Showing posts with label dialectical thinking. Show all posts
Showing posts with label dialectical thinking. Show all posts

Gingerbread Houses and Cognitive Behavioral Therapy

Thanksgiving is one of my hypomanic seasons. I'm getting better at not taking on projects that worry my wife. In fact, I have given up gingerbread houses altogether. Which is not to discourage you, just to acknowledge that they were once my one great weakness. That woman in the fringed dress down there? - Each bit of fringe was an individually placed sprinkle, separated out from a container of red, green, and white sprinkles. See what I mean?

But I did learn some things from my hypomanic gingerbread houses. And learning is good for the brain. The following post is a repeat from ten years ago, when I was in the throes of it. It explored the relationship between gingerbread and cognitive behavioral therapy. I am one of many who have a love/hate relationship with CBT, which I freely acknowledged to my CBT therapist in our first session. Nevertheless, she persisted, and I persisted, and I do rely on it daily and have written about it from a variety of angles. So here it is again, for those of you who want to explore CBT and also for those of you who want to know how to make a nine patch quilt out of fruit rollups:


Cognitive Behavioral Therapy - Gingerbread Style, 11-25-2010

First Cognitive Therapy Technique -- Distraction

How to Stay Sane

Shock, rage, fear, despair, depression, hopelessness, apathy, or even how about - drinking the kool-aid, surrender. Do we have a better choice?

Robin Chance, behavioral specialist and therapist, did a little therapy for the nation three years ago with her article, How to stay sane if Trump is driving you insane: Advice from a therapist. She offered a better choice.

Two questions: (1) How do we integrate this crisis into our understanding of the world? and (2) what do we do now? Now that the crisis of three years ago is our new normal, it seems time to revisit her words.

Ring The Bells That Still Can Ring

Liturgical Christians, Catholics, Lutherans, Episcopalians keep a season called Advent, four weeks before Christmas.  It is a difficult practice, because it calls us to be thoughtful.  Thoughtful?!  You mean making a list and checking it twice?  No.  Advent is a time to acknowledge the truth that we hide from, behind our shopping lists and party schedules, the truth of emptiness and brokenness, in ourselves and in the world.  We are surrounded by Ho Ho Ho.  Advent says Hmm.

Advent says, Yes we will rejoice, because the baby, The Baby is born.  And yet.  And yet...

This has been a hard week.  Our defenses against the darkness have been found wanting.  And yet.  And yet...



For When Your Therapist Goes on Vacation

I have two therapists and they were both on vacation the week I got home from my mother's funeral and all those issues and all the family and all those issues.  And still on vacation the week after that!  My brother-in-law subbed - thank you, Darryl - with the following email.  I offer it as a resource for when your therapist picks a lousy time to go on vacation.

For extra entertainment value (my entertainment, anyway), I have identified which one I hear Michael telling me with >>, and which ones I hear Liz telling me with **.  One of them regularly irritates me.  I'll let you guess which one.  I have to keep both, because the double-teaming seems to help.

Wisdom Learned From the Seat of a Tractor


Your fences need to be horse-high, pig tight, and bull-strong.

Recovery In Progress -- My First NAMI Convention

Dr. Ken Duckworth's job at the Ask A Doctor about PTSD session was to make some opening remarks and then let people ask their questions.  He rattled off a list of treatments and said, The good news about PTSD is, we know what causes it -- trauma that was not able to be processed adequately.  The bad news is, the treatments just don't work so well.

Short and to the point.  Actually, I am not so negative (right this very minute, anyway) about treatment as Dr. Duckworth, because I am not looking for the magic med anymore.  I know about recovery.

Recovery is about collecting tools and pulling them out when the occasion requires.  I will illustrate.  But first the setting...

Last week I attended my first NAMI (National Alliance on Mental Illness) Convention in Chicago -- 2300+ people who have mental illnesses, family members, advocates, volunteers and caregivers, with a few scientists thrown in for good measure.  As a friend said to prepare me, A NAMI Convention has a certain kind of energy.  Yes, it does.

I have been to big conventions before, used to be a legislator (called Deputy) for the Episcopal Church, which gathers 8-10,000 or so Deputies, Bishops, exhibitors, visitors, volunteers and the like every three years.  I stopped doing that when I figured out that every three years General Convention tripped my hypomania and was followed hard on by a depressive episode.

