Mind and Brain

“A biological analysis of a deed is like a chemical analysis of a painting.  It is not false, but it does not account for what makes the paints into a painting.  It stops before the essential part of the story starts.”  (Leon Wieseltier, 1952-- )

While teaching a class of psychiatry residents, I wrote this quote on the blackboard.  “The mind is its own place, and in itself can make a heaven of hell, a hell of heaven.” (John Milton from Paradise Lost) 

A week later, the quote remained on the board but underneath someone had scrawled, “Not true!!  Mind is Brain.”  Obviously, my quote pushed someone’s button.  I am almost sure that this uninvited editorial comment was written by an enthusiastic and aspiring scientist-to-be.  There is a growing belief among many researchers that mind and brain are equivalent. The way to better understand the mind is to better understand the brain. 

I wanted to let the young scientist that I strongly disagreed, and I wrote in response, “How sad and how absurd.”  The mind is more than just a brain. A mind is not understood by understanding brain parts. Love, a state of mind, is not understood by understanding chemicals of the brain.  Oxytocin and endorphins may significantly influence the perception of love, but to know this chemistry is not to know ‘the chemistry’ of love. 

I wanted to find out more about the person that wrote on the board.  I wanted to hear their perspective.  And I wanted to debate. 

I wanted to point out to this unknown editorialist the absurdity of the assertion that Mind is Brain. Remember if A=B and B=C then A=C. If mind is brain and brain is chemicals then mind is chemicals.  And if mind is chemicals and chemicals are atoms, then mind is atoms.  And so on and so forth into reductionistic absurdity. How little is revealed about the mind in this process! 

If I had met this person face to face, I would have asked if they thought the following statements to be true or false:

·         Hamlet is English words

·         Mona Lisa is brushstrokes on canvas

·         Beethoven’s 9^th is notes and chords

Of course, there is no Hamlet without English words.  There is no Mona Lisa without brushstrokes on canvas.  There is no Beethoven’s 9^th without notes and chords.  And there is no mind without brain.  So, the statements are true, but they tell us very little and convey nothing of the essence of the play, the painting or the music.  An analysis of the brain does not account for what makes the brain into a mind.  “It stops before the essential part of the story is starts.” 

If like the aspiring scientist-to-be you disagree with what I’ve said, pay this blog no brain.

Behavior Mod

“Give me a child and I’ll shape him into anything.”  (B.F. Skinner, 1904—1990)

Rewarding a desired behavior increases the frequency of that behavior.  This is the core principle of behavior modification, demonstrated by Harvard Psychologist B. F. Skinner in the mid-twentieth century.  This is the core principle of behavior modification (‘behavior mod’ for short), that continues to be demonstrated daily by animal trainers, teachers, parents, and electronic game designers, to name but a few.

If life is a laboratory, then the arcade at Chuck E Cheese was my laboratory for learning about behavior mod.  I remember observing children putting their tokens into the games.  If a child won the game, then tickets were automatically dispensed.  Kids collected and counted their tickets eventually exchanging them for prizes.  In the language of behavior mod, kids were conditioned (or trained) to spend tokens (desired behavior) on games (stimulus) in exchange for tickets (reinforcement).

Rewarded was token spending behavior.  Not rewarded was curiosity, creativity and risk-taking. Often avoiding the more challenging games, children sought out games with the best ticket payout.  A game that did not reward generously was a game ignored.  Kids loved spending lots of tokens on games in pursuit of tickets.  No amount of tokens completely satisfied and when the tokens ran out, kids became irritable.  Ultimately, tickets were exchanged for worthless trinkets.  From what I observed in the lab, the influence of behavior mod was powerful.

