Tag Archives: thought

But I’m normally a rational person …

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She shifted uncomfortably in her seat, her uneasy hands fidgeting together, her eyes flitting around as she tried to focus on the wall across from her, unable to find a target for her empty gaze.

“But … I’m normally a rational person,” she said, finally putting words to the thought that had been evading her for half a minute.

She was a woman in her mid thirties, with a comfortable job, a family and a mortgage in the suburbs.  We were halfway through a standard GP consult, and we had already discussed and resolved something trivial before she finally plucked up the courage to change tack and reveal the hidden agenda she’d hoped to discuss all along.

“I’m anxious all the time.  I try so hard, but I can’t seem to stop thinking about all the things that could go wrong.”

I empathised.  I’ve been there too – I’ve lived through times when my anxiety disorder was so debilitating that I wouldn’t call someone on the phone for fear of dialling the wrong number.  Or when I was so depressed that I couldn’t see anything positive for the future, when nearly every thought I had was saturated with moribund darkness.

I was anxious as a teenager, but I was depressed as an adult.  I’d been through medical school and I had attained by GP fellowship when my depression took hold.  During the four years or so that I spent with the black dog, I was constantly haunted by the same narrative that now haunted my patient … “I’m a rational person, why am I thinking like this?”

The fact I had fellowship level medical training intensified my mental self-flagellation, “I know all about depression.  I understand CBT.  I know I’m ruminating on catastrophic thoughts.  So why can’t I stop them?  If only I could think more positively, I’d be so much better.”

I found myself in a self-defeating spiral, often called the struggle switch, where I thought I knew how to climb out of my psychological mire, but all I achieved in trying to climb out was to sink further in, making me feel more defeated, even more of a failure.  It was a very difficult time which I thought would never end.

Eventually it lifted, like a heavy fog thinning in the morning sunlight, but it certainly wasn’t the result of anything clever I did.  So why did my rational brain keep filling my mind with irrational thoughts?

The answer lay in a paradigm shift away from the long held beliefs that we were taught at medical school and in our general practice training.  We’ve been lead to believe for so many years that our thoughts were the key driver of our behaviour, but it turns out that it’s actually the other way around, our behaviour is but one of a number of key driver of our thoughts.

The foundation of CBT is the notion that challenging maladaptive thoughts helps to empower behavioural change.  Except that research suggests that cognitive therapy specifically targeting problem thoughts offers no extra improvement over behavioural therapy alone.

Herbert and Forman confirm this when they point out that, “proponents of behavioral activation point to the results of component control studies of CT, in which behavioral activation or exposure alone is compared to behavioral activation (or exposure) plus cognitive restructuring. The majority of these studies have failed to demonstrate incremental effects of cognitive restructuring strategies.” [1]

This fact has been further confirmed by a number of meta-analyses [2] and by a large randomised controlled trial comparing behavioural therapy and cognitive therapy side by side with medication for depression [3].

So therapies aimed at fixing thinking works equally as well as therapies aimed only at promoting therapeutic action.  However, when thinking therapies are added to behaviour therapies, they add no extra benefit over and above the behaviour therapies alone [2].  This suggests that action is the driver of the therapeutic effects of psychological therapy.  If thinking were the driving force of psychological change, the addition of cognitive therapy to behaviour therapy should have an incremental effect.

That cognitive therapy works equally well as behavioural therapy may be related to their fundamental similarities. Dobson et al explains, “Behavioural Activation is implemented in a manner that is intended to both teach coping skills and to reduce future risk. The same is true for Cognitive Therapy, which adds an emphasis on cognitive change, but otherwise takes a similar skills-training approach.” [3]  In other words, cognitive behavioural therapy is just behavioural therapy with bling.

Herbert and Forman summarise it nicely, “The ideas that thoughts and beliefs lead directly to feelings and behavior, and that to change one’s maladaptive behavior and subjective sense of well-being one must first change one’s cognitions, are central themes of Western folk psychology.  We encourage friends to ‘look on the bright side’ of difficult situations in order to improve their distress. We seek to cultivate ‘positive attitudes’ in our children in the belief that this will lead to better academic or athletic performance. Traditional cognitively-oriented models of CBT (e.g., CT, stress inoculation training, and rational emotive behavior therapy) build on these culturally sanctioned ideas by describing causal effects of cognitions on affect and behavior, and by interventions targeting distorted, dysfunctional, or otherwise maladaptive cognitions.” [1]

I understand this is going to ruffle some feathers, and not everyone is going to be keen to dispense with CBT just yet, but I hope this gets us thinking about thinking at the very least.

For me, coming to an understanding that my thoughts were just the dashboard and not the engine helped me to pay less attention to them and to focus my healing energies on what was really important, taking values based action rather than just fighting with my stream of thoughts.

And it’s helped me to empathise differently with my patients and reassure them that you can still be a rational person even if your thoughts don’t always seem to follow suit.

References
[1]       Herbert JD, Forman EM. The Evolution of Cognitive Behavior Therapy: The Rise of Psychological Acceptance and Mindfulness. Acceptance and Mindfulness in Cognitive Behavior Therapy: John Wiley & Sons, Inc., 2011;1-25.
[2]       Longmore RJ, Worrell M. Do we need to challenge thoughts in cognitive behavior therapy? Clinical psychology review 2007 Mar;27(2):173-87.
[3]       Dobson KS, Hollon SD, Dimidjian S, et al. Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression. Journal of consulting and clinical psychology 2008 Jun;76(3):468-77.


