Category Archives: Psychological

Dr Caroline Leaf – Serious questions, few answers (Part 2)

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Yesterday I published the first part of an essay discussing the presentation of Dr Caroline Leaf, Audiologist, Communication Pathologist, and self-titled cognitive neuroscientist, at Kings Christian Church, Gold Coast.

Tonight I want to continue dissecting some of the more pertinent statements that she made, including her view of the mind-brain connection, a smattering of smaller issues, her over-reliance on case studies, and her opinion on the cause and treatment of ADHD.

Tomorrow I will publish the last, and most important part of my essay – That Dr Leaf believes that ‘toxic’ thoughts are sinful, and why this single statement unravels her most fundamental premise.

THE MIND IS IN CHARGE OF THE BRAIN

A large part of her sermon was based on her next premise, that the mind changes the brain, and not the other way around. That is half true. The mind influences the brain, and how we think will have effects on neural pathways within the brain. But for a cognitive neuroscientist to state that the brain does not influence the mind is somewhat concerning.

There are several reasons why her assertion is deeply flawed. For starters, where else does the mind or thought come from other than our neural networks? Thought is built on our neural connections. To say that the brain does not influence thought is like saying that the foundation of a building doesn’t influence the bricks.

There are clinical reasons as well. These come from a few areas – firstly the research that showed that newborn babies (who do not have thought like we have thoughts) are pre-wired for emotions which are refined as we learn. There is no time for neonates to have enough stimulation to form those emotions and reactions if it was from our mind.

Secondly, people with brain injuries or tumours can have personality or mood changes. The most famous was a man in the 1800’s called Phineas Gage, who on 13 September 1848 was packing explosives into rock with a tamping iron (a long, tapered, smooth crow-bar). History says that the explosives sent the tamping iron through his left face and skull, taking a fair chunk of his frontal lobe with it. Depending on who you believe, Gage’s personality changed after his physical recovery, reportedly from a moral, respectful man into a cursing, angry one (Kihlstrom 2010). Some reports of his story were that Gage made an almost full recovery, but assuming that some of the historical record is true, changes to his brain changed his mental function, ie: his thoughts.

Further, I have personally seen two patients with personality changes secondary to brain tumours. The first was a woman in her late 20’s who had six months of worsening anxiety, who did not seek help despite my referrals, until she had a seizure and the diagnosis was made. Then there was the sad case of a girl in her pre-teens who had only two weeks of rapidly escalating sullenness then aggression then violence. Her parents initially thought she was moody, and when they brought her into the Emergency Department they thought she was perhaps in the middle of a psychotic episode. It turned out that she had a very aggressive tumour near her frontal lobe.

It is clear from these cases, and from a basic understanding of the concept of thought, that changes to the brain result in changes to thoughts and the mind, and vice versa.

SOME MISCELLANEOUS ISSUES

If I had the time I would like to look at many others issues that she raised, but this isn’t a book. Suffice it to say that she claimed that stress prunes our “thought trees” although the evidence is only in animal models and only related to severe stress (Karatsoreos and McEwen 2011). She also stated that EVERY thought we EVER have is stored in ALL of our cells (so some random fibroblast in my big toe is somehow affected by my thought about tonights dinner), and that ALL our thoughts are stored in our gametes (our sperm and eggs) and are passed down to our 4th generation (but packed, like in a metaphysical zip-lock bag, and only opened if we choose to have the same thoughts.) And here I was thinking that nurture had something to do with learned behaviour.

ASD/ADHD – MORE OPINION THAN FACT?

She also claimed that 55-70% of ASD/ADHD cases are over-referred and the problem is in educational modeling. This one made me mad.

Not even professorial level researchers know exactly what’s going on in ASD/ADHD, so her statement is a brave one to make, especially without referencing her evidence.

She then espoused the party line of ADHD ignorance – that Ritalin is evil and all you need to do is stop their sugar intake and feed them organic foods and give them supplements. Ritalin isn’t perfect, to be sure, but it is the most effective treatment that’s currently available. If dietary measures and educational measures were effective, then ritalin wouldn’t be prescribed. I have never met a parent that has wanted their child on ritalin. Most of them have tried educational/psychological measures or dietary controls first. The reason why ritalin is prescribed is because dietary and psychological interventions on their own do not adequately control the symptoms, or fail altogether.

