Dr Caroline Leaf and the Mental Monopoly Myth

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What’s more important to a person’s health and well being?

Is it their physical attributes – their genes, their fitness, their diet? Is it their psychological state – their mind, their emotional balance? Is it their social context – how they relate and contribute to the communities that they’re a part of? Or is it their spirituality – the depth of their connections to faith and the supernatural?

According to Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist, it’s the mind that dominates. This is a common theme of her books [1: especially chapter 1] and her social media memes.

Take today’s gem: “Mind action is the predominant element in well being and mental health.”

In other words, it doesn’t really matter what your genes are, where you were born or the depth of your acceptance in your community. It doesn’t matter whether you have a deep faith either. The psychological dominates the physical, the social and the spiritual. As she said in her books,

“Thoughts influence every decision, word, action and physical reaction we make.” [2: p13]
“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.” [1: p33]
“Research shows that 75 to 98 percent of mental, physical, and behavioural illness comes from ones thought life.” [1: p33]

Dr Leaf’s philosophy of our wellbeing can be pictured like a pyramid, with our ‘mind action’ (read, ‘choices’) dominating every other facet of our lives.

Leaf Mental Monopoly Model

The problem with this philosophy is that it doesn’t fit with science, scripture, or even common sense.

You don’t have to be a rocket scientist to recognise that Dr Leaf’s assertion doesn’t fit with every day experience. Where you were born and raised, and where you live, significantly impact a persons overall wellbeing, independent of their thoughts and choices.

Does Dr Leaf honestly believe that the wellbeing of a ten year old boy living in rural Sedan, with no access to running water and sewerage systems, living on a subsistence diet and drinking contaminated water from the only well in his village, has the same wellbeing as a ten year old in rural Ohio, who has access to clean water, plentiful food, and an education?

Does Dr Leaf think that the wellbeing of a pregnant woman in Afghanistan, with poor nutrition and limited access to meaningful antenatal care or a trained midwife to deliver her baby, is the same as the wellbeing of a pregnant woman in London, who has access to fresh food, vitamin supplements, GP’s, midwives, and specialist obstetricians in big city hospitals?

These are just two simple examples which demonstrate that the action of your mind has very little to do with your overall wellbeing.

But if you want to be more scientific about it, then look no further than the biopsychosocial model. Modern health professionals moved beyond the idea that only one facet of human existence was responsible for all of your wellbeing way back in the 1980’s. The biopsychosocial model proposes that the overall health of a person was equally dependent not just on the physical, but was part of a broader system of the medical, mental and the social [3]. The model recognised that a person’s overall wellbeing was made worse by social disadvantage as well as physical illness or poor coping skills, and so often, the physical, social and psychological would affect each other in loops – physical illness would often reduce a persons ability to mentally cope, which strained their social connections, making them lonely and reduced the care given to them, which then made them sicker.

Most Christian would recognise that one element is still missing, which is the spiritual. Our faith is a realm beyond rational thinking, and isn’t fairly grouped with the mental, although they are both housed in our brain. Still, faith influences our social interactions, our psychology, and our physical health, as much as each mutually influences our faith.

Putting it altogether, we don’t have a pyramid, but a collection of ponds. Our mind action does not dominate our health and our wellbeing, but is simply one part of a much larger whole, with our health and wellbeing at the centre.

Biopsychosocial spiritual coloured

It’s interesting that a woman with as much influence amongst the western Christian church as Dr Leaf would suggest that the mind is more influential to our wellbeing than our faith. This makes her teaching seem more humanist than holy, more secular than spiritual. It may invite questions about the deepest influences of her ministry – is it humanistic philosophy with a garnish of scripture, or does the Bible really promote thinking over faith? Ultimately, it’s up to each individual to examine the evidence for themselves and make up their own mind.

Irrespective of Dr Leaf’s philosophical foundations, I’d suggest that her hypothesis of the mental monopoly falls down at the level of common sense and good science. Medical science moved beyond the idea of the single dominant facet of humanity more than three decades ago.

It’s time for Dr Leaf to do the same.

References

[1]        Leaf CM. Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. Grand Rapids, Michigan: Baker Books, 2013.
[2]        Leaf C. Who Switched Off My Brain? Controlling toxic thoughts and emotions. 2nd ed. Southlake, TX, USA: Inprov, Ltd, 2009.
[3]        Borrell-Carrio F, Suchman AL, Epstein RM. The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Ann Fam Med 2004 Nov-Dec;2(6):576-82.

