Month: January 2012

Your Brain Talks To Their Brain

Let’s take a moment to consider what is actually happening during a conversation; we’ll take a few passes at it striping away the layers of narrative to reveal something wonderful.

Two people are talking, exchanging ideas and information.

The ideas and information are created, stored and processed by the brain. The ears and mouth are the tools the brain uses to transmit and receive information.

The sound waves are manufactured by the vocal chords based on the nerve impulses that represent the information the brain is trying to transmit. The sound waves are received and shake the ear drum of the other creating nerve impulses that are channeled into the brain for processing.

The brain is the center of all information processing, the body is a tool that the brain uses to give-out and take in information.

During a conversation, two brains are interfacing to trade information. Any other distinction we add serves only to complicate what our understanding of what is happening.

So what?

This simplifies things. The fact that you are talking to the other persons brain, and that it is actually your brain talking to it, opens-up the ability to alter the way the other persons brain processes the information. The brain does not do the same thing with all the information that comes in. First off, different parts of the brain do different things with information. These parts are all interconnected so the combination of possible routes through the brain is limitless. Next, not all parts of the brain are active all of the time – the ramifications of this are that certain types of information / information processing services may not be available all of the time. This can be due to lack of fuel, chemical inhibition, or the conscious by-passing of processes.

It also complicates things. After all the narrative stuff has been stripped away we’re left with two of the most powerful information and pattern matching machines interfacing to exchange ideas. But how often does one really consider this fact during a conversation? Rarely. For most of us, there are two people, separate from each other and their environment. They are talking, exchanging stories, facts and feelings. They likely believe that what they are talking about is important and of significance in their lives. The impact of these narrative layers is powerful and it can bias the way the information is received, twisting the way one perceives facts. Imagine, for example, the impact a volatile relationship can have on the stories one tells their brain about what the other person is doing.

What does this mean?

Well, if you have the self-awareness to realize that there’s a lot going on in your brain and that you are only aware of a small portion of what it’s doing, you’ll see that there is a big difference between knowing this to be a fact and not knowing that it is a possibility. Those that know gain insight and control over their thinking simply because they accept that the brain is a machine and that consciousness and spontaneous thought are just consequences to it being a brain. Emotions are other consequences and they reflect a match of a pattern that is significant for some reason. Pattern matching isn’t perfect, and miss pairings are very simple given the amount of sensory input flowing into the brain while something is happening. Realizing that you are your brain is liberating. We can learn new patterns / pairings, we can stop thoughts at will and direct our mind onto the things we want, we can accept that some of our automatic behaviors are based on poor information collected years ago and we can replace them by doing the things that work for us.

Those that know that they are their brain are at a distinct advantage when they engage other people because they know how the other person can approach the world – as self-aware or not. This distinction is very important when communicating effectively with others. If a person doesn’t have much self-awareness, you are talking to their mind, their understanding of the world, all the assumptions and lessons they hold. With a self aware person, you are talking to someone who realizes that their mind can add or remove the different levels of narrative (those mentioned above when describing what is happening during a conversation) so you are able to engage the each other in the most effective way – your brain talking to their brain.

How To Sprain Social Development – Incorrect Attribution of Why

Our abnormal psychology professor admitted to the most dreadful thing to our class. “As a psychiatrist in the 60’s I told parents of schizophrenic children that their parenting caused the illness. I feel horrible still for having said it, but that was the understanding then. The theory was based on the science at the time. The science advanced then the disease became chemical with environmental stress being an agonist.” The good in this evolution of understanding is the realization that the social environment of a child in not likely to create physiological brain dysfunction – the thought processes will be created and shaped, and volumes of information will be stored but the brain is developing according to the genetic plan.

Childhood does not change the brain, it shapes the processes that run. It helps to create an understanding of the world that allows the brain to plan and coordinate the body’s interactions with the external environment. This internal representations of the world is based on an interpretation of all of the information known and assumed about the world. When there isn’t enough information, the brain generates possible reasons, and one of them eventually fills in the missing info. What gets rendered into ones world view is a mixed stew of real and make-believe. Needed are answers to the “why” of what happened so we can move on to the next experience and we’re willing to make-up stuff not provided.