Behavior mod is not just for kids. In a different laboratory, an adult version of the Chuck E. Cheese arcade, I observe grown-ups playing the slot machines. A slot machine (the stimulus) is basically an electronic game, requiring zero skill, that offers a monetary payout. For every dollar put into a slot machine (the desired behavior), the machine returns, on average, 96 cents (the reward).  Doesn’t sound like such a good deal.  However, the casino owners know that the longer you sit in front of the slot machine, the more money you spend, and the more the casino profits.  Through the power of intermittent reinforcement, attractive visual displays, and occasional ‘jackpot’ payouts, vulnerable adults become addicted to the slot machine.  They can’t stop spending.  Some lose far more than they can afford.  The influence of behavior mod is powerful.

I make the following offer (the stimulus) to any of you who might be interested.  Send me your money (the desired behavior) and for every dollar I receive I will gladly return 96 cents (the reward), minus the cost of postage and handling.  Behavior mod can be powerful . . . especially in the wrong hands.

Brains

One famous philosopher speculated how different the world must seem to a bat than to a person.  Another famous philosopher speculated how different the world must seem to a dog than to its owner.  Bat, dog, person; each is wired differently.  Each has a very different brain, thus to each their world is very different.  All that is seen, heard, smelled or touched is interpreted in the brain.  What I know of the world is determined by and limited by the wiring of my particular brain. 

Trying to understand the relationship of the world I know to the ‘real world’ out there, I consider this analogy:  the brain is to the universe as the record player is to the record. Now, my attempt to explain.

What is a record without a record player?  A record consists of waves and patterns etched into a continuous vinyl groove.  A record is potential not yet realized.  Without a record player there is no music. It is the record player that interprets the patterns etched in the vinyl, subsequently turning it into music.

Suppose aliens found a vinyl record.  Would they detect the waves and patterns?   Would they build a machine and try to solve the mystery and meaning of the patterns?  What if their machine started at the end of the record and played backwards, or played at the wrong speed?  Chances are an alien record player would play a different tune.  Perhaps aliens would build a machine that interpreted the patterns as pictures or smells and not sounds.  What if aliens had altogether different sense organs?  The record might then be played in ways we cannot even imagine.

If the universe is, like the record, a series of waves and patterns, then different brains will interpret waves and patterns differently.  A dog and I exist in the same universe, yet my world is filled with sights.  A dog’s world is filled with smells.  Same universe, but a very different tune.  The title of a onetime bestseller, “Men Are from Mars, Women Are from Venus,” suggests that even for the sexes; same universe, different brains, different tune.

I’ll take the analogy one step further.  If there were no waves and patterns, but only random irregularities in the vinyl groove, then the record being played would just make noise and not music.  But the patterns and waves in a record are not random.  They are unique to the artist's music.  So too, the universe is not random, but has its interpretable patterns and waves.  Our brains as record players, our minds the listeners, we recognize there are patterns.  Every day we see, hear, smell and feel the music of our universe.  Is it possible that there is an 'artist' responsible for this patterned universe?

If my analogy seems hard to follow, not to worry.  I am aware that many of you are too young to have ever listened to a vinyl record.  I am pleased to see that, in this world, records and record players are making a comeback..

Golden Rules

It is possible to be a well-disciplined person and an otherwise despicable human being.  I recently wrote about the importance of raising self-disciplined children.  I failed to mention one thing.  It is important to raise self-disciplined children AND it is important to raise them with a moral compass.

As a psychiatrist and therapist, it was not my place to tell people how to believe, but it was well within my domain to ask them to articulate what they believed.  I often asked patients and parents to describe their family values, what for them was the measure of ‘good behavior’, and what values made them proud to be a member of their family.

I often asked children and adolescents to explore their values, their behaviors and their choices according to the feelings that follow.  “If you choose to do such-and-such, how will you feel the next day?”  I suggested to them that, when faced with important decisions, they use a ‘mirror-test’.  “Choose today in such a way that, when you look in the mirror tomorrow, you are proud of who you see.”

I often asked parents how they conveyed their beliefs and values to their children.  I asked parents to consider if their behaviors were consistent with their professed beliefs.  As my wife is fond of quoting, “if you don’t model what you teach, you’re teaching something else.”  I reminded parents that it is not enough to just correct children’s misbehavior.  Parents must provide children with the language for understanding moral choice and behavior.

