Tuesday, March 06, 2007

Who Are We?

I haven't posted anything funny for a few days. Is that just coincidence, or am I going through another mild mood swing? I cannot tell for sure, and it disturbs me that I do not know.

My father was an alcoholic for many years before finally finding sobriety through AA. Another relative has a neurological condition similar to OCD, which forces her to exhibit behaviors that are not entirely under her control. Annie's grandmother was a schizophrenic who heard voices telling her that the Communists were about to assassinate her. I get into depressions that are seemingly unrelated to anything actually going on in my life or to how I actually feel, like a dark blanket being pulled involuntarily over my head.

And yet, all of us have felt like "us" the entire time. We believe that we are in control, that this immaterial thing called "us", our mind or soul or personality or whatever you want to call it, is separate from and dominant over the physical "us", the meat and blood and chemistry that forms our shells. But are we really? Was my dad just a no good drunk for years before finally seeing the light, or was his addiction caused in part by his biology? Is my other relative to blame because she cannot control the OCD symptoms she has, was Annie's grandmother weak or did she just have a malfunctioning brain?

Scientist and author Robert Sapolsky gave a speech recently that contains several other documented cases like this, only even more extreme, which I'll post after the jump (all emphasis is mine).

Here's a scenario: 40-year-old guy, 20-year happy marriage, white-collar job, living in the suburbs, utterly colorless, stable life. One day, from out of nowhere, he punches somebody in the face at work, in his office, some guy at the water cooler who had made some comment about a sports team. This guy hasn't had a fight since junior high school. Utterly bizarre, unprecedented. Three months later, his wife of this 20-year marriage discovers he's been having an affair with a 17-year-old kid at the checkout down at the supermarket. Totally bizarre. Three months later, he's arrested for drunken brawling in a bar--and he never even used to drink. Three months later, he embezzles the funds from his workplace, disappears, and is never seen again.

How can we explain this guy?

Explanation number one: the guy is no damned good. [laughter]

Explanation number two: he's having the world's most dramatic and childish midlife crisis.

Explanation number three: it's a neurological disease; he has a single-gene defect that makes him do this.

This, amazingly, is what a particular neurological disease looks like, a disease called Huntington's Disease, Huntington's chorea. Huntington's chorea is most famous for a neuro-muscular disorder: it starts with a tremoring, and by the time it's done with, you have your entire body writhing--absolutely horrendous. It kills you within a decade or so. It gets you in your mid-40s, Woody Guthrie being the most famous Huntington's Disease case. Three or four years before it's a neurological disease, it's a psychiatric disorder. You see precisely the profile that was just described: people become disinhibited. You find Huntington's patients are famed for always showing up in the dayroom in the hospital having forgotten to wear half of their pajamas, and things of that sort. It causes a massive disinhibition of the personality, and initially, it's a psychiatric disorder. It's not a mid-life crisis--it's a single-gene defect.

This was first noted in one of the most famous neurological patients of all time, a man named Phineas Gage. In the 1840s, Phineas Gage worked the railroad lines. That's about where the folk song ends, because he didn't do anything interesting beyond that. He was a foreman, he showed up to work every day, totally reliable, sober.

One day there was a dynamite accident, and a metal rod was blown through his forehead and out the other end, and took his frontal cortex with it, and amazingly, this was such a concussive trauma that it cauterized all his blood vessels. He got knocked on his rear, and stood up again and kind of dusted himself off, and walked to the doctor who examined him. The guy in charge of the worksite said, "Gage, tell you what. Take the rest of the day off, see you tomorrow morning." [laughter]

Gage came back the next morning, literally and metaphorically transformed overnight. And this man was now a drunken, aggressive bully, hypersexual, completely disinhibited. He was never able to hold a stable job again. When the doctor examined him, the doctor looked in the hole there and said, "Geez. No frontal cortex," and thus concluded, "Ah! This part of the brain reins in our animal energies."

And 160 years later, that's as good a description as you can get about what this part of the brain does. Damage the frontal cortex and you disinhibit how the rest of you works. This is a part of the brain that keeps you from burping during the quiet part in the wedding ceremony [laughter], or it keeps you from telling a person exactly what you think of their new outfit, or keeps you from being a serial murderer. Aged individuals have strokes that often damage the frontal cortex, and you get these disinhibitory syndromes. Blow away that part of the brain, and there's a transformed person.