KINTSUKUROI CHRISTIANS – Available at Koorong, Amazon, iBooks and other good book retailers

Dr Caroline Leaf and Testimonials – Good marketing, poor evidence

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Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. She is a pseudoscientist of the highest order. She once wrote a PhD. Now she has episodes of her TV show titled “Surviving cancer by using the Mind”.

This weeks edition of her newsletter started off with some subtle boasting:

“We have received many E-mails over the past years asking for Testimonies with regards to Dr Leaf’s research and teachings. We have summarized eight pages of testimonies received at TESTIMONIES. Be encouraged and feel free to refer them to friends, family, acquaintances, and work colleagues struggling with Mind issues.”

Testimonials are an empty box wrapped in shiny paper and trimmed with a bow. They look really good but offer nothing of substance. They’re simply an old advertising trick.

According to the Market Science Institute, “Testimonial solicitations – in which firms solicit consumers’ personal endorsements of a product or service – represent a popular marketing practice. Testimonials are thought to offer several benefits to firms, among them that participating consumers may strengthen their positive attitudes toward a brand, through the act of writing testimonials.” [1]

Who can argue with a person who says that Dr Leaf helped turn their life around? Saying anything negative just makes you sound like a cynical old boot.

And that’s the real problem, because while publishing a whole bunch of positive stories is good for marketing, it makes it very hard for those who had a genuinely bad experience to say anything. No one wants to listen to those people whom Dr Leaf has confused or mislead – it makes for terrible PR. Those people feel devalued, and sometimes worse, because it seems like everyone else had a good result from Dr Leaf’s teaching, except them.

Testimonials also make for very poor scientific evidence. Indeed, testimonials are considered the lowest form of scientific evidence [2]. It’s all very well and good for a bunch of people to share their positive experiences, but as life changing as the experience may have been, they are not evidence of the effectiveness of Dr Leaf’s teaching. Without specific, well-designed research, no one can say if the testimonials Dr Leaf is publishing are the norm. Recent research demonstrates that self-help literature for depression may not have any benefit over a placebo treatment [3]. So it may be that any improvement attributed to Dr Leaf’s teaching was actually the placebo effect. Dr Leaf can list testimonials until she’s blue in the face, but that doesn’t prove that her work is scientific or therapeutic.

Indeed, selectively publishing testimonials is duplicitous, telling half-truths, positively spinning her own story. How many e-mails has Dr Leaf gotten from people who have found her teaching inaccurate, ineffective, unbiblical or harmful? Dr Leaf’s social media minions deliberately delete any negative comments and block anyone from her sites that disagree with her. And over the years, many people have shared with me how arrogant and dismissive her team has been to polite, genuine concern or criticism. I can personally attest to the same treatment. If Dr Leaf was honest with her followers, she would be openly publishing the brickbats as well as the bouquets.

For her readers and followers, the testimonials need to be seen for what they are: just individual stories. Sure, we should rejoice with those who are rejoicing (Romans 12:15), and so good for those who feel Dr Leaf has helped them. But they do not constitute evidence for the therapeutic efficacy or scientific integrity of the work of Dr Leaf.

For people genuinely struggling with “mind issues”, the last thing they need is testimonials collated by Dr Leaf’s marketing team.  They don’t need to be referred to Dr Leaf’s work, they need to be referred to psychologists and doctors.

And if Dr Leaf really wanted to prove her legitimacy, she would rely on independent peer-reviewed published research, not on the list of vacuous, self-serving cherry-picked testimonials that she is currently offering.

References

[1] Marketing Science Institute. Consumer Testimonials as Self-Generated Advertisements: Evaluative Reconstruction Following Product Usage. [cited 2014, Aug 3]; Available from: http://www.msi.org/reports/consumer-testimonials-as-self-generated-advertisements-evaluative-reconstru/.
[2] Fowler, G., Evidence-based practice: Tools and techniques. Systems, settings, people: Workforce development challenges for the alcohol and other drugs field, 2001: 93-107
[3] Moldovan, R., et al., Cognitive bibliotherapy for mild depressive symptomatology: randomized clinical trial of efficacy and mechanisms of change. Clinical psychology & psychotherapy, 2013. 20(6): 482-93

The Secret Teaching of Dr Caroline Leaf

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Unless you’ve lived under a rock for the decade, “The Secret” is no secret.  We’ve all heard of the book or the movie, or the countless gurus that promote how they’ve made millions of dollars and found untold happiness by unlocking the power of the Law of Attraction.  You can have that same success too if you buy their book or attend their seminar, or sign up to be part of their network marketing scheme.

Let’s be honest, we’ve probably all, at some point, indulged someone telling us that we just need to think positive or visualise our goal and it will be ours.  It’s even something that many preachers over the years have sold to us in various guises, like hyper-faith, name it and claim it, sowing your seed.

The Secret claims that if we understand we’re all energy, one with the universe and its power, then we can leverage that power to create or receive anything we want with our thoughts.  We just need to think positively and visualise it.  It’s a repackaging of the human potential movement, new age philosophy and cosmic consciousness, all of which is a repackaging of pantheism and Eastern religious teaching.

The author, Rhonda Byrne, (who I’m embarrassed to say is Australian) wrote, “If you’re feeling good, it is because you are thinking good thoughts.”  Ok, but what about when you’re thinking good thoughts and you still feel bad?  What exactly are ‘good thoughts’ anyway?

She also wrote, “Remember that your thoughts are the primary cause of everything.”  So the rise of ISIS is because of my thoughts.  Donald Trump might be President … my thoughts.  An oceanic tectonic shift cuts the undersea trunk line taking out the internet for half the eastern seaboard … Sorry, my bad, I was having negative thoughts again.

