secondary receptive areas
that interpret more abstract attributes of sensation, for example put words and sequence meanings
and melodies for sound, interpret
movement for vision and so forth. They
are handling a higher level of perceptual abstraction. Othe
These areas have to be connected. The full range of cortical interconnections, the job of white matter tracts that interconnect cortical regions, has just begun to be appreciated. It’s easy to see that the view of the brain or cortex as merely a system of modules, without full appreciation of the interaction of these modules to perform function is entirely inaccurate and incomplete. It’s fair to ask what happens when these connections fail.
This failure to connect is not uncommon and was explored most
specifically by Norman Geschwind who wrote
extensively about so-called "disconnection syndromes" over 30 years
ago. There are many fascinating
examples, some of which we have explored
in earlier chapters. One particularly
instructive one is the disorder “Alexia
without agraphia”,
a specific problem where a person loses the previously acquired ability to read, even though still able to write. These patients can understand words presented
to them aurally. Some can read a word
spelled out to them on their hand. They
can spell and write, sometimes
fluently. What they can’t do is read
and interpret visually, a written word or sentence syntax. The disorder is a disconnection. The visual areas of the brain in the
occipital lobe, can see a complete word, but the visual information is prevented
from getting to the
language-interpreting area of the brain in the
left temporal lobe. The fibers
that go from the occipital to the temporal lobe are destroyed, most often by a stroke in that area. Patients who have alexia without agraphia, have a lesion in
the left occipital area of the brain and also the connecting fibers from
thei
Thus
we have one of many examples of defects of cross talking areas of cortex. Information from one region or module, must
reach other modules if the brain is to function as a whole. Other examples we
have explored previously are anosognosias, unawareness of diseases or deficits. The language module surrounding the left Sylvian fissure is disconnected, therefore unaware, of a specific difficulty
or deficit and thus is unable to "report" to the examiner that there
is anything wrong. Sometimes this
unawareness is quite striking as when a person is completely blind yet does not
report blindness. The subject instead
invents answers to visual questions; he
confabulates. This is known as Anton's
syndrome. Similarly a memory defect causes confabulation, invention of wrong answers, when language
module is disconnected and thus unaware
of a deficit in what is known as Korsakov's syndrome. There is ignorance of one's left side or
neglect when the right parietal lobe is affected by disease, and so forth.
All of these deficits result from disconnections, mostly isolation from the language o
The frontal lobe is what it is
primarily because of its connections. The frontal lobe connects directly to the
limbic system which it overlies. Recall the limbic system relates to emotional
coloring of memories and experience. It has rich connections to the frontal
lobes which overlie it. All the other
cerebral lobes, enjoy vigorous connections as well which means that the frontal lobe has heteromodal or multi-sensory associations. As we have seen
diffusely projecting nuclei within the thalamus such as the dorsomedial
nucleus also connect with the frontal lobe.
The ascending reticular system responsible for activating the entire
cortex and also the diffusely projecting cholinergic nucleus of basalis of Meynert has rich
frontal lobe connections all for a reason.
In many cases frontal lobe dysfunction comes not from destruction of
parts of the frontal lobe, but results mainly from dissociation with other
cortical and subcortical regions, comes from disconnection[26]. When
you look at the brain, the first thing
that impresses you is the massive size of white matter areas in relation to the
gray matter, which is a thin ribbon
overlying it. This tells us that the
business of the brain is more the connection of concepts and data than
initiation. Look at a map of the
Understanding of whole brain function has evolved from a lesional or modular construct, through a committee structure as described above with a description of networks of elaborately interacting modules communicating through an interstate highway system of white matter tracts. The modules work at all levels of sophistication and function as we have seen, gradually integrating more and more data at higher abstract levels, areas of cortex loosely handling greater levels of abstraction as one travels further from the primary sensory and motor cortices.
Very loosely speaking the frontal lobes are felt to bring about the "responsible" elements in our personality. A person with good frontal lobe function is a serious planner, initiator, worker, saver, one who can follow through with an elaborate scheme and is not afraid to work and sweat for long periods to accomplish his goal. He will always follow through. He's a bull-dog as much as his personal plans are concerned in that he will never let go until he accomplishes what he wants. This single minded individual is the entrepreneur, the leader in our own society. As a general rule, he has qualities that are seen as positive and adaptive, at least in American culture. The opposite situation, which we have conjectured might be due to a lesion in the frontal lobe, might be the person with ADHD who has trouble maintaining his focus, accomplishing and following through on his task, is easily distracted by any stimulus that comes along.
As far as the frontal lobes are
concerned, various authors have
described their own particular versions of what is meant by hypo, diminished, vs. hyper,
exaggerated frontality. According to one very reasonable point of
view schizophrenia may represent the extreme of hypofrontality. Schizophrenics are rarely the neatly
groomed shirt and tie type of person.
They are sloppy and unfocussed.
They rarely are able to function in life or social tasks, to plan and stay with a specific goal and
work it through. Schizophrenics tend to
move from job to job, from superficial
relationship to superficial relationship.
Two of the primary diagnostic features of schizophrenia as presented by Eugen Bleuler a turn of the
century psychiatrist who gave the disease it name, still widely quoted are apathy and ambivalence. The opposite of our social mover or
entrepreneur. They fail in social and
material endeavors. On a more basic
level, schizophrenia represents a loss
of or weak development of ego structure, poo
According to this view, if schizophrenics represent one pole, namely the hypofrontal pole in this scheme, then the opposite or hyperfrontal pole is the obsessive-compulsive disorder (OCD). The major characteristic of persons with OCD is that they can't let go. They are interminable worriers. Before leaving the house they have to check the oven, not once but over again, then the locks, then look through their pocketbooks to make sure they have their money. These poor folks worry so much they can never get out. They may be victims of certain ritual behaviors that they cannot control. For instance they may have to wash their hands over and over again because of concern over germs. They may never be able to accomplish anything because of their disorder.
This construct, schizophrenia on one extreme, OCD on the other, receives its own support from PET scan data,
at least interpreted superficially. As
can be seen in Figure 6, the schizophrenic has lower frontal lobe
activity, the OCD higher frontal
activity than normal. There is more
relevant information bolstering this construct. OCD is successfully treated in many cases
with medications that increase Serotonin in the brain, the so-called SSRI's specific Serotonin uptake inhibitors. Newer drugs used to treat schizophrenia work
primarily by blocking serotonin,
especially working according to the model of the novel drug Clozepine which
revolutionized treatment of schizophrenia for some patients. This implies that schizophrenia in part
involves an overaction of serotonin or serotonin
receptors and that OCD may involve a certain underaction
of serotonin. The SSRI's
on the model of Prozac, are extremely
useful for many neurotic disorders characterized by over-worry, increased fear and anxiety such as panic
attack disorder and some forms of depression,
also Tourette's syndrome which at least as far
as this particular characteristic is concerned, is similar to OCD. Psychiatrists like to use many of these drugs
together as all patients present with a gamish of
paralyzing psychiatric problems. They
need to be vi
Then our businessman or
entrepreneur, the productive person, the
mover or shaker of our society needs to be removed from our model or spectrum
of frontal lobe function. I jumped to my
own conclusions prematurely.
Entrepreneurs have some but not all of the characteristics of hyperfrontality, at
least some of them do. What do they
lack, compared to our OCD, or panic disorder patients? Why don't most entrepreneurs require Prozac
or something similar? As a general rule
they don't suffer from much anxiety. These productive folks are fully able to get
off the dime once they make a decision,
may easily decide whether to fish or cut bait, not so our OCD subjects, as we have
seen. In fact, more productive folks, once they decide in an informed way, can just do it or, as Yogi Berra said, "you can't hit and think at the same
time." They follow through with
their decision with a minimum of doubt o
As I have indicated it is common for ADHD, sometimes thought of as a manifestation of hypofrontality, may often co-occur with Tourette's, related to OCD, a hyperfrontal disorder. This should remind us that our model suffers from being to simple, generic or global. There are conflicting portions of the frontal lobe, for example midline versus lateral surfaces that are responsible for differing aspects of frontal lobe function. The midline portion of the frontal lobes, is more closely connected with the emotional or limbic part of the brain and so is connected with basic motivation. The more well developed and evolutionarily newer lateral frontal lobe, on the other hand, is more involved with the actual intellectual aspects of strategy and planning, reasoning and flexibility, with directed attention, order and the actual sequencing of action. So we may conclude that the frontal lobe concerns itself with sequencing, executive control, future memory, drive (especially the midline of the frontal lobe) and self-awareness. These are all hard commodities to appreciate and measure on psychological test batteries.
So-called "reduplicative
amnesia" is a curious though transient disorder of psychological
function. It sometimes occurs in the
healing phase of head injuries and is related to frontal lobe damage. Here the injured person correctly identifies
his surroundings, so that it is clear he
can register and recall memories and is functioning verbally. However he insists that his surroundings have
been duplicated in a different place, that is not really where he is. A related situation called "Capgras Syndrome",
is the insistence that acquaintances or family members look and talk
like exactly as they should, but are
actually different people reduplcated somewhere
else. "Yes, this lady looks
and talks exactly like my wife but
doctor, it isn't her!!" Somehow it
appears the affected person hasn't the wherewithal to check out reality, or perhaps has an uneasy feeling of unreality
that comes with the partial dissolution of the self or what may loosely be
called ego structure. In the Freudian sense, it is the ego or self that is
involved with truth o
Figure 6: Flourodeoxyglucose PET scan comparing frontal lobe
metabolic rate. This is increased in OCD and decreased in Schizophrenia[27].
