All in a tangle – Dr Caroline Leaf tries to explain Alzheimer disease

Posted on July 21, 2019 by cedwardpitt

In her latest blog post, Dr Caroline Leaf attempted to tackle the complex topic of Alzheimer disease.

Alzheimer disease is an important topic. It’s the most common progressive neurodegenerative disease worldwide and accounts for 60 to 80% of dementia cases. It causes a spectrum of memory impairment from forgetting where the car keys are through to forgetting to eat or drink. According to the 2018 report by the Alzheimer’s Association, an estimated 5.7 million Americans are diagnosed with Alzheimer dementia, costing their economy $277 billion in 2018 [1]. That’s a staggering economic cost, but the human cost is higher. Alzheimer’s exacts a great emotional toll on someone’s family and friends, both in terms of carer stress, and in seeing the person they love gradually slip away as the disease slowly erodes their personality until there’s nothing left.

There are two main forms of Alzheimer disease, an early onset type which accounts for about 5% cases, and a late onset type which accounts for the rest. Early onset Alzheimer disease occurs before the age of 65. It’s also called Familial Alzheimer disease because it’s caused by one of three autosomal dominant genes (if you have a copy of the gene, then you will get the disease). Late onset Alzheimer disease, as the name suggests, occurs late, after the age of 65. It’s more complex and is associated with a mix of both genetic, lifestyle and environmental risk factors.

The neurobiology of Alzheimer disease is complicated. Essentially, the symptoms of Alzheimer disease result from the death of too many nerve cells in the parts of the brain that manage memory and planning, but scientists are still trying to establish exactly why the nerve cells die. There are a number of pieces of the jigsaw already in place.

For example, scientists know that amyloid plaques and neurofibrilliary tangles are part of the disease process. These result from genetic changes to a number of enzymes which are critical to the nerve cells maintaining their structural integrity. It was first thought that these particular cell changes were critical factors to the nerve cells dying, but there are a number of other contributing factors that are also involved, such as changes to the metabolism of the nerve cells [2], inflammation of the brain, changes in the brain’s immune function, and changes to nerve cell responses to insult or injury (technically, endocytosis and apotosis, just in case you were wondering)[3].

In fact, it may be that the plaques and tangles are not the cause of the damage but are simply present while the other causes such as neuro-inflammation are doing all of the damage in the background. This is possible as there are a small group of people that have cellular changes of plaques and tangles, but who do not have the clinical signs of dementia. This was one of the discoveries in the Nun Study. We’ll talk more about the Nun Study later in the post.

Whether it’s the plaques and tangles doing the damage or not, most of these changes are happening well and truly before a person ever shows any symptoms. In fact, by the time a person has some mild cognitive impairment, the plaques have reached their maximum level and the tangles are close behind. This makes Alzheimer disease clinically challenging. It would be ideal if we could start treatment early in the course of the disease before the damage has been established, but right now, the fact is that by the time a person is showing signs of memory loss, the damage to the cells is already done.

This begs the question, can we reduce our risk of Alzheimer disease? There’s no good treatment for it, and even if there was, prevention is always better that cure. So what causes Alzheimer disease in the first place?

There are a number of factors which contribute to the development of Alzheimer disease, some of which we can change, but some of which we can’t.

Unmodifiable Risk Factors

Aging

Aging is the greatest risk factor for late onset Alzheimer disease. The older you get, the more likely you are to get the disease. Statistically, late onset Alzheimer disease will affect 3% of people between the ages 65–74, 17% of people aged 75–84 and 32% of people that are aged 85 years or older [1].

That’s not to say that Alzheimer disease and normal aging are the same. Everything shrinks and shrivels as you get older and the brain is no exception. And it’s true that Alzheimer disease and normal aging share some similarities in the parts of the brain most affected. However, these occur much more rapidly in Alzheimer disease compared to normal aging [4].

So, while aging is a necessary and significant risk factor for late onset Alzheimer disease, aging alone is not sufficient to cause Alzheimer disease.

Also, normal aging of the brain is not dementia. And forgetting things is not dementia. Everyone forgets things. My teenage children forget lots of things I tell them. They don’t have dementia. Getting old doesn’t mean getting senile. Some elderly people remain as sharp as a tack until the rest of their body gives up on them.

Genetics

There are a number of genes which have been associated with Alzheimer disease.

As I alluded to earlier, early onset Alzheimer disease is strongly hereditary, with three different autosomal dominant genes that lead to its development. They are known as APP, PSEN1and PSEN2genes[5]. The APPgene encodes for a protein is sequentially cleaved into peptides which then aggregate and form amyloid plaques. PSEN1and PSEN2encode subunits of one of the enzymes which breaks up the amyloid protein. Then there is a problem with one of the genes, the breakdown of the amyloid proteins is limited and the amyloid plaques start to accumulate at a much earlier age.

For late onset Alzheimer disease, there are 21 associated gene variants which are either splice variants, or single nucleotide polymorphisms (SNPs), and while they don’t cause Alzheimer disease, they increase the risk when they interact with other risk factors. Each of the genes is important to one of the five main biological processes that influence the cellular structure and function of nerve cells.

(taken from Eid A, Mhatre I, Richardson JR. Gene-environment interactions in Alzheimer’s disease: A potential path to precision medicine. Pharmacol Ther. 2019;199:173-87)

The risk that any of these genes confers for developing Alzheimer disease is ultimately dependent on other risk factors, but one of the most well-known of the genes related to Alzheimer disease is the gene APOE4. Apolipoprotein (APO) is a lipid carrier and is significantly involved in cholesterol metabolism. In humans, it’s expressed as either E2, E3 or E4 variants. The E4 variant has a much lower affinity for lipoproteins than its siblings, and if you have the APOE4, you have much poorer cholesterol metabolism – in your liver cells and in your brain cells. Again, this fact may not seem important now but it will be more important later in the post.

If you inherit a copy of the APOE4 gene from your mother and your father, you have an 8 – 12 times greater risk of developing Alzheimer disease than another person without both copies of the gene.

Family history

So if there are genes that can send your risk of Alzheimer disease through the roof, then it follows that having a family history of Alzheimer disease is a risk factor.

Individuals who have a first-degree relative, such as a parent, brother or sister who was diagnosed with Alzheimer disease are predisposed to develop the disease with a 4–10 times increased risk, compared to individuals who do not [6].

Of course, family history is not all to do with genetic risk factors, but it’s usually a combination of both genetics and share home environment between parents and siblings, hence why the risk conferred is not as high as APOE4, but is still very high.

Ethnicity

Early studies suggested that Alzheimer disease was more common in certain races, although the thought was that the risk was related to social and economic conditions common to those races, and not to specific genes.

Recently, better genetic studies have linked a few genes with some races. For example, there is a link with genes such as APOE4 which is twice as likely in African-American’s than other races, or a higher rate of mutations in the CLU gene amongst Caucasians [7].

Gender

There is a strong gender difference for Alzheimer disease. Overall, women are twice as likely to develop Alzheimer disease than men are.

There are a few possible reasons why this might be so. Inflammatory mechanisms might play a part, as does the function of the part of the cell called mitochondria. Hormonal differences might make some differences as well, specifically in relation to the oestrogen or the cell receptors for oestrogen.

There are also some gender differences in the way other genes play out. For example, it’s known that women with the APOE4 gene will experience a faster cognitive decline than men with the same gene [8]. Sorry ladies.

Modifiable Risk Factors

So whether we like it or not, there are some risk factors for Alzheimer disease that we can’t change. We can’t change our genes, our race, or our gender. We can’t get any younger either.

What about the risk factors for Alzheimer disease that we might be able to change?

Education

There’s some correlation between how much education someone has had and their risk of Alzheimer disease.

A meta-analysis by Larsson and colleagues which examined studies through to mid 2014 reported a statistical association of low education attainment (less than or equivalent to primary school) and increased Alzheimer disease risk. For those with a primary education or lower, the risk of Alzheimer disease was 41 to 60 percent higher compared to someone who had better than primary school. In a separate study, those who completed higher education (university level or above) had a lower risk of Alzheimer disease compared to those without higher education – approximately 11 percent per year of completed university level education [9]. There is some evidence that Alzheimer disease patients with higher education have a bigger part of the brain related to memory which is thought to be protective (if you have a bigger memory part of the brain, it will take longer to shrink in Alzheimer’s).

Two points to think about here. First, these studies are not demonstrating cause and effect. They don’t definitely prove that learning more stuff protects you from Alzheimer disease. The statistics could simply reflect that people with the ability to learn more information had more robust nerve cells and connections to start with.

Also, while a 60 percent increase in risk sounds high, remember that the APOE4 gene carries a 1200 percent increased risk. Comparatively speaking, the effect of education is actually quite small compared to other risk factors.

Metabolic factors

Remember how we talked before about cholesterol and the APOE4 variants? If you have both copies of the APOE4 gene, your liver cells and your brain cells aren’t good at handling lipoproteins.

Your liver cells are important in regulating your blood cholesterol. Your brain cells are important for handling the amyloid proteins and lipids for making new nerve cell branches.

With APOE4, the liver doesn’t handle the blood cholesterol properly and you end up with high cholesterol and cholesterol plaques in the coronary arteries. When the brain cells don’t handle cholesterol properly, there is an increase in plaques and tangles and neuro-inflammation which increases the risk of Alzheimer disease.

At one stage, researchers thought that having a higher blood cholesterol was linked to Alzheimer disease but further research has shown that the results are inconsistent – some studies show a link while others show no link at all. So all in all, there’s probably no cause and effect relationship with cholesterol and Alzheimer disease. In fact, there’s some suggestion that high cholesterol is not a causative factor, but rather the result of Alzheimer disease [10] or simply a correlation, related to an underlying genetic or metabolic disorder which is common to both conditions.

Blood sugar was also considered to be a key factor for Alzheimer disease. The Rotterdam Study conducted in the 1990s linked diabetes to Alzheimer disease [11], while a more recent nationwide population-based study in Taiwan showed that there was a higher incidence of dementia in diabetic patients [12].