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Dr Caroline Leaf and the Sound Mind Meme

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Caroline Leaf is a brave woman.

Dr Caroline Leaf is a Communication Pathologist and self-titled Cognitive Neuroscientist.  She regularly publishes memes on her social media sites like FaceBook and Instagram that are supposed to reinforce her main teaching.

Her recent post declared:

“Your mind is all-powerful.  Your brain simply captures what your mind dictates. 2 Timothy 1:7”

We’re supposed to smile and nod, and accept that it must be right on face value alone.  Like, “Trust me, I’m a cognitive neuroscientist”.

But if we peel away the thin veneer of trust that covers the surface of this meme, we see that there isn’t much in the way of substance that supports it.

For a start, the only reference that Dr Leaf supplies is the scripture from 2 Timothy 1:7. She’s used this scripture in her work before, stating in her 2013 book, “For now, rest in the assurance that what God has empowered you to do with your mind is more powerful and effective than any medication, any threat, any sickness, or any neurological challenge.  The scripture is clear on this: You do not have a spirit of fear but of love, power and a sound mind (2 Tim 1:7).” [1]

So, first things first: the scripture 2 Timothy 1:7 says: “For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.”  (KJV)  But what does it actually mean?

Studying the full context and the original Greek reveals that this verse is not a reference to our mental health, but to the courage to perform the work that God has given us.

The Greek word for “fear” in this scripture refers to “timidity, fearfulness, cowardice”, not to anxiety or terror.  The Greek word that was translated “of a sound mind” refers to “self-control, moderation”, not to serenity.  So Paul is telling Timothy that God doesn’t make him timid, but full of power, love and self-control.  Paul teaches that through the Holy Spirit, we have all the tools: power, love and the control to use them, so we don’t have to be afraid.

In addition, looking at the verse in its context, and in a different translation, shows it in a completely different light to the way Dr Leaf promotes it.  From the NIV, “I am reminded of your sincere faith, which first lived in your grandmother Lois and in your mother Eunice and, I am persuaded, now lives in you also.  For this reason I remind you to fan into flame the gift of God, which is in you through the laying on of my hands. For the Spirit God gave us does not make us timid, but gives us power, love and self-discipline. So do not be ashamed of the testimony about our Lord or of me his prisoner. Rather, join with me in suffering for the gospel, by the power of God.” (2 Timothy 1:5-8)

The scripture doesn’t say that our minds are more powerful than medication, sickness or “neurological challenge”.  It clearly doesn’t say that our mind is all-powerful, and that our brains simply capture what our minds dictate.  This scripture doesn’t have anything to do with our mental health (nor is there any scientific evidence to suggest that our mind is all-powerful or that the brain captures what our mind dictates, although that is another blog entirely (see also: Dr Caroline Leaf and the Myth of Mind Domination)).

Scripture is the inspired word of God.  It’s poor form to knowingly misquote someone to support your position, but it’s a very brave person that would misquote scripture for the sake of their argument.  And the inaccuracy of Dr Leaf’s use of both scripture and science surely calls into question the accuracy of all of her other memes.  Perhaps those who follow Dr Leaf’s social media feeds should also start taking them with more than a pinch of salt.

References

1.         Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan:

(New Testament Greek lexicon used for the word search was the Blue Letter Bible Strongs Lexicon, Reference: Greek Lexicon: G1167 (KJV). Retrieved from http://www.blueletterbible.org/lang/lexicon/lexicon.cfm?Strongs=G1167&t=KJV and Greek Lexicon: G4995 (KJV). Retrieved from http://www.blueletterbible.org/lang/lexicon/lexicon.cfm?Strongs=G4995&t=KJV)

Bad choices cause brain damage?

“To err is human; to forgive, divine.”  Alexander Pope.

I’m not perfect.  At least, not the last time I checked.  And we’re all the same, aren’t we.  We all know through experience that we all stuff things up on a fairly regular basis.  We make bad choices.  We’re human!

Dr Caroline Leaf, Communication Pathologist and self-titled Cognitive Neuroscientist, believes that these bad choices literally cause brain damage.  Her fundamental assumption is that our thoughts control our brain [1: p33].  These thoughts can be healthy or they can be toxic.  Toxic thoughts “are thoughts that trigger negative and anxious emotions, which produce biochemicals that cause the body stress.” [2: p19]

Dr Leaf’s assumption is that thoughts and bad choices cause our brain cells to shrivel or die. “Once your body is truly in stress mode and the cortisol is flowing, dendrites start shrinking and even ‘falling off’” [2: p32].  She also says that, “We have two choices, we can let our thoughts become toxic and poisonous or we can detox our negative thoughts which will improve our emotional wholeness and even recover our physical health.” [2: p21]

It sounds a little extreme.  We all make bad choices, and we all experience stress.  When we’re stressed, do our memories really go missing, or the dendrites of nerve cells shake and fall like tree branches in a storm?  If we make a bad choice, do we really get brain damage?  Lets see what the scientific literature has to say.