So The Secret really doesn’t make a lot of objective sense.  I could go on, but it’s been taken down well enough by a number of commentators and critics over the last decade or so (https://skeptoid.com/episodes/4096; http://www.christianitytoday.com/ct/2007/june/20.71.html), so I’m not going to reinvent the wheel.  But suffice to say, The Secret fundamentally sells the power of thought to shape our reality … wait, that sounds oddly familiar.  Dr Leaf said the same thing at TD Jakes’ church, the Potter’s House, only this week.

leaf-the-secret

@bishopjakes proudly shared this Instagram post which Dr Leaf duly forwarded to her adoring fans.  “You can shape your reality by the way you think” was even the title of her message.  (She followed it up with an e-mail to her subscribers saying the exact same thing …)

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Dr Leaf’s teaching is eerily similar to The Secret in many other ways.  That quote from before: “Remember that your thoughts are the primary cause of everything” sounds remarkably similar to “Thoughts influence every decision, word, action and physical reaction we make.” (Who Switched Off My Brain, p13)

There are lots of others.  From The Secret:

“Everything else you see and experience in this world is effect, and that includes your feelings. The cause is always your thoughts.”

“Every thought of yours is a real thing – a force.”

“Everything else you see and experience in this world is effect, and that includes your feelings. The cause is always your thoughts.”

“Food cannot cause you to put on weight, unless you think it can.” (This one made me giggle more than the others … yep, those three bottles of Coke I just drank have absolutely no effect on my waistline because I believe that excessive soda consumption is slimming …)

“Your imagination is an extremely powerful tool.”

“Quantum physicists tell us that the entire universe emerged from thought!”

“Quantum physics … says that you can’t have a universe without mind entering into it, and that the mind is actually shaping the very thing that is perceived.”

“The amazing work and discoveries of the quantum physicists over the last eighty years has brought us a greater understanding of the unfathomable power of the human mind to create.”

“Thoughts are magnetic, and thoughts have a frequency. As you think thoughts, they are sent out into the Universe, and they magnetically attract all like things that are on the same frequency. Everything sent out returns to the source – you.”

“There are no limits to what you can create for you, because your ability to think is unlimited!”

Compare that to just a small sample of Dr Leaf’s work:

“Our mind is designed to control the body, not the other way around.  Matter does not control us; we control matter through our thinking and choosing.” (Switch On Your Brain, p33)

“Research shows that 75 to 98 percent of mental, physical and behavioral illness comes from ones thought life.” (Switch On Your Brain, p33)

“DNA actually changes shape according to our thoughts.” (Switch On Your Brain, p35)

“Whatever you are thinking about affects every cell in your body.” (Switch On Your Brain, p94)

“Everything you do and say is first a thought in your physical brain.  You think, then you do, which cycles back to the original thought, changing it and the thoughts connected to it in a dynamic interrelationship.  If your thinking is off … then your communication though what you do and say is off, and vice versa.” (Switch On Your Brain, pp98-99)

“Quantum theory converts science’s conception of humans from being mere cogs in a gigantic, mechanical machine to being freethinking agents whose conscious, free choices affect the physical world.” (Switch On Your Brain: p120-1)

“Thought signals seem to move faster than the speed of light and in ways that classical physics cannot explain.  This means our mind controls matter, and is therefore a creative force.” (Switch On Your Brain, p121)

“These statistics show that the mindset behind the meal – the thinking behind the meal – plays a dominant role in the process of food-related health issues …” (Think and Eat Yourself Smart, p84)

The only difference between The Secret and Dr Leaf’s ministry is Dr Leaf’s claim that science and scripture support it, though lexical contortions of scripture, and cherry-picked pseudoscience does not qualify as supporting evidence.

In the last ten years since The Secret was published, many critics have lined up to pull it apart, some prominent Christians included.  So they should, because The Secret is an abhorrent, unscientific concoction of new age humanism, or as one critic astutely put it, “spiritual narcissism”.

I’ve dissected Dr Leaf’s teaching over the last three-and-a-bit years and shown that her science is wanting, and her scripture is tenuous.  As this week’s sermon aptly demonstrates, Dr Leaf’s teaching appears to be a lukewarm re-serving of The Secret, sprinkled with some scripture and pseudoscience to try and make it more palatable for the Christian church.  Despite the shared narratives of self-obsession and magical thinking, the Christian church still fawns over Dr Leaf.  It’s embarrassing to see the same Christian leaders and media outlets lambaste The Secret but unquestioningly accept the same message woven through Dr Leaf’s teaching.  Dr Leaf’s teaching is so close to The Secret I’m surprised Rhonda Byrne hasn’t asked for royalties.

“The only thing necessary for the triumph of evil is for good men to do nothing”.  The same goes for ignorance—the only thing necessary for the triumph of ignorance is for smart men (and women) to do nothing.  We also need consistency.  Rejecting The Secret but accepting the same teaching from Dr Leaf creates a cultural cognitive dissonance amongst the Church that’s unhealthy.

Church, it’s time to stand against mistruth no matter what the source.

Bibliography

Byrne, R., The Secret, Atria Books, New York. 2006 ISBN 978-1-58270-170-7

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

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

Leaf C.M., Think and Eat Yourself Smart. USA: Baker Books, 2016.

60 seconds – Dr Leaf and Anxiety

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Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist, says that “A chaotic mind filled with rogue thoughts of anxiety and worry sends out the wrong signals and affects you right down to the level of your DNA!” She also says that “Toxic thinking destroys the brain!”

