The Man Who Mistook His Wife for a Hat p.137

Such descriptions remained purely anecdotal until the extraordinary studies of Wilder Penfield, half a century later. Penfield was not only able to locate their origin in the temporal lobes, but was able to evoke the ‘elaborate mental state’, or the extremely precise and detailed ‘experiential hallucinations’ of such seizures by gentle electrical stimulation of the seizure-prone points of the cerebral cortex, as this was exposed, at surgery, in fully conscious patients. Such stimulations would instantly call forth intensely vivid hallucinations of tunes, people, scenes, which would be experienced, lived, as compellingly real, in spite of the prosaic atmosphere of the operating room, and could be described to those present in fascinating detail, confirming what Jackson described sixty years earlier, when he spoke of the characteristic ‘doubling of consciousness’:

There is (1) the quasi-parasitical state of consciousness (dreamy state), and (2) there are remains of normal consciousness and thus, there is double consciousness… a mental diplopia.

This was precisely expressed to me by my two patients; Mrs. O’M. heard and saw me, albeit with some difficulty, through the deafening dream of ‘Easter Parade’, or the quieter, yet more profound, dream of ‘Good Night, Sweet Jesus’ (which called up for her the presence of a church she used to go to on 31st Street where this was always sung after a novena). And Mrs. O’C. also saw and heard me, through the much profounder anamnestic seizure of her childhood in Ireland: ‘I know you’re there, Dr. Sacks. I know I’m an old woman with a stroke in an old people’s home, but I feel I’m a child in Ireland again—I feel my mother’s arms, I see her, I hear her voice singing.’

Oliver Sacks – The Man Who Mistook His Wife for a Hat and Other Clinical Tales p.137

The Man Who Mistook His Wife for a Hat p.93

Charcot and his pupils, who included Freud and Babinski as well as Tourette, were among the last of their profession with a combined vision of body and soul, ‘It’, and ‘I’, neurology and psychiatry. By the turn of the century, a split had occurred, into a soulless neurology and a bodiless psychology, and with this any understanding of Tourette’s disappeared.

Oliver Sacks – The Man Who Mistook His Wife for a Hat and Other Clinical Tales p.93

The Happiness Hypothesis p.12

The importance of the orbitofrontal cortex for emotion has been further demonstrated by research on brain damage. The neurologist Antonio Damasio has studied people who, because of a stroke, tumor, or blow to the head, have lost various parts of their frontal cortex. In the 1990s, Damasio found that when certain parts of the orbitofrontal cortex are damaged, patients lose most of their emotional lives. They report that when they ought to feel emotion, they feel nothing, and studies of their autonomic reactions (such as those used in lie detector tests) confirm that they lack the normal flashes of bodily reaction that the rest of us experience when observing scenes of horror or beauty. Yet their reasoning and logical abilities are intact. They perform normally on tests of intelligence and knowledge of social rules and moral principles.

So what happens when these people go out into the world? Now that they are free of the distractions of emotion, do they become hyperlogical, able to see through the haze of feelings that blinds the rest of us to the path of perfect rationality? Just the opposite. They find themselves unable to make simple decisions or to set goals, and their lives fall apart. When they look out at the world and think, “What should I do now?” they see dozens of choices but lack immediate internal feelings of like or dislike.

They must examine the pros and cons of every choice with their reasoning, but in the absence of feeling they see little reason to pick one or the other. When the rest of us look out at the world, our emotional brains have instantly and automatically appraised the possibilities. One possibility usually jumps out at us as the obvious best one. We need only use reason to weigh the pros and cons when two or three possibilities seem equally good.

Human rationality depends critically on sophisticated emotionality. It is only because our emotional brains works so well that our reasoning can work at all. Plato’s image of reason as charioteer controlling the dumb beasts of passion may overstate not only the wisdom but also the power of the charioteer. The metaphor of a rider on an elephant fits Damasio’s findings more closely: Reason and emotion must both work together to create intelligent behavior, but emotion (a major part of the elephant) does most of the work. When the neocortex came along, it made the rider possible, but it made the elephant much smarter, too.