Imagine walking along a path in a forest and you see a snake, only inches in front of you on the path.  What do you do? When faced with a high level of acute stress, the brain switches into a binary mode – fight/flight or freeze. Self-preservation has to kick in.  The only decision you have to make then and there is whether to run, to try and kill the snake before it kills you, or stop dead still and hope that the snake ignores you and slithers away.

At that point, most memory is redundant, as is a high-level analysis of snake species, or any other cognitive pursuit.  The brain doesn’t need them at that precise moment.  If they did engage, they would just get in the way.  Switching the thinking parts of your brain off focuses your attention on the immediate danger.  It’s an adaptive survival response.  Meantime, your memories and your theoretical knowledge about snakes don’t disappear.  They are still there, unchanged.  It is false to suggest that the memories “shrink”.

We’ve all experienced “mental block”.  Sometimes when we get into a situation, like an exam or a business meeting, our stress levels are high, and binary mode kicks in again, although this time it can be a hindrance.  This phenomenon of mental block under high stress was first proposed in 1908 and is currently known as the Yerkes-Dodson Law, a fundamental principle of the behavioural sciences [3].  Similar to the stress-productivity curve, Yerkes and Dodson proposed a U-shaped curve to represent the relationship between arousal (which could be either level of consciousness or stress) and behavioural performance.  At low arousal, there is poor performance.  At the mid-point of arousal, there is peak performance, and at high arousal, performance diminishes.

But again, our memories don’t shrink, and our nerve cell branches don’t fall off.  Once we reduce our level of arousal, we move away from the fight/flight/freeze mode, and everything is still there (and we perform better, according to Yerkes-Dodson).

Dr Leaf has a favourite analogy of “neurons as trees”.  And if neurons are trees, then the branches can “fall off”.  But neurons are not trees and dendrites are not tree branches.  The dendrites do not ‘fall off’ the neuron.  The neurons in the brain have mechanisms for ongoing brain plasticity – the ability of the brain to adapt to the challenges and changes in its internal and external environment that are constantly occurring.  If the brain needs to build a new circuit to encode a new piece of information, then it grows new dendrites and creates new synapses.  But the brain is limited by the amount of energy it can consume, and therefore the number of synapses it can maintain.  So the brain trims unnecessary dendrites, a process called “synaptic pruning”.

Synaptic pruning is a normal process. Chechik and Meilijson confirm that, “Human and animal studies show that mammalian brains undergoes massive synaptic pruning during childhood, removing about half of the synapses until puberty.” [4]

Synaptic pruning is not deleterious, but beneficial.  Chechik and Meilijson also note that, “synaptic overgrowth followed by judicial pruning along development improves the performance of an associative memory network with limited synaptic resources.” [4] So synaptic pruning is a normal physiological process, and occurs in all of us for many reasons, predominantly to improve the efficiency of our neural networks.  Perhaps synaptic pruning associated with the stress response is also an adaptive process?

Synaptic pruning also occurs in other physiological states that have nothing to do with stress or thought, such as the effects of oestrogen during the menstrual cycle and at menopause [5, 6].

A link between stress and dendrite loss has been discovered, but it is not consistent.  Some authors like Kopp and Rethelyi suggest that “severe stress for a prolonged period causes damage in hippocampal pyramidal neurons, especially in the CA3 and CA4 region and reductions in the length and arborization of their dendrites.” [7] However, Chen et al writes, “Whereas hippocampus-mediated memory deficits commonly were associated with—and perhaps result from—loss of synapse-bearing dendrites and dendritic spines, this association has not been universal so that the structure–function relationship underlying the effects of stress on hippocampal neurons has not been resolved.” [8]

It’s more accurate to think that chronic stress causes dendritic remodeling in animals [9], in which some nerve cells prune their synapses, which others grow them, and energy is diverted away from new nerve cell formation to the new synapses that are needed to cope with the stress.