For parents struggling to find the right words to say, I suggested The Golden Rule as a good starting point.  Whether secular in origin or God-given, The Golden Rule is a universal principle for moral discourse and behavior.  Some iteration of The Golden Rule is found in almost every culture and religion. 

Some iterations focus on moral intent. “Love your neighbor as yourself.” (Leviticus 19:18). 

Some iterations focus on moral restraint. “Do not do unto others what you do not want done unto you.” (The Analects of Confucius).

Still other iterations focus on moral action. “As you would that men should do to you, do you also to them.” (Luke 6:31)

Intent, Restraint, Action . . .  I recommend that parents teach their children the I.R.A.’s of moral behavior.  It's a good investment.  Parents can expect to receive good dividends.

Challenged

Many years ago, I met someone who was born deaf.  “Deaf” was the term of choice back then.  The hearing loss was profound and probably due to complications from maternal rubella.  Nevertheless, this person had learned to speak fluently and confidently.  And, she had graduated valedictorian, at the top of her professional class.

I had the opportunity to talk to her mother and ask how she had taught her daughter to speak.  Her mother first told me about the older and unimpaired sibling.  “With our first child, we had to repeat a sound four or five times.  With each repetition he took in more information, until he could accurately repeat what he had heard.”

“With our younger daughter it was different.  First, we had to recognize that something was wrong.  Once the proper diagnosis was made, we had to get her fit with the best hearing aids available.  Even with that, she had only one or two percent of normal hearing.  Then came the hard work.”

“Instead of repeating sounds five or six times, we had to repeat sounds 50 or 60 times.  But, if we did this enough, if we persevered, she too got enough information in to be able to imitate and repeat our words.”

This story is filled with important lessons that I shared with many patients and parents.  First, a problem must be recognized and acknowledged, then followed by a thorough evaluation.  Proper treatment begins after an accurate diagnosis is made.

I compared the hearing aid to medication.  The hearing aid was not a cure.  Often, neither is medicine, especially when prescribed for conditions like ADHD.  The hearing aid created a window of opportunity, an increased receptivity to sound.  It made learning sounds possible.  Like the hearing aid, ADHD medication is prescribed in order to create an increased opportunity for learning. If medication allows more information to get in, more efficiently, then more learning is possible.

I reminded parents that the hearing aid did not make the hearing perfect, but it helped.  Medication does not make things perfect, but often it helps.

I pointed out that had the mother tried to teach speech without the use of a hearing aid, all the hard work would have been for nothing.  But if there had only been the hearing aid, and not all the hard work and diligent teaching, nothing would have been gained.   I cautioned parents that medication is not the end point, only a beginning.  The hard work of diligent parenting and teaching must follow.

I encouraged patients and parents to remember that this young girl’s deafness was a daunting challenge, but it was never allowed to become her excuse.

November 22nd, 1963

November 22^nd,1963, my tenth birthday, was marked by two great occurrences, one of great historical significance, one of great personal significance. 

It was lunch hour at school.  I’d finished eating and was outside for recess.  My friend Paul lived nearby.  He’d gone home for lunch.  When he got back to school, he immediately looked for me on the playground.  He told me that President Kennedy had been shot. My initial reaction was disbelief. I told Paul that I didn’t appreciate his humor, especially on my birthday.  However, I soon realized he was not joking. Something serious had happened.  We returned to class.  The teacher was in tears.  A black and white television was set up for us to watch.  We heard that President Kennedy was dead.  We continued to watch the news quietly, until it was time to go home. 

If I recall correctly, this took place on a Friday afternoon.  I am told that memory is quite unreliable, yet my recollections from that day feel very real to me. 

