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Dr Caroline Leaf and the chemistry of perceptions

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On her social media feed just now, Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist, said, “Your perceptions adjust your brain chemistry”.

Hmmm … yes and no.

I’m not really sure what Dr Leaf is trying to suggest with this statement, because it’s so vague. The brain works through the passage of an electrical current travelling along a nerve cell, and being passed to the next nerve cell by the release of a “chemical” neurotransmitter that floats across the space between the nerve cells.  If that’s what Dr Leaf is referring when she talks about our brain chemistry, then sure, our perceptions adjust our brain chemistry. But then again, so does everything else that our brain does. In this sense, perception is nothing special.

What I think Dr Leaf was trying to suggest is that our mind influences our brain chemistry, following along with her “mind controls matter” theme. But perception is the process of translating the raw data into a signal that the brain can process, for example, the light coming into your eye is translated into the electrical impulses your brain can utilise. It’s not an explicit process. It has nothing to do with our consciousness or our volition.

Also, our “brain chemistry” as it’s considered in neuroscience is usually referring to the neurotransmitters and their function, which is often determined by our genetics and influences how we perceive and understand our environment [1].

So if anything, it’s not our perception altering our brain chemistry, but rather it’s our brain chemistry that alters our perceptions.

Our mind does not control our brain. Our brain is responsible for the function of our mind.

References

  1. Caspi, A., et al., Genetic sensitivity to the environment: the case of the serotonin transporter gene and its implications for studying complex diseases and traits. Am J Psychiatry, 2010. 167(5): 509-27 doi: 10.1176/appi.ajp.2010.09101452

Dr Caroline Leaf and the tongues trivia tall tales

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In every day life, if someone started talking in strings of indecipherable, chaotic syllables, you’d be giving them quite a lot of space, concerned about how much methamphetamine they’d been using.

In the average charismatic church, it’s just another service (the speaking in tongues, not the meth).

I’ve grown up in Pentecostal churches, and was baptised in the Holy Spirit when I was a child, so I forget how freaky it is for those who’ve never seen a whole church start talking or singing in tongues. For the uninitiated, the Bible talks about speaking in other tongues, which is a “New Testament phenomena where a person speaks in a language that is unknown to him. This language is either the language of angels or other earthly languages (1 Cor. 13:1). It occurred in Acts 2 at Pentecost and also in the Corinthian church as is described in 1 Corinthians 14. This New Testament gift was given by the Holy Spirit to the Christian church and is for the purpose of the edification of the Body of Christ as well as for glorifying the Lord.” (http://carm.org/speaking-in-tongues)

In scientific terms, speaking in tongues is referred to as “Glossolalia”, from the Greek, ‘glosso-‘ ~ ‘the tongue’ and ‘-lalia’ ~ ‘to speak, to chat’. Scientists who initially studied it in the 60’s and 70’s drew the conclusion that glossolalia was related to psychopathology (that people who spoke in tongues were crazy) [1, 2], and in later decades, it was thought to be caused by a form of temporal lobe epilepsy [3].

Earlier today, Dr Caroline Leaf, a communication pathologist and self-titled cognitive neuroscientist, declared that, “When we speak in tongues, research shows that the areas involved in discernment in the brain increase in activity, which means we increase in wisdom.”

I was fascinated to find this research for myself. Dr Leaf never references her social media memes, so I started looking through the medical literature on the subject from respected databases like PubMed, and search engines like Google Scholar.

Despite a thorough search, I was only able to find one article that studied the pattern of brain activity during speaking in tongues. The article, “The measurement of regional cerebral blood flow during glossolalia: A preliminary SPECT study” [4] took five healthy women, psychiatrically stable, long term members of their churches, who had all spoken in tongues for many years. They scanned their brain activity after a period of singing to gospel songs in English and compared it to their brain activity after the same amount of time praying in tongues (while listening to the same music as before).

What they found was that the brain was more active in the left superior parietal lobe, while there was a decrease in brain activity in the prefrontal cortices, left caudate nucleus and left temporal pole. There was a trend for an increase in the activity of the right amygdala, but this may have just been chance.

So are any of those brain regions responsible for discernment as Dr Leaf suggested?

Well, that all depends on how you define “discernment”. “Discernment” is not really a common neurobiological term. The standard term in the literature is “judgement”. The brain regions that are associated with evaluation and judgement are the amygdala and ventral portions of the striatum as well as the ventromedial prefrontal cortex (vmPFC), orbitofrontal cortex (OFC), the insula, the dorsal anterior cingulate cortex (dACC), and the periaqueductal gray (PAG) [5].

Are there any parts of the brain that match in the two lists? Only one – the ventromedial prefrontal cortex, or vmPFC for short. The prefrontal cortex is important in reasoning and decision-making, especially if there is uncertainty or novelty, while the vmPFC in particular is involved in the use of goal-relevant information in guiding responses, e.g., assigning value to choice options [6].

According to Dr Leaf, “When we speak in tongues, research shows that the areas involved in discernment in the brain increase in activity”. But that’s certainly not what the research paper said. The actual research is entirely the opposite.

Again, there are really only two reasonable explanations as to why the research contradicts Dr Leaf; either there is another piece of research which supports Dr Leaf’s assertion, or Dr Leaf is simply wrong.

At the risk of repeating myself, Dr Leaf needs to quote her sources when she is writing her little social media memes. Her meme may be perfectly justified by robust scientific evidence, but if she isn’t willing to share her sources, we’ll never know, and the only conclusion remaining is that Dr Leaf can’t interpret simple research.

So as it stands, there really isn’t any evidence that speaking in tongues makes you more discerning. By trying to claim otherwise, Dr Leaf further undermines her own reputation and credibility as an expert.

References

  1. Hine, V.H., Pentecostal glossolalia: towards a functional reinterpretation. Journal for the Scientific Study of Religion, 1969. 8: 212-26
  2. Brende, J.O. and Rinsley, D.B., Borderline disorder, altered states of consciousness, and glossolalia. J Am Acad Psychoanal, 1979. 7(2): 165-88 http://www.ncbi.nlm.nih.gov/pubmed/370074
  3. Persinger, M.A., Striking EEG profiles from single episodes of glossolalia and transcendental meditation. Perceptual and Motor Skills, 1984. 58: 127-33
  4. Newberg, A.B., et al., The measurement of regional cerebral blood flow during glossolalia: a preliminary SPECT study. Psychiatry Res, 2006. 148(1): 67-71 doi: 10.1016/j.pscychresns.2006.07.001
  5. Doré, B.P., et al., Social cognitive neuroscience: A review of core systems, in APA Handbook of Personality and Social Psychology, Mikulincer, M., et al., (Eds). 2014, American Psychological Association: Washington, DC. p. 693-720.
  6. Nicolle, A. and Goel, V., What is the role of ventromedial prefrontal cortex in emotional influences on reason?, in Emotion and Reasoning, Blanchette, I., (Ed). 2013, Psychology Press.