We are beginning to define abundant conflicts of this kind in our model built on disturbances seen among patients. Parts of the frontal lobe counterbalance each other and add to the emotional and intellectual matrix of consciousness, the frontal lobe may also be seen modulate countervailing influences of the parietal lobe. This has been extensively described by Lhermitte and others[28]. Lhermitte described patients with a so-called environmental dependency syndrome who had, as above described, an urge to touch and use objects in a room, to be distracted by all kinds of stimuli not relevant to their situation of tasks, ignoring generally accepted norms of behavior. These patients had frontal lobe deficits or lesions. The common denominator, as described in some distractible subjects with ADHD as above, is that such persons are unable to keep an appropriate distance, unable to control their desire to approach objects, indeed have trouble even objectifying objects. They approach objects and use them in an uncontrolled manner, unable to keep themselves from being distracted for a larger purpose. Lesions of the frontal lobe promote this type of inappropriate approach to objects. Lesions of the parietal lobe of the brain, on the other hand, promote inappropriate maintenance of distance as we have seen, so-called neglect. The model here is that the frontal lobe promotes distance in conflict with the parietal lobe which promotes approach. Lesion the parietal lobe and the frontal lobe has free reign. The person objectifies himself. Lesion the frontal lobe and he can't keep himself away.
Very similar models are constructed
for other lobes of the brain. As we have
seen lesions of the amygdala, the almond-shaped nucleus of the temporal
lobe, on both sides will cause a KlÜver-Bucy
syndrome. Persons or monkeys with KlÜver-Bucy
syndrome are unaggressive, excessively docile, hypersexual - they will approach almost any
inappropriate object in a sexual way,
and hyperphagic. Some affected folks will eat vaginal creams
or their own pubic hair. The amygdala as we have seen, has extensive connections with
the hypothalamus and other emotion generating parts of the brain as an integral
part of the limbic system. In a way
patients with lesions here may be said to be hypotemporal. The opposite, what may be called hypertemporality happens in the so-called Geschwind
Syndrome. The temporal lobe is often
the site of abundant electrical seizure discharges which propagate through the amygdalas inside the temporal lobe. The amygdalas,
being in the pathway of an electrical discharge, may themselves become electrically
active sometimes pathologically so. The amygdala will
start to generate its own electrical activity.
This is a process called kindling.
An electrical discharge is like a spreading forest fire which lights
adjacent structures in the brain. Pretty
soon these electrically active areas light up on their own, may start their own fire, in other
words. As the amygdala
becomes more active, the subject
acquires high emotion which he connects with almost anything. He may be overly serious or morose, aggressive and hostile (in opposition to
emotional docility as in the Kluver-Bucy
syndrome). Such persons are often
grandiose, very frequently
hyper-religious for they see great cosmic significance in everyday events, proselytizing everyone in sight. In ou
What I am developing here, which is a bit more involved than a simple committee model of brain function, is what I call a "push-pull model" that describes conflicting influences of various groups of neurons within and between lobes of the brain resulting in some final state that is a sort of sum or compromise between elements in the network. One problem as we shall see is that this model derives from appreciation of pathology in the brain and as such may not be totally applicable when we consider the personality structure of normal or even better-than-normal functioning individuals.
Table 1: A "Push-Pull"
conflictual model of brain modular function (see
text)
|
LOBE |
HYPO-FUNCTION |
HYPER-FUNCTION |
|
FRONTAL |
ADHD, SOCIOPATHY |
ENTREPRENEUR |
|
|
SCHIZOPHRENIA |
OCD, PANIC |
|
FRONTAL (VS PARIETAL) |
Environmental dependency, "Utilization" |
Neglect, Objectification, Distance |
|
TEMPORAL |
KlÜver-Bucy |
Geschwind |
In Chapter one I presented an anatomical view of consciousness. The cerebral cortex, reticular activating system, thalamus, limbic system, each added their own singular contribution to the brain product we loosely called "consciousness". Recall that the reticular activating system would keep the cortex awake, the cortex itself lent meaning to percepts and actions, while the limbic system aided in memory and emotional coloring etc. Each area would contribute on its own, and influence other areas (much of this influence was reciprocal) until the whole brain put out its final product. Now, describing in more detail the workings of the cerebral cortex, it is possible to add to this committee model, which still pertains, a push-pull summation model of conflicting influences.
Its very tempting to
generalize from pathological states and
apply these principles to real people.
Simply put, according to the above model, if the temporal lobe and particular the amygdala had its way with your personality, took over,
you would be a very serious person indeed. All of a sudden you would wish to attach
cosmic significance to every small event.
Suddenly you would get religion.
Sprinkle in some influence from a hyperactive frontal lobe and a rigid
system of rituals would be added to the mix. We have our evangelist for whom
nothing is more important than serving God,
who needs to pray x number of times a day, follow religious precepts to the letter, who can't understand the sinner who does not
take religion as seriously, has seen the
light and is unable to accept any othe
Its really something to find the rare patient who has electrical seizure discharges within the temporal lobe, who will express emotions as part of their seizure. Some will laugh uncontrollably, ("gelastic" seizures), some cry. I know one woman with tuberous sclerosis, a genetic disease with abnormal benign growths or "tubers" deep in the brain, who cries and cries when she has an epileptic seizure. One tuberous growth is in a temporal lobe. Dostoyevsky had temporal lobe epilepsy and had many of the characteristics described. His seizures had an aura of high emotion, ecstasy, his literary themes were highly religious. He certainly took himself very seriously and had a compulsion to write. Would one consider him then hypergraphic? He would continue to write under the most adverse personal circumstances. The only reason why we read and admire him is because of his genius and the obvious power of his insights as opposed to many other persons compelled to write everything down despite their more pedestrian abilities. But it makes you think about what is truly is the meaning of what we hold to be important or even sacred.
Is it fair to apply these known anatomical influences as they have been defined, to all of us? How much do the same formulations apply to the ordinary personality and to men of genius who have no known brain pathology? By this calculus each of us is the mere sum of modular influences in a committee structure, and resultant of contradictory push-pull influences. This defines our basic self, our baseline personality.
Having said this, we need a model also for environmental influence. In recent times we've begun to understand how some of these might work. Lately articles have been written about how playing Mozart might have a positive effect on learning[30]. Students who listened to a Mozart sonata were able to score higher on spatial reasoning tasks given to them than a control group. What's more, exposing them to the minimalist music of Philip Glass had no such effect. So it was not music itself, but a particular pattern of stimulation that had an effect of increasing brain power.
Immediately this information was
applied in a public educational program for disadvantaged kids in a
Which makes you wonder what a person is doing when you observe him doing nothing? Suppose he is awake. Is his cerebral electrical activity patterned or unpatterned? As you observe him sitting in front of you, you've no idea whether a thought, or a melody, or a picture is in his head, or whether he is thinking of nothing. Think about this in your own case. What is happening for you most of the time when you are mentally idling? Most likely the answers are as different as varied personalities and temporary mental states. Some people like to turn off when they relax. They have little taste for patterned thought, music or visualization. Others have an unrelenting need to think and perform mental gymnastics. In all cases the awake brain, when unengaged in productive (motor or efferent) activity is idling. The brain is an electrically active organ that never stops except rarely under very pathological circumstances, as when you are under deep anesthesia. The ignition is always in the "on" position. The only question is whether activity is patterned or unpatterned firing and about the complexity of firing patterns.
By playing Mozart you are stimulating, tickling, intrinsic brain firing patterns. You are pulling up memories that previously were buried and unavailable as presented in Beginnings the chapter on memory, where memory engrams were pulled out of oblivion by "handles" attached to them up to the surface ready to be accessed in the process of recall. These memories include logical patterns used in learning and problem solving. Thus Mozart helps the brain to idle logically and pulls abilities, previously buried, to the surface, making them accessible.
Brain disorders alter the firing patterns within the brain and the effects are more enduring and usually permanent. These disorders reinforce the argument that the final common pathway for all thought and behavior is the wetware of the brain (Table 2). A whole host of disorders may alter the personality and sometimes are first noticed with a personality change. Some of these affect the brain diffusely and merely cause dementia starting with different patterns as with Alzheimer's disease which typically begins either with memory loss or language function problems or Pick's disease. Other degenerations such as Creutzfeldt-Jakob disease begin variably and the mode of presentation depends on which neurons are attacked first. Creutzfeldt-Jakob disease is caused by a new type of organism, the so-called prion or proteinaceous infectious agent, the only reproducing biological entity that doesn't contain nucleic acids. It is the same as the mad cow disease of common parlance, that affected British cows and a few humans otherwise known as a "slow virus" since symptoms may not be manifest until decades after infection. In one of the commonest forms of Creutzfeldt-Jakob disease, the cerebellum the part of the brain controlling coordination and balance, gets hit first. Only later is there a change in mental function and the personality. However, patients with Creutzfeldt-Jakob disease are frequently encountered on the psychiatric ward of a hospital. In the typical case an elderly person who has no history of psychiatric disease, presents with severe depression or schizophrenia. Now these disorders most of the time start at a younger age and when they do occur for the first time in the elderly in a person who apparently is not prone to develop them, this raises a red flag of concern that what the psychiatrist may really be dealing with, is a brain and not a psychiatric disease. Your first attack of depression or schizophrenia should not happen when you are old. On the other hand, Creutzfeldt-Jakob disease almost always occurs in the elderly.
