by Bor, Daniel
He started to spot bizarre patterns, coming to believe, for example, that anyone wearing a red tie was a member of a “crypto-communist party.” He would write frantic notes to colleagues complaining that aliens from outer space were ruining his career. He also sent letters to all the embassies in Washington, D.C., declaring that he was forming a world government and wanted to discuss the matter with them. It was his plan to become emperor of the Antarctic. Although he continued to believe his work was of the highest caliber, the ideas were by this stage nonsensical, and soon the illness took full hold and his mind was ravaged by insanity.
During the time leading up to his first schizophrenic episode, Nash was mentally exhausted and probably chronically stressed from the combination of his teaching duties and his stupendously abstruse mathematical research. His wife was also about to give birth.
Nash’s case raises the possibility that it is this very propensity to obsess over deeply challenging mental problems that contributes to mental imbalance in this small pocket of previously mentally superior individuals. Those like Nash are particularly skilled at searching for structure in the world and highly predisposed to devoting hours, days, and weeks to solid concentration on a single topic—which in itself probably places a great strain on their usually highly able prefrontal parietal network. Once the cancerous strands of this imbalance take hold, their conscious machinery can then, far more readily than most, become an internal enemy as it generates intricate paranoid delusional theories, which ramps up the stresses exponentially.
It’s well known that stress is the single biggest trigger for almost all mental illnesses. As Nash’s tragic life demonstrates, it can mangle the most able mind and plunge a person into years of nightmarish suffering. So in order to understand mental illness more generally, we need to understand how stress arises and what effects it has on our awareness and cortex.
If we’re seriously under threat and our lives are in danger—for instance a car, out of control, is headed straight for us—then there is a tension about how best to respond. On the one hand, action is the key—we want to make a decision as fast as possible to move in order to get out of the way. On the other hand, we don’t necessarily want to make too rash a decision to act, as we may run straight into the path of another car, or fail to realize that there’s a concrete reinforced barrier we could hop over and protect ourselves with. This tension is reflected in our emotions and thoughts. First comes our primitive fear, which floods our body with chemicals in readiness for movement and orients us to the danger. The amygdala, our fear center, tends to suppress prefrontal cortex activity so that we don’t think too much, and we act swiftly in whatever automatic way will keep us alive. On the other hand, the prefrontal parietal network can make a slower, more sophisticated, deliberative, conscious assessment of the situation—say, by noticing that although we appear to be in danger, the car moving straight for us is an illusion created by the movie projector on the cinema screen—and we are quite safe. So the half-strangled prefrontal cortex can, in turn, suppress amygdala activity, along with our feeling of fear, and bounce back to retain full conscious control of our movements.
In humans, in real life, the amygdala wins the battle all too often, and for entirely unnecessary reasons. If we were living, as our ancestors did, in a particularly threatening world, where big cats commonly stalked us, cantankerous rhinos and elephants regularly charged us, aggressive snakes liked to bite us, other members of the tribe sometimes wanted to fight us, and competing tribes sometimes declared war on us, then it arguably would be rather useful to be prone to surges of fear. However, it’s not entirely clear that a chronically fearful life, even for our hominid ancestors, would have been beneficial, except in the most unusual, extreme times.
The simple fact is that, in the vast majority of cases, conscious understanding and innovation is a superior tool to instinctive fear. Every one of us faces potentially mortal threats every day. Walking down the stairs could kill us, as could crossing the road. But we learn over our developing years to give such events respect, and we maintain simple routines so that the events seem safe. This is in stark contrast to those animals with less intellect, such as cats, which probably have a burst of terror whenever they cross a busy road.
Most people, especially in the developed world, live safer lives than ever before. But we still carry within us this evolutionary legacy, this primitive machinery of fear, which all too easily latches onto any target we consciously deem important, regardless of whether it is a threat to our lives. So we may be intensely nervous when having to give a public speech, or when playing in a sports tournament. With our prefrontal parietal network shut down by our anxious amygdala, we might be keenly aware of the object of our fear, but the world outside that one meaningful object dims, and those tasks requiring consciousness, such as answering questions during a talk, suddenly seem almost impossible.
Thus one major factor in stress is the inappropriate labeling of a multitude of safe events as life threatening. This in itself arises out of a combination of the primacy of our primitive, unconscious drives in controlling our thoughts and behaviors, and the plethora of habits we form in life, partly in the service of such impulses.
Our propensity for chunking, for consciously seeking out those little habitual nuggets, in other ways so successful in giving us control of our environment, can fail catastrophically when applied to our inner emotional world. It’s easy to underestimate the dizzying extent to which our lives revolve around the deep-seated chunks we’ve developed over the years. We are born utterly defenseless, with few instincts, but have minds exquisitely built for learning. Virtually every aspect of how we move, act, or carry out our daytime profession or evening hobbies is little more than a vast set of chunks we’ve learned over a lifetime. From the way we greet our parents on the phone to how we brush our teeth to the way we turn off our computer, every little detail of our lives involves the recalling of a piece of structured memory, a well-worn strategy, so that we have a fine-grained control over our world and an awareness that’s free to notice and react to new or complex events.