While it may be that high blood sugar leads to Alzheimer disease, more recent research has suggested that there is a two-way interaction between Alzheimer disease and diabetes – diabetes increases the risk of Alzheimer disease, but Alzheimer disease increases the risk of diabetes. Other scientists have recognised that there is a metabolic disease with overlapping molecular mechanisms shared between diabetes and Alzheimer disease. These molecular mechanisms relate to less total insulin and higher insulin resistance, a mix of the pathologies seen in type 1 and type 2 diabetes – hence why one scientist called the underlying metabolic disorder “type 3 diabetes” [13].

So while cholesterol and blood sugar are linked to Alzheimer disease, it’s not clear whether aggressively lowering them would decrease the risk of Alzheimer disease or not.

Lifestyle choices (food and exercise)

If it’s not clear how much our metabolic factors have on our Alzheimer disease risk, what about the food we eat?

There’s some evidence that having a healthy lifestyle reduces the risk of Alzheimer disease, but it’s not known what factors of lifestyle are the most important. There was a study done on residents of New York City, and those who had a strict adherence to a Mediterranean diet and who participated in physical activity decreased their Alzheimer disease risk by about 35 percent [14]. That’s promising, but while there have been lots of studies into various aspects of diet and Alzheimer disease, it’s not clear what exactly works and why [15].

We can’t dismiss lifestyle changes, but more research is needed.

Others

Smoking and alcohol are usually implicated in everything bad, and one would expect that their role in Alzheimer disease would be the same. So it surprised everyone when one meta-analysis declared that smoking had a protective effect on Alzheimer disease.

The result sounded too good to be true and it probably is. It’s likely that either smoking killed off all of the weaker people and only left those “healthier” smokers for the study population, or that smokers would have gotten Alzheimer disease had it not been for the fact that the smoking simply killed them off first.

Moral of the story – don’t take up smoking in the hope it will protect you from Alzheimer disease. Even if it did, the lung cancer and emphysema will get you first.

Alcohol, on the other hand, was fairly neutral in broad population studies. That may be because the benefits of a small amount of wine drinking were being averaged out by the harmful effects of drinking too much hard liquor. When the amount and type of alcohol drunk was separated out, there’s some evidence that a little bit of wine infrequently is somewhat preventative of Alzheimer disease [16].

Air pollution is a potential risk factor for Alzheimer disease. It’s thought that the high exposure to chemicals and particulate matter in the air increases neuro-inflammation and death of the nerve cells leading to Alzheimer disease. In a case-control study in Taiwan, individuals with the highest exposure to air pollution had a 2 to 4-fold increased risk in developing Alzheimer disease [17].

There are similar concerns about the risk of pesticide exposure and Alzheimer disease, although there are often a lot more confounders within the research itself, which makes the associations somewhat weaker. Still, evidence is generally supportive of a link between pesticide exposure and the development of Alzheimer disease.

Risk factors – what can we learn?

In summary, there are a lot of different risk factors which are involved in Alzheimer disease, some of which can be influenced, and some which cannot.

Alzheimer disease is not a homogeneous disease that can be treated with one specific drug, but rather AD presents as a spectrum, with complex interactions between genetic, lifestyle and environmental factors. So to really understand a person’s risk for Alzheimer disease, the interactions of these risk factors need to be understood which actually makes things exponentially harder.

That means that anyone telling you to eat this, or learn that, or do my program to reduce the risk of Alzheimer disease clearly doesn’t understand just how complicated Alzheimer disease is and has oversimplified things way too much.

Which brings us back to Dr Leaf and her blog.

I was surprised that Dr Leaf even tried to broach the subject of Alzheimer disease, because diseases like Alzheimers disprove her most fundamental assumption. Dr Leaf has always taught that the mind is separate to the brain and is in control of the brain. But if that were the case, the brain changes in Alzheimer disease would make no difference to a person’s cognition and memory. Yet Dr Leaf admits throughout the entire post that the brain changes in Alzheimer disease do cause changes in the mind.

Dr Leaf can’t have it both ways. Real cognitive neuroscientists don’t constantly contradict themselves, tripping themselves up on the most fundamental of all facts. Dr Leaf needs to correct her most fundamental of all her assumptions and admit that the mind is a product of the physical brain and does not control the brain.

Dr Leaf also needs to stop exaggerating her “research and clinical experience”. She’s quick to point over every time she opens her mouth that she has decades of research and clinical experience, but such repeated and unjustified exaggeration is just another form of lying. Her research was an outdated and irrelevant PhD in the late 1990’s, based on a theory which she tested on school children. Her limited clinical experience was as a therapist for children with acquired brain injuries.

Alzheimer disease affects the other end of the age spectrum and has nothing to do with acquired brain injury. It is the absolute polar opposite of Dr Leaf’s already limited research and clinical experience. Dr Leaf is like an Eskimo trying to build an igloo in the Sahara.

Dr Leaf’s credibility on the subject quickly evaporates with her introductory caution:

Before we go into too much detail, I want to remind you that our expectations can change the nature of our biology, including our brains! Indeed, recent research suggests just fearing that you will get Alzheimer’s can potentially increase your chance of getting it by up to 60%.

Dr Leaf doesn’t offer any proof that “Our expectations change the nature of our biology” but she does allude to “recent research” which suggests that “just fearing that you will get Alzheimer’s can potentially increase your chance of getting it by up to 60%”. She doesn’t reference that either. She could be referring to the research from Yale which she alludes to later in her post, although that research by Levy and colleagues didn’t mention anything about the risk of Alzheimer disease increasing by 60 percent [18]. In fact, given certain methodological weaknesses, it didn’t conclusively prove that negative beliefs about aging did anything to the brain, but that’s a topic for another day.

Dr Leaf made several attempts throughout the rest of the blog to portray Alzheimer disease as a disease related to toxic thoughts and poor lifestyle choices. For example:

There is now a growing body of research that approaches the question of Alzheimer’s and the dementias as a preventable lifestyle disease, rather than a genetic or biological fault. More and more scientists are looking at Alzheimer’s and the dementias as the result of a combination of factors, including how toxic stress and trauma are managed, the quality of someone’s thought life, individual diets and exercise, how we can be exposed to certain chemicals and toxic substances, the impact of former head injuries, and the effect of certain medications.

That statement is just a big furphy. Yes, Alzheimer disease is the result of a complex interaction of genes and environmental factors. Yes, there is some evidence looking at the interactions of diet and exercise, environmental exposures and former head injuries (although there’s very mixed evidence for the role of brain trauma in Alzheimer disease. It’s not clear cut [19]). But there is no ‘growing body of research’ that claims Alzheimer disease is not strongly genetic or biological, and there’s certainly no real scientist dumb enough to call Alzheimers a “preventable lifestyle disease”.

The evidence is pretty clear, that there are very strong genetic factors for developing Alzheimer disease. Yes, some of them can be modified by environmental factors, but it’s foolhardy to claim that Alzheimer disease can be entirely prevented, based on the current evidence I outlined earlier. Dr Leaf is rushing in where angels fear to tread.

Dr Leaf’s baseless exaggerations don’t stop there.

It is therefore unsurprising that professor Stuart Hammerhoff of Arizona University, who has done groundbreaking research on consciousness and memory, argues that the kind of thinking and resultant memories we build impacts our cell division and can contribute to the development of Alzheimer’s and the dementias.

Dr Leaf includes a hyperlink which when clicked, takes you to this article: https://www.theglobeandmail.com/life/health-and-fitness/health/conditions/new-theory-targets-different-origins-of-alzheimers/article4210442/.

It’s not a scientific paper, but a newspaper article which is more than seven years old. The only thing it says about Professor Stuart Hameroff is this:

One of the co-authors, Stuart Hameroff at the Center for Consciousness Studies at the University of Arizona, has argued that microtubules may also be involved in consciousness.

That’s it. There’s nothing else in the article about Prof Hameroff at all, nothing to back up Dr Leaf’s wild claim that our thinking and our memories alters cell division and contributes to the development of Alzheimers and dementia. Dr Leaf is just confabulating.

Dr Leaf also claims that:

One of the many studies that have come out of this research, done by the Buck Institute for Research on Aging, showed dramatic improvement in patients diagnosed with Alzheimer’s and the dementias when they were put on an individualized lifestyle-based program that includes diet, exercise and learning.

Again, that’s a gross exaggeration. The “research” that Dr Leaf is alluding to is a paper written by Bredesen [20]. It’s a narrative paper which describes a total of ten cases. That’s it – just ten cases. That’s nowhere near enough information to draw even the weakest of conclusions, but it gets worse. The paper only gives a formal description of three patients and their treatments, the rest were listed in a table. So there is even less data to draw any definitive conclusions from. The other serious weaknesses of the paper were that the patients self-identified, and most of them didn’t have dementia at all, but instead had “amnestic mild cognitive impairment” or “subjective cognitive impairment”. In other words, they were a little forgetful, or they only thought they were forgetful. The one subject that did have Alzheimer disease continued to rapidly deteriorate in spite of the program.

If you took Dr Leaf at her word, you would think that this treatment program was working miracles and clearly proved that Alzheimer disease could be cured by lifestyle treatment. The study showed anything but.

Again, Dr Leaf is proving herself untrustworthy – either she knew that the study failed to demonstrate significant results and she was deliberately deceptive, or she didn’t understand that the results of the study were not conclusive, in which case she’s too ignorant to be treated as an expert.

In the same vein, Dr Leaf writes:

Another famous study, known as the “Nun Study,” followed a number of nuns over several years, showing that, although extensive Alzheimer’s markers were seen in their brains during autopsy (namely neurofibrillary plaques and tangles), none of them showed the symptoms of Alzheimer’s and the dementias in their lifetime. These nuns led lifestyles that focused on disciplined and detoxed thought lives, extensive learning to build their cognitive reserves, helping others and healthy diet and exercise, which helped keep their minds healthy even as their brains aged!

The hyperlink that Dr Leaf included was to a Wikipedia page which again, said nothing about the nuns who were apparently impervious to the effects of Alzheimers. It did say that

Researchers have also accessed the convent archive to review documents amassed throughout the lives of the nuns in the study. Among the documents reviewed were autobiographical essays that had been written by the nuns upon joining the sisterhood; upon review, it was found that an essay’s lack of linguistic density (e.g., complexity, vivacity, fluency) functioned as a significant predictor of its author’s risk for developing Alzheimer’s disease in old age. The approximate mean age of the nuns at the time of writing was merely 22 years. Roughly 80% of nuns whose writing was measured as lacking in linguistic density went on to develop Alzheimer’s disease in old age; meanwhile, of those whose writing was not lacking, only 10% later developed the disease.