So this was my largest gathering in some time, with plenaries, workshops, symposia, networking and ask-a-doctor sessions, drumming, theater, yoga and talent show, internet cafe and peer counselors, exhibitors, book sales and an information booth which was the best hidden spot of the whole damn Chicago Hilton.

You can expect a number of blogposts out of this event, including dueling comments between me and fellow blogger John McManamy.  Now that we have finally shared a beer, does that make us blogmates?  I began writing this piece in the hotel room, late after the last gasp, the rawest of my posts to come.

I knew it was a mistake to make Ask-The-Doctor-About-PTSD the last thing I attended.  It's just, that was the schedule.  Most helpful take-away: The brain is simply not designed to metabolize certain experiences.  PTSD is the result of incompletely metabolized traumas.  Bottom line, it is a normal response to an abnormal event or series of events.

The brain keeps trying to metabolize these unprocessed events/memories/emotions/bodily sensations.  They lurk beneath the surface, waiting for the next opportunity to emerge, when triggered by some reminder.


Oh, I was triggered, alright.  The last question of the day was about a particular symptom I don't talk about and religiously avoid.  I left the room reliving it, dizzy and disconnected.

Walking out, I heard the voice of my therapist, who once ended a session saying, The things we have talked about today probably have triggered your past traumas, and you will be dealing with the effects after you leave.  So how are you going to take care of yourself today?

Time to pull out that toolbox.

The Ask-A-Doctor doctor listed half a dozen treatment modalities for PTSD: meds, support groups, EMDR (Eye Movement Desensitization and Reprocessing), sleep regulation and aerobic exercise.  He mentioned Prazocin for nightmares.

First off, pop my anti-anxiety rescue med, put on my walking shoes and go get some aerobic exercise.  Work off that negative energy.

Just outside the door was Grant Park.  An art exhibit diverted me from my aerobics.  But art is good, very good.  Change the channel -- that's Cognitive Behavioral Therapy 101.


I stood still and drank in paintings inspired by water.  Not this painting, actually, which is exhibited just down the street.  But I thought of it.

Water is good.  It evens out the emotional turmoil. -- So says my other therapist, the one who does eastern-based energy work.  You see, when even the doctors acknowledge that western treatments (they don't call them western, because they don't speak of there being any other treatments) work poorly, I am not going to limit my tool box to only half the planet, especially not the more rigid half.

I spoke with the artist about perspective.  He paints on a flat surface, so doesn't think it matters which side is up.  I breathed into the here and now.  Thich Nhat Hanh taught me here and now.  But here and now is my worst subject.  And somebody interrupted to talk about showings and art business.  There were too many people -- had to reduce stimulation.


My energy therapist would recommend grounding.  I headed back to the gardens, flowers, trees, dirt, all good, all grounding.  Eating is good for grounding, too.  Maybe I should eat something.

From Alcoholics Anonymous: HALT = pay attention to when you are Hungry/Anxious/Lonely/Tired.  No, a martini is not in the recovery toolbox.

So I bought my inner child a strawberry ice cream -- a drippy cone instead of my usual adult cup.  Sugar isn't really the best choice, but it was red and a gift to my inner child.  Then I head off to find some meat.  Meat feeds the first chakra.  First chakra is about safety.  PTSD is about the amygdala is about safety is about the first chakra.

Still I was struggling.  I don't just have my own pain; I suck up the pain of every person with whom I have spent the last three days.  All those stories -- how can there be such a world?  How can I live in such a world?

I picked up my whole personal Book of Traumas, the traumas that never got resolved, that get retriggered today when I try to resolve them in therapy, the distrust I try to pretend does not exist toward the people who try to help me but they end up retriggering the traumas I can't resolve because they never seem to address that they are retriggering them and my retriggered shame prevents me from telling them and I truly believe the result will be retrauma anyway.

There are exceptions to that negative thought.  List the exceptions -- Cognitive Behavioral Therapy 102.  But how do I know who is for real...?

So I head back to the convention, walk over the train tracks.  And there is another trigger, another overpass, another trip to Chicago, another episode, another long time ago.  How quickly is that train traveling?  How far away?  How fast does a body fall that far?  How to time the collision of the two?  Velocity problems were the one thing that defeated me in high school math.

