Mental Health and the Adapting Brain

I'm reading more of Sack's commentary on migraine--this time in a blog at the NYTimes, in which he explores the phenomena of migraine aura, or the visual disturbance that often precedes a migraine headache.  Both his own experience with aura, and his research of the phenomena, have revealed a fascinatingly uniform and transcendent geometrical patterns.  He writes:

 "Such gemetrical form constants are not dependent on memory or personal experience or desire or imagination...these hallucinations reflect the minute anatomical organziation, the cytoarchitecture, of the primary visual cortex, including its columanr structure--and the ways in which the activity of millions of nerve cells organizes itself to produce comples and ever-changing patterns.  We can actually see, through such hallucinations, something of the dynamics of a large populations of living nerve cells and, in particular, the rolse of what mathematicians term deterministic chaos in allowing complex patterns of activity to emerge through the visual cortex.  This activity operats at a basic cellular level, far beneath the level of personal experience.  They are archetypes, in a way, universals of human experience...  

Migraine-like patterns, so to speak, are seen not only in Islamic art, but in classical and medieval motifs, in Zapotec architecture, in the bark paintings of Aboriginal artists in Australia, in Acoma pottery, in Swazi basketry--in virtually every culture.  THere seems to have been, throughout human history, a need to externalize, to make art from, these internal experiences, from the decorative motifs of prehistoric cave paintings to the psychedelic art of the 1960s.  Do the arabesques in our own minds, built into our own brain organization, provude us with our first intimations of geometry, of formal beauty? 

Sacks seems to describe a phenomena of the cognitive unconscious, or tacit knowledge, breaking though, almost taking over or hijacking the conscious, or the storyteller.  Does this happen in other mental illness--the conscious or storyteller losing its "supremacy" over the conscious?  

Check out the migraine-art slide show here.  

I've been thinking more about "the storyteller"/conscious and it's characteristics... and whether or not a need for logical coherence (or rationality?) is really one of them. I bring this up because I've been thinking about the concept of confabulation. This was brought up in relationship to Capgras syndrome last class, but I've been thinking about it more as a result of my experiences working with some individuals with brain injuries.

Does the storyteller really care if a "story", or explanation of observations/feelings/beliefs/etc., are "logical" (probable? rational?)? An example... a man who has recently become incontinent during the night. He has never had many "physical" problems and refuses to accept that it is possible for him to be wetting the bed at night. His firm belief is that someone, in the middle of the night, is coming into his room and urinating both on his bed and him to make it look like he's incontinent.

Some other general cases that come to mind are... psychotic delusions--- stories, but are they logical/rational/probable? Obsessive-compulsive beliefs (which may be a problematic example since they are usually defined as irrational beliefs)? Body Dysmorphic Disorder?

At any rate, it was said during class that in essence "we are all confabulators" which I think is a good (useful?) way of thinking about how the brain and specifically the "storyteller"/conscious works.

From Sir Thomas Browne's Religio Medici (1642), via Oliver Sacks' Migraine:

We carry with us the wonders, we seek without us: There is all Africa, and her prodigies in us; we are that bold and adventurous piece of nature, which he that studies, wisely learns in a compendium, what others labour at in a divided piece and endless volume.

First, I just want to reflect on what Dr. Grobstein's assertion that humans are not superior to other organisms because of our "storytellers."  This is an understanding that has not come naturally to me.  

I always assumed that humans were the culmination of some great master plan.  I'm not really sure why.  Perhaps my brain was inherently programmed to believe this.  Or perhaps there was some sort of cultural programming that was responsible (more on this next week?..)

If anyone else shares these beliefs... and would enjoy having them shattered... I would recommend Bill Bryson's A Short History of Nearly Everything.  I think a more appropriate title would be "a short history of the discoveries of science."  I just finished it a few weeks ago and it definitely gave me a few new stories to mull over.  

I wanted to post two quotes...  The first, from Bryson himself.

"We are so used to the notion of our own inevitability as life's dominant species that it is hard to grasp that we are here only because of timely extraterrestrial bangs and other random flukes.  The one thing we have in common with all other living things is that for nearly four billion years our ancestors have managed to slip through a series of closing doors every time we needed them to."

The second is from Ian Tattersal quoted in Bryson's book...

"One of the hardest ideas for humans to accept is that we are not the culmination of anything.  There is nothing inevitable about our being here.  It is part of our vanity as humans that we tend to think of evolution as a process that , in effect, was programmed to produce us." 

There were a lot of observations in Bryson's book to back up these statements, but I just wanted to get the general message here.  The storyteller is not some divine gift or possession of ultimate significance... It's just something we have...  Like an elephant has a trunk.

Also.... I just wanted to share a story from last weekend.  I think it might give us something to think about as we consider the interaction between the conscious and the unconscious.  

I ride the train in and out of Philly each Friday for volunteering.  As I was riding home last weekend, I sat down next to a woman who looked friendly enough.  It was rush hour so the train car was packed and another person eventually joined us.  I was sandwiched in the middle of a three person seat.  

As the train ride continued towards Bryn Mawr, the woman next to me began to have seemingly involuntary jerking fits with her limbs.  Her arm would twitch randomly and then stop.  I noticed it, but didn't give it much thought.  

A few stops down the rail, things escalated.  Her whole body started to twitch and she started making strange guttural noises.  She would have a fit of motion and sound, then calm down, readjust herself, and look out the window.  It was a very strange thing to observe... slightly frightening because she sounded so angry.  It was as if something in her just wanted to go on a screaming rant, but she was trying to keep her mouth closed.  Imagine trying to yell a string of angry obscenities but keeping your mouth closed.  That's what it looked like.    

By now most most everyone in our train car had noticed.  I just kind of sat there, palms sweaty, unsure of whether to ask if she was ok or just pretend I didn't notice and not call any more attention to her.  It came to my attention that there was a newsletter or something by my feet with headlines such as "Are you Crippled by Anxiety?" and "New Schizophrenia Breakthroughs!"  

Suddenly, at the Ardmore stop, after finishing one of her episodes, she calmly gathered her things and said in a pleasant voice, "This is my stop."  My and my seat partner let her by and she left.  

I didn't really know what to make of this whole experience at the time, but after a few people have suggested that mental illness might be a disconnect between the conscious and unconscious mind I have tried to think about it in these terms.  However, in this situation, it didn't so much seem like a disconnect as it seemed like her unconscious mind was trying to bubble out or escape and her conscious mind was holding it in.  I can definitely see how people from ages past might say she was possessed by a demon.  

Perhaps mental illness is not only a disconnect between storyteller and tacit knowledge (not that anyone suggested it was) but can also arise from a malfunctioning storyteller or a malfunctioning tacit knowledge.  Anyone else who might have interpretations of the experience... I'd love to hear them.