This is how most development gets sprained – incorrect reasons attributed to why things happen.

The biggest offender is sexual abuse. Young person gets molested by a family member, friend, or coach. It’s new to them so they have no idea what to make of the whole thing. It feels wrong but it’s so far from the norm that there’s no reconciling it with real information. The assumptions begin and the underlying thought processes start to morph. “My care givers don’t love me because they let that happen” is a common assumption to make as it answers the why question instantly. The children don’t talk about it either out of fear or because they are now sure that their parents don’t love them. The parents don’t talk about it because they don’t know anything about it. They’ll ask the child about any change in behavior (the withdrawal that occurs when your parents don’t love you enough to protect you from bad things). When the parents continue to expose the child to the abuser it serves to reinforce the assumption and can change the narrative from neglect to enabling. These assumptions can get traction and write themselves into interesting areas of their future.

Personal relationships can become a mine field as one advances with incorrect assumptions about cause and effect, particularly ones involving feelings of love. In some cases the person never allows themselves to get close to anyone and lives a fairly isolated life full of efforts to avoid receiving love from others as that ultimately means suffering because people who love you let bad things happen. In other cases the person will begin to experience what most would call true love with someone and they will begin to do things that will make the other person change their view of them. There is an element of what seems like sabotage but it is simply the persons desire to be unlovable so that they can be the way they believed they are supposed to be; an assumption made in the past to help manage the experience of being abused.

Love hurts more than anything else in the world because there is a need to feel it, but it has become associated with so much suffering, cognitive-dissonance and a mis-pairing of cause and effect. For those who are willing to try romantic relationships as an adult, they will often leave a sea of damaged and bitter people in their wake as the recovering party recreates the relationship dynamic of the past. Without the knowledge and acceptance of what happened, the past becomes the future and the emotional pain rolls on.

Pressing Reset

Sometimes life, like your computer, can just lock-up and stop almost dead in its tracks. I’ve asked some computer guys why this happens and while they didn’t say for sure they said it’s usually because some process gets stuck in a loop and all of the resources are being feed into it. I think that’s kind of what happens with life sometimes; you get caught in a thought process and over time it begins to sap away the energy needed to do anything else. The brain is a computer so of course this will happen.

With a computer it’s easy to fix, you just reach forward and push the reset button. The computer reboots. There’s a good chance things will be fine when the computer starts-up again, but you know you’ve lost any unsaved recent data. Pressing reset is rarely the end of your computer or its operating system.

Pressing reset on life is a lot like that. You are going to lose a lot of recent information and what remains after the reboot is often just a little bit more than was there after the last reboot. The body and the brain are fine, running more smoothly for having stopped and restarted. Some recent stuff is sticky and will be there when you walk back after pressing reset on life. A lot of things won’t be and these are likely the things that didn’t need to be there in the first place. Life is simpler and you may be slightly wiser if you don’t ever think about it again.

But the wisdom lies in realizing that the things that were not working for you were just symptom of a problem that likely still resides within you. You need to be fair with yourself here and admit that the brain does a ton of stuff that we know nothing about; if we did know something about it we might actually be able to change our behavior when we need to.

The reason for the life lock-up is the result of something inside of you that manifested itself as unworkable situations, behaviors, relationships or people in your life. None of those is good or bad, they simply are things. The issue is in the interaction between them and you; given that these things do not causes problems with everyone. What are YOU doing with those things that is creating or recreating the loop that drains your energy and causes the lock-up?

“Have you pressed “F8″ after you reboot?” was one of the questions the computer guy asked me. My “no, why?” was greeted with “it’s a little safer. You don’t get all of the functionality but it’s a lot easier to figure-out what went wrong.”