STOP THE PRESSES! Dr Leaf releases a new meme based on my correction, still doesn’t acknowledge source. (13 November 2014)

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So, I can’t find fault on what Dr Leaf said here.  It fits with the paper I quoted from Newberg et al (2006).  Still, it begs the question of why Dr Leaf couldn’t have said this in the first place, and why she still isn’t willing to share her citations?

It also raises the other obvious question, why is it important to know what our brain does in glossolalia?  It’s only a study of 5 patients, and I’m sure that not all episodes of speaking in tongues is associated with decreased intentionality.  The research, being so small, isn’t a true reflection of the practice of speaking in tongues.  Lets hope that the future will bring more funding to better study this central tenet to the charismatic faith.

Dr Caroline Leaf: Putting thought in the right place

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Following hard on the heels of her false assumption that our minds control our health, not our genes, and following the same theme, Dr Leaf had this to say today, “Everything is first a thought; the brain is being controlled with EVERY thought you think!”

Dr Caroline Leaf is a communication pathologist and a self-titled cognitive neuroscientist. Reading back through my blogs, this “thought controls the brain / mind controls matter” is a recurrent theme of hers. It is repeated multiple times in her books, like when she writes, “Thoughts influence every decision, word, action and physical reaction we make.” [1: p13] and “Our mind is designed to control the body, of which the brain is a part, not the other way around. Matter does not control us; we control matter through our thinking and choosing” [2: p33] just as a couple of examples.

So how does thought relate to the grand scheme of our brain and it’s processing? Does our thought really control our brain, or is it the other way around. Through all of the reading that I have done on neuroscience, I propose a model of the place of thought in relation to the rest of our brains information processing. It is based on the LIDA model, dual systems models, and other neuroscientific principles and processes.

We’ve all heard the phrase, “It’s just the tip of the iceberg.” It comes from the fact that icebergs are made of fresh water, which is nine-tenths less dense than seawater. As a result, ten percent of an iceberg sits above the waters surface with most of it hiding beneath.

The information processing of our brains is much the same. We may be aware of our conscious stream of thought, but there is a lot going on under the surface that makes our thoughts what they are, even though we can’t see the process underneath.

What’s going on under the surface is a complex interplay of our genes and their expression which controls the structure and function of our brains, which effects how we perceive information, how we process that information and combine it into our memories of the past, predictions of the future, and even the further perception of the present [3].

CAP v2.1.2
Genes, epigenetics and the environment
We start with the most fundamental level of our biological system, which is genetics. It becomes clear from looking at any textbook of biological sciences that genes are fundamental to who we are. From the simplest bacteria, fungi, protozoans and parasites, through to all plants, all animals and all of human kind – EVERY living thing has DNA. DNA is what defines life in the broadest sense.

Proteins are responsible for the size, shape and operation of the cell. They make each tissue structurally and functionally different, but still work together in a highly precise electrochemical synchrony. But ultimately, it’s our genes that hold all of the instructions to make every one of the proteins within our cells. Without our genes, we would be nothing more than a salty soup of random amino acids.

Epigenetics and the environment contribute to the way genes are expressed. Epigenetics are “tags” on the strand of DNA that act to promote or silence the expression of certain genes (I discuss this in more detail in chapter 12 of my book, https://www.smashwords.com/books/view/466848). Environmental factors (the components that make up the world external to our bodies) can influence genes and epigenetic markers. The environment can cause genetic mutations or new epigenetic marks that change the function of a particular gene, and depending on which cell they effect (a very active embryonic cell or a quiet adult cell) will largely determine the eventual outcome. The environment is more influential to our genetic expression than epigenetics.

Still, on average only about 25% of the expression of a complex trait is related to environmental factors. So while the environment is important, it is still outdone 3:1 by our genome.

Yes, epigenetics and the environment are important, but they influence, not control, the genome.

Perception
We live in a sensory world. The five senses are vital in providing the input we need for our brain to understand the world and meaningfully interact with it.

Different organs are needed to translate the optical, chemical or mechanical signals into electrical signals. Different parts of our brain then interpret these signals and their patterns.

Our genes significantly influence this process. For example, if someone is born with red-green colour blindness then how he or she interprets the world will always be subtly different to someone with normal vision. Or a person born with congenital deafness will always interpret his or her environment in a different way to someone with full hearing. I’ve highlighted these two conditions because they provide stark examples to help demonstrate the point, but there are many unique genetic expressions in each of the five senses that subtly alter the way each of us perceives the world around us.

So while we may all have the same photons of light hitting our retinas, or the same pressure waves of sound reaching our ears or touch on our skin, how our brains receive that information is slightly different for every individual. The information from the outside world is received by our sensory organs, but it is perceived by our brain, and even small differences in perception can have a big impact on the rest of the system.

Personality
Personality is “the combination of characteristics or qualities that form an individual’s distinctive character” [4]. Formally speaking, personality is, “defined as constitutionally based tendencies in thoughts, behaviors, and emotions that surface early in life, are relatively stable and follow intrinsic paths of development basically independent of environmental influences.” [5]

Professor Gregg Henriques explained it well in Psychology Today, “Personality traits are longstanding patterns of thoughts, feelings, and actions which tend to stabilize in adulthood and remain relatively fixed. There are five broad trait domains, one of which is labeled Neuroticism, and it generally corresponds to the sensitivity of the negative affect system, where a person high in Neuroticism is someone who is a worrier, easily upset, often down or irritable, and demonstrates high emotional reactivity to stress.” [6] The other four personality types are Extraversion, Agreeableness, Conscientiousness, and Openness to Experience.