Another very interesting case of
personality altering diseases is a kind of
neurosyphilis,
an entity called "general paresis of the insane" (GPI) in
which there is an active syphilis infection over a very long period of time, a
meningitis affecting the coverings of the brain. At one time up to 4-10%
patients hospitalized in chronic psychiatric facilities had GPI but now it is
rarely seem thanks to penicillin and other antibiotics. At one time, syphilis
caused GPI was held out as the archetype of a mental disorder caused by a
physical process, but no more since it is now so rare that few clinicians have
any experience with it. Still GPI is
still a sort of model of an illness with a known biology and pathology which
causes severe mental change, not just generalized deterioration in mental
processes. This is because so much of
the course of events is well-known and documented. The psychiatric changes go
hand in hand with pathology in the brain to such a degree as to make an
extremely potent case for physical
processes being the main cause of mental affliction. Some small proportion of affected
individuals start with megalomania and grandiosity, having a king o
The only problem with GPI is that it is mostly an historical disease with which today's clinicians have little contact. However the pathology is well-described. Syphilis is caused by Treponema pallidum, a spirochete which is a close cousin to biologically and in its biological effects on the brain and other organs as the popular Lyme disease organism Borrelia burgdorferi. Central nervous system syphilis is a disease that develops over a long period of time, taking years ordinarily to cause its full effect. It starts by causing a chronic meningitis, an inflammation to be found in the spinal fluid that bathes the brain and spinal cord and affects the meninges which cover these structures. Apart from finding signs of a syphilis infection in the blood, a positive RPR test, the best way to document the effect in the nervous system is by a spinal tap that allows examination of the spinal fluid. The spinal fluid shows evidence of inflammation in the form of increased protein content including the antibody portion, gamma globulins also increased inflammatory white blood cells (lymphocytes) in the fluid. This is the definition of the term meningitis, signs of inflammation one can see in the spinal fluid. The gamma globulin is interesting. The antibodies are directed against the syphilis spirochete. Clones of IgG antibody actually react with Treponema pallidum, so this is one of the body's defense mechanisms against the bug, which persists despite the poor patient's best efforts to eliminate it. Because the infection lasts years the meninges become thickened and the syphilis treponeme actually ends up getting the best of these defense mechanisms invading the brain tissue itself. Brain derived inflammatory cells known as microglia are present in brain tissue, but neurons are lost and eventually there is loss of valuable brain volume as the infection takes over, the treponemes continue to be present right in the brain tissue and a chronic infection ensues ending in alteration of the personality as we have seen as well as later general dementia and dissolution of mental processes and finally death. The pathological and microscopical processes parallel mental and cognitive changes to such an extent in syphilis that it can be used as a model for such changes. At its worst, Lyme disease seems to be a milder process, but the changes are essentially the same, eventual invasion of the nervous system causing chronic meningitis affecting the spinal fluid and brain coverings, followed much later by actual invasion of the sanctus sanctorum the brain itself in a process that is very much like what used to be seen in patients with GPI. Lyme disease affects peripheral nerves and cranial nerves more than does syphilis yet its Central nervous system effects are rather less pronounced. This is a difficult call since there are no cases today where patients are untouched by multiple antibiotics which while they may not cure the disease entirely in rare instances still likely lessen natural processes. Still Lyme disease is more catholic in its tastes than syphilis seeming to affect just about any part of the central nervous system, cranial nerves especially the facial nerve causing paralysis of facial muscles, the spinal cord and peripheral nerves. On the other hand the personality changes apart from fatigue are not as vividly described as in the old cases of GPI. Lyme is perhaps more protean in its clinical manifestations than syphilis and a lot of personality changes have been connected with Lyme infection especially various forms of chronic fatigue with very poor documentation for this effect. Depression and all kinds of personality alterations have been connected with Lyme meningoencephalitis in popular literature and among patient support groups. Yet very few claims have been documented objectively. At one time various Lyme treatment centers had sprung up throughout the country treating persons who complained of symptoms empirically but with little to no documentation of any disease process in most cases.
A host of other diseases infectious and non-infectious, infect the brain in their late stages and often cause mental changes. Other forms of infection, killed off by antibiotics in the rest of the body, may hide out in the spinal fluid partly excluded from antibiotic penetration by the blood-brain barrier, an unusual combination of tight capillary endothelium, basement membranes, and astrocytes that exclude unwelcome molecules from the central nervous system (described in chapter one). The BBB may block antibiotic penetration into the CNS as well. So it is possible for certain dangerous organisms to hide out as for example, the pneumococcus bacterium which lives in our mouths and nasal passages close to the spinal fluid and is the most frequent bacterial invader of the adult CNS.
More tragically perhaps, certain
cancers also hide out in the central nervous system well after they have been
cleared and cured from the rest of the body by strong chemotherapy. You can cure a cancer everywhere. There may be no signs of it for years
sometimes, yet just one or a few tumor cells may have lodged themselves in the
CNS, once in protected by the BBB where the chemotherapy agents cannot get at
them, only to cause a recurrence of the tumo
Illnesses currently classified as psychiatric are, in reality neurologic that is they are brain and not mental disorders. The mental symptoms are secondary to brain changes. This is particularly true for psychoses, the affective (emotional) disorders such as depression and bipolar (manic-depressive disorder) and schizophrenia, so-called thought disorders, but is undoubtedly true for neuroses and personality traits and disorders as well. Theoretically these disorders should be treated by a neurologist or brain specialist, not a psychiatrist primarily except to the extent that the psychiatrist has organic orientation and training (he or she is in fact a physician first and foremost which is good) or if not organically oriented may at least address psycho-social fallout which is secondarily affected by the primary brain disease. My point of view is sounds rather shrill and extreme yet is borne out by various separate lines of evidence, viz.:
1. It has not been possible to define an environment
conducive to the development of schizophrenia.
Schizophrenics come from all kinds of environments. Even taking into account that schizophrenics
tend to be raised under less affluent circumstances that they tend to
come from disadvantaged socio-economic groups,
there are still a number born into the wealthiest families. The disorder tends to cluster in families
with a 10 to 11 times greate
2. Schizophrenia
represents a pervasive and all encompassing pattern of mental dysfunction which
is extremely disabling. Subjects have
difficulty following logical progression of thoughts and instead reasoning is
contrary to common convention thus conclusions tend to be false. One recent
example. Lyndon Johnson was president
when Martin Luther King was shot. Johnson was a powerful man who had access to
a lot of information. Ergo Johnson must
have known about plans to assassinate King and is thus responsible for the King
assassination. Since conclusions derived
from these erroneous logical processes are unlikely to be correct, persons are not likely to be successful in
most endeavors. Another common example
is flow of thought by loose sound or "clang" associations as occurs
in some forms of art. e.g. from spine, swine, supine,
behin(d), mine, entwine etc, . Schizophrenics have thought
progressions that are all but impossible for a normal conventional thinker to
follow, hence they are observed to have
looseness of associations, what is manifest as tangentiality
or circumstantiality sometimes much worse in their
conversation. Often there is complete
breakdown of mental processes so far as these can be ascertained aurally or in
writing.
3. There is
no evidence that any kind of talk or non-organic derived psychotherapy is of
benefit for the cardinal symptom complex of schizophrenia. Psychotherapy and social interventions may
allow improvement in one's marital, employment or benefit status, or may put
the patient into a milieu where he will be able to better function yet seems to have no bearing on the basic disease
process. Physical interventions on the
other hand, especially drugs, alter the
cardinal manifestations of the disease,
not just via sedation, drugs do
tend to be sedating, but by reduction of positive and negative symptoms, illogical thought associations, delusions,
hallucinations, paranoia, and social withdrawal and generalized decompensation.
4. Schizophrenia
may be the result of a number of different processes but they are all brain
processes. Early attempts to find a common microscopic pathology failed. There
is no specific degenerative change you can observe under the microscope. Modern imaging techniques have found common
abnormalities particularly whole brain atrophy, enlargement of intracranial
spaces, ventricles and sulci is very common in schizophrenics though by all means
not always present and is a finding even when patients are compared with a
non-affected identical twin. Certain
areas of the brain have been found to have reduced volume or hypofunction. These have included variously in different
studies, areas of the temporal lobe, and
some PET studies show hypofunction of the frontal
lobes. The problem in characterizing
physical features of the disease underlines the fact that schizophrenia is not
one disease, but the endpoint of many
processes, cerebral insults, environmental,
genetic but above all, physical that affect the brain and interfere
behaviorally with thinking so as to cause looseness of associations and
erroneous reasoning, delusions hallucinations, withdrawal, and other
manifestations that spur clinicians to make this diagnosis. Many of the disease processes listed
above, encephalitis, syphilis, porphyria,
Creutzfeldt-Jakob disease among them,
may lead to the diagnosis of schizophrenia, though once any of these
underlying processes is defined, once one is aware of a specific cause, that is in fact listed as the disease even
though some of the behavioral manifestations may be similar.