In The Wake Of Destruction

When I paddled with the Mississauga Canoe Club I would see the good ones riding the wash that another canoe or kayak was creating. They’d get into the wake and keep their body weight on the down side of the wave coming off of the other boat so it would push them along. It was a skill and when it worked, it saved a lot of energy. When the wave passed you though, you were screwed. Paddling a sprint canoe through the wash of another boat is a different sport. Point the front of the boat, paddle hard and hope for the best. Most of the time they would open up water between you and you’d find matching their speed became possible only when you drift back and out of the random waves they’ve left. It was messy water if you ended-up falling behind. Washed-out is what it felt like.

I did find some comfort in the calmness of the water after the wash goes away. There was a lot of frustration there because there could be. It was easy to berate myself for falling off the wave because I wasn’t trying to hang on anymore. The choppy water was gone, as though it needed some time to regroup and consider its options before trying to tip the next person into the drink. The washed-out survivors were spared the waters torment and given the chance to think or learn from the previous few minutes. The great ones stuck by the water and became national level athletes. I moved on, replacing relationships and work for the water and trying to ride their wash. Sometimes unsuccessfully.

In the wake of destruction there is silence. There is a flattened landscape void of potential, void of anything that was how things just were. If left standing, one is lucky and slightly damaged. That’s all that’s needed. The damage means they’ll try to avoid that type of thing again. They’ll be a little wiser when it comes to the wash of life, at least in terms of how their  choices got them this time round. They’re lucky because they got washed-out and can take a rest in the calmer seas. That race is over, the lesson given. They can now look around with a shifted attitude that lets new or previously impossible thoughts bounce around. There’s a liberation in failing that you don’t get with continuing. There is a massive boost in mental resources. As the brain releases from the battle it can focus on managing the lessons and taking the most out of the experience.

In time things begin again and with enough time those things will be new.

Being Honest About Time

Seeing life slip away can be beautiful. It has a big impact on the willingness for honesty and there’s a dramatic shift towards being authentic. Why pretend anymore? There’s a big difference between having 6 and believing you have 500 and knowing you have 6. When you know you have 6 you’ll enjoy them fully and you’ll not let anyone take any from you.

And I suppose that we all think we have 500 so we float along enjoying some, sharing others, and allowing some to be stolen from us.

Cancer is greedy. It takes more than it’s fair share of the 500. It takes more than what we let others steal. But it gives something in return those who steal do not, it illuminates the end of the timeline. The flash of the terminal diagnosis shines brightly on what you have left so following the path to the end is very easy. You clear your schedule of the stuff that steals any of the time that remains.

You call in your troops and they shield you from the nonsense. The family pick to block obnoxious one on ones, musical chairs to maintain the wall of one between the cancer and the cancer, it’s a play book being written with each visit from someone who never mattered to us and always seemed to cost us energy.

It’s a sad sort of dream team simply because it is needed.

I’ve been left wondering after a well played game why I’m in this situation and what other things have I been letting into my life that share the same root cause.

I really want to be liked by other people. At least I used to want this. I’m not sure it’s worth the cost anymore; not to assume it ever was. I’ve normalized this habit though. I’m more aware of the interactions with people that leave me feeling unsettled than I am about the ones that leave me feeling nothing. In the last 3 years I’ve started to tread away from these types of interactions in favor of ones that leave me feeling good but I still have a tough time telling people to get away from me or just ending “friendships” that never worked.

The new awareness that death comes sooner and that time becomes more valuable as you near the end is forcing the issue about the pointlessness of wanting to be liked by other people. Almost everyone I know now will not be there when I die. The people I am choosing to generate mental friction about are not even aware of it and none of them will be there in the end. Wanting to be liked isn’t working for me anymore so I’m giving up on that habit. It hasn’t been authentic for a long time.

How Doctors Die

How Doctors Die: It’s Not Like the Rest of Us, But It Should Be by Ken Murray is a very interesting article about how doctors respond to the news that they are terminally ill. It goes into the costs associated with keeping someone alive when their bodies can no longer keep the disease in check – financial, social and suffering costs.