As it turns out, lots of nuns did end up with dementia after all … well that’s awkward – the page that Dr Leaf used to try and support her argument actually directly contradicted her.

Wikipedia’s entry was supported by the original journal article in the research from Riley et al [21]. And after a bit of gentle trawling of the scientific literature, I also found this article from Latimer and colleagues which said, “Interestingly, our results show very similar rates of apparent cognitive resilience (5% in the HAAS and 7% in the Nun Study) to high level neuropathologic changes” [22].

So, sure, some nuns did indeed have some plaques and tangles without showing signs of the disease, but not 100 percent of them as Dr Leaf tried to make out. In reality, it was only 7 percent of them! And given what we know from the current research, plaques and tangles often precede clinical symptoms, so it may be that the nuns in question were on their way to cognitive impairment, but they hadn’t quite made it. Who knows. One thing’s for sure, the “lifestyles that focused on disciplined and detoxed thought lives” didn’t stop dementia affecting most of the nuns in the study.

Dr Leaf finishes off her post with what she thinks will help prevent Alzheimer disease. Given that she clearly doesn’t understand Alzheimer disease, we need to take what she advises with a large dose of salt. Let’s look at what Dr Leaf suggested and see if it lines up with actual research.

Research shows that education, literacy, regular engagement in mentally-stimulating activities and so on results in an abundance of and flexibility in these neural connections, which help us build up and strengthen our cognitive reserves and protect our brain against the onset of Alzheimer’s and the dementias.
Like everything in life, the more you use your ability to think, the more you get better at it and the stronger your brain gets!

Rating: Half-true

Education has a small positive benefit, but the research isn’t clear if that’s cause or correlation. So yes, stimulate your brain and see what happens. It might not help stave off Alzheimer disease, but at least it will make the journey interesting it nothing else.

What else can you do to prevent Alzheimer’s and the dementias, or help someone already suffering cognitive decline?
1. Detoxing the brain:
I have written extensively about the importance of detoxing the brain by dealing with our thought life in a deliberate and intentional way. Our minds and brains are simply not designed to keep toxic habits and toxic trauma; we are designed to process and deal with issues. If, however, we suppress our problems, over time our genome can become damaged, which will increase the potential for cognitive decline as we age. This is why it is important to build up a strong cognitive reserves AND live a “detoxing lifestyle”, which essentially means that you make examining and detoxing your thoughts and emotions a daily habit. We want to have good stuff in our brain, yes, but we don’t want the neurochemical chaos of a bad thought life affecting our healthy cognitive reserves!

Rating: BS (“Bad Science”)

This is Dr Leaf’s favourite pseudoscientific claptrap, her neurolinguistic-programming-voodoo-nonsense that has no scientific basis whatsoever. Skip it and move on.

2. Social connections:
Intentionally developing deep meaningful relationships can help build up our cognitive reserves against Alzheimer’s and the dementias – our brains are designed to socialize! Loneliness and social isolation, on the other hand, can seriously impact the health of our brains, making us vulnerable to all sorts of diseases, including ones associated with cognitive decline and the dementias …

Rating: Half-true

Loneliness has deleterious effects on health, but there’s nothing in the research to suggest that loneliness is a risk factor for Alzheimer disease. Like we discussed about education and mental stimulation before, I think you should make friends and enhance your social connections. There’s no guarantee that it will make any difference to your risk of Alzheimer disease, but it will make things fun and interesting at least.

3. Sleep:
Dr. Lisa Genova, a neuroscientist, wrote the book Still Alice (this was also made into a movie), which describes the impact of the early onset of Alzheimer’s. She believes that buildup of plaques and tangles associated with Alzheimer’s can be averted, since it takes about 10 to 20 years before a tipping point is reached and cognitive decline becomes symptomatic. We all build plaques and tangles, but it takes at least a decade for them to actually affect our ability to remember, so there is hope!
There are things we can do to prevent this buildup, and sleep is an important one. During a slow-wave, deep sleep cycle, the glial cells rinse cerebrospinal fluid throughout our brains, which clears away a lot of the metabolic waste that accumulates during the day, including amyloid beta associated with the dementias. Bad sleeping patterns, however, can cause the amyloid beta to pile up and affect our memory. Essentially, sleep is like a deep cleanse for the brain!

Rating: What?

Dr Leaf’s advice here isn’t necessarily BS, it’s just plain confusing as she takes two unrelated chunks of information and tries to conflate them.

I don’t know if Dr Lisa Genova is a neuroscientist, or if she thinks the build-up of plaques and tangles can be averted or not. The science as I outlined earlier in the post shows that the rise in plaques and tangles predate clinical symptoms, so you don’t know if you have them or not. If that’s the case, how can you hope to reverse them. Science is working on it, but it’s not there yet.

Irrespective, Dr Leaf doesn’t present any evidence to support her statement that sleep clears amyloid proteins. And neither is there any evidence that sleep has a significant impact on the development of Alzheimer disease.

I think it’s good general advice to try and get a reasonable amount of good quality sleep so you can wake up refreshed. Whether it changes your Alzheimer disease risk, who knows.

2. Diet:
We can now say with a good degree of certainty that consuming highly processed, sugar-, salt-, and fat-laden foods contributes to increased levels of obesity, cardiovascular disease, diabetes, stroke, allergies, autism, learning disabilities, and autoimmune disorders and Alzheimer’s! Some of the ways modern, highly processed and refined foods can contribute to Alzheimer’s and the dementias include added, highly-processed sugars, which cause your insulin to spike and the enteric nervous system of your gut to secrete an abnormal amount of amyloid protein. This will start destroying the blood-brain barrier, and can contribute to the formation of the amyloid plaques of Alzheimer’s disease. Some researchers now even refer to Alzheimer’s as type III diabetes!

Rating: Complete and utter BS

High sugar and high fat foods is certainly a contributing factor to obesity and to diabetes, and indirectly to cardiovascular disease and stroke. That’s where the intelligence in Dr Leaf’s statement comes to a grinding halt. The rest of it is just a stream of fictitious nonsense without any basis in reality.

The western diet does not contribute to allergies, and it’s scientifically impossible for it to contribute to autism since autism is a genetic condition which expresses itself during foetal development, and I am yet to see a foetus chow down on a cheeseburger. But wait, there’s more – learning disabilities, and autoimmune disorders too, and of course, Alzheimer disease. Who cares that there’s no definitive trials to clearly prove that Alzheimer disease is in any way connected to our diets.

But apparently it’s the evil sugar which causes insulin to make the gut nervous system secrete amyloid proteins which destroy the blood brain barrier. When you put enough medical terms in a sentence, you would fool about 99 percent of people. But looking past the random string of medical jargon, it’s clear that Dr Leaf is deluded. The structural damage in Alzheimer disease comes from the nerve cell’s poor lipid metabolism, most of which comes from a gene which codes for a lipid carrying protein. Lipids have nothing to do with sugar. Besides, who cares if the enteric nervous system secretes amyloid … the enteric nervous system is in the gut [23], not the brain. Even her inconsistencies are inconsistent.

Dr Leaf’s throw-away line at the end, “Some researchers now even refer to Alzheimer’s as type III diabetes!” is ignorant or intentionally misleading. We’ve already established that the name “Type 3 diabetes” referred to the fact that scientists have recognised a metabolic disease with overlapping molecular mechanisms shared between diabetes and Alzheimer disease, not that Alzheimer disease is a metabolic disorder. Alzheimer disease is not because of too much sugar or bad lifestyle choices.

5. Exercise:
There is extensive research on the importance of exercise as a preventative tool against Alzheimer’s and the dementias. A number of studies show that people who exercise often improve their memory performance, and show greater increase in brain blood flow to the hippocampus, the key brain region that deals with converting short-term memory to long-term memory, which is particularly affected by Alzheimer’s disease.

Rating: Plausible

I don’t know what the state of the research is, but the study discussed earlier in the post about lifestyle changes did show improvement in risk for those who exercised. And out of all of Dr Leaf’s pronouncements, at least this one has scientific plausibility.

Exercise promotes a growth factor in the brain called BDNF. BDNF does stimulate the growth of new nerve cell branches. Growth of new nerve cell branches results in improved mood. It’s not entirely implausible to think that it would help with new memory formation and an enhanced hippocampus.

How much it really prevents Alzheimer disease is not clear, but given that exercise is universally good for you, I think it should be first on the list, not the last.

Dr Leaf – in a tangle

So in summary, Alzheimer disease is a complex multifactorial disease with a number of factors that affect its development, some of which can be changed, while others cannot.

Dr Leaf doesn’t understand this. Her reading of the literature about Alzheimer disease is limited and skewed by her biased assumptions about toxic thinking and lifestyle. Sure, there are some risk factors for Alzheimer disease which may be related to lifestyle and which may be modifiable, but Dr Leaf has failed to synthesise that information into the broader understanding of Alzheimer disease.

So some of her advice is helpful. Most of it is not. If you’re concerned that you or a loved one might have early memory loss, please don’t listen to Dr Leaf – see a real doctor instead and get the right advice.

References

[1] Alzheimer’s A. 2018 Alzheimer’s disease facts and figures. Alzheimers Dement 2018;14(3):367-429.

[2] Area-Gomez E, Schon EA. On the Pathogenesis of Alzheimer’s Disease: The MAM Hypothesis. FASEB J 2017 Mar;31(3):864-67.

[3] Eid A, Mhatre I, Richardson JR. Gene-environment interactions in Alzheimer’s disease: A potential path to precision medicine. Pharmacol Ther 2019 Jul;199:173-87.

[4] Toepper M. Dissociating Normal Aging from Alzheimer’s Disease: A View from Cognitive Neuroscience. J Alzheimers Dis 2017;57(2):331-52.

[5] Dai MH, Zheng H, Zeng LD, Zhang Y. The genes associated with early-onset Alzheimer’s disease. Oncotarget 2018 Mar 13;9(19):15132-43.

[6] Cupples LA, Farrer LA, Sadovnick AD, Relkin N, Whitehouse P, Green RC. Estimating risk curves for first-degree relatives of patients with Alzheimer’s disease: the REVEAL study. Genet Med 2004 Jul-Aug;6(4):192-6.