A number of scientists have pointed out that patients with depression or anxiety, who normally have high levels of stress, have a smaller hippocampus and larger amygdala, so stress and depression must cause the smaller brain regions [9].  There may be some reduction in the number of synapses within the hippocampus and the frontal lobes of the brain, which may account for the change in size observed by a number of researchers.  But the modern thinking on these changes is that they are associated with depression, not caused by depression [10] (Correlation does not equal causation).

So, stress is associated with depression, but this is because genetic defects in one or multiple genes reduce the ability for the brain cells to produce synaptic branches.  It’s this decrease in the number of synapses that contributes to the typical changes in the brain seen at autopsy of patients who suffered from depression or anxiety [11].  The reduced ability of the nerve cells to grow synapses means that new branches can’t grow fast enough to process the stress signals properly [11, 12].  The poor signal transmission leads to a predisposition towards mood disorders like anxiety and depression [10, 11, 13-15], and less synaptic branches means both a smaller volume of the hippocampus, and an inability to process stress signals leads to a larger, overactive amygdala.

In summary, synaptic pruning is not due to toxic thinking or bad choices, unless every one of us engages in nothing but toxic thinking from early childhood to puberty, and menopause causes bad choices and toxic thoughts.  Stress doesn’t cause dendrites to fall off, but causes a reorganization of the dendrites to adapt to the new signals. The reduced capacity to form new dendrites makes those prone to mood disorders more vulnerable to stress, and depression or anxiety is the end result.

We are all bound to make bad choices and to have stress.  They don’t cause brain damage.  Which if you’re not perfect like me, is good news.

References

1.         Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan

2.         Leaf, C., Who Switched Off My Brain? Controlling toxic thoughts and emotions. 2nd ed. 2009, Inprov, Ltd, Southlake, TX, USA:

3.         Cohen, R.A., Yerkes–Dodson Law, in Encyclopedia of Clinical Neuropsychology, Kreutzer, J.S., et al., Editors. 2011, Springer Science+Business Media LLC: New York ; London. p. 2737-8.

4.         Chechik, G., et al., Neuronal regulation: A mechanism for synaptic pruning during brain maturation. Neural Comput, 1999. 11(8): 2061-80  http://www.ncbi.nlm.nih.gov/pubmed/10578044

5.         Chen, J.R., et al., Gonadal hormones modulate the dendritic spine densities of primary cortical pyramidal neurons in adult female rat. Cereb Cortex, 2009. 19(11): 2719-27 doi: 10.1093/cercor/bhp048

6.         Dumitriu, D., et al., Estrogen and the aging brain: an elixir for the weary cortical network. Ann N Y Acad Sci, 2010. 1204: 104-12 doi: 10.1111/j.1749-6632.2010.05529.x

7.         Kopp, M.S. and Rethelyi, J., Where psychology meets physiology: chronic stress and premature mortality–the Central-Eastern European health paradox. Brain Res Bull, 2004. 62(5): 351-67 doi: 10.1016/j.brainresbull.2003.12.001

8.         Chen, Y., et al., Correlated memory defects and hippocampal dendritic spine loss after acute stress involve corticotropin-releasing hormone signaling. Proc Natl Acad Sci U S A, 2010. 107(29): 13123-8 doi: 10.1073/pnas.1003825107

9.         Karatsoreos, I.N. and McEwen, B.S., Psychobiological allostasis: resistance, resilience and vulnerability. Trends Cogn Sci, 2011. 15(12): 576-84 doi: 10.1016/j.tics.2011.10.005

10.       Palazidou, E., The neurobiology of depression. Br Med Bull, 2012. 101: 127-45 doi: 10.1093/bmb/lds004

11.       Karatsoreos, I.N. and McEwen, B.S., Resilience and vulnerability: a neurobiological perspective. F1000Prime Rep, 2013. 5: 13 doi: 10.12703/P5-13

12.       Russo, S.J., et al., Neurobiology of resilience. Nature neuroscience, 2012. 15(11): 1475-84

13.       Felten, A., et al., Genetically determined dopamine availability predicts disposition for depression. Brain Behav, 2011. 1(2): 109-18 doi: 10.1002/brb3.20

14.       Bradley, R.G., et al., Influence of child abuse on adult depression: moderation by the corticotropin-releasing hormone receptor gene. Arch Gen Psychiatry, 2008. 65(2): 190-200 doi: 10.1001/archgenpsychiatry.2007.26

15.       Hauger, R.L., et al., Role of CRF receptor signaling in stress vulnerability, anxiety, and depression. Ann N Y Acad Sci, 2009. 1179: 120-43 doi: 10.1111/j.1749-6632.2009.05011.x