Gene x environment studies suggest that personality is highly heritable, with up to 60% of personality influenced by genetics [7], predominantly through genes involved in the serotonin [8] and dopamine systems [9, 10]. The “non-shared environment” (influences outside of the home environment) contributes heavily to the remainder [11, 12].

Personality is like a filter for a camera lens, shaping the awareness of our emotional state for better or worse, thus influencing the flow on to our feelings (the awareness of our emotions), our thoughts, and our actions.

Physiology
Watkins describes physiology as streams of data that are provided from the different parts of your body, like the heart rate, your breathing rate, the oxygen in your blood, the position of your joints, the movement of your joints, even the filling of your bladder telling you that you need a break soon.

All of these signals are constantly being generated, and collated in different parts of the brain. Some researchers consider them positive and negative depending on the data stream and the signal its providing. They coalesce into emotion [13].

Emotion
According to Watkins, “emotion” is the sum of all the data streams of physiology, or what he described as “E-MOTION … Energy in MOTION.” [13] In this context, think of emotion as a bulls-eye spirit-level of our body systems. The different forces of our physiology change the “level” constantly in different directions. Emotion is the bubble that marks the central point, telling us how far out of balance we are.

In the interest of full disclosure, I should mention that although emotion is a familiar concept, the work of literally thousands of brilliant minds has brought us no closer to a scientifically validated definition of the word “emotion”. Some psychologists and researchers consider it vague and unscientific, and would prefer that it not be used altogether [14].

I’ve retained it because I think it’s a well-recognised word that conceptually describes the balance of physiological forces.

Feelings
“Feelings” are the perception of emotion.

I discussed earlier in the chapter that what we perceive is different to what we “see” because the subtle genetic differences in our eyes and brains causes the information to be processed differently between individuals. The same applies to the perception of our emotion.

As I wrote earlier, personality is largely determined by our genetics with contributions from our environment [11, 12]. The emotional signal is filtered by our personality to give rise to our feelings. Classically, an optimistic personality is going to bias the emotional input in a positive, adaptive way while a pessimist or neurotic is going to bias the emotional signal in a maladaptive way

That’s not to say that an optimist can’t have depressed feelings, or a neurotic can’t have happy feelings. In the same way that a coloured lens will allow a lot of light through but filter certain wavelengths out, most of our emotional state of being will come through the filter of our personality but the feelings will be subtly biased one way or another.

Executive Functions
Executive function of the brain is defined as a complex cognitive process requiring the co-ordination of several sub-processes to achieve a particular goal [15]. These sub-processes can be variable but include working memory, attention, goal setting, maintaining and monitoring of goal directed action and action inhibition. In order to achieve these goals, the brain requires flexibility and coordination of a number of networks and lobes, although mainly the prefrontal cortex, parietal cortex, anterior cingulate and basal ganglia, and the while matter tracts that connect them.

Executive functions process the incoming information and decide on what goals are best given the context, then plan the goals, execute them to the motor cortices, and monitor the action. Research work from Marien et al [16] demonstrates that unconscious/implicit goals can divert resources away from conscious goals especially if it is emotionally salient or otherwise strongly related. They also confirm that conscious awareness is not necessary for executive function but that implicit goals can be formed and executed without conscious involvement.

Thoughts
Thoughts are essentially a stream of data projected into our conscious space. Baars [17, 18] noted that the conscious broadcast comes into working memory which then engages a wider area of the cerebral cortex necessary to most efficiently process the information signal. We perceive thought most commonly as either pictures or sounds in our head (“the inner monologue”), which corresponds to the slave systems of working memory. When you “see” an image in your mind, that’s the visuospatial sketchpad. When you listen to your inner monologue, that’s your phonological loop. When a song gets stuck in your head, that’s your phonological loop as well, but on repeat mode.

There is another slave system that Baddeley included in his model of working memory called the episodic buffer, “which binds together complex information from multiple sources and modalities. Together with the ability to create and manipulate novel representations, it creates a mental modeling space that enables the consideration of possible outcomes, hence providing the basis for planning future action.” [19]

Deep thinking is a projection from your brains executive systems (attention or the default mode network) to the central executive of working memory, which then recalls the relevant information from long-term memory and directs the information through the various parts of the slave systems of working memory to process the complex details involved. For example, visualizing a complex scene of a mountain stream in your mind would involve the executive brain directing the central executive of working memory to recall information about mountains and streams and associated details, and project them into the visuospatial sketchpad and phonological loop and combine them via the episodic buffer. The episodic buffer could also manipulate the scene if required to create plans, or think about the scene in new or unexpected ways (like imagining an elephant riding a bicycle along the riverbank).

Even though the scene appears as one continuous episode, it is actually broken up into multiple cognitive cycles, in the same way that images in a movie appear to be moving, but are really just multiple still frames played in sequence.

Action
Action is the final step in the process, the output, our tangible behaviour

Our behaviour is not the direct result of conscious thought, or our will (as considered in the sense of our conscious will).

We discussed this before when we talked about our choices in chapter 1. There are two main pathways that lead from sensory input to tangible behaviour – various automated pathways that take input from the thalamus, deep in the brain, and sent to motor circuits in the supplementary motor area and motor cortex of the brain. These can be anything from evasive “reflex” actions[1] to rehearsed, habituated motor movements, like driving. Then there is the second pathway, coming from the executive areas of our brain, that plan out options for action, which are reviewed by the pre-supplemental motor area and the default mode network.

This second pathway is amenable to conscious awareness. Like thought, the projection of different options for action into our consciousness helps to engage a wider area of cerebral cortex to process the data. Most of the possible plans for action have already been rejected by the implicit processing of our executive brain before consciousness is brought in to help. Once an option has been selected, the action is sent to the pre-supplementary motor area, the supplementary motor area, the basal ganglia and finally the motor cortex.

According to the model proposed by Bonn [20], the conscious network has some feedback from the control network of our brain, providing real time context to actions about to be executed, and a veto function, stopping some actions at the last minute before they are carried out. This is largely a function of the basal ganglia [21], with some assistance from working memory.

So as you can see, according to the CAP model, conscious thoughts are one link of a longer chain of neurological functions between stimulus and action – simply one cog in the machine. Thoughts are dependent on a number of processes that are both genetically and environmentally determined, beyond our conscious control. It’s simply wrong to assume that thoughts control the brain.