[7] Nordestgaard LT, Tybjaerg-Hansen A, Rasmussen KL, Nordestgaard BG, Frikke-Schmidt R. Genetic variation in clusterin and risk of dementia and ischemic vascular disease in the general population: cohort studies and meta-analyses of 362,338 individuals. BMC medicine 2018 Mar 14;16(1):39.

[8] Altmann A, Tian L, Henderson VW, Greicius MD, Investigators AsDNI. Sex modifies the APOE‐related risk of developing Alzheimer disease. Annals of neurology 2014;75(4):563-73.

[9] Larsson SC, Traylor M, Malik R, et al. Modifiable pathways in Alzheimer’s disease: Mendelian randomisation analysis. Bmj 2017 Dec 6;359:j5375.

[10] Rantanen K, Strandberg A, Pitkälä K, Tilvis R, Salomaa V, Strandberg T. Cholesterol in midlife increases the risk of Alzheimer’s disease during an up to 43-year follow-up. European Geriatric Medicine 2014;5(6):390-93.

[11] Ott A, Stolk R, Van Harskamp F, Pols H, Hofman A, Breteler M. Diabetes mellitus and the risk of dementia: The Rotterdam Study. Neurology 1999;53(9):1937-37.

[12] Huang C-C, Chung C-M, Leu H-B, et al. Diabetes mellitus and the risk of Alzheimer’s disease: a nationwide population-based study. PloS one 2014;9(1):e87095.

[13] de la Monte SM. Type 3 diabetes is sporadic Alzheimer׳s disease: mini-review. European Neuropsychopharmacology 2014;24(12):1954-60.

[14] Scarmeas N, Luchsinger JA, Schupf N, et al. Physical activity, diet, and risk of Alzheimer disease. JAMA : the journal of the American Medical Association 2009 Aug 12;302(6):627-37.

[15] Hu N, Yu J-T, Tan L, Wang Y-L, Sun L, Tan L. Nutrition and the risk of Alzheimer’s disease. BioMed research international 2013;2013.

[16] Heymann D, Stern Y, Cosentino S, Tatarina-Nulman O, Dorrejo JN, Gu Y. The Association Between Alcohol Use and the Progression of Alzheimer’s Disease. Curr Alzheimer Res 2016;13(12):1356-62.

[17] Wu YC, Lin YC, Yu HL, et al. Association between air pollutants and dementia risk in the elderly. Alzheimers Dement (Amst) 2015 Jun;1(2):220-8.

[18] Levy BR, Ferrucci L, Zonderman AB, Slade MD, Troncoso J, Resnick SM. A culture-brain link: Negative age stereotypes predict Alzheimer’s disease biomarkers. Psychol Aging 2016 Feb;31(1):82-8.

[19] Kokiko-Cochran ON, Godbout JP. The Inflammatory Continuum of Traumatic Brain Injury and Alzheimer’s Disease. Front Immunol 2018;9:672.

[20] Bredesen DE. Reversal of cognitive decline: a novel therapeutic program. Aging (Albany NY) 2014 Sep;6(9):707-17.

[21] Riley KP, Snowdon DA, Desrosiers MF, Markesbery WR. Early life linguistic ability, late life cognitive function, and neuropathology: findings from the Nun Study. Neurobiology of aging 2005 Mar;26(3):341-7.

[22] Latimer CS, Keene CD, Flanagan ME, et al. Resistance to Alzheimer Disease Neuropathologic Changes and Apparent Cognitive Resilience in the Nun and Honolulu-Asia Aging Studies. J Neuropathol Exp Neurol 2017 Jun 1;76(6):458-66.

[23] Costa M, Brookes SJH, Hennig GW. Anatomy and physiology of the enteric nervous system. Gut 2000;47(suppl 4):iv15-iv19.

Anxiety – It’s not a ‘real’ disease until it is

Posted on July 15, 2019 by cedwardpitt

“I feel awful, doc”, one man said to me today. “I’m never going to call a cold ‘the flu’ again”, he said as he shivered away under three jumpers, aching and mildly delirious.

It’s the middle of winter here in Australia, and Influenza A is cutting a swathe through the community. Everyone who walks in with a stuffy nose thinks they have ‘the flu’, that is, until they actually get Influenza and they realise just how atrocious having the real flu is.

It’s the same with mental health and illness. So many people think think that anxiety or depression aren’t real diseases. They think that everyone gets a bit sad at times, or gets a bit stressed, so depression and anxiety aren’t real diseases, they’re just normal emotions, or what weak people experience because they don’t have the inner strength to cope.

Such stigma isn’t helped when people who like to think they’re experts in mental health write blogs which declare that “anxiety is a signal that we need to listen to, not an illness we need to manage. It is a reaction to life’s challenges, not a biological disease to be treated.”

Yes, that’s right people, pretend experts are quick to tell you that the debilitating condition you’re experiencing isn’t a real disease.

Saying “Anxiety isn’t a real disease, it’s just a warning sign, a normal part of life” is a bit like saying, “You don’t really have Influenza, you just have a cold. Harden up princess … you don’t need to be ventilated in ICU, it’s just a virus. I took some Vitamin C and I was better in just a couple of days. What’s wrong with you?”

Part of the problem is because of how we use the word “anxiety”, which can mean different things to different people. To a lot of people, being anxious is the same as being a little frightened. To others, it’s being really scared, but with good reason (like if you were confronted by a very venomous snake).

Medically speaking, anxiety isn’t just being frightened or stressed. After all, it’s normal to be frightened or stressed. A little bit of fear is protective. There are dangers all around us, and our brain is our “don’t get killed” organ. If we had no fear at all, we’d end up becoming road kill. A little bit of fear, in the right amount, for the right reason and in the right place and time, is actually very protective.

But to label all anxiety as normal, or to claim that anxiety is not a mental illness is obnoxious and ignorant.

That’s because anxiety at the wrong time and in the wrong amount can disrupt our day-to-day tasks and make it hard to live a rich and fulfilling life. At the extreme, anxiety disorders are as debilitating as any major illness.

There are six main disorders that come under the “anxiety disorders” umbrella, reflecting either an abnormal focus of anxiety or an abnormal intensity:
1. Panic Disorder (abnormally intense anxiety episodes)
2. Social Anxiety Disorder (abnormal anxiety of social interactions)
3. Post-traumatic Stress Disorder (abnormally intense episodes of anxiety following trauma)
4. Obsessive-Compulsive Disorder (abnormally intense and abnormally focussed anxiety resulting in compulsive behaviours)
5. Specific phobias (abnormally focussed anxiety on one particular trigger), and
6. Generalised Anxiety Disorder (abnormal anxiety of everything)

The common underlying theme of anxiety is uncertainty. Clinical psychologists Dan Grupe and Jack Nitschke from the University of Wisconsin wrote in Nature Reviews Neuroscience that “Anxiety is a future-orientated emotion, and anticipating or ‘pre-viewing’ the future induces anxiety largely because the future is intrinsically uncertain.” [1]

The fear of uncertainty that defines anxiety comes from genetic changes that affect the structure and function of the brain, primarily in the regions of the amygdala and the pre-frontal cortex. As a result of these changes, the brain processes information incorrectly.

For example:
> the brain thinks that threats are more likely and will be worse than they are,
> the brain spends more time looking for possible threats,
> the brain fails to learn what conditions are safe, which is aggravated by avoidance, and
> the brain assumes that unavoidable uncertainty is more likely to be bad than good.

It’s important to understand at this point that anxiety disorders aren’t the result of poor personal choices. They’re the result of a genetic predisposition to increased vulnerability to early life stress, and to chronic stress [2]. The other way of looking at it is that people who don’t suffer from anxiety disorders have a fully functional capacity for resilience [3,4].

