Summarizing Neurologist Elkhonon Goldberg’s Book Entitled “The New Executive Brain: Frontal Lobes in a Complex World” (Part III)

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When I was a boy back in the 1960s I enjoyed watching country singer Mel Tillis on the Tonight Show with Johnny Carson. (How a young boy was able to stay up past his bedtime to watch late night TV without his parents knowing is a story for another day.) I remember feeling bad for Mel because he had a speech impediment, a stutter. But the audience and Johnny would howl when they thought they knew what word Mel was stammering toward, only for Mel to then go on to perfectly annunciate a word no one expected at all. That’s humor—juxtaposing unlikely ideas or images for comedic effect—and Tillis was very good at it. Mind researchers such as Gilles Fauconnier and Mark Turner (see their 2002 book The Way We Think) call what Mel was able to do conceptual blending—blending elements taken from two different conceptual domains. All comedians, really, are masters at conceptual blending. But what truly amazed me was when Mel would get up from the couch to sing (and he had many hits back in those days). It was perfect! No stuttering at all! How could that be? I was baffled and amazed all at once.

The movie The King’s Speech had a great depiction of the Mel Tillis effect: the King (to be) able to recite Shakespeare perfectly while listening to Mozart on the headphones. I remember watching that scene in the King’s Speech and saying to myself, “It’s Mel!” I also remember thinking about brain/mind researchers such as Antonio Damasio (of The Feeling of What Happens fame) and Joseph LeDoux (of The Emotional Brain fame) and their descriptions of how language is an emergent property: it emerges out of various brain centers working together in concert. When they don’t work together so well, a speech impediment often results. Language is a great example of mind emerging from brain. And as the Mel Tillis effect shows us, there’s more than one way to get language to emerge. Mel could have perfect language if he sang it (e.g., went “sing-song” or “right brain”). The King could have perfect language if he also went sing-song or right brain by listening to Mozart. Mothers coax their infants and young children to “emerge” language by using high pitched, sing-song “motherese.” Mothers are “speech pathologists” in that they use motherese to bridge the gestalt or global right brain to the specific or linear left brain. If there is a problem with the bridging, you can sing your speech out of the right (like Mel), or type it on a keyboard using the left. Damasio will often tell his readers that if you wish to protect against the devastating effects of a stroke on the left side of the brain (maybe in the speech area of Broca’s), learn a second language. People who sustain a brain lesion in the left are often still able to speak using their learned second language (which emerges more from the right—go figure). People with left brain lesions are often able to sing their speech. Amazing stuff eh? The brain is compensatory—a term I recently heard used by Dr. John Arden during a lecture on brain-based therapy. Heck, you can remove an entire brain hemisphere (usually as a last resort in extreme cases of seizure disorders) and still function fairly well. Consider this excerpt from the entry hemispherectomy over at Wikipedia (now back online after its 24 hour blackout period in protest of SOPA/PIPA):

All hemispherectomy patients suffer at least partial hemiplegia on the side of the body opposite the removed or disabled portion, and may suffer problems with their vision as well. This procedure is almost exclusively performed in children because their brains generally display more neuroplasticity, allowing neurons from the remaining hemisphere to take over the tasks from the lost hemisphere.

It’s amazing how many ways brain can protect (e.g., compensate for) itself, and how many ways brain can give rise to mind. And I’m sure that the immaterial mind affects the material brain.

This is a longwinded introduction to my final installment in my multipart summary of Elkhonon Goldberg’s 2009 book The New Executive Brain: Frontal Lobes in a Complex World. In this final installment I’d like to look at two final themes from Goldberg’s book: 1) an amazing case of the compensatory brain, and 2) the philosophical question, “How is it that brain (the material) can change through some form of brain elasticity (radically so in cases of hemispherectomy), but yet self (the immaterial) remains essentially unchanged?”

Toward the end of his book Goldberg talks about brain conditioning, effectively, exercising the brain as one exercises the body. Goldberg puts forth the idea that when a “severe neurological illness” (like dementia or Alzheimer’s) hits, the well-conditioned brain will suffer less “because of the extra reserve that the well-conditioned brain has by way of additional neural connections and blood vessels.” Goldberg continues, “The case of sister Mary makes the point with dramatic and remarkable clarity.” Apparently sister Mary is a superstar in the annals of neurology (right up there with Phineas Gage, the poor fellow who had a tamping iron shot through his frontal brain). Allow me to quote Goldberg at length:

Sister Mary was one of the School Sisters of Nortre Dame, the much-studied and reported nuns from Mankato, Minnesota. Remarkable for their longevity, they were also known for the absence of debilitating dementia among them. The phenomenon was unanimously attributed to the lifelong habit of being cognitively active. The nuns constantly challenged their minds with puzzles, card games, debates of current policy issues, and other mental activities. Furthermore, the nuns with college degrees, who taught and engaged in other mind-challenging activities on a systematic basis, on average lived longer than their less well-educated counterparts. So compelling were the observations of the nuns’ cognitive well-being that a postmortem brain study was designed to examine the relationship between cognitive stimulation and dendritic sprouting.