Functional neuroimaging
(PET) scanning has allowed researchers[32] to
monitor, moment to moment some positive symptoms of schizophrenia, such as
auditory hallucinations. From such studies one sees not only the decreased
activity in the frontal lobes chronically, but activation of such areas as
temporal lobes, during an auditory hallucination. Speech areas of the brain
also take part in auditory hallucinations.
Table 2: Some Diseases presenting with personality change.
|
Disease |
Cause |
Findings |
Examples |
|
Syphilis/Lyme disease |
spirochete |
paranoia, dementia, neurological focal changes |
Idi Amin Robt Schumann, Friedrich Nietzsche |
|
Pick’s disease |
degeneration |
dementia, language disturbance |
|
|
encephalitis (Herpes) |
Virus, e.g. Herpes |
seizures, change in level of cons. Focal signs |
|
|
Alcohol |
death of brain cells, other injuries |
neuronal loss, effects of trauma |
|
|
HIV disease |
Retrovirus |
secondary infection, direct viral invasion, focal or generalized findings |
|
|
limbic encephalopathy |
tumor antibody that cross-reacts with brain cells |
altered emotions, dementia |
|
|
Alzheimer disease |
amyloid accumulation |
memory or language disturbance, then dementia |
Ronald Reagan Arthur Fiedler |
|
Porphyria |
inborn enzyme deficiency |
episodic madness and melancholy |
King George III of |
|
Schizophrenia |
various |
"thought disorder" |
|
|
Wilson’s disease |
enzyme deficiency responsible for carrying Copper |
liver flap movement disorder hemolysis, liver failure |
|
Another interesting case in point
is the familial disease Acute Intermittent Porphyria. This is a disorder that ran, as hemophilia did, within some of the Royal families of
Herpes Encephalitis causes personality and emotional change that progress rapidly over days. The virus lives in neurons in a dormant state but probably gets into the brain due to its close proximity in such structures as the trigeminal ganglion or olfactory nerve as it tends to attack the medial frontal and temporal lobe. Listlessness, depression, disorientation, headache neck stiffness are followed by fever and convulsions by which time it is often too late to expect a compete recovery. Nowadays we have effective drugs such as acyclovir block viral reproduction. The trick is that Herpes encephalitis has to be suspected and diagnosed very early since without treatment viruses will proliferate in the brain which will be irreversibly damaged or the patient may die. Some patients have been cured but only after the virus has damaged both temporal lobes, resulting in a devastating recent memory defect. The subject is in limbo of disorientation unable to lay down new memories. Depending on how extreme the situation is, he may be disoriented living life entirely in the past, or some engrams may be able to get through and be stored resulting in a partial state of confusion and disorientation.
Limbic encephalopathy is a rare disorder associated with a common cancer, small cell carcinoma of the lung. It is not due to the spread of the cancer, but rather a substance elaborated by the cancer itself into the blood, perhaps an antibody called Hu, that is usually found in the blood of such patients. Hu is a brain protein constituent and this disease seems to be caused by an antibody against that protein. They most often suffer from memory deficit for as we have seen, the limbic system is closely associated with emotion and memory, but there can also be profound emotional and personality changes as this process affects the emotion expressing areas of the brain.
As time passes goes on more focal and specific disorders will be defined anatomically and functionally. This will allow more explicit statements about functional anatomy of the brain and how groups of neurons interact to form a complete personality structure. Susan Swedo and colleagues[33] have found a fascinating group on children who, in response to repeated Strept throat infections, have a complete obsessive-compulsive ritualistic syndrome. Their personalities change when they are reinfected, often going back to normal between infections. Some children have been treated successfully with plasmapheresis and other therapies that alter immunity. In some cases enlargement of the caudate nucleus in the brain and other structures has been associated with the temporary profound personality change. Hypertrophy of the caudate may be evidence for increased function within that area of the brain overwhelming other inhibitory regions. Movements such as chorea, may be associated with these personality changes as well which remit with therapies aimed at ameliorating the structural changes in that disease.
If certain regions of the brain mediate alterations in diseased states, then it is reasonable to conclude that one’s character is determined by a crosstalk anatomical brain loci.
Generally the conditions described
above result in an obliteration of function of one or another part of the
brain, which means that they may be
considered pathological conditions. It is reasonable to presume that "normal"
behavioral variations, in other words personality, is explained along the same
lines. For example in
Given a push-pull set-up and conflicting influences of various parts of the brain, characteristics may be described along organic scales of hyper and hypofunction of brain regions or modules. Thus it makes eminent sense to build an organic personality profile. Why should be confine considerations of organicity to obvious pathological states such as schizophrenia, Tourette syndrome, epilepsy and the like? These conditions are merely emblematic of other personality characteristics, perhaps extremes. All of us carry elements of these supposedly pathological states. Disease states may thus be useful in delimiting normal variances. Brain physiology and pathology sheds a certain light on the inner workings "normal" personality. With tongue in cheek I present my own fanciful conception of a brain derived (organic) personality profile. One day it is hoped arm with ever more sophisticated knowledge derived from anatomical and physiological probes, tests may be devised to plumb the depths of these conceptions, in much the same way that the Minnesota Multiphasic Personality Inventory (MMPI) graphs personality profiles on a series of scales on the basis of self report true false or other questionnaire. While a semi-projective test like MMPI, is based on purely psychological constructs, a new profile, based on knowledge of brain physiology would seem to have even more promise.
THE BRAIN-DERIVED (PHYSIOLOGIC) MUTLI-AXIAL PERSONALITY PROFILE:
(P-MAPP)
Continuum:Spectrum:
I. Temporal Lobe:
Hypo (KlÜver-Bucy) Hyper
(Geschwind)
Sex Editor non-selective …………………… over-selective
Food Editor
Seriousness non-serious …………………….. over-serious
Religiosity (religious)
Emotion
Hypergraphia No ……………………….. Yes
(Script Editor)
Aggressivity Low ………………………….. High
II. Frontal Lobe:
Hypo Hyper
Inhibition vagrant …………………………… Nerd
Anxiety Sociopathy ………………………. Panic
Guilt ADHD Depression
Schizophrenia
Inhibition Low ………………………… High
Imitation High …………………………. Low
Objectivity Low ……………………….. High
(Parietal Lobe) Sensory …………………….. Motor
III. Left vs. Right Hemisphere
High Left High right
Precision Verbal (mathematical) ………. Artistic (imprecise)
Auditory ……..…………………. Visual
Speech …….……………………. Song (expression, prosody)
IV. Subcortical Structures:
Low High
Motor artist ……….……..………………. Athlete
Afferent
Entrepreneur …………………… Artist
Associative
Philosopher
Consider the practical implications. Take the food
and the sex editor. Some among us are
truly omnivores thinking very little of what they eat and are willing to
experience almost anything. With no constraints at all, some persons, children
or mental patients typically, may put almost anything into their mouth, perhaps
hair or toiletries as well as food (known as "Pica" for
woodpecker-The biggest concern over the years has been children who may eat
peeling lead paint from tenement walls but pica refers to all manner of
unnatural non-food consumption). Bezoars
are composite indigestible objects found on x-ray sitting in the stomach
such as balls of hair or seeds or even wood or metal. I've seen patients pick up and eat hair or
creams and so-forth. On the opposite end
of the spectrum are persons extremely selective with their diets, a selectivity
which ranges from rational to irrational over-selectivity, some of it highly rationalized. There are the vegans and vegetarians whose
dietary habits are followed almost with religious fervor, that is any slight
impurity the inclusion of animal matter will cause great anxiety. A lot of these persons feel it is morally
wrong to kill and eat an animal. Strict diets may be followed fo
Generally, but by no means always, other characteristics on the temporal lobe spectrum such as hypergraphia, the need to write things down, overall seriousness, and religiosity covary, but these separate but related characteristics are also independent and deserve their own scale. Many hypersexual subjects are also hypergraphic for instance, which means they tend to tell us in writing about their varied exploits. By the same token It is possible to conceive of an overall scale of temporality, encompassing food and sex choosiness, religiosity, seriousness, graphophilia.
The same may be said about the frontal lobe. As mentioned, some frontal lobe effects conflict with the parietal lobe in accordance with Alajouanine above, especially the character of overall "subjectivity" versus "objectivity." Anxiety and certain types of compulsivity may relate to an overall hyperfrontal personality, whereas the far less caring sociopath would seem to be hypofrontal. A lot of this remains speculative but is part of a physiological personality profile which emphasizes that many personality characteristics are brain mediated. Thus these constructs are based on physiological data and thus reality, subject to modification with new discovery and less to theoretical armchair speculation.
