The Pathological Brain

In the previous post  I cited Norman Doidge who walked us through what happens in a normal brain when presented with a problem. Doidge has contrasted how the normal brain compares to the brain of a person who suffers from obsessive compulsive disorder (OCD):

“…the brain of the obsessive-compulsive does not move on or ‘turn the page.’ Even though he has corrected his spelling mistake, washed the germs off his hands, or apologized for forgetting his friend’s birthday, he continues to obsess. His automatic gearshift does not work, and the mistake feeling and its pursuant anxiety build in intensity.

We know that Doidge is correct because of brain scans that have been performed on people who struggle with obsessions. Repeat brain scans have also been performed on the same patients after successful therapy and shown that the brains had normalized. Continue reading

The Normal Brain

In Dr. Norman Doidge’s book The Brain that Changes Itself, Doidge explains what happens in a normal brain when we make a mistake or have reason to feel anxiety over something:

“Normally, when we make a mistake, three things happen. First, we get a ‘mistake feeling,’ that nagging sense that something is wrong. Second, we become anxious, and that anxiety drives us to correct the mistake. Third, when we have corrected the mistake, an automatic gearshift in our brain allows us to move on to the next thought or activity. Then both the ‘mistake feeling’ and the anxiety disappear.”

In neurological terms, the first level Doidge describes, where we detect mistakes, occurs with the part of our brain known as the orbital frontal cortex. The second level, where we become anxious because of the mistake, occurs in the part of our brain known as the cingulate gyrus, located deep inside the cortex. The third level, which allows the brain to shift gears and move on after the mistake has been corrected, occurs in the part of the brain known as the caudate nucleus.

In a follow-up post we will compare this normal process to the brain of someone who suffers from OCD.

Further Reading

EPPP study material, Obsessive Compulsive Disorder, and You

We’ve been doing a lot of blog posts recently about the neurological principle that Freud called ‘the law of association by simultaneity’ but which is more easily summarized by Carla Shatz’s catchphrase: neurons that fire together wire together.

We began the series by considering various examples of this phenomenon and explaining what happens in the brain when two things, ideas or experiences become associated with each other. We saw that this understanding of the brain was central to therapies which aim to address conditions such as Agoraphobia and other pathologies. The goal of these treatments is to replace negative neuro-pathways with healthy positive ones.

I’d like to continue this discussion with a few posts exploring how these basic principles of neuroplasticity can be used to help sufferers of Obsessive Compulsive Disorder (OCD), which is one of the key words in your EPPP study materials. Continue reading

EPPP Exam & Earning Your Own Confidence, part 2

In my previous post ‘The EPPP Exam & Earning Our Own Confidence, part 1,’ I shared the importance of earning our confidence by taking steps that lead to competence. I want to suggest that this same principle applies in many areas of life.

If there is a problem in our lives that we are trying to overcome, we must identify the steps needed to succeed, and equip ourselves with specificity to do the “right things” that contribute to success. The more we do this, the more there comes to be a reciprocal relationship between our confidence and our success: the more we succeed, the more confidence this breeds, and the more confidence we have, the more this conditions us to succeed even further. Continue reading

The EPPP Exam & Earning Your Own Confidence

In our post ‘The Power of Imaginative Rehearsal’ I shared the importance of the principle “what you expect is what you get” and the corollary importance of imaginatively rehearsing positive outcomes, like you passing the EPPP exam. This is an important part of the picture for anyone hoping to build self-confidence, yet it remains only part of the picture. The other key aspect is that confidence has to be earned.

I have already shared that sports psychologists have long understood that the brain’s power to ‘rehearse’ optimal performance outcomes is crucial for an athlete to realize his goals and dreams. However, coaches and sports psychologists also understand that confidence by itself is insufficient if it is not matched with competence, including the type of competence that only comes after methodical, rigorous training.

A person can spend all day imagining that he is a successful NFL quarterback, but if he doesn’t actually train, he’ll be lucky if he can even throw a complete pass. While self-belief and confidence are important for success, if our confidence isn’t earned, our self-belief can be little more than self-deception.

With the teams I’ve coached, I’ve wanted them to have a confidence in themselves for any situation that happened during play, but I had to set up practice experiences that simulated the types of situation they might encounter. This enabled them to be prepared to do “right things” in any situation. Confidence requires competence, and competence requires mastery, and mastery is derived from doing right things repeatedly. Practice only makes permanent; perfect practice makes perfect permanent results.