Those nuns who tended to write more grammatically complex and conceptually rich essays [as can be seen in cases of conceptual blending] in their youth retained their mental vigor until much later in life than those who wrote simple, factual prose as young women.

Quite amazing stuff, eh? Goldberg alerts us to the fact that Sister Mary “performed well on cognitive tests until her death at age 101, despite the fact that the postmortem study of her brain revealed multiple neurofibrillary tangles and plaques, the hallmarks of Alzheimer’s disease.” Goldberg makes this startling conclusion: “It would appear that Sister Mary had an intact mind inside an Alzheimer’s brain.” Yeow! Even an Alzheimer’s brain can give rise to an intact, fully functioning mind given that one engages in a lifetime of cognitive exercise. It would appear that it’s not enough to develop brain so that mind emerges; we should also develop brain in a way that brain can give rise to a primary mind and even a backup or compensatory mind. What’s your best offense against a left brain lesion? Yup, learn a second language. But this idea of a brain giving rise to multiple compensatory minds raises an interesting philosophical dilemma: how is it that the immaterial self tends to stay the same? As Goldberg puts it, this is “one of the central riddles of information processing in the brain.” Allow me to quote Goldberg as he talks about this riddle:

The brain is somehow able to acquire new information without the loss of previously acquired information. It can learn how to deal with new challenges without “unlearning” how to deal with previously encountered situations. The brain can exhibit the properties of plasticity AND [my emphasis] stability at the same time. Although we take this dual ability for granted in our everyday activities as brain users, we are confounded by this ability as brain researchers. Many a serious neuroscientist has found this dual property of the brain to defy clear mechanistic explanations. The problem is particularly apparent to neural network modelers. It turns out to be very difficult to design a network capable of learning new information without paying the price of losing previously acquired information.

Goldberg goes on to suggest that some researchers have solved this dilemma by proposing two separate brain systems: one system that holds the stable and coherent self, and another that allows for change. Hopefully the reader can see that we are quickly falling into the philosophical conundrum of body versus mind. Some researchers solve the duality of body and mind by creating a “monism”—a conceptual system that tries to encompass and conceptualize everything. Reducing mind to brain is an attempt to create a monism. By proposing two brain systems—one for changing information, and one for a stable self—a monism is created, that is to say, brain gives rise to both systems. This type on monism is also referred to as materialism—only the material counts, only changing the material counts, only the material condition counts.

Writing in his book Artificial Happiness (which I have mentioned in earlier posts), Dworkin has this to say about the monism of materialism:

Although many doctors have never heard of monism or the mind-brain debate, they benefit from monism’s triumph [over religion]. The story of Artificial Happiness is a story of competing ideologies [e.g., competing conceptual domains]. Because the medical profession’s ideology [of materialism] was rivaled only by [the spiritualism] of religion, any retreat by religion affected the doctors’ position. Monism’s triumph over dualism signified not only religion’s loss but also medicine’s gain. … When neuroscientists showed how the mind could spring from the brain, doctors reaped an overarching conceptual framework to supplement psychotropic drug ideology, thereby boosting Artificial Happiness’s legitimacy.

Ernest Keen, writing in his book Chemicals for the Mind: Psychopharmacology and Human Consciousness, warns against the overarching conceptual frameworks that monisms can bring. Keen argues that the immaterial, like mind or spirit, should not be conceptualized using a conceptual framework centered on materialism. But why then would doctors wish to develop and actively promote a monism like materialism? By reducing mind to brain, doctors insist on placing mind within the individual. The overarching conceptual framework of materialism precludes the possibility that mind exists in multiple minds, say, within a mass, or that mind exists in the environment, say, embodied within our technologies or other cultural artifacts. Language is a cultural artifact; it’s also a tool. Therapy is a tool in large part because it typically uses language. Writing in Hamlet’s BlackBerry, social commentator William Powers makes this statement concerning media and technology guru Marshall McLuhan: “[McLuan] traced [the modern shift from inward self to the outward world] to the nineteenth century, when, he said, the telegraph had, in effect, extended the entire central nervous system, including the brain, out into the world [my emphasis].” Materialism attempts to reduce or eliminate such extensions of biology out into the world. And that makes good sense. Doctors can’t bring society into their office. There’s no DSM (Diagnostic and Statistical Manual of Mental Disorders) for society (although there should be). As a result, doctors can’t give society a diagnosis (although they should). Doctors can’t prescribe a drug to society. And by telling us to leave our technology at the office door, doctors are tacitly telling us to only use their technology, their therapeutic tools. And this makes sense because by using therapy tools we become therapy man in the same way McLuan suggests that people who use typography become Typographic Man.