I got home.  Our television set was on.  A birthday celebration had been planned, but my parents were unsure what to do.  We ended up going out for a birthday dinner.  I remember the restaurant being very quiet, the employees and customers very somber. A television set was on for all to watch.  After dinner, there was a muted celebration. Relatives came to the house, presents were opened, and birthday cake was served. 

The day Kennedy was assassinated marked the end of “Camelot”, a period of national optimism and innocence.  What followed was the tumult that characterized the remainder of the ‘60’s. 

November 22^nd, 1963 was also the day my parents gave me a microscope.  It was not a plastic toy microscope.  It was a Swift student microscope, the kind used in the high schools.  It came in a heavy locked wooden cabinet.  It was anchored to the cabinet by a bolt, so it couldn’t slide around and get damaged in transport.  It had built in illumination and could magnify up to 600X. 

Over the next months and years, I built a small laboratory in the basement.  I did some primitive dissections, mostly on insects and worms.  From my specimens I prepared some primitive slides.  However, my favorite ‘experiment’ was examining drops of pond water under the microscope to see otherwise unseen creatures; daphnia, paramecium, and amoeba. 

Around then, I read Microbe Hunters by Paul De Kruif.  I learned about Louis Pasteur and Robert Koch, scientists who used the microscope to discover killer bacteria, heroic discoveries that subsequently led to cures and the saving of countless lives.  These famous scientists became my inspiration.  As it turned out, the day I got my microscope marked the beginning of a personal journey, culminating in my medical degree. 

November 22^nd, 1963, was my tenth birthday. It was a day of great historical significance.  And it was a day of great personal significance.  I remember that day well.

Discipline

“True freedom is impossible without a mind made free by discipline.”  Mortimer Adler (1902—2001)

When children and adolescents came to the office with out-of-control behavior, it was rarely for lack of punishment.  Many had accumulated years and years of punishments.  They’d been spanked, grounded, and yelled at.  They’d lost privileges and had possessions taken away.  Some had even been to court, in juvenile detention or on probation.  Most of these youngsters were over-punished and all were under-disciplined.

Mistakenly, impulse-ridden acting-out children are often labelled ‘willful’ whereas it would be more accurate to label them ‘will-less.’  They are not making ‘bad choices.’  There is no act of decision making.  Without self-discipline they don’t stop to think and choose.  They react.  Like tapping on a knee, their behavior is reflexive, not reflective.

It is important to know the difference between discipline and punishment.  Discipline comes from the Latin root ‘Discipulus’ meaning pupil.  Discipline is process of teaching that emphasizes hard work, the practice of good habits over time, setting long-term goals, and accepting delayed gratification.

Take for example a child learning to play a musical instrument.  Discipline is the 15 or 20 minutes spent practicing every day, even when they’d rather being doing something else, even when it feels boring or hard.  It may feel like punishment, but it’s not.  At first the music sounds clunky.  Scales are no fun.  But stick with it for a few months and they begin to play some melodies.  Stick with it for a few years and they begin to play and create beautiful music.

Punishment is getting yelled at or grounded for not practicing.  Punishment gets you no closer to the goal of mastery.  Practice does.  Inevitably a parent asks, “What do I do if my child refuses to practice.”  I reply, as in the movie Apollo 13, “Failure is not an option.”  “If your expectations are clear, your child will practice.”  (By the way, it is estimated that 1,200 hours of practice are needed to become 'good' on the violin.  6,000 to 8,000 hours of practice are needed to become a concert violinist.)

There are important keys to raising a disciplined child.  It takes a caring and committed parent, willing to instruct and to model.  The parent must teach the value of delayed gratification and help their child to set long-term goals.  The parent must motivate, conveying the belief in their child’s capacity for ultimate success. 

Disciplined, a child learns to postpone immediate gratification for more distant goals.  Disciplined, a child acquires the self-confidence that comes from hard work and achievement. Disciplined, a child grows prepared to assume adult responsibilities to family and to community.  Disciplined, a child is prepared to face life’s trials and challenges with courage and with character.