In other words:

Anxiety → Toxic thought → DNA changes +  Brain damage

But that’s not what science says. According to modern research, anxiety disorders are the result of a genetic predisposition to increased vulnerability to early life stress, and to chronic stress [1]. The other way of looking at it is that people who don’t suffer from anxiety disorders have a fully functional capacity for resilience [2,3].

In other words:

DNA changes + External stress → Anxiety

Dr Leaf’s teaching is backwards. Perhaps it’s time she turned it around.

References

[1] Duman EA, Canli T. Influence of life stress, 5-HTTLPR genotype, and SLC6A4 methylation on gene expression and stress response in healthy Caucasian males. Biol Mood Anxiety Disord 2015;5:2
[2] Wu G, Feder A, Cohen H, et al. Understanding resilience. Frontiers in behavioral neuroscience 2013;7:10
[3] Russo SJ, Murrough JW, Han M-H, Charney DS, Nestler EJ. Neurobiology of resilience. Nature neuroscience 2012 November;15(11):1475-84

Dr Leaf and Anxiety

Dr Caroline Leaf and the mind-brain revisited again

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Dr Leaf’s theme for the week is the mind-brain link. In the last few days, Dr Leaf has posted memes claiming that the brain is seperate from, and subservient to, the mind. Despite evidence to the contrary, she continued the same theme today.

Dr Caroline Leaf is a communication pathologist and a self-titled cognitive neuroscientist. Her teaching is strongly influenced by one of her foundational philosophical positions; that the mind (the intellect, will and emotions) controls the body, which includes the brain. While this idea may be popular with philosophers, it’s not with neuroscientists.

Not that this bothers Dr Leaf, of course, since she’s not really a neuroscientist.

Today’s meme is more or less exactly the same as what she claimed over the previous couple of days, except today’s version is more verbose.

She said,

“Mind directs what the brain does, with the mind being our intellect, will and emotions (our soul realm). This is an interesting concept posing huge challenges and implications for our lives because what we do with our mind impacts our spirit and our body. We use our mind to pretty much do everything.”

At this point, I’m having a strong and nauseating sense of deja vu.

I know I’m going to be repeating myself, but to reinforce the message, lets go through Dr Leaf’s meme to show that it hasn’t gotten any righter with repetition.

“(The) Mind directs what the brain does” … The relationship of the mind to the brain is like the relationship of music and a musical instrument. Without a musical instrument, there is no music. In the same way, the mind is a product of the brain. It’s not independent from the brain. Without the brain, there is no mind. Indeed, changes to the structure or function of the brain often results in changes to the mind. Yesterday I used the example of medications. Caffeine makes us more alert, alcohol makes us sleepy or disinhibited. Marijuana makes it’s users relaxed and hungry, and sometimes paranoid. Pathological gambling, hypersexuality, and compulsive shopping together sound like a party weekend in Las Vegas, but they’re all side effects linked with Dopamine Agonist Drugs, which are used to treat Parkinson’s disease. If a pill affecting the brain can change the function of the mind, then it’s clear that the mind does not direct what the brain does.

“This is an interesting concept posing huge challenges and implications for our lives because what we do with our mind impacts our spirit and our body” … The relationship between our body, mind and spirit is interesting. I’ve written about this before in an essay on the triune being and dualism. But there are no great challenges here or implications here. If anything, knowing that our thoughts don’t have any real power over us is incredibly freeing. Rather than increasing our psychological distress in trying to suppress or control our thoughts, we can step back and focus on committed actions based on our values.

“We use our mind to pretty much do everything” … Actually, we don’t. Much of what we do, say, and even perceive, is related to functions of our brain that are entirely subconscious. This idea is summed up very nicely by Dr David Eagleman, best-selling author and a neuroscientist at Baylor College of Medicine in Texas;

” … take the vast, unconscious, automated processes that run under the hood of conscious awareness. We have discovered that the large majority of the brain’s activity takes place at this low level: the conscious part – the “me” that flickers to life when you wake up in the morning – is only a tiny bit of the operations. This understanding has given us a better understanding of the complex multiplicity that makes a person. A person is not a single entity of a single mind: a human is built of several parts, all of which compete to steer the ship of state. As a consequence, people are nuanced, complicated, contradictory. We act in ways that are sometimes difficult to detect by simple introspection. To know ourselves increasingly requires careful studies of the neural substrate of which we are composed.” https://goo.gl/uFKF47

So no matter which way Dr Leaf says it, it simply isn’t true that the mind controls the brain. As I said in my previous post, this is a fatal flaw for Dr Leaf’s teaching. That she keeps using this trope is entirely her choice and her right, but it certainly doesn’t aid her reputation as a credible neuroscientist.

Running of the Elephants – Why thought suppression doesn’t work

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Have you ever found yourself about to give a speech or sit an exam, and one of your friends tries to calm you down by saying, “Stop worrying … just don’t think about it!”  Does that ever work?  Not usually!  The more you try to intentionally block it from your mind, the more it wants to pop up again.

Why is that?  It seems intuitive that if you don’t want to think about something, all you need to do is to take control and block it out of your mind, right?

One of Hollywood’s better movies in recent times was “Inception”.  In one of the key early scenes, Arthur is explaining to Saito why inception is impossible,

“Saito: If you can steal an idea, why can’t you plant one there instead?
Arthur: Okay, this is me, planting an idea in your mind. I say: don’t think about elephants. What are you thinking about?
Saito: Elephants?”

This is a great little dialogue about thought suppression.  Thought suppression is the process of consciously trying to avoid certain thoughts, either by trying to replace the unwanted thought with another thought, or simply trying to repress the unwanted thought.