Amid these myriad chunks, though, there will be some examples in all of us that cause us to react in an unhelpful, irrational way to a given event. For depressives like my wife, not getting absolute top marks on a test might trigger a set of thoughts and memories that will cause her to think she’s utterly stupid, for instance. I can occasionally feel nervous talking to certain people not because of what they may say to me, or even what they ever did say, but simply because I once felt nervous in the past when talking to them, and this has become an inextricable habit. Because these are such well-used chunks, we are barely aware of them, just as we are barely aware of the mechanics of performing a forehand stroke in tennis.
This destructive form of chunking is particularly relevant to those with a mental illness. They might initially inappropriately label a given event as presenting an immense threat, as many of us do, but then fail to notice there was no threat after all. Instead, they may consciously chunk the link between the event and the level of danger so that it becomes reinforced and well established. Once this crystallizes in their minds, they will then repeatedly feel unavoidably, intensely threatened by these and any similar experiences. This can easily be compounded by further little chunks or tricks that are designed, in vain, to help. For instance, someone may be terrified of seeming awkward and foolish in social situations. But developing the habit to avoid all social moments means that this individual can never discover evidence to counteract his fears. Someone else may be terribly self-conscious of a small spot on her face, so she develops the habit to smother her whole face in thick makeup whenever she interacts with people, which means that she seems abnormal for this reason instead.
So while we are ingenious at understanding and innovation, we are unfortunately just as adept at forming thousands of personal strategies that can create chronic traps of stress and suffering, handing the advantage away from the prefront
al parietal network and to the amygdala. And when we are repeatedly exposed to stressful or frightening situations, then a damaging neural bias can develop: Our brains become entrained to overactivate the amygdala. This in turn can create a negative feedback loop that further inhibits activity in our prefrontal parietal network, reducing both our conscious space to deal with problems and our conscious control to filter out unhelpful thoughts and feelings.
The situation can then become semipermanent, with this imbalance continuing outside of episodes. For instance, if depressive or anxious patients are shown fearful stimuli in the scanner, then, understandably, they have greater amygdala activity than controls. But even if they are performing a neutral task requiring working memory or attention, these patients show reduced activity in parts of the prefrontal parietal network, as if these regions were chronically constricted, regardless of task.
Thus, a sustained period of stress or anxiety can largely turn off prefrontal function and consequently reduce conscious resources, with working memory half-disabled. In these situations, the brain learns by default to fear and to assume the most negative interpretation imaginable. The amygdala becomes trigger-happy, and its activity is sustained more aggressively, while the prefrontal parietal network is now easily and regularly inhibited. For schizophrenics, who may already have a far more fragile neurochemical system, stress may tip the scales toward catastrophic prefrontal dysfunction. But this mechanism may be an even more important clue to those mental illnesses more centrally defined by their emotional torments, such as post-traumatic stress disorder, anxiety disorder, and depression.
A WIDER, PURER OCEAN OF AWARENESS
If stress is such a profound game changer when it comes to mental illness, what can be done to reduce it and return the reins to the prefrontal parietal network? Aside from medication, which has only limited success, there is a practical list of lifestyle changes, which includes the usual suspects, such as avoiding or reevaluating those specific events that induce stress (not easy in most cases), getting decent quality sleep, exercising regularly, and so on. And these do all help reduce psychiatric symptoms, or have a protective effect against succumbing to a mental illness. But eclipsing this list in the fight against stress is one simple mental exercise: meditation. This is often written off as being too esoteric and not sufficiently scientific, but it’s been shown to profoundly help virtually any mental ailment, whether the person has a psychiatric condition or is merely suffering from the stresses and strains of everyday life.
There needn’t be anything mystical to meditation. Although there are hundreds of different varieties, in my view meditation is at its most powerful in its purest, most basic form: An ideal meditation is one where you try to be as aware as you can of as little as possible.
We can focus on the world with our attentional magnifying glass set in two broad modes: We can mainly attend to the thoughts, ideas, facts, and so on that relate to other mental events or what our senses are picking up; or we can simply attend to our senses directly, passively absorbing the experience without thoughts.
We may be on a mountaintop and feel a calm, profound awe as we attend entirely to the delicate beauty of the vast snowcapped peaks surrounding us. Or we could enter a very different experiential mode and try to calculate the volume of each mountain as a mathematical exercise, infer what the name of each mountain is from various clues, and recognize the different geological features of the rocks around us. In one state we have an open, quiet, passive perspective. In the other, we have a narrower, chattering mind, which isn’t nearly so aware of our sensory experiences. This quieter sense of beauty is closely related to the so-called meditative experience.