One of my patients was a man named Jack, a 78-year-old who had been ill for years and undergone about 15 major surgical procedures. He explained to me that he never, under any circumstances, wanted to be placed on life support machines again. One Saturday, however, Jack suffered a massive stroke and got admitted to the emergency room unconscious, without his wife. Doctors did everything possible to resuscitate him and put him on life support in the ICU. This was Jack’s worst nightmare. When I arrived at the hospital and took over Jack’s care, I spoke to his wife and to hospital staff, bringing in my office notes with his care preferences. Then I turned off the life support machines and sat with him. He died two hours later.

Even with all his wishes documented, Jack hadn’t died as he’d hoped. The system had intervened. One of the nurses, I later found out, even reported my unplugging of Jack to the authorities as a possible homicide. Nothing came of it, of course; Jack’s wishes had been spelled out explicitly, and he’d left the paperwork to prove it. But the prospect of a police investigation is terrifying for any physician. I could far more easily have left Jack on life support against his stated wishes, prolonging his life, and his suffering, a few more weeks. I would even have made a little more money, and Medicare would have ended up with an additional $500,000 bill. It’s no wonder many doctors err on the side of overtreatment.

But doctors still don’t over-treat themselves. They see the consequences of this constantly. Almost anyone can find a way to die in peace at home, and pain can be managed better than ever. Hospice care, which focuses on providing terminally ill patients with comfort and dignity rather than on futile cures, provides most people with much better final days. Amazingly, studies have found that people placed in hospice care often live longer than people with the same disease who are seeking active cures. I was struck to hear on the radio recently that the famous reporter Tom Wicker had “died peacefully at home, surrounded by his family.” Such stories are, thankfully, increasingly common.

The author recaps a number of stories about doctors who get the news and simply stop working and spend their remaining time doing things they like that make them happy. He feels that for many of them, having seen the suffering caused by futile care for years, the choice to just say “no thanks” is not just easy but the only choice they can make and still do no harm to their patients (in this case themselves).

The article reminded me of doctor Mark Greene in the TV show E.R. He had ended up getting cancer and having a new wife and a young child he fought it and beat it into remission. It did however come back and he made the choice to not fight anymore. It had been hard and he didn’t want to do it again. Dr. Greene spend his dying days in Hawaii with his family and died peaceful in bed.

When I watched the show I remember thinking that it was odd that a doctor would choose not to fight again given that he had been successful the first time. But there was also something that resonated with me that sometimes the distinction that you have a battle to win is simply not true. Even if you are not sick, you will never be new again. Your body has been falling apart since you were born. If you are sick, you will never be cured, even if they cut it out, zap it with radiation and stop the bad cells from dividing. Getting cancer is a one way street and no matter what they do, it can come back. You can fight the toughest battle, but without a new body, the old one has that weakness and the cancer has time on its hands.

There isn’t anything wrong with fighting, there isn’t anything wrong with wanting more time for yourself or your loved ones. There isn’t anything wrong with being grateful for the warning and having the time of your life as it winds down. That’s what a lot of doctors do and I get the feeling it’s what most of my dad’s doctors would do.

Narcissism – A Social Need For The Unenlightened

I wondered for a long time why so many seemingly normal and highly functional people constantly find themselves at the source of all of the bad things that happen in their world yet take responsibility for few of their own actions. It was disturbing until Des told me that believing you’re are a piece of unlovable crap is a sure fire way to ensure that you seek out the social situations to validate your lack of value. Initially it struck me as odd until I saw Donald Trump talking on TV and it hit me that there is a man who doesn’t really care what anyone thinks of him. He’s not narcissistic, he’s confidence because he knows he has a lot of value and this prevents him from needing other people’s approval. He’ll settle for their money and he’s just right for that.

If you are able to consider the inverse – that you are unlovable – you’ll see how seeking out this type of validation is a much bigger a social motivator than KNOWING you are the best. People who know what they bring to the table do not seek out proof of this from others because knowing it is all that is needed. I had an old girlfriend who would talk about things she knew nothing about but when it came time to debate about the things she knew, there was no debate. No need, I didn’t know what I was talking about. She’d correct me and then move on if I continued to disagree. What’s funny is that she would debate endlessly when she was full of crap.