Our minds tend to focus on the content of a subject.  If the subject is elephants, no matter what words I put in front of it, your mind will think about elephants.  Like if I say, “I love elephants, or I say “Don’t think about elephants”, your brain hears, “blah blah blah elephants.”  And having been sensitized to the idea of not thinking about elephants, when your mind inevitably brings it up again, you’re primed to pay even more attention to it, “D’oh, I’ve just thought about elephants again … stop thinking about elephants …”.

This phenomenon is even more pronounced if your mind has already been focusing on the subject.  If you’re mind is going over and over a speech you have to give and I say, “Oh, don’t worry about that speech”, all your mind registers is, “blah blah blah SPEECH”.

Although it’s been discussed in the psychological sciences for decades, it’s only been since the late 1980’s that considerable attention has been given to the concept of thought suppression.  Despite our natural tendencies to try it or recommend it to people, the conclusion of nearly all the research is the same: thought suppression doesn’t work.

Wenzlaff and Wegner, two American psychology researchers, looked at all of the different research on thought suppression and came to the following conclusion,

“What has compelled the interest of the scientific and clinical communities is that suppression is not simply an ineffective tactic of mental control; it is counterproductive, helping assure the very state of mind one had hoped to avoid. The problem of thought suppression is aggravated by its intuitive appeal and apparent simplicity, which help mask its false promises.” [1]

I’m not really sure why we naturally gravitate to thought suppression.  Perhaps it’s part of our natural delusion of control.  Perhaps it’s a throwback from the pop-psychology assumptions that we can control our destiny, or the common myth that our mind is in control of our brain.

Whatever the reason, as time has passed, researchers are coming to understand why thought suppression is so unhelpful.  This quote from Magee and his colleagues helps to explain why:

“This shift in focus parallels advances in cognitive theories of intrusive thoughts, which suggest that having intrusive thoughts is a normative phenomenon; instead, the way an individual interprets those thoughts is expected to lead to benign versus serious outcomes … Similarly, having difficulties with thought suppression is a common experience … it is the way an individual interprets that experience that may be key. Previous discussions of thought suppression have frequently implied that people having difficulties with thought suppression often ascribe negative meaning to their difficulties.” [2]

We naturally struggle to suppress intrusive thoughts because intrusive thoughts are normal.  Trying to suppress them is like trying to suppress any other normal biological process.  Try to stop breathing for any length of time and you’ll see what I mean – it’s impossible, and trying is simply counterproductive.

The key is how we react to or feel about our thoughts.  If we feel like our thoughts might be somehow causing us harm, then our failure to stop them from bubbling up to the surface of our consciousness is going to cause us distress.  It’s a double whammy – we’re stressed because we’re expecting the negative consequences of our thoughts, and we’re distressed by our ‘failure’ to stop them.

Since it first started more than a century ago, the death toll from the famous Pamplona event, “Running of the Bulls” currently stands at 13.  Countless others have been gored and trampled.  Who are the people who get injured during the event?  Certainly not the smart ones standing behind the barriers on the edge of the streets, or the ones watching it broadcast on TV?  Only the morons who try to outrun the pack of foot-long bony skewers attached to the half-ton lumps of very cranky steak.

Similarly, the best way to manage our thoughts is to learn not to fight with them in the first place.  By non-judgmentally observing them, we can simply observe our thoughts for what they are … just thoughts.  By stepping back from our thoughts and giving them room, we find that they don’t have any real power over us.  Stepping back away from our thoughts and letting them be is the skill of defusion, one part of the process of psychological acceptance.  It’s the first step in living a life abundant in meaning and significance.

So just remember: don’t try to suppress an unwelcome thought.  Having intrusive thoughts is actually a normal process, not a sign of disease or mental weakness.  They’re not toxic or harmful, they’re just thoughts.  Give them space, like you would a charging angry bull (or elephant!)

References

[1]        Wenzlaff RM, Wegner DM. Thought suppression. Annual review of psychology 2000;51(1):59-91.
[2]        Magee JC, Harden KP, Teachman BA. Psychopathology and thought suppression: a quantitative review. Clinical psychology review 2012 Apr;32(3):189-201.

Does sadness make you sick?

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We’ve all heard of being “homesick”, or “heartsick”, or “lovesick”.   Sometimes when we’re extremely sad, we feel the knot in our stomachs, the pressure in our chests, or the confusion and distraction in our minds as the waves of sadness wash over and discombobulate us.

But can being sad really make you physically ill as well as emotionally distraught?

Dr Caroline Leaf declared today on her social media platforms that “Feeling sad can alter levels of stress-related opioids in the brain and increase levels of inflammatory proteins in the blood that are linked to increased risk of comorbid diseases including heart disease, stroke and metabolic syndrome.”

Dr Caroline Leaf is a communication pathologist and a self-titled cognitive neuroscientist.  She believes that our cognitive stream of thought determines our physical and mental health, and can even influence physical matter through the power of our minds.

She also added some further interpretation to her meme: “So this is more evidence that our thoughts do count: they have major epigenetic effects on the brain and body! We need to apply the principles in the Bible and listen to the Holy Spirit – no excuses this year!”

With all due respect to Dr Leaf, the study she quotes doesn’t prove anything of the sort.

Dr Leaf’s meme is a copy and paste of the opening paragraph of a news report published by the university’s PR people to promote their faculty.  This isn’t a scientific summary, it’s a hook to draw attention to an article which amounts to a PR puff piece.  If Dr Leaf had read further into the article, I don’t think she would have been quite so bold in claiming what she did.

The article discussed a study by Prossin and colleagues, published in Molecular Psychiatry [1].  You can read the original study here.  The study specifically measured the change in the level of the activity of the opioid neurotransmitter system and the amount of a pro-inflammatory cytokine IL-18 across two experimental mood states, and in two different groups of volunteers, people with depression, and those without.