Other subcortical scales apply. Some persons are kinetic doers as distinguished from primarily afferent feelers, entrepreneur-athlete on the one hand, versus the artist. Others have cognitive and theoretical orientation such as priests and philosophers who seem to be taken over by association cortices, as opposed to primarily afferent or efferent subjects. Some persons, by their own natures, are meant to have less contact with the practical world. They function as armchair speculators, or worse, are isolated from reality altogether within the ivy-covered walls of the university or the cloistered convent. The practice of medicine is, for me, a spectacular example of a real world oriented profession. As a medical resident initiate the idea is to teach by massed practice. You're fully immersed in blood and guts and stool, human suffering and disease day and night in training. I feel privileged to have had this experience. Entering medical school it's traditional for you to be introduced to a cadaver. This is more than symbolic. You get more than experience of life and death and disease. You are immersed in it. There is nothing like it. Quite the opposite of being sheltered from the world, if you want to experience it first hand, there is not a lot that can be compared with medicine. So from this standpoint the monk is the opposite of the physician. Of course, we are all mixtures of these cerebral influences and variations. Why confine these physiological considerations to pathological states when it is highly probable that they are responsible for normal variations in personality?
For any individual it should be
possible to derive a score on all of these scales that defines their
personality profile, what may be termed the brain-derived (because it is
derived from a knowledge of brain mechanisms) or simply, Physiological
Multi-axial Personality Profile, the P-MAPP.
The idea is not so much that such scales may be exploited and used, but
that much of a personality is derived
from purely physical or brain mechanisms. This would be a combination of simple
and composite scales. The sociopath, the person with ADHD, the
"marine" or soldier of fortunef,
roller coaste
This kind of instrument, as with other psychological tests that are less based upon physiology, has all kinds of applications. One can define criminal types using this technology, but as I've pointed out previously, the best predictor or future behavior and the most empirical, is past behavior, one's personal history. I don't believe that personal historical data is used as much as it should be as a preventive measure. One's behavior, as it turns out, does not depart from certain previously established norms. As far as perpetration of a crime and indeed in all other fields or endeavor the two components to prediction of future behavior are proclivity, previously expressed talents and preferences, and the behavioral repertoire, skills and past experiences that enable certain behaviors to be performed. A man may occasionally raise his hand to his girlfriend or child. Having done this a number of times without paying any penalty, his behavior could inexorably creep into the realm of the slightly more outrageous, perhaps bruising a hapless family member. The next time he may break a bone or aggress against a non-family member. The point is that each time his new behavior is not totally different from past expeditions into the realm or brutality. Yet incredibly, our legal system seeks to keep historical data from discovery in order to protect the legal rights of the suspect. From the scientific standpoint this is tantamount to throwing away the best information we have not only about guilt or innocence but even more importantly in trying to prevent future tragedies. A psychological instrument, one rooted in physiology, will render at best a reasonable approximation of expectations of future behavior and performances which is likely to be inferior to a survey of past historical behavioral output. When it comes to doing what we'd like to do with psychological tests, measure the fitness of persons for work, to be admitted into academic programs, estimate the future probability of such diverse acts as completing a course of study, performing on a job and even committing crimes, all testing is woefully inadequate. The inadequacy of prediction is due to a residuum of volition. It is theoretically possible, though admittedly this doesn't happen very often, for person to suddenly wake up and decide he will change his life, cease acting the way he did before to do something fundamentally different. Even then of course abundant remnants of a previous behavioral style will creep into a new repertoire or paradigm, but the point is that psychological profiles and past history may be thrown to the winds.
With furthe
Yet there is a sense, that any
psychological scale, even based on physiology or more accurately pathophysiology, physiology rooted in knowledge of disease
states is inadequate, not only because, as we have seen, personal historical
information probably supersedes, is a far better predictor of future
behavior, but for othe
In one's behavioral schema some
mental activities and possibilities are, instantly rejected or, legitimized.
This instantaneous rejection or acceptance I conceptualize with the term
editor. And it is in just the same way that other actions, be they dietary,
sexual, and all of our behaviors and activities of daily life are accepted o
The editor: Turning off the logic machine
The editor is a firewall between the two worlds we
all inhabit, Cerebus
between real earth and the netherworld. There's an entire universe of unedited
thought processes, the vast majority of which is considered to be junk, or
worse, perversity. The unthinkable, the perverse, occurs in all of us. Mostly these thoughts are excluded from the
light of day, as if these terrible
thoughts do not occur, which in fact,
they do. A lot of this thinking is not
so terrible. Some is simply illogical or contrary to practical experience in
the real world. As we age the realm of
the unthinkable gets larger, meaning that rejection occurs more instantaneously
with experience. I can feel this happening in myself. When I was younger, I was often dogmatic, but
had less practical knowledge and I was more willing to examine other possibilities
which today I reject out of hand. I have a much firmer notion of what I'll
accept and what is unacceptable.
We inhabit two worlds. All of us function in our workaday world. We make a living and feed our families, concern ourselves with continuing existence, with practical immediate mundane matters. This is our world by day. Our main focus has to be secular practicalities, which as we have seen is a source of great dissatisfaction a feeling of lack of wholeness completion that is the lot of modern material man. But whether acknowledged or not, there is another simultaneous existence, one more nocturnal, supernatural, mythical, religious. This is a separate subterranean intellect, the world of fantasy. Each datum, each contact or memory engram may divide simultaneously into two sub-particles that go in opposite directions. One will remain in consciousness, in the world of applicable logical practicality while each datum impinging on our being may have simultaneously an alternate illogical valence. Everything has both a logical and an emotional effect, is interpreted on the level of practical reality and fantasy. Some engrams may simply go in one direction or another but often enough they split. For physicists this is nearly analogous to a photon being simultaneously a particle and a wave, to Schrodinger's cat being at the same time dead and alive its existence described as a probabilistic wave function, or, the split of an elementary particle into two virtual simultaneous states.
Figure
7: Incoming stimuli often split in two on the model
of an subnuclear particle splitting.
The
dream is emblematic of this process.
Dreams happen at night, out of
the glare of daylight, and logical processes. Dream images are less precise,
less practical than daytime apparitions. Dreams associations are
sub-logical, they are freer than waking
associations. In order to explore the
meaning of a dream you need to engage sub-logical processes that I talked about
above including but not limited to, mythic emotional association, pure clang or
poetic association, linguistic accidents
or puns, predicate reasoning, connection
with bodily functions such as sexuality and
urination. Typical dreams utilize
incompletely processed memory engrams from the previous
day or immediate experience as raw material for their subject matter. The dream is helpful for final processing as
assignment of meaning of immediate experiences.
For example I'm often bombarded with of shards of information that I
cannot possibly process at a particular moment.
I receive piles of mail which I will typically review over one or two
minutes in rush while a patient is getting ready to be examined in the next
room. I open it next to a garbage can
which means I throw most of it out immediately.
Occasionally a piece I have discarded comes back to haunt me later on
and I think to myself, maybe I threw out something prematurely. The interesting thing is that out of a whole
large pile, I may receive one or two
pieces of significance, perhaps a
magazine has rejected a paper I'd written, or a course that I'd really like to
attend or something of that nature. I
know if something like this comes my way I just can't deal with it at that
time. I'm expected in the next room in
one minute. What I do is mentally
"file" data to be processed at
a later time. Right now, I just have to
think about something else. The full-blown
emotional fallout of events of the day,
decisions about which pieces of
information to keep and which to discard, filing and other tasks will be
handled as the day wears on perhaps on a subconscious level but also may well
occur that very night in a dream. We
have physiological theories relating to dreams and memory espoused by Crick and
others. Dreams are viewed as a sorting
device for memories helping us decide which engrams
to keep and which to discard. Our brains
are only so large the theory goes. Much
of the data we take in has to be discarded.
Animals who don't dream are unable to discard data from that day and need
have a disproportionately large cortex to store all that unneeded
information. The example given is the
ant-eating Echidna, a type of primitive vestige of egg laying mammals, which doesn't seem to have REM sleep and thus
has an enormous cortex for the size of the animal. (As we have seen in pictures
of dolphin brains, other mammals all cortex was not created equal and mammals
with large brains lack the advanced cellular cortical architecture found in
humans which is multilayered and loaded with synapses). In any event we now have centuries of
research on dreams that proves that dreaming involves far more processing of
data than simple sorting o
Dream work is but one example, probably the most obvious, of mental processing that allows ideas to fly in under the radar of the logical thought editor. It is characteristic of early childhood that fantasy is not distinguished from reality. Parents and teachers are frustrated with the "lies" of young children for whom wishful thoughts are reality. As these kids grow up, suddenly they cease to lie (in most cases). Numerous studies have shown how suggestible young children are which creates a nightmare in courts of law. Studies by Ceci and a host of others have proven children to be highly suggestible. Ceci was easily able to alter young children's views of reality fully convincing them that fabricated events had occurred merely by suggesting that these happened in questions[35]. Stories of sexual abuse involving caretakers and parents are often as not fabrications of police, social workers and other professional questioners. Though much parental sexual abuse undoubtedly does happen such material has been used extensively by parents in custody battles but is notoriously unreliable. Children so often confuse their own dreams and fantasies with reality. Many normal children have pretend friends and act in every way as if they truly exist. In elderly folks too, dream and fantasy material creeps into their perceptions of reality. They may dream that a deceased parent or sibling is in the room and while awake, act as if this is fact. Delusions about an elderly spouse's infidelity are extremely common, perhaps stemming from insecurities of younger years which occurs in paranoia connected with dementia and involutional melancholia. In the very young logical judgment and reality testing are not yet fully developed, while in the old judgment is impaired by brain disease. And delirium or encephalopathy impair one's faculty for distinguishing fact from wishful fiction though in these pathological states, aging, dementia, disease, delusional systems tend to be primitive and underdeveloped compared with fertile childhood fantasies.
