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This newsletter
shares with the public useful understandings of psychological matters
that are part of living today. It comes from the New York State
Psychological Association, Division of Psychoanalysis.
Our core membership includes hundreds of highly trained, licensed
clinical psychologists and psychoanalysts practicing in New York at
this time. We offer you fresh, effective understandings based on
our current and cumulative experience and knowledge. Each topic is
covered by a contemporary expert in the chosen area. We hope it helps.
We welcome your feedback, comments and questions at NYSPADIV@gmail.com
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The Social Brain
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Discoveries being made in our time about human genes, brain function,
brain structure, and neurochemical processes are reworking our
understanding of human emotional problems as well as our physical
health, yet the meanings of these new discoveries may surprise people
who read of them mainly in the popular press.
Learning about the existence of genes that transmit human traits, or
hearing that the different chemicals that pass through the brain's
connection points influence our mood states, seems to say that neural
biochemistry determines our state of mind. It is misleading,
however, to think that brains, genes, and neurobiology operate alone to
deliver predetermined outcomes, like running computer hardware.
Our brain evolved over time to handle the complexities of the social
world in which we live, giving us the largest primate brain and
most complex organ known. The brain manages the human social as well as
physical environment and is in turn shaped and changed by
it. It is open to social influence, for better or worse, at every
biological level from total bodily health to submicroscopic processes
of gene expression (more about this below) -- so much so that we could
talk about social interaction as part of biology.
The fact that the brain is always being changed and shaped by ongoing
real social relationships as much as by purely microbiological
processes, influencing those relationships in turn, is often a
surprise to those who assume that things must be either biological OR
social. What is interesting is to see how both processes collaborate
and to understand that we can influence the health of our minds and
bodies through the quality of our social relationships.
Here are some examples:
- The most widely known function of genes is
the transmission of hereditary traits from parent to offspring. But
there is a second major function of genes - the transcription function
- where the information is copied to RNA molecules that
govern cell development and the expression of genes in a given person.
This transcription process combines the influence of genes with social
and environmental factors in complicated ways to influence behavior.
The Nobel
prizewinner Erich Kandel said "The regulation of gene
expression by social factors makes all bodily functions, including all
functions of the brain, susceptible to social influences. People who
are not scientists think that genes are the ultimate controllers of
behavior, but what they don't realize is that the environment can alter
the expression of genes and thereby modify the anatomical construction
of the brain."
- Studies have shown that such
environmental stimulation can positively impact the weight of the
brain, the thickness of the cortex, the size of nerve cell
bodies, the number of nerve connectors, and more.
- Negative social influence has
been shown to negatively influence the brain. Studies have
demonstrated that stress releases neurotransmitters that impede the
ongoing production of new nerve cells in the brain. Lab rats with
high-status social positions had about 30 percent more neurons
generated than rats with low status relations. In another study, mice
that were exposed to predatory mice for ten days in a row - thus
experiencing social defeat - had altered behavior after this, becoming
socially avoidant with unfamiliar mice.
- Childhood maltreatment, or an adverse first social
relationship environment, has been shown to release a cascade of
negative neural reactions. Some are: an early activation of
the stress response system such that it remains over - active without
intervention, meaning the person lives on "red alert" even
when unnecessary; decreased integration between the two brain
hemispheres, leading to dissociated mental states; increased
electrical irritability in the limbic system, the seat of fear, terror
and rage; high risk for the development of Post Traumatic Stress
Syndrome (PTSD), depression, and substance abuse.
- In a positive vein, lab animals with attentive
and caring mothers had brain changes in the hippocampus
that prepared them to explore the world around them with more attention
and less fearfulness than those animals that were not so well reared.
The stress response system was less active in the animals reared by
more attentive mothers.
- In 2003, Joseph Le Doux, a researcher in
neuroscience at New York University, published studies on fear
conditioning in the brain, focusing on the amygdala and hippocampus,
parts of the limbic system. He found that positive social
relationships such as occur in loving family bonds or in a good therapy
relationship, can increase nerve connections from the prefrontal zone
to the limbic center, meaning that terror, rage and panic become
more manageable and controlled.
Psychotherapy provides a relationship within which new synaptic
connections can arise that reduce fearfulness. Good social
relationships, such as personal intimacy or good therapy, also
facilitates the release of the neural peptide oxytocin, which reduces
pain and anxiety, slowing heart rate and reducing blood
pressure.
- The researcher Lewis Baxter did a PET-scan
study on psychotherapy patients struggling with severe
Obsessive-Compulsive Disorder (OCD), some given psychotherapy and
others, Prozac. OCD was known to result in a self-repeating loop in
certain brain regions; psychotherapy and drugs both led to reduced
activity in those brain areas.
Another
researcher demonstrated that the uptake of the neurotransmitter
serotonin improved when the patient finished psychotherapy.
- In 2006 the researcher Louis Cozolino showed that
when people saw photos of loved ones, the activity in brain regions
connected to fear diminished; they felt relief from having to scan the
world around them for threats.
In 2007 another researcher (Carter)
pointed out that good social relationships and social support are
strongly correlated with overall improved health in relation to heart
disease and cancer.
Cozolino comments: "despite
all of the leverage evolution has given fear our social brains can be
healed by loving relationships."