But I am not in the right spot anyway.  Geometry I got.  I need to be right -- there -- where -- a woman is pushing a baby stroller.

Oh.  Okay.  Not tonight.  I have an Iron Rule.  In a world filled with trauma, to the extent that it lies within my power, I will not cause trauma.  A two-year-old is sitting where my demon would call me.  The two-year-old wins.

God bless the internet that led me to David Conroy some years ago.  The first sentence of his book Out of the Nightmare brought sense out of the chaos that compounded the pain of my suicidal symptoms.  Suicide is not chosen; it happens when pain exceeds resources for coping with pain.

Tonight my pain was painful.  But I have survived worse, much worse.  And tonight my resources are many.  Tonight the thought was more than a mosquito, but it wasn't a tiger.  I do not underestimate the lethality of this disease.  One in five people with bipolar II do not survive it.  Tonight, I am still of the four.

I know people freak out over the suicidal ideation part of mental illnesses.  I apologize to my friends for causing them pain by bringing up the subject -- even though my need to protect you from this pain adds to my own.  I try not to bring it up, except with people who know what I am talking about.  But this is one of the tools in the Recovery Toolbox.  Those who do know what I am talking about need this tool.  And this post is for us.

Ironically, the state of the art treatment for people who have a lot of suicidal ideation and behavior, people with a diagnosis of Borderline Personality Disorder, is Dialactical Behavioral Therapy, radical acceptance.  Starting, not ending, but starting with acceptance even of that symptom that freaks out so many of you.

Yes, sometimes I have those thoughts.  They are well-worn grooves in my neurological pathways.  Any number of things will trip the cascade that leads there, including things you might not imagine, a cold sunny day, my doctor suggesting a new medication, an overpass.  These are not reasons.  Suicide is not about reasons.  These are triggers of neurological pathways that have a current of their own.

It is what it is.  Those five words sum up Dialectical Behavioral Therapy, an offshoot of CBT.  They were the chorus sung by one of the players in the lunchtime drama troupe.  Saturday night, I repeated them to myself.  Often when that thought appears, somewhere between a mosquito and a tiger, I say, There it is again.  That's all.  Mindfulness.  The thought doesn't have to freak me out, doesn't have to freak you out.  It is what it is.  Move on.


As I crossed the overpass, I felt a draw, a pull toward the hotel.  It was an energy, a spiritual energy on the side of life, two thousand people in that building, rooting for me, for my life, for one another, for you.  One of them even blowing a didgeridoo, accompanied by a flute, to be followed later by another who whistled Somewhere Over The Rainbow, all spiritual energy on the side of life.

The wisdom is ancient.  Two are better than one, because they have a good reward for their toil.  For if they fall, one will lift up the other; but woe to one who is alone and falls and does not have another to help.  Again, if two lie together, they keep warm; but how can one keep warm alone?  And though one might prevail against another, two will withstand one.  A threefold cord is not quickly broken.  [Ecclesiastes 4:9-12, New Revised Standard Version]

So that is my first report of my first NAMI Convention, the most confusing and most compassionate experience I have ever had with 2300 people.


(Find your local NAMI Chapter here.)

photo of toolbox by Per Erik Strandberg and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
General Convention Seal for the Episcopal Church in public domain
Olaus Magnus's Sea Orm, 1555 in public domain
Water Lilies by Claude Monet, 1906, in public domain
photo of Grant Park in Chicago by Alan Scott Walker and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
root chakra by Muladhara Chakra and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
photo of Chicago Orange Line by Daniel Schwen and used under the Creative Commons Attribution-Share Alike 2.5 Generic license
photo of Coal Creek Falls by Walter Siegmund and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
fresco at the Karlskirche in Vienna by Johann Michael Rottmayr, in public domain
book covers by amazon.com

10 Items Or Less -- Shedding And Keeping

Archetypes For The Turning Of The Year

For some people, New Years Day means the Rose Bowl.  For others, black-eyed peas.  For my mother, that was the day we were required to organize our clothes drawers.

Where did that come from?  You got me.  But it must be an archetypal response to the turning of the year.  Right now advertising is crowded with sales on organizational supplies.  If you don't know how to organize your sock drawer, surely there is one of those Dummies book to tell you how.