In our post, ‘EPPP Exam & Earning Your Own Confidence, part 2‘ we’ll see how these insights can help you as you prepare for your EPPP exam.

What You Expect is What You Get

In our previous posts ‘Perception and Expectations’, we discussed some of the ways a person’s self-perception can be conditioned by his or her expectations. A fascinating article on the Science-Based Medicine website has suggested some applications this same principle might have in treating various illnesses and pathologies:

“Much of chronic illness is learned behavior. Would sufferers from chronic fatigue syndrome and fibromyalgia recover faster if they could somehow re-map their neurons into healthy patterns?… A recent article in the New England Journal of Medicine described the effects of mild traumatic brain injury in soldiers returning from Iraq. These soldiers had a high incidence of associated health problems, but when they controlled for post-traumatic stress disorder (PTSD) and depression, there was no longer any significant association with adverse health outcome.”

“They discuss the implications of telling a patient he has a traumatic brain injury versus telling him he has recovered from a concussion and his symptoms are due to treatable, transient depression and/or stress reactions. They say, ‘…the most compelling efficacy data highlight the importance of education to normalize symptoms and provide expectation of rapid recovery.’…

“In psychotherapy, when we delve into childhood traumas, are we reinforcing brain maps for the sick role and the victim label? Wouldn’t it be more effective to concentrate on the current life situation and reinforce what coping skills the patient already has? Instead of ‘Poor you, you can’t get along with your boss because your Mommy didn’t love you’ what if we said, ‘Good for you, you’ve overcome a bad start in life and have finished school, you have a girlfriend, you have become good at making friends, and you coped with the recent death of your dog by playing sports to keep your mind off your grief. You’ve done well, so let’s look at how you can use some of those strengths and coping skills to help you solve this current problem.’ What if we helped consolidate the positive brain maps and helped prevent negative brain maps from wiring together? If nothing else, the concepts of neuroplasticity can contribute to a brain-based understanding of what various psychotherapies can accomplish….”

EPPP Preparation Success and The Power of Imaginative Rehearsal

I ended the last post  by saying that it is crucial what you think of yourself, so that you do not inadvertently become a victim of your own negative expectations.  This is especially important as you continue your EPPP preparation process.

As you begin the journey of psychology licensing prep, expect success and you will be more likely to succeed. Expect failure, and you will be increasing the likelihood that you will actually fail. Continue reading

EPPP Preparation: Perception and Expectation

During your EPPP preparation, it is not unusual to experience anxiety. In fact, manageable anxiety can be a good thing, because it alerts you to the fact that passing the EPPP is extremely important. (See Dr. Elizabeth Soliday’s comments on anxiety during your EPPP prep.)

Anxiety can be a relatively harmless part of life, as it is our body’s mechanism for telling us that something is wrong. But anxiety can also become pathological and disabling, leading to phobias.

In phobias and anxieties, what often happens is that certain experiences activate neuro-pathways that are actually pathological. To illustrate this, I’d like to share an experience of a friend of mine, whom we will call Jeff, who used to suffer from chronic fatigue.

If Jeff woke up in the morning and the day was cloudy, he would label it a “gloomy day” and this would immediately activate a well-worn network of neuro-pathways associated with gloom, depression and tiredness. On such days, Jeff found it incredibly difficult to have energy or sometimes to even get out of bed. Each time this happened, it strengthened those unhelpful neuro-pathways even more, making it more difficult to overcome these neurological habits the next time there was a gloomy day. Continue reading

Count the F’s

I’d like to begin this post with a little exercise. I want you to count how many ‘Fs’ are in the following passage:

Remember what your answer is and we’ll come back to it in the next post. At the moment, I’d like to briefly switch gears and share some interesting facts about the brain.

In the brain neurons don’t communicate directly with each other because they don’t actually touch. Instead they secrete chemical molecules (called neurotransmitters) which travel across the gaps (called synapses). Neurotransmitters can link neurons in an almost infinite amount of ways. Indeed, the average neuron communicates with between 1000 and 10,000 other cells! The patterns that regulate these links are called neuro-pathways and here is a good explanation of how neuro-pathways work, taken from ‘The Brain 101’: Continue reading