The main point of this post is simply this – pretend experts are everywhere, and they are usually various combinations of ignorant, stupid or lazy. They might try and tell you that your debilitating anxiety isn’t really a mental illness, but they’re usually the ones who have never experienced just how atrocious a true anxiety disorder is. Don’t listen to them, no matter how many equally ignorant followers they have on social media. Just like Influenza can make you really sick but there is treatment, so it is with an anxiety disorder – the anxiety disorder may be much harder to get through, but with the right treatment and support, you can get through it.

~~~

If you are struggling with anxiety or depression, help … real help … is available. See your general practitioner or psychologist, or if you’re in crisis and you need to talk to someone urgently:

In Australia
> you can call either Lifeline on 13 11 14, or
> BeyondBlue provides a number of different support options
> the BeyondBlue Support Service provides advice and support via
>> telephone 24/7 (call 1300 22 4636)
>> daily web chat (between 3pm–12am) and
>> email (with a response provided within 24 hours) via their website https://www.beyondblue.org.au/about-us/contact-us.
In the US
> call the National Suicide Prevention Lifeline by calling 1-800-273-TALK (8255).
In New Zealand
> call Lifeline Aotearoa 24/7 Helpline on 0800 543 354
In the UK
> Samaritans offer a 24 hour help line, on 116 123
For other countries, Your Life Counts maintains a list of crisis services across a number of countries: http://www.yourlifecounts.org/need-help/crisis-lines

References
1. Grupe DW, Nitschke JB. Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective. Nature reviews Neuroscience 2013 Jul;14(7):488-501.
2. Duman EA, Canli T. Influence of life stress, 5-HTTLPR genotype, and SLC6A4 methylation on gene expression and stress response in healthy Caucasian males. Biol Mood Anxiety Disord 2015;5:2.
3. Wu G, Feder A, Cohen H, et al. Understanding resilience. Frontiers in behavioral neuroscience 2013;7:10.
4. Russo SJ, Murrough JW, Han M-H, Charney DS, Nestler EJ. Neurobiology of resilience. Nature neuroscience 2012 November;15(11):1475-84.

Dr Caroline Leaf and Zombie Chemical Imbalance Myth

Posted on December 28, 2018 by cedwardpitt

Sometimes if you tell a story often enough, people forget that it’s just a story and it takes on a life of its own. It’s like a zombie … the story isn’t real but it continues to wander around eating people’s brains and it’s very hard to kill off.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. She also believes that reading a few blogs from fringe psychologists entitles her to call herself a mental health expert. She is the Christian church’s pin-up girl for the Dunning-Kruger effect.

Dr Leaf recently posted a blog on “The Chemical Imbalance Myth”. It’s a zombie. She’s posted on this before (on the 26th of October 2015 to be precise) but her blog post in 2015 was so inaccurate that she later took it down, only for it to resurface later on her website (in the section dubiously titled “Scientific FAQ”).

And like every good zombie, it’s resurfaced again. Dr Leaf hasn’t changed any of the inaccuracies that forced her to take down the original post, but instead added a couple of extra bits in, mixed it up a little and then just served it up, like a reheated bowl of rancid Christmas scraps.

I won’t go through each and every point like I did with her previous iteration of this blog, although if you want to review my more in-depth analysis of this subject, then please feel free to read my previous blog post: https://cedwardpitt.com/2015/10/26/dr-caroline-leaf-and-the-myth-of-chemical-imbalances-myth/. But I thought it was worth highlighting a couple of key things from this year’s fetid reincarnation which are so flawed that not even a B-grade science fiction writer would seriously entertain them.

THE MIND AND THE BRAIN

Dr Leaf says:

“In other words, mental ill-health is a thought disorder based in the mind, which changes the brain physiologically and is a response to the complex and multifaceted challenges of life.” This is based on her underlying assumption that the brain doesn’t control the mind, but instead the mind controls the brain.

However, she also says that “Psychotropic drugs can directly affect our health, with side effects such as an increased risk of suicide, loss of sexual ability, potential brain shrinkage, agitation, insomnia, weight gain and obesity-related diseases like diabetes, lethargy, mental fog, emotional apathy, homicide”.

This statement is really ignorant and prejudiced; psychiatric drugs don’t make people into murderers for a start.

But the most striking flaw of all is that Dr Leaf is contradicting herself. She confidently asserts that psychotropic medications and their terrible chemical imbalances have ghastly side effects on emotional and cognitive functions such as “mental fog” and “emotional apathy”. But how can that be? After all, if the brain does not control the mind as she says, then the medications affecting the brain would not have any effect on the mind.

Dr Leaf can’t have it both ways – either her entire ministry is built on a false premise (the brain really controls the mind after all) or her dire assertions about psychiatric medications are unfounded (chemical imbalances in the brain can’t cause effects on the mind).

One way or the other, Dr Leaf has a serious problem in her reasoning.

Real science has clearly demonstrated that the mind is a product of the brain. Things that alter the structure of the brain (trauma, tumours) or the function of the brain (medications like ropinirole, every day drugs like caffeine, or illicit drugs like LSD) can all cause changes in how the mind functions with resulting changes in behaviour.

If Dr Leaf isn’t able to get the basics of science right and make even the most basic cogent argument then how can she be trusted to speak to more complicated issues surrounding mental health and illness.

DR LEAF’S RESEARCH

Dr Leaf has never been one to undersell her scientific work. Accordingly, in her blog post she says:

Following a similar research path, I have also demonstrated, using my research on the power of mind-action in changing the brain, that mental disorders are primarily based in the mind …

I have researched the effectiveness of mind action techniques (which are thought-based) in overcoming the negative effects of neurological issues such as TBI, dementias, movement disorders, autism, aphasia, and learning disabilities, emotional trauma as well as various cognitive, emotional and mental health issues …

My Geodesic Learning Theory has been shown not only to be effective in mental health care, but also treating physical damage to the brain that occurs in Traumatic Brain Injury (TBI), learning disabilities and to improve learning techniques in both schools and the corporate world …

my research and experience indicated that many of these conditions were influenced by, or originated in, a disorder of the mind that was either caused by a trauma or negative thinking patterns. In other words, mental ill-health is a thought disorder based in the mind, which changes the brain physiologically and is a response to the complex and multifaceted challenges of life.

And yet the reality is that Dr Leaf only did one PhD in South Africa, and has not done any other university based research since. Her PhD did not look at “the power of mind-action in changing the brain”. In fact, her research didn’t focus on mental health or illness at all, and it certainly didn’t focus on dementias, movement disorders, autism, aphasia, and learning disabilities, emotional trauma, cognitive, emotional or mental health issues.

Her PhD was the evaluation of her Geodesic Learning Theory on a group of very normal students in a South African School. None of them had dementia. None of the other conditions were mentioned either. The overall results were likely due to chance, and in some cases, her intervention made the students grades worsen. The only other research that Dr Leaf performed was a similar intervention in come schools in Dallas, but the results were much the same as her PhD and given the unflattering results, this study was never published in a peer-reviewed journal.

Dr Leaf should know what she studied for her own research, and yet her description in her current blog post is so strikingly different from what is on the public record. So again, this begs the question – how can someone who is so wrong about her own research be trusted with any level of authority in any other subject?

PREJUDICE AGAINST MENTAL ILLNESS

For someone who claims to be an expert on mental health, Dr Leaf is extremely callous and dismissive of those people who suffer from mental illnesses. She repeatedly uses quotation marks to refer to mental illnesses, like ‘“diseases” like depression’ as if to suggest that they aren’t illnesses at all. Can you imagine if this same level of disrespect was applied to someone with a physical disability? That people in wheelchairs have the “disability” of paraplegia, for example. It’s extremely disrespectful and intolerant whether it is speaking about a physical disability or a mental illness.

The other thing which is highly inappropriate is her scare-mongering about psychiatric treatments. Psychiatric patients are not imprisoned, drugged, locked in solitary confinement and compelled to “live their days marinating in their own excrement.” I doubt whether Dr Leaf has ever set foot in a psychiatric facility. She is simply regurgitating the information fed to her by alarmist groups such as Mad In America, a group of psychologically trained rogue extremists – the Taliban of the world of psychiatry. It’s propaganda in it’s purest form, but Dr Leaf takes it at face value and repeats it no matter how inaccurate it actually is.

Dr Leaf’s criticism of modern psychiatry is breathtaking in it’s ignorance, especially in the face of published science, but what makes it more concerning is that it is internally inconsistent her own teaching, and this isn’t the first time that she’s contradicted herself.

Dr Leaf should take down this ignorant, inaccurate and intolerant post. This particular zombie myth needs to be buried once and for all.

More love, not less guns?

Posted on February 25, 2018 by cedwardpitt

Wow.

Just … wow.

Dr Caroline Leaf is no stranger to ignorance and controversy – she thinks that our minds can create matter, that our thoughts can control our genetic expression, and that psychiatric medications are a leading cause of death. So it should come as no surprise when she proves the Dunning-Kruger Effect over and over again.

Still, I found her podcast and meme today utterly breathtaking.

Dr Leaf, communication pathologist and self-titled cognitive neuroscientist-cum-life-guru continues to weigh in on the gun debate every time there’s a mass shooting. I wouldn’t if I were her, but fools rush in.

At least Dr Leaf has finally stopped blaming mental illness or psychiatric medication for causing such mass murders. That said, there’s still more twisting and contorting in her statement than at a pretzel convention.

Dr Leaf has relinquished one over-simplistic solution in favour of another. Yes, mass shootings aren’t related to mental illness, but can you really say with a straight face that mass shootings occur because of a lack of love? So we should all hold hands and sing Kumbayah? Have a few more hugs? Dr Leaf’s suggestion is childish and inane.

Since 1996, Australia’s number of mass shootings has been zero. Australia’s gun-related homicide and suicide rate also fell. Why? It’s not because we all started loving each other more down here after 1996. It’s because, amongst other reasons, the Australian government introduced gun law reform, drastically reducing the number of guns available within the general population.

Perhaps living in Texas has rubbed off on her, or perhaps Dr Leaf is an NRA sympathiser. I honestly don’t know why Dr Leaf is so afraid to speak directly to the problem. Most of the US and the entire rest of the world can see the issue for what it is. If it wasn’t so tragic, her dance around the issue would be comical.

Dr Leaf is welcome to her opinion, but she can not claim any level of moral or professional authority on this issue. Her “years of experience in the mental health field” are zero, as is her credibility as an expert. Encouraging more love with the same number of handguns and semi-automatics on the street is not going to prevent more casualties.

Dr Caroline Leaf – Inside Out and Back-to-Front

Posted on February 4, 2018 by cedwardpitt

Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist, put this up on her social media pages this morning:

“Never feel bad for being sad. Emotions should not be kept inside because that will only make things worse. Talk to someone, cry, scream… whatever helps you feel better. One of my favorite movies is Inside Out because it really highlights the importance of letting yourself feel sad as part of the healing process. I really encourage all of you to not keep emotions bottled up. Let it out!”

