Authors: Rudolph E. Tanzi
But as Siegel points out, the brain is caught between two dysfunctional states: chaos and rigidity. If your inner world is chaotic, you feel confused. Conflicting emotions are hard to resolve; impulses are hard to resist. If the chaos gets out of hand, fear and hostility can roam your mind at will, and sometimes you aren’t responsible for your own behavior. We casually describe chaotic people with ill-defined terms like
flighty, “a mess,” hysterical, out of control, spacey
—all attempts to get at a state of disordered confusion.
Rigidity counters chaos in the wrong way. Rigid people have clamped down. Their behavior is set along fixed patterns. They deny themselves any spontaneity, and they resent (while secretly fearing) anyone who is spontaneously happy. Rigidity leads to ritualistic behavior—like long-married couples who repeat the same arguments year after year. Taken to an extreme, rigidity leads to severe judgments against others, enforcing rules with harsh punishments. We casually refer to rigid people as anal, uptight, hard asses, tight asses, “fascists,” morality police—these terms have in common a constricted, tightly organized approach to life. But considered without judgment, the suffering that results from a tightly wound inner world is real. Rigidity, because it feels safer than being chaotic, can gain social approval. Every society has a law-and-order party; none has a
carpe diem
(live for the moment) party.
Siegel places the integrated brain in the middle between chaos
and rigidity; it is the true solution to both, which is why inner work is necessary. We will be more specific about the spiritual side of inner work later. The key thing to absorb here is the natural cycle that every day should follow. For example, sleep research has indicated that all but the tiniest fraction of adults needs eight to nine hours of good sleep every night. After a good night’s sleep, the brain needs to wake up on its own, taking the time it needs to switch from the chemical state of sleep to the chemical state of being awake, which is entirely different.
It’s a myth that sleep can be shortchanged. From the brain’s viewpoint, getting six hours of sleep during the week is a permanent loss. You can’t fully make it up by sleeping in on the weekend. Waking up with an alarm clock is also detrimental. The brain transitions from deep sleep in a series of waves, each one getting closer to full wakefulness. You rise up to light sleep, then back down again, several times during this process, and as you do, your brain secretes a bit more of the chemicals needed to be awake. If you cut the process short, you may tell yourself that you are awake, but in fact you aren’t. Schoolkids who stay up late playing video games will sit through homeroom and first period the next day basically in their sleep. Adults who have slept six hours can function reasonably well for the first four to six hours of their workday, but after that there is a steep falling off. The loss of one hour’s sleep impairs driving skills—about as much as taking two alcoholic drinks.
Most people are aware of the importance of sleep, but as a society we don’t do what is good for us in this area. We are chronically sleep deprived and even proud of the fact, since it indicates a life on the go and total dedication to our work. But the mind platter indicates that true dedication would consist of balancing the brain for optimal performance, which means taking seriously time in, down time, and sleep time. Our overworked, overstimulated society ignores these three areas.
Outer work:
Physical time, play time, connecting time
This is the area of outward activity. Inner and outer work cannot be strictly divided from each other, since all brain processes are inner and all behavior is outer. Speaking generally, however, when you interact with someone else, you are doing outer work. You chat, gossip, and bond. You go to restaurants and conduct a hopeful crawl through bars. You build a family and find things to do together. As many sociologists have pointed out, this area of life used to dominate everyday existence, at a time when families sat around the fire of an evening and ate every meal together.
That’s no longer true. Families today are often loose constellations. Contact is intermittent and rushed. Everyone has their own space. Activity is scattered all around town, not confined to the home. Cars have made everyone mobile, but central heating may be the most powerful force in shaping modern society. In the past, bedrooms were cold chambers where you retreated for sleep. Otherwise, you spent the evening in the one or two rooms of the house that had a fire going. The kitchen, now considered the heart of a home, was the province of servants in all but the poorest households.