Fantasy and invention are what the
arts are made of. Associations are
emotional and illogical, often
outrageous and fly in the face of reason but they work within the creative
psyche. Connections here are out of the realm of the apparent or obvious for
most ordinary persons. They work out of the range of consciousness. Using
ordinary adult reasoning, for many of us it is still possible to
"admit" this type of fantastic mental processing, but many persons,
entirely exclude artistic illogical modes of thought. We see all degrees of
admission and exclusion of alternate modes of thinking. Arguments in American
congress with regard to public support of funding for the arts revolve about
the inclusion of what is felt to be the ridiculous, illogical or experimental
in the arts and how much of what seems to be patent absurdity ought to be
supported or even tolerated. The very
same considerations hold fo
Myth and religion heavily utilize sub-logical associations. Indeed this explains their universality and success. Myth and religion need to be something other than logical. Otherwise they are cut from the common cloth of every day experience which is no fun at all. Religion wouldn't work for most persons except to give respite from the tyranny of science and logic. The Sabbath is so much more than a simple day of rest. It is an escape into a world ideas other than work and productivity.
When we use Jungian "free
association" what we really mean is
that we are freed from ou
What do all these processes, dreaming, fantasy, art, free association, poetry have in common? They are generators of new thoughts and emotions that occur before the level of rejection. They create possibilities. In the absence of a rejecting thought editor, ideas are limitless. This other world is thus a great generator of ideas which in the light of day would be thrown out, a remnant of the primitive and childlike mind, almost an internal random number generator of possibilities before they get rejected repressed out of hand.
The random generation of
possibilities is common and necessary. Evolution works this way. Diversity in biology is the random generation
of alternative forms which are then tried in the real world. The vast majority of
these possibilities is, on the surface, ridiculous, too ridiculous to be
considered. Most mutations have to result in the formation of an impaired
protein product that will adversely affect survival. Some few mutations will improve the
product. Even more important is the new
combination that results in a slightly different phenotype every time an animal
or plant comes to be. Each and
every animal or plant is thus an
individual experiment in reality which to a varying extent either succeeds or
fails. As we have seen, so many animals
and plants are sexual because sexuality is evolutionarily advantageous. Why?
Sexual reproduction adds furthe
But at any event the scheme here is that organisms are first diverse then they find by practical experience, that they can compete in different conditions. In my housing development, squirrels have few predators and reproduce so as to overwhelm the carrying capacity of their environment. There is not enough space for all of them. The same is true for deer which live close to housing developments which have no non-human predators. This is the origin of Lyme disease which lives in deer ticks that parasitize humans and deer. Some of these squirrels are resourceful enough to live not in trees but inside attics and other man-made structures. Others haven't the "personality" inventiveness or other adaptive ability or perhaps are more dominant on the ground or in trees which squirrels more typically inhabit. The squirrel world is diverse (chac'un à son gout) hence more adaptive. By the same token, our human ancestors at various times in our history, in some groups sooner, among others, later, made a number of discoveries, the most important of which converted hunter gatherers to farmers. They discovered domestication of animals and plants allowing humans to extract a living for greater numbers of people on a smaller amount of land. The discovery of agriculture and domestication came first, the practical application second. But the very store of raw material of ideas which was able to escape detection by rejecting radar or the thought editor of hunter-gathering lifestyle created the possibility, galvanized later, into the practicality of agriculture and rise of cities, that we call civilization. As I'd pointed out earlier, bio-genetic adaptation has crossed into the realm of mental adaptation or the generation of ideas and this mode of preadaptation reaches a peak in humans.y It is a commercial for pure scientific research. You don't usually know what practical benefit you'll derive from studying something until you actually begin to seriously learn about it.
Pharmaceutical houses are just now
waking up to the same strategy in discovery of new drugs. The first step, a rate-limiting step, turns out to be the rapid generation of novel
compounds which only later be tested for a specific effect. The greatest obstacle being the generation of
a large enough number of new chemical possibilities[36]. One of
the major advances in drug research is the use of robots to generate compounds
with start with some basic characteristic then can be tested further for safety
and efficacy, such as a ligand that can bind to one
or another specific receptor. For
example, a research group may need to generate a class of compounds (the more
members the merrier) which bind to a certain receptor. Later on these compounds can be weeded out
according to their stability and safety profile, strength of binding etc. and
the vast majority of candidates can then be rejected until an ideal candidate
is found. This is not unlike the crucible of evolution which occurs in the real
world. First there is variation and lots
of it. Only later on will all these
varieties be tried. Imagination is, in
essence sort of a random number o
Material disseminated over the Internet falls into roughly the same category. Most of it is untried. The process is not like getting it into a magazine or book which has to pass under to watchful eyes of an editor who decides what lives and what dies. Instead a lot of material is out there for all to see. Supposed news and gossip items are floating around with no one to confirm their validity. A small amount of material may be true and some may be worthwhile. But it is all out there for a certain public to see, a way to test its mettle. This is a mass of raw material, the subconscious of the publishing world.
Out of this disorganized morass comes a very small amount of worthwhile material that will stand up in the real world. Creativity, even scientific creativity, is based on reaching down into this giant welter of possibility. One example which is frequently cited is Kekule's discovery of the ring structure of Benzene, a pivotal insight that underlies the structure of many organic molecules. Appreciation of the 6 carbon benzene ring required a paradigm shift, away from the conventional linear array of carbon atoms which scientists had pictured carbon to occur up until the end of the 19th centuryÆ . This insight, Kekule claimed, came first to him in a dream. In fact there are many examples of scientific insights that first came to the discoverer in dream form. It may come as a surprise that dreams provide profound insight not only for prophets and seers who uncover principles which are then accepted as a matter of religious faith or doctrine, but for scientists who while simultaneously recognizing the truth or insight of their discoveries, then subject these to the crucible of the scientific test. Theories uncovered in this way will be tested. Presumably the fittest theories will survive. But the imaginative dreaming facility provides the grist, the raw material, for scientific mill. The advantages are presumably that ideas are not prematurely rejected by a condemning thought editor but are brought to the light of day where they can be tested.
Just as the fitness of every organism will be tested in the real world, alternative mental states provide raw varieties of ideas that may be tested in consciousness, if they are ever brought to the surface and command the attention for the conscious brain. It is worth considering how these alternative mental states develop in all of us. Consider that developed normal adults, we have at least three highly distinct mental states that are rigorously separated from each other. We experience slow wave sleep, REM or dream sleep and waking activity, all of which are distinguished on the EEG and which you can see also with other physiological parameters recorded as when a polysomnogram or sleep physiological study. These separate states develop in infancy to crystallize into approximate adult form in early childhood. Of course children and adults, daydream at which time they are electrophysiologically awake but ordinarily involved in wishful thinking or fantasy that is usually somehow satisfying and a way of passing one's time when bored. The hypnotized subject too, is restfully awake. Electrophysiologically the hypnotized person has not entered an altered state and this does not resemble sleep at all despite the name which incorporates the Greek root hypnos meaning sleep.
The first electrical brain activity that develops in prematures which can be appreciated with electrodes place over the scalp is an uncoordinated burst suppression pattern. Long periods of virtual total electrical silence or quiescence are punctured with bursts of high amplitude brain activity that looks almost like an epileptic seizure and this occurs in a seeming random pattern. The first nascent electrical brain activity is escaping from the newly formed brain as it begins to function. Activity comes first, regulation and control second.
Every mother knows that by 18-20 weeks of gestation, there are periods of physical activity in the fetus alternating with inactivity. At first, these are so undifferentiated that it is difficult to correlate with changes in electrical brain activity. If you look at an EEG of a premature, you will not be able to tell whether he is apparently, behaviorally awake or asleep. Newborns sleep about 70% of the time while as adults we spend less than a third of our time asleep. By about 28-30 weeks of gestation sleep is broken fundamentally into active and quiet sleep, the forerunner of REM vs. Slow wave sleep. In active sleep you can see that respiration, pulse, eye and body movements are irregular. In a full-term (40 week) newborn, it is easier to distinguish active REM sleep from quiet sleep but there are periods of indeterminate sleep by then as well which it is harder to categorize. The work of distinct separation of states of consciousness is not yet done. A form of quiet sleep on the EEG termed tracé alternant is only seen from about 32-40 weeks. This is replaced by the sleep spindles characteristic of mature slow wave sleep that replaces infantile quiet sleep early after birth[37]. Slow wave sleep will still later differentiate into the four prolonged distinct stages that we have in the adult, very early in life. In adults there are four stages of slow wave sleep and shorter period of REM or dream sleep. The active sleep precursor to REM sleep decreases in relative sleep time very early in life. While infants may fall directly into REM or dream sleep, this rarely to never happens in a normal adult. Always an adult goes through what seem to be meticulously orchestrated slow wave sleep stages before entering REM dream sleep. It may be 60-90 minutes before REM sleep occurs as you first drop off to sleep at night.