Inside Out is one of my favourite movies too. It is a rich layering of some complex psychology, told through a wonderfully relatable narrative that is beautifully told.

Inside Out is about the emotions that live inside us. Riley, an 11-year-old girl, moves from Minnesota to San Francisco, and the movie tells the story of her emotions as they deal with all of the conflicts and chaos that comes with adapting to such a big change.

The main characters are Joy and Sadness, which share “headquarters” with Anger, Fear and Disgust. Each character has its own role to play, which Joy, as the main narrator of the movie, explains:

“That’s Fear. He’s really good at keeping Riley safe.”
“This is Disgust. She basically keeps Riley from being poisoned, physically and socially.”
“That’s Anger. He … cares very deeply about things being fair.”

And Sadness? “And you’ve met Sadness. She … well, she … I’m not actually sure what she does …”

Dr Leaf explained that Inside Out, “… really highlights the importance of letting yourself feel sad as part of the healing process.”

Well, that’s one way of putting it, but Inside Out is actually much much deeper. The story of Inside Out demonstrates that all of our emotions are needed in order to be a healthy human being.

Joy thinks of herself as the primary emotion, and does her best to keep Sadness away from the control panel. Over the arc of the story, Joy learns that Riley needs Sadness too – that some problems can’t be solved with distraction or a pop-psychology pep-talk and positive attitude.

By the end of the movie, Joy allows Sadness to take over, helping Riley to process all of the things she had been struggling with after the major life change of her move to San Francisco.

This is what Dr Leaf was referring to, I think. Yes, sadness is part of healing from any major life change including grief.

What Dr Leaf didn’t discuss was the role of the other emotions in Riley’s life. Yes, Joy and Sadness are important, but the movie demonstrated all the way through that Fear, Anger and Disgust were all just as important, and the end of the movie showed that Riley’s core memories, which each formed a different aspect of her personality, were various combinations of all of the emotions.

But that’s not what Dr Leaf teaches. For decades, her teaching has been back-to-front, claiming that emotions like anger and fear are toxic, and that toxic emotions cause damage to your brain and damage to your health. She tells her followers not to think toxic thoughts or to have toxic emotions, but to take control of your thought life.

“Toxic thoughts are thoughts that trigger negative and anxious emotions, which produce biochemicals that cause the body stress.” [1] (p19)

“Hostility and rage are at the top of the list of toxic emotions; they can produce real physiological reactions in the body and cause serious mental and physical illness.” [1] (p30)

“There are two groups of emotions that are polar opposites: positive, faith-based emotions and negative, fear-based emotions. Each has its own set of molecules and performs as spiritual forces with chemical and electrical representation in the body. Faith-based emotions are love, joy, peace, happiness, kindness, gentleness, self-control, forgiveness and patience. These produce good attitudes and thoughts. Fear-based emotions include hate, anxiety, anger, hostility, resentment, frustration, impatience and irritation. These produce toxic attitudes and create a chemical reaction in the body that can alter behavior.” http://tkr-onfire4him.blogspot.com.au/2009/01/controlling-toxic-thoughts-and-emotions.html

“When you think a toxic thought, or make a bad choice, or you hang on to anything that is negative—anger, bitterness, hurt, irritation, or frustration—it impacts the production of those chemicals.”
“Through an uncontrolled thought life, we create the conditions for illness; we make ourselves sick! Research shows that fear, all on its own, triggers more than 1,400 known physical and chemical responses and activates more than 30 different hormones. There are INTELLECTUAL and MEDICAL reasons to FORGIVE! Toxic waste generated by toxic thoughts causes the following illnesses: diabetes, cancer, asthma, skin problems and allergies to name just a few. Consciously control your thought life and start to detox your brain!” https://drleaf.com/about/toxic-thoughts/

So it’s really interesting to see Dr Leaf discuss a movie that promotes the exact opposite of her teaching. Perhaps she’s finally coming around to what real neuroscientists and researchers have been saying for ages, that “adaptive coping does not rely exclusively on positive emotions nor on constant dampening of an emotional reaction … Adaptive coping profits from flexible access to a range of genuine emotions as well as the ongoing cooperation of emotions with other components of the action system.” [2]

If Dr Leaf is finally coming around to real science, then that’s great, but she can’t have it both ways … she can’t promote expressing your emotions on one hand and then suppressing them on the other. If she wants to come back to the fold of real science, then she’s going to have to renounce her previous teaching, and take it down from her website. Otherwise it ends up being conflicting and hypocritical as well as being downright confusing.

So, Dr Leaf, you’re welcome to use movies like Inside Out to illustrate good psychological principles, but if you want credibility, you should work on some consistency.

References
[1] Leaf CM. Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. Grand Rapids, Michigan: Baker Books, 2013.
[2] Skinner EA, Zimmer-Gembeck MJ. The development of coping. Annual review of psychology 2007;58:119-44.

Dr Caroline Leaf – stop spreading ADHD stigma and ignorance

Posted on August 30, 2017 by cedwardpitt

“Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity.” ~ Martin Luther King Jnr.

Sincere ignorance … conscientious stupidity – I’m struggling to know which category to put Dr Leaf’s latest e-mail newsletter into.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist and self-titled mental health expert. She is not a doctor. She is not a psychologist. She does not work for a university. She hasn’t published any peer reviewed medical papers for two decades. She is not accountable to any peak professional body.

Yet the Christian church gives her unfettered access to their pulpits despite the ignorance and stigma she enthusiastically promotes.

Take the “Mental Health News” e-mail that she posted today for example. Dr Leaf seamlessly moves from one misrepresentation to another, weaving a narrative that unfairly undermines scientifically proven treatments for mental illness, eroding confidence and destroying hope.

She starts with the story of Michelle and Carter, although it wasn’t Michelle and Carter as her e-mail newsletter stated. It was Michelle Carter and Conrad Roy, something which Dr Leaf got right in her blog post dated 1 August 2017 (see the image at the bottom of the page), but then got wrong in her e-mail newsletter on 30 August 2017. Dr Leaf says that Michelle texted Conrad to kill himself, and he did. Michelle and Conrad were on “brain-disabling” (psychiatric) drugs. Therefore, psychiatric drugs killed Michelle and Conrad. In my opinion, that Dr Leaf would stoop so low as to use the suicide of a teenager to try and push her own ideological barrow says much about her character, but then I shouldn’t be surprised as she did the same thing when Carrie Fisher died earlier this year. It’s sick, and it’s low, and it’s something that Dr Leaf should apologise for.

It’s also incredibly disingenuous, drawing a conclusion from incomplete evidence. Dr Leaf has no experience with the case. Instead, the source of this information is Dr Peter Breggin, himself an outspoken and discredited critic of psychiatric medication with a penchant for cherry picking and bias. Dr Leaf has used the story of Michelle and Conrad based on the tainted recall of half a story. She has no idea what really contributed to Michelle and Conrad’s tragedy. Her statement, “Yet, as is often the case, there is a large and dreadful disparity between what actually happened and what we are told happened” is therefore sadly ironic.

Dr Leaf then moves on to ADHD and drugs. Dr Leaf treats the concepts of ADHD and its treatment with the same respect as she gave Michelle and Conrad. She makes statement after misleading statement which do nothing but demonstrate her myopic bias.

Let’s just take one sentence: “These drugs create, rather than cure, chemical imbalances in the brain, are difficult to come off and can have terrible side-effects that last for years, including suicide and homicide.”

ADHD is often misunderstood and almost always stigmatised. ADHD is more than just being an active child who likes to play. ADHD is a dysfunctional lack of control that’s abnormal compared to other children the same stage of development, is long standing and affects their entire lives.

ADHD is caused by an abnormal pattern of genes, the expression of which are triggered by environmental conditions in pregnancy and early childhood, resulting in slower maturation of the brain and an uncoordinated network of “connectomes”, which disrupts the attention and planning processes of the brain.

We know that children with ADHD have slower maturation of the grey matter [1] and structural changes in the frontal regions and deeper parts of the brain [2]. In more recent times, modern brain imaging techniques have been able to show differences in the way that the regions of the brain link together to form networks.

Think of the brain networks as a tug-o-war team. When all the members of a tug-o-war team work in unison, they increase their collective strength, but if the different team members don’t co-ordinate their efforts properly, the strength is lost. The same goes for the brain. Modern neuroscientists have discovered that the function of the brain relies on physical networks within the brain, called “connectomes” and how these connectomes co-ordinate with each other.

In the ADHD brain, the connections between the different connectomes are immature [3]. These immature connections weaken the collective strength of the network, because they aren’t synchronously “pulling” together.

What’s better understood is that the neurotransmitter called dopamine is crucial to the ADHD disease process [4]. Medications such as Ritalin which enhance the dopamine signals in the brain significantly reduce the symptoms of ADHD [5].

So Ritalin and other drugs like it actually balance the neurotransmitters in the brain. Dr Leaf’s argument that they “create … chemical imbalances in the brain” is as misleading as trying to argue that diabetic treatments are creating an “insulin imbalance”.

“These drugs … are difficult to come off” is also misleading. Once the brain eventually matures as it does in most children with ADHD, the drug is simply weaned. Dr Leaf doesn’t seem to understand that some children with ADHD will grow into adults with ADHD who will still need medication. This isn’t because the drugs are hard to come off, they are simply treating an ongoing condition.

“These drugs … can have terrible side-effects that last for years, including suicide and homicide.” Actually, the effects of Ritalin last less than a day because the drug is rapidly metabolised, and ‘homicide’ is not listed anywhere in the official product information. Suicide has been reported in patients taking the Ritalin although the official product information notes that, “Adverse events reported since market introduction in patients taking methylphenidate include suicide, suicide attempt and suicidal ideation. No causal relationship between methylphenidate and these events has been established.” Even so, medications like Ritalin are not meant to be given to people who have severe depression, anorexia, psychotic symptoms or suicidal tendency, just in case Ritalin might worsen these conditions.

Indeed, a Cochrane Review as recently as November 2015 said, “The evidence in this review of RCTs suggests that methylphenidate does not increase the risk of serious (life threatening) harms when used for periods of up to six months. However, taking methylphenidate is associated with an increased risk of non-serious harms such as sleeping problems and decreased appetite.” [6]

So “these drugs” don’t have side effects for years, don’t make people homicidal, don’t make people addicted and don’t unbalance their brain chemicals. It’s amazing how much profound mistruth Dr Leaf was able to pack into one littlesentence.

Then Dr Leaf goes on to attack the concept of ADHD itself – “Unfortunately, there is little scientific evidence for these labels … the very idea of ADHD, which includes vague operational definitions such as ‘often fidgets with hands or feet or squirms in seat,’ is subjective and defined by what society currently deems as ‘normal’ or ‘abnormal’”.