Physical separation makes outer work harder. We are seeing new brain changes in the digital generation, who have adapted to physical separation more than ever. By spending hours focused on video games and social networking, young people are expanding one set of skills—the eye-hand coordination needed for video games and the technical expertise for computers—while neglecting the neural pathways for interacting with people face to face. It is telling that being on Facebook, which is essentially a constantly updated photo album with commentary, is considered a “relationship.” Actual personal contact isn’t necessary.
But if you leave judgment out of the picture, social networking represents a new kind of shared mind, a global brain with activity
that connects hundreds of millions of people. The sense of connection that comes from instantly tweeting your thoughts is real, and the sense of belonging to something bigger than yourself is real, too, as when news of the turbulent events of the Arab Spring in 2011 went around the world in real time. There is much optimism about social networks changing the world for the better. In repressive societies in the Middle East, some feel that the future is a race between the mullahs and the iPad—in other words, a contest between traditional repressive forces and the technology that frees people’s minds.
If connecting time is exploding in the digital era and play time can be had with the touch of a Wii box, the neglected ingredient is usually physical time. The brain needs physical activity, even though we think of this organ, naturally, as mental. But because it monitors and controls the body, your brain participates in physical stimulation. The things that decrease physical time are all around us, and unfortunately they are all detrimental to the brain. Being depressed keeps people shut inside and inactive. Replacing outdoor exercise with compulsive computer activity puts the body in a sedentary state, which is unhealthy. Being totally sedentary increases the risk of almost every lifestyle disease, including heart attack and stroke.
The message to get out and exercise has increasingly fallen on deaf ears—guilty deaf ears—as Americans and Europeans grow more sedentary and gain weight. According to a 2011 report from the Centers for Disease Control, a quarter of U.S. adults report that they devote no time to physical activity. The number increases to 30 percent across the South and Appalachia—for them, “couch potato” has become a dismal reality—while only 20 percent meet the recommended amount of physical activity. For reference, federal guidelines recommend that adults between eighteen and sixty-four get a total of two and a half hours of moderate activity or one hour and fifteen minutes of intensive activity per week. The recommendation goes up for children and adolescents (ages six to seventeen), who should be doing at least an hour of intensive activity a day, which
would typically be provided in physical education class at school. Participation in PE has been on a steady decline, however.
Residents are most likely to be physically active in parts of the Northeast, the West Coast, Colorado, and Minnesota. (One reason for regional variation may be the influence of peers. If someone in your peer group goes for a run, you are more likely to do the same.) But because the data were self-reported, people may have overstated their level of physical activity, which means that these statistics are overly optimistic.
One result is almost predestined. A third of adult Americans are overweight compared to where they should be, and another third have become obese. Exercise has a direct brain connection, when you consider what it actually does. The benefits to increased cardiovascular health are well known, and obviously exercise gives you better muscle tone. What we tend to overlook are the feedback loops that connect the brain to every cell in the body. Therefore when you throw a ball, run on a treadmill, or jog along the shore, billions of cells are “seeing” the outside world. The chemicals transmitted from the brain are acting the way sense organs do, making contact with the outside world and offering stimulation from that world.
This is why the jump from being sedentary to doing a minimal amount of exercise—such as walking, light gardening, and climbing the stairs instead of taking the elevator—is so healthy. (Each step of doing more exercise adds benefit to your health, but the single largest benefit comes from getting off the couch in the first place.) Your cells want to be part of the world. Such a statement would have sounded far-fetched in the past. Mainstream physicians back then regarded the mind-body connection as suspect. As a result, medicine adopted a hostile attitude toward “soft” psychological explanations, considering drugs and surgery all-important. Drugs and surgery require a simple cause-and-effect relationship between disease X and cause Y. The cold virus causes colds, and pneumococcus bacteria cause tuberculosis. The breakdown of simple cause-and-effect is vital for us,
however. It leads to the idea of the fully integrated brain as essential to health—a super brain.