For a start, it’s important to note that the study isn’t referring to normal day-to-day sadness.  This was an experimentally induced condition in which a sad memory was rehearsed so that the same feeling could be reproduced in a scanner, and the study was looking at the effect of this sad “mood” on people who were pathologically sad, that is, people diagnosed with major depression.

It’s well known that people with depression are at a higher risk of major illnesses, such as heart attacks, strokes and diabetes [2] The current study by Prossin et al looked experimentally at one possible link in the chain, a link between a neurotransmitter system that’s thought to change with emotional states, and one of the chemical mediators of inflammation.

They found that:

> Depressed people were much sadder to start with, and remained so throughout the different conditions.  The depressed people stayed sadder in the ‘neutral’ phase, and the healthy cohort couldn’t catch them in the ‘sad’ phase.
> Depressed people had a much higher level of the inflammatory marker to start with, and interestingly, this level dropped significantly with the induction of the neutral phase and the sad phase.  What was also interesting was that the level of the inflammatory marker was about the same in the baseline and the sad phase for the healthy volunteers.
> A completely different pattern of neurotransmitter release was seen in the two different groups.  People with depression had an increase in the neurotransmitter release over a large number of areas of the brain, whereas in the healthy controls with normal mood, the sad state actually resulted in a decreased amount of neurotransmitter release, and in a much smaller area within the brain.  This suggests that the opioid neurotransmitter system in the brains of depressed people is dysfunctional.

Affect/Sadness Scores - Prossin et al Molecular psychiatry 2015 Aug 18.

Affect/Sadness Scores – Prossin et al Molecular psychiatry 2015 Aug 18.

IL18 v Mood state/diagnosis - Prossin et al Molecular psychiatry 2015 Aug 18.

IL18 v Mood state/diagnosis – Prossin et al Molecular psychiatry 2015 Aug 18.

Effectively, the results of the study reflect what’s already known – the emotional dysregulation seen in people with depression is because of an underlying problem with the brain, not the other way around.  And, sadness in normal people is not associated with a significant change in the evil pro-inflammatory cytokine.

So, according to Prossin’s article,

  1. normal sadness in normal people is not associated with physical illnesses.
  2. sadness is abnormally processed in people who are depressed, which maybe related to an abnormal inflammatory response, which might explain the known link between depression and increased risk of illness

The article is not “more evidence that our thoughts do count.”  If anything, it shows that underlying biological processes are responsible for our thoughts and emotions and their downstream effects, not the thoughts and emotions themselves.

And unfortunately, it appears that Dr Leaf hasn’t got past the opening paragraph of a puff piece article before jumping to a conclusion which only fits her worldview, not the actual science.

References

[1]        Prossin AR, Koch AE, Campbell PL, Barichello T, Zalcman SS, Zubieta JK. Acute experimental changes in mood state regulate immune function in relation to central opioid neurotransmission: a model of human CNS-peripheral inflammatory interaction. Molecular psychiatry 2015 Aug 18.
[2]        Clarke DM, Currie KC. Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence. Med J Aust 2009 Apr 6;190(7 Suppl):S54-60.

The significance of thoughts

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A few days ago, I posted a rebuttal to one of Dr Leaf’s favourite memes, “Thoughts are real and occupy mental real estate.”

In short, I wrote that thoughts are real, but the issue hasn’t ever been whether thoughts are real, but what thoughts really are. The conclusion was that thoughts are just a projection, a function of the brain. They are not independent of the brain and they do not control the brain.

Dr Caroline Leaf is a communication pathologist and a self-titled cognitive neuroscientist. Dr Leaf tried to refine her meme today, saying:

“Your thoughts produce proteins, which form real structures that change the landscape of your brain.”

So, is that true? Do thoughts produce proteins which change the structure of the brain? To answer that, we need to have a look at some basic neurobiology.

The brain is made of nerve cells. Nerve cells have three unique structures that help them do their job. First are dendrites, which are spiny branches that protrude from the main cell body, which receive the signals from other nerve cells. Leading away from the cell body is a long thin tube called an axon which helps carry electrical signal from the dendrites, down to the some tentacle-like processes that end in little pods. These pods, called the terminal buttons of the axon, and then convey the electrical signal to another nerve cell by directing a burst of chemicals towards the dendrites of the next nerve cell in the chain.

In order for the signal to be successfully passed from the first nerve cell to the second, it must successfully traverse a small space called the synapse.

Despite being very close to each other, no nerve cell touches another. Instead, the spray of chemicals that’s released from the terminal button of the axon floats across a space of about 20-40nM (a nanometre is one billionth of a metre).

Combining nerve cells and synapses together creates a nerve pathway, where the input signal is received by specialised nerve endings and is transmitted down the nerve cell across a synapse to the next nerve cell, across the next synapse to the next nerve cell, and on and on until the signal has reached the destination for the output of that signal.

And that’s it. The entire nervous system is just a combination of nerve cells and the synapses between them.

What gives the nervous system and brain the near-infinite flexibility, and air of mystery, is that there are eighty-six billion nerve cells in the average adult (male) brain. Each nerve cell has hundreds to thousands of synapses. It’s estimated that there are about 0.15 quadrillion (that’s 150,000,000,000,000) synapses throughout the average brain [1]. Each of these cells and synapses connect in multiple directions and levels, and transmit signals through the sum of the exciting or inhibiting influences they receive from, and pass on to, other nerve cells.