Denying the existence of ADHD is an old trick used by medication critics and the ignoranti for decades, but it’s like denying the existence of rain so you don’t have to buy an umbrella. Dr Leaf’s assertion that the diagnosis of ADHD includes ‘vague operational definitions’ is just a strawman, because ADHD diagnosis is rigorous and relies on more than just a single characteristic like fidgeting. I have listed the diagnostic criteria for ADHD at the end of this post, or you can look it up here: http://www.cdc.gov/ncbddd/adhd/diagnosis.html

In all of Dr Leaf’s railing against medications for ADHD, she fails to cite the evidence that shows that medications for ADHD improves the lives of those with ADHD [6], more than restrictive diets or cognitive retraining or neurofeedback [7].

Dr Leaf may like to think of herself as an expert, but her claims on ADHD and it’s treatment do not hold up under scrutiny. She may think she’s acting benevolently but the promotion of her Dunning-Kruger style ignorance erodes the enormous hope that medications like Ritalin give to people who, without it, are held back by the mental and physical chaos that ADHD causes.

Dr Leaf, please, stop spreading the ADHD stigma and ignorance. We already have to put up with enough suffering from the disease itself and the social stigma without you adding to it.

References

[1]       Shaw P, Lerch J, Greenstein D, et al. Longitudinal mapping of cortical thickness and clinical outcome in children and adolescents with attention-deficit/hyperactivity disorder. Archives of general psychiatry 2006 May;63(5):540-9.
[2]       Cortese S. The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): what every clinician should know. European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society 2012 Sep;16(5):422-33.
[3]       Cao M, Shu N, Cao Q, Wang Y, He Y. Imaging functional and structural brain connectomics in attention-deficit/hyperactivity disorder. Mol Neurobiol 2014 Dec;50(3):1111-23.
[4]       Wu J, Xiao H, Sun H, Zou L, Zhu LQ. Role of dopamine receptors in ADHD: a systematic meta-analysis. Mol Neurobiol 2012 Jun;45(3):605-20.
[5]       Reichow B, Volkmar FR, Bloch MH. Systematic review and meta-analysis of pharmacological treatment of the symptoms of attention-deficit/hyperactivity disorder in children with pervasive developmental disorders. Journal of autism and developmental disorders 2013 Oct;43(10):2435-41.
[6]       Storebo OJ, Ramstad E, Krogh HB, et al. Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). The Cochrane database of systematic reviews 2015 Nov 25;11:CD009885.
[7]       Sonuga-Barke EJ, Brandeis D, Cortese S, et al. Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. The American journal of psychiatry 2013 Mar 1;170(3):275-89.

ADHD Diagnostic Criteria

The current criteria that must be matched to qualify for a diagnosis of ADHD is:

(1) Inattention: Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:
* Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
* Often has trouble holding attention on tasks or play activities.
* Often does not seem to listen when spoken to directly.
* Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
* Often has trouble organizing tasks and activities.
* Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
* Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
* Is often easily distracted
* Is often forgetful in daily activities.

(2) Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
* Often fidgets with or taps hands or feet, or squirms in seat.
* Often leaves seat in situations when remaining seated is expected.
* Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
* Often unable to play or take part in leisure activities quietly.
* Is often “on the go” acting as if “driven by a motor”.
* Often talks excessively.
* Often blurts out an answer before a question has been completed.
* Often has trouble waiting his/her turn.
* Often interrupts or intrudes on others (e.g., butts into conversations or games)

In addition, the following conditions must be met:
– Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
– Several symptoms are present in two or more setting, (e.g., at home, school or work; with friends or relatives; in other activities).
– There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
– The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.
– The symptoms are not better explained by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).
(http://www.cdc.gov/ncbddd/adhd/diagnosis.html)

Where are all the shepherds?

Posted on July 21, 2017 by cedwardpitt

In “The Myth of Icarus”, Icarus, full of the folly that comes with pride, flew too high and the sun melted his wings.

Dr Caroline Leaf is the modern day Christian version of Icarus, foolishly flying higher and higher, deluded by her self-importance and unaware of the weakness and fissuring of her presumed competence.

But unlike the myth of Icarus where only Icarus himself paid the ultimate price, Dr Leaf isn’t the only person flying too close to the sun, but she is encouraging the church to follow her lead.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. Unfortunately, despite no training or experience whatsoever in psychiatry, psychology or even basic counselling, Dr Leaf has assumed the role of a mental health expert for the church.

Having the untrained Dr Leaf lecture Christian congregations on mental illness is an absolutely absurd proposition – it’s like having a plumber give a public lecture about coronary bypass surgery. Yet the uncredentialed Dr Leaf continues to speak at church after church after church about mental health and illness, given a free license as if she were a psychiatrist with decades of experience.

And my question is “Why”?

Why do pastors and church leaders give Dr Leaf a free pass to speak from their platforms on a subject that she is objectively unqualified to speak on? Where is the public process of due diligence? Where is public demonstration of accountability that undergirds the reverence, the sacred gravitas, of the church pulpit? Why do our church leaders stay silent when unqualified preachers poison their congregations with saccharine subterfuge?

Where are all the shepherds? Why aren’t they shepherding?

Dr Leaf’s latest e-mail newsletter aptly demonstrates what the church needs protecting from – an entire e-mail encouraging people to withdraw from psychiatric medications. Her bias is clear – psychiatric medications are harmful and you can withdraw from them if you want to. If you do, you’ll feel better.

This might as well be unsolicited, unlicensed medical advice. There’s no discussion about the nuances of psychotropic medication, or the proven benefits. She then encourages people to look for more information by reading books or visiting websites that are known to be unhinged or, at best, clearly biased against medications for mental ill-health.

In the past, Dr Leaf has clearly shown her ignorance when it comes to psychiatric medications. She has accused them of everything from being poisonous to being unspiritual. Never once has she acknowledged the scores of research papers that confirm the judicious use of psychiatric medications saves lives and extends the lifespan of those who take them.

Now, she has advised people that they can stop their medications and promotes unscrupulous and biased sources of information to help. This isn’t just ignorant, this is dangerous. [1]

Will it take the untimely death of one of their congregation before our church leaders say ‘enough is enough’? It will be all too late then.

It’s time for our church leaders to stand up for the congregations they lead and denounce the teaching of Dr Caroline Leaf. Her ignorance and her arrogance are becoming a dangerous mix. Our pastors can’t wait until blood is on their hands before they’re forced into action – they need to act now, before it’s too late.

~ ~
If you are concerned about the medications you’re taking or you think you don’t need them any more, for heaven’s sake don’t just stop taking them or try and wean yourself. Go see your doctor for advice specific to your medication and your situation.

Don’t believe me? https://psychcentral.com/lib/discontinuing-psychiatric-medications-what-you-need-to-know

DISCLAIMER: Just in case anyone was wondering about my motives, I declare that I have no connection with any pharmaceutical company. I do not accept gratuities of any form from any sales representative. I don’t eat their food, I don’t take their pens, and I don’t listen to their sales pitches.

References and bibliography

[1] Valuck RJ, Orton HD, Libby AM. Antidepressant discontinuation and risk of suicide attempt: a retrospective, nested case-control study. J Clin Psychiatry 2009 Aug;70(8):1069-77.

Anti-depressants – Not the messiah

Dr Caroline Leaf – Howling at the moon

Anti-psychotics, damn lies and statistics

Caroline Leaf – Carrie Fisher killed by bipolar meds

Dr Caroline Leaf – Not a mental health expert

Dr Caroline Leaf – Increasing the stigma of mental illness again

https://cedwardpitt.com/2015/10/18/dr-caroline-leaf-and-her-can-of-worms/
https://cedwardpitt.com/2015/10/19/dr-caroline-leaf-and-the-can-of-worms-update/
https://cedwardpitt.com/2015/10/26/dr-caroline-leaf-and-the-myth-of-chemical-imbalances-myth/

Dr Caroline Leaf – Howling at the moon

Posted on June 18, 2017 by cedwardpitt

The night is darkest just before the dawn, so says the age-old phrase. It’s funny how we just accept these old adages as true, but when you actually think about it, they’re nothing more than a concoction of the imagination. The night isn’t darker just before dawn – it’s just as dark when the sun goes down as it is before the sun comes up again.

In the same way, we so often accept things said by ‘experts’ as truth when in reality, they’re also just some particularly imaginative concoctions.

Take, for example, Dr Leaf’s latest e-mail newsletter and blog for June 2017. In it, she merrily gloated about how a recent UN Human Rights report “exposed the current failings of diseased-based psychiatry” and “challenges the dominant narrative of brain disease and its overreliance on psychoactive drugs”. The smugness is palpable – she finally has something more authoritative to try and back up her psychiatric antagonism than just the collective ranting of an outspoken, ill-informed fringe group.

Dr Leaf is a communication pathologist (essentially an academic speech pathologist) though she continues to delusionally claim that she’s a cognitive neuroscientist. She also grandiosely believes her training in speech pathology make her a mental health expert, above psychiatrists with actual medical training and decades of real clinical experience. She might feel vindicated by this report and her ill-formed friends, but her view is naive and her narrative is based on inaccurate statistics and logical fallacy.

For example, this paragraph encapsulates Dr Leaf’s statistical errancy and general self-deception: “Several of my previous blogs, as well as some of my FAQs, deal with the current state of mental health care, which has crippled so many lives, led to countless deaths, and left millions of people thinking that there is ‘something wrong with my brain.’ Indeed, an estimated 20% of the American population take psychiatric drugs, which amounts to a staggering cost of $40 billion, as mental health advocate Robert Whitaker points out (a 50-fold increase since the late 1980s).”

It’s a “see-I-told-you-so” attempted justification, except that modern mental health care has not “crippled so many lives” or “led to countless deaths.” It’s actually untreated mental illness which really cripples people’s lives, or ends them. Suicide is an unspoken epidemic that is so often the end result of undiagnosed or untreated mental illness. Suicide is the major cause of premature death among people with a mental illness and it’s estimated that up to one in ten people affected by mental illness die by suicide. Up to 87% of people who die by suicide suffer from mental illnesses. There are more deaths by suicide than deaths caused by skin cancer and car accidents. Up to three percent of adults have attempted suicide within their lifetime and it’s estimated that for every completed suicide, at least six other people are directly impacted in a significant way [1].

On the flip side, the use of any anti-psychotic medication for a patient with schizophrenia decreased their mortality by nearly 20% [2]. In another study, the mortality of those with schizophrenia who did not take anti-psychotics was nearly ten times that of the healthy population, but taking anti-psychotic medication reduced that by a factor of five! [3] Dr Correll and colleagues summarised the literature, noting that, “clozapine, antidepressants, and lithium, as well as antiepileptics, are associated with reduced mortality from suicide. Thus, the potential risks of antipsychotics, antidepressants and mood stabilizers need to be weighed against the risk of the psychiatric disorders for which they are used and the lasting potential benefits that these medications can produce.” [4]