Dr Leaf is welcome to her opinion, but it is in contradiction to the overwhelming majority of neuroscientific knowledge

References

  1. Leaf, C., Who Switched Off My Brain? Controlling toxic thoughts and emotions. 2nd ed. 2009, Inprov, Ltd, Southlake, TX, USA:
  2. Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan:
  3. Hao, X., et al., Individual differences in brain structure and resting brain function underlie cognitive styles: evidence from the embedded figures test. PLoS One, 2013. 8(12): e78089 doi: 10.1371/journal.pone.0078089
  4. Oxford Dictionary of English – 3rd Edition, 2010, Oxford University Press: Oxford, UK.
  5. De Pauw, S.S., et al., How temperament and personality contribute to the maladjustment of children with autism. J Autism Dev Disord, 2011. 41(2): 196-212 doi: 10.1007/s10803-010-1043-6
  6. Henriques, G. (When) Are You Neurotic? Theory of Knowledge: Psychology Today; 2012, 23 Nov 2012 [cited 2013 23 Nov 2012]; Available from: http://www.psychologytoday.com/blog/theory-knowledge/201211/when-are-you-neurotic.
  7. Vinkhuyzen, A.A., et al., Common SNPs explain some of the variation in the personality dimensions of neuroticism and extraversion. Transl Psychiatry, 2012. 2: e102 doi: 10.1038/tp.2012.27
  8. Caspi, A., et al., Genetic sensitivity to the environment: the case of the serotonin transporter gene and its implications for studying complex diseases and traits. Am J Psychiatry, 2010. 167(5): 509-27 doi: 10.1176/appi.ajp.2010.09101452
  9. Felten, A., et al., Genetically determined dopamine availability predicts disposition for depression. Brain Behav, 2011. 1(2): 109-18 doi: 10.1002/brb3.20
  10. Chen, C., et al., Contributions of dopamine-related genes and environmental factors to highly sensitive personality: a multi-step neuronal system-level approach. PLoS One, 2011. 6(7): e21636 doi: 10.1371/journal.pone.0021636
  11. Krueger, R.F., et al., The heritability of personality is not always 50%: gene-environment interactions and correlations between personality and parenting. J Pers, 2008. 76(6): 1485-522 doi: 10.1111/j.1467-6494.2008.00529.x
  12. Johnson, W., et al., Beyond Heritability: Twin Studies in Behavioral Research. Curr Dir Psychol Sci, 2010. 18(4): 217-20 doi: 10.1111/j.1467-8721.2009.01639.x
  13. Watkins, A. Being brilliant every single day – Part 1. 2012 [cited 2 March 2012]; Available from: http://www.youtube.com/watch?v=q06YIWCR2Js.
  14. Dixon, T., “Emotion”: The History of a Keyword in Crisis. Emot Rev, 2012. 4(4): 338-44 doi: 10.1177/1754073912445814
  15. Elliott, R., Executive functions and their disorders Imaging in clinical neuroscience. British Medical Bulletin, 2003. 65(1): 49-59
  16. Marien, H., et al., Unconscious goal activation and the hijacking of the executive function. J Pers Soc Psychol, 2012. 103(3): 399-415 doi: 10.1037/a0028955
  17. Baars, B.J. and Franklin, S., How conscious experience and working memory interact. Trends Cogn Sci, 2003. 7(4): 166-72 http://www.ncbi.nlm.nih.gov/pubmed/12691765 ; http://bit.ly/1a3ytQT
  18. Baars, B.J., Global workspace theory of consciousness: toward a cognitive neuroscience of human experience. Progress in brain research, 2005. 150: 45-53
  19. Repovs, G. and Baddeley, A., The multi-component model of working memory: explorations in experimental cognitive psychology. Neuroscience, 2006. 139(1): 5-21 doi: 10.1016/j.neuroscience.2005.12.061
  20. Bonn, G.B., Re-conceptualizing free will for the 21st century: acting independently with a limited role for consciousness. Front Psychol, 2013. 4: 920 doi: 10.3389/fpsyg.2013.00920
  21. Beste, C., et al., Response inhibition subprocesses and dopaminergic pathways: basal ganglia disease effects. Neuropsychologia, 2010. 48(2): 366-73 doi: 10.1016/j.neuropsychologia.2009.09.023

[1] We often describe rapid unconscious movements, especially to evade danger or to protect ourselves, as “reflexes”. Medically speaking, a true reflex is a spinal reflex, like the knee-jerk reflex. When a doctor taps the knee with the special hammer, the sudden stretch of the tendon passes a nerve impulse to the spinal cord, which is then passed to the muscle, which makes it contract. A true reflex doesn’t go to the brain at all.

Dr Caroline Leaf and the matter of mind over genes

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I think I might have to throw away my genetics textbook.

I was always taught that genes were the main driver behind health and disease, and I always thought it was a pretty good theory.

But not according to Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist, who said on her social media feeds today, “Our health is not controlled by genetics – our health is controlled by our mind.”

Taking her statement at face value, she appears to be saying that genes have nothing to do with our health. Dr Leaf has made some asinine statements in the past, but to suggest that genes are irrelevant to human health seemed so stupid that no one in their right mind would suggest such a thing.

Perhaps I was taking her statement the wrong way? I wanted to make sure I didn’t jump to any rash conclusions about Dr Leaf’s statement, so I pondered it at length. Could she be referring to ‘control’ in the absolute sense? How much control do genes have on our health? What about the mind?

After deliberating for a while, I still came to the conclusion that Dr Leaf’s statement was nonsense.

Unfortunately, Dr Leaf’s statement is, like so many of her previous Facebook memes, so vague as to be misleading. The meaning of ‘health’ and ‘controlled’ could be taken so many ways … which part of our health? How much regulation constitutes ‘control’? What about genetics?

Looking at her statement in more depth, it becomes clear that no matter which way Dr Leaf meant it, it’s still wrong. For example, all of human health is controlled, in part, by genetics. That’s because life itself is controlled by genetics. The human genome provides a blueprint for the construction of all of the proteins in all of the cells in our entire body. The expression of those genes determines exactly how our body will run. If the genes are wrong, if the translation of the gene code into a protein is wrong, or if too much or too little of a protein is made, all determines whether our body is functioning at its optimum level or not.

The stimulus for the expression of our genes is influenced by the environment in which we live. If I go out into the sun a lot, the UV light triggers my skin cells to make the protein melanin, which makes my skin go darker and helps to provide some protection against the damaging effects of the UV light.