Spending 20 minutes or more with nothing to do may sound pointless and tedious, but for those who try it, boredom, strangely, never seems an issue. It’s as if, by intensely focusing attention continuously on the darkness of your closed eyes, a blank wall, or something equally minimal, you are telling your brain that this object is utterly fascinating. Early in meditation practice, there may be a struggle as the mind wanders, but after a while it becomes easier to sustain attention on virtually nothing for long periods of time.
And, far from being ineffectual, meditation causes substantial brain changes, both in the short term of a single session and in the long term, after months or years of practice. What’s more, these brain alterations seem the exact reverse of those caused by stress and many mental illnesses.
In striking contrast to the effects of anxiety and stress, the simple act of entering a meditative state increases activity in the prefrontal parietal network, especially in the lateral prefrontal cortex. So, intriguingly, this is indirect objective evidence that meditation really does raise awareness.
Over years of practice, regular meditation also seems to permanently change the prefrontal parietal network, such that it becomes more pliable and efficient in its activity. And, again in direct contrast to what happens in depression and anxiety disorders, long-term meditation shifts the see-saw battles between the amygdala and prefrontal cortex firmly in the prefrontal cortex’s favor: The amygdala becomes far less likely to activate, probably partly because the prefrontal parietal network is now so good at stepping in and taking control. There is even evidence that long-term meditation increases the thickness of the prefrontal cortex, helping to protect against the natural thinning of this part of the brain in old age. At the same time, two months of meditation is sufficient to shrink the size of the fear-creating amygdala in previously stressed individuals.
All these results fit perfectly with long-term meditators’ descriptions of how this practice modifies their experiences. They report becoming profoundly calm, largely free from fear, and better able to handle pains and bothersome emotions when they do arise. They describe a greater degree of awareness and mental control, as if they somehow have more space and flexibility by which to perceive and handle all the details of the world and their own inner life. It’s as if, by establishing new attentional habits that shift focus away from highly grooved mental chunks, any unhelpful old ideas can more easily be displaced. When it comes to our emotional habits particularly, meditation is undoubtedly an invaluable tool to dislodge those painful schemas that might have housed themselves firmly in our unconscious minds, and which can be the source of so much of our painful thoughts and feelings.
If meditation really can cause awareness to expand in a nourishing way, and consciousness is intimately linked with attention and working memory, then meditation should in turn generate improvements in tasks tapping these processes. This is exactly what researchers are discovering: Long-term meditation does improve a range of attentional tasks as well as working memory skills and spatial processing. Strikingly, regular meditation also seems to reduce a person’s need for sleep, possibly because it is a neurally nourishing activity.
However, one needn’t spend many years in intensive meditation practice before any benefits are seen. Fadel Zeidan and colleagues, for instance, found that just four meditation sessions were sufficient to reduce feelings of tiredness and increase working memory performance. Another study, by Yi-Yuan Tang and colleagues, found that only five days were needed for volunteers to improve on an attentional task that measured the subject’s ability to deal with conflicting stimuli. In addition to this improvement in a central component of cognition, the volunteers felt less anxiety, depression, anger, and tiredness.
Therefore, for normal, healthy participants, meditation reduces stress, improves alertness, and enhances performance on an impressive array of demanding tasks. It’s unsurprising, therefore, that meditation is increasingly being used as an effective weapon against depression, anxiety disorder, severe pain management, schizophrenia, and a host of other conditions.
HEALING CONSCIOUSNESS FROM MANY ANGLES
Along with our astounding conscious capacity to understand the universe and fashion increasingly sophisticated tools to control it, we have uniquely rich experiences punctuating our lives. The price for
all this, though, is sharper suffering. Some traumas are to be expected, given that we lead such extensive, long lives, and thus have many decades by which to experience the sorrows as well as the joys. But we are also prone to, by far, the widest, most intense range of mental illnesses of any species, and these can cripple us as commonly as any disease of the heart or lungs. These heavy costs of a vast, immensely capable consciousness are themselves intimately related to awareness at every turn. While autism, the odd-one-out, partially relates to an overabundant awareness, other conditions reflect a permanent or episode-driven diminished consciousness, with working memory reduced and attention failing to filter out unhelpful thoughts and feelings. This combination creates an attachment to the aberrant and upsetting structures of thought that so heavily reinforce mental diseases.
Research is revealing many ways to soften symptoms and approach cures, with each method presenting a different angle to the challenge of returning consciousness to normal levels. Current and emerging drugs can rebalance a dysfunctional neurotransmitter system and in turn return prefrontal parietal processes to their optimal levels. Future tools of psychiatric diagnosis, however, need to give more emphasis to neuroscientific dysfunction, and appropriate drugs need to be provided that are tailored to meet this specific dysfunction. Cognitive training and meditation offer complementary routes to boosting working memory and refocusing attention. And all these methods can encourage a new sense of control over one’s inner mental world.