The brain is a highly plastic organ. When biologists talk about plasticity, they aren’t talking about the chemical plastic that we make everything out of, like plastic cups or bottles, but the ability for the cells, tissues or organs to change or adapt. And the brain does this all of the time. Every stimulus changes one or more of the billions of branches and synapses that the brain has. Branches can be pruned back, or new ones grown. Existing branches can be strengthened or weakened. Each change to the branches of the nerve cells helps the brain to adapt to the ever-changing internal and external stream of signals that the brain is required to process.

So returning to Dr Leaf’s statement: The key part of the meme is, “Your thoughts produce proteins”. This is where Dr Leaf’s statement is wrong. The error is deceptively subtle, but it’s still wrong. When changes are required, new branches are formed, which do indeed require new proteins. But most brain function, including our thoughts, is simply electrical current running along the pathways already formed by the branches of our nerve cells.

Even then, our stream of conscious thought is only a tiny fragment of the billions of nerve impulses our brains produce each and every second of our lives. As I described in my previous post, thought is not dominant. Our thoughts do not control our brains, it’s our brains that control our thoughts. Thoughts are real, but they’re real like an image on a screen is real, but isn’t the real thing.

Thoughts are only significant when they are considered for what they truly are. Our stream of consciousness is simply a selective place of refinement for highly salient parts of our non-conscious information that need further processing before further action is taken with that information. They are like the dials on your dashboard, which give selective important information about the car but they don’t control the car. Thoughts do not control our brains growth, or alter our brains architecture.

Dr Leaf should have said something along the lines of, “The landscape of the brain is created by real structures called neurons and synapses, which have many functions including our thoughts.”

As it is, Dr Leaf’s meme creates a false impression that our thoughts are the critical factor in determining our brains structure and function, when the reality is the exact opposite.

References

[1]        Sukel K. The Synapse – A Primer. 2013 [cited 2013 28/06/2013]; Available from: http://www.dana.org/media/detail.aspx?id=31294

Dr Caroline Leaf – Thoughts are real. So what?

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Today’s meme from Dr Leaf is one of her favourite, often repeated phrases:

“Thoughts are real and occupy mental real estate.”

Dr Caroline Leaf is a communication pathologist and a self-titled cognitive neuroscientist. Her entire preaching empire rests on her assumption that our thinking is the driving force of not just our mental health but also our physical health, and even physical matter!

No one’s denying that thoughts are real. The key issue is not whether thoughts are real, but what thoughts really are.

Professor Bernard J. Baars is an Affiliate Fellow at The Neurosciences Institute in La Jolla, California. He is a real cognitive neuroscientist. In the late 1980’s, Professor Baars built on Baddeley’s model of working memory by proposed the Global Workspace theory [1]. Together with Professor Stan Franklin, also a real cognitive neuroscientist (and a mathematician and computer scientist) at the University of Memphis, they took the Global Workspace theory further with the Intelligent Distribution Agent model [2]. Central to this model is the “Cognitive Cycle”, a nine-step description of the underlying process from perception through to action. In the model, implicit neural information processing is considered to be a continuing stream of cognitive cycles, overlapping so they act in parallel. The conscious broadcast of our thought stream is limited to a single cognitive cycle at any given instant, so while these thought cycles run in in parallel, our awareness of them is in the serial, sometimes disparate, streams of words or pictures in our minds. Baars and Franklin suggests that about ten cycles could be running per second, and since working-memory tasks occur on the order of seconds, several cognitive cycles may be needed for any given working memory task, especially if it has conscious components such as mental rehearsal [2].

In recent years, the Global Workspace/Intelligent Distribution Agent hypothesis has been updated to help facilitate the quest to create different forms of artificial intelligence. The LIDA (“Learning Intelligent Distribution Agent”) model incorporates the Global Workspace theory with the concepts of memory formation to create a single, broad, systems-level model of the mind.

Franklin et al summarise the process, “During each cognitive cycle the LIDA agent first makes sense of its current situation as best as it can by updating its representation of its current situation, both external and internal. By a competitive process, as specified by Global Workspace Theory, it then decides what portion of the represented situation is the most salient, the most in need of attention. Broadcasting this portion, the current contents of consciousness, enables the agent to chose an appropriate action and execute it, completing the cycle.” [3]

Information within the cognitive cycle is broadcast to our consciousness in order to recruit a wider area of the brain to enhance the processing of that information [2, 4]. It’s the broadcasting of this portion of the information flow that renders it “conscious”.

So thought is nothing more than a broadcast of one part of a deeper flow of information. In the same way that a projection on a movie screen is a real series of images of a historical or fictional event, but not the actual event, so thoughts are a real but are just a projection of the deeper information stream within the brain.

This is very important, as it means that thought is not an instigator or a controlling force. It’s not a case of, “I think, therefore, I am”, but, “I am, therefore, I think.

So Dr Leaf is right, thoughts are real. So what? Thoughts are just a projection, a function of the brain. They are not independent of the brain and they do not control the brain. And they definitely don’t control physical matter.

In posting things like todays meme, Dr Leaf is proving just how far her assumptions are from the work of real cognitive neuroscientists, while misdirecting her audience, duping them into believing that her tenuous speculation is scientific fact.

References

[1]        Baars BJ. A cognitive theory of consciousness. Cambridge England ; New York: Cambridge University Press, 1988.
[2]        Baars BJ, Franklin S. How conscious experience and working memory interact. Trends in cognitive sciences 2003 Apr;7(4):166-72.
[3]        Franklin S, Strain S, McCall R, Baars B. Conceptual Commitments of the LIDA Model of Cognition. Journal of Artificial General Intelligence 2013;4(2):1-22.
[4]        Baars BJ. Global workspace theory of consciousness: toward a cognitive neuroscience of human experience. Progress in brain research 2005;150:45-53.