To confirm that I’m not just having a rant, there is published scientific literature to back me up. In their recently published meta-analysis, Nigg et al (2012) state, “An estimated 8% of children with ADHD may have symptoms related to synthetic food colors.” Eight percent. That’s all! That’s ninty-two percent of children with ADHD (real ADHD, not just rambunctious children with lots of energy) DID NOT have symptoms due to food colourings. Their conclusions: “A restriction diet benefits some children with ADHD. Effects of food colors were notable but susceptible to publication bias or were derived from small, nongeneralizable samples.” In terms of sugar, Kim and Chang (2011) note that, “children who consumed less sugar from fruit snacks or whose vitamin C intake was less than RI was at increased risks for ADHD (P < 0.05).” (emphasis added) The study was only of about 100 children, but the result was statistically significant. It wasn’t a chance effect.

The misinformation she stated as fact from the pulpit promotes scare-mongering and ignorance throughout the church, which has flow on effects. Church members with children with ADHD or ASD will avoid standard medical treatment on Dr Leaf’s advice. When her treatments fail in the majority of cases, those parents will either live with unnecessarily heightened stress because of their child’s poorly controlled condition, or the guilt of using ritalin, all the while believing that they are ruining their childs brain.

This also places the hosting church in a bind. Do they stand behind their guest speaker, or do they support the advice of the medical community? Is their duty of care to the reputation of the guest speaker or to the congregation under their protection? What would happen if Dr Leaf’s advice lead to the death or disability of a person in their congregation? Would they be libel?

CASE STUDIES – INSPIRATIONAL STORIES, BUT POOR SCIENTIFIC EVIDENCE

Dr Leaf also told a lot of stories of how everyone afflicted came to her and how she healed them all. If you took her at face value, she would have you believe that people with ASD, ADHD, anorexia, OCD, depression etc, just needed a glimpse of their self-worth and their inner gift and they would be cured. While her stories were inspirational, the world of scientific research demands more. If Dr Leaf’s insights are worth more than the hot air she produces when espousing them, then they should be put to the wider research community so they can pass through the fire of peer review. If peer review prove her insights to be valid, I would be happy to apply them and promote them.

Tomorrow, I will publish the last, and probably the most important part of my essay – that Dr Leaf believes that ‘toxic’ thoughts are sinful, and why this single statement unravels her most fundamental premise.

REFERENCES

Crum, A. J., P. Salovey and S. Achor (2013). “Rethinking stress: the role of mindsets in determining the stress response.” J Pers Soc Psychol 104(4): 716-733.

Karatsoreos, I. N. and B. S. McEwen (2011). “Psychobiological allostasis: resistance, resilience and vulnerability.” Trends Cogn Sci 15(12): 576-584.

Kihlstrom, J. F. (2010). “Social neuroscience: The footprints of Phineas Gage.” Social Cognition 28: 757-782.

Kim, Y. and H. Chang (2011). “Correlation between attention deficit hyperactivity disorder and sugar consumption, quality of diet, and dietary behavior in school children.” Nutr Res Pract 5(3): 236-245.

Leaf, C. (2009). Who Switched Off My Brain? Controlling toxic thoughts and emotions. Southlake, TX, USA, Inprov, Ltd.

Nigg, J. T., K. Lewis, T. Edinger and M. Falk (2012). “Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives.” J Am Acad Child Adolesc Psychiatry 51(1): 86-97 e88.

Dr Caroline Leaf – Serious questions, few answers (Part 1)

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Caroline Leaf. The name is popping up more and more around Christian circles. I was curious to hear her speak, since as a Christian and a (family) physician, I like to know how people integrate science and spirituality. So I took the opportunity to drive down to Kings Christian Church on the Gold Coast to hear what she had to say.

I left with more questions than answers.  And some serious concerns.

The following blog posts are a discussion on some of the points that she raised. I simply don’t have the time to go through all of them, although I’m seriously considering whether to do a formal review and response to her teaching.

I had to divide up the original post into three parts to make it more manageable. Here’s part 1, in which I review her academic qualifications, her link of thoughts and illness, our innate wiring, and the myth of the mini-brain.

