“Touching the hem of her garment” – A Review of Dr Caroline Leaf at Nexus Church, Brisbane, 2nd August 2015

Dr Caroline Leaf is a communication pathologist and a self-titled cognitive neuroscientist. She’s currently on tour through Queensland and New South Wales in Australia. Her only stop in Brisbane, my home town, was at Nexus, my former home church. Dr Leaf presented a keynote address at Nexus’s annual Designing Women conference yesterday, and was the guest speaker at their two morning services today.

This morning typified Brisbane winter – cloudless azure skies and a refreshingly cool breeze. In contrast to the air temperature, the hospitality at Nexus was warm and friendly. The worship, soulful and uplifting. I really enjoyed being there.

Then it was Dr Leaf’s turn. It’s amazing just how much misinformation one person can fit into a 30 minute sermon.

The main theme for her sermons was an exposition on the parable of the sower, linking the different ways people receive information, with the story of the woman with the issue of blood. Dr Leaf tried to prove that thought and faith are synonymous by linking verses at the beginning and of the story from the gospel of Mark (5:25-34) – “because she thought, ‘If I just touch his clothes, I will be healed.’” (v28) and “He said to her, ‘Daughter, your faith has healed you. Go in peace and be freed from your suffering.’” (v34).

The link is highly tenuous to start with. Faith is an action, whereas thought is not. We assume that action is always preceded by thought, but it is not. Action does not require thought. Many people act without thinking. This is explained in more detail in my discussion on the Cognitive Action Pathways model.

Though to try and make her explanation more plausible, Dr Leaf padded out the story by telling the Nexus crowds that it was only because the woman had spent 12 years in deep intellectual thinking, meditating on the scriptures, that Jesus could heal her. But that’s Dr Leaf’s conjecture. In truth, no one knows exactly what that woman was doing or thinking in the 12 years that preceded her healing. The Bible never says anything else about the woman, in either version of the story in Mark or Luke (8:43-48), other than “She had suffered a great deal under the care of many doctors and had spent all she had, yet instead of getting better she grew worse” (Mark 5:26). If you have to rely on pure speculation to make your sermon work, then that’s story-telling, not preaching.

The other part of her sermon was an attempt to link the parable of the sower to some neuroscience, specifically the role of hippocampal synaptogenesis in the formation of long term memory (or in English, the changes that take place to nerves in the brain when you hear information and try to remember it).

Dr Leaf interpreted the parable as describing four different types of listener – Listener 1, corresponding to the man who hears the word but the devil takes it away, Listener 2, who hears the word and receives it with joy, but it doesn’t take root, Listener 3 who hears the word but it gets choked out by worries, riches or pleasure, and Listener 4 who hears the word and retains it, and the word produces a harvest.

According to Dr Leaf, these types of listener correspond to different levels of nerve branch growth in the formation of long term memory – Listener 1 doesn’t get past 24 hours before the memory dissipates. Listener 2 only lasts about four to seven days but there isn’t enough emotional salience to continue the growth of the nerve branch. Listener 3 doesn’t get past fourteen days, while the 4th Listener makes it through to a full 21 days, Dr Leaf’s magic number for long term memory.

Sounds great … except that the encoding and consolidation of incoming information is much more complex, and doesn’t rely on just new nerve growth [1]. That, and her numbers are completely arbitrary – with some permanent long term memory encoded in a couple of days. In fact, some long-term memory doesn’t need new synaptic growth at all, just a state of high excitation of the nerve network, known as Long-Term Potentiation, which is reliant on a self-reinforcing chemical cascade (if you want more information on the neurobiology of memory, a good place to start is The Brain From Top To Bottom, maintained by McGill University in Canada).

So the bulk of her sermon was based on biblical conjecture and bad science. Dr Leaf also made a myriad of misleading or mistaken statements: we are wired for love not fear, we learn through the quantum zeno effect, every thought effects every one of our 75 trillion cells, your toxic thoughts poison other people in relationship with you because of quantum physics, and many, many others.

