Thursday, January 1, 2009

There really is no spoon - Part II

The starting point is of course our minds.
The mind is our way of interacting with the outside world - and also with our bodies. Being the artist that I am I postulate that there really is no difference between the two: our bodies (yes - even the one you feel you inhabit) - are the same as the outside world.

For me - in terms of the "Theory of Everything" - our bodies and the outside world are one and the same thing. Why? Because our bodies don't have fixed boundaries. Our body schema is flexible - enabling us to incorporate tools, peripersonal space and other things.
And once something is incorporated into our body schema we show the same stress response as if our real body were in danger.

And yes - you even can swap bodies or faces in a few minutes if you want to.

I don't think this happened "on purpose" - but is simply a happy/serendipitous effect of us being able to use tools. It's just one of the mechanisms we can exploit if we want to.

However - I also wonder about the effects it has on us - even if we are not consciously attending to them. As we have shown the brain is remarkably plastic - it changes all the time. And since the mind is a product of the brain it also changes with it.

So if our body schema is changed by tool use - what happens to our minds? For those who want to rant about the Internet - remember that language is an invention and a tool also - albeit without an external power source.

The Alphabet is a tool any of us uses on a daily basis - and yet we don't think about it that way. But it has to have an effect on us - as we can see when scientists compare peoples way of thinking that are from different cultural backgrounds.


"You" are changed by where you were born and where you live and what language you use. Twins raised apart show strikingly similar behavioral patterns - I wonder what would happen if you compared twins that were raised apart - one in the US and the other one in China for example. My guess is that only then could you clearly show how much genetics (really) influences a persons behavior.

Our brains use a lot of tricks, shortcuts and even lies to present a coherent world to our minds - and we can exploit those weaknesses almost at will. That's very useful in treating chronic pain syndromes as shown by mirror therapy.

But what about all the drawbacks this haphazard way of creating the world has?
What effect on the mind has sitting in a chair all day long? I'm not talking about back trouble here - but by not moving we are changing our cortical maps. And the mind is based on those maps. So what happens to the mind - your way of thinking - when you sit for long periods of time?

I know from my own experience that I can't do any serious work when sitting in my otherwise excellent Stokke Gravity. It is the best piece of furniture I have seen in my entire life - comfortable, well made, sturdy, gorgeous to look at - but I can't think when in the sitting position.

For me pacing around is the best way to come up with new ideas.

This folks is the riddle of the embodied mind. Our minds are based on our brains and bodies - and what you do with one of them has an effect on the other. Which one has which - well - that's for you to find out.

The only thing that seems pretty clear to me so far is this: as you exercise your body - you also have to exercise your mind.

And I'm not talking Sudoku here - but "deeper stuff" like focusing attention, meditation and the like. As one improves - so will the other. Attention in itself seems to be the most important part - but that requires a whole series of postings on itself.

There is no spoon - Part I

A while ago I did a series of postings about pain and about mirror therapy for phantom limb pain and other chronic pain syndromes.

The good news is that all of the information contained in that series of articles is still as accurate as when I wrote it - and is a good starting point for most laypersons, therapists and those who suffer from chronic pain and want to try a new form of treatment.

From the feedback that I got it is clear to me that I did a good job of explaining the very often difficult science behind it and made it accessible and understandable for everyone.

However - as an Artist and Visionary (I took a test that said that I am both) ;-) my brain refuses to stop thinking about that stuff.
And that's what I have been up to for the last year or so.

In order to go even farther - to develop even better and faster ways to treat pain we have to construct a "Theory of Everything" as I like to call it - because only then will we be able to see how we can exploit the weaknesses of the brain even more to our advantage.

The good news: there is enough experimental data available from a lot of different fields that we can start to construct such a theory. The bad news: it's a lot of different disciplines from which I have to "borrow" from and try to integrate them into one comprehensive overview. And new stuff keeps cropping up all the time which makes it hard to keep up with all the new input.

In the past I've made a few pretty wild guesses (based on the data available at the time) - and most of them were shown to be true. See for example my description of how to treat chronic pain in paraplegics (Yahoo Group Supertraining, Message 29357).
My idea of using visual feedback in treating chronic low back pain by showing the patient an image ofhis back on a monitor is now undergoing trials in Australia.

So I want to start this series with a few questions that are on my mind right now and that show where my "Theory of Everything" is heading at the moment.
And - since I am an Artist - I don't recognize authorities or self-made boundaries I'm going to sound pretty weird at times. ;-)

Here we go:

- We are still accustomed to thinking in terms of influencing the real body when treating patients. However research on Phantom limb pain has shown that there is a virtual body which our brain constructs. The simple solution to phantom limb pain turned out to be not to treat the real body - but the virtual one.

Something similar happens in CRPS - the symptoms we see in the real body are just that - symptoms. The real disease is in the brain - in the representation of the affected limb - a software error so to speak. And treatment that tries to correct that software error leads to automatic changes in the body. We simply have to tell the brain what we want it to do and it does all the things necessary - like increasing blood flow and so on.

In the talks I give I always try to teach my students to shift their perspective from a hardware based model to a software based one.

Now - what if we took this idea even further? What if we applied this model to all forms of pain? What if instead of: "When I want to move my arm I tell my boy to do it." we were to say "If I want to move my arm I move my virtual body - which then sends out a signal to the real body to replicate the movement."?