Jonathan Haidt – The Happiness Hypothesis: Finding Modern Truth in Ancient Wisdom p.12

In an Unspoken Voice p.316

[William] James was able to perceive that fear was not a primarily cognitive affair, that there was a muscular and visceral reaction in his body first, and that it was the perception of this body reaction that then generated the emotion of fear. What James observed was that, yes, when the brain calculates that there is danger, it makes this assessment so quickly that there isn’t enough time for the person to become consciously aware of it. What happens instead, according to James, is that the brain canvases the body to see how it is reacting in the moment. In what was a revelatory revision, James relocated the consciousness of feeling from mind to body. In doing this he demonstrated a rare prescience about what neuroscience was only to begin to discover a hundred years later.

Peter A. Levine – In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness p.316

Global Sperm Counts are Falling. This Scientist Believes She Knows Why

The mystery is this. Since the late 1930s, sperm counts around the world appear to have dropped significantly. While the decline was initially observed in western countries, there is evidence of the same phenomenon in the developing world, and it seems to be accelerating.

For more than two decades Swan has devoted her life to studying the effects of “endocrine disrupting” chemicals(opens a new window) (EDCs), which can interfere with the body’s natural hormones. These include pesticides, bisphenols(opens a new window), which harden plastic so it can be used in food storage containers and baby bottles, and phthalates(opens a new window), which soften plastic for use in packaging and products such as garden hoses. In recent years, traces of EDCs have been found in breast milk, placental tissue, urine, blood and seminal fluid.

In the glare of orange spotlights, Swan led the Copenhagen audience to her conclusion: that the innocuous products in your kitchen cupboard, bathroom cabinet or garden shed may be lowering sperm counts. They could also affect the reproductive systems of your unborn children. The implications of EDCs for human health don’t stop there: they can disrupt thyroid function, trigger cancer and obesity.

Then Swan got to the “ass-ball connector”. A slang term for ano-genital distance (AGD), the span from the anus to the base of the penis, it is “also known as ‘the taint’, ‘the gooch’ and ‘the grundle’”, she told the crowd in Copenhagen. She enunciated the words with an innocence that stripped them of prurience. The audience listened intently as she described one of her pivotal discoveries: that AGD can act as a predictor of a man’s ability, years later, to conceive a child. It has provided evidence for her thesis that inadvertent exposure to EDCs in utero can inflict harm on a developing foetus.

She was sitting next to a chemist from the CDC called John Brock, now a professor at the University of North Carolina, who told her that scientists had identified a “phthalate syndrome” in rats. When male foetuses were exposed to di-2-ethylhexyl phthalate (DEHP), one of the worst actors among the phthalates, a normal testosterone surge early in pregnancy failed to take place. The effects on the rats included a smaller penis, sometimes malformed, undescended testicles and a shorter AGD. Swan was fascinated. It was a new puzzle: could something like a phthalate syndrome affect humans?

Her success in working out a way to measure AGD in babies and children to help answer that question has been one of her most crucial contributions to the field. When I visited her in New York, she went to a cupboard and brought out an anatomically correct doll — called Willy, she said, somewhat impishly — and a pair of callipers to demonstrate the simplicity of the procedure, which is painless. AGD, or the length of the perineum, she explained, can reflect how much testosterone or androgen a foetus was exposed to during a very small window of pregnancy. “If there’s too little androgen for a boy, he doesn’t get fully masculinised,” she said. “If there’s too much androgen for a girl, she gets over-masculinised.” A mother with polycystic ovary syndrome, for example, will produce an excess of testosterone, and her daughter might have a longer, more masculine AGD.

Determining whether a short AGD was a predictor of later fertility problems meant leaping forward in time to forecast how men would be affected in adulthood. In 2009, while working for the University of Rochester, Swan launched the Rochester Young Men’s Study, involving 126 volunteers aged 18-22. It provided the missing link to show that the shorter the AGD, the lower the sperm count. The research has been backed up by others. Around the same time, Michael Eisenberg, professor of urology at Stanford University School of Medicine, undertook a number of studies involving men in their thirties and forties, and similarly found an association between a shorter AGD and infertility.