I’ve only really got room for a few extra-special mentions.

1. “The mind controls brain”, and “the non-conscious mind is not bound by time and space”

No actual cognitive neuroscientist would be caught dead making those sort of statements. Saying that the mind controls the brain is like saying that air controls your lungs. The mind is a function of the brain, because when the brain is changed in certain ways, structurally or chemically, the mind changes. This has been known about for over a century, at least as far back as Freud who experimented with cocaine and other “mind-altering” substances.

Therefore if the brain controls the mind, then the non-conscious mind must be bound by the physical universe, which includes space and time. To suggest anything otherwise is just science fiction.

Besides, Dr Leaf herself tells us in her book “The Gift In You” [2], that our brain controls our mind. Dr Leaf is simply contradicting her own teaching.

2. “75 to 98% of all physical, mental and emotional illness is caused by your thought life.”

This factoid has been thoroughly debunked. If you would like to read more, you can click here or see chapter 10 in my book [3].

Today, in the second service, Dr Leaf took her fiction a step further and categorically stated that “98% of cancer comes from your thought life”. What nonsense! There is no rational evidence for such a ridiculous statement, and I don’t think there is anything more insensitive to cancer victims and their families than to blame then for causing their own cancer.

3. Mental Health

(a) “Mental illness is worse in the last 50 years than ever before”

To try and prove this is true, Dr Leaf flashed up a slide of ‘horrifying statistics” on mental illness. She claims that,
“35-fold increase in mental illness in children”
“Our children are the first in human history to grow up under the shadow of ‘mental illness'”
“Dramatic increase in the number of mentally ill since 50’s … things are worse not better”
“Mental ill health worst its ever been in history of mankind”

Every one of these statements is patently false. Mental illness has been with humankind for ever. The ancient Egyptians were writing about hysteria in women some two thousand years before Christ [4]. It’s only been in the last century or so that mental illnesses have become seen for the biological entities that they are, and not some form of demon possession, criminal behaviour or sexual deviancy.

Dr Leaf was quick to malign the DSM (the Diagnostic and Statistical Manual of psychiatry), suggesting that it’s unscientific. The DSM isn’t perfect, true, but before the DSM, there was even less science to the diagnosis of mental illness. As Dr Leaf herself pointed out, mental illness was previously viewed philosophically or spiritually. There was no consistency in diagnosis and no collection of statistics.

The DSM, for all its faults, gave a framework for mental health diagnosis, but as the science has become more refined, and with increasing awareness and general acceptance of mental health conditions, more people have qualified and/or accepted a diagnosis.

Mental illness has always been there, but now we know what to look for, it’s no longer hidden or ignored.

(b) “Psychotropic medications cause damage to the brain”

While on the subject of mental health, Dr Leaf made the litigation-attracting statement that psychotropic medications (anti-depressants, anti-psychotics) cause damage to the brain. That’s a particularly bold statement to make without citations, or a medical degree, to back it up.

Rather than ‘causing’ damage to the brain, there is scientific evidence that psychotropic medications increase synaptogenesis (the growth of new nerve branches) [5-7], while the NICE guidelines in the UK reviewed the evidence for anti-depressants and found them to be an effective treatment for depression [8], not harmful as Dr Leaf suggests.

(c) Biological causes for psychiatric illnesses have not been proven.

Dr Leaf also made the preposterous claim that biological causes of psychiatric illness have never been proven, but again, changes to brain structure have been associated with psychiatric symptoms ever since a 13-pound, three-and-a-half foot iron rod went through Phineas Gage’s skull and frontal lobe in 1848, and his personality suddenly changed from pleasant and congenial to depressed and angry [9]. Personality changes represent early symptoms of brain tumours. Use of drugs such as crystal meth can cause paranoia and extreme aggression. You don’t even need to be a doctor to know that, you just need to watch ‘Breaking Bad‘. So examples of the biological basis of psychiatric symptoms are everywhere. There are no grounds for Dr Leaf’s assertion.