Social relationships are biological
in their impact. Our basic social relationships in life -
our core attachments - are genetically organized and have a regulating
impact on our bodies at many levels.
All of these different areas of
study suggest that making a clear division between brain and mind,
biology and psychology, is misleading, and leaves people feeling
helpless about changing their "chemistry" or their
"genes."
Respectful, caring,
compassionate relationships can slowly change the very way our nerves,
chemistry, and brain work for us.
Brian Koehler Ph.D.
Written with Susan Parlow, Ph.D.
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Personal Meaning, Understanding, And Drug and Alcohol
Use
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Personal Meaning, Understanding, and
Drug and Alcohol Use
Is a guy who goes out several evenings after work with friends and
often gets drunk sharing a meaningful social experience? Or is he
killing time, zoned out to avoid dealing with the depressing emptiness
of his life? Is a college student who uses speed to cram for a test
just using it to stay up later to get in more studying? Or is she
self-medicating ADD (Attention Deficit Disorder), or trying to make up
for a semester of missed schoolwork because of paralyzing anxiety and
insecurity about her intelligence? Is a successful executive who smokes
high potency pot most evenings just relaxing with music after work? Or
is he retreating to a private cocoon, safely insulated from a social
world filled with the anxiety or sexual insecurity that often
contribute to bouts of suicidal despair about the lack of intimacy in
his life?
All of these people were patients of mine who appeared to be social
recreational users, not evidencing any serious signs of abuse or
dependency. The substances of choice help in some way that is highly
meaningful to them. They are used not only for the pleasure they
provide but also to cope with painful feelings and life circumstances.
These meanings and functions had to be clarified and addressed for them
to successfully resolve their problem substance use.
Over a long career as a psychologist working with people with drug and
alcohol problems, I have had an ever-growing conviction that
recreational drugs are never the real problem; instead, it is the multiple
meanings and functions that drugs, their physiological effects and the
rituals associated with them take on for the user that determine
whether drug use becomes a problem or not. Just as with automobiles and
video games, it is the reasons for using them and the way in which they
are used that are at issue.
Thinking of the drug alone as the problem can reinforce a denial in the
user and in society at large of the many factors that make drugs so
desirable to some that they would risk everything to continue using
them. At the personal level, a disconnection from the reasons for using
gives rise to the addictive process. Instead of feelings being about
oneself, one's needs, wishes, or suffering - the pain or struggles are
expressed in the desire for the drug; the problem is put "in the
drug," not in one's self.
If
we consider that the personal and social meanings of substances
determine why and how use patterns become problems, we see that it is
essential to identify and address the particular meanings that
substances carry in order to bring about positive change. Each person
has a unique set of meanings and feelings that he or she gives to their
own substances.
A great many Americans experiment with drugs and alcohol. Some of these
experimenters find the initial experience desirable enough in some way
to want to repeat it. Fifteen to thirty percent of casual users go on
to develop patterns of use that interfere with, threaten, or damage
some important aspect of their lives.
Why
do some use safely and others develop serious life threatening
problems? Drugs lead to dramatic and varied biochemical changes that
result in shifts in body sensation and states of consciousness. These
changes are not meaningful, pleasurable, or desirable to all people in
the same ways.
Many people experiment with drugs and don't like the way they make them
feel, or don't like them enough to use them with their attendant
risks. It is important to realize that the use of substances is
experienced as desirable in relation to other aspects of one's inner
and outer life.
From this "bio-psycho-social" perspective, problem substance
use is understood to result from the interaction of personal meaning,
sociocultural, and biological factors - elements that are unique for
each individual. With chronic use, substances may become increasingly
relied upon for whatever functions they perform for each person - for
example, interrupting the anxiety of dealing with intimacy or sexual
performance.
Substance use can become intertwined with psychological functioning and
lifestyle such that it becomes part of the fabric of the user's
experience and essential to psychic stability. It can be said that each
user develops a highly personal relationship to drugs that reflects
this complex interaction.
Katherine was a patient of mine with a history of early sexual abuse
and a series of intensely humiliating experiences related to a chronic
illness in childhood. She used substantial amounts of alcohol and
marijuana every day to keep herself in an emotionally numbed state and
to ward off intense feelings of shame, self-hate, and suicidal
depression. The initial work in therapy clarified the meaning and
function of her use as protection against these painful issues. As this
connection was made by Katherine in the safety of the therapy
relationship, she became more aware of these feelings and we were able
address them in our work together. As Katherine's self-critical
attitudes began to decrease and she became increasingly self-accepting,
she became aware of her desire for an intimate relationship. Such
changes in turn led her to feel more conflicted about her substance use
than she had been - more aware of its threat to her health and
self-mage and more motivated. She then was able to reduce her use
dramatically.
To best understand the troublesome aspects of drug use, a clarification
of the highly personal meanings and functions of the drug is essential.
Since the true meanings and functions of the desire to use may be
disguised from the user or out of awareness, exploration is often a
central focus of psychotherapy. Whether in psychotherapy or on ones
own, acknowledging that one's relationship to substances is highly
meaningful can open up many avenues worthy of personal attention;
a healthy relationship to drugs or alcohol is a valuable goal.
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