In 2011, Swan and a team of andrologists, statisticians, epidemiologists and a reference librarian, began conducting the most complete search of the literature on falling sperm count to date. A total of 185 studies were examined in detail, using meta-analysis methods not available to the Danish academics 30 years before. The conclusion was deeply unsettling. Sperm count appeared to have declined 52 per cent in 38 years, or something over 1 per cent a year. When the study was published in 2017, it made “big, big news”, she recalled, eventually leading her to publish Count Down, a book aimed at a general audience.

Full article: https://archive.ph/N6mvb#selection-2447.0-2451.37

The Myth of Normal p.364

The truth I speak of is much more modest and down-to-earth: a clear look at how it is, how things actually happen to be at this moment. This is the kind of truth that ushers in healing. To access it, we will have to tap into something more resourceful than our smarts.

The intellect becomes a far more intelligent tool when it allows the heart to speak; when it opens itself to that within us that resonates with the truth, rather than trying to reason with it. “And now here is my secret, a very simple secret,” the fox advises the Little Prince in Antoine de Saint-Exupéry’s beloved tale: “It is only with the heart that one can see rightly; what is essential is invisible to the eye.” The intellect can see verifiable facts—provided that denial doesn’t obscure or distort them, as it often does to protect the wounded or pain-averse parts of us. It is possible to declaim, declare, and insist on facts, all without a scintilla of what l’m calling truth. The kind of truth that heals is known by its felt sense, not only by how much “sense” it makes . . . And yet we can’t ignore our minds, either, since that’s where so much of the action is. If the heart is our best compass on the healing path, the mind—conscious and unconscious—is the territory to be navigated. Healing brings the two into alignment and cooperation, often after a lifetime of one hiding behind or being disregarded by the other.

“Everything has mind in the lead, has mind in the forefront, is made by the mind,” the Buddha said 2,500 years ago. I return to this phrase of the great teacher Gautama because it is key to understanding our relationship to what we consider real. It is also the bedrock of the therapeutic approach I take to my work and, when I am conscious, to my personal path. With our minds we construct the world we live in: this is the core teaching. The contribution of modern psychology and neuroscience has been to show how, before our minds can create the world, the world creates our minds. We then generate our world from the mind the world instilled in us before we had any choice in the matter. The world into which we were born, of course, was partly the product of other people’s minds, a causal daisy chain dating back forever.

Gabor Maté and Daniel Maté – The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture p.364

The Myth of Normal p.264

A chronic, reflexive tuning out is one of the hallmarks of attention deficit hyperactivity disorder (ADHD), now being diagnosed worldwide with increasing and alarming frequency. This is not dissociation-level “out of body”-ness, but it does disconnect one from oneself, from one’s activities, and from other people in ways that disrupt functioning and are, as I personally attest, often highly frustrating. ADHD’s features include poor attention span, distractibility and low boredom threshold, poor impulse control, and (mostly in males) difficulty being still. Millions of children are receiving stimulants as a result, and hundreds of thousands are even being treated with antipsychotic medications—not for psychosis, but simply to calm them, to make them more pliable. This amounts to a vast and uncontrolled social experiment in the chemical control of children’s behavior, since we don’t know the long-term effects of such drugs on the developing brain. What we do know from adult research should give us pause. It has been understood since at least 2010 that prolonged use of antipsychotics is associated with shrinkage of brain volume in adult subjects.” In children we are already witnessing some short-term systemic harm. Here in Vancouver, British Columbia Children’s Hospital has had to establish a special clinic just to deal with the metabolic consequences of such drugs, which include obesity, diabetes, and threats to cardiovascular health.