Let’s look more closely at the path that mind-body integration had to travel when it came to a disorder that afflicts society en masse: heart disease.
Making the Link
The link to the brain was slow in coming. In the 1950s America began to experience an alarming increase in premature heart attacks, those that occur primarily in men between the age of forty and sixty. As deaths from heart disease and stroke skyrocketed, physicians began to see more and more men complaining of chest pain, which turned out too often to be angina pectoris, a primary symptom of blocked coronary arteries. At the turn of the century the renowned William Osler, one of the founders of Johns Hopkins Medical School, was on record noting that a doctor in general practice would hardly see one case of angina a month. Suddenly it became common to see half a dozen a day.
Scrambling for an explanation for the epidemic, cardiologists focused on a physical cause, as the drastic increase of fats in the American diet compared with that of our grandparents, who ate far more whole grains and vegetables. One factor that seemed eminently scientific: cholesterol. A massive public campaign was launched to get the public to consume a diet lower in red meats, eggs, and other sources of cholesterol. The campaign may not have been a huge success, since the national diet remains high in fat, but cholesterol became a scary word (overlooking that your body produces 80 percent of the cholesterol in the bloodstream and that this steroid is absolutely necessary for building cell membranes); a billion-dollar industry has grown up around reducing the “bad” blood fats and increasing the “good” ones. From the beginning, nobody seriously considered the brain as a cause of heart attacks. It was left out of the loop because
no model existed for how the brain could transmit messages to heart cells, and the term
stress
was barely being mentioned.
As it happened, some experts were dubious about cholesterol from the start; they pointed out that soldiers who were casualties in the Korean War had been autopsied, and it was found that even in their early twenties, their coronary arteries already contained enough plaque to lead to a heart attack. Why didn’t heart attacks arrive until much later? No one knew. It was suggested, when analyzing the extensive data provided by the Framingham Heart Study, that men in their twenties who faced their childhood psychological issues were better protected against premature heart attacks than those who didn’t. But this was no time for such “soft” explanations.
No one believed that you could think your way to a heart attack. The decision was made to back cholesterol as a ready-made villain. (We won’t go into the problems facing the cholesterol hypothesis, except to mention that the cholesterol you ingest doesn’t necessarily lead to high blood cholesterol—the physiological picture is complex and growing more so every decade.) The brain wasn’t taken into account even when a psychological argument finally became popular, the argument over Type A and Type B personalities. Type A people were tense, demanding, perfectionists, prone to anger and impatience, and addicted to control. As a result, the theory went, Type As were more prone to heart attacks than Type Bs, who were relaxed, tolerant, even-tempered, patient, and more accepting of mistakes. Type As did seem much more likely to create stress. (There was a quip at the time about having a Type A boss: he’s not the kind who gets a heart attack—he’s the kind who gives them.) As it turned out, actually identifying and testing who was Type A or Type B proved elusive; now instead of “personality,” medicine speaks of Type A or Type B behavior.
Once stress and behavior entered the picture, you’d think that the brain must have become a major player, but it didn’t. There was
still no model for explaining how an external stress could enter the body and find a physical pathway to the cells.
By the late 1970s such a pathway began to emerge with the discovery of
messenger molecules
, a class of chemicals that turn moods, stress, and disorders like depression into something physical. The public began to hear about brain cells in detail as biologists named the neuropeptides and neurotransmitters that leap across the synapses, the gaps between neurons.
Serotonin
and
dopamine
became household terms, with links to chemical imbalances in the brain (for example, too much serotonin or too little dopamine). A great era of discovery was at hand, and the decisive step came when it was found that these chemicals not only leap across the synapse but course through the bloodstream. Every cell in the body contains receptors that are like keyholes, and the brain’s chemical messengers are the keys that precisely fit the hole. To simplify a complex model, the brain was telling the entire body about its thoughts, sensations, moods, and general health. The link between psyche and soma, mind and body, had been made at last.