4. Toxic thinking causes dementia

Dr Leaf claimed at the end of both sermons that toxic thinking results in the tubular backbone of the new nerve branches becoming contorted, which caused the accumulation of the tau protein in the nerve cells, which was responsible for dementia of every type. This, too, is a fallacy. The accumulation of the tau protein is found only in Alzheimers, not in Lewy Body dementia or in vascular dementia. The abnormal tau protein is likely related to the loss of a intracellular clean-up enzyme system [10], but Alzheimers is more complicated than just tau protein deposition, and has nothing to do with toxic thinking.

At the conclusion of the second service, I was outside the church when Dr Leaf and her entourage left the church auditorium before the rest of the crowd did, and I approached them to shake her hand and introduce myself. It was the mature thing to do after all. When I was about two metres from her presidential detail, a woman stepped out in front of me, blocking my way.

“You can’t follow them,” she said. “They’re going inside” (ie: hiding in the green room).
“Really?” I said, somewhat caught off guard. “I was simply going to introduce myself.”
“No”, was the firm reply. “You’re not allowed.”

By that time, the presidential detail had disappeared into their fortified sanctuary. The woman with the issue of blood may have got to Jesus, but there was no way I was even getting close to Dr Leaf.

This was a common pattern … Dr Leaf made herself deliberately scarce before and after each service, only coming into the church when the service was well underway, and leaving as soon as she preached, under heavy guard. One has to ask why? What’s she got to be afraid of? Is she so insecure about her teaching that she couldn’t possibly risk speaking to someone and being exposed as intellectually brittle? Or is it that she’s so arrogant as to insist on avoiding the rank-and-file church goer?

The pattern of avoidance of anyone other than her devotees, and her tendency to block anyone who disagrees with her from her social media accounts, would strongly suggest the former, although since she is so insistent on hiding from regular people, it’s really anyone’s guess.

Not that it matters. Dr Leaf could be the nicest person in the world.  Her ministry doesn’t rest on her sociability, but its own Biblical and scientific merits, and on that alone, it has been found seriously wanting.

References

[1]        Citri A, Malenka RC. Synaptic plasticity: multiple forms, functions, and mechanisms. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology 2008 Jan;33(1):18-41.
[2]        Leaf CM. The gift in you – discover new life through gifts hidden in your mind. Texas, USA: Inprov, Inc, 2009.
[3]        Pitt CE. Hold That Thought: Reappraising the work of Dr Caroline Leaf. 1st ed. Brisbane, Australia: Pitt Medical Trust, 2014.
[4]        Tasca C, Rapetti M, Carta MG, Fadda B. Women and hysteria in the history of mental health. Clinical practice and epidemiology in mental health : CP & EMH 2012;8:110-9.
[5]        Karatsoreos IN, McEwen BS. Resilience and vulnerability: a neurobiological perspective. F1000prime reports 2013;5:13.
[6]        Duric V, Duman RS. Depression and treatment response: dynamic interplay of signaling pathways and altered neural processes. Cellular and molecular life sciences : CMLS 2013 Jan;70(1):39-53.
[7]        Karatsoreos IN, McEwen BS. Psychobiological allostasis: resistance, resilience and vulnerability. Trends in cognitive sciences 2011 Dec;15(12):576-84.
[8]        Anderson I. Depression. The Treatment and Management of Depression in Adults (Update). NICE clinical guideline 90.2009. London: The British Psychological Society and The Royal College of Psychiatrists, 2010.
[9]        Kihlstrom JF. Social neuroscience: The footprints of Phineas Gage. Social Cognition 2010;28:757-82.
[10]      Tai HC, Serrano-Pozo A, Hashimoto T, Frosch MP, Spires-Jones TL, Hyman BT. The synaptic accumulation of hyperphosphorylated tau oligomers in Alzheimer disease is associated with dysfunction of the ubiquitin-proteasome system. The American journal of pathology 2012 Oct;181(4):1426-35.