This is one of my favorite topics as I age because I am uncovering more and more people who don’t understand that their motivation to see themselves as the center of the world and the cause of everything is a symptom of a sense of unlove-ability and that it is paying service to something that happened when they were growing-up. More often that not, their narcissism is a result of an incomplete developmental stage and an inaccurate pairing of cause and effect – for example, very attractive people tend to become narcissistic as they age because they were never recognized for their efforts (the things they can control) and tend to receive favor simply for being good looking. Their pathological behavioral patterns will tend to pop out any time they begin to feel overwhelmed by someone they view as better than them (a meaningless distinction) or anytime they feel the withdrawal of approval. They will often say the oddest things that you cannot reconcile in your head because they are not based on fact. To them though, they are based on fact; they are based on the interpretation of the evidence which just happens to see them as unlovable.

We tolerate this from children, movie stars and anyone we want something from because we can’t actually care that much about people who view themselves as unlovable because they tend to act in unlovable ways and alienate those who bring them kindness – they are dishonest, they create drama where it didn’t need to be, they involve others in their and other peoples business, they denigrate others in an attempt to make themselves feel or look better, they tell you who you can and cannot be friends with and they will throw you under the bus as soon as they realize that you are not treating them as unlovable as they act. Narcissism is obvious once you’ve seen it and the people it afflicts are toxic to those unfortunate to have to continue to engage them.

The prognosis is poor for these types of people because they are incapable of seeing their actions has shaping their world – I’ve yet to meet one who later said “I was creating all of my bad luck because I was acting unlovable.” Sadly for them and the people they impact, you tend to hear “look what you made me do” or “that isn’t fair” when you treat them the same way they treat you.

Chances are they are too heavily invested in keeping their delusion going to actually look at the root cause of their actions.

“I Was Given Three Months To A Year To Live As Are All GBM Patients”

And it is really tough to hear anything other than “dead soon” in those words. That is the acute emotional reaction to news of a brain tumor in you or someone you love. But the symptoms of the disease are treated, they go away, the mind returns and you then get to the business of what to do about it.

You cannot predicate the future so the doctors say weeks to months. The doctors that have the tools to do something about it – radiation, chemo or surgery – have more optimistic predictions as they have some power to cut out, kill or retard the tumor cells ability to replicate. The rest of us float in a fog wanting it all to be a dream.

But the doctors can’t predict the future so they have to say weeks to months. 5 years is 60 months and there’s a 4% chance of that. They encourage you to get your affairs in order because it’s just good practice and because it forces the family to have the conversations that are easy to avoid otherwise. Being alive in 5 years is a possibility. Being alive in 1 year is a good likelihood. Feeling better than before being diagnosed is an almost certainty with treatment. But the decision to undergo treatment needs to be made and it should be made with some level of understanding of what the treatment is like.

I happened across a site by and about a guy named Ted who was diagnosed with GBM in 2006. An interesting first hand account of what it is like to get treated and to live with a non-growing tumor in your body. I particularly liked a section written by his wife:

Personality Changes:  Ted’s attitude had gotten really bad right
before he was diagnosed.  He was angry all the time and kept telling
me he had no passion for a cause anymore. Fortunately his anger wasn’t
directed at me.  He seemed to be angry at the world but at the same
time he felt numb.  He went from the energizer bunny to not wanting to
see anyone or go anywhere.  At one point, I asked him what he had
done with my real husband.

The day before he was diagnosed I actually told him I thought he had a
brain tumor.  So I wasn’t as shocked as he was when the doctor told us
that he did.

Mood swings:  After surgery the doctor predicted mood swings.  I was
really concerned.   He did have a few, but as he has healed, the mood
swings have virtually disappeared and he has gone back to pre-tumor
behavior.  I have him back.  It’s wonderful.  I will always be
grateful to the surgeon for bringing him back to me.

Having seen a lot of the passion my father had for live disappear over the last 6 months it’s reassuring to read that it is cancer. The foundation of the world shakes when one of your mentors seems to give up hope for anything. It’s nice to know that the hope and passion are still there, they’re just being blocked by a tumor.