I find it tempting to sit here on the shoulders of giants, at the pinnacle of human cultural achievement, and think that I am master of all I survey. But there is this vast, unacknowledged mountain of history beneath my feet, the dark and murky of legacy millions of years of human evolution contained in my genes over which I have absolutely no control. If I get depressed, is it my mind, my soul, my "true self", immaterial and separate that has somehow stroked a melancholy cosmic string, or is it just a bad chemical reaction caused by an accidental byproduct of ancestral development?

As Calvin said in the cartoon I posted the other day, "It's either mean or it's arbitrary, and either way I've got the heebie-jeebies."


Anonymous said...

Interesting post. I'd certainly like to think it is our choice because there is more hope in that, but there's no denying that for some people it is totally out of their control. One philosophy I like is Existential, which focuses on us finding our purpose. It says that if we hit these down moments, or midlife crises, or anything of that sort, that it is simply a matter of us searching for meaning in our life. Everyone finds meaning in different ways, some through work, some through family, some through art, etc., but once we find our meaning we are able to deal more effectively life's ups and downs. What I like most about it is that we decide what our purpose is, and it is in making that choice and our power over that choice that we truly find peace.
Hope, aka "Landon's mom" :) my new purpose.

Denise said...

I'm taking a class in child development, and it is absolutely incredible how the brain continues to evolve and how the brain branches out and forms new pathways as new information is fed into the brain. Studies are ongoing as to how the brain is able to assimilate and accommodate new information, and those studies provide new insight into how humans process both information and emotions. I have a respect for the existential movement except it seems depressing. There is also a deontological ethics philosophy that states the consequences of an act are not as important but the features in the act. Then there is the moral ethics field that takes a different approach in that the consequences are just as important as the actions. Even though ethical and moral schools of thoughts differ, most share the premise that choices matter. The older I get, the more I realize people aren't just rotten, altruistic or other faults/virtues. There's always a reason for their behavior and their choices, although it's not initially easy to see. Perhaps it's neurological, like in the Gage case you mentioned or physical as in people who are bipolar, OCD, ACHD or schizophrenic. Or perhaps someone lost their job, found out their wife has terminal cancer or they've lost everything in the stock market. It could also be our brains are trained to go in certain directions when we're happy, sad or going through an emotional situation. I believe if the chemicals in the brain are on an even keel, people can change to react in a different way to stress, especially if they see the benefits of making a different choice. A woman I work with has walked all over everyone to get what she wants. In my 20's and 30's, I'd have thought she was a backstabber. Now I see she is motivated by a personal need and desire to prove she's as good as everyone else. I tend to be a "people pleaser," because I want people to like me and for life to be more balanced than turbulent. Occasionally, I've discovered a person has a true mental and/or chemical disorder. More often, though, we find a way to cope in the world and we continue to use what works for us, whether it's food, alcohol, prayer, meditation, anger, journaling, rage, sewing, saying the rosary, quiet time, walking, exercise, helping animals, etc. I agree with "Landon's Mom" that we are searching for meaning in our lives. Often times, we get discouraged on the path, but that's often the most exciting and illuminating part of the journey -- what we find along the way. What's absolutely incredible is that these reactions to mood swings (again if we're okay physiologically) is that we can change the outcome. We can try a different path and change our way of dealing with those down times. It's tough, however, to open that door to the real reason for the swings. From experience, once I did that and actually took a look in that monster closet (as Opus describes it), the monster wasn't really that scary (thank you Maurice Sendak) because the monster was me. Knowing we have the power to choose is where strengh begins.

David M said...

We're a couple of moody mofos. Or did you mean it in a more universal sense?
I mean that both lightly and seriously.
Unless the depression is debilitating or destructive, why not attribute to a natural cycle which your body/mind/soul needs. Would you prefer to be even keel all the time? or always funny?
Sounds like I'm giving advice, but I'll be in a similar state of mind within the month, I can almost guarantee it. And it'll frustrate me. And I'll be asking similar questions.