I just looked it up on Amazon.com.  Sure enough, here it is.

Responding, I suppose, to that archetypal imperative, I am currently recycling meeting agendas, staff reports, conference handouts and class notes, things I no longer need since I have become unemployed.

You know me.  Overboard is my middle name.  At 100.4 pounds and still shedding -- make that shredding now -- old checks with my social security number on them, I am well on the way to my goal for the week: to shed my weight in discarded paper.  I am not even counting paper clips and empty three ring binders. 

Benzos

The process is alternately liberating and anxiety-producing.  I dispose of old grudges, and then panic about what I might need after all.  I celebrate, and then I grieve.  I really did do a lot of good work.  And I left important things undone.

It is good that I refilled my prescriptions before I started this project.  Valium is my current best friend. 

Diets Are Hazardous To Your Health

I do not recommend shedding body weight as a New Year's resolution.  I say this every year, because it is one of the most common New Year's resolutions and it is wrong, wrong, wrong.  Dieting is the first step to gaining weight.  You know this.  You take this course every year and you flunk it every year.  When will you ever decide you have paid enough tuition for this lesson?

Yes, I know.  Having put the word diet in my blog, the mindless web crawlers will signal the advertising gods to place ads for weight loss programs on this page.  I do not endorse them.

I did lose weight a few years ago, which makes it thirty-five pounds easier to meet this week's goal.  I did not diet.  I repeat, I did not diet.  I changed the way I eat.  I changed my eating habits.  I still eat anything I want.  It's just the quantity and the frequency that changed.  I love my food.  I did not diet.

But this is not a dieting blog, and you can go searching for a better way to eat somewhere else.

This post is about shedding. 

Ten Items Or Less

My cognitive therapist is big on distraction.  So I watch a lot of movies.  A lot.  Many are movies that did not exist until they jumped off the library shelf at me.  A recent example was 10 Items Or Less.  Filmed in just fifteen days, it was an exercise in shedding all by itself.  It stars Morgan Freeman and Paz Vela, with Rhea Perlman and Danny DeVito in a drive by cameo.  And I do mean drive by.  They were on the set for all of fifteen minutes, during which time they asked for and received a couple of Starbucks lattes.  Then the director told them their lines.  Then they said them.  They never got out of their car.

So at one point Morgan Freeman, playing an actor, asks Paz Vela, playing a grocery clerk, If you could keep just ten items or less in your life, what would they be?  After she names her list, he names his.  That's eleven.  You just have to push it, she says.  This is the theme of her life in the express checkout lane, people who want eleven items when the sign says ten.

Later they change the exercise, If you could get rid of ten items or less in your life, what would they be?

Dinner Party New Year's Eve

I just got home from a dinner party with dear friends and we played that game, 10 Items Or Less.  We never got to the items we would get rid of.  The ones we would keep had so many stories behind them that we had to leave before we could finish the keepers so the restaurant could turn the table.

The right ten items can make a person rich enough, not only for a dinner party, but for a lifetime.

We will get to that other list at the next dinner party.

Ten Items Or Less

So that is my gift to you for the start of the new year, those two questions.  What ten items or less would you keep?  What ten or less would you discard?

Choose well.  You may not need wishes for the new year after all.  You may find you are already rich.


Winter sunrise by Stefan Mayrhofer, in the public domain 
shelves of file folders by Alex Gorzen, licensed under the
Cashier at Register by Young in Panama,  licensed under the

Cognitive Behavioral Therapy -- Mindfulness

Last Week's Cognitive Therapy Technique -- Distraction

 I can't stop thinking about... [some traumatizing thought.]

So think about something else instead.

Distraction is a basic Cognitive Therapy tool.  Personally, I think it's stupid on the face of it.  The point is, I can't stop thinking about what I am already thinking about.  I am stuck on this horror movie, and somebody stole the channel changer.

Except I can change the channel.  You can, too.  You can think about something else instead.

That diagnosable gingerbread house of mine worked just fine.  It changed my channel.  How weird is that?

Here's the deal.  I think it worked is because, just like that other channel, it was all-consuming.  I had to pay exquisite attention to those cans supporting those fragile walls, whether the walls would meet, whether the pretzels would break... 