As for her example taken from the equally prejudiced Robert Whitaker that “an estimated 20% of the American population take psychiatric drugs, which amounts to a staggering cost of $40 billion … (a 50-fold increase since the late 1980s)”, even if it were true, it’s simply misleading and ill-informed. Twenty percent of the US population might be taking “psychiatric drugs” but some of them might be taking them for different reasons. For example, tricyclic anti-depressants are no longer used primarily for depression but have found a niche in the treatment of chronic and nerve-related pain. And so what if there’s been a 50-fold increase in the use of psychiatric medications since the 1980’s, that doesn’t mean they’re being used inappropriately. Her analogy is like saying that because there has been a 900-fold increase in the number of road deaths since the turn of the century [5], cars are being used inappropriately and we should all start travelling by horse-back again.

It’s the height of arrogance for Dr Leaf to sit in her ivory tower and condemn modern psychiatry based on her utopian fantasy, but mental illness affects real people and causes real suffering – like the two heart-broken parents told a Parliamentary Enquiry in Australia a few years back, “We would rather have our daughter alive with some of her rights set aside than dead with her rights (uselessly) preserved intact.” [6]

Dr Leaf may smugly think the sun is shining on her, but she’s still in the darkness of night, barking and howling at the moon like a rabid dog. If she really wants to step into the light, she should try looking at the mountain of scientific evidence supporting modern psychiatry and if that’s not enough for her, then she should at least look at all those afflicted and distressed because the mental illness they or their loved one suffered from was ignored in favour of an ideology that claims to support human rights but which ignores the most basic human right of all, the right to life.

References
[1]        Corso PS, Mercy JA, Simon TR, Finkelstein EA, Miller TR. Medical costs and productivity losses due to interpersonal and self-directed violence in the United States. Am J Prev Med 2007 Jun;32(6):474-82.
[2]        Tiihonen J, Lonnqvist J, Wahlbeck K, et al. 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet 2009 Aug 22;374(9690):620-7.
[3]        Torniainen M, Mittendorfer-Rutz E, Tanskanen A, et al. Antipsychotic treatment and mortality in schizophrenia. Schizophrenia bulletin 2015 May;41(3):656-63.
[4]        Correll CU, Detraux J, De Lepeleire J, De Hert M. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World psychiatry : official journal of the World Psychiatric Association 2015 Jun;14(2):119-36.
[5]        “List of motor vehicle deaths in US by year” https://en.wikipedia.org/wiki/List_of_motor_vehicle_deaths_in_U.S._by_year Accessed 18 June 2017
[6]        “A national approach to mental health – from crisis to community – First report” 2006 Commonwealth of Australia http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Former_Committees/mentalhealth/report/c03 Accessed 18 June 2017

Hollywood knows more about cognitive neuroscience than Dr Caroline Leaf

Posted on April 22, 2017 by cedwardpitt

Anyone ever watched the Will Smith movie, “Concussion”?

The movie is based on the true story of Dr Bennet Omalu who is a Nigerian-born pathologist (a pathologist is a forensic specialist who is able to determine the cause of a person’s disease and death). Dr Omalu became curious as to why otherwise healthy middle-aged men were displaying changes to their behaviour and memory before dying at a young age.

What he found was changes to the brain of these NFL players similar to that seen in Alzheimer’s Disease. The recurrent physical head trauma sustained by those football players was resulting in abnormal proteins in their brain cells. The abnormal proteins resulted in the destruction of those brain cells. As a result of the destruction of those brain cells, the thinking and behaviour of those players changed.

After initially denying the link, the NFL was forced to change their policy on repetitive head trauma under the weight of the avalanche of confirmatory data that followed in support of Dr Omalu’s findings and it’s been reported that “as of the summer of 2015, more than 5,000 former players were involved in a consolidated lawsuit, with a settlement figure of $765 million deemed insufficient by a judge”.

But good news for the NFL … self-titled cognitive neuroscientist Dr Caroline Leaf reassures us that “Your mind controls your brain. Your brain does not control your mind.”

Maybe she can act for the NFL as their star witness.

But if I were her, I wouldn’t be holding my breath. After all, it’s not like she’s able to mount particularly strong logical arguments. Today she wrote on Facebook, “It’s important to remember that our thinking changes the structure of our brains because our minds are separate from our brains.”

How is the mind going to control the brain if they’re separate? Suggesting that one thing controls another carries the implication that they are intrinsically linked. If your hands are separated from the steering wheel of your car, are you in control of your car?

The other reason why Dr Leaf won’t be getting a call from Roger Goodell any time soon is because she isn’t really an expert on cognitive neuroscience as much as she’s convinced the Christian church otherwise.

Oh, and then there’s that minor detail that even Hollywood knows more about cognitive neuroscience than she does. The whole point of “Concussion” is that brain damage results in disordered thinking which is the exact opposite of what Dr Leaf is trying to claim, and it’s hard to withstand any real scrutiny when your hypothesis has been trumped by a Hollywood screenplay.

The mind is a function of the brain, it does not control the brain. The fact that Dr Leaf can not or will not bow to the weight of the undeniable scientific evidence means that she is either delusional, ignorant or utterly obstinate. The fact that the western church is still willing to deify Dr Leaf in spite of these qualities is a stain on the reputation of the church and a blight on it’s witness to a world which only needs to look to Hollywood to find more credible information than what’s coming from Dr Leaf’s pulpit.

Dr Caroline Leaf on Drugs

Posted on March 22, 2017 by cedwardpitt

We all have a drug problem.

Well, we do according to communication pathologist and self-titled cognitive neuroscientist-come-health guru, Dr Caroline Leaf. She’s pretty chirpy for a woman with essentially no health credentials. She did a PhD two decades ago on a specialized area of educational psychology, but she has no medical training or experience. Essentially she is the Christian equivalent of the health and relationships section of a tabloid newspaper. Her information lurches between unfounded and the bleeding obvious.

Today’s e-mail newsletter, “Mental Health News March 2017” is a mixture of both. It’s more moderate than usual in its tone, but it’s still inspired by her open rejection of pharmaceuticals, especially medications for mental health which she has railed against many times.

Her second paragraph is a specific case in point. “Although many medications have saved lives and can help us, we cannot have a quick-fix-pop-a-pill mentality for everything in life, and we should not denigrate alternative methods of health and healing, such as diet, exercise, human relationship, love, compassion and therapy, particularly when it comes to mental health.”

She’s right – we shouldn’t have a quick-fix-pop-a-pill mentality, but she overstates her case. Most people don’t want pills for everything – people want good care and good treatment. Sometimes that involves a pill, sometimes it just involves reassurance. This is bread and butter for any good GP, and I’d love to show Dr Leaf what the front-line of medicine looks like if she ever wanted to see (seriously, the offer’s open).

And who’s denigrating diet and exercise? Diet and exercise aren’t “alternative” health, they’re mainstream. Is Dr Leaf so out of touch that she can’t see this?

Her bias against pharmaceuticals is more obvious in their third paragraph. Pharmaceutical medications are not a major cause of death. According to the Centre of Disease Control, the top ten causes of death in the US are:

* Heart disease
* Cancer (malignant neoplasms)
* Chronic lower respiratory disease
* Accidents (unintentional injuries)
* Stroke (cerebrovascular diseases)
* Alzheimer’s disease
* Diabetes
* Influenza and pneumonia
* Kidney disease (nephritis, nephrotic syndrome, and nephrosis)
* Suicide

Notice how medications do not feature on that list. Dr Leaf is so biased against medications that she is willing to ignore official government data in favour of her own bias.

But the truth is, pharmaceutical grade medications have revolutionised our lives. When used in the right way, for the right people, they improve our quality and quantity of life. They give people independence. They give people choice. They help people work, spend time with their family and care for others where that may not have been possible otherwise.

Do medications have side effects? Can people feel worse sometimes while taking them? Of course! We need to be realistic. Pharmaceutical medications are powerful agents and we have to use them respectfully. Prescription drugs are like power tools. In the right hands they can do wonders, but they can also be very dangerous when used incorrectly. But while medications can be used incorrectly, using that as a reason why we should use less drugs is like arguing that we should use less knives because sometimes they cut people, or that we should drive less cars because there are car accidents.

Oh, and what was that about the widespread manipulation of data and results in the world of science? Dr Leaf would never misrepresent the results of her studies, or misrepresent the results of other people’s research, in order to make her products look better than they are?

Lifestyle is important, and in some cases, lifestyle is more important than medication, but there is much more nuance involved. You need different tools for different jobs. Imagine a surgeon going into surgery and the scrub nurse passed over a nerf scalpel. It wouldn’t be particularly helpful would it. Or what if the scrub nurse passed over a butter knife? The surgeon might get the job done but with great difficulty, without the precision needed.

What a surgeon needs to perform surgery is an extremely sharp stainless steel scalpel blade. It is more effective and more precise. It might occasionally do some unintentional harm, but it will be a lot more effective than a butter knife (and a nerf scalpel!)

There are three different levels of treatment in health – “alternative” medicines, lifestyle treatments, and pharmaceuticals. “Alternative” medicines are, by definition, useless. As comedian Tim Minchin says, “Do you know what they call alternative medicine that’s been proven to work? Medicine.” Alternative medicines are probably not going to cause a lot of harm other than making their user poorer for wasting their time, but they’re highly unlikely to do any good.

Lifestyle treatments are the equivalent of the butter knife. They work, but their effect is non-specific and cumulative. Hear me right, “non-specific and cumulative” is not code for “ineffective”. Exercise is one of the most effective non-pharmacological health strategies with clearly proven benefits, but like all lifestyle changes, the effect is fairly general, and the benefit accumulates.

And sometimes, despite doing everything right, people still get sick, and this is where pharmaceuticals have their place. They are like the scalpel – they might have some unwanted effects, but in the right hands, when used correctly, they make a specific and tangible difference to a person’s life and health.

Dr Leaf then goes on to assert that “Changing your lifestyle and, significantly, the way you THINK can have dramatic effects on your health”. That’s a furphy. Thoughts make no difference to our health (I’ve shown how little difference thought makes to our health in my review of Dr Leaf’s book “Think and Eat Yourself Smart”). Some scientists may have recommended produce over Prozac, but that doesn’t mean to say they’re right.

And Dr Leaf has trotted out the same worn, tired old factoid about loving and serving others that I’ve shown to be inaccurate as well.

If you want to improve your health without medications, then start walking. Eat vegetables. Drink water. Don’t waste your time and money buying into Dr Leaf’s inaccurate teaching.

Dr C. Edward Pitt

Faith, Hope, Love, Science.

Tag Archives: caroline leaf

Anxiety – It’s not a ‘real’ disease until it is

Dr Caroline Leaf and Zombie Chemical Imbalance Myth

Dr Caroline Leaf – Inside Out and Back-to-Front

Dr Caroline Leaf – stop spreading ADHD stigma and ignorance

Where are all the shepherds?

Dr Caroline Leaf – Howling at the moon

Hollywood knows more about cognitive neuroscience than Dr Caroline Leaf

Dr Caroline Leaf on Drugs