The Prospering Soul – Just what is mental health?

When Paul wrote to the church at Thessalonica a couple of thousands years ago, he said, “May God himself, the God who makes everything holy and whole, make you holy and whole, put you together—spirit, soul, and body—and keep you fit for the coming of our Master, Jesus Christ.” (1 Thessalonians 5:23 -The Message)

The modern western church has two out of three. As modern Christians, we have the fitness of the Spirit pretty well down, and we’re not too shabby on our physical fitness either. Unfortunately, we still have a way to go on the Soul thing.

In 2013, Rick Warren stood in front of his church after the suicide of his son, and promised he would work to reduce the stigma of mental illness in the Christian church (http://swampland.time.com/2013/07/28/rick-warren-preaches-first-sermon-since-his-sons-suicide/). Rick Warren experienced the stigma and destruction of poor mental health first hand. So have many others in the church, as have I.

It’s my passion to help the Christian church prosper, our bodies, our spirits, AND our souls.   Over the next few months, I’ll be doing a series of blogs on mental health, to encourage and help those in the church battling mental illness, and everyone else in the church to know how to assist them in their battle.

Together, we can help to eliminate the stigma and destruction that mental health can bring into the lives of Christians, and that we may prosper in all things and be in health, just as our soul prospers (3 John 1:2).

To start with, it would help if we knew what it meant to be in good mental health, and what separates mental health from mental illness. The distinction isn’t always so obvious. There are a few ways to define or conceptualise mental health and illness, but to cut through the thousands of words of medical and scientific jargon, the difference between good mental health and bad mental health is often to do with changes to our thinking, mood, or behaviour, combined with distress and/or impaired functioning. [1] Our mental health is intimately linked with our physical health, and often physical illness will lead to changes to our thinking, mood, or behaviour, combined with distress and/or impaired functioning too, although strictly speaking, that’s not a pure mental health disorder.

What IS important for the average church goer to understand is that we all experience some changes to our mental health at different times in our lives. For example, we all experience grief and loss at some time in our lives, and at that time, it’s normal to experience extreme sadness, sleeplessness, anger, or guilt. What differentiates grief from depression is the trigger, and the time the symptoms take to resolve. In general, how we perceive our thoughts and behaviours, and how much any signs and symptoms affect our daily activities can help determine what’s normal for us.

There are some common signs that can help in knowing if professional help may be needed. This isn’t an exhaustive list, but if you or a loved one experiences:

  • Marked change in personality, eating or sleeping patterns
  • Inability to cope with problems or daily activities
  • Strange or grandiose ideas
  • Excessive anxiety
  • Prolonged depression or apathy
  • Thinking or talking about suicide
  • Drinking alcohol to excess or taking illicit drugs
  • Extreme mood swings or excessive anger, hostility or violent behaviour

then consult your family doctor or psychologist, or encourage your loved one to seek help. With appropriate support, you can identify mental health conditions and explore treatment options, such as medications or counselling.

Many people who have mental health conditions consider their signs and symptoms a normal part of life or avoid treatment out of shame or fear. If you’re concerned about your mental health or a loved one’s mental health, don’t hesitate to seek advice.

If you or a loved one have, or still struggle with, mental illness, I welcome your comments.

I can’t give specific counselling or advice in this forum, but if you are suffering from mental health problems and need help, see your GP or a psychologist, or if you’re in Australia, 24 hour telephone counselling is available through:

Lifeline = 13 11 14 – or – Beyond Blue = 1300 22 4636

References

  1. National Institute of Mental Health, Mental Health: A Report of the Surgeon General, U.S. Department of Health and Human Services, Editor 1999, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services: Rockville, MD.

Labels – the good, the bad, and the ugly

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