This might not sound like a big difference - but in terms of rethinking movement and movement control it's huge. Remember that the virtual body can be quite different from the real one!

What happens when a distorted virtual body is simulating a movement that the real body can't replicate because there is a limb missing? Phantom pain is the answer.

Now take chronic low back pain - and you can see the same mechanism at work - the cortical field of the low back is enlarged - and yet the real lower back stays the same. Pain is the result.

Giving up the idea of treating/working with/even having a real body is difficult - one of the drawbacks of having an embodied mind - but I think it's crucial for us to "just let go" if we want to develop new ideas and treatments.

Scream If You Can

- Placebo. Placebo is a fact. There are enough studies out there showing that it works - and works really well.
And yet - the mechanism of action is as yet unknown. Really?
Again - think about the difference between a virtual and the real body. What if the placebo (be it a procedure or a pill) - is simply becoming a "piece of software" - and the brain tries to simulate it's effects on the virtual body - thereby changing the real body.

The brain has to represent the outside worlds so our minds have something to act upon. This is where the mirror neuron system comes in. So while the brain simulates the interaction with the placebo it accidentally changes the real body in response - setting free endorphins and the like.

This of course is just a rough idea at the moment - but what if placebos manage to - once again - fool the brain by using this "trapdoor"? The mirror system wasn't "meant" to be there for placebos - but for understanding others/empathy and so on - for all the stuff you need to be able to do when living in groups. It seems to me that placebos exploit this weakness of our brains quite efficiently.

- Environment changes behavior. Lasting behavior change is difficult. We are after all creatures of habit. But again - what study after study shows is that the environment we find ourselves in actually determines some of our behavioral responses.

We are not "in charge" - but are influenced by what and who is around us. And yet - our brains still hold up the illusion that "we" are in charge and give us the feeling that we wanted to do this or that. The short story is this: if you have identified a behavior that you want to change - don't try to change it directly - but try to change the environment in which it manifests itself.
Remove the "cues" if you will that "make your brain do things automatically" - and you will succeed far more quickly and it will last.

As I've written before - starting an exercise regime is often quite difficult - because there really is no spare time left in a day. By identifying "empty time" - time that is spent doing meaningless tasks you create time in which to exercise.

And just to make clear that it works really really well: I've been going to the Gym for a year now - doing 3 sessions each week (1 hour each) - and have lost 45 pounds. Just as I said I would. And I'm not going to stop there ;-) - because by now it's turned into a habit - like brushing my teeth.

- "Me". Our brains create the illusion of "I" in order to .......? What is a feeling of "Me" good for? Based on the fact that our environment changes our behavior quite dramatically I think we should take a closer look at the concept of "I".

What if we really are like worker bees - mindless robots following a few simple rules in order for the queen to survive? Would it make us less happier? Look at the people around you: seems to me that most of them are unhappy anyway.

Since this feeling of "I" is so strong I think it's pretty much impossible to try to imagine a theory without it - the drawback of an embodied mind again. But if you look at the Hardware/Software approach I think it's one well worth pursuing. What if "we" are really just cogs in the machine being made to think we actually have a say in the matters of what the bigger machine does?!

One of the first steps in this direction is the Biopsychosocial Model. It recognizes that we as people are a part of different environments and groups - and looks at what influences us.

The Omnivores Dilemma

- Another trapdoor of our minds. Here is more evidence for my hunch that "we" don't really exist: you can be made to swap your body within a few minutes. One can - by visual trickery and exploiting our sensory system - be made to experience another body as one's own.

We can also include objects into our body schema quite easily. "We" don't really have fixed boundaries. What we think of as our body is really just a constantly changing "sphere of influence". This helps us in using tools.

It was never "meant" to be more than that - but this is the beauty of the brain: you can use all these mechanisms that evolved over time and do some crazy stuff with them. As you can see our bodies aren't real in any way - you can change them, make them bigger or smaller, give them extra arms - even swap bodies completely.

What if the same goes for our minds? What if our mind is just a tiny part of a bigger (hive) mind? After all - culture looks to have a mind of it's own sometime. The culture you grow up in shapes you and your brain - and you become part of it by reinforcing the same behaviors and cultural norms. You become part of it. And that becoming part of it is manifest in your brain.

And since your brain creates your mind it changes you. If you grew up in a different culture you would be different and have different ways of thinking and acting. But you'd still feel as if "you" were in charge - which you are quite clearly not. I wonder what would happen if you got rid of the "Me" module in your brain and would start to experience yourself as part of something bigger - a hive mind.

I sometimes get the feeling that there are people who either have achieved this or are close to it: people who are driven by the need to do something to benefit humanity as a whole. (or it's just the endorphins released by doing something good which you can get hooked on too). Either way - I guess this approach would give us some pretty far-reaching insights.

As I've said - these are the questions that keep me up at night at the moment. ;-)
The difficulty in making progress is that the feeling of "I" is so strong that you can't run a simulation in your head without the "I" part being central to it.

We'll see where it leads as more evidence is produced in labs around the world.
The following postings will show different aspects as the relate to my development of the "Theory of Everything" and present proof that most of my crazy ideas are based on science and solid facts.
Have fun! (It's just a ride)

Out Of Reach