Part 2 of this post will look further at the pecking order of the mind and brain, some miscellaneous issues, and her ‘professional’ opinion on ADHD.

Part 3 will examine her claim that “Toxic thoughts are sin” and why such a statement is incongruent with the Christian faith.

IS SHE A COGNITIVE NEUROSCIENTIST?

For a start, she was introduced as a cognitive neuroscientist. Her CV lists her degrees as a Bachelor of Science, Masters in Speech Therapy and Audiology, and a PhD in Communication Pathology. She did not advise where she has tenure or does her research. Her CV lists guest lectures at a few Universities (Wits, University of Pretoria, University of Cape Town, University of Western Cape Annual Education Conference, SASHLA, Rotary Foundation), but no tenure.

Admittedly, the definition of a cognitive neuroscientist is somewhat vague (http://careersinpsychology.org/becoming-a-cognitive-neuroscientist/) but the term ‘cognitive neuroscientist’ confers the idea that one is actively involved in cognitive neuroscientific research, or at least in the recent past.

So the question remains: is she really a cognitive neuroscientist, or is she just a woman with a PhD that reads a lot?

THE CORRELATION OF ILLNESS AND THOUGHT

The next thing to grab my attention was her statement: “75 to 98% of ALL illness is related to our thought life.” Somehow I doubt that. The influence of stress is high.  But I am a GP – I see sick people everyday, on the coal face, before they are collected in subspecialist clinics, or improve spontaneously. It’s a real stretch to ascribe stress to more than 30%. Looking at her book ‘Who Switched Off My Brain’ (Leaf 2009, p15), she says that 80% of all diseases are the result of our thought lives. So her own figures are conflicting. (The other thing is that, for a PhD recipient, she has poorly referenced her book!)

Besides, stress causes illness, but I’m not yet satisfied she’s proven that ‘negative’ thought and stress are the same thing.

THE MINI-BRAIN

She also claimed that the brain and the heart connect to every cell in your body. Again, it’s a bit of a stretch. Every cell needs to be bathed in nutrients from the blood which in turn is connected to the heart, and nerves are every where.  But there are many cells that are not innervated directly.

The only way that the brain or the heart are connected to every cell is simply because, technically, every cell is connected to every other cell. Like if everyone in a church stood up and held hands, the man in the front row would be “connected” to the woman in the back.

But she went further on her theory, by claiming that the heart has a mini-brain that directly influences the real brain – by making moral decisions on its own, and that it is part of our conscience. She justified her statement by saying that the heart has 40,000 interconnected nerve cells, and the heart is directly connected to the brain. But on that same logic, my rectum could be a mini-brain and be part of my conscience.

She alluded to the effect of ANF, atrial natriuretic factor. There are actually three natriuretic peptides. ANF, produced by the top two chambers of the heart, actually regulates blood pressure (http://www.cvphysiology.com/Blood%20Pressure/BP017.htm). If it has an effect on thought, it is secondary, not primary.

WIRED FOR OPTIMISM?

She also states that we are wired for optimism, and that emotions like fear are learned. That doesn’t make sense since I have seen research that shows a newborn baby is wired for pleasure and emotions like disgust. These pathways are developed and refined during childhood, but we are born with built-in templates for basic emotion.

I will have more in the next 24 hours, including her statement on the pecking order of the mind and brain, some miscellaneous issues, and her ‘professional’ opinion on ADHD.

REFERENCES

Leaf, C. (2009). Who Switched Off My Brain? Controlling toxic thoughts and emotions. Southlake, TX, USA, Inprov, Ltd.

Fear: Friend or Foe?

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Fear.  Should we run, fight, or think?

I was lazily wasting time at Zarraffas this afternoon, and while I was savouring the richness and depth of my triple masai mocha, I was filling the time by flicking through Facebook.

I came upon a blog post by one of the best thinkers and writers I’m personally acquainted with, one Ruth Limkin, who shared the story of how she was given an opportunity to snorkel in a pristine area of ocean in the South Pacific that is limited to only a handful of people, such is the fragile beauty of the ecosystem there.  As she started swimming into the warm, calm, azure waters, she felt this sudden dread.