Dr Caroline Leaf – Manhandling scriptures again

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I recently heard a great quote, “If you take the text out of context, all you’re left with is a con.” It’s a quote that seems to describe Dr Leaf’s social media pings quite nicely over the last twenty-four hours.

Dr Caroline Leaf is a communication pathologist and a self-titled cognitive neuroscientist. She is also a self-titled theologian.

Today she posted, “3 John 2 = Mental Health ‘Beloved, I wish above all things that thou may prosper and be in health, even as your soul prospers.’ Everything relies on your soul, which is your mind, prospering” (original emphasis).

Except that her statement is blatantly false. The soul isn’t just the mind. A simple search of an on-line Bible dictionary reveals that there are a number of ways in which the word ‘soul’ is used, but more specifically to the meaning in 3 John 2, “the (human) soul in so far as it is constituted that by the right use of the aids offered it by God it can attain its highest end and secure eternal blessedness, the soul regarded as a moral being designed for everlasting life”. (http://goo.gl/AjhvNO)

It should also be noted that the two words used in ancient Greek that referred to our inner reality were pneuma (‘spirit’) and psyche (‘soul’). According to Thayer’s Greek Lexicon, the words pneuma (‘spirit’) and psyche (‘soul’) were often used indiscriminately. The Apostle Paul distinctly used the word pneuma separately to the word psyche in 1 Thessalonians 5:23, but nearly every other New Testament writer wasn’t so precise.

Thus, John wasn’t referring to the mind at all, but probably our spirit, or at the very least, our generic soul, not specifically to our mental faculties or our thoughts. The scripture in 3 John 2 doesn’t have anything to do with our mental health.

Yesterday, Dr Leaf tried to merge one of her favourite authors views with scripture. She posted a quote from Dr Bruce Lipton, “Genes cannot turn themselves on or off. In more scientific terms, genes are not ‘self-emergent’. Something in the environment has to trigger gene activity.” Dr Leaf added, “That ‘something’ is your thoughts! Read Proverbs 23:7”.

So I did.   Proverbs 23:7 in the King James Version says, “For as he thinketh in his heart, so is he: Eat and drink, saith he to thee; but his heart is not with thee.”

So what is it with the second half of the verse? If this scripture is all about our thought life, then what’s the eating and drinking half of the verse got to do with our thought life?

The explanation is that this verse has nothing to do with our thought life at all. Dr Leaf has simply been misquoting it for years, and no one checked to see if she’s right. According to the Pulpit commentary found on the Bible Hub website, “The verb here used is שָׁעַר (shaar), ‘to estimate … to calculate’, and the clause is best rendered, ‘For as one that calculates with himself, so is he’. The meaning is that this niggardly host watches every morsel which his guest eats, and grudges what he appears to offer so liberally … He professes to make you welcome, and with seeming cordiality invites you to partake of the food upon his table. But his heart is not with thee. He is not glad to see you enjoy yourself, and his pressing invitation is empty verbiage with no heart in it.” (http://goo.gl/nvSYUh)

The other half of her meme comes from Dr Bruce Lipton, an agnostic pseudoscientist who was a cell biologist before he flamed out, and now teaches chiropractic in New Zealand. He believes that there is a metaphysical link between our thoughts and our cell function [1]. He’s ignored by real scientists (http://goo.gl/cX7Aeg).

As for his quote, it’s a misdirection. Sure, genes aren’t self-emergent – they don’t think for themselves. DNA is just a long chemical string which just carries a code, the biological equivalent to your DVD discs. Like a DVD, DNA isn’t worth anything if it doesn’t have a machine to read it. In every cell, there are hundreds of proteins that read and translate DNA. Those machines respond to the external environment, but they also respond to the cells internal environment, and to other genes themselves. Simply put, DNA is decoded by intracellular proteins, but intracellular proteins are only made by the expression of DNA, which happens all the time. A single-celled embryo becomes a baby because of DNA self-copying and expression that happens a trillion times over by the end of pregnancy. So while a single gene can’t turn itself on and off, the genome as a whole is essentially self-controlling, only being partly modulated by the external environment. Genes are turned on and off all the time by other genes through the proteins those genes make. Lipton’s assertion that “something in the environment has to trigger gene activity” is simply nonsense.

So Dr Leaf uses a flawed quote from a pseudoscientist to try and back up her specious interpretation of an out-of-context verse of scripture.

Somewhat poor from an “expert” theologian and cognitive neuroscientist really.

These memes speak to the issues of trust and legitimacy. Dr Leaf can call herself whatever she likes, but how can church leaders continue to endorse her to their congregations as an expert when she consistently misinterprets science and scripture? Can they honestly look their parishioners in the eye and say that Dr Leaf’s teaching is accurate? Can they stand at their pulpits and confidently support her book sales at their back of their churches?

Dr Leaf needs to re-evaluate. She needs to re-evaluate her claims to be an expert in cognitive neuroscience and the Bible. She needs to re-evaluate the quality of information that she relies on. She needs to re-evaluate what she’s trying to achieve in posting to social media, and re-evaluate the accuracy of her memes.

Because ultimately it’s the truth that sets people free, not errant opinions and misinterpretations.

References

[1]        Lipton BH. The biology of belief: Unleashing the power of consciousness, matter and miracles: Hay House, Inc, 2008.

Addit: Dr Leaf’s social media post in between the two memes mentioned above was also a doozy. A repeat offender, as it were, since she has posted it several times before, and I have blogged about it here.