Mindfulness -- Another Cognitive Therapy Technique

 There was no room for a wandering mind on this construction site.  Gingerbread was my own personal Yoda, sitting on my shoulder, hitting me over the head any time my mind was not on where I was.  Like when I knocked over that nearly new bottle of single malt scotch holding up the back wall.  Balvenie, to be precise.

Matthew A. Killingsworth and Daniel T. Gilbert of Harvard University recently published a study on wandering minds and happiness.  The short version: a wandering mind is an unhappy mind.

“Mind-wandering is an excellent predictor of people’s happiness,” Killingsworth says. “In fact, how often our minds leave the present and where they tend to go is a better predictor of our happiness than the activities in which we are engaged.”

The researchers estimated that only 4.6 percent of a person’s happiness in a given moment was attributable to the specific activity he or she was doing, whereas a person’s mind-wandering status accounted for about 10.8 percent of his or her happiness.

The unhappy news: people spend 46.9% of their waking hours thinking about something other than what they’re doing.  That would be the average.  Me -- here and now is my worst subject in all the world.  This has something to do with a hippocampus the size of a poppy seed.  And yet so often it has that channel changer in a death grip.

Mindfulness is the non-judgmental observation of the ongoing stream of internal experiences as they arise.  Mindfulness acknowledges the hippocampus.  It just doesn't let it run the show.

Other parts of my brain deserve their say, as well.  My traumas are not here and now.  In any given moment, the odds are overwhelming that I am perfectly safe -- an objective fact.

There are other objective facts, including that I was not always safe.  But that was then, this is now.  Remember, remember.  Keep a tight grip on this fact -- this is now.  This is when I need to focus on whether the roof meets the side wall or if there is a gap.

My misery comes from two things, then and the fear that then is next, with no room for now in between.  Like the Jewish joke, without guilt and dread, who am I?

But the odds of an unsafe event in the future are not overwhelming -- they are as miniscule as my poppy seed sized hippocampus.  My frontal cortex is perfectly able to calculate the odds.

Here and now is pretty cool.  This exact moment is a gift.  And many good things are possible in it.

By the way, that prototype served its purpose.  It taught me a lot, including the fact that it was not possible to replicate it in the one week I had onsite.



I did have a Plan B.  And not chained to my past aspirations, I decided to go to Plan B before, not after the meltdown.


I like this channel a lot better.


gingerbread photos by Helen Keefe
Harold Lloyd from Safety Last in public domain

Cognitive Behavioral Therapy -- Gingerbread Style

First Cognitive Therapy Technique -- Distraction

My therapist said Think of something you might find enjoyable.  You don't have to do it.  You don't even have to enjoy it.  The goal is not to move your mood from 1 to 10.  Any mood change is a bonus.  The goal is simply to give you something else to think about [-- besides what I had been thinking about.]

Distraction is one of those really irritating CBT techniques.  I am traumatized and can't stop thinking about this.  Okay, so think about something else.  I pay money for this?

But my other therapist, totally different method, said pretty much the same thing.  And I was six weeks from a major project I had promised for the holiday season.  And I am not sure it would have worked except that the wheel was ready to turn from early autumn danger to late autumn hypomania.  But he did and it was.  So...

She said think about it.

I guess I overshot the mark.


Ya think?

To Diagnose Hypomania -- Pay Attention

I used to churn out 10-12 gingerbread houses each season, back in my undiagnosed days.  I used the Joy of Cooking recipe and floor plan.  But each and every one was one of a kind: a log cabin made of pretzel sticks and peanuts for the chimney, another with candy canes on the roof for a chalet effect... No, I wasn't manic.  I was excited...

It could be said I don't know when to quit.  So a simple suggestion, think about something you might enjoy instead of what you are thinking about right now, became a fourteen inch high, furnished gingerbread house.


See what I mean?  Once I decided to tile the kitchen floor with candy corn, I was gone.  Note the faucets for the aluminum kitchen sink.  And the handles on the refrigerator.  There is a fireplace hearth down there, made of a Milano cookie.  Even as I was installing these things, I knew I was out of control.  But I could not stop.