Part of maturity is the stricter definition and separation of altered states of awareness. Slow wave sleep is a firewall in essence between two worlds or two states of being, dream or REM sleep and ordinary conscious awareness (waking). This separation is so well developed that it is reasonable to ask why it is so necessary at all. Add to that the fact that memories of dream experience are so rarely recalled while awake that one must postulate that there is some active process of forgetting of dream material. The separation of these different states is so well made for most of us that it must serve an adaptive purpose.
The facility for dreaming, fantasy is seemingly present in many advanced mammals. Dogs and cats dream and have REM sleep. Perhaps they are fantasizing about a chase or catching prey, they seem to have episodes during sleep that look like a simulated hunt. Aristotle and Maimonides a twelfth century Aristotelian, both remarked that Animals have the facility for dreams and fantasy. Fully conscious awareness though, reality testing, was held to distinguish humans from animals. Waking consciousness is the pride of humanity, not that it too, isn't present, but in much more rudimentary fashion in other animals, especially mammals. There is electrical precedence and analogous state change on the EEG in other animals to be sure.
So in sleep we have one example of the alternative states, the conflict of reality of waking conscious life by day, with the phantasmagorical REM or dream sleep at night when things aren’t so clearly visible. One shouldn't give autocratic thought too tight a reign on all of thought processes. As we age this capacity for fantasy, the generation of new ideas, withers. As we all know there is less REM or dream sleep with increasing age. This is emblematic of a more universal process I think. The crustiness of aging, mental rigidity, is no more than the rejection of alternative modes of thought. As soon as you begin to just know out of hand what is to be rejected and what accepted, your thought processes become more Parkinsonian. Free association, fantasy, day and night dreaming, play, suggestion, are all generators of new ideas. Admittedly It's a difficult balancing act we have between the two alternate worlds because there has to be some means editor in altered states, the editor is turned off and the brain is allowed to function without fear of rejection of ideas.
|
Unconscious |
Conscious |
|
Fiction |
Non-fiction |
|
Poetry |
Prose |
|
Art |
Science |
|
Fantasy |
Reality |
|
Night |
Day |
|
Dreams |
Conscious wakefulness |
|
Play |
Work |
|
Stars |
Sun |
|
Free, Clang Association |
Logic |
|
Myth, Religion |
Technology |
|
Ideas |
Matter |
Table
3: The dichotomy of awareness.
The dichotomy of awareness is much the same as separating primitive from modern modes of thought. As I have tried to point out in the chapter on memory, rather than throw old forms away outright, these remain a part of us. As sentient living beings we differ from machines in that the past is part of our current essence, history is important, the past is not discarded. It remains inside us.
The following table is adapted from a book on Dreams by Anthony Davis, but in form it is quite analogous to the table above, even without going into detail about some of the specific elements. The primordial mind is still a very important part of modern person's thought process. It has not been thrown away just replaced by a manifest thought paradigm. Some explanatory notes are essential. In man's acquisition of knowledge, the eating of the apple in the Garden of Eden, the change from hunter gatherer status to agriculture, the ego is gradually separated from the self, creating an ego-self axis which expands as man's abilities and knowledge base expand. There is a separation from the natural primordial self so that the entire structure becomes more complicated. One's view of oneself is expanded by marriage, community and other social factors. All of the other considerations in the table are self-explanatory. In primordial Ptolomaic terms, man is the center of the universe, but ever since Copernicus we've been aware that we are not the center of the Cosmos or even the Solar system. In nature we've matured from being subject and part of it, to at least partly, manipulators and beneficiaries of its largesse. With the advent of agriculture, our view of the flow of time was largely circular and seasonal, but in modern times we view the flow of time as synonymous with progress, so that time has acquired a linear quality. Our modern reality is "show-me" scientific enmeshed in matter and less in spiritual imaginings of the past. Life is viewed as finite, with eternal life reduced to the status of wishful thinking. Myth and ritual are expendable as religion takes a back seat to science and values are no longer absolute or god-given to the modern scientific mind, they must be reproved and changed.
|
|
PRIMORDIAL MIND |
MODERN MIND |
|
Ego-Self Axis |
Short and compact |
long and attenuated |
|
Cosmic location |
central |
peripheral |
|
Relationship to nature |
subjective participation 'participation mystique' |
separation, objectivity |
|
Concept of time |
rhythmic and circular |
progressive and linear |
|
Reality |
the world of the spirit |
the world of matter |
|
Moral values |
absolute |
relative |
|
Life |
eternal |
finite |
|
Attitude to myth and ritual |
essential |
futile |
Table
4: Phenomenological differences between primordial and
modern minds[38].
Primordial thought patterns are still a part of our modern reality. There is certainly a persistent element of these primitive thought structures in much the same way as the dark or nighttime side of our mental processes influence consciousness. Proponents of more primitive ritualistic thinking make a valid point. For example, we've seen in recent years an outcry against moral relativism in favor of less well-developed god-given rigid rules. On many levels persons would be better off following absolute precepts. The beauty of human consciousness as opposed to mechanical objects, is the persistence of historical or past modes of thought even as newer paradigms and strategies take command of the mind. Old modes are not just thrown away. On the contrary, they remain part of us.
Biologist Ernst Mayr defines the useful concept of teleonomy from teleos meaning purpose or end driven as in teleology. Biologists so often speak, of animal behaviors teleologically, as though serving a purpose or intention such as bird's migration south in the Wintertime to escape lack of food and harsh circumstances in the north. As we have seen the predator and prey behaviors of even the simplest one-celled organisms seem to be goal-directed. Mayr contends that these behaviors are determined to a program carried out encrypted in our genes and passed down through the generations. Seeming intention is the unfolding and carrying out of a program determined by genetics.
At some point this genetic program
is applied to the specific situation the animal is in. A program of fight or flight is intrinsic to
every deer chased by a predator. Hearing
a noise o
"Organisms
are unique at the molecular level because they have a mechanism for the storage
of historically acquired information, while inanimate matter does not. Perhaps
the was an intermediate condition at the time of the origin of life, but for
the last three billion years or more this distinction between living an
nonliving matter has been complete. All
organisms possess a historically evolved genetic program, coded in the DNA of
the nucleus (or the RNA in some viruses). Nothing comparable exists in the
inanimate world, except in man-made machines. The presence of this program
gives organisms a peculiar duality, consisting of the genotype and a phenotype.
The genotype (unchanged in its components except for occasional mutations) is
handed on from generation to generation, but, owing to recombination in ever
new variations. In interaction with the environment, the genotype controls
the production of the phenotype, that is, the visible organism which we
encounter and study.
The genotype
(genetic program) is the product of a history that goes back to the origin of
life, and thus it incorporates the "experiences" of all
ancestors…. It is this which makes
organisms historical phenomena. The genotype
also endows them with the capacity for goal-directed (teleonomic)
processes and activities, a capacity totally absent in the inanimate
world." [39]
But Mayr
would make the observation that in animals with complex brains, especially in
man, the programs referred to range
further and further from simple genetic plans.
Our brains are large, complex and plastic. The human's childhood and
dependency are prolonged in advanced
societies sometimes well into child-bearing years, as is adulthood and old age,
so that learning, wisdom and culture may be passed down. Many of us are not allowed to practice our
profession independently until well into our 30's. We are as children until then, immature and
dependent in our art on our still older mentors. This is the major adaptive feature in higher
animals, especially in humans and even more so in highly functioning humans.
Superimposed upon our genetic or biological endowment is a cognitive endowment
as well. Many times, but not always, it
is the learned component that supersedes biological influence as when you're
hungry but wait to eat until you get done with work, or you're angry, but do not attack, o
Even birds with their notoriously small brains function behave not according to built in genetic programs alone, but need to learn from their fellows. Fully-formed bird song is not a product of genetics only, but partly determined by learned behavioral repertoire. Songbirds acquire a local dialect from their fellow mentor older birds. In humans though this process, like others, becomes so complex and highly developed, is almost hypertrophied because of the sheer size and complex circuitry of our brains. Somehow, especially for us, Mayr's programmatic teleotomy seems insufficient to explain the richness or behavior and social interaction.
A purely biological point of view, especially biology overly reliant on mechanical principles, does not begin to account for the wide range of human feelings and behaviors. While even a mechanistic view of behavior may be somewhat useful, it cuts off a complete view of how humans function. It gives a partial view of humanity without accounting for a fuller whole. This is why biological science and psychology cannot account for or predict future behavior, because always there is a residuum. A residuum better expressed in the history of the organism, personal and collective history.
Perhaps this is why we are unable to come up with biological explanations for behaviors which should, by rights, be explained biologically. The neurobiologist Simon Levay has written extensively on homosexuality. In his book Queer Science he resorts to sociology, anthropology, history to explain homosexual behavior. This is due the inadequacy of endocrine and brain related explanations for this complex of behaviors. No neuroanatomic, genetic or endocrine explanation determines homosexuality and psychological explanations or inadequate as well.
It is better to acknowledge that complex behaviors will never be explained completely with biology because we have already wandered too far from our biological origens. Reasoning has to come from a realm other than the scientific or mechanistic. Full appreciation of science, a reverence for the scintific method should incorporate an appreciation of science's limitations.