While the environment plays a part of the expression of some genes, it’s wrong to say that genetics doesn’t control the process. If I go into the sun too much, I risk developing a melanoma, because the sun damages the genes in some of my skin cells, causing them to grow without control.

Genes are still responsible for the disease itself. Sometimes the trigger is from the environment, sometimes it’s not. There are some people with genes for melanoma who don’t need an environmental trigger, because they develop melanoma on skin that’s exposed to very little UV light, like the genital skin.

So fundamentally, even taking the environment into account, our health is controlled by our genetics.

The other part of Dr Leaf’s meme is also wrong. Our health is not controlled by our mind. Our genes are influenced by “the environment”, which according to the seminal paper by Ottman, “The environmental risk factor can be an exposure, either physical (e.g., radiation, temperature), chemical (e.g., polycyclic aromatic hydrocarbons), or biological (e.g., a virus); a behavior pattern (e.g., late age at first pregnancy); or a “life event” (e.g., job loss, injury). This is not intended as an exhaustive taxonomy of risk factors, but indicates as broad a definition as possible of environmental exposures.” [1]

Even if one considers the mind as part of the sub classification of “a behavior pattern”, it’s still pretty clear that most of the factors that make up our environment are not related to our mind at all but are related to the external world, of which we have minimal or no control over. Sure, we make choices, but our choices aren’t truly free. They’re constrained by the environment in which we find ourselves. In the same way, our mind may have some tiny influence on our health, but only insofar as our environment and our genes will allow.

When it all boils down, this meme of Dr Leaf’s is rested on her foundational presumption that our mind can control matter, a very strong theme throughout her most recent book [2], but which is still preposterous. Our thoughts are simply a function of our brain, which is in turn determined by the function of our nerve cells, which is in turn a function of our genes and their expression.

Our mind doesn’t control matter. Matter controls our mind.

I can keep my genetics textbooks after all.

References

  1. Ottman, R., Gene-environment interaction: definitions and study designs. Prev Med, 1996. 25(6): 764-70 http://www.ncbi.nlm.nih.gov/pubmed/8936580
  2. Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan:

Dr Caroline Leaf and the mistruth done three ways.

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“Every thought you think impacts every one of the 75-100 trillion cells in your body at quantum speeds!” – Dr Caroline Leaf

I was going to stick to my series on thoughts over the next few days, but Dr Leafs social media gem today was so farcical and fanciful, I had to briefly comment on it.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. She is ‘flexible’ with the truth when she blogs or posts on social media. It’s never really quite clear exactly where the facts end and the generous ‘poetic licence’ begins. Of course, she never references any of her posts, so it’s anyone’s guess as to how she arrived at the statement in the first place.

Today’s offering is a typical example. It’s a breathless melding of some exaggerated statements, impressive sounding numbers, and a brief reference to a science which sounds catchy but that not even physicists fully understand. It is a master class in taking a concept that’s scientifically incorrect and making it sound like a Nobel Prize winning idea.

Lets breaking it down into its different components and analyse their validity separately:
“Every thought you think impacts … every cell in your body …”
“… every one of the 75-100 trillion cells in your body …”
“… at quantum speeds!”

  1. “Every thought you think impacts … every cell in your body …”

This is the core part of Dr Leaf’s statement. Like most of Dr Leaf’s teaching on our thoughts, her definition of thoughts is incorrect, as is the place of thoughts in the neuro-informational processing schema. Our streams of thought are just slivers of information projected from the deeper regions of the brain into to a wider area of our cerebral cortex. The brain uses this process to analyse the information to a higher degree before acting on it or sending it into memory.

Our thoughts are nothing special. They’re just a small cog in a much larger machine. They do not have any influence beyond what the rest of the brain would allow [1].

Thoughts certainly don’t influence every cell in our body. They physically can’t. Cells are not connected to every other cell in the body

Even if they were connected, it doesn’t make sense that our thoughts influence every other cell. The hyperbole verges on the ridiculous. As if a random fibroblast in the tip of my 5th pinkie toe was significantly influenced by the thought that I had when I felt like chicken for dinner. Dr Leaf’s assertion that, “Every thought you think impacts … every cell in your body”, is a nonsense statement.

  1. “… every one of the 75-100 trillion cells in your body …”

How many cells do you really have in your body? I’ve never really tried to count them all myself, but according to the Smithsonian in Washington, USA, there are only 37.2 trillion (http://www.smithsonianmag.com/smart-news/there-are-372-trillion-cells-in-your-body-4941473/?no-ist). The fact that Dr Leaf has so badly estimated, when all she needed to do was a one line Google search, suggests that she just made the number up. Out of respect to Dr Leaf, she really needs to reference her facts or she will continue to lose credibility,

  1. “… at quantum speeds.”

Quantum physics remains largely mysterious even to those physicists who study it. So it’s a brave person who invokes the “quantum” word in any statement.

It appears that most scientists believe that the maximum quantum speed is the speed of light (http://www.wired.com/2012/01/quantum-information-speed/) so Dr Leaf believes that thought works at light speed. Interesting, because any communication between distant cells in the body is done through electrical transmission or signalling via hormones, which is certainly not at light speeds.

So thought doesn’t talk to our 37.2 trillion cells or even significantly impact them. It can’t. Thought doesn’t control our physiology or our actions, and our body does not work at light speed.

Dr Leaf seems to be largely basing her statement on theory that she has derived from a paper called “Local and nonlocal effects of coherent heart frequencies on conformational changes of DNA”, which suggested that deep love meditation changed some DNA’s ability to wind and unwind. They suggest that the same meditation can change DNA from 3 miles away. Except … that study is deeply flawed.   (see my blog on the subject )

So ultimately, Dr Leaf has just published a social media post which has no scientific basis whatsoever. I would suggest that her followers deserve something better than some flighty, exaggerated puff-piece.

References

  1. Pitt, C.E., Hold That Thought: Reappraising the work of Dr Caroline Leaf, 2014 Pitt Medical Trust, Brisbane, Australia, URL http://www.smashwords.com/books/view/466848

Dr Caroline Leaf and the shotgun approach

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“It has been collectively demonstrated by researchers around the world that just about every aspect of our brainpower, intelligence and control – in normal, and psychiatrically and neurologically impaired individuals – can be improved by intense, efficient, organised and appropriately direct mind training … thank you Jesus.”