Here is a nine patch quilt, made from fruit rollups.  Plus a teddy bear on the pillows.  Should you decide to start quilting with fruit rollups, here are my methods.  Unroll them a few days in advance to dry a bit.  Don't overreach.  Let the materials tell you what they are willing to do.  Use liberal amounts of vegetable oil on your fingers and cutting utensils.  Keep the knife clean.  I recommend an exacto knife, under supervision if you have a problem with sharp objects.  Place your product between oiled sheets of cling wrap, then between sheets of paper.  Iron at LOW heat for five seconds.  Breathe.

I refer to this as my diagnosable gingerbread house.


By doubling the dimensions, I had introduced engineering issues.  I needed weight bearing walls.The closet was designed for that purpose.  I made a double wall facing the living room.  But I failed to double the wall with the door.  Two by twelve inches, it was the first piece to break.  The pretzel sticks inside the closet hold it together.


Metaphor Alert -- Community

If I were to get philosophical -- and while I bent over this project, holding my breath and waiting for icing to turn to cement, I had plenty of time -- I would reflect that sometimes things or people are created that do not have the structural integrity to withstand the pressures to which they will be submitted.  Nevertheless, they can get by with a little help from their friends, even friends that brittle themselves, like pretzel sticks.  This is the essence of support groups.  Get into one.

Some of us are not particularly unstable, but we collapse under pressures beyond normal experience.  If we don't have to bear the weight by ourselves, we can make still our own creative contribution to the whole.  The fireplace wall fell into three places.  Twice.  It stood, once it received a full back brace.  The brace is not flashy.  It is not even visible, covered by the outside of the fireplace.  But it is essential.

This is the essence of community.  Christians call it the Body of Christ.  If the house were all ribbon candy, how would it stand?  If the house were all support, what would cover the kitchen floor?

Anyway, diagnosable.  The roof also collapsed, the weight bearing walls notwithstanding, because I pushed too hard while attaching it.  Be gentle with yourself, my friends.  The stronger parts can injure the weaker.  Self-restraint is especially important where you are strong.

But we can learn from our mistakes, and turn them into more creative opportunities.  The roof went for snacks to a bible study group.  I replaced it with a lighter version.  And then I broke one side again.  This time I finally listened to my spouse, and put up just half a roof, so people could look in on that nine patch quilt.  None of us has all the answers.  And sometimes irritating advice is good advice.

Even if it is irritating.

Another Cognitive Therapy Technique -- Dialectical Thinking

Even in the midst of this craziness, I kept aiming at sanity.  My mantra was Prototype, prototype.  The point of a prototype is to make as many mistakes as possible, in order to learn, and not make the same mistakes while doing the real thing.

I was making a lot of mistakes.  Boy, was I learning.

Dialectical thinking means that life is not divided into black and white.  One can hold a painful thought and a positive one in the same brain at the same time.  That and valium got me through.

I learned not to use a double barrel aged single malt scotch as a brace to hold up a wall while assembling, like the soup cans above.  The bottle was missing only as much as is pictured here before I made that particular mistake.  Sigh.

After mopping up the nearly full bottle of scotch and as much shattered glass as I could find, it was time, it was time to stop working on the prototype.  Well, after I built the fire in the fireplace.


Two hot tamales, cut on the bias, a couple little pretzel sticks and a sprinkling of ribbon candy crumbs.  The back of the fireplace is the inside of a mint Milano with the white frosting scraped off.

Like I said, diagnosable.

It wasn't finished.  It still isn't finished.  But the time for prototype was at an end.  The time for the real deal had begun.

To be continued...



all photos of gingerbread houses by Helen Keefe 
photo of scotch by Suat Eman

Nonsense and the Anterior Cingulate Cortex -- Redux


This traffic monitor should read YOUR SPEED 60 MPH.  But I couldn't find that image.  I suppose creating it would not be a good idea.  So this image will have to do.

If you are traveling too fast when you hit the pothole, you break your suspension.

So I am taking a break while we try to balance the GAMA and glutamate in my synapses.  Here is a slightly modified rerun of an oldie but a goodie.  I think it addresses the current phenomena of the Tea Party, the growing rigidity of those whom it threatens, and the retreat of the rest into reality tv.  If I didn't make so many connections like that, my brain wouldn't hurt so much.  Then again, Prozac Monologues wouldn't exist.

Nonsense and the Anterior Cingulate Cortex -- November 7, 2009 

John McNamany put the thought into my head, the New York Times tickled my fancy and a blog new to me gave me the art work.