Five years ago in a similar situation, she misjudged the current, was swept into some coral, and sustained a laceration to her knee.  This left a lot of blood in the water which, quite reasonably, made her think that she had suddenly become shark bait.  She made it back to shore otherwise unscathed. But it left her with the implicit memory of that event.

This year, despite the obviously calm surroundings, she recalled that fear. Her brain told her to get out of there.  She did manage to overcome her fear though, and enjoyed the snorkelling!

Her lesson was that the pain of yesterday can become todays fear, which robs tomorrow of its promise.

I don’t disagree with Ruth.  I’m not intelligent enough to do that.  But I guess I come from a more medical and analytical perspective of this phenomenon, and I wanted to flesh out her point a bit further.

We all feel it at sometime or another – your heart pounds faster and heavier in your chest. Your breathing gets faster. Your muscles tighten. And your brain either says, “Run” or “Fight”, or sometimes it says nothing at all and we simply freeze up.

The human fear response is both rational and irrational.  We usually don’t understand why we are faced with conflicting realities of internal anxiety and external tranquility, feeling scared while looking at calm clear waters.  Sometimes when we take a step back, we can gain some understanding of why we have reacted the way we did, and cognitively overcome our fear.

B-grade pop-psychologists make us believe that courage is the absence of fear, and that the way to move forward is to eliminate or repress your fears.  But that approach is wrong for a couple of reasons.

There is a good reason why we have fear conditioning.  There is a part of the brain called the limbic system, which is integral to emotional processing.  Central to this is the amygdala, which is responsible for adding emotions to our experiences, especially fear and anger.  When something happens that has real or perceived negative consequences (we experience pain, or we think that there is a high chance that we will experience pain) the amygdala pairs that aversive sensation with the memory of the total experience.  This helps us learn from our mistakes [1].

For example, if a pre-historic man was walking through a forest and came across a sabre-toothed tiger, the fight-or-flight response would help him escape.  But the amygdala would attach the memory of the emotion to the memory of the event itself.  Next time the man walked through a similar forest, or even recalled that event in his mind, the emotion of the memory would also be recalled.  This is why Ruth felt uneasy despite the lack of danger.  Her surroundings triggered the emotional memory of the previous snorkelling experience.

But while unpleasant, fear does confer a survival advantage.  Without the same emotion being recalled, we wouldn’t remember what situations were dangerous and which were safe.  Recalling the emotion and realising there may be sabre-toothed tigers around, or strong currents and sharks, means that there is a much smaller chance of us becoming lunch.

There are two pathways in the brain that are involved in the fear response.  The direct pathway goes from the senses to the amygdala, bypassing the thinking parts of our brain entirely.  Again, this confers a survival advantage as the quicker you can prepare yourself for danger, the more likely you are to survive it.  The signal is not properly analysed, but it doesn’t need to be.  It is better to be wrong and live than to be right and eaten by something.

The second pathway from the senses to the cerebral cortex then back to the amygdala is more precise, but it is slower than the direct path.  It can downgrade the fear response if it is not appropriate.  Well, it can in most people.  Anxiety and panic disorders arise when the balance between the direct and indirect pathways is skewed in the direction of the amygdala.

If you think you may have an anxiety disorder or panic disorder, you should see a good GP.  There are specific forms of psychological therapy that you may need to engage with.  Some people also need medications to assist with the process.

For most people though, we can simply allow the recalled feeling of fear stop us from engaging in life.  When we sense fear, the natural reaction is to run or fight.  That is the direct pathway talking in our brain. The lesson from our neurobiology is that we have another choice.  We can let our cerebral cortex do its job, we can think about the situation, and allow our higher functions to downgrade our primitive reactions.

We also need to understand that fear is ok.  It is necessary, in fact.  Without it, we wouldn’t adapt to our surroundings or learn from our mistakes.  We should not avoid fear.  We should not fight fear.  But we should not let fear control us.

Nelson Mandela, a man who experienced great fear but greater hope, sums it up beautifully, and so gets the final word, “Courage is not the absence of fear, but the triumph over it.”

References
[1] Dalgleish, T., The emotional brain. Nat Rev Neurosci, 2004. 5(7): p. 583-9.