Sounds impressive doesn’t it.

Unfortunately for Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist, grandstanding does not equate to authority.  It’s all very well and good to publish broad, sweeping generalisations, but it’s like firing a shotgun at a cork from thirty paces.  Sure, you might hit your target, but the scatter pattern of the ammunition misses more times than it hits.

If Dr Leaf wants her statement to be taken seriously, then she needs to do a couple of small things.
(1) Reference her statement.  This should be fairly easy if “researchers around the world” really have demonstrated the power of mind training.  To sum it up more effectively, perhaps Dr Leaf could cite a meta-analysis that proves the value of mind training.
(2) Stop confusing the mind with the brain. This is the biggest problem with her statement. The mind does not control the brain.  If Dr Leaf produced any references in support of her statement, they would be along the lines of training or retraining the brain, not the mind.

It may seem trivial, because most people think the mind and the brain are the same, but they’re two distinct things.  Old psychological therapies were based upon the notion that fixing your thoughts was the key to improving your mental health, but this notion is now outdated, considered part of “Western folk psychology” [1]. By using the concept of “mind” and “brain” interchangeably, Dr Leaf confuses the issue for the average person trying to come to grips with modern science.

I’d be grateful if Dr Leaf could publish some evidence to support her claim, because I’m unfamiliar with research showing that things like intelligence can be improved with brain training. Sure, there’s good evidence for the improvement in the damaged brain with specific physical exercises – it’s one of the primary tools in Rehabilitation Medicine. There is also good evidence for psychological therapies such as ACT, or Acceptance and Commitment Therapy, in improving mood amongst other things [2, 3]. Though I’ve read a recent meta-analysis of multiple studies that suggests “brain training” for working memory offers minimal benefit which is not maintained and not transferable across categories [4], which means there’s no proof that “brain training” improves intelligence.

In future posts, I hope that Dr Leaf provides something more accurate instead of grandiose shotgun statements.

References

  1. Herbert, J.D. and Forman, E.M., The Evolution of Cognitive Behavior Therapy: The Rise of Psychological Acceptance and Mindfulness, in Acceptance and Mindfulness in Cognitive Behavior Therapy. 2011, John Wiley & Sons, Inc. p. 1-25.
  2. Harris, R., Embracing Your Demons: an Overview of Acceptance and Commitment Therapy. Psychotherapy In Australia, 2006. 12(6): 1-8 http://www.actmindfully.com.au/upimages/Dr_Russ_Harris_-_A_Non-technical_Overview_of_ACT.pdf
  3. Harris, R., The happiness trap : how to stop struggling and start living. 2008, Trumpeter, Boston:
  4. Melby-Lervag, M. and Hulme, C., Is working memory training effective? A meta-analytic review. Dev Psychol, 2013. 49(2): 270-91 doi: 10.1037/a0028228

 

Labels – the good, the bad, and the ugly

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Yesterday, I wrote a rebuttal to Dr Caroline Leaf’s social media post, that “Psychiatric labels lock people into mental ill-health.” In my rebuttal, I suggested that psychiatric labels don’t lock anyone into mental ill-health any more than a medical diagnosis locks people into physical ill-health.

In the feedback I received, one intelligent young lady commented that, “I understand your point completely, but I took her words differently. I have often seen people who use their diagnosis as an excuse. For example, a kid gets diagnosed with Autism or ADHD, and suddenly the parents are using that as an excuse for their bad behaviour instead of teaching and helping them to deal with it. Another example, an adult is diagnosed with something mild, but uses it as an excuse to no longer care about trying to get a job or trying to get treatment and make an effort to get better”.

I certainly understand where she’s coming from. I’ve seen it too. A diagnosis is used as an excuse for someone’s avoidance, or a tool to milk every drop of sympathy from another. Giving someone a label seems to hinder some people more than help them.

Thankfully, there’s more than one side to the label story. I wanted to use today’s post to discuss the good, the bad, and the ugly side of diagnostic labels.

First, lets look at the ugly side of a diagnostic label. There will always be emotional and social connotations to every diagnosis that a person receives. Sometimes that’s sympathy, and sometimes that’s stigma. If a young woman told her friends that she had breast cancer, I’m sure that news would be met with an outpouring of care and support. If the same young woman told the same friends that she had chlamydia or genital herpes, I’d bet that most of the responses would be blaming or shaming, which is one reason why no one tells other people they’ve got chlamydia or herpes.

The same goes for mental health. The media often portrays people with mental illness as either homicidal or weak [1]. So the general response to mental health diagnoses is either fear or contempt. Even those who are neutral towards mental health often don’t understand it, so it’s difficult for those with mental health issues to receive true empathy for their plight.

Then, there is the bad side of a label. Labels can be misused, intentionally or unintentionally, for all sorts of reasons. They can also be wrongly applied. It might be that someone uses their diagnosis to draw sympathy from people, or money, or help when they don’t really need it. They might use their label as an excuse to avoid certain things they don’t like. There are innumerable ways that people can milk secondary gain from their problems.

However, appropriate diagnosis can bring many benefits. For example, correct labelling brings with it understanding and empowerment.

A diagnosis can help us understand more about ourselves, or the person with the diagnosis. That child with ADHD isn’t just being naughty, but has difficulty regulating their behaviour. That person with Asperger’s isn’t being intentionally rude, but has trouble with social cues, understanding body language, and communicating in an empathic way. A correct diagnosis also helps us understand our own strengths and weaknesses. They help us recognise what it is about ourselves that we can’t change, what we can change, and what we need to change.

Once you understand what it is you can change and what you can’t change, it empowers you to change what you can for the better, and accept and adapt to what you can’t change. You stop wasting precious strength and time fighting what you can’t change. Instead, all of the effort that would have been needlessly spent on the unchangeable can be effectively spent on improving what needs to be, and can be, changed.

In fairness, I should point out that a diagnosis isn’t always needed to make positive change. Acceptance and Commitment Therapy is a form of psychological therapy that encourages flexibility to accept those parts of our lives that are uncomfortable, whether they have a label or not, and allow our values to shape our life direction. Sometimes we can spend so much energy looking for a diagnosis that we stagnate, forgoing the forward momentum of what we value to focus on having a label for the symptoms.