Function of the Anterior Cingulate Cortex

Finally, it's Anterior Cingulate Cortex Week!  This lovely portion of the brain is found in the limbic system, located just above the center, about where Iowa would be and extending into western Pennsylvania, if you flip the image so that it faces right, as I did here.  Like a true Midwesterner, the ACC modulates emotional response.  A hard-working manager, the ACC handles motivation to solve problems and anticipation of tasks and rewards.  It also monitors for conflict, things that don't make sense.  The brain is unhappy when it cannot detect a pattern.  Confronted with anomaly, the ACC goes to work.

The Absurd Stimulates Pattern Finding Behavior

"Researchers have long known that people cling to personal biases when confronted with death... In a series of new papers, Dr. Travis Proulx of University of California Santa Barbara and Steven J. Heine, a professor of psychology at the University of British Columbia, argue that these findings are variations on the same process: maintaining meaning, or coherence. The brain evolved to predict, and it does so by identifying patterns.

"When those patterns break down — as when a hiker stumbles across an easy chair sitting deep in the woods, as if dropped from the sky — the brain gropes for something, anything that makes sense. It may retreat to a familiar ritual, like checking equipment. But it may also turn its attention outward, the researchers argue, and notice, say, a pattern in animal tracks that was previously hidden. The urge to find a coherent pattern makes it more likely that the brain will find one." [Benedict Carey, New York Times, October 5, 2009]

To test whether confronting the absurd leads to pattern-searching behavior, they had twenty college students read Kafka, The Country Doctor, a story that is urgent, vivid and nonsensical.  Does anybody who is not in college ever read Kafka?  Anyway, after reading the story, they were given a task, to study strings of letters that did not form words.  They were then shown a longer list, and asked to find the strings they had seen before.  The letters did have patterns, very subtle patterns.  And the students who had read Kafka did better at this task than another twenty who had not been exposed to the absurd, 30% better.  With a Kafka-stimulated ACC, they were primed to find the patterns.

I wonder if that explains the college student's propensity to read Kafka in the first place.  Not to mention all those posters by Salvador Dali on dorm room walls.  The college student is at a crossroads, and has to puzzle through the animal tracks of his/her life, to discern the pattern, the call, the next direction.  These representations of the absurd stimulate the part of the brain needed at this developmental moment, just as caffeine stimulates the system before the exam.

I graduated from college at loose ends, with the Episcopal Church still discerning the patterns that would allow for the ordination of women.  That was a few years off, and I wasn't ready to commit to a vocation that might not be received.  But I didn't read Kafka.  Instead, I decided to read everything that Kurt Vonnegut had written up to that point, a modern day Kafka.  Kafka-lite, if you will.  Today, as I fill out disability applications, I am again at a crossroads, and again instinctively, am drawn to Vonnegut, whose body of work has grown since 1975.  Evidently I am stimulating my ACC and boosting my pattern/meaning/coherence finding abilities, priming myself to discern my next direction.

Patterns and the fMRI

Oh boy, I found another fMRI experiment!  There is a study in the Journal of Pain (what a title!) that discovered, when people were prompted by pain-related words to remember painful autobiographical episodes, the fMRI machines showed that it was -- you guessed it?! -- the anterior cingulate cortex that lit up.

Dialectical Thinking -- On Not Blowing Out Your ACC

This person loved me; this same person abused me -- two memories in conflict, absurd.  Put them together, they cause pain. They call it dialectical thinking when you hold two seemingly contradictory ideas in the same head at the same time.  But dialectical thinking is a highly developed skill.  Before anybody ever suggested to me that I could employ it to reduce my pain, I spent (and still do spend) enormous amounts of energy trying to make sense of events that were absurd.

Some of us had Kafka-esque childhoods.  I wonder, does the ACC become quiet if we engage in dialectical thinking?  I wonder, does it blow a fuse if we don't?

If you are searching for Christmas gift ideas for the Prozac Monologues blogger, an fMRI machine would certainly be well received. 

photo of traffic sign by Richard Drdul, Creative Commons  

image of brain from NIMH 

Obama inauguration photo taken by
 Petty Officer 1st Class Chad J. McNeeley, USN 
and in the public domain 

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