So, doctors, through the medium of materialism, ask us to give up our extensions—extensions of the nervous system into the world—and then to only use their extensions: drugs, talk, exercise, etc. Doctors are not opposed to extensions per se, they’re just opposed to extensions they do not control. Doctors don’t wish to see the Cognition in the Wild (the title to a book by Edwin Hutchins), the brain in the wild, the brain in society. Again, you can’t bring the wild brain or the societal brain into the office. I wonder how much of Sister Mary’s so-called “backup brain” was held by the environment that surrounded her. The conceptual system of materialism is not designed to look at such questions. Where brain exists is probably one of the most perplexing and vexing philosophical questions, and materialism answers this question simply and elegantly: “The brain is material and the brain gives rise to mind.” As Dworkin talks about, it is this worldview that has given rise to the market of Artificial Happiness: to change the happiness of the individual, change the material of the individual.

Let me end by coming back around to the work of Fauconnier and Turner (mentioned above). In their book The Way We Think, they have a fascinating section entitled How Safe is Safe? Given that John Bowlby’s theory of attachment is centrally about safety, I paid close attention to this section. Fauconnier and Turner state:

[C]onsider the following unremarkable uses of “safe” in the context of a child playing at the beach with a shovel: “The child is safe,” “The beach is safe,” “The shovel is safe.” There is no fixed property that “safe” assigns to child, beach, and shovel. The first statement means that the child will not be harmed, but so do the second and third—they do not mean that the beach or the shovel will not be harmed (although they could in some other context). “Safe” does not assign a property but, rather, prompts us to evoke scenarios of danger appropriate for the noun and the context.

When Fauconnier and Turner talk about evoking “scenarios of danger appropriate for the noun and the context,” I immediately thought about Bowlby’s focus on Inner Working Models (which he brought over from Piaget’s work). Mental models are in effect scenarios. Piaget focused on object permanency, however, object permanency implies mental model permanency—for objects to appear permanent, our models of such objects must have a certain permanency to them. It’s the mental model that allows us to know that the object is still there even though we cannot see it. Mental models allow us to assign value to what is there as much as what is not there. As LeDoux (mentioned above) writes about in his work, animals will perceive danger by both what is in a scene or scenario as well as what the scene implies. A watering hole surrounded by a certain type of shadow cast by rocks and trees implies a predator even though the predator is not seen. Animals will react to what is not seen as much as what is. It is the context that allows us to react to nothing, the immaterial. It’s the context that allows a mother to sense that her child is in danger even though no tangible danger is perceived. A beach implies a piece of glass just under the surface. A child digging with a shovel implies a possible encounter with the glass. The ocean lapping up on the beach implies sharks, maybe even an undertow. And a child moving toward the water for a swim implies a possible encounter with what is not seen. As Fauconnier and Turner put it, “[N]onthings [e.g., immaterial things] do indeed play a large role in everyday thinking.” Fauconnier and Turner point to the development of the concept “zero” as constituting one of the greatest immaterial tools that we use everyday without comment. Imaginary and negative numbers simply could not exist without zero. We constantly live in fields that bridge the material to the nonmaterial, and vice versa. Bowlby’s theory is centrally about how biological safety is bridged to societal safety. Simply, monisms, whether radical materialism or radical spiritualism, try to reduce or eliminate the material/immaterial bridges we cross everyday, often without even knowing it. At its core isn’t Bowlby’s theory about the presence/absence continuum? The logic of grief, according to the late Professor Robert Solomon, is simple: the object of grief is the impossible, for the departed to return back to life, for absence to turn to presence. I’ll always remember Mel Tillis on Carson because Mel showed me that life is just as much about what is there as it is about what is not, and, sometimes, that realization can be a real hoot. Grief exists on the absence/presence continuum, and humor reminds us of that fact.