But where a diagnosis can be made without undue effort, it can provide clarity to what often seems to be a jumbled mess of dysfunctional traits.

So, sure, sometimes labels can be used for the wrong things. That doesn’t mean they’re not useful or we should stop using them. There may be a stigma to a diagnosis of herpes or depression, but there are also good treatments available. The diagnosis may provide a way of changing a life of ongoing suffering to a life fulfilled.

More often than not, a good diagnosis helps bring clarity to a situation, enabling understanding, acceptance and empowerment. Rather than locking people in, a correct label usually unlocks a person’s potential to grow despite the problems they face.

References

  1. Corrigan, P.W. and Watson, A.C., Understanding the impact of stigma on people with mental illness. World Psychiatry, 2002. 1(1): 16-20 http://www.ncbi.nlm.nih.gov/pubmed/16946807

Dr Caroline Leaf – Exacerbating the Stigma of Mental Illness

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It was late in the afternoon, you know, that time when the caffeine level has hit critical and the only way you can concentrate on the rest of the day is the promise you’ll be going home soon.

The person sitting in front of me was a new patient, a professional young woman in her late 20’s, of Pakistani descent. She wasn’t keen to discuss her problems, but she didn’t know what else to do. After talking to her for a few minutes, it was fairly obvious that she was suffering from Generalised Anxiety Disorder, and I literally mean suffering. She was always fearful but without any reason to be so. She couldn’t eat, she couldn’t sleep, her heart raced all the time.

I was actually really worried for her. She let me do some basic tests to rule out any physical cause that was contributing to her symptoms, but that was as far as she let me help her. Despite talking at length about her diagnosis, she could not accept the fact that she had a psychiatric condition, and did not accept any treatment for it. She chose not to follow up with me either. I only saw her twice.

Perhaps it was fear for her job, social isolation, or a cultural factor. Perhaps it was the anxiety itself. Whatever the reason, despite having severe ongoing symptoms, she could not accept that she was mentally ill. She was a victim twice over, suffering from both mental illness, and its stigma.

Unfortunately, this young lady is not an isolated case. Stigma follows mental illness like a shadow, an extra layer of unnecessary suffering, delaying proper diagnosis and treatment of diseases that respond best to early intervention.

What contributes to the stigma of mental illness? Fundamentally, the stigma of mental illness is based on ignorance. Ignorance breeds stereotypes, stereotypes give rise to prejudice, and prejudice results in discrimination. This ignorance usually takes three main forms; people with mental illness are homicidal maniacs who need to be feared; they have childlike perceptions of the world that should be marveled; or they are responsible for their illness because they have weak character [1].

Poor information from people who claim to be experts doesn’t help either. For example, on her social media feed today, Dr Caroline Leaf said, “Psychiatric labels lock people into mental ill-health; recognizing the mind can lead us into trouble and that our mind is powerful enough to lead us out frees us! 2 Timothy1:7 Teaching on mental health @TrinaEJenkins 1st Baptist Glenardin.”

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. It’s disturbing enough that Dr Leaf, who did not train in cognitive neuroscience, medicine or psychology, can stand up in front of people and lecture as an “expert” in mental health. It’s even more disturbing when her views on mental health are antiquated and inane.

Today’s post, for example. Suggesting that psychiatric labels lock people in to mental ill-health is like saying that a medical diagnosis locks them into physical ill-health. It’s a nonsense. Does diagnosing someone with cancer lock them into cancer? It’s the opposite, isn’t it? Once the correct diagnosis is made, a person with cancer can receive the correct treatment. Failing to label the symptoms correctly simply allows the disease to continue unabated.

Mental illness is no different. A correct label opens the door to the correct treatment. Avoiding a label only results in an untreated illness, and more unnecessary suffering.

Dr Leaf’s suggestion that psychiatric labels lock people in to their illness is born out of a misguided belief about the power of words over our thoughts and our health in general, an echo of the pseudo-science of neuro-linguistic programming.

The second part of her post, that “recognizing the mind can lead us into trouble and that our mind is powerful enough to lead us out frees us” is also baseless. Her assumptions, that thought is the main driving force that controls our lives, and that fixing our thought patterns fixes our physical and psychological health, are fundamental to all of her teaching. I won’t go into it again here, but further information on how Dr Leaf’s theory of toxic thinking contradicts basic neuroscience can be found in a number of my blogs, and in the second half of my book [2].

I’ve also written on 2 Timothy 1:7 before, another of Dr Leaf’s favourite scriptures, a verse whose meaning has nothing to do with mental health, but seized upon by Dr Leaf because one English translation of the original Greek uses the words “a sound mind”.

So Dr Leaf believes that labelling someone as having a mental illness will lock them into that illness, an outdated, unscientific and purely illogical notion that is only going to increase the stigma of mental illness. If I were @TrinaEJenkins and the good parishioners of 1st Baptist Glenardin, I would be asking for my money back.

With due respect, and in all seriousness, the stigma of mental illness is already disproportionate. Mental illness can cause insurmountable suffering, and sometimes death, to those who are afflicted by it. The Christian church does not need misinformation compounding the suffering for those affected by poor mental health. Dr Leaf should not be lecturing anyone on mental health until she has been properly credentialed.

References

  1. Corrigan, P.W. and Watson, A.C., Understanding the impact of stigma on people with mental illness. World Psychiatry, 2002. 1(1): 16-20 http://www.ncbi.nlm.nih.gov/pubmed/16946807
  2. Pitt, C.E., Hold That Thought: Reappraising the work of Dr Caroline Leaf, 2014 Pitt Medical Trust, Brisbane, Australia, URL http://www.smashwords.com/books/view/466848

Dr Caroline Leaf and the myth of the myth of multitasking

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Can you successfully multitask?

According to Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist, multi-tasking is a myth.

Actually, Dr Leaf isn’t completely wrong. Her factoid is so vague that there may be some truth in it somewhere. The problem with teaching via vague factoid is that no one can apply anything from it. If we were to take Dr Leaf’s statement as a specific teaching or advice, then we would be misled.

Why? Because it all comes down to how you define ‘multi-tasking’.

I have a couple of patients in a nursing home, two old ladies who sit on a balcony in the sun, knitting and talking at the same time. Isn’t that multi-tasking? Think of what you do every day. How often are you doing something menial while doing something requiring a bit more attention? How often do you have a conversation with your passenger while your driving? Isn’t that multi-tasking? When you get up in the morning and you are able to make a cup of tea and some breakfast at the same time, read some of the paper or your e-mails while you’re eating your breakfast at the same time, etc. Isn’t that multi-tasking?