ADHD is sometimes said to be the “most heritable” mental illness, which in my view is a bit like calling quartz the most chewable crystal. Some experts estimate—I should say misestimate—the heritability of ADHD traits to ‘be in the range of 30 to 50 percent. The genetic thesis never made sense to me, even though two of my children and I myself have been diagnosed with this “brain disease.” Tuning out is dissociation’s less extreme cousin, part of the same family of escapist adaptations. It is invoked by the organism when the circumstances are stressful and there is no other recourse for relief, when one can neither change the situation nor escape it. Such was the imperative in my own infancy. Such, too, was the situation for my three sensitive children—a trait they may well have inherited, as discussed in the last chapter—in an emotionally chaotic home characterized, amid plenty of love, by parental anxiety, depression, and conflict. This adaptation then becomes wired into the brain, without the brain itself being the original source of the problem.

Gabor Maté and Daniel Maté – The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture p.264

The Myth of Normal p.253

Let’s begin with something rather simple, now on the rise: depression, a state I know intimately. The word’s literal meaning is quite telling. To depress something means to push it down, as one might a beach ball in a swimming pool. I like that analogy especially because one can easily feel how much concerted force it takes to keep the ball submerged, and the way it “wants” to find a way back up to the surface. Keeping it down takes a toll.

What is pushed down when a person is depressed is easily identified by its absence: emotion, the continual flow of feelings that remind us we’re alive. Unlike the wrangler of the beach ball, a depressed person doesn’t choose this submersion of life energy—it imposes itself, turning a once-vibrant emotional landscape into arid desert. The only “feeling” that remains, typically, is more sensation than emotion, a thrumming, indistinct pain that threatens to consume everything, and sometimes does.

If we label this depression of feeling a disease, we risk not recognizing its original adaptive function: to distance oneself from emotions that are unbearable at a time in life when to experience them is to court greater calamity. Recall what I called the tragic tension between authenticity and attachment. When experiencing and expressing what we feel threatens our closest relation-ships, we suppress. More accurately, we don’t: our mind does that automatically and unconsciously on our behalf.

Gabor Maté and Daniel Maté – The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture p.253

The Myth of Normal p.250

Some people will feel more pain and will therefore have greater need to escape into the adaptations that mental illness, or addiction, represent. They will have more need to tune out, to dissociate, to split into parts, to develop fantasies to account for realities they are unable to endure. But that’s a far cry from saying that they have a heritable neurobiological disease. These are the children that Tom Boyce, a professor of pediatrics and psychiatry at the University of California, San Francisco, describes as orchids, “exquisitely sensitive to their environment, making them especially vulnerable under conditions of adversity but unusually vital, creative, and successful within supportive, nurturing environments.” The same “sensitivity” genes that in a stressed environment can help potentiate mental suffering may, under positive circumstances, help promote stronger mental resilience and therefore happiness. Sensitive people have the potential to be more aware, insightful, inventive, artistic, and empathic, if their sensitivity is not crushed by maltreatment or disdain. The most sensitive of our kind have made some of the most lasting cultural contributions; many of these have also suffered the most intense pains during their lives. Sensitivity can be the quintessential combo package: gift and curse, all in one.

Gabor Maté and Daniel Maté – The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture p.250

The Myth of Normal p.241

Contrary to what I, too, used to believe, a diagnosis like ADHD or depression or bipolar illness explains nothing. No diagnosis ever does. Diagnoses are abstractions, or summaries: sometimes helpful, always incomplete. They are professional shorthand for describing constellations of symptoms a person may report, or of other people’s observations of someone’s behavior patterns, thoughts, and emotions. For the individual in question, a diagnosis may seem to account for and validate a lifetime of experiences previously too diffuse or nebulous to put one’s finger on. That can be a first and positive step toward healing. I know this from firsthand experience.

The dead end comes when we assume or believe that the diagnosis equals an explanation—an especially futile view when it comes to illnesses of something as inherently abstract as the mind. As the British psychologist Lucy Johnstone said to me, “In physical illness you have, in principle, a way of checking it out. You can say, ‘Let’s look at the blood test or the enzyme levels.’ And you could, in most cases, confirm or disconfirm it. But in psychiatry, it’s simply a circular argument, isn’t it? Why does this person have mood swings? Because they have bipolar disorder. How do you know they have bipolar disorder? Because they have mood swings.”

Gabor Maté and Daniel Maté – The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture p.241