Scientific understandings leave us persons without a will or soul. Biologists and evolutionists, if they believe that consciousness exists at all, will ask why it exists. How is consciousness an evolutionary adaptation? John Searle in The Rediscovery of the Mind, makes the observation that many scientists, frustrated by their inability to explain or understand consciousness using purely the scientific method, deny that consciousness exists. The scientific method depends on firmly reproducible objective data. Whatever you are studying should look exactly the same, no matter who the observer is. The identity of the scientist is unimportant. If an observation is scientifically valid, all scientists will get the same result. That is what makes the concept of consciousness so slippery. By nature it is felt and appreciated subjectively. Try as we might, it is near impossible to get at someone else's mind. We have tools that help us transmit thought and feelings, writing, language, music, and art yet one person's experience is still not readily transmitted to someone else.
Consciousness for Searle is a real phenomenon that cannot be ignored. By its nature it is subjective and this challenges the scientific notions of wholly objective knowledge. Consciousness depends on reports of subjective experience to define it phenomenologically.
Consciousness is unique in this regard. While undoubtedly yours and my consciousness has common features, neither of us can quite experience the consciousness of the other and another persons consciousness cannot be described in purely objective and readily reproducible terms. Consciousness, in a word, seems to be, at least for the time being, non-transferable from one person to the next. For a scientist to reject the existence of consciousness because it is impossible to objectify is an easy out, but it does not represent truth. Considering all of this consciousness seems impossible to objectify, and document which leads some scientists to suspect that it does not exist at all. Yet the notion that there is no such thing as consciousness, which all of us experience seems he absurd.
Consciousness is not a mere
byproduct or epiphenomenon of advanced cerebral cortical activity, but functions as a command-control mechanism
fo
More than supplying the raw ability to learn and pass down information, the larger brain is now seen as an instrument for consciousness, which makes humans far more plastic and adaptable. The invention of consciousness and its efferent extension, free will, has to be seen as being instrumental in bringing about the obvious success of the human experiment.
Consciousness began as a biological construct, surviving because of evolutionary advantage. It is formed out of the conspiratorial primordia of various brain modules. That being the case, it has spun off free will. Biology, evolution, mechanism has gotten far more than it's bargained for or even what may have reasonably have been predicted, in this process. It's ended in the great bulk of human creation being extra-corporeal even extra-cerebral, that is, cars and machines to increase our speed, grand buildings that provide shelter and comfort, stone, paper and computers to record and build upon our thoughts and expand infinitely human memory along with thousands of other devices, lastly grand schemes and mental representations of meaning of life on earth.
All of this may at this point sound rather obvious, yet for the majority of us, notions of a mechanical automatic man making only predictable reflex behaviors dies hard. Some scientists continue to preach that persons do no more than express a certain limited variety of instincts and behavior programs. To them behavior is nothing more than the drives built into us and a certain limited repertoire of actions we've been taught.
Thus we are left with two distinct alternative images, alternative forms. On the one hand is executive personhood fully developed but difficult to explain utilizing current scientific concepts and terminology. On this level we have to accept our ignorance our inability to explain everything. It's analogous really to our not having a firm grasp of physics, the beginnings of time and the creation of the universe. On the other hand we go on contentedly explaining human behavior on the basis of current mechanistic and material constructs. This latter course is hubris, abundant self-confidence in our current state of knowledge about human thought and behavior. Where does this latter course lead? It leads directly to Frankenstein, to zombies, doppelgängers, shadow men, persons without dreams, consciousness and will.
I had an unpleasant experience of being misjudged and abused by a functionary in state government. In the scheme of things it was rather trivial, but I took it very seriously at the time and I felt helpless, because in this situation, there was no one I could appeal to. This bureaucrat had essentially no oversight in her job. One morning I awoke to the vision of two lines of persons. One line was for people who would be sent to the gas chamber. On the other line were persons chosen for temporary reprieve. I thought about the identity of people on the lines, and who were making life and death decisions. Those with power were bureaucrats, worse, thugs with authority. The heinousness of the Nazi crime is magnified by the fact that the victims were far more human than their handlers. Victims were the highly educated, inventors, artists, poets, engineers, entrepreneurs, physicians, musicians, scientists whose life or death was in the hands of criminals. It was Hannah Arendt writing of the Eichmann trial who introduced the pivotal concept of the "banality of evil". Daniel Goldhagen[40] (Hitler’s Willing Executioners”) and many others, showed how this was true by empirically confirming the obvious fact that the average person through silent acquiescence or worse, was responsible for crimes and mass murder. We live in a world painful to think about, turned on its head, where the vulgar mobs of evildoers have power over the good and just. How many of us go into our jobs - we are authorities in our mini-worlds and judge with authority?
The bureaucrat or apparatchik left to his own devices is an automatic shadow-man, a doppelgänger exactly. To do well, to do the unexpected, not the spectacular for which you may expect to get immediate recognition, but to perform small acts of kindness, means not always working for your manifest immediate self-interest, but for something larger than yourself, for some ultimate reward perhaps, that is not in clear view. To perform the unexpected residual and improve a world full of cruelty that is the meaning of life.
Our world is not one of Zoroastrian symmetry between good and evil. Evil is common, banal. Good transcends evil. To do good is to go beyond expectations. To be good, maybe at times have people get angry at you, not appreciate your every motive, even though it is always comes from a sincere effort to understand and to help is believe it or not, better than being handsome smooth, slick, sophisticated or always popular.
Lots of ethnic traditions include of beings without souls. These are zombies, doppelgängers, Draculas, Frankensteins, and the homunculus or little man of Paracelcus the alchemist and golems[41]. These latter products of human as opposed to divine creations, arise solely out of matter and thus lack a soul, or will of their own. Lacking a higher consciousness they are beholden to their human maker. The legend of the golem (Hebrew for embryo) is the best developed in Talmudic, and Kabalistic legend and explored extensively in Yiddish literature, theatre and musical productions. According to Jewish legend humans are divine creation imbued with a neshama for soul. Adam (="earth") for the first 12 hours of life had a vitality alone, but only later was infused with a neshama. Some sages, on the other hand, having some secret knowledge, had the power to create a golem, or clay man, through their incantations, out of ordinary earth as if they were by virtue of superior wisdom, given enough of the power of God to create a living being but one with profound limitations. The golem was an imperfect creature with no will of his own, no neshama, but could perform, zombie-like, as an automaton, according to the will of his human creator. The golem could not speak. Tradition has it that the word emet for "truth", or knowledge, was stamped on the golem's forehead. You could deactivate or decommission a golem simply by rubbing out the first Hebrew letter of the word emet, the aleph, thus converting emet to met for "death". Its creators would dance about the inanimate clay creature reciting alphabetical letters or the secret Name of God bringing the golem to life. The incantations that originally created the golem could be recited in reverse, the dance being reversed as well, deactivating the creature. Thus a material creature was made to live and die out of the word, reliving the creation of the world where matter sprang from nothingness, and man was made from clay.
The human creators had an undeveloped embryonic simpleton monster on their hands, one with raw physical power that would grow beyond the man's ability to control it. Eventually the Golem would have to be destroyed. Many stories and plays were written about golems created to protect the Jewish neighborhoods from gentile oppressors who accused Jews of the Middle Ages of Blood Libels and other false crimes. The golem represented physical power brought about by the earthy materialist knowledge that was the province of man who had not the power which was the property of the divine presence alone, to make a total person having its own will, speech and soul.
As with many legends there is truth in the underlying ideas. Human knowledge has advanced to the extent that our own creations extend and enhance human capacities. The computer and calculator are tools that extend human abilities with speeds unrivaled by our brains. We can use drugs and transplant human organs to extend life for finite periods of time. Our machines carry us many times faster and with much less effort than natural means of locomotion (our own legs). With our knowledge of the human brain we are able to compartmentalize and modularize nervous system function and have, as we have seen, revolutionized our own picture of consciousness and human will.
But as of the present we have no idea how to create or animate willful sentient beings. We have mastered the machine language, the technicalities of medicine to a great extent but haven't yet created a being with its own strategy for existence even on the level of our ameba. Our scientists are the sages of the golem story. They have created their own golems, shadow men, doppelgängers but haven't even a vague idea about how to create and manipulate self-consciousness, awareness or its efferent component which is human will. With our knowledge as limited as it is, we have been unable to recreate life, certainly life which acts and thinks on its own accord. We have been successful at creating neither Carbon nor Silicon beings that act of their own free will.
The major question that we have to answer is where is our deficiency in understanding of ourselves. Will full understanding come eventually from more of the same, from brute force of applying mechanistic and materialist principles, or is it possible we are missing something less tangible, less material, in human and even animal nature? When we finally come to understand all of the chemistry, the electrophysiology, anatomy, will we then understand ourselves?
Those steeped in science respect its accomplishments at the same time understand the limits of science and materialism. We have seen that our ability to explain the inner workings of the mind with brain science is quite remarkable but at the same time incomplete. Experience teaches that we may at once admire what we can do, but at the same time have healthy understanding of our own ignorance. The instruments and understanding may be miraculous. We can rescue a person from the jaws of death and frequently do. At the same time, we have all seen situations of persons given a clean bill of health one day and show up dead on arrival the next. The inability to predict the future, to reproduce by artifice or invention the diversity of nature makes us forever humble. Always there is a hidden element, there is so much we do not know and the more we learn the more we find we have to learn.
This material is copyrighted and may be reproduced only by permission of its author, Charles Yanofsky