We multi-task all the time. If we had to do everything in a linear, sequential fashion, we would never get anything done. We are able to multi-task because routine tasks have become largely habitualised by our brains and don’t need lots of processing power to complete. Hence why we can do something as complex a driving a car while still talking to our passenger or listening to music. Certain occupations, such as air-traffic control, involve high levels of multi-tasking [1].

When a task is new and/or complicated, our brains need to utilise our resources of attention to properly process the information required by the task. There is only so much that our working memory can handle. Our working memory uses tricks to handle larger amounts of information through a process called “chunking” [2] but there is still a finite limit. Performing two or more cognitively demanding tasks at the same time is difficult, and the brain can often cope by shifting tasks, although there is always a price to pay for this [3].

So it is true that there are some tasks that require more of the cognitive capacity of the brain to process. The higher the cognitive load, the more capacity needed, and the less likely that the brain will be able to multi-task with it. Thus, it’s reasonable to suggest that we can’t multi-task all of the time with every task we have to perform (although the more we do a task, the more habitual it becomes, thus reducing the cognitive load of the task, and increasing our ability to multi-task it).

However it’s misleading to say that we can’t multi-task at all. It’s a myth that multi-tasking is a myth. Dr Leaf’s comment that, “Paying attention to one task at a time is the correct way”, isn’t a summary of the neuroscience of attention, but a subjective statement based on her grandiose pretension. There is no objective evidence that “one task at a time” offers generally applicable benefit.

So don’t be afraid of multi-tasking. Just know your limits.

References

  1. Nelson, J.T., et al., Enhancing vigilance in operators with prefrontal cortex transcranial direct current stimulation (tDCS). Neuroimage, 2014. 85 Pt 3: 909-17 doi: 10.1016/j.neuroimage.2012.11.061
  2. Bor, D. and Seth, A.K., Consciousness and the prefrontal parietal network: insights from attention, working memory, and chunking. Front Psychol, 2012. 3: 63 doi: 10.3389/fpsyg.2012.00063
  3. Monsell, S., Task switching. Trends in cognitive sciences, 2003. 7(3): 134-40

Dr Caroline Leaf and the cart-before-the-horse conundrum

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A chaotic mind filled with thoughts of anxiety, worry, etc. sends out the wrong signal right down to the level of our DNA

So says Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist.

Her Facebook factoids have varied in their quality lately, ranging from the almost reasonable, down to the outright ridiculous. Today’s contribution rates an 8.5 out of 10 on the pseudoscience scale.

The reason why it rates so high is for the same reason why many of her factoids, and indeed nearly all her teaching, rates the same: Dr Leaf has the relationship between the brain and the mind back to front.  Dr Leaf squarely puts the proverbial cart before the horse.

One would think if you were going to claim to be a cognitive neuroscientist, you would at least get the basic facts right. But Dr Leaf’s teaching, from her first book through to her last, is based on this idea that it’s the mind that is in control of the brain, hence why she thinks that thoughts can be so toxic.

Dr Leaf’s entire teaching heavily rests on her fallacious assumption that the mind is in control of the brain. Thoughts are only important if the mind controls the brain. Toxic thoughts can only affect our health if the mind controls the body. Controlling toxic thoughts is only worthwhile if our mind can influence our brain and body in positive or negative ways.

The problem for Dr Leaf is that there is no credible scientific evidence that the mind controls the brain. The only evidence she does tend to proffer is based on the work of other pseudoscientists, or she misinterprets or misquotes real scientific data to fit her erroneous working theory. For example, Dr Leaf refers to a paper titled, “Local and nonlocal effects of coherent heart frequencies on conformational changes of DNA” [1]. She says that this paper is, “An ingenuous experiment set up by the HeartMath Foundation (which) determined that genuine positive emotion, as reflected by a measure called ‘heart rate variability’, directed with intentionality towards someone actually changed the way the double helix DNA strand coils and uncoils. And this goes for both positive and negative emotions and intentions.” [2: p111] Actually, the experiment was based on faulty assumptions, and so full of flaws in their methodology and analysis, that it could show nothing at all [3]. All it could prove was that Dr Leaf was so desperate to grasp hold of anything that seemed to support her theory that she was willing to use a twenty-year-old study from a group of pseudoscientists that also believe in occult practices like ESP and telekinesis (http://psychotronics.org).

The concept that we have a soul that’s separate to, and controls our brain, is called dualism. Modern science gave up on dualism a long time ago. While psychological sciences have been slower to give up on the idea of our thoughts as influential, no credible scientist still holds on to the idea that we have an ethereal force that controls our biology. Dualism is untenable both scientifically and philosophically [4].

The reality is the exact opposite to what Dr Leaf teaches. Our brain is responsible for all of the functions that are traditionally associated with the mind/soul/spirit. For more in depth information, please see my essay: Dr Caroline Leaf, Dualism, and the Triune Being Hypothesis. Therefore, a “chaotic mind filled with thoughts of anxiety, worry, etc” doesn’t send signals down to our DNA. It’s our DNA and the many steps in it’s expression, and the interaction of our biology and our environment, that then causes our minds to be worried, anxious, chaotic etc.

Dr Leaf is welcome to hold any view she likes, but she cannot claim to be a cognitive neuroscientist while holding a view that is directly contradicted by actual cognitive neuroscience. Nor should she be welcome to speak as an expert when she clearly is not one.

For the sake of her audiences and the Christian church as a whole, Dr Leaf needs to revise her teaching and bring it into line with the facts established by real cognitive neuroscientists.

References

  1. Rein, G. and McCraty, R. Local and nonlocal effects of coherent heart frequencies on conformational changes of DNA. in Proc. Joint USPA/IAPR Psychotronics Conf., Milwaukee, WI. 1993.
  2. Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan:
  3. Pitt, C.E., Hold That Thought: Reappraising the work of Dr Caroline Leaf, 2014 Pitt Medical Trust, Brisbane, Australia, URL http://www.smashwords.com/books/view/466848
  4. Bunge, M., The Mind-Body Problem, in Matter and Mind. 2010